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Despite high rates of smoking among all racial/ethnic groups in the United States, Native Americans are particularly affected by it. The Centers for Disease Control and Prevention estimates that they are more than twice as likely to die from smoking-related diseases than other U.S. adults. That’s partly because national health surveys under-sample the 576 federally recognized tribes in the United States, and it’s also because, like other people of low socioeconomic status, tribal members smoke at higher rates for a variety of reasons.
One of the biggest obstacles to cutting cigarette use in tribal communities is that cheap cigarettes can still be found. While states and cities have learned that a big price increase can decrease tobacco sales, that’s not always the case on reservations.
The Grand Chief of Akwesasne, near Cornwall, Canada, writes that smuggling continues to run rampant on the reserve. He compares the defense of cigarette smuggling by some of his community leaders to the arguments used by Pablo Escobar and other Colombian drug lords in the 1980s to justify their own lucrative trade.