Epidemiology of tobacco use among Lumbee Indians in North Carolina

Background. Little is known regarding tobacco use among the Lumbee Indians in southeastern North Carolina, despite high prevalence of use and ties to tobacco-related agriculture. This report describes current and early childhood tobacco use in this population. Methods. A cross-sectional telephone survey of 400 adult Lumbee Indians was done in Pembroke, Robeson County, NC, Information was collected on demographics, tobacco use, knowledge and practices related to tobacco agriculture, and ceremonial tobacco use. Results. 17.8% and 18.2% of the sample reported current and former smokeless tobacco (ST) use, and 26% and 19.5% reported current and former cigarette (CG) use, respectively. 17.3% reported ever use of both CG and ST. Current ST use was associated with older age, childhood involvement in tobacco-related agriculture, and less education. Current CG use was associated with younger age, male sex, less education, having never been married, infrequent church attendance, and fewer close friends or relatives. Early initiation of ST and CG use was more common among women, while early initiation of CG use was more common among persons who were younger and had lower levels of education. Conclusions. Current ST use is unusually common among Lumbee adults, while CG use reflects rates found in other populations. These data show different patterns of CG use and ST use, and suggest that strategies for tobacco use cessation must target each specific product.