# Advocacy Intervention for Smoke-Free Policy in Lakota Communities

> **NIH NIH S06** · BLACK HILLS CTR/AMERICAN INDIAN HEALTH · 2020 · $325,871

## Abstract

Secondhand smoke (SHS) is recognized as a class A carcinogen and has no safe level of exposure.
SHS is estimated to contribute to over 3,000 lung cancer deaths in non-smokers annually. With widespread
legislation restricting smoking in workplaces and other public venues, most of the U.S. public now live in states
with laws to protect against SHS exposure. Yet, the primary place in which involuntary exposure to SHS still
occurs is in workplaces and public places on federally-recognized tribal reservations. Nonsmokers from the
Oglala Sioux Tribe, a Lakota tribe from South Dakota, disproportionately share the burden of SHS, especially
in their workplaces and public places. Our own recent findings show that Lakota adult nonsmokers have
cotinine levels equal to those regularly seen in active smokers. With smoking prevalence as high as 50%
among this population, the consequences of SHS already manifest among the Lakota include high prevalence
of childhood asthma and sudden infant death syndrome. Further complicating matters, the expanded use of
commercial tobacco products for ceremonial and cultural practices is creating challenges not typically seen in
non-American Indian communities. Therefore, eliminating SHS exposure in a culturally appropriate manner is a
fundamental step in decreasing morbidity and mortality among members of the Oglala Sioux Tribe and other
Northern Plains Tribes.
 Our primary study objective is to develop and test a culturally informed smoke-free advocacy training
intervention to encourage Lakota opinion leaders to more effectively advocate for their tribe to generate
smoke-free policies addressing SHS exposure in workplaces and public places We propose to conduct a
randomized, wait-list controlled pragmatic trial to develop, implement and evaluate a culturally informed SHS
advocacy training module versus standard smoke-free policy print materials.
 Therefore, our Specific Aims are to 1) Assess knowledge, attitudes and beliefs about secondhand
smoke exposure and perceived facilitators and barriers to adoption of smoking restrictions on the Pine Ridge
Sioux Reservation; 2) Use a highly participatory, culturally informed approach to design, implement, evaluate
and disseminate an advocacy training intervention for smoke-free policies among adults living on the Pine
Ridge Indian Reservation; and 3) Determine the effect of the intervention on health-related quality of life, SHS
risk perception, SHS exposure and smoking 6-months after implementation of the advocacy intervention.
 The results from this study will have many programmatic and policy-related implications. Lakota
communities will have a better understanding of the impact of SHS exposure, and recognition that they have
the capability to create a healthier environment. This innovative study design is also scalable to other low-
resourced settings and populations. Finally, our community-based, participatory methods will strengthen our
tribal partner's knowledge, expertise, and...

## Key facts

- **NIH application ID:** 9999620
- **Project number:** 5S06GM123544-04
- **Recipient organization:** BLACK HILLS CTR/AMERICAN INDIAN HEALTH
- **Principal Investigator:** Jeffrey A Henderson
- **Activity code:** S06 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $325,871
- **Award type:** 5
- **Project period:** 2017-09-15 → 2021-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9999620

## Citation

> US National Institutes of Health, RePORTER application 9999620, Advocacy Intervention for Smoke-Free Policy in Lakota Communities (5S06GM123544-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9999620. Licensed CC0.

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