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Secondhand Smoke Exposure in Lakota Homes

In collaboration with the Cheyenne River Sioux Tribe of South Dakota and Northern Arizona University, BHCAIH is conducting an innovative research project to address secondhand smoke exposure (SHS-e) in Lakota homes.  With smoking prevalence as high as 50% among Lakota people, the consequences of SHS-e are evident among this population. Furthermore, the expanded use of commercial tobacco products for ceremonial and cultural practices is creating challenges not seen in non-American Indian communities. Therefore, eliminating SHS-e in a culturally appropriate manner is fundamental to decreasing morbidity and mortality among Cheyenne River Sioux Tribe nonsmokers.

The primary study objective for this NIH-R01 funded project is to develop and test a culturally relevant intervention to encourage adoption of smoking restrictions in Cheyenne River Sioux Tribal households where nonsmokers are present. Through a randomized controlled trial, we are testing advocacy training both with and without urinary biomarker feedback. Biomarker feedback is an intervention method that can give personalized information—like levels of urinary tobacco-specific pro-carcinogen markers—back to individuals in order to characterize evidence of the negative sequelae of smoking in the household. This study appears to be the first to use biomarker feedback with adult nonsmokers for advocacy efforts.

Our Specific Aims are to:
1) Assess knowledge, attitudes and beliefs about SHS-e and perceived barriers to adoption of smoking restrictions in tribal member households on the Cheyenne River Sioux Tribe Reservation. Based on our prior work we expect that few participants know about the dangers associated with SHS-e. We expect that few have smoke-free homes. 
2) Augment, implement, and evaluate a nonsmokers’ urinary cotinine and carcinogen biomarker feedback intervention on the adoption of household smoking restrictions. We expect that the nonsmoker adults who receive advocacy training with urinary biomarker feedback will be more likely to affirm that smoking restrictions are needed within their households than those just receiving advocacy training only.
3) Determine the effect of the intervention on health-related quality of life 6 months after implementation of advocacy and biomarker feedback intervention. We hypothesize that the intervention will be associated with improved health-related quality of life, beyond any improvement experienced by advocacy training-only control group.

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