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As successes mount in reducing commercial tobacco use, an alarming disparity has taken shape in Minnesota. Recent studies revealed that overall smoking rates have dropped to 14%, whereas American Indians' rates remain higher than 50%. With support from ClearWay Minnesota, the organization created from the state's tobacco settlement, advocates working within sovereign tribal governments to create smoke-free policies came together to discuss effective strategies within tribal Nations. We discussed the history behind mainstream tobacco control's failure to resonate with Native audiences and the need to reframe the movement to a goal of restoring traditional tobacco practices. We share our insights on this critical area for achieving health equity and provide recommendations for tribes, non-Indian advocates, and funders, with a plea for tribal inclusion in commercial tobacco "end-game" strategies.

Why the World Will Never Be Tobacco-Free: Reframing “Tobacco Control” Into a Traditional Tobacco Movement