Promoting tobacco control policies in northwest Indian tribes.

A culturally sensitive consultative process to facilitate adoption by tribal councils of more effective tobacco control policies was developed and evaluated. Thirty-nine Northwest Indian tribes were randomized to early intervention or late intervention conditions. Early intervention tribes received a policy workbook and consultation by means of meetings and telephone calls. Late intervention tribes were assessed but received no assistance or encouragement regarding tobacco use policies. The stringency of the policies was assessed via telephone at baseline and after intervention. At postintervention, there were consistent, and generally statistically significant, differences in adoption of more stringent and comprehensive smoking policies for early intervention tribes compared with late intervention tribes. The intervention could be used in other Indian settings.