Smokers across the country are kicking the habit.

But in Indian country in New Mexico, health officials are not finding any evidence of a decrease in adult smoking cigarettes rates. And with one in four adults estimated to be current smokers, American Indians have one of the highest smoking cigarettes rates in the state for the first time in the state's history.

"There is some reason for concern," said Wayne Honey, an epidemiologist for the New Mexico Health Department. "Nationally there is a decline in smoking cigarettes rates among American Indians as there is in all the other groups. But we are clearly not seeing that decline here."

Honey authored a report on adult behavioral risk soon to be published on the health department's website. The report will state that American Indian smoking cigarettes rates should be monitored.

Statewide, about 15.8 percent of Anglo adults smoke cigarettes and 24.1 percent American Indians smoke, according to the report.

What is alarming about the difference in smoking cigarettes rates between American Indians and Anglos is that current statistics were not always the case.

Anglo people in New Mexico have higher rates of lung cancer than American Indians, according to health department reports. Lung cancer rates are good ways to determine who was a current smoker 25 to 30 years ago because the cancer takes years to develop, said Dr. Susan Baum, the medical director for the state's Chronic Disease Prevention and Control Bureau.

"Up until very recently the American Indian adult smoking cigarettes rate was essentially the same, and historically it was even considerably lower, than some of the other races and ethnicities," Baum said. "Just for the past couple years the American Indian smoking cigarettes rates have been significantly higher than the (Anglo adult smoking cigarettes rates.) I'm assuming that may be because the (Anglo) rates are decreasing."

Among all New Mexico adults, the smoking cigarettes rate went from 24 percent in 2001 to 18.5 percent in 2010, according to health department statistics.

The discrepancy in smoking cigarettes rates among the two races could be partially explained by age differences. But there are also differences in cigarettes control policies between state and tribal governments.

"Smoking is associated with age, we know that younger populations are more likely to smoke cigarettes than older populations," Honey said. "The American Indian population, on average, is younger than the Anglo population is."

There are three significant differences between cheap cigarettes polices on the Navajo Nation, the largest American Indian tribe, and in the state: Government cigarettes store taxes, tobacco education programs funded with settlements with big tobacco companies and workplace smoking cigarettes laws.



Cigarette Tax

At $1.66 per pack, New Mexico taxes discount cigarette online about 30 cents more per pack than the nationwide average, according to Campaign for Tobacco-Free Kids, a national anti-tobacco organization.

Some of the revenue from that tax funds cancer treatment centers and other health facilities around the state, according to the New Mexico Department of Taxation and Revenue's website.

The state has a program where tribal and pueblo governments can impose a $1.66 tax and receive state cigarette stamps. Enacting a qualifying tribal cigarette tax allows tribes and licensed tribal retailers to purchase cigarettes online from New Mexico distributors without paying the state cigarette excise tax, S.U. Mahesh, a spokesman for the department, said in an email.

There are 21 pueblos and tribes that have enacted a qualifying cigarette tax and are part of the program and the Navajo Nation is not one of them, he said.

The Navajo Nation imposes a cigarette tax of five cents per pack, said Deswood Tome, a spokesperson for the nation.

The revenue from that tax — which in 2011 fiscal year was $158,045, according to Navajo tax records — goes to the tribes general fund and is not specifically earmarked for tobacco education or treatment, he said.

In additional to funding cancer treatment, increasing the cost of buy cigarettes has been proven to deter smokers, Baum said.



Big tobacco bills

Most states in the country, including New Mexico, receive big payouts annually from big tobacco companies because of lawsuits filed by state attorneys.

Since 2000 New Mexico received tens of million of dollars each year because of the state's settlement with big tobacco companies. New Mexico received $38.6 million in 2011, according to Tobacco Settlement Revenue Oversight Committee documents.

The money helps cover the health care costs for smoke-related diseases and funds tobacco education prevention programs.

New Mexico Tobacco Use Prevention and Control is an entire state agency funded with money from the big tobacco settlement. The organization provides tobacco education and cessation services, according to its website.

"None of the tribes or pueblos receive this money," Mahesh said of the settlement funds. "They were not party to the lawsuit settlement."

The Navajo Nation has not made any settlement with any big tobacco company to cover the cost of smoke-related illnesses and there is no pending litigation, Tome said.



Workplace smoking cigarettes laws

The New Mexico Legislature passed a clean air act, which bans indoor smoking cigarettes in most buildings in the state, in 2007.

The result of the law is that 92 percent of New Mexico residents are protected from second hand smoke cigarettes in the workplace, according to health department statistics.

Exempt from the clean air law are tribal buildings. And most Indian casinos in the state have held on to at least designated smoking cigarettes sections.

The first attempt at passing a clean air act on the Navajo Nation ended when Nation President Ben Shelly vetoed the bill because tribal casinos were exempt from the law.

"The president has taken a very aggressive position on smoking cigarettes," Tome said. "We're battling with diseases like diabetes and obesity and ... smoking cigarettes is a habit that the president wants to catch at the youth level and stop it there. The president wants to see a healthy Navajo Nation in every respect."

The new Navajo Casino near Farmington, expected to be completed in January, will allow smoking cigarettes when it is first opens. But it might not be smoky for long.

In August 2012, Tome said Shelly will introduce an initiative to ban indoor smoking cigarettes in all buildings on the Navajo Nation.

"It's an initiative to say we're going to go smoke cigarettes free in all public places and that includes casinos in resorts," Tome said. "Voters will decide their future in that respect."

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