The tobacco industry has a well-documented history of targeting minority and marginalized populations, including American Indians and Alaska Natives. Targeted marketing and advertisements can be directly linked to tobacco use. Across Michigan, the most significant health disparities among American Indian/Alaska Native (AI/AN) populations are related to commercial tobacco use, including menthol and flavored tobacco products. Compared to other populations AI/ANs have higher rates and increased mortality due to tobacco-related chronic disease. AI/ANs are no strangers to this public health issue and have long endured health disparities and premature mortality. AI/ANs have suffered from the systemic effects of colonization which has also impacted their health due to the effects of intergenerational trauma, loss of land, and connection to culture. An increased allostatic load, due to the cumulative effects of stressful life events, exacerbates health problems, contributes to maladaptive coping strategies such as smoking cigarettes and vaping among youth. Reducing commercial tobacco use and its impacts on health for AI/ANs requires multi-pronged approaches using culturally appropriate, evidence-based interventions, and effective policy changes. The ITCM Three Fires Our Breath is Sacred; A Three Fires Menthol and Flavored Tobacco Reduction Project proposes a comprehensive scope of work to remote, rural, tribal, and underserved communities within the State of Michigan. The menthol/flavored tobacco project will address upstream and downstream SDOH factors that influence the AI/AN and inter-sectional rural subpopulations within the state of MI. ITCM will use community-based participatory approaches to increase participation, engagement, and mobilization among diverse multi-level/multi-sector rural and urban community partners to implement evidence-based interventions that increase access to cessation referrals and promote, educate and implement economic an
d community policy changes regarding the sale and use of commercial menthol and other flavored commercial tobacco products.
