Between 2005 and 2015, five tribal communities in Michigan conducted a series of community based surveys called the American Indian Adult Tobacco Survey (AIATS).  Results of these surveys revealed striking health disparities related to commercial tobacco use, including:

• In most communities, the average age of smoking initiation was between 13 and 15 years old.
• Most people started smoking regularly by the time they turned 17.
• Smoking rates among adults ranged from 34% to 72%.
• Tribal members who smoked were more likely than non-smokers to have chronic health conditions like high blood pressure and diabetes.

This evidence reflects what some community members have referred to as an “epidemic” of commercial tobacco use.  Community members have used this evidence to strengthen their response to commercial tobacco use through formal programs, policies, and educational efforts.  While the mechanisms of the AIATS are well-documented, what’s missing from the literature are stories of how tribal communities have created lasting change using data.  This report tells the story of how Michigan tribal communities turned health data into sustainable action.