This report intends to highlight tribally-based strategies developed over a 10-year period through the Centers for Disease Control and Prevention’s (CDC’s) formerly funded national Tribal Support Centers and through ClearWay MinnesotaSM’s Tribal Tobacco Education
and Policy (TTEP) grant initiatives. The CDC’s Tribal Support Centers were charged with advancing commercial tobacco control in tribal and American Indian/Alaska Native (AI/AN) communities across the country, and the TTEP initiative worked on advancing commercial tobacco-free policies on tribal lands in Minnesota. Both projects have worked to promote health in Indian Country for at least eight
to 10 years, working to reduce the harm of commercial tobacco and restoring traditional tobacco practices. It is crucial that we acknowledge that tobacco exists in two ways in American Indian communities. Commercial tobacco use causes death and disease and is marketed for pro t. Traditional tobacco use honors the Creator and is governed by cultural and ceremonial protocols.

This report is by no means intended to be a comprehensive look at the broad work
around commercial tobacco education, advocacy and policy reform across the breadth
of AI/AN communities, but we hope that it captures the key lessons and spirit of a time where increased resources were available to tackle one of the toughest health issues facing indigenous populations in the U.S. It is imperative to not approach the search for and replication of solutions with a ‘one-size- ts-all’ approach. Each of these communities is di erent, with varying traditions, cultural practices and relationships to traditional tobacco. Mainstream public
health has largely failed to decrease commercial tobacco use rates in these communities. Solutions that have shown impact largely come from within the communities
themselves: not top-down solutions, but those emerging from the grassroots.

The raw material for this report came in two forms, the rst of which was a two-day meeting
at the o ices of ClearWay MinnesotaSM in October of 2016. That meeting was followed by a
series of individual interviews with the participants which gave the interviewer the opportunity to gather more details on issues and themes that had emerged in the meeting. What follows here will touch on these themes:

• The Role of Tobacco Traditions in Indian Country
• Reframing “Best Practices” From an indian Point of View
• Interventions That Empower All Generations
• Honoring Relationships, Building Capacity With Partnerships
• The Historical Context of Policy in AI/AN communities
• Building In-Roads Within Gaming Establishment
• Culturally Appropriate Messaging
• Educating Funders, Stakeholders, and Researchers
• The Power of Tribal Specific Data
• Reawakening and Reconnecting with Traditional Medicine