Minnesota's American Indians have higher than average cancer death rates, mostly caused by tobacco. But completely taking tobacco out of the Indian community is not always an option.
Herbert Sam is a traditional healer and spiritual advisor with the Mille Lacs Ojibwe Nation. He recently shared his views on the dangers of abuse of commercial tobacco and the of the use of the "traditional" tobacco of Kinnikinnick for ceremonial purposes. Kinnikinnick does not contain the same toxic chemicals found in commercial tobacco.
When Herbert Sam leaves his home in Hinckley, he places a pinch of tobacco on the ground, praying that his family will return safely. When he asks a tribe member for a favor, he places it in the person's hand as a sign of respect. As a healer for the Mille Lacs Band of Ojibwe Indians, he considers tobacco a sacred plant.
But he also knows it's killing his people.
American Indians in Minnesota are dying of cancer, especially lung cancer, at a higher rate than any other ethnic group -- and double that of other American Indians in the country, according to a recent study by the American Cancer Society.
Health officials in Minnesota say they've made little progress trying to get Indians to quit smoking, partly for cultural reasons.
"If you were to ask a Catholic not to use holy water, what kind of reaction would you get from them?" said Sam, a tribal elder. "That's the same thing as me telling our people not to use tobacco anymore."
Now, some health organizations, which normally have a "just say no" attitude toward tobacco, are changing their approach with the Indian community. They're encouraging Indians to use a traditional -- and less dangerous -- tobacco blend called kinnikinnick, which is made of tree bark and leaves, in ceremonies and worship. And in the process, turn their backs on commercially produced cigarettes and pouched tobacco.
"Tobacco is used all the time in ceremony, in a traditional way," said Dr. Dawn Wyllie, chief medical officer of the Bemidji Area Indian Health Service. "I support traditional use, but those who are smoking commercial tobacco or using it outside of tradition are misusing it."
In May, ClearWay Minnesota, a nonprofit organization that funds smoking cessation programs, gave the Mille Lacs tribe a two-year, $230,000 grant that would, among other things, encourage band members to use kinnikinnick for ceremonies.
A homegrown alternative
Nicole Toves Villaluz, ClearWay's community development manager, said the organization realized that tobacco is always going to be a part of this community. So instead of trying to eliminate it, it's offering a substitute that doesn't contain the same additives and carcinogens found in commercial tobacco.
"They use commercial tobacco in ceremonies because that's all they have had access to," said Villaluz. "The goal is to use traditional tobacco so they don't have to."
Carol Hernandez, the outreach coordinator for the Mille Lacs Band of Ojibwe, said Minnesota is an ideal place to grow kinnikinnick. But it's not always readily available to the band members. It can only be harvested in the fall, and it's not sold in many stores.
"It takes a lot of work to make kinnikinnick," Sam said. "[Indians] don't do that anymore. They just go out and buy this," he said, pulling out a red pouch of commercial tobacco. "They don't realize the consequences that are going on in the body."
Indian health officials say tobacco use is higher among Minnesota's tribes than elsewhere in the country, in part because it is such a sacred part of their community. In other parts of the country, tobacco is less important in Indian rituals.
But health experts acknowledge that social and economic factors also play a role. Lisa Blahosky, the Mille Lacs Band public health director, said people living in poverty tend to have higher smoking rates, and that's true in many Indian communities. "I can't honestly tell you what is going to make things change," she said.
Changing cultural habits
As part of the ClearWay grant, the Mille Lacs tribe is making a video about kinnikinnick, giving Sam, the elder, a chance to explain how and why it's used.
Sam said he gave up cigarettes more than 25 years ago but continued to use commercial pipe tobacco during ceremonies. He switched to kinnikinnick seven years ago, after he learned he had a chronic lung disease. He said the blend brings the same spiritual fulfillment without the health risks.
"When you are talking about 4,000 chemicals in [commercial] tobacco, it deteriorates your health so much," Sam said. "Eventually, it started taking a toll."
But Sam said the majority of his tribe members continue to use commercial tobacco in ceremonies. Now, he says, if he wants to avoid secondhand smoke, he can't attend some traditional drum ceremonies or funerals.
"Whenever you go to some ceremonies, they pass out cigarettes," Sam said. "You can see that really thick haze, and that's what you are breathing."
Vivien Bruce, another elder in the Mille Lacs tribe, also avoids some of those ceremonies. After smoking for 54 years, she finally quit seven months ago because of lung disease. But the fumes are hard to escape, she said, especially when she spends time at the tribe's casino, the Grand Casino Mille Lacs.
"The worse part is the casino," she said. "When I want to go play at the casino, I come home and just take my clothes off and throw them away."
Some Indians have resisted anti-smoking efforts, such as smoking bans, because they fear it will hurt business, especially at casinos.
"[Indian leaders] are afraid of going smoke-free because of the loss of revenue," said Kris Rhodes, director for the American Indian Cancer Foundation in Minneapolis. "I have seen young pregnant women in the casinos, and they aren't just there a couple of hours. They are exposed to all this secondhand smoke."
The ClearWay grant is also designed to promote smoke-free policies on the reservations, which are exempt from state smoking bans.
"It is moving in the right direction, but [Indian people] have to do it their own way," said Dr. Jane Korn, the medical director for health promotion and chronic disease at the Minnesota Health Department. "We can give them tools and information that they need, but they need to figure out how to do it."
Sam, for one, said he will continue to encourage fellow tribe members to leave their cigarettes behind.
"All tribes have a long way to go," he said. "Tobacco is good, but it's also not. Leaves have two colors on each side, and we have right and we have wrong. We have to make good health decisions."
Alejandra Matos • 612-673-4028