which he did for 14 years.

"I can't do any of those

things anymore," he said.

Nathan decided it was

important to share his

story, with the hope that

others would not suffer as

he did. He spoke at

schools, Pow-Wows, and

conferences as much as his

health allowed. He wanted

to make everyone aware of

the dangers of smoking and

exposure to secondhand

s m o k e .

Young people were a

special passion for Nathan.

He urged teens not to start

smoking and if they did, to

quit. He encouraged every-

one to protect children from

s e c o n d h a n d s m o k e .

"Some people tell me they

smoke, and I ask them if they

have grandchildren. 'If you

smoke, you may be taking

that smoke home to the

grandchildren and their small

lungs,' I tell them. I never

smoked; look what happened

to me. I want to make people

aware of the damage that

exposure to secondhand

smoke can do to you."

The secondhand smoke

Nathan was exposed to per-

manently damaged his lungs

and led to his early death. He

died on October 17, 2013.

He was 54.

—From the CDC’s TIPS

Campaign 2014.

Nathan, a Native Ameri-

can and member of the

Oglala Sioux tribe, had per-

manent lung damage. He

never smoked cigarettes,

but for 11 years he worked

at a casino that allowed

smoking. After breathing

people's cigarette smoke

daily, Nathan began to have

frequent asthma attacks

triggered by the secondhand

smoke. "You could see the

smoke hovering inside the

cas ino , " he reca l l ed .

As he worked at the ca-

sino, Nathan noticed more

changes to his health. Along

with asthma attacks, he

started having frequent prob-

lems with eye irritation, head-

aches, allergies, ear and sinus

infections, and bronchitis.

Over the years, the symp-

toms got worse. "A common

cold escalated into pneumo-

nia, sending me to the emer-

gency room," he said. "During

one of the visits, a doctor

was looking at x-rays of my

lungs and commented that I

had the lungs of a heavy

smoker. I told him, 'I never

smoked a day in my life!'"

In 2009, doctors deter-

mined that Nathan's airways

were seriously damaged by

repeated infections from ex-

posure to secondhand

smoke, which led to scarring

and widening of his airways

called bronchiectasis. Lung

damage from bronchiectasis

is permanent. His lung prob-

lems were so serious that

Nathan finally had to leave his

job to avoid the smoke. Just

walking a short distance, he

would get out of breath and

had to use oxygen daily.

Nathan and his wife en-

joyed a long marriage with

five adult children and three

grandchildren. Nathan prided

himself on being a very active

person. As a young man, he

served in the Second Battal-

ion, Fifth Marines reconnais-

sance division, where he re-

ceived sniper training. He also

raced motorcycles and re-

ceived sponsorship from a

major motorcycle company.

Nathan participated in

tribal dance competitions and

loved to referee at high

school basketball games,

A TIP About Second-Hand Smoke: Nathan’s Story

A u g u s t 2 0 1 4 V o l u m e 4 , I s s u e 4

I n s i d e t h i s i s s u e :

TIPS on SHS 1

Youth & E-Cigarettes 2

Canli Coalition Float 3

CVS Stops Cigarette

Sales

4

Smoking Bans 5

UTTC Smoke-Free

Campus

6

Traditional Tobacco

Benefits

7

Meet the New

NPTTTAC Manager

8

S p e c i a l P o i n t s o f

I n t e r e s t :

Real Stories from the

TIPS Campaign

Study Finds Youth Who

Have Used E-cigarettes are

Almost Twice as Likely to

Intend to Smoke Conven-

tional Cigarettes

National Retailer Re-

moves Tobacco Products

from Stores

Smoke-Free Laws Were

Followed by Fewer Hospi-

talizations for Respiratory

Diseases, Among Other

Conditions, According to a

New Study.

Smoking Bans Cut Health

Care Costs and Protect

Non-smokers

Sacred Life

Promoting Smoke-Free Lifestyles in Indian Country

http://www.cdc.gov/tobacco/campaign/tips/

groups/american-indian-alaska-native.html

More Than a Quarter-million Youth Who Had Never Smoked a Cigarette

Used E-cigarettes in 2013

P a g e 2 V o l u m e 4 , I s s u e 4

-August 25th, 2014. Press Release from

the CDC.

More than a quarter of a million youth

who had never smoked a cigarette

used electronic cigarettes in 2013, ac-

cording to a CDC study published in

the journal Nicotine and Tobacco Re-

search. This number reflects a three-

fold increase, from about 79,000 in

2011, to more than 263,000 in 2013.

The data, which comes from the 2011,

2012, and 2013 National Youth To-

bacco surveys of middle and high

school students, show that youth who

had never smoked conventional ciga-

rettes but who used e-cigarettes were

almost twice as likely to intend to

smoke conventional cigarettes as those

who had never used e-cigarettes.

Among non-smoking youth who had

ever used e-cigarettes, 43.9 percent

said they intended to smoke conven-

tional cigarettes within the next year,

compared with 21.5 percent of those

who had never used e-cigarettes.

“We are very concerned about nico-

tine use among our youth, regardless

of whether it comes from conventional

cigarettes, e-cigarettes or other to-

bacco products. Not only is nicotine

highly addictive, it can harm adolescent

brain development.” said Tim McAfee,

M.D., M.P.H., Director of CDC’s Office

on Smoking and Health.

There is evidence that nicotine’s ad-

verse effects on adolescent brain devel-

opment could result in lasting deficits

in cognitive function. Nicotine is highly

addictive. About three out of every

four teen smokers become adult smok-

ers, even if they intend to quit in a few

years.

“The increasing number of young peo-

ple who use e-cigarettes should be a

concern for parents and the public

health community, especially since

youth e-cigarette users were nearly

twice as likely to have intentions to

smoke conventional cigarettes com-

pared with youth who had never tried

e-cigarettes.” said Rebecca Bunnell,

Sc.D., M.Ed., Associate Director for

Science in CDC’s Office on Smoking

and Health and the lead author of the

study.

The analysis also looked at the asso-

ciation between tobacco advertise-

ments and smoking intentions among

middle and high school students. Stu-

dents were asked about whether they

had seen tobacco ads on the internet,

in magazines and newspapers, in retail

stores, and in television programs and

movies. Consistent with previous

studies, this study found that youth

who reported exposure to to-

bacco ads had higher rates of

intention to smoke than those

who weren’t exposed to such

ads.

The researchers also found the

greater the number of advertis-

ing sources to which young

people were exposed, the

greater their rate of intention

to smoke cigarettes. Thirteen

percent of students who said

they had no exposures to such

ads had intentions to smoke,

compared to 20.4 percent

among those who reported

exposures from one to two ad

sources and 25.6 percent

among those who reported

exposures from three to four of

the sources.

More than 50 years since the

landmark Surgeon General’s

Report linking cigarette smoking

to lung cancer, smoking remains

the leading cause of preventable

death and disease in the United

States. Smoking kills nearly half a

million Americans every year. More

than 16 million Americans live with a

smoking-related disease. Smoking-

related diseases cost Americans

$132 billion a year in direct health

care expenses, much of which

comes in taxpayer-supported pay-

ments. Each day, more than 3,200

American youth smoke their first

cigarette. The Surgeon General has

concluded that unless the smoking

rate is rapidly reduced, 5.6 million

American children alive today –

about one in every 13—will die pre-

maturely from a smoking-related

disease.

http://www.cdc.gov/media/releases/2014/p0825-e-cigarettes.html

P a g e 3 V o l u m e 4 , I s s u e 4

parade spectators witnessed a

moving sight, as the coalition’s

float drove by with powerful

smoke-free messages both writ-

ten and visual. Six chairs, 5 with

school books and shoes and one

lone chair draped in a starquilt,

signified the alarming statistic

found on a float sign that read,

“1 in 6 kids on CRST will die

from tobacco, if we don’t make a

change.” The Canli Coalition has

a mission to protect children and

non-smokers by making all public

spaces of the Cheyenne River

Reservation, smoke-free .

The Canli Coalition also shares

educational material and updates

about program activities on social

media sights such as Twitter and

Facebook. They can be found at

( h t t p s : / / t w i t t e r . c o m /

CanliCoalition) & (https://

w w w . f a c e b o o k . c o m /

CanliCoalitionOfCRST)

The Cheyenne River Sioux

Tribe’s Canli (Chun-lee: Lakota

word for tobacco) Coalition is a

recognizable force in the battle to

control tobacco and create

smoke-free tribal environments.

Research shows that smoke-free

public spaces protect children

and non-smokers from the harm-

ful effects of second-hand smoke.

Creating safe and healthier envi-

ronments will improve the over-

all health of tribal members and

future generations of American

Indian people.

The Canli Coalition advocates

for policy change and works hard

to provide tobacco prevention

education, resources, and to

maintain a noticeable presence at

community events. At the An-

nual 2014 CRST Fair & Rodeo,

The Canli Coalition’s Float Draws Attention to the

Impact of Secondhand Smoke on Tribal Youth

Image: The Canli

Coalition’s Parade

Float warns the

community about

smoking rates and

the impact of

tobacco on CRST

youth, as young

onlookers enjoy the

parade, at the 2014

CRST Tribal Fair.

From the Canli

Coalition of CRST

Facebook Page.

http://www.cdc.gov/media/releases/2014/p0825-e-cigarettes.html

CVS Stops Selling Tobacco, Offers Quit-smoking Programs

P a g e 4 V o l u m e 4 , I s s u e 4

Jayne O'Donnell and Laura Ungar, USA

TODAY 12:59 a.m. EDT September 3,

2014

—CVS Caremark plans to stop selling

tobacco products in all of its stores

starting Wednesday —a move health

experts hope will be followed by other

major drugstore chains.

CVS announced in February that it

planned to drop tobacco by Oct. 1 as

the sales conflicted with its health care

mission. To bolster its image as a health

care company, CVS will announce a

corporate name change to CVS Health.

Retail stores will still be called CVS/

Pharmacy.

CVS, which has 7,700 retail locations, is

the second-largest drugstore chain in

the USA, behind Walgreens. It manages

the pharmacy benefits for 65 million

members and has 900 walk-in medical

clinics.

The American Pharmacists Association

called on drugstores to stop selling to-

bacco in March 2010 and several small,

independent chains have done so, APA

spokeswoman Michelle Spinnler says.

CVS is the first large chain to stop to-

bacco sales.

"CVS' announcement to stop selling

tobacco products fully a month early

sends a resounding message to the en-

tire retail industry and to its customers

that pharmacies should not be in the

business of selling tobacco," said Mat-

thew Myers, president of the Wash-

ington-based Campaign for Tobacco-

Free Kids. "This is truly an example of

a corporation leading and setting a

new standard."

CVS is also launching a smoking-

cessation campaign that will include an

assessment of the smoker's "readiness

to quit," education, medication sup-

port to help curb the desire to use

tobacco and coaching to help people

stay motivated and avoid relapses.

CVS says research shows its decision

will have a big impact. A study the

company is releasing Wednesday in

the journal Health Affairs shows bans

at pharmacies in Boston and San Fran-

cisco led to more than 13% fewer

purchasers. Smokers didn't just switch

where they bought cigarettes and

other tobacco products, some

stopped buying them altogether.

About 900 households in the two

cities recorded everything they

bought after the bans went into effect.

Troyen Brennan, CVS' chief medical

officer, says if the results were ex-

trapolated for pharmacies across the

USA, it would lead to 65,000 fewer

deaths a year.

Ellen Hahn of the Tobacco Policy Re-

search Program at the University of

Kentucky says one chain not selling

tobacco will have a limited effect, and

other tobacco control strategies, such

as price and tax increases and smok-

ing bans, have been shown to be

more effective. Still, she said, "every

little bit helps because they are such a

large chain. If every pharmacy would

follow suit, that would be best. But

this sends a clear message that phar-

macies should not be selling tobacco."

Audrey Silk, founder of Citizens Lob-

bying Against Smoker Harassment, or

CLASH, a national smokers' rights

group based in New York City, says

CVS has every right to change

what it sells, but she believes the

company is falling for the anti-

smoking "crusade."

Pharmacies no longer sell just

medicines, she said, "they have

turned into grocery stores. They

sell candy. They sell beer. CVS

Health? It's a perception war. ...

Tobacco is legal. They're engaging

in public coercion by not selling

cigarettes."

CVS says its tobacco sales total

about $2 billion a year.

The U.S. Centers for Disease

Control and Prevention calls to-

bacco "the single most prevent-

able cause of disease, disability

and death in the United States,"

saying 443,000 people die from

smoking or exposure to second-

hand smoke each year.

Tobacco deaths are very personal

to two top CVS executives. CEO

Larry Merlo's father died of to-

bacco-related cancer at age 57

and the mother of CVS/Pharmacy

President Helene Foulkes died

five years ago of lung cancer from

smoking.

After its announcement in Febru-

ary, Foulkes says CVS was del-

uged with personal stories from

customers who had quit smoking.

Many said it was the "hardest

thing they had ever done," she

says. The company is determined

to make it easier for them, she

says, because it simply makes

sense. "The contradiction of sell-

ing tobacco was becoming a

growing obstacle to playing a big-

ger role in health care delivery,"

Merlo says.

http://www.usatoday.com/story/news/

nation/2014/09/03/cvs-steps-selling-tobacco-

changes-name/14967821/

Smoking Bans Cut Number of Heart Attacks, Strokes

P a g e 5 V o l u m e 4 , I s s u e 4

—Liz Szabo, USA TODAY 10:07 a.m.

EST November 14, 2012

Smoking bans quickly and dramatically

cut the number of people hospitalized

for heart attacks, strokes and respira-

tory diseases such as asthma and em-

physema, an analysis out Monday

shows.

Heart attack hospitalizations fell an av-

erage of 15% after communities passed

laws banning smoking in areas such as

restaurants, bars and workplaces, ac-

cording to the largest analysis of smoke-

free legislation to date. The analysis

included 45 studies covering 33 laws in

American cities and states, as well as

countries such as New Zealand and

Germany.

Stroke hospitalizations fell 16%, while

hospitalizations for respiratory disease

fell 24%, according to the study, pub-

lished Monday in Circulation.

The more comprehensive the law, the

greater the impact, says senior author

Stanton Glantz, director of the Center

for Tobacco Control Research and Edu-

cation at the University of California-

San Francisco.

For example, a 2002 law banning smok-

ing only in restaurants in Olmsted

County, Minn., had no effect on heart

attacks, according to a study also pub-

lished Monday in the Archives of Internal

Medicine. However, hearts attacks fell

by 33% after a 2007 law that expanded

the smoking ban to all workplaces, in-

cluding bars, according to the report,

from Minnesota's Mayo Clinic. That

drop is especially impressive, given that

people in Minnesota got less healthy in

the same time, with higher rates of dia-

betes and obesity. Rates of high blood

pressure and unhealthy cholesterol lev-

els stayed the same.

Glantz says state lawmakers should

consider these findings when voting to

exempt certain facilities, such as bars

or casinos, from smoke-free laws.

"The politicians who put those exemp-

tions in are condemning people to be

put into the emergency room," Glantz

says.

David Sutton, a spokesman for Philip

Morris USA, the country's leading

cigarette maker, says his company

agrees that secondhand smoke is dan-

gerous, but he says smoking bans

aren't always necessary, and that busi-

nesses such as restaurants can accom-

modate non-smokers through sepa-

rate rooms or ventilation.

"Reasonable ways exist to respect the

comfort and choices of both non-

smoking and smoking adults," Sutton

says. "Business owners -- particularly

owners of restaurants and bars -- are

most familiar with how to accommo-

date the needs of their patrons and

should have the opportunity and flexi-

bility to determine their own smoking

policy. The public can then choose

whether or not to frequent places

where smoking is permitted."

Neither report provides information

about why smoking bans reduce heart

attacks. But Glantz says smoke-free

laws tend to lead people

to smoke less or quit

altogether.

Fewer people smoked at

home, as well. The per-

centage of smoke-free

homes in the state grew

from 64.5% in 1999 to

87.2% in 2010, a period in

which state and federal

taxes also rose signifi-

cantly, the Mayo study

shows.

Smoking bans also

protect non-smokers, says cardiologist

Raymond Gibbons, past president of

the American Heart Association, who

was not involved in either study. Ciga-

rette smoke can trigger heart attacks

in non-smokers with underlying heart

disease, he says.

Secondhand smoke affects a non-

smoker's blood vessels in as little as

five minutes, causing changes that in-

crease the risk of heart attack, accord-

ing to the Mayo Clinic study. About

46,000 non-smoking Americans die

from secondhand smoke exposure

each year, according to the National

Cancer Institute.

Smoking bans also reduce health care

costs -- for individuals, health plans

and government payers, Glantz says.

Total savings ranged from $302,000 in

all health care costs in Starkville, Miss.,

to nearly $7 million just in heart attack

-related hospitalizations in Germany,

according to the Circulation study.

"If politicians are serious about cutting

medical costs, they need to look at

this," Glantz says. "The best way to

keep health care costs down is to not

get sick. ... There is nothing else you

can do to have these big an effect on

hospital admissions."

http://www.usatoday.com/story/news/nation/2012/10/29/smoking-bans-heart-attacks-strokes/1664193/

Tobacco-Free Campus

P a g e 6 V o l u m e 4 , I s s u e 4

Pat Aune, UTTC, Nov 2013

—BISMARCK (UTN) - United Tribes Tech-

nical College has become the first tribal col-

lege in North Dakota to adopt a "Tobacco

Free" campus policy. College President

David M. Gipp signed the policy November

21 on the anniversary of the 38th annual

Great American Smoke Out.

"United Tribes is committed to the health

and wellbeing of the children, students, fac-

ulty and staff of our campus, and to visitors

who come here," said Gipp. "Our goal is to

help protect our campus community from

the harmful effects of tobacco use while

maintaining our respect for Native tradi-

tions."

The new policy takes effect January 1, 2014.

It prohibits the use of tobacco on campus

properties, in campus-owned vehicles, and at

institution sponsored off-campus functions. It

includes any product containing tobacco or

manufactured from it, or containing nicotine.

It also prohibits the use of e-cigarettes.

Exempted is the traditional or sacred use of

tobacco. United Tribes will continue to be a

"tobacco honoring" campus for Native

American spiritual and cultural ceremonies,

when requests are made and approved in

advance.

Currently 13 college campuses in North

Dakota have tobacco-free policies. Several

others are smoke-free. United Tribes is the

third tribal college nationwide to take the

more comprehensive step to become to-

bacco-free, joining Fort Peck Community

College, Poplar, MT, and Oglala Lakota Col-

lege, Kyle, SD.

The United Tribes policy outgrowth of a

campus wellness initiative started 12 years

ago. The effort to curb smoking parallels

state and national programs aimed at im-

proving learning and productivity, lowering

rates of absenteeism, and addressing organ-

izational health insurance issues.

The policy was developed by the United

Tribes Wellness Circle, in cooperation with

Bismarck Burleigh Public Health, the North

Dakota Center for Tobacco Prevention and

Control and Policy, and was adopted by the

college's administrative council.

According to Jeanne Prom, executive direc-

tor of the Center, tobacco-free policies

shape how the younger generation perceives

tobacco use.

"We're incredibly grateful that United Tribes

has taken this important step," said Prom.

"It's a clear statement that your campus

values health. It demonstrates that a tobacco

-free life is encouraged and supported."

According to Prom, the tobacco industry

attempts to take advantage of college age

youth, understanding this is when many long-

term lifestyle choices are made.

Witnessing the signing were members of the

United Tribes staff and faculty, and young-

sters who attend Theodore Jamerson Ele-

mentary School on the college campus. The

K - 8 students are children of those attend-

ing college.

Also present was a group of human services

professionals from Russia, participating in the

Dacotah Territory International Visitor Pro-

gram's Open World Leadership Program.

According to the Centers for Disease Con-

trol, tobacco use is the leading cause of pre-

ventable disease. Last year, tobacco use

killed 800 North Dakotans prematurely and

cost the state over $247 million in health-

care.

UTTC's new policy places more impor-

tance on quitting smoking. The college's

Wellness Center will host a series of

smoking cessation programs beginning in

the new year. UTTC's Family Nurse Prac-

titioner, Ian Grey Bull, will be available to

provide individual attention during his

regular hours in the wellness center. As-

sistance from additional, off campus

sources will also be provided.

To see a complete list of North Dakota's

t oba cco - f r ee sc hoo l s , g o to

w w w . b r e a t h e n d . c o m .

David M. Gipp signing UTTC's Tobacco Free Pol-

icy. Looking on is Pat Aune, UTTC Wellness Circle

coordinator.

http://www.uttc.edu/tfree/

P a g e 7 V o l u m e 4 , I s s u e 4

If you are ready to quit, thinking about quitting, or know someone who wants to quit…these quit lines offer

services designed to help smokers kick the habit for good. Call or visit these sites for more information:

The South Dakota QuitLine: 1-866-SD-QUITS http://sdquitline.com/

The North Dakota QuitLine: 1-800-QUITNOW http://www.ndhealth.gov/ndquits/?id=55

The Nebraska QuitLine: 1-800-QUITNOW http://quitnow.ne.gov

The Iowa QuitLine: 1-800-QUITNOW http://quitnow.net/iowa

When tobacco is offered to the earth and fire,

it is held in the hand and not smoked. Some

sacred pipes are smoked but not all pipes con-

tain tobacco.

Some tribes don’t use tobacco at all and some

will use a blend of tobacco and other herbs.

Traditional tobacco teaches you discipline.

You learn respect for the creator and all crea-

tion.

You have a better understanding for your In-

dian culture.

Traditional tobacco is free of chemicals and

poisons.

You gain spiritual development towards being

a good person.

You use it to pray with and is considered a

Medicine for one’s health and

well being.

Benefits of Traditional Tobacco According to the National

Native Network

http://www.keepitsacred.org/network/index.php?option=com_content&view=article&id=32&Itemid=24

QuitLine Resources

Meet the New NPTTTAC Program Manager

P a g e 8 V o l u m e 4 , I s s u e 4

The Northern Plains Tribal Tobacco Technical Assis-

tance Center’s Coalition is committed to enhancing and

increasing awareness for tobacco control and prevention

for American Indians in the Northern Plains by providing

a forum for input, advocacy, education, collaboration,

planning and action along the tobacco prevention contin-

uum. To become a member, please call 605.721.1922,

ext. 121, or email Sadie.inthewoods@gptchb.org

Become a Coalition Member

Sadie Jo In The Woods is the daughter of Marla Herman and Byron In The Woods

and granddaughter of Wilma (Whirlwind Horse) and Rex Herman and Ellen (Condon) and

Jobe In The Woods. She has one 4-year-old daughter named Jade Mahpiya Hill. Sadie is an

enrolled member of the Cheyenne River Sioux Tribe. Her grandmother Wilma Herman

delivered her in Wagmiza Wakpa (Allen, South Dakota) on the Pine Ridge Indian Reservation

where Sadie grew up. She graduated from Little Wound High School as a Gates Millennium

Scholar in 2006 and went on to receive her Bachelors in Psychology with a minor in Political

Science from Duke University in North Carolina. Sadie later moved to Miami, Florida where

she graduated with her Masters in Public Health, specializing in Environmental and Occupa-

tional Health from Florida International University in April of 2014.

Sadie loves to play basketball. She was a Junior Nationals 1st-Team All-American

and was a manager for the Duke Women’s Basketball team. She is the founder of the non-

profit Lakota Initiative for Future Empowerment (LIFE) which is a suicide prevention and

youth empowerment focused organization. She has taught at SD GEAR UP as a College Re-

search and Exploration instructor for American Indian high school students.

Ms. In The Woods began her work as the Policy, Systems, and Environmental

Change Intern at GPTCHB, focusing on cancer prevention efforts to honor the memory of

her beloved sister Elita In The Woods who passed away from Leukemia at the age of 10. She

began her professional career as the National Native Network Coordinator and has recently

been promoted as the Northern Plains Tribal Tobacco Technical Assistance Center Program

Manager and plans to focus on community assessment and outreach, tobacco control policy

creation and enforcement, and honoring traditional tobacco use. Growing up on a Great

Plains reservation, Sadie has experienced the many issues that American Indian youth deal

with when it comes to commercial tobacco: usage, second-hand smoke, peer-pressure, the

need for increased traditional use education, and the loss of loved ones due to tobacco re-

lated deaths. She hopes to use her energy to help tribal members and to honor her grand-

mother Wilma who passed from smoking-related health issues.

NPTTTAC Program Manager

Sadie In The Woods, MPH

1770 Rand Road

Rapid City, SD 57702

Cell: 605-863-1503

PH: 605-721-1922 ext. 121

Fax: 605-721-1932

Sadie.inthewoods@gptchb.org