THE TRIBAL TOBACCO POLICY PROJECT - WORKING WITH NORTHWEST INDIAN TRIBES ON SMOKING POLICIES

Background. This article reports on the objectives, study design, inte rvention methods, baseline results, and process data from a trial invo lving 39 Northwest Indian tribes. Methods. Tribes were stratified and then randomized to either early or late intervention conditions. Inter vention consisted of a consultation process to assist tribes to review and modify existing tobacco policies or to develop new policies relev ant for their tribe and that protect tribal members from environmental tobacco smoke. Outcome measures consist of: (a) phone interviews to a ssess the comprehensiveness of tribal tobacco policy, (b) surveys of t ribal leaders to assess norms and attitudes regarding tobacco use, and (c) observations of tribal settings to assess policy implementation a nd indicants of tobacco use.Results. Early and later intervention trib es were well matched on baseline measures and tribal characteristics p otentially related to policy outcomes. There was considerable variabil ity across tribes on all measures though, in general, tribal leaders e xpressed support for more stringent tobacco use policies. Process data indicated that early intervention tribes strengthened their tobacco p olicies, but generally did not do so through tobacco policy committees as originally envisioned. Conclusions. There is good potential for to bacco policy interventions with Indian tribes. Consultation processes and products, such as policy guidebooks, that are sensitive to traditi onal uses of tobacco and 60 differences among tribes can help to modif y policies to reduce exposure of tribal members to environmental tobac co smoke. (C) 1995 Academic Press,Inc.