The social context of experimenting with cigarettes: American Indian "start stories".

Smoking rates among American Indians are higher than any other racial or ethnic group. Focus groups were conducted with 140 American Indian middle school students who were not living on reservations to explore the social context of smoking initiation. Most teens smoked their first cigarettes with friends, siblings or cousins, usually out of curiosity, or in response to peer encouragement. There was no indication of any link between smoking initiation and use of tobacco in traditional ceremonies. Overall, the social context for these teens was very similar to the social context of other teens in the United States.