Menominee perspectives on commercial and sacred tobacco use.

The Menominee Indian Tribe of Wisconsin has the highest smoking rate in the state. To address the resultant health disparities, the tribe conducted a qualitative pilot project to examine tobacco use. The findings indicated mainstream models of addiction did not capture the tribe's context well; the Indigenist Stress-Coping Model was most applicable. Participants suggested that Menominee-centric ways of knowing related to commercial and sacred tobacco use should be included in all levels of prevention as a key strategy. Recommendations include primary prevention targeted specifically to youth, pregnant women, and adults who care for children, as well as access to commercial tobacco products.