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In the United States, as of 2022, the federal government recognizes 574 distinct American Indian and Alaska Native (AI/AN) Tribes across 37 states [1]. Together, the combined AI/AN population comprises 9.7 million people, representing 2.9% of the US population in 2020 [1]. The AI/AN population is young, with 30% being up to 18 years old, compared with 24% of the US total population [2], making adolescent health an important topic in native communities.
JMIR Form Res 2025;9:e67885
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This could be especially true for Alaska Native people, who have the highest smoking prevalence in any US racial or ethnic subgroup [1]. Furthermore, Alaska Native residents of Alaska have a smoking prevalence more than double than that of Alaskan White residents (42% vs 17%), [2,3] but are difficult to reach with traditional face-to-face interventions because of their remote geography [4].
J Med Internet Res 2022;24(2):e28704
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At 22%, American Indian (AI)/Alaska Native (AN) persons have the highest US smoking prevalence; and within this group, AN residents of Alaska (AK) have a prevalence of smoking more than double that of Alaskan whites (42% vs 17%) [2]. Accordingly, AN people who smoke experience more tobacco-related diseases and mortality compared with non-Native people living in AK or US whites [3-6]. A national public health objective is to reduce tobacco-caused health disparities [7,8].
JMIR Res Protoc 2019;8(11):e15155
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