Gina Boudreau Tobacco Prevention Specialist: White Earth Nation ext.1357

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Gina Boudreau Tobacco Prevention Specialist: White Earth Nation 218-983-3286 ext.1357 ginamb@whiteearth.com

Jimmy Jackson, Ojibwe Jimmy, a medicine man who now passed on to the spirit world, understood how to heal. He gave a story about the instructions that the Creator gave to people around the world. The Creator gave gifts to all our relatives in all countries of the world.

The First Gift given was to native people was tobacco the Creator said When you want to speak to me, when you want me to listen to you, use this. when we wake in the morning, we put out an offering of tobacco and we thank creator for everything we ve been given, for each day. We use tobacco in ceremony, we make tobacco ties, we use tobacco in a pipe (we don t inhale the smoke) and the smoke travels to give messages to Creator. Asema travels through four levels before reaching creator. We are also instructed to put asema in the water.

Summary 2001-2007 Traditional Tobacco Use In 2007, there were increases in the use of traditional tobacco use! Slightly more household members were using traditional tobacco in 2007 Less youth reported using commercial tobacco (cigarettes, pouch or packaged) for ceremonial purposes and native tobacco use doubled in 2007

Summary 2001-2007 Commercial Tobacco Use In 2007, there were decreases in youth smoking! Overall, slight less youth are smoking Among current smokers, youth tend to smoke their first cigarette before they are 13 years old. Among youth smokers, Slightly more are smoking all 30 days in the past month More can wait 1 week or more before needing another cigarette

Summary 2001-2007 Secondhand Smoke Exposure Overall SHS exposure has decreased! In 2007: Slightly less youth were in the same room with someone who was smoking in the past 7 days Slightly less youth were in a car with someone who was smoking in the past 7 days Slightly less youth live with someone that smokes cigarettes or uses smokeless tobacco Slightly less youth reported having friends who smoke cigarettes, but slightly more reported having friends who use smokeless tobacco

White Earth Reservation Tobacco Project Survey Analysis (N=200) Fall, 2008 Prepared for: White Earth Community Health Education Program/Tobacco Prevention Prepared by: Isaiah Brokenleg MPH Epidemiologist Great Lakes Inter-Tribal Epidemiology Center

You can t sit at your desk and expect to build community support. You have to be out there building those good relationships and a whole lot of social capital. Your presence is what the community remembers down the road when smoking discussions take place.

Leaders in the community know that we work on tobacco issues constantly. The fact that we are known tobacco advocates helped us to create part of the desired change in policy.

Gina Boudreau: Health Ed.WE Nation\Tobacco Prevention Specialist Jean Dakota: WE CD Prog. Jane Fox: WE CD Prog. Mindy Iverson: S. Star White Earth Nation ishkonon-i u bimaadizid Save that Life Tobacco Coalition Julie Doerfler S. Star LaRaye Anderson: Health Ed. Mary Leff: Child Care Mary Farley: WE Head Start Jach Mohr WE Pharmacy Charles Punkin Hanks WE Elder Peggy Chisholm WE Boys and Girls Club

Help smokers quit by offering cessation resources and group support as requested. Youth and elder involvement Network with businesses, tribal and community leaders, and workplaces to create smoke free policies and reinforce policies when necessary.

The mission of the White Earth Reservation ishkonon i u bimaadizid (Save that life) Tobacco Coalition is to improve the health of the White Earth Nation residents by providing education about second-hand smoke, 3rd hand smoke, cessation, harms of commercial use, tobacco policy creation, and policy enforcement with a emphasis on utilizing this sacred medicine the way it was originally intended to be used in order to create a positive impact on the future generation.

White Earth creates smoke free policy at Shooting Star Casino By 2005 the coalition began discussing how we could help improve policy at Shooting Star casino, hotels and event center. Employees were of great help when they voiced concerns about exposure to second hand smoke at service windows. The public was also a huge contributor to the smoke free event center policy. The coalition knew it was up to them to ask for more smoke free space but never thought it was possible to create a 100% smoke free policy. Instead we decided to develop a chip away strategy by keeping the focus on small changes over a linger period of time.

The tribe is a sovereign nation and this means that it does not have to follow the state wide Freedom to Breathe Act. This is a huge barrier to furthering our work on smoke free policies. Within the casino. We have to move forward with baby steps in order to create healthier environments.

Lessons Learned about creating change: Community ownership and participation is critical. Framing the message in a positive light via emphasis of the cultural aspect of tobacco as our sacred medicine. That gift from creator that we were give as Anishinabeg in an important message in building a healthier future for our people. We encourage all coalition members to see themselves as change agents. This requires patience and persistence in our work which builds a strong reputation with community leaders. Understand politics. When we deal with elected officials we need to understand that they are sensitive to feedback from constituents. This can cause setbacks in moving forward in policy creation and or enforcement. Patience is necessary.

The Europeans were given other gifts: Wine and Bread. Creator instructed them on how to uses these gifts. He said to them, when ever you want to think about me, talk to me, use these gifts. And they do, they communicate during communion, during church service they eat little wafers of bread and drink wine. They brought their gift with them when they came to this continent.

In 2005 the Health Educators began working with a doctor on the coalition and the EO of the Indian Health Clinic. We reviewed and revised the smoke policy. Within 4 months a 100% smoke free policy was implemented. This also started a new program at the clinic called the

Inform your primary care provider at your regular appointment. If you are referred from you provider, you will be seen by our Tobacco Cessation Staff the same day. If you do not have a primary care provider, call the appointment desk and schedule an appointment in White Earth with the next available provider. Products offered include: Nicotine Gum Nicotine Patches Zyban (bupropion) Chantix (varenicline)

A 4-week supply of medication is given at a time. You will receive a telephone follow-up within 2 weeks after the initial appointment. The pharmacist or nurse will schedule an inperson follow-up every 4 weeks. provider, pharmacist, or nurse and you will decide what medication is best for you. They will also help you plan the date you will quit using tobacco products. A maximum of 12 weeks of medication is given during the program. Don t be discouraged if you attempt to quit and fail. You will be able to re-enroll in the program 2 times per year.

For Calendar Year 2010: 230 patients enrolled: 38 are smoke free which = a quit rate of 16.5% as of 9-22-11 For Calendar Year 2011 through 9-22- 11 there are 133 patients enrolled; 25 are now smoke free = quit rate of 18.8% Number of visits for 2011 through 9-22- 11 = 359; with a projected number of visits for the year to be 380. which would be an increase in visits by 5.5%

Mii-gwetch Thank You! Questions? Gina Boudreau White Earth Nation

Ishkonon i u bemaadiiziid Save that Life Gina Boudreau Tobacco Prevention Specialist: White Earth Ojibwe