Prepared by staff in Prevention and Cancer Control. Citation: Cancer Care Ontario. Cancer Fact: High prevalence of smoking in First Nations in Ontario. May 2016. Available at http://www.cancercare.on.ca/cancerfacts. Prepared by staff in Prevention and Cancer Control. High prevalence of smoking in First Nations in Ontario (May 2016) A recent report found that smoking is twice as common in the First Nations population of Ontario (living on- and off-reserve) as in the non-Aboriginal population of Ontario. Exposure to tobacco smoke is strongly linked to several cancers and other chronic diseases. In addition to smoking, the report examines other modifiable risk factors for cancer, such as alcohol consumption, inadequate intake of vegetables and fruit, excess body weight, physical inactivity and inadequate participation in cancer screening. Cancer in First Nations in Ontario: Risk Factors and Screening, a report recently released by the Chiefs of Ontario and Cancer Care Ontario, found an especially high prevalence of smoking in the First Nations population. In Ontario, 50 per cent of First Nation adults (age 20 and older) living on-reserve and 43 per cent of First Nation adults living off-reserve reported smoking cigarettes daily or occasionally compared to only 22 per cent of non-Aboriginal adults. Higher smoking rates among First Nation adults were seen for most age groups. Differences in smoking prevalence, however, were most pronounced in young adults ages 20 to 29, with 67 per cent of on-reserve First Nations reporting currently smoking, compared to 48 per cent of off-reserve First Nations and 27 per cent of non-Aboriginal adults. A similarly concerning pattern of tobacco use is seen among First Nation youth (ages 12 to 17). Smoking rates are seven and three times higher, respectively, in on-reserve (30 per cent) and off-reserve (14 per cent) First Nation youth than in non-Aboriginal youth (four per cent) of the same age (data not shown). While traditional tobacco plays an important medicinal and ceremonial role in many Indigenous communities, the spiritual use of traditional tobacco has no connection to the recreational use of commercial tobacco. Non-traditional use of tobacco (e.g., cigarette smoking) is the single most important modifiable cause of cancer, responsible for an estimated 15 per cent of all cancers diagnosed in Ontario each year, or about 10,000 cases.1 Cigarette smoking is strongly linked to multiple cancers, including lung, mouth and throat, colorectal and pancreatic.2 Many of the cancers highly associated with smoking have poor prognoses. Smoking is also linked to numerous other chronic health conditions, such as chronic respiratory and cardiovascular diseases.1,3 The link between smoking and chronic disease means that the current high prevalence of smoking in First Nations in Ontario, especially among young people and those living on-reserve, is of concern. In addition to smoking, the report examines other modifiable risk factors for cancer, such as alcohol consumption, inadequate intake of vegetables and fruit, excess body weight, physical inactivity and inadequate participation in cancer screening among on-reserve First Nations, off-reserve First Nations and non-Aboriginal Ontarians. In general, First Nations living on-reserve fared poorer than those living off-reserve and non-Aboriginal Ontarians across all indicators of cancer risk, although the high prevalence of cigarette smoking and obesity, and the low prevalence of vegetable and fruit intake were highlighted as priority areas for concern. First Nation women living on-reserve were also significantly less likely to have had a mammogram within the last five years to screen for breast cancer. Measuring the prevalence of current smoking in First Nations in Ontario is an important component in the prediction of the future cancer burden in the province. Cancer in First Nations in Ontario: Risk Factors and Screening provides much-needed information on the prevalence of smoking and other cancer risk factors in this population. This expanded knowledge can help support the development and implementation of chronic disease prevention policies and programs. In particular, culturally-appropriate smoking prevention and cessation initiatives, such as the Aboriginal Tobacco Program, are essential for reducing the future burden of tobacco-related cancer and chronic conditions in First Nations in Ontario. For more information, the full report is available at www.cancercare.on.ca/FirstNationsReport. information on the Aboriginal Cancer Control Unit’s Aboriginal Cancer Strategy III can be found at www.cancercare.on.ca/about/programs/aborstrategy/aboriginal. Aboriginal Tobacco Program resources can be found at www.tobaccowise.com. References Cancer Care Ontario. Cancer Risk Factors in Ontario: Tobacco. Toronto, Canada; 2014. Gandini S, Botteri E, Iodice S, et al. Tobacco smoking and cancer: a meta-analysis. Int J Cancer. 2008;122(1):155–64. Mitchell S. Tobacco Cessation Strategies for First Nations, Inuit and Métis: An Environmental Scan and Annotated Bibliography. Prince George, BC: National Collaborating Centre for Aboriginal Health; 2007.