To the Editor.—
Earlier we reported data detailing the health effects of smokeless tobacco use by adolescents.1 In the course of our current research, we studied tobacco use rates among Indian youths from Colorado, North and South Dakota, Idaho, Montana, and Oklahoma. We believe that the disquieting results bear reporting.
Our cross-tribal sample included 1150 youths (93% Indian; 48.1% female; mean age, 10.3 years). Informed consent was obtained prior to assessment of this school-based sample of preadolescents. Responding to 126 items on a confidential questionnaire, children reported their lifetime prevalence of smoked and smokeless tobacco and their use during the prior 7 days and 24 hours. The privately completed questionnaires were sealed and deposited into a collection box. Analysis of self-reported tobacco use, by sex, focused on rates of lifetime prevalence, recent incidence, and peer use (Table).High rates of tobacco use are evident in the sample