title: Advancing smoke-free policy adoption on the Navajo Nation.
abstract: Comprehensive smoke-free laws are effective at protecting non-smokers and reducing tobacco use, yet they are not widely adopted by tribal governments.
  
  
  
  A series of smoke-free policy initiatives on the Navajo Nation, beginning in 2008, were reviewed to identify key issues, successes and setbacks.
  
  
  
  It has been essential that proposed policies acknowledge the Navajo people's spiritual use of nát'oh, a sacred plant used for gift-giving, medicinal purposes and traditional ceremonies, while simultaneously discouraging a secular use of commercial tobacco. Concern that smoke-free policies economically harm tribal casinos has been a major barrier to broad implementation of comprehensive smoke-free laws in Navajo Nation.
  
  
  
  It is necessary for tobacco control researchers and advocates to build relationships with tribal leaders and casino management in order to develop the business case that will take comprehensive smoke-free policies to scale throughout tribal lands.
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Nez Henderson
authors.affiliation: California Tobacco Control Program, California Department of Public Health, Sacramento, California, USA.
authors.forename: April
authors.initials: A
authors.lastname: Roeseler
authors.affiliation: InSource, Coquitlam, British Columbia, Canada.
authors.forename: Gregg
authors.initials: G
authors.lastname: Moor
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Hershel W
authors.initials: HW
authors.lastname: Clark
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Alfred
authors.initials: A
authors.lastname: Yazzie
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Nez
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Chantal
authors.initials: C
authors.lastname: Nez
authors.affiliation: Department of Health Promotions Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Sabo
authors.affiliation: Mayo Clinic Arizona, Scottsdale, Arizona, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Leischow
mesh_terms: D003466:Cultural Characteristics; D005715:Gambling; D006801:Humans; D007198:Indians, North American; D012147:Restaurants; D061845:Smoke-Free Policy / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention / Q000331:legislation & jurisprudence*; D014028:Tobacco Smoke Pollution / Q000331:legislation & jurisprudence / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Disparities; Priority/special populations; Public policy; Secondhand smoke