IntroductionIndigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide.ObjectiveWe describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy.MethodsFocus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy.ResultsDiné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments.ConclusionsIndigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.
BackgroundComprehensive smoke-free laws are effective at protecting non-smokers and reducing tobacco use, yet they are not widely adopted by tribal governments.MethodsA series of smoke-free policy initiatives on the Navajo Nation, beginning in 2008, were reviewed to identify key issues, successes and setbacks.ResultsIt 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.ConclusionsIt 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.
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