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Cigarettes spelling out "quit"

All Nations Breath of Life

All Nations Breath of Life (ANBL) is a quit smoking program designed specifically for Native people that respects traditional tobacco use while helping participants quit recreational use of cigarettes. Creation of the program began in 2003, when a group of patients at the Haskell Health Center approached the CEO about getting a quit smoking program for the clinic that would respect Native culture. The CEO came to the University of Kansas Medical Center to find such a program. After looking at currently available programs and talking with Native community members, researchers at KUMC decided it would be better to create a new program rather than use an existing one. They turned back to the Native community to ask for help in creating such a program.

Since that time, ANBL has gone through several iterations, with community members working side by side with researchers to develop a program that combines the latest scientific evidence and best practices in helping people quit smoking with Native values and a respect for traditional tobacco. ANBL is a group-based program that meets weekly for eight weeks, with additional meetings four weeks later and three months after that. You can learn much more about the program by going to We have several research projects related to ANBL:

Randomized Trial: To test the efficacy of ANBL, we are running a randomized clinical trial, comparing our culturally tailored program to a current best practices program that is not tailored. We are partnering with the University of Oklahoma Health Sciences Center for the project.

Urban Implementation: To test the real-world effectiveness of ANBL, we recently completed an implementation trial in multiple urban areas. We are analyzing the data and should have it available in the next few months. In addition to running the program, we created materials to accompany the program, including a book and video about traditional use of tobacco among different Nations, and a video about tobacco facts in the Native population. To view the videos, go to our program website,

Education Intervention: Throughout implementing ANBL, we have learned that there are many Native people who are not yet ready to quit smoking. To help people learn more about the health benefits of quitting, we conducted a series of educational interventions with Native smokers who were not yet ready to quit. The sessions lasted about 30 minutes and taught about health problems associated with smoking. We are looking at feedback from participants in these sessions and are hoping to modify them to make them better and begin them again soon!

Internet ANBL: We are currently developing an Internet-based version of our program specifically for tribal college students. We hope to be able to begin the program by the end of 2014.
If you are interested in learning more about our tobacco research, take a look at some of our publications:

  • Choi WS, Daley CM, James A, Thomas JL, Schupbach R, Segraves M, Barnoskie R, Ahluwalia JS. Beliefs and Attitudes Regarding Smoking Cessation among American Indians: A Pilot Study. Ethnicity & Disease, 2006; 16:35-40.
  • Daley, CM, James, AS, Barnoskie, R, Segraves, M, Schupbach, R, & Choi, WS (2006) "Tobacco has a purpose, not just a past": Feasibility of developing a culturally appropriate smoking cessation program for a pan-tribal Native population, Medical Anthropology Quarterly 20(4):421-40.
  • Daley, CM, Cowan, P, Nollen, NL, Greiner, KA, & Choi, WS (2009) Assessing the scientific accuracy, readability, and cultural appropriateness of a culturally-targeted smoking cessation program for American Indians, Health Promotion Practice 10(3):386-393, ePub ahead of print 2007.
  • Daley, CM, Greiner, KA, Nazir, N, Daley, SM, Solomon, C, Braiuca, SL, Smith, TE, Choi, WS (2010) All Nations Breath of Life: Using Community-Based Participatory Research to Address Health Disparities in Cigarette Smoking among American Indians. Ethnicity & Disease 20:334-8.
  • Daley, CM, Faseru, B, Nazir, N, Solomon, C, Greiner, KA, Ahluwalia, JS, Choi, WS (2011) Influence of traditional tobacco use on smoking patterns among American Indians. Addiction 106(5):1003-9, ePub ahead of print, Feb 10.
  • Choi, WS, Faseru, B, Beebe, LA, Greiner, KA, Yeh, HW, Shireman, TL, Talawyma, M, Cully, L, Kaur, B, Daley, CM (2011) Culturally-tailored smoking cessation for American Indians: study protocol for a randomized controlled trial. Trials 18(12):126.
  • Filippi, MK, McCloskey, C, Williams, C, White Bull, J, Choi, WS, Greiner, KA, Daley, CM (2012) Perceptions, barriers, and suggestions for creation of a tobacco and health website among American Indian/Alaska Native college students. Journal of Community Health, ePub ahead of print, Nov 13.

Tribal College Tobacco and Behavior Survey (TCTABS)

The goal of this five-year study is to establish a group (cohort) of American Indian tribal college/university students to determine the predictors of smoking initiation (non-use to experimentation), progression (experimentation to established use), and cessation (established use to quitting). A lot of what is known about the process of smoking initiation and progression comes from studies with non-Native populations. Information related to smoking use among American Indian tribal college/university students is entirely unknown and needs further investigation.

In order to achieve our goal, we will administer the Tribal College Tobacco and Behavior Survey (TCTABS) twice a year to incoming freshman at two tribal colleges and continue to survey them for up to four years. The information gathered from this survey will be used to create future programs to help students quit smoking. In addition to the questions about tobacco use, questions related to other health behaviors as well as demographic characteristics are included. We will collect saliva samples from those who agree to give them in order to study the rate at which tribal college students metabolize nicotine in their bodies. To learn more about the study, read our publication:

  • Faseru, B, Daley, CM, Gajewski, KK, Pacheco, C, Choi, WS (2010) A longitudinal study of tobacco use among American Indian and Alaska Native tribal college students. BMC Public Health 10:617.

Youth Prevention

Quitting smoking is one of the hardest things anyone can do; never starting is a far better option. With this premise in mind, we have begun multiple efforts to reduce smoking among Native youth. We conduct youth education sessions and can bring our education to any location within traveling distance. We also have a series of youth coloring books focused on traditional tobacco and health problems associated with recreational cigarette smoking. In addition, we have a series of posters warning children of the hazards of smoking, all featuring different trickster figures from around the country, with the common theme, "Don't get tricked into smoking". All of our coloring books and posters are available free to Native communities and organizations.

Last modified: Jul 26, 2018
Learn More

All Nations Breath of Life logoLearn more about All Nations Breath of Life smoking cessation program at the website,