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9,10,11 They have used these funds to build strong, community-based programs to reclaim Tribal traditions, such as: Engaging communities with knowledge of cultural practices around traditional tobacco and the harms of commercial tobacco use Increasing access to traditional tobacco by growing and harvesting asemaa (Anishinaabek) and casasa (Dakota) for ceremonial use Telling their own history of the origins and purpose of traditional tobacco to continue the tradition among American Indians and to educate non-natives 12 Participating in the development of commercial tobacco treatment and cessation programming designed for American Indians (see The American Indian Quitline below)

While this study was not designed to evaluate the mechanism, it seems to suggest that epigenetic changes could play a role, with reactive oxygen species appearing to be a key contributor that creates the primary source of damage, followed by secondary contributors

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