They are descendants of the various indigenous peoples of the U.S., both those living on reservations and in sovereign communities, and mainstreamed people who identify themselves as Native American or Indian. Approximately 2 million American Indians and Alaskan Natives live in the United States. Smoking rates among this group vary by region and state.
Smoking rates are highest in Alaska and the North Plains and lowest in the Southwest.
In the Southwest, the Native American death rate from lung cancer ranges from a low of 4.1 deaths per 100,000 in the Tucson district, to a high of 28.5 deaths per 100,000 in the Billings district, which covers Montana and Wyoming. From 1958 to 1982, the New Mexico death rate from lung cancer increased 104 percent among Native American men and 163 percent among Native American women. The rate in New Mexico may be affected by employment in uranium mining, which is known to contribute to lung cancer. Infection with the HIV virus and AIDS is rare among Native Americans as compared with whites, blacks and Hispanics. Native Americans account for less than one percent of all AIDS cases in the United States.