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Tobacco's a sacred plant to many Native people and so the idea of smoking has a different connotation. The program, led by Native people, combines weekly in-person group support with individual telephone counseling

However, its usage is infrequent due to its higher cost

Its really not possible to set a minimal threshold because even very light, occasional smoking is associated with some risk, she says

Its helpful to know youre up against two different types of cravings

Photo courtesy of Terri Morse, FNP, Upstate Golisano Childrens Hospital Accessible Version A photo of a back with 8 hyperpigmented oval areas that are in a regular pattern along the spine and on either side, each larger than the size of a thumb