Tobacco cessation in cancer care part of Mi’kmaw cancer care strategy

Mi’kmaq Nation Cancer Care strategy team
Mi’kmaq Nation Cancer Care strategy team (left to right) Aaron Prosper, team lead; Karlee Francis, cancer learning lead; Dylan Letendre, health promotion and cancer screening lead; and Chelsea Googoo, policy analyst

The daily adult smoking rate among Mi’kmaq Nova Scotians is more than 43 per cent as compared to the provincial smoking rate of more than 18 per cent. 

These numbers show us that tobacco cessation (the act of stopping smoking) is a massive concern for Mi’kmaq people, said Dylan Letendre, health promotion lead for the Mi’kmaw Cancer Care strategy. 

Aaron Prosper, lead for the Mi’kmaw Cancer Care Strategy, and Letendre, have been working with NSHA Cancer Care Program members to gather information on available supports and discuss the best approaches for working together, sharing information and building awareness around tobacco cessation as an important part of cancer treatment within the Mi’kmaq communities. 

“There is very little happening with tobacco cessation right now in our communities,” said Prosper.  

“We need to work with the cancer care program to increase knowledge and capacity at health centres on reserves and improve the continuity of care between cancer care and community providers.” 

This includes providing health care staff on reserves with information on programming and tools to help them raise the issue of tobacco cessation with patients and reinforce the information patients received at a cancer centre. 

It also includes educating cancer care teams about the difference between commercial and traditional tobacco use. 

“Colonial policies have really affected the different ways that Mi’kmaq people engage with tobacco,” said Letendre.

“The intended purpose of Residential schools was to remove indigenous children’s identities and break family and community relationships. This creates higher rates of low sense of identity and low community belonging which puts youth and young adults at risk of starting to use commercial tobacco. The commercialization of one of our sacred medicines has created added challenges that have yet to be addressed in Mi’kmaq communities. Smoking cigarettes/cigars, vaping, and chewing are not sacred uses of tobacco to Mi’kmaq people.”

Letendre said there is a fine line between not talking about the harms of commercial tobacco use, which communicates to a patient it isn’t important; and talking about tobacco use as all bad, which for Mi’kmaq people may harm the relationship they have with their health care provider. 

“Sacred use of tobacco is completely different than commercial use,” said Letendre. 

“Our approach is to help health care providers understand and respect the importance of the cultural use of tobacco for Mi’kmaq communities and work with them to find ways to talk about (commercial) tobacco cessation in a respectful way.” 

Letendre and Prosper said there is much work to be done to fully integrate tobacco cessation as an important component of cancer care for Mi’kmaq people, but gathering information and sharing perspectives is a good starting place.