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Aboriginal Peoples Clinical Considerations


The following clinical considerations are included in CAN-ADAPTT's guideline and have been approved by the Guideline Development Group (GDG).


·  The Guideline Development group found that there was a significant gap in the research on Aboriginal peoples and tobacco misuse. Guidelines developed in New Zealand were utilized recognizing that these guidelines also require further research. Despite the lack of research there is evidence that there is a disproportionate burden of tobacco use amongst Aboriginal peoples. For example, youth uptake of tobacco is at a much earlier age than that of the general Canadian population (See Youth section). 
·  It should be emphasized that providers should recognize and distinguish between use of traditional (ceremonial/sacred) tobacco and misuse of commercial tobacco. Therefore assessment and questions need to be conducted with care and respect for this difference.
·  Healthcare practitioners should work with community members including health care providers, community health representatives, caregivers, elders and other leaders where possible, to deliver smoking cessation interventions for Aboriginal peoples. There are a growing number of materials and methods to assist with tobacco cessation and prevention that have been developed and/or adapted for Aboriginal peoples. (see Tools and Resources Section)
·  Efforts should also be made to identify, engage and understand the range of resources available to provide appropriate referrals and connectivity to the Aboriginal community. For example, local First Nations communities, urban Aboriginal programs, Friendship Centres etc. (see Tools and Resources Section)
·  In general, interventions that have been proven to be effective in the general population are also likely to be effective for these population groups. However, the manner in which these interventions are delivered may need to be adapted for each group in order to be as acceptable, accessible and appropriate as possible. Therefore, tools and strategies that have been developed for other populations should be tailored appropriately with a full understanding of the context, barriers, and possible approaches when providing care to Aboriginal peoples within practice settings.
·  Practitioners should recognize the heterogeneity of individuals and communities within the Aboriginal population and tailor interventions appropriately. 



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Note that these clinical considerations were developed by the Guideline Development Group (GDG) and then edited or added to by CAN-ADAPTT network members.
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