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Primary examples of this include not allowing expedited review and requiring prepublication review of all manuscripts.Because of its broad mandate, the Navajo Nation IRB may also require review of some projects that would not normally be subject to IRB approval, including investigative journalism and secondary research about Navajo People that does not involve direct data collection from human subjects.However, tribes have the authority to adopt laws that regulate smoking on tribal lands, including tribal casinos.8 While the states of Arizona, Utah and New Mexico implemented comprehensive smoke-free laws between 20,9 the Navajo Nation and most tribes have not adopted similar written comprehensive smoke-free policies.10Because of the unique relation, the Navajo people have with nát'oh, a sacred plant used for gift-giving, medicinal purposes and traditional ceremonies, any educational and policy efforts on commercial tobacco use on the Navajo Nation are approached in a cultural context that reflects the role of nát'oh.11 12 In recent decades, though, nát'oh is increasingly replaced by, or used in combination with, commercial tobacco within ceremonial practices.This use of commercial tobacco is a topic of discussion and controversy among Navajo ceremonial healers and community members. Today, Navajo Nation is faced with a dilemma not found in cultures that do not have a sacred connection with tobacco: how to maintain the use of nát'oh that promotes spiritual growth and harmony, while discouraging secular uses of commercial tobacco.The Navajo Nation institutionalized an approach to protecting members of the nation when it took over Institutional Review Board (IRB) responsibilities from the US Indian Health Service (IHS) in 1996.While written regulations for the Navajo Nation IRB are not dissimilar, and in some ways are less detailed than those of the IHS IRB, in practice the Navajo Nation allows less flexibility.These efforts were instrumental in facilitating adoption of the Navajo Nation Commercial Tobacco-Free Act of 2008 by the 21st Navajo Nation Council in July 2008.
A review of smoke-free policy efforts in Navajo Nation over time provides an opportunity to find out how these unique factors influence smoke-free policymaking on tribal lands., concluded that there is no safe level of exposure to secondhand smoke and that establishing smoke-free environments is the only proven way to prevent exposure.13 A 2012 systematic review of smoke-free policies concluded that there is strong evidence that smoke-free polices are effective at: reducing exposure to secondhand smoke; increasing quitting behaviours; reducing tobacco use; reducing the initiation of tobacco use and reducing tobacco-related morbidity and mortality.14 15While the public health benefits of smoke-free workplaces are well known, the gaming industry is a sector that lags in adopting comprehensive smoke-free policies.16–18 Casino workers and patrons are exposed to high levels of secondhand smoke, including carcinogens and fine particulate matter associated with cardiovascular disease (PM).18–23Air quality studies demonstrate that non-smoking areas within casinos, without physical barriers, provide no protection from secondhand smoke exposure; non-smoking areas, partially separated from smoking areas, provide minimal protection and smoke-free areas, completely separated from smoking areas by physical barriers, provide good protection.18 22 Studies show that a small portion of actively smoking casino patrons (7–12%) are responsible for the high levels of secondhand smoke found in casinos and ventilation systems are not effective at removing secondhand smoke.19 A grassroots coalition—Team Navajo—formed in 2006, after its leaders identified the lack of a comprehensive smoke-free policy as a major public health problem in Navajo Nation, because having no law: (1) fosters a social norm that commercial tobacco use is acceptable; (2) increases the likelihood that commercial tobacco use will lead to tobacco-caused diseases and (3) increases the risk of morbidity and mortality among non-smokers exposed to secondhand smoke.
According to statistics provided by the Navajo Nation Gaming Enterprise, we can expect a 20% reduction of project revenues.
This means, essentially, that Navajo jobs will be cut, the Enterprise will default on the loan with the Nation, and the ability to seek outside financing from the other lending institutions is very unlikely, all of which would prohibit the development of additional gaming establishments’.29 An attempt to override the President's veto was unsuccessful.
The legislative branch is comprised of a 24-member council, representing 110 chapter houses or communities.
With 300 000 enrolled tribal members, the Navajo Nation is the second largest tribe in terms of population.1 Because of its high unemployment rate (43%),2 the Navajo Nation began to explore gaming as a form of economic development in the late 1990s and the Navajo people approved gaming in a 2004 referendum.
Conclusions It is necessary for tobacco control researchers and advocates to build relationships with tribal leaders and casino management in order to develop the business case that will take comprehensive smoke-free policies to scale throughout tribal lands.