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[45] Potential for Indigenous American opposition [edit] As some traditions and ceremonies of a number of cultures and ethnicities of Native Americans in the United States and First Nations in North America have been based on tobacco since pre-Columbian times, some potential for unintended abrogation of such traditions may exist from authorities seeking to eliminate tobacco from worldwide use traditions of non -combustive use of tobacco for some forms of indigenous American ceremonial purposes have begun to be used for cessation of cigarette use among indigenous tribal members, [46] while members of the Oglala Lakota have had their struggles to retain important historic tribal artifacts used for tobacco's traditional role in their ethnicity's traditions, to prevent their illegal sale

In conclusion, in the recent United States Department of Health and Human Services (HHS) "Equity Action Plan Summary," HHS states that the agency has a fundamental role to play in advancing health equity to ensure that every person in our nation can achieve their full potential and thrive