BACKGROUND: Aboriginal populations in Canada, the US and Australia have higher incidences of sudden infant death syndrome (SIDS) as compared with the non-Aboriginals. After education campaigns identified prone sleeping as a SIDS risk factor, mothers altered infant sleeping position from prone to supine and the SIDS incidence decreased. Educational campaigns on SIDS risk factors also encouraged mothers to stop smoking during and after pregnancies. OBJECTIVE: The objective of the current study was to determine the rate(s) of smoking among reproductive age Cree women. DESIGN/METHODS: A questionnaire was distributed to 84 mothers who met the inclusion criteria for the study. Seventy (83.3%) of the 84 mothers were interviewed. Participatory observation (an anthropological perspective) was employed. This consisted of observing what was in the immediate environment. RESULTS: Mothers interviewed were between 15 and 37 years old (median: 26 years). Smoking and non-smoking mothers did not vary in age. In the group of smoking mothers, however, older mothers smoked more than younger ones (p = 0.03). Smoking mothers smoked a median of 5 cigarettes/d (range = 1-30). Six of 48 mothers stopped temporarily for the duration of their pregnancy. Mothers had a median of 1 other person that smoked in their household (range 0-7), that smoked a median of 5 cigarettes/d (range 0-120). The number of other people smoking in the household did not vary depending on whether the mother was a smoker or not, nor did the number of cigarettes that they smoked. 50% of smoking mothers did so in the house rather than outside and this was also true when they had other smokers in their household. 26 of 37 households where both the mother and others were smoking, the smoking was done in the house. There were no associations between the age of the mother (below or above 21) and the location of her smoking (in the house or outside) or between the age of the mother and the location of the smoking of the other smokers in the household. CONCLUSIONS: A high level of smoking continues to exist among Cree reproductive age females. Use of tobacco for ceremonial purposes differs significantly in the habitual use of cigarettes where environmental tobacco smoke has been found to increase the risk for SIDS in a dose-dependent manner. Culturally sensitive cessation campaigns and more than nicotine addiction must be addressed, since disadvantaged women seek solace from their difficulties in smoking.