The word tobacco comes from the Arawak tribe of Borikén. The word is centuries old. The people of the Antilles and the Caribbean have used tobacco in sacred ceremonies and rituals for thousands of years. Tobacco or Tobako, was considered sacred and to be respected which is in far contrast to the commercialized poison of modern day. (TainoWoods, 2024). However, when discussing the link between cancer and tobacco there is traditionally no distinction made between commercial tobacco and sacred or ceremonial tobacco. This is problematic for two reasons. Firstly, the United States made it illegal for Indigenous tribes to use sacred tobacco in their traditional rituals in the 1800’s. According to the South Dakota Department of Health