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The first outcome variable measured was tobacco users awareness of fixed SCCs, operationalized as users knowledge of the existence of fixed SCCs in their area

In the religious ceremonies of the Hopi, the head chief was attended by an assistant of nearly equal rank, who ceremonially lighted the pipe, and with certain formalities and set words handed it to the chief, who blew the smoke to the world quarters and over the altar as a preliminary to his invocation

Despite being associated with adverse health outcomes, this practice is not included in the list of risk factors examined by the Global Burden of Diseases, Injuries, and Risk Factors (GBD)