ST. PAUL, Minn. (AP) -

American Indians in Minnesota have significantly higher rates of cancer than the general population, a troubling trend that experts in part link to economic and spiritual ties to tobacco.

A recent tribal survey found that 59 percent of Minnesota's American Indians smoke. Nearly 3,000 people completed the questionnaire, making it the largest tobacco survey ever conducted among American Indians in Minnesota, according to Minnesota Public Radio News.

"We can't talk about cancer in American Indian communities without addressing the high rates of tobacco and the rates of secondhand smoke exposure in our communities," said Kris Rhodes, a member of the Bad River Band of Lake Superior Chippewa and executive director of the American Indian Cancer Foundation. The nonprofit organization sponsored the recent Powwow for Hope at Fort Snelling.

The use of ceremonial tobacco may be another factor that has influenced American Indian smoking rates.

Tobacco is considered a sacred medicine and is regularly used in ceremonies. But, Rhodes said there has been some debate within the community about whether it is appropriate to translate that spiritual meaning to smoking commercial tobacco.

Cancer is Minnesota's number one cause of death. And for American Indians, their risk of dying from lung cancer is more than two times higher than it is among non-Hispanic whites. Their rates of cervical and larynx cancer are four times higher, according to the Minnesota Cancer Surveillance System and the Minnesota Department of Health.

American Indians also have the state's highest rates of colorectal, kidney and oral cancers.

Breaking the smoking habit has also been difficult because cigarette sales are an important part of the tribal economy.

"Those of us that work in tobacco control in tribal communities know that the economics associated with tobacco in our tribal communities are really sensitive issues," Rhodes said.