In the discussion below, we describe our emergent understanding
of elements of the Andean worldview and ceremonial tobacco use
in the Pachamama ceremony and how each of these thematic
constructs might be used in smoking prevention strategies. We
discuss four emergent themes below: historical continuity,
cosmological beliefs (holism, reciprocity, and balance), the
hierarchy of social relations and respect for elders and
tradition, and norms governing ceremonial tobacco use. These
results are summarized in . We then turn to a discussion of how
youth characterize secular, recreational use of tobacco in
contrast to ceremonial use and close with a discussion of how
our results can be integrated into smoking prevention programs
for Andean youth. Ceremonial and recreational smoking among
Andean youth Andean youth are reared with an understanding of
the ancient origin and historical continuity of the Pachamama
ceremony. As these young men indicate, offerings to Pachamama
transcend time and ensure the continuity of li