Rates of e-cigarette use, marijuana use and binge drinking are higher among AIAN adults than the statewide rates for all adults, the study found. The new research is the first in a series of projects funded by the California Rural Indian Health Board, Inc. (CRIHB) California Tribal Epidemiology Center (CTEC) that examines the health of American Indian and Alaska Native populations in the state. Nearly one-third reported using marijuana in the past month compared with 19% of AIAN adults overall and 18% of heterosexual AIAN adults. What challenges do American Indian and Alaska Native adults face in managing chronic disease? What should policymakers do to help minimize disparities in chronic disease and substance use faced by American Indian and Alaska Native adults in California?