The prevalence of tobacco use is disproportionately high among American Indian and Alaska Native people, with rates and patterns of use varying greatly by tribe, community and geographical region. Targeted interventions are needed to reduce this troubling disparity between non-Native and Native rates of use. Among non-Native individuals, the college years are being investigated as a time when lifelong tobacco use patterns may be established, and interventions are being tested to help college students to stop using tobacco. Currently, no interventions have been developed for American Indian or Alaska Native college students. Data obtained from Alaska Native college students at a site in Alaska and American Indian college students at a site in Montana ( n = 68 and 105, respectively) were analyzed to describe tobacco use and related characteristics within each population and to determine whether differences existed between the populations with respect to proportion of students using spit tobacco and using tobacco in a ceremonial context. The proportions of current tobacco users in Alaska and Montana were 63% and 54%, respectively. A significantly higher proportion of Montana than Alaska participants used tobacco in a ceremonial context. A significantly higher proportion of Alaska than Montana participants were users of spit tobacco, with some Alaskan participants' use of Iqmik (a homemade substance made from combining leaf tobacco and a regional botanical substance) contributing to that difference. Qualitative research conducted with Alaska Native college student participants in combination with survey results yielded information about the psychosocial factors related to tobacco use and the acceptability of various potential interventions to help Native college students stop using tobacco.