Commercial tobacco use remains a critical public health challenge in the United States, particularly among American Indian (AI) communities, where smoking rates significantly exceed national averages. In addition to high smoking prevalence, AI populations face substantial exposure to secondhand smoke, leading to severe health outcomes such as cardiovascular disease, lung cancer, and type 2 diabetes. This study aims to evaluate the effectiveness of core objectives implemented by grantees of the California Department of Public Health, California Tobacco Prevention Program American Indian Initiative in reducing commercial tobacco use and exposure among California American Indians. The evaluation focuses on activities aligned with AII goals, challenges faced, and the overall impact on tobacco-related health disparities. Using a mixed-methods approach, this study analyzed qualitative data from key informant interviews conducted during the follow-up period of the CAITIE evaluation. Interviews were transcribed and coded using descriptive and evaluation coding to assess the alignment of activities with program objectives, their implementation success, challenges, and impact. Key findings reveal the success of various objectives, including Youth Coalitions, Smoke-Free Households, Tobacco Product Waste initiatives, and Excise Tax implementation. Youth Coalitions were particularly impactful, engaging young community members in tobacco prevention activities and fostering leadership. Despite challenges such as fluctuating participation and funding constraints, these coalitions empowered youth to advocate for tobacco-free lifestyles. Smoke-Free Household pledges increased significantly, demonstrating growing community commitment, though ideological resistance posed challenges. Tobacco Product Waste initiatives effectively raised environmental awareness and involved the community in clean-up efforts. Excise Tax implementation faced allocation challenges but provided crucial funding for tobacco prevention programs. The evaluation highlights the importance of culturally relevant and community-driven approaches in tobacco control. Engaging youth, addressing ideological resistance, and ensuring flexible funding allocation are critical for the success of tobacco prevention initiatives. Future programs should continue to integrate traditional cultural elements and foster community involvement to effectively reduce tobacco-related health disparities among American Indian populations.