Salvia apiana is widely used by Native American groups on the Pacific coast of the United States. The seed was a main ingredient of pinole, a staple food. The Cahuilla harvested large quantities of the seed that was mixed with wheat flour and sugar for gruel or biscuits. The leaves and stems were eaten by the Chumash and other tribes. Several tribes used the seed for removing foreign objects from the eye, similar to the way that Clary sage seeds were used in Europe. A tea from the roots was used by the Cahuilla women for healing and strength after childbirth. The leaves are also burnt by many native American tribes, with the smoke used in different purification rituals.
Smudging with white sage, has been adopted in some variant forms into a number of modern belief systems, including many forms of New Age and eclectic Neopagan spirituality, such as modern Wicca.