While campaigns to quit smoking are becoming ubiquitous across America, a more potent form of tobacco is quietly lurking under lips in rural areas.
Research by Colorado's State Tobacco Education and Prevention Partnership in 2001 found smokeless tobacco usage in northwest Colorado so significant the situation was deemed "urgent."
In the northwest region, including Moffat, Rio Blanco and Garfield counties, 16.7 percent of adult males use smokeless tobacco, more than double the state average of 6.9 percent.
But because smokeless tobacco usage is more common in rural areas, campaigns to help quit chewing are left up to local organizations as opposed to state efforts, said Karen DeLeeuw, director of STEPP for the Colorado Department of Health and Environment.
Moffat County's answer to the chewing problem may be the Tobacco Prevention Program for Northwest Colorado, which is funded by grants from STEPP.
Program coordinator Judy Hiester of the Northwest Colorado Visiting Nurse Association Inc., said that there is no direct reason for the popularity of smokeless tobacco in rural areas, but suggested that Northwest Colorado's long history of chewing contributes to the above-average rates.
That possibility also helps explain another troubling smokeless tobacco trend in northwest Colorado: the rising rate of youth chewing.
Among youth (under 18, male or female) 17.2 percent use smokeless tobacco according to a 2001 tri-county study by STEPP. The state average was 12 percent.
JoDeena Bullock, the manager at the Craig Smoker Friendly, said she had recently noticed an increase in the 18-year-old age group buying chew.
"Everyone is asking why youth rates are higher than adults," Hiester said. "Youth are led by example (of older community members), and have the same misperceptions about chew that the adult population have."
Heister said correcting user misconceptions is one of the best ways to tackle the issue for adults and youth. The most common misconception is believing smokeless tobacco is a safe substitute for cigarettes.
Contrary to that reasoning, chewing tobacco contains 4.6 mg of nicotine, compared to 1.8 mg in cigarettes. It also contains 28 cancer-causing agents and other dangerous chemicals, according to the Colorado Quitline.
Education about these dangers are the northwest Colorado Tobacco Prevention Program's most effective tool to curb smokeless tobacco usage, Hiester said.
She has planted ads in papers and posters around town, focusing on high schools and middle schools, with slogans such as "Smoke free, but not cancer free."
But for some people addicted to nicotine, the method of delivery doesn't matter.
Craig resident Steve Deyo began chewing when he was 13 or 14 and began smoking after college. Cigarettes are his choice of tobacco now, but he still chews when he can't smoke, which is all day while he's working at Craig Ford.
"Chewing? I could take it or leave it. I just do it for the nicotine," he said. "I couldn't stop smoking."
Whether quitting, chewing or smoking, Hiester said, "It's important for people to understand that quitting cold turkey is not the most successful way. People who get counseling or nicotine replacement therapy have a much higher success rate."
The Colorado Quitline, at 1-800-639-QUIT, and Colorado Quitnet at www.co.qiutnet.com are free services for all Colorado residents that offer counseling in smoking and smokeless tobacco cessation.