Smoking is still the leading cause of preventable death in the United States.
In Colorado, it kills more people than HIV, illegal drug use, alcohol, motor vehicle accidents, suicide, and murder combined. It claims about 5,000 lives in the Centennial State every year. Despite this fact, state data shows nearly 16 percent of Colorado adults smoke.
How A Western Slope County Is Combating Tobacco Use
In Delta County 1 in 4 adults smoke.
Sarah Hall started smoking when she was a teenager.
"I really needed to quit smoking," said Hall. "I had been smoking for 20 years."
She tried to stop in the Navy, then again when she was pregnant, and again when her father-in-law died of lung cancer. Then she found out she was pregnant with her son.
"I wanted to have a much healthier pregnancy this time. I had a lot of labor complications with my daughter which ended up in an emergency C-section."
Hall signed up for the Baby and Me Tobacco Free program offered through the Delta County Public Health Department. The program helps expecting moms quit. It also offers incentives. For instance, the health department provides up to a year’s worth of free diapers if the mother stays smoke free.
Health educator Karen O’Brien said this is one way the county is trying to address the issue. It also works with the school district, hospital and health providers to educate the public about the dangers of tobacco use.
O’Brien said the most effective changes the county can make are smoke-free policies.
"Working in policy change at different organizations really can encompass the most individuals," she said. "The sustainability factor is if for some reason our funds get cut, which they do all of the time, those policies are still in place."
Several years ago, the county banned smoking inside public housing. And, last year it worked with the local technical college on implementing a tobacco-free campus policy.
Smoking Rates Vary By Community, How The State Is Tackling The Issue
Data complied by the Robert Wood Johnson Foundation and analyzed by Rocky Mountain PBS News shows smoking rates vary across the state. In Douglas County, one of the wealthiest counties in Colorado, only 8 percent of adults smoke. Huefano County, one of the poorest, has the highest rate at 31 percent.
Jill Bednarek oversees the Colorado Department of Public Health and Environment’s Tobacco Policy Initiatives program. She said smoking rates are linked to socioeconomics.
"Low-income communities, their prevalence was nearly three times that of their higher-income counterparts at about 27 percent," said Bednarek . "We see very significant disparities in tobacco use based on income level and education level. Those are the two biggest factors."
Research shows low-income individuals are usually dealing with more stress like living paycheck to paycheck. That’s why it can be harder for them to quit.
Bednarek said what seems to work is increasing the immediate cost. She points back to 2004, when Colorado voters approved boosting the excise tax on a pack of cigarettes by 64 cents.
"We did see a significant drop in prevalence right after that. Tobacco price increases are known to be particularly effective with youth, low-income smokers and pregnant women who are trying to quit."
She said raising the purchase age to 21 could also reduce use. In 2014, state lawmakers proposed doing just that, but the bill died in committee.
"When the age is 18, there are older kids who have products that are making it available to younger kids as well as illegal sales happening in retail outlets across the state. When the age in other states has gone up to 21, then they do see a decrease in use and initiation, particularly among those younger kids."
Still, Colorado’s efforts are paying off. The state has seen a steady decline in smoking rates for the past 25 years.
On average, the state gives $6 million annually to counties to combat tobacco use. It funds programs like the Delta County one that helped Hall quit.
"I’ve done some pretty great things in my life…having two children , being in the military, college, traveling the world, but I really think that quitting smoking was the hardest thing I ever did," she said.