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Emerging Infectious Diseases Journal


Volume 2: No. 2, April 2005

Conducting a Successful “Through With Chew” Week


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Sylvia Bagdonas, Niki Mueller, Amy Russian

Suggested citation for this article: Bagdonas S, Mueller N, Russian A. Conducting a successful “Through with Chew” Week [abstract]. Prev Chronic Dis [serial online] 2005 Apr [date cited]. Available from: URL:


Track: Communications and Technology

An idea of the American Academy of Otolaryngology — Head and Neck Surgery, “Through With Chew” Week is an educational campaign designed to prevent and reduce the use of chew/spit tobacco, a type of tobacco use that has not received as much attention as cigarette smoking. The state of Wyoming successfully conducted a “Through With Chew” Week (including a Great American Spit Out Day) in February 2003. The statewide program targeted Wyoming’s small and rural population, which has a disproportionately high chew-tobacco-use rate — the second highest in the nation (Behavioral Risk Factor Surveillance System [BRFSS], Adult Tobacco Survey [ATS], 2003).

The component aims of the program were the following: 1) to educate the public about the extent of chew-tobacco use in Wyoming and its costly health implications for all citizens; 2) to conduct surveys to establish baseline data on current levels of prevention and intervention; 3) to partner with health care providers to promote quitting; 4) to counteradvertise the tobacco industry; and 5) to determine adaptations necessary for American Indian populations. Wyoming’s comprehensive statewide plan included tool kits, media kits, and “quit spit” kits for use by local program managers. Extensive media coverage included newspaper and pizza-box ads, television coverage, and presentations by Gruen Von Behrens, a 25-year-old man severely marred by oral cancer. Additional “guerrilla” advertising was conducted in barbershops, rodeos, fairgrounds, little league fields, bowling alleys, agriculture shops, and publications.

Follow-up surveys to Tobacco-Free Wyoming Communities and the dental community indicated that dental office interventions increased by 58%, and response volumes to Wyoming’s Quitline and QuitNet from chew tobacco users doubled. Wyoming’s “Through With Chew” campaign, including lessons learned and tangible tools for success, can be replicated easily in other states and communities.

Corresponding Author: Sylvia Bagdonas, MA, Tobacco Program Consultant, Wyoming Department of Health, Substance Abuse Division, 6101 Yellowstone Ave, Suite 220, Cheyenne, WY 82002. Telephone: 307-777-3690. E-mail:

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