A Common Enemy


​It’s September 2001. As our communities rally against the attack on our way of life, we find ourselves united with one message of hope and resilience. We have come under attack before, but through collaboration and cooperation at the basic community level, we now find ourselves working together under one accord to fight a common enemy. If successful, preventing other attacks will strengthen our resolve and save thousands of lives. But if we divert our focus, and become unable to fight off additional attacks, new enemies will surface, and we will begin to lose the war. ​​​​​​

And, yes, the assault on the World Trade Center and Pentagon has indeed changed our way of life, but that event, which mobilized our democracy and unified a nation, was not to which I was referring. It was, simply, our commitment to stronger, healthier communities in tackling tobacco and nicotine addiction.

In 2001, this movement was valued fiscally and much more of a concern comprehensively than it is today. It is for that reason why I think we, as prevention professionals, have a public health obligation to protect our communities and ‘get back to basics.’

When I started working in prevention with Community Connections twenty years ago, we worked to establish a direct line of communication with the WV Division of Tobacco Prevention (DTP). We had amazing relationships established with Bruce Adkins and the entire team. We were able to mobilize with grants for individual coalitions to help promote activities in schools, train others on the value of the NOT ON TOBACCO program, do cessation activities and even have the latest resources and promotional support through the WV Tobacco Clearinghouse, a centralized repository housed at the WV Division of Culture and History building on the Capitol grounds.

We were mobilized. We had teams within our schools and did compliance checks even whe​n it wasn’t time for SYNAR inspections. Mini grants for my own coalition in Mercer County totaled nearly $20,000 annually, and we put the tobacco education in ATOD!

We organized special game nights with our minor league baseball teams, the Bluefield Orioles and Princeton Rays, and had partnerships with Dick Meckstoth and the West Virginia Dental Association on the harmful effects of spit tobacco. The National Spit Tobacco Education Program (NSTEP) was essential in sharing an anti-tobacco message to local sports teams; Gruen Von Behrens, NSTEP’s national spokesperson, shared his testimony in visits to our area schools. When you see a pitcher, first baseman, or outfielder with cheeks streamed with salt from an hour’s worth of tears, lay down a snuff can on the stage and walk out of the room, you know you have had an impact.

Around 2003, the state reorganized. No longer would coalitions act independently, but ten regional initiatives would help guide the direction for our efforts. Armed with variable strategies of policy, education, and a willingness to formulate coalitions around the Strategic Prevention Framework, these organizations met with local health departments, school boards, county commissions, and the state legislature to share that if we could work together, we could prevent people from using a product that, according to the package, will kill you.

Raze, a youth movement, worked to “tear down the lies of big tobacco.” Thousands of youth from across the state would cause “commotions” and partner with adults to call 1-877-966-8784 (now, 1-800-QUITNOW) and share the message that “Smokeless Does Not Mean Harmless.” Murals and billboards shared the message that destructive decisions were not only harmful to the individual, but to all. With the help of DTP, a few prevention-themed barns were painted around the state, much like the Mail Pouch barns of years past.

We pushed to educate coal miners about the dangers of poly-use of products (smoking above ground and smokeless below), and we worked to educate mothers of newborns and pregnant women who smoked. We reached out to veterinarians to promote proper cessation and calls to the WV Tobacco Quitline in the hopes that if people wouldn’t stop producing secondhand smoke for their kids, that they may do it for their pets. We also engaged our African American population for their disproportionate use of menthol-based products, and guided churches to preach prevention from the pulpit.

Unfortunately, the harder we worked, the less we became relevant. Opioids were ravaging our state and vaping began to replace other ‘crisis’ products like SNUS and Cigarillos. The ten region network decreased to six, and then as relevancy continued to diminish, the monies to prevent one of the most addictive substances that impacts all West Virginians was no more.

Flash forward to today. We know more about the harmful effects of nicotine delivery devices and traditional tobacco products than ever before. Our communities want to help to stop a new generation of addiction within our middle school population and the science has shown that those suffering the most from COVID-19 are those that do not have the lung capacity to overcome the disease.

To help alleviate a new growing epidemic within our public health system, the West Virginia Tobacco Use Prevention and Cessation Task Force came to be. With my passion for prevention, I’m honored to be part of initiative with so many talented and dedicated people. This appointed body devised a strategic initiative to use the plans developed by DTP and formulate a plan to solve the issues at hand. This plan, available online at https://issuu.com/thinkkidswv/docs/2021_final_report-_tobacco_use_prevention_and_cess​, provides the strategies needed to drive down this public health crisis and outlines the funding needed to reconstruct a comprehensive system that was once called “revolutionary” by the Centers for Disease Control and Prevention (CDC).

Statistics show increases in West Virginia youth starting tobacco/vaping products during the pandemic and that West Virginia adult smoking rates are still the highest in the nation. As noted in the report, tobacco prevention strategies in West Virginia receive approximately $445,000, compared to the $27.4 million recommended by the CDC for effective prevention and cessation programs and initiatives. Sadly, one in three West Virginian teens vape. This is an epidemic all on its own and, while people worry about opioids (and rightfully so), if we know that if the correlation of addiction is true, then focusing on tobacco prevention strategies can also be productive in driving down other addictions.

In the last twenty years, we have had tremendous success and monumental loss. Population level change through evidence-based environmental strategies drives down numbers of 30-day and lifetime usage rates, increases health policies to promote healthy workplaces, and decreases our overall lifetime health care dependency by millions of dollars. The fact is that if we don’t start treating our basic, most foundational source of addiction like an attack on our way of life, then we will never understand how to overcome and unite against an enemy. It’s simply putting our communities first. And that is one attack we should “Never Forget!” ​​

Contact Information

Greg Puckett is a Mercer County Commissioner and Chair of the National Association of Counties (NACo) Rural Action Caucus. He has served on NACo’s National Opioid Taskforce and is on the Exective Director of Community Connections.