Though tobacco use among youth has been greatly curbed nationally in the last several decades, in certain cultures and communities, it can still be an issue. In fact, according to Center for Disease Control data, in 2013, an average of 6.4% of American middle school students and 22.9% American high school students were tobacco users. According to the Centers for Disease Control and Prevention, smoking and smokeless tobacco use is initiated and established during adolescence. More than 80 percent of adult smokers began smoking before the age of 18.

The Family Resource & Youth Service Center Directors in Bell County were keenly aware of this issue in their schools and reached out to the Bell County 4-H Program for help. The 4-H Agent designed and developed a program to address this need. The goal of the program was to make youth aware of the dangers of smoking cigarettes and using smokeless tobacco. They are given information about health effects of smoking, and discuss the ingredients in a cigarette and in smokeless tobacco. They calculate the cost of using tobacco. They do a physical activity while breathing through straws and coffee stirrers to simulate what it would feel like to struggle to breathe. They are shown a specimen of a healthy lung compared to an emphysema lung, and they are shown interactive models, "Mr. Dip Lip" and "Foul Mouth". The interactive models reveal the oral health problems that result from using tobacco, like gum disease, tooth decay, and lip and tongue cancer lesions.  

The program has been delivered by the 4-H Agent and many different partners over the years (other Agents, Registered Nurses, former tobacco users, concerned teachers, coaches, and school faculty) to hundreds of Bell County youth with much initial and intermediate success. 

Recently, the 4-H Agent had an opportunity to have a conversation with a high school junior at a Bell County High School Career Fair who had experienced the program as a 6th grade student. When he was in the program in 2013 and the 4-H Agent asked if he would like to pledge not to use tobacco in the sixth grade, his answer stood out. Many youth will make pledges that show that they have taken information away from the program, such as, "I pledge not to smoke because I don't want secondhand smoke to hurt those around me," or "I pledge not to dip because I don't want my teeth to decay." This young man, in 2013, said, "It's a little too late for that," and admitted that he did use smokeless tobacco regularly. So when the 4-H Agent saw him, she remembered and inquired, "Are you still dipping?" 

The young man responded that he had quit using tobacco! "That Mr. Dip Lip you brought to school was so gross! And I just decided there's a lot of other things that I want to spend my money on other than dip," he said. 

While the intermediate success and reach of the program has shown successful results since its implementation in prevention of tobacco use, for this young man to have quit using tobacco as a result of this program is a long-term success that will have lifelong beneficial health implications for him. Studies show that individuals who stop using tobacco increase their life expectancy, reduce their risk of stroke, cancer, high blood pressure, gingivitis, tooth decay and tooth loss.