Health professionals in the region are fighting back, however.

In Crook County, they’ve made some inroads by targeting an influx of new health care professionals to the area. Reaching out to health care professionals, Williams said, has shown effectiveness at turning people away from tobacco because people tend to trust their nurses, doctors and dentists when it comes to health matters.  

And that single bike trail in Prineville? The area is actively working toward more bike and pedestrian paths in the future.

Progress also can be seen in Ulyatt’s own neighborhood.

When she moved to Deschutes River Woods in 2001, nearly everyone smoked. They’d have weekly “hangouts” and smoke around a campfire.

When Ulyatt quit in July, however, she was the second-to-last holdout amongst her neighbors.

She said Bend’s effort to “get out of the smoker’s lounge” helped her, through simple peer pressure.

“Everyone kind of wants to fit in and I think that’s why people start when they’re younger,” Ulyatt said. “But now everyone is quitting, so that’s the thing people do to fit in. I know I want to fit in that way.”