Smokeless tobacco use among women living in rural areas is poorly understood and largely ignored. This qualitative study explored the use of smokeless tobacco with 10 participants living in rural areas in Alabama, with the women telling their own stories of use. Themes emerging from interviews included the initiation of use, secrecy, health-risk beliefs, daily-use patterns, and thoughts about quitting. The study results could assist community health nurses in awareness of risks, case finding, and development of community-based prevention strategies. Additional research would help better understanding of the epidemiology of the problem, cultural implications, and practice interventions.