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Local programs work to combat high smoking rate in pregnant women

Southeast Ohio’s rate of women who smoke while pregnant is three times the national rate.

Cathy Baker, a nursing professor at Ohio University’s College of Health Sciences and Professions, said that in southeast Ohio, approximately 30 to 35 percent of women reported smoking during the last three months of pregnancy, compared to a state rate of approximately 20 percent.

The national rate of women who smoke while pregnant is about 10 percent, according to the Centers for Disease Control and Prevention’s (CDC) 2011 survey called Pregnancy Risk Assessment and Monitoring System (PRAMS).


Several studies and programs have been launched in recent years to combat the issue, including an initiative called SAVE-A-MOM – Smokefree Air AVailable for Every Appalachian Mom – which was launched about two years ago. Baker and two colleagues partnered with local community action agencies and received a $3,000 grant from the Appalachian Rural Health Institute. Although the group dropped from three people to two, Baker, the principle investigator, said she is still applying for more funding sources.

SAVE-A-MOM was first implemented in Meigs County, and since then, the study has expanded to Athens County, Gallia County, Hocking County and Jackson County. Baker said that she and her colleagues did not select the order in which they studied each county because one had a particularly worse situation than the others. But, because Ohio University tends to skew data, they decided to look at counties without large universities for a more accurate representation before considering Athens.

“It’s an issue obviously not only for the women but for their babies,” Baker said, referring to problems such as low birth weight, sudden infant death syndrome and premature birth.

According to CDC data, smoking during pregnancy can also contribute to Attention Deficit/Hyperactivity Disorder (ADHD), miscarriage and certain birth defects and heart defects.

These problems make “a big difference in [a baby’s] starting life, and they tend to be delayed then for the rest of their developmental years,” Baker said. “That could be because, if a woman smokes during her entire pregnancy, she would probably continue to smoke in the early years around the child.”

Even if the woman quits during her pregnancy, starting back up again after delivery also means serious health consequences for her and the baby.

Through extensive interviews, she assesses “the attitude toward smoking: is it different compared to other areas of the state? And we have a lot of poverty in southeast Ohio, so we know that people who are (of) lower socio-economic status do have a higher rate of smoking. …That’s one piece of it.”

Baby and Me Tobacco Free

Graphic by Kelly Fisher

Kim Knapp-Browne is a smoking cessation coordinator who works with another program to help women stop smoking at the time of their pregnancy called Baby and Me Tobacco Free. The program, part of the community health programs at the Heritage College of Osteopathic Medicine, is possible through an Ohio Department of Health grant.

Baby and Me Tobacco Free is an active program in 44 states, and Knapp-Browne said it has “just taken off in Ohio.” Twenty-five Ohio counties, including Athens, have adopted the program, and within those 25 counties, 355 women are enrolled. The particular program in Athens has been operating since November 2014, and Knapp-Browne began working with it in the spring of 2015.

Knapp-Browne echoed Baker in that culture, poverty rates and education levels are large contributing factors to the issue.

“It’s kind of interesting that, (in) the population that I work with, it’s all about the stress. This is the way they deal with the stress in their lives,” Knapp-Browne said. “So when you think about the population, they don’t have much money. They can afford this, and it helps them feel better.”

Both programs serve young women; SAVE-A-MOM has interviewed 12 women in their 20s, and Baby and Me Tobacco Free has had a total of 45 women, ages 19 through 24, enrolled in Athens in the past year. Currently, Knapp-Browne is working with 16 women, four of whom have recently delivered their babies.

“You don’t need to be smoking to be part of this program. If you quit a month before you find out you’re pregnant, or two months, you’re still eligible,” Knapp-Browne said. “We want to make sure that even if they quit during pregnancy, they don’t go back to smoking toward the end or after they deliver, because there is a rise in women going back to smoking postpartum. It’s usually six months after they deliver.”

Provided the women are smoke-free throughout the program and up to a year after the birth, they are eligible for $25 vouchers, cashable at Walmart, to purchase items such as diapers.

The program entails four main educational sessions during the pregnancy with Knapp-Browne. “Sessions deal with second hand smoke, stress, nicotine, how addictive it is, and one of the big things is support. If they’re living in a household where everybody else is smoking around them (second-hand smoke), it’s very difficult sometimes to click.”

She uses a monitor to check each participant’s carbon monoxide level – everyone has carbon monoxide in his or her lungs, but the level increases when inhaling the 7,000 chemicals of a cigarette – to ensure that the women are not just saying that they quit. The monitor not only detects cigarette use, but things such as marijuana or e-cigarettes, too.

Both representatives of their respective initiatives also expressed the concern of women residing in households in which their other family members smoke; the problem is multi-generational, as it is often the woman’s siblings, parents, grandparents, etc.

Baker highlighted that smoking cessation in mothers is a much larger issue than just the woman and just during her pregnancy. She hopes her research will help pinpoint more contributing factors to the problem to better understand the support women in southeast Ohio need to quit.

Kelly is a senior who, aside from College Green Magazine, spends her time writing for WOUB’s culture blog, freelancing for the Athens News and editing Southeast Ohio Magazine. She’s fascinated by health news and loves data-driven journalism (creating spreadsheets, wrestling data out of the hands of government officials… all that fun, nerd stuff). This summer, she traveled to Leipzig, Germany for an internship program at the University of Leipzig’s student radio station, mephisto 97.6. After returning to the states, she interned at the Commercial Appeal, the daily newspaper in Memphis, Tennessee…

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