Doctors have little training regarding pregnant people with disabilities. Credit: Frank de Kleine / flickr creative commons


By Rose Hoban

New data from the Centers for Disease Control and Prevention show almost 10 percent of North Carolina women smoked while they were pregnant.

The researchers found a surprising number of pregnant women still smoked cigarettes, a cause of often-dramatically higher cadmium blood levels. Photo by Fried Dough, courtesy Flickr Creative Commons
Photo by Fried Dough, courtesy Flickr Creative Commons

Smoking during pregnancy is one of the prime risk factors for infant death. The new data for 2014 show 9.8 percent of pregnant women in North Carolina smoked during pregnancy and 13.3 percent were smoking in the three months prior to becoming pregnant.

In many counties, however, more than 20 percent of pregnant women continued smoking, and in mountain counties Graham and Allegheny more than 30 percent of babies were born to women who smoked, according to 2014 state data.

North Carolina has one of the worst infant mortality rates in the country, with 7.1 infant deaths per 1,000 live births, compared to a national average of about 6.0 deaths per 1,000.

The state has struggled to improve outcomes for newborns. But the rate has remained stubbornly high, as have the rates of low birth-weight babies, which is a risk factor for infant death.

Smoking during pregnancy has been shown to contribute to both low birth weight and infant death, as well as to preterm birth.

Across the U.S., Native Americans had the highest pregnancy smoking rates, at 18 percent, followed by whites (12.2), blacks (6.8) and Latinos (2.0).  Nationwide, young women between the ages of 20 and 24 were most likely to continue puffing while pregnant.

BRFSS_TobaccoResearch shows that investing a dollar in tobacco cessation saves three dollars in health care costs, said Tom Vitaglione, a long-time advocate for children’s health issues.

Progress halted

For years, North Carolina saw a decreasing rates of cigarette smoking for teens. Then in 2012, the General Assembly all but eliminated funding for teen tobacco-cessation programs. The legislature also eliminated state funding for You Quit, Two Quit, a program aimed at helping pregnant women stop smoking.

“If you’re smoking while pregnant, the baby is smoking as well, and that program is not funded,” Vitaglione said. “We’re hoping that the General Assembly will take a good look at this and realize that it’s money saved, and to put a special emphasis on the prenatal period.”

Since funding for North Carolina's teen smoking cessation program was cut, more teens are using nicotine, either by lighting up or using e-cigarettes.
Since funding for North Carolina’s teen smoking-cessation program was cut, more teens are using nicotine, either by lighting up or using e-cigarettes. Photo courtesy Nerissa’s Ring, flickr creative commons

Rates have inched up for teens since 2012, but have skyrocketed in the past three years for teens using e-cigarettes. A growing body of data exists on the effects of e-cigarette use on fetal development; nicotine from the devices is able to cross the placenta. Research has shown nicotine impairs neurological development and constricts blood vessels, among other effects.

North Carolina rates are in the middle of the pack for the U.S.: The state with the highest rate is West Virginia, where 27.1 percent of pregnant women were smokers, while only 1.8 percent of California women lit up during pregnancy.

North Carolina has one of the lowest excise taxes for cigarettes in the nation, at 45 cents per pack, despite decades of research showing that increasing cigarette taxes decreases the rate of smoking.

“We know for every 10 percent that we increase the tax, we’re able to reduce the overall smoking rates by 4 percent, and it’s higher for children than for adults,” said Christine Weason, a lobbyist for the American Cancer Society.

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