TOPEKA — A recent survey of birth-certificate data shows that in 2009, more than 6,200 Kansas women smoked while pregnant.

Smoking during pregnancy is harmful to the fetus and increases the risk that the mother will deliver and unhealthy infant.

“All the carcinogens that are in tobacco pass directly from the mother’s bloodstream to the baby’s bloodstream,” said Candace Ayers, a section director at the Kansas Department of Health and Environment. “(Smoking) does all kinds of damage.”

Babies born to women who smoke are more likely to premature and have low- birth weight. They also are at increased risk of Sudden Infant Death Syndrome.

According to the survey, 15.2 percent of the state’s pregnant women smoked while pregnant: 6,163 women reported smoking in the first three months of pregnancy, 5,460 reported smoking in the second trimester and 5,246 smoked in the final three months of pregnancy.

In 2009, 10 perent of the babies born in Kansas weighed less the 200 grams, a threshold for being considered low-birth weight. In recent years, Medicaid has paid for roughly 40 percent of the births in Kansas, costing taxpayers more than $100 million annually. Medicaid, financed by a mix of state and federal funds, underwrites health care for the poor and low-income.

The survey findings, included in KDHE’s latest Health Statistics Report and in the department’s Annual Summary of Vital Statistics, were based on birth-certificate data that until last year had been collected but not compiled and reported by health officials.

Identifying the pockets

“The concern has been that the information may not be 100 percent accurate – that women who smoke may not tell their doctors that they’re smoking, or that the doctors, for whatever reason, leaves it off the form,” Ayers said. “But now, the thinking is that even if the information is not totally accurate, it’s still really good at helping us identify the pockets where intervention efforts will do the most good.

“The other thing is that if anything, the numbers are low,” Ayers said. “I doubt very much that someone is going to say they were smoking during their pregnancy when they really weren’t. It’s more likely the other way around.”

In 52 of the state’s 105 counties, according to the survey, more than 20 percent of the pregnant women smoked during their pregnancies; in nine counties more than 30 percent smoked while pregnant.

In Chautauqua County in southeast Kansas, 40.5 percent of the women smoked while pregnant, according to the survey. No county had a higher percentage

No surprise

The finding came as no surprise to Chautauqua County Health Department Administrator Jeanie Beason.

“This is a very low-income county with very few job opportunites,” she said, “and I think that we all know that for whatever reason, poverty and smoking pretty much go hand in hand.”

The health department, Beason said, has seen a “good number” of the women who smoked while pregnant.

“What they tell us is that they started smoking when they were young and now they’re addicted,” she said. “They’d like to quit, but they’re not ready. We do what we can to help but until they’re ready, there’s not much you can do, really.”

The department’s efforts are hampered by funding shortfalls, Beason said.

“We’re small and we’re poor,” she said of the agency. “We’re working with some other counties to try to get something going on a regional basis because we can’t take on more than what we’re already doing.”

Several other counties also reported high incidence of smoking. In Atchison, Barber, Ottawa and Woodson counties, more than one in three women smoked during their pregnancies.

In 12 Kansas counties, fewer than 10 percent of the pregnant women smoked.

In Johnson County, the state’s most populated and one of its most affluent, 5.5 percent of the women smoked during their pregnancies.

“Our overall smoking rate, which pregnant women are part of, has been below the state’s for several years now,” said Nicole Brown, chronic disease coordinator at the Johnson County Health Department.

Smoking bans and education credited

Brown attributed to below-average rate to past education campaigns, ongoing access to cessation services and to Johnson County adopting clean-air ordinances ahead of most of the rest of the state.

“Probably 90 percent of our population was covered by fairly comprehensive clean indoor-air laws prior to the state passing its law,” she said. “We stared passing (anti-smoking) laws in 2005, 2006 and 2007. A lot of studies have shown that these laws drive down smoking prevalence,” Brown said.

Kansas began its statewide ban on indoor, public smoking in July 2010.

“The other thing,” Brown said, “is we’ve had a lot of really well-coordinated, multi-faceted community education that’s gone on here. We work with the schools, with the local universities and with the (Kansas University) Medical Center. We’ve been very fortunate. We’ve been able to put a lot of resources into this.”

The percentages in other urban counties including Sedgwick, Shawnee, and Wyandotte were considerably higher:

• Wyandotte County – 13 percent

• Shawnee County – 22.4 percent

• Sedgwick County – 15.7 percent.

Powerful addiction

Mary Jane Hellebust with the Tobacco Free Kansas Coalition said the survey also underscored how difficult it is to quit smoking once one has the habit.

“What I think these numbers speak to is the addictiveness of tobacco,” said Mary Jayne Hellebust of the Tobacco Free Kansas Coalition. “I find it hard to believe many, many of these women don’t know that tobacco is not good for them and not good for their babies, but they’re addicted. And that addiction is very powerful.”