During a meeting at Citrus Memorial Hospital, members of the Central Healthy Start Coalition focus on ways to get their message out.
By COLLEEN JENKINS
Published June 13, 2003
A woman who smokes during her pregnancy significantly increases her infant's risk of low weight at birth, premature delivery, sudden infant death syndrome, respiratory problems during childhood and learning disabilities.
So said Dr. Rose M. Sobel, a Crystal River obstetrician, to the Central Healthy Start Coalition members who gathered Thursday at Citrus Memorial Hospital for their triannual meeting.
The Healthy Start providers, who aim to provide risk screening to all of Florida's pregnant women and newborn infants, already knew the dire facts. Their daily challenge is to make that message stick with women and, in some cases, health care providers.
"What we're doing is working to a point, but it hasn't worked nearly as well as we'd like," said Mary Ann Maguire, program planner for the North Central Florida Health Planning Council, which oversees the Healthy Start coalition that serves Citrus, Hernando, Lake and Sumter counties.
Case in point: According to information provided by mothers on birth certificates, 9 percent of women in Florida smoked while pregnant in 2001. But in Citrus County, about 24 percent of women reported smoking during their pregnancies. Hernando County was only slightly lower with almost 21 percent.
The news isn't good, and health department workers aren't sure why pregnant smokers are so prevalent in the area.
It isn't that services aren't available. Expectant mothers eligible for Healthy Start prenatal care - meaning they typically have no insurance and no way to pay for care - can participate in a one-on-one smoking cessation program to help them quit.
The Citrus County Health Department also offers the American Lung Association's "Freedom from Smoking" program, which includes six to eight sessions for anyone age 18 or older who want to kick a smoking habit.
Plus, the American Lung Association in Citrus and Hernando counties sends JROTC students to fifth-grade classrooms to explain what smoking does to their bodies and why it's best to never pick up a cigarette in the first place, said Anne Black, coordinator for the organization's Nature Coast area.
However, the Legislature's decision to nearly wipe out the funding for the youth antitobacco initiative statewide means Black is now looking for a business to pick up the costs of providing these materials to Citrus County students. She already found a sponsor in Hernando County.
Asthma is the leading cause for school absences and trips to the emergency room for kids younger than 15, Black said. Many parents don't realize that smoking contributes to asthma flareups, either in their own bodies or in their children, she said.
"When you're pregnant and you smoke and you have asthma, you're in big trouble," Black said.
The Central Healthy Start Coalition's action plan for the next three years includes tackling the high rates of pregnant smokers in the four counties, Maguire said.
In Citrus, health department officials have said they might need to offer a smoking cessation class for pregnant women, with incentives to draw them in and motivate them to complete the program.
Sobel said a pregnancy is an effective time to combat smoking because mothers-to-be have continuing contact with their doctors, who can drive home the benefits of tossing out their cigarette packs.
"A mother is generally highly motivated to do what she can to help her baby," said Sobel, who works at Crystal River Women's Health Center and delivers babies at Citrus Memorial and Seven Rivers Community Hospital.
Janie Counts, program supervisor for Sumter County's Healthy Families program, said health care providers and educators should get graphic. She suggested distributing pictures of cancerous lungs, mouths and esophaguses, which often are linked to smoking.
"I really think we need to get down and dirty and show these moms what their insides look like," she said.
Margaret E. Purdy already goes there. As a human service counselor and certified childbirth educator for the Hernando County Health Department, she has a favorite analogy to use with expectant mothers who don't really understand what smoking does to them or their babies.
"It's like putting your mouth over the car exhaust," she said. "That's what you're taking into your body each time you put a cigarette in your mouth."
If that doesn't send a clear and unsettling message, she doesn't know what will.
