State’s smoking rate still high

Smoking by women is one of the gravest preventive health concerns in Kentucky. While numerous smoking cessation and public health programs have been initiated to address the problem, Kentucky women continue to smoke in numbers that lead the nation and they are not quitting or even trying to quit, according to health experts at the University of Kentucky.

The median state prevalence of current smoking was 22.4 percent, but Kentucky prevalence is 34.7 percent (the next highest was West Virginia at 34 percent), while the median percent of daily smokers who quit is 39.8 percent - in Kentucky, it’s only 28.9 percent, according to data from the Center for the Advancement of Women’s Health at the University of Kentucky in Lexington.

Further, the median percent of daily smokers who made a quit attempt was 58 percent, but in Kentucky it was only 43.4 percent.

“So we are not quitting in Kentucky,” said Dr. Leslie Crofford, the center’s director. “We’re not even trying to quit.”

Gov. Steve Beshear last week announced a major public health initiative to curb smoking in Kentucky, in the face of mounting evidence that the problem is becoming more costly to the state in both financial and health terms.

An analysis of smoking behaviors of Kentucky Women’s Health Registry participants by Angela Brumley-Shelton for UK’s College of Public Health found that Kentucky women consistently have high-ranking morbidity rates for conditions most closely associated with smoking, such as heart disease, stroke and lack of physical activity. They are also likely to have insufficient or no health insurance coverage than women in nearby states, according to Shelton.

Kentucky also far exceeds the nation in current smokers among both women of child-bearing age (34.7 percent vs. 22.4 percent) and pregnant women (26.3 percent vs. 10.7 percent), making smoking a significant public health concern and the necessity for accessible and effective smoking cessation intervention for low income women clear, the Kentucky Cabinet for Health and Family Services’ Pregnancy Risk Assessment and Monitoring System 2008 report concluded.

The Centers for Disease Control and Prevention reports that women who smoke during pregnancy increase the risk that their infants will suffer from low birth weight, intrauterine growth retardation, prematurity, various respiratory diseases and infant mortality. According to “The Health Consequences of Smoking; a report of the Surgeon General,” smoking during pregnancy increases the risk for and exacerbates several pregnancy complications such as premature rupture of the membranes, infections, placenta previa and placental abruption, all of which are associated with preterm birth.

“We have a high rate of pregnant women who are smokers here,” said Joyce Adkins, a health educator at the Barren River Area District Health Department, “but the rate in Warren County is lower than the statewide percentage.”

While the state percentage hovers around 26.5 percent each year, the percentage of pregnant Warren County smokers is 17.9 percent, lower also than the eight-county Barren River District Area’s 27.1 percent, according to Adkins. Smoking is not only a significant contributing factor in miscarriages, but in Sudden Infant Death Syndrome cases as well, she added.

Registered nurse Susan H. Brown, Kentucky Folic Acid Campaign coordinator, works with breastfeeding women at the Barren River District Office in her capacity as a public heath educator. She uses a breathing device similar to a breathalizer to show women carbon dioxide levels in their bodies.

“It’s an eye-opener,” Brown said. “One of the biggest surprises people have is learning about the risk smoking presents to the unborn baby. A lot of people say they plan to quit once the baby is born, but the risk to baby prior to birth is also high.”

Brown also said there is a trend in late pre-term births, an outcome also closely tied to smoking.

“From 1992 to 2002 gestational time was reduced by a week - from 40 weeks to 39 weeks. That is not an evolutionary change, it’s a man-made change.”

Smoking is twice as devastating for women in terms of cardiovascular disease, said Dr. Randy Hansbrough, a pulmonologist at Graves-Gilbert Clinic in Bowling Green. For a man who smokes 10 to 20 cigarettes per day, risk for heart attack increases threefold, while the odds for a woman who smokes the same amount increase sixfold, Hansbrough said.

Smoking cessation efforts usually do not work, Hansbrough said.

“Nothing really works,” he said, “unless an individual is really motivated to quit.”

Even then, statistics for quitters are not good. Within one year of quitting, half of all former smokers will have started smoking again and 30 percent will have started again after two years, Hansbrough said. The best way to quit is through using medicines and a smoking cessation program, he added.

By LIZ SWITZER, The Daily News, [email protected]/783-3240
November 2, 2009

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