Women who smoke while pregnant may harm themselves and baby


November 03, 1992|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

The tobacco industry spends $5,000 a minute advertising cigarettes in this country. As a result, we pay $65 billion each year in health-care costs and lost productivity. And five years ago, lung cancer surpassed breast cancer as the leading cause of cancer death in women.

The American Lung Association (ALA) warns that women start )) smoking at a younger age than ever before, so pregnant women and their babies are at particular risk.

Q: Why is smoking so appealing to women, even if they are pregnant and aware of what it can do to their children?

A: Nicotine is the answer. This addictive substance is found only in the tobacco leaf, and high doses of it are used as a poison in insecticides. It is one of thousands of chemicals in cigarette smoke, where it appears in lesser amounts. When inhaled, nicotine stimulates nerve cells and smokers feel alert or relaxed, depending on the amount of nicotine and several other factors.

Q: How does nicotine have its addictive effects?

A: When inhaled, nicotine goes through the smoker's lungs, through the bloodstream and into the brain within seven seconds. The rapid, high dose is probably what causes the psychological stimulation. According to the ALA, nicotine affects other chemicals that regulate mood, learning, alertness the ability to concentrate and performance.

Q: How many women continue to smoke when they're pregnant?

A: Scientists estimate that up to 25 percent of pregnant American women smoke throughout pregnancy. Although the number of cigarettes smoked each day tends to decline, a substantial number of women continue to smoke a pack a day.

Q: What happens to the child of a woman who smokes when she's pregnant?

A: Again, nicotine is the known addictive substance in cigarette smoke, and the carbon monoxide present is known to be lethal in large quantities. There are actually several thousand chemicals, some of which are proven carcinogens, in cigarette smoke. While scientists can't say precisely how these chemicals affect the fetus, they are proven to cause reproductive problems. Among the risks to smokers are the reduction of blood flow and oxygen to the fetus, which can have profound implications, including spontaneous abortion, prematurity, low birth-weight and death after birth.

Q: How big a problem is it?

A: The U.S. surgeon general estimates that up to 5,000 infants die each year from health problems that could be linked to their mothers' smoking before they were born. In fact, Fetal Tobacco Syndrome is the term now applied to a group of factors that cause low birth-weight in particular.

Q: What can a woman do to kick the habit during pregnancy -- and, it is hoped, the rest of her life?

A: Support programs, clinics, video- and audiotapes and self-help books provide positive steps that can help the smoker through the difficult process of breaking the addiction. There is debate among physicians about whether pregnant women should have prescriptions for the two nicotine replacement products -- nicotine gum and skin patches. They supply low levels of nicotine that help overcome the addiction without the need to inhale the other chemicals. However, small amounts are transferred to the fetus.

Some health-care providers feel that since the levels are lower than in cigarette smoke, they help kick the habit when used in conjunction with other support programs. Check with your physician if you are trying to stop smoking for your health and the health of your baby.

For more information, contact the American Lung Association of Maryland Inc. 1840 York Road, Suite M, Timonium 21093. Call 560-2120.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Hygiene and Public Health.

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