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September 2, 2009

STEPHANIE SALTER: Big surprise: Indiana’s in the Top 10 for pregnant smokers

By Stephanie Salter

TERRE HAUTE — If Hoosiers or Americans in general really acknowledged the health threat that is smoking, we would have declared a real national war on tobacco addiction — complete with readily available smoking cessation programs and the prescription aids to go with them.

Instead, we continue to wag our fingers with radio, television and billboard PSAs and struggle to enact piecemeal anti-smoking legislation in this county or that city, often to see efforts fail because public smoking is portrayed as pro-business and pro-individual rights.

We also tend to levy sin taxes on cigarettes to dissuade people from smoking, but we dilute the potency of such taxes by (a) using the money to finance state programs that have zero to do with smoking cessation and (b) provide little or no help for poor people who are priced out of their cigarette addiction and slammed into withdrawal.

A recent study on pregnant women and cigarettes, alcohol and drugs was conducted by researchers at Indiana University. They found that 18,000 babies are born each year in this state to mothers who smoke. That number put Indiana seventh in the nation for pregnant smokers. (The alcohol and drug numbers are smaller, but no less serious.)

Indiana also is near the top among general population smokers. This spring, the Centers for Disease Control and Prevention released state-by-state smoking rates, and the online site WebMD used the figures to rank 50 states and the District of Columbia.

Indiana is sixth in the nation in the number of adults who smoke. Nearly one-fourth of all Hoosier men — 24.1 percent — smoke, as do 22.4 percent of women.

Kentucky leads the country with 28.3 percent of its population hooked on cigarettes. Utah is at the bottom with only 11.7 percent classified as smokers.

When I use the word “hooked,” I am not being hyperbolic. A non-smoker my entire life (there but for the grace of physical revulsion go I), I have watched friends and loved ones of all ages and levels of education and economics battle their cigarette habits. I’ve seen many of these folks quit and stay smoke-free. But I’ve seen almost as many start again, try something else to stop, fail, give up for a few more years then try again and fail.

A man I interviewed once told me he had kicked both heroin and cigarettes, and the cigarettes were, by far, the harder to stop for good.

Several years ago, I watched my generous and much-loved aunt, diagnosed with terminal lung cancer, go cigarette-free for the first time in her adult life — for a couple of weeks. In her 70s, with grandchildren she adored, she nevertheless started sneaking cigarettes in the bathroom, as if she were again a teenager.

Those of us on her hospice caregivers’ team finally begged her to stop the charade and smoke in front of us because we didn’t want her going up in flames when she forgot to remove her oxygen canula from her nose.

What difference did it make? God bless her, her cigarettes were a huge part of maintaining some quality of life over her final few months. What were we going to argue: It will hurt your health?

Since then, I’ve encountered numerous women and men in similar situations. Non-addicts can look at them and sniff about how irrational their behavior is, but irrationality is a hallmark of addiction. Almost all smokers have administered lectures and heaped ridicule upon themselves, especially when they’ve gone for weeks or months without smoking, then succumbed when a crisis or intensified life stress has driven them back to their pernicious, but oh-so-comforting pal.

An addictions counselor I know is himself a former smoker. (He has to remain anonymous because he isn’t authorized to speak about the various agencies and programs for which he works.) Smoking cessation resources do exist in Indiana, he said, but they aren’t well-utilized because the state still hasn’t mustered the political will to motivate people to use the programs.

“There is a reason California, the most-populous state in the country, has the second-lowest incidence of smoking while Indiana has the sixth-highest,” he said. “California has changed its culture through laws that made just about every inch of public space smoke-free. Here, smoking is still socially acceptable.

“Until tobacco is too expensive and relegated to personal homes and cars, you just can’t motivate people to do the hard, hard work of quitting.”

One of the resources available here is 1-800-QUIT NOW, the official state “quit line” that will connect people who want to stop smoking with information about everything from local programs to prescriptions. Pregnant women can receive 10 phone counseling sessions for free.

“The thing is,” the counselor said, “a lot of people in Indiana who are addicted to cigarettes are poor. They may have cell phones, but they don’t have cell phones with unlimited minutes. That may not seem like a big deal, but it is if you have to weigh spending all your minutes on phone counseling.”

Poor smokers, the counselor said, “are living from one moment to the next and they’re not all that optimistic about their future in the first place. That has got to be taken into account when you’re trying to get them to stop. People with money, good insurance and postgraduate educations have a terrible time quitting. Being poor makes it that much harder.”

Maybe one day we’ll accept that and get serious about real remedies. In the meantime, somebody needs to pray for those 18,000 babies — and their moms.



Stephanie Salter can be reached at (812) 231-4229 or stephanie.salter@tribstar.com.

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