Lack of affordable healthy foods, abuse of alcohol, and lack of physical activity were among the top health concerns that 1,500 Douglas County residents expressed during a six-month community health assessment that included online surveys and in-person interviews.

Smoking was not on the list.

“I thought it was interesting that nobody talked about smoking or tobacco use, but we know that it is a big driver of poor health,” said Dan Partridge, director of the Lawrence-Douglas County Health Department. “When you look at the data, it looks like we have a lot of work to do when it comes to women who smoke during pregnancy.”

According to a new 38-page Community Health Assessment report, 13 percent of the live births in Douglas County in 2010, were to women who smoked during pregnancy. That’s up from 2006 when 11 percent smoked. It’s also higher than the national average of 10 percent.

Not only is the Douglas County rate going up, but it’s a long way from reaching the Healthy People 2020 object of less than 1.4 percent.

“We are 10-fold more than that and that’s concerning,” Partridge said.

Miranda Steele, spokeswoman for the Kansas Department of Health and Environment, said pregnancy smoking rates are likely higher for two reasons. First, the statistics are self-reported so women may not disclose the information to their doctors. Second, particularly among younger women, occasional smoking may be overlooked when asked by their physician if they are a smoker, resulting in misclassification.

In Douglas County, the percent of women smoking during pregnancy also is higher than the teen smoking rate of 5 percent in 2010, down from 7 percent in 2006.

Kim Ens, director of clinic services at the health department, said it’s not healthy for anyone to smoke, but it’s especially important for pregnant women because it affects the mother and her developing baby.

She said smoking during pregnancy can cause:

• Miscarriage.

• Problems with the placenta, which is the source of the baby’s food and oxygen. For example, the placenta can separate from the womb too early, causing bleeding, which is dangerous to the mother and baby.

• Premature births or babies born with a low birth weight making it more likely the baby will be sick and have to stay in the hospital longer. A few may even die.

• Sudden Infant Death Syndrome or SIDS.

• Birth defects like a cleft lip or cleft palate.

Ens said about 200 pregnant women are enrolled in the health department’s nutrition program for women, infants and children called WIC. About 15 percent of them report smoking.

“These aren’t huge numbers, but it’s a serious issue,” she said. “We encourage people to quit smoking before they get pregnant. If they are trying to get pregnant, they should stop smoking.”

They also shouldn’t pick up the habit again after giving birth. Second-hand smoke can cause problems for babies, including asthma, upper respiratory infections and ear infections. It also puts the child at risk for SIDS.

Ens said the health department has stepped up its efforts to help curb the problem by educating and training its nurses, WIC employees, case workers and other staff on how to more effectively influence their clients to quit smoking. They’ve also received in-depth training on smoking cessation resources like the Kansas Tobacco Quitline — 800-784-8669 or QuitNow.net/Kansas — which provides free one-on-one counseling.

“It is a hard addiction to quit,” Ens said. “So, we want to do a better job of offering help if someone is ready.”

TIPS TO HELP QUIT

Aynsley Anderson, community education coordinator at Lawrence Memorial Hospital, offered these resources for people who want to quit smoking:

• Kansas Tobacco Quitline. It is free and a counselor works with participants through emails, online chats or phone calls. Call 800-784-8669 or visit the website Quitnow.net/Kansas.

• Centers for Disease Control and Prevention — smokefree.gov.

• American Cancer Society — cancer.org.

• The National Partnership to Help Pregnant Smokers Quit — helppregnantsmokersquit.org.

• The American Lung Association — lung.org.

• The American Heart Association — heart.org.

Anderson teaches smoking cessation classes and can provide them anywhere, such as a workplace or church, for free as long as there are five participants. Her next class at LMH, 325 Maine, will be from 6 p.m. to 7:30 p.m. Aug. 14 and advance registration is required. Contact Anderson at 505-3066 or aynsley.anderson@lmh.org.