(June 20, 2005) - A Democrat and Chronicle editorial ("The decline of smoking," June 6) commended New York state for its efforts to end smoking, and certainly the decline in smoking is worth celebrating. However, one category of smokers remains of great c

After peaking in 2001 at 19 percent, the percentage of Monroe County women who smoked during pregnancy declined to 15.6 percent in 2003. While any decline is good news, these statistics mask two chilling facts: Even at 15 percent, there were 1,380 babies born in Monroe County in 2003 who were poisoned by the most toxic form of secondhand smoke. There are pockets of far higher tobacco use in Monroe County. The impact of mom's smoking will stay with these babies their entire lives, and will cost all of us in support services, increased medical insurance costs and lost opportunities. Compared with nonsmokers, pregnant smokers are up to two times more likely to deliver babies pre-term, as much as 10 times more likely to have babies who are small for their gestational age, and up to 3.5 times more likely to deliver low-birth-weight babies. Mothers who smoke during or after pregnancy are three times more likely to lose their babies to Sudden Infant Death Syndrome. Prematurity is the leading killer of babies in their first month of life and a major cause of long-term health problems, including cerebral palsy, mental retardation, blindness and chronic lung problems, including asthma. Low-birth-weight children score significantly lower on intelligence tests than do children of normal birth weight, even when other risk factors are taken into account. The community as a whole has a vested interest in helping women stop smoking. Two myths get in the way. Myth No. 1: Women who smoke are just lazy and could quit if they wanted to. Even tobacco companies have been forced to acknowledge that their product is viciously addictive. Chemicals in cigarettes act as a mood enhancer; smoking is a way of self-medicating. Quitting smoking is difficult for anyone; it is especially difficult during the often stressful time of pregnancy. Myth No. 2: Because pregnant women cannot be given nicotine-replacement therapy, there is nothing that can be done to help them. It is true that helping pregnant women quit is not as simple as giving them the patch. However, there are also some supporting factors. For many women, pregnancy and the health of their babies are stronger motivators than their own health for quitting smoking. And during pregnancy, there are more frequent interactions with medical personnel who can provide intervention. Pregnant women who smoke can be helped. The first step is to ask (and ask, and ask again): Are you smoking and do you know what smoking does to your baby? Medical and human service providers can be trained in a brief intervention called the "5 A's" and in other techniques that have proved effective in helping women quit. The key is not to give up. Stopping smoking will help even at later stages of pregnancy. The Perinatal Network of Monroe County and our partners in the Smoking Cessation Coalition will host a conference on June 23 at which local and national experts will present the latest tools and techniques demonstrated to help women quit smoking and other addictions. Health and human service providers are invited to join us to learn what they can do to make a difference that could save a baby's life. Brantingham is executive director, Perinatal Network of Monroe County.

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