Everyone knows that smoking causes health problems for the smoker. Smoking during pregnancy, however, causes a wide variety of additional health problems for the mother, the fetus and newborn.

The American Lung Association is especially concerned about the higher incidence of low-birth weight babies born to smokers, because they are at increased risk for breathing problems. Children exposed to secondhand smoke also are more likely to develop asthma.

A recent report by the Maine Center for Disease Control deserves wide public attention and policy action. It reviewed 22 years of data comparing the smoking rate during pregnancy for women who are covered by MaineCare to those who are not.

The good news is that progress in reducing smoking during pregnancy has been made in both groups. Unfortunately, the degree of success for low-income women has lagged behind significantly.

From 1990 until 2011, the smoking rate dropped 68 percent among pregnant women who were not enrolled in Medicaid. While the rate also dropped for women covered by Medicaid, it dropped only 27 percent in this same period.

It is encouraging to see this progress, but it is alarming that more than one-third of low-income women still smoke during pregnancy. We need to implement strategies that have been shown to drive down the smoking rate among this group.

Maine is one of the few states that continues to invest part of its tobacco settlement money through the Fund for a Healthy Maine in smoking prevention and helping smokers quit. Reducing smoking during pregnancy among all women and eliminating this health disparity needs to become one of Maine’s top public health priorities.

Edward Miller


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