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FOR RELEASE: April 11, 2000
CONTACT: Dick Gunn
405/271-5601

Maternal Smoking in Oklahoma Costs $14 Million Annually - Prevention Urged

One in every seven low birth weight (LBW) deliveries in Oklahoma is attributed to smoking during pregnancy, according to findings released this week by the Oklahoma State Department of Health in collaboration with the Department of Biostatistics and Epidemiology at the University of Oklahoma College of Public Health.

Researchers studying Oklahoma's maternal smoking problem report these low birth weight (less than 2500 grams) deliveries cost Oklahomans an excess $14.4 million each year in direct health care expenses.

State health data indicate nearly one in five pregnant women in Oklahoma smokes during her last three months of pregnancy. Among LBW infants, 29 percent of mothers smoke during pregnancy. The average excess hospital costs for each of these infants is $26,000. These costs do not include professional fees, which can add 10 to 20 percent to hospital charges. In addition to their initial medical treatment, many babies born too small will require long-term care.

Based on results in other states, health officials project that Oklahoma could dramatically reduce maternal smoking and the resulting number of LBW deliveries by investing in a statewide comprehensive tobacco use prevention and cessation program following the proven "four cornerstones" model. States that have funded comprehensive prevention and cessation programs based on the "four cornerstones for success" – community-based initiatives, classroom programs, counter-marketing media campaigns, and cessation assistance – have shown that maternal smoking can be reduced dramatically in just a few years. Massachusetts recently reported a 48 percent decline in smoking during pregnancy within the first five years of starting its statewide program. Meanwhile, rates in Oklahoma have remained constant over the last 10 years.

"These preventable low birth weight deliveries cause untold anguish among Oklahoma families," said State Health Commissioner J.R. Nida. "The immediate economic costs caused by these high-risk deliveries are staggering; however, the good news is that much of the human suffering and economic costs can be prevented."

LBW is the single greatest predictor of deaths during the first month of life. Babies that are born too small account for two-thirds of all deaths in the neonatal period. These infants are also at higher risk for neurological problems, severe mental retardation and lower respiratory tract conditions.

"If Oklahoma uses a sufficient portion of the tobacco settlement dollars to implement an effective tobacco use prevention and cessation program, we can prevent hundreds of Oklahoma families from having to suffer the consequences of LBW deliveries and we'll begin to save millions each year in excess health care costs," said Nida. "When costs from other tobacco-caused medical problems, including heart disease, cancers, strokes, and emphysema are included, the citizens of Oklahoma will ultimately save hundreds of millions of dollars each year by investing in a comprehensive program."

The study used smoking prevalence rates during the last trimester of pregnancy based on data from the state health department's 1998 Oklahoma Pregnancy Risk Assessment Monitoring System (PRAMS). Hospital costs were calculated using data from several major hospitals in the metropolitan Oklahoma City area.

Previous studies have estimated the total direct costs for treating tobacco-caused disease in Oklahoma at $690 million each year. When indirect costs, including missed workdays and lost productivity are included, the total annual costs in Oklahoma are estimated to exceed $1 billion each year, or an average of $300 each year for every person in the state. An effective statewide prevention and cessation program in Oklahoma has been projected to cost about $10 per person per year.

"This is simply a matter of saving lives and saving money. We can either prevent the problem before it occurs or pay the price in both human and economic costs later," said Nida.

Information on the proposed "four cornerstones" model for comprehensive tobacco use prevention and cessation in Oklahoma can be viewed on the state health department Web site located at www.health.state.ok.us.

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