As someone working in this field, I am far too familiar with the importance of maternal health to child development. During my pregnancy, I was constantly stressing myself out trying to make sure that I was eating all of the right things, exercising enough, gaining enough weight—but not too much. I tried my best—with all of my resources and supports—to increase the likelihood of a healthy birth. It’s hard to imagine smoking during my pregnancy—even back in 2008 when my daughter was born. Yet, in Michigan nearly one in five births in 2014 was to a mother who smoked during her pregnancy. That’s actually an increase from 2008.
Why, in 2014, were so many expectant moms smoking and why has it increased? The Right Start: 2016 Annual Report on Maternal and Child Health – Mothers Smoking During Pregnancy Increased Since 2008, Disparities Exist by Race & Place reveals that state efforts targeted to help pregnant women quit smoking are very minimal. Tobacco Settlement dollars continue to be redirected to support unrelated activities and the tobacco industry spends nearly $190 on marketing for every $1 dollar spent by the state on smoking prevention.
The American Lung Association grades Michigan an “F” in funding for smoking prevention and cessation and for access to these programs.
So, while over 19% of births in Michigan were to mothers who smoked during their pregnancy, less than 2% of mothers reported receiving classes or support for smoking cessation and only 5% of mothers who smoked during the last three months of pregnancy were referred to a smoking cessation program. And, most adult smokers started smoking before or at age 18. Evidence-based prevention and smoking cessation programs need to be supported, expanded and targeted.
Smoking during pregnancy—or even being exposed to smoke in a household—is extremely harmful for babies. It can cause a number of complications at birth, low birthweight in babies, birth defects and increase the likelihood of a sleep-related infant death. It can also result in babies being born too early.
In Michigan, according to the new report, preterm births are also on the rise. In 2014, over 12% of births were considered preterm (less than 37 weeks gestation), which is more than a 20% rate increase from 2008. Babies who are born too early or too small often face adverse health outcomes both in the short- and long-term. For example, children who are born preterm and whose mothers smoked during pregnancy are at a higher risk of chronic lung disease and asthma.
Maternal and child health outcomes vary by race and ethnicity and geography. While White women have the highest rates of smoking during pregnancy, the rate of smoking increased the most for Latina mothers. The rate of babies born too early has also increased for Whites, African-Americans and Hispanics with African-Americans having the highest rate of preterm births. Higher smoking rates also tend to be found in counties with smaller populations and seem to be concentrated in the lower northern part of the state. Information on maternal and child health is also available online by county and for Michigan’s 69 largest cities and townships at the Kids Count Data Center.
All mothers want the best for their babies. Because of institutional and geographic barriers, efforts to prevent and help expectant mothers quit smoking need to be targeted and evidence-based. Smoking is one of the most preventable behaviors. We need to do more to ensure that moms and babies are healthy.
Emily Jorgensen joined the Michigan League for Public Policy in July 2019. She deeply cares about the well-being of individuals and families and has a great love for Michigan. She is grateful that her position at the League enables her to combine these passions and work to help promote policies that will lead to better opportunities and security for all Michiganders.
Jacob Kaplan 
Mikell Frey is a communications professional with a passion for using the art of storytelling to positively impact lives. She strongly believes that positive social change can be inspired by the sharing of data-driven information coupled with the unique perspectives of people from all walks of life across Michigan, especially those who have faced extraordinary barriers. 
Rachel Richards rejoined the League in December 2020 as the Fiscal Policy Director working on state budget and tax policies. Prior to returning to the League, she served as the Director of Legislative Affairs for the Michigan Department of Treasury, the tax policy analyst and Legislative Director for the Michigan League for Public Policy, and a policy analyst and the Appropriations Coordinator for the Democratic Caucus of the Michigan House of Representatives. She brings with her over a decade of experience in policies focused on economic opportunity, including workforce issues, tax, and state budget.
Donald Stuckey 
Patrick Schaefer
Alexandra Stamm 
Amari Fuller
Renell Weathers, Michigan League for Public Policy (MLPP) Community Engagement Consultant. As community engagement consultant, Renell works with organizations throughout the state in connecting the impact of budget and tax policies to their communities. She is motivated by the belief that all children and adults deserve the opportunity to achieve their dreams regardless of race, ethnicity, religion or economic class.
Megan Farnsworth joined the League’s staff in December 2022 as Executive Assistant. Megan is driven by work that is personally fulfilling, and feels honored to help support the work of an organization that pushes for more robust programming and opportunities for the residents of our state. She’s excited and motivated to gain overarching knowledge of the policies and agendas that the League supports.
Yona Isaacs (she/hers) is an Early Childhood Data Analyst for the Kids Count project. After earning her Bachelor of Science in Biopsychology, Cognition, and Neuroscience at the University of Michigan, she began her career as a research coordinator in pediatric psychiatry using data to understand the impacts of brain activity and genetics on children’s behavior and mental health symptoms. This work prompted an interest in exploring social determinants of health and the role of policy in promoting equitable opportunities for all children, families, and communities. She returned to the University of Michigan to complete her Masters in Social Work focused on Social Policy and Evaluation, during which she interned with the ACLU of Michigan’s policy and legislative team and assisted local nonprofit organizations in creating data and evaluation metrics. She currently serves as a coordinator for the Michigan Center for Youth Justice on a project aiming to increase placement options and enhance cultural competency within the juvenile justice system for LGBTQIA+ youth. Yona is eager to put her data skills to work at the League in support of data-driven policies that advocate for equitable access to healthcare, education, economic security, and opportunity for 0-5 year old children. In her free time, she enjoys tackling DIY house projects and trying new outdoor activities with her dog.
Amber Bellazaire joined the Michigan League for Public Policy as a policy analyst in June of 2019. Her work primarily focuses on state policy and budgets affecting Michigan’s Medicaid programs. Previously, Amber worked at the National Conference of State Legislatures tracking legislation and research related to injury and violence prevention, adolescent health, and maternal and child health. She also brings with her two years of Americorps service. As a full time volunteer, Amber had the opportunity to tutor high school students in Chelsea, Massachusetts and address issues of healthcare access and food insecurity through in-person outreach in Seattle, Washington.
Simon Marshall-Shah joined the Michigan League for Public Policy as a State Policy Fellow in August 2019. His work focuses on state policy as it relates to the budget, immigration, health care and other League policy priorities. Before joining the League, he worked in Washington, D.C. at the Association for Community Affiliated Plans (ACAP), providing federal policy and advocacy support to nonprofit, Medicaid health plans (Safety Net Health Plans) related to the ACA Marketplaces as well as Quality & Operations.
What are successful “evidence based smoking cessation” strategies? Statistically, how effective are they? The chart seems to indicate that most of the demographics (including total) declined slightly in the last year and that all demographics except white, non-hispanic were below the average. Do we know the reason for the difference or is that a difference generated by sampling size?
Thank you for your comment. Part of the recommendation in the full report includes identifying evidenced-based smoking cessation programs that are working in other states to reduce the number of expectant mothers smoking during pregnancy and help connect them to programs to quit smoking. Prevention is a significant part of the solution. While the rate for Hispanic mothers increased from 2013 to 2014, the other groups and total did have a slight improvement representing less than a 1% rate decrease. It is unclear yet what caused this small one-year decline (after five years of increasing), but we will be monitoring the trend data. We hope this is helpful.