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More Michigan women are smoking during pregnancy, according to a Kids Count report released on Nov. 17, 2016.

(File Photo)

Smoking among pregnant women in Michigan is on the increase, a worrisome trend that correlates to an increase in premature births, according to a Kids Count report released today.

About 21 percent of expectant women were smokers in 2014 compared to 18 percent in 2008, said the report, which was produced by the Michigan League for Public Policy.

"With all of the information out there on the risks of smoking, the increase in pregnant women who are smoking in this day and age is particularly startling," Alicia Guevara Warren, Kids Count in Michigan project director, said in a press release accompanying the report.

"With these numbers, you would think its 1986, not 2016," she said.

The trend is most apparent in the Upper Peninsula and northern Lower Peninsula, although 78 of Michigan's 83 counties show an increase in smoking among pregnant women between 2004 and 2014, based on state data.

Fifteen counties had an increase of at least 10 percentage points during that time span. Those counties: Alcona, Alger, Antrim, Benzie, Cheboygan, Crawford, Delta, Gratiot, Ingham, Luce, Mackinac, Menominee, Montmorency, Otsego and Roscommon.

Roscommon and Montmorency counties had the highest rate of smokers among pregnant women in 2014 -- 49 percent. The lowest rate was 9.7 percent in Kent and Oakland counties.

Smoking during pregnancy is associated with preterm births, babies with low birthweight, infant deaths and other complications. In 2008, 10 percent of Michigan babies were born before 37 weeks gestation compared to 12 percent in 2014.

"You look at this numbers and the question is, Why? What's going on?" Warren said in an interview with MLive.

Her take: The numbers reflect funding cutbacks in smoking prevention and smoking cessation programs.

In the 2016-17 budget, including state and federal funds (excluding Medicaid dollars), smoking prevention and cessation initiatives were funded at $3.78 million, which is down 34 percent from the 2008 budget year, according to the report. Currently, there is $10,800 targeted to prenatal outreach, up $800 from the 2008 budget.

"Most smokers start before age 18," so funding prevention efforts among teenagers is key, she said.

Michigan has also a dearth of smoking cessation programs, Warren noted, adding the American Lung Association has given the state an "F" on that issue.

Pregnant women most likely to be smokers are white people with lower levels of education who live in rural communities.

Although white women continue to have the highest rate of smoking, the rate of smoking among pregnant Latina women jumped 46 percent between 2008 and 2014, the report said.

On a more positive note, the report found five of eight indicators on maternal and infant health are improving when comparing 2014 numbers to 2008. Those indicators:

A 30 percent rate decrease in births to teenagers;

A 10 percent rate decrease in repeat teen births;

A 21 percent rate decrease in births to mothers with no high school diploma or GED;

A 9 percent rate decrease in the number of pregnant women who received late or no prenatal care;

A 1 percent rate decrease in the number of low-birthweight babies.

The improvement in teen births is likely the result of a combination of factors, such as fewer teens having sexual intercourse, increased access to long-acting reversible contraceptives and an increase in the use of postpartum contraception, the report said.