Bill Stanczykiewicz, Indianapolis Star

Too many babies in Indiana are smoking. Not directly, obviously, but through their moms who are smoking during pregnancy. The severe health consequences suffered by these children are alarming and avoidable.

Indiana is one of the worst states in the nation when it comes to maternal smoking. According to the most recent data, 19 percent of Hoosier moms admitted that they smoked tobacco while pregnant. In Indiana, 88 of the state's 92 counties have maternal smoking rates higher than the national average, which is why the state's overall numbers are 73 percent greater than the rest of the country.

In actual lives, that means about 16,000 babies -- nearly enough to fill a basketball arena -- are born each year in Indiana to moms who smoke.

"There is denial about the consequences of smoking," said Deborah Hudson, a respiratory therapist who is the program manager of the Clarian Tobacco Control Center. "So many people like to say, 'What's the harm in four, five or six cigarettes a day? That is not going to hurt me. That is not going to hurt my baby.' There's a huge lack of knowledge and a high level of denial in the moms who are smoking."

The stakes are high. According to Hudson, smoking during pregnancy reduces the amount of oxygen and nutrients that are reaching the baby. As a result, the children of women who smoke during pregnancy can suffer serious health consequences before birth, at delivery, throughout infancy, and into adulthood. For example the American Lung Association reports that maternal smoking accounts for about 10 percent of all infant deaths in America. Other research finds that babies born to moms who smoke are twice as likely to die from sudden infant death syndrome.

Smoking during pregnancy increases the likelihood of miscarriage by 30 to 50 percent. Hyperactivity and attention deficit disorder among children are three times more likely. And the baby is twice as likely to be born at low birthweight, which can lead to a greater risk of vision and hearing impairment, cerebral palsy, developmental delays and mental retardation.

A lack of prenatal care is not the reason for Indiana's dangerously high rate of maternal smoking. In fact, more than 90 percent of Hoosier women start receiving prenatal care within the first four months of pregnancy. Instead, Hudson points to a deeply entrenched culture of smoking within Indiana and the highly addictive nature of tobacco. Also, she says, too many family members, friends and even health-care providers are reluctant to tell mom that she should stop smoking.

This article can be read in its entirety on IndyStar.com.