Clatsop County coalition applies 'positive culture' framework to perinatal tobacco use after data review

Clatsop County public-health and community partners on Wednesday reviewed county and national data on tobacco and nicotine use in pregnancy and discussed using an appreciative “positive culture” framework to guide outreach and prevention work.

Lisa Schuyler, co‑facilitator of the Clatsop County Public Health Coalition, told attendees that “the level that Clatsop County is in is, like, that third dot down, which is the 8.7 to 11.2, and it says we actually have 9.4 percent. And this was from 2020 to 2022.” The figure refers to births to people who reported tobacco use at any point during pregnancy.

The meeting combined a brief training on the Positive Culture Framework — a coalition-building model that promotes “appreciative” approaches (emphasizing local strengths and successes) — with a review of local data and a group exercise using the social‑ecological model. Schuyler described the framework as encouraging “hope and concern, but not fear,” and urged partners to identify existing community assets to expand, rather than focusing solely on deficits.

Why it matters: Tobacco and nicotine exposure during pregnancy is associated in medical literature with miscarriage, preterm birth, low birth weight and increased respiratory and developmental problems in children; meeting participants also raised postpartum mental‑health and neonatal withdrawal as concerns. County leaders and service providers said pregnancy is an interval of heightened motivation for many people and a useful engagement point for cessation services.

Participants reviewed two data snapshots. One county map placed Clatsop in a midrange category (8.7–11.2 percent) with a county value of 9.4 percent (2020–2022). A long‑term trend chart cited the National Center for Health Statistics and showed declines in births to parents who used tobacco nationally and in Oregon (for example, U.S. estimates fell from about 15.8 percent in 1993 to about 3.0 percent in 2022; Oregon from about 18.9 percent to about 3.5 percent). Coalition members noted the data’s limits for rural jurisdictions: small counts can be suppressed and cross‑county care use (patients traveling for services) can obscure residence‑based rates.

Speakers also warned the county’s tobacco numbers might undercount use of synthetic nicotine products. “There’s not as much information on synthetic nicotine products,” Schuyler said, “which is why I have ... there’s not a lot of data around this, but that doesn’t mean it’s safe.” The group flagged that some statewide and national sources track “tobacco” and may not capture newer synthetic nicotine products or clarify whether reports reflect any use during pregnancy or persistent use throughout gestation.

Discussion focused on practical local steps. Recommendations included expanding distribution of quit‑line and cessation materials at pregnancy touchpoints (WIC, prenatal clinics, community colleges), continuing school‑based prevention (Catch My Breath curriculum was cited), promoting motivational interviewing among providers, and reinforcing smoke‑free policies at institutional and community levels. Several speakers pointed to existing local policy: a local tobacco retail licensing ordinance that predates the state program and, according to coalition members, limits new retailers near schools and restricts discounts.

The group emphasized culturally tailored outreach for the county’s Spanish‑speaking residents. Participants said WIC and trusted community networks reach many Latino families and that Spanish‑language digital ads and paid YouTube outreach had higher clickthrough in recent efforts. Coalition members advised repeating messages across trusted channels (WIC, churches, soccer clubs) and increasing Spanish materials and bilingual staffing for perinatal cessation support.

Organizers also named programs and operational steps the coalition can use: broadened school and workplace smoke‑free zones, leveraging tourism and business groups to promote a “welcoming, smoke‑free” community image, and making cessation resources more visible at institutional touchpoints. Several attendees recommended mapping where pregnant people already interact with services and ensuring those sites carry cessation referrals and printed materials.

Closing and next steps: Schuyler said she would circulate the presentation materials and the Positive Culture Framework manual used in the workshop and asked members to bring business cards to an October 8 networking meeting. Community partners also shared announcements: a Spanish‑language doula training with scholarships, a free online “Nurturing Fathers” series beginning Sept. 17, and local Red Cross shelter management trainings. No formal actions or votes were taken at the meeting.