Depression Linked To Smoking During Pregnancy

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Recently released studies indicate that many pregnant women whosmoke also might suffer from depression, indicating that "quit for yourbaby" messages are "too simplistic an approach for many women," the AP/Yahoo! Newsreports. The U.S. government estimates that about 12% of pregnant womensmoke despite evidence that it increases the risk of miscarriage,premature birth, low birthweight, sudden infant death syndrome, andlearning and behavior disorders.

According to a study published in the April issue of the journal Obstetrics and Gynecology,pregnant smokers were about three times as likely to have a mentalhealth disorder as pregnant nonsmokers. For the study, Renee Goodwin, aColumbia Universityepidemiologist, and colleagues followed more than 1,500 pregnant womenwho took part in an expanded study of the health of U.S. residents.

Twenty-twopercent of the women smoked at some point during pregnancy, and about12% were classified as nicotine-dependent. The pregnant smokers weretypically poor, less educated and had less access to health care.According to the study, a majority of the women who smoked sufferedfrom depression. Thirty percent of the smokers and more than 50% of thewomen who were nicotine-dependent had a mental health disorder, thestudy found.

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Smaller studies also have found a link between depression and smoking during pregnancy, the AP/Yahoo! News reports. Nora Volkow, director of NIH's National Institute on Drug Abuse,said nicotine and other chemicals in cigarette smoke can act in thebrain like mild antidepressants. Women "are not just smoking to get thehabit-forming aspects ... they are seeking the therapeutic effect,"Volkow said. She added that because it often is difficult for peoplewho are depressed to realize they need help, smoking can become
more of "a disease instead of a choice."

M.D. Anderson Study

The University of Texas' M.D. Anderson Cancer Centerrecently launched a study, called Project Baby Steps, which aims todetermine whether nondrug depression therapy helps pregnant smokersquit. The study has enrolled more than 250 poor, inner-city pregnantwomen who smoke to examine whether a form of cognitive therapy fordepression is more effective in helping them stop smoking thananti-smoking counseling alone.

Nearly half of the women arecurrently experiencing major depression, and many also have a historyof abuse or other trauma, Jan Blalock of M.D. Anderson said. The womenvolunteered for the study because they want to quit smoking. Thepsychological therapy teaches women to problem-solve so they canimprove unhealthy relationships that can cause the depression and thesmoking, Blalock said. She added that researchers do not know ifdepression is a factor for pregnant smokers in general or is an addedrisk mostly for poor women.

"These ladies all know ... about thehealth risks" of smoking, Blalock said, adding, "We should at leastunderstand more about why these ladies don't quit." Goodwin said,"There's a lot of social disdain" for pregnant smokers, adding, "Therearen't a lot of treatment programs. There's just advice ... not tosmoke, but that's not going to do the job" (Neergaard, AP/Yahoo! News, 9/11).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyWomen's Health Policy Report, search the archives, and sign up for emaildelivery at kaisernetwork.org/email. The Kaiser Daily Women's Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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