Smoking during pregnancy in the United States, 2005–2014: The role of depression

Abstract

Background Despite success of public health-oriented tobacco control programs in lowering the smoking prevalence over the past several decades, it is unclear whether similar reductions in smoking have been experienced among pregnant women, especially in vulnerable groups such as those with major depression and/or lower socioeconomic status. Objectives The purpose of this study is to examine the relationship between major depressive episode (MDE) and smoking among pregnant women overall, and by demographics and to estimate changes in the prevalence of cigarette smoking among pregnant women with and without MDE from 2005–2014. Study Design Cigarette use among pregnant women with and without MDE was examined using logistic regression models in the National Survey on Drug Use and Health. Results Prenatal smoking is more common among pregnant women with, compared to without, MDE (32.5% vs. 13.0%; (adjusted OR=2.50 (1.85, 3.40)), and greater disparities were revealed when also considering income, education and race. Over time, smoking during pregnancy increased significantly among women with MDE (35.9% to 38.4%; p=0.02)) and showed a decreasing trend among women without MDE (12.5% to 9.1%; p=0.07) from 2005–2014. Conclusions Over the past decade, smoking during pregnancy has increased among women experiencing a major depressive episode and is over four times more common among pregnant women with, than without, MDE. Disparities in smoking during pregnancy by MDE status and socioeconomic subgroups appear substantial. Given the multitude of risks associated with both MDE and smoking during the prenatal period, more work targeting this vulnerable and high-risk group is needed.

Prenatal cigarette smoking as a mediator between racism and depressive symptoms: The Biosocial Impact on Black Births Study

“…Thus, smoking cessation programs should focus on identifying and treating depressive symptoms for pregnant women. Targeted smoking cessation programs for pregnant Black women with the highest rates of smoking and lowest utilization of smoking cessation of counseling services (e.g., lower levels of education, higher levels of depressive symptoms) are needed (Goodwin et al, 2017).…”

Psychosocial well-being and efforts to quit smoking in pregnant women of South-Central Appalachia

“…Much of the research done between smoking and depression involves adolescents, and the close relationship between the two variables is thought to be developed in adolescence and maintained throughout adulthood ( Tjora et al, 2014 ). Without the criterion of rural, women with depression are four times more likely to smoke during pregnancy compared to women without depression ( Goodwin et al, 2017 ). Not only are women with depressive symptoms more likely to smoke during pregnancy, they are also less likely to quit smoking before delivery ( Tong et al, 2016 ).…”

Does Current General Mental Health Status Relate to Current Smoking Status in Pregnant Women?

“…Tobacco use during pregnancy has been linked to several demographic, socioeconomic (SES), and health-related factors. For example, pregnant women who smoke are more likely to be of younger ages, non-Hispanic, and not married [1–3, 5, 6] and of lower SES status, including lower income and education levels [1–3, 5, 7]. Moreover, tobacco use during pregnancy is more common among pregnant women who lack prenatal and antenatal care [4, 6] and health insurance [3, 5].…”

“…Mental health is also an important issue during pregnancy with as many as 30% of pregnant females experiencing depression [7–11]. This is also of public health concern as mental health issues can have similar negative health effects for both of the mother and her baby, including increased complications during pregnancy, low birth weight, birth defects, and long-term negative impacts on children's cognitive and behavioral functioning [9].…”