Cigarette smoking cessation and mental health treatment receipt in a U.S national sample of pregnant women with mental illness

Abstract

Objectives: To (1) compare the probability of cigarette smoking cessation for pregnant women with and without past-year mental illness by the trimester of pregnancy; and (2) examine the association between the receipt of past-year mental health treatment and prenatal cigarette smoking cessation among pregnant lifetime-smokers with mental illness. Methods:We conducted secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2008-2014. The NSDUH included 2019 pregnant lifetime smokers aged 18-44 years, 528 of whom had a mental illness. We used multiple logistic regression to model the probability of prenatal cigarette smoking cessation.Results: Pregnant lifetime-smokers with mental illness had a lower rate of cigarette smoking cessation than women without mental illness (47.9% vs. 61.7%, p = 0.001).Compared to pregnant women without mental illness, pregnant women with mental illness had a significantly lower odds of smoking cessation in the first trimester

Cigarette Smoking Cessation Counselling in Pregnant Smokers with Mental Illness/Substance Use Disorders

“…Little is known about mental health professionals’ practices regarding smoking cessation counselling for pregnant smokers. In a prior study based on the 2008–2014 NSDUH, pregnant women who received mental health treatment had higher odds of cigarette smoking cessation ( Salameh et al, 2021b ), though this relationship was not significant; this indicated a potential effect of mental health treatment on smoking cessation. In a study among the general population, those who received mental health treatment had a significantly higher odds of cigarette smoking cessation ( Cook et al, 2014 ).…”

“…A global systematic review revealed that health care providers acknowledge that they need to consider women’s stressors and psychological state while advising them to quit smoking ( Kumar et al, 2021 ). Given the higher prevalence of cigarette smoking in pregnant women with mental health disorders ( Salameh et al, 2021b ; Tong et al, 2016 ), further research is needed to examine cessation counselling in clinical settings among pregnant women with mental illness.…”

“…ACOG (2020) recommends that the best benefit of smoking cessation is by 15 weeks gestational age. This indicates the importance of early screening and counselling for pregnant smokers, especially since research shows women with mental illness and SUD are motivated to quit ( Fallin et al, 2016 ), and most pregnant women may quit early in the second trimester of pregnancy regardless of the presence of mental illness ( Salameh et al, 2021b ). Hence, pregnancy provides a unique opportunity to support those with mental illness and SUD to quit smoking and sustain abstinence, thereby decreasing smoking rates in this population.…”

“…Over the past decade, there was an increase in SUD along with co-occurring cigarette use in pregnant women, especially in those with opioid use disorder ( Jarlenski et al, 2020 ). Pregnant women with mental illness also are less likely to quit smoking than women without mental illness ( Salameh et al, 2021b ; Tong et al, 2016 ), indicating the urgency to meet their clinical needs.…”

“…Based on national data, 9.6% of pregnant women reported past-month tobacco use in 2019 ( Substance Abuse and Mental Health Services Administration [SAMHSA], 2020 ). Cigarette smoking is higher in pregnant women with mental illness ( Salameh et al, 2021b ; Tong et al, 2016 ) and substance use disorders (SUD) ( Jarlenski et al, 2020 ) than in women without these disorders. Given their lower quit rates along with higher cigarette smoking rates ( Salameh et al, 2021b ; Tong et al, 2016 ) and the toll of cigarette smoking on the mother and her child, a better understanding of the receipt of counselling for cigarette smoking cessation in pregnant smokers with mental health and SUD is critical.…”