Effects of an intensive depression-focused intervention for smoking cessation in pregnancy.

Abstract

Objective-The objective of this study was to evaluate a depression-focused treatment for smoking cessation in pregnant women, versus a time and contact health education control. We hypothesized that the depression-focused treatment would lead to improved abstinence and reduced depressive symptoms among women with high levels of depressive symptomatology. No significant main effects of treatment were hypothesized.Method-Pregnant smokers (N=257) were randomly assigned to a 10-week intensive depressionfocused intervention (Cognitive Behavioral Analysis System of Psychotherapy-CBASP) or to a time and contact control focused on health and wellness (HW); both included equivalent amounts of behavioral and motivational smoking cessation counseling. Fifty-four percent of the sample was African American; 37% met DSM-IV criteria for major depression; mean age (SD) was 25 (5.9) and women averaged 19.5 (8.5) weeks gestation at study entry. Ongoing symptoms of depression were measured using the Center for Epidemiological Studies Depression scale (CES-D).Results-The results showed that at 6-months posttreatment, women with higher levels of baseline depressive symptoms treated with CBASP had a higher probability of prolonged abstinence (F(1,253) =5.61, p=.02) and more improved depression (F(1,2620)=10.49, p=.001) than those treated with HW, whereas those with low baseline depression fared better in HW. The differences in abstinence were not retained at 6-months postpartum. Conclusions-The results suggest that pregnant women with high levels of depressive symptoms may benefit from a depression-focused treatment in terms of improved abstinence and depressive symptoms, both of which could have a combined positive effect on maternal and child health.Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at www.apa.org/pubs/journals/ccp NIH Public Access Pritchard, 1994;Solomon et al., 2006;Zhu & Valbo, 2002) as well as post-partum relapse . There is evidence that depression clusters with SES and other risk factors for persistent smoking during pregnancy, and that the clustering of such factors predicts smoking in a gradient fashion (Kahn, Certain, & Whitaker, 2002). That depression cooccurs with low SES is not surprising. Children who grow up with low SES parents are at two to three times greater risk for developing major depressive disorder (MDD) than those who grow up with parents of higher SES, even when parental MDD status is controlled (Ritsher, Warner, Johnson, & Dohrenwend, 2001;Gilman, Kawachi, Fitzmaurice, & Buka, 2002). Because persistent smoking du...

Smoking cessation: Next steps for special populations research and innovative treatments.

“…Three studies in this special section utilize theory-based treatments that have demonstrated effectiveness in other areas of health behavior change and apply them to smoking cessation (Borrelli et al, 2010;Cinciripini et al, 2010;MacPherson et al, 2010). Although these articles report the main effects of treatment on smoking cessation, more research is needed on the mechanisms of change so that intervention targets can be more accurately pinpointed.…”

“…Prior research on affect and smoking has focused almost exclusively on the role of negative affect, but positive affect has also shown a strong association with treatment outcome (al'Absi, Hatsukami, Davis, & Wittmers, 2004;Doran et al, 2006). Similarly, Cinciripini et al (2010) in this issue apply a treatment typically used for the treatment of chronic depression to help pregnant smokers quit. Study participants received 10 individual counseling sessions of smoking cessation plus the Cognitive Behavioral Analysis System of Psychotherapy (CBASP; McCullough, 2000), which focused on interpersonal stress and on increasing the quality of one's relationship with significant others or they received smoking cessation plus health and wellness.…”

“…Four articles in the special issue focus on innovative treatments or novel theoretical approaches: one uses a novel channel for treatment delivery (Borrelli et al, 2010), two test theory-based treatments that have not yet been applied to smoking cessation (Cinciripini et al, 2010;MacPherson et al, 2010), and one uses creative methods to increase participation and smoking cessation treatment (Lamb et al, 2010).…”

“…Three articles in the special section focus on innovative theorybased treatments for smoking: Two articles (Cinciripini et al, 2010;MacPherson et al, 2010) integrate evidenced-based treatment for depression into smoking cessation treatment. Lamb, Kirby, Morral, Galbicka, and Iguchi (2010) utilized a creative contingency management approach to motivate treatment participation and smoking cessation.…”

Active Smoking and Associated Behavioural Risk Factors before and during Pregnancy - Prevalence and Attitudes among Newborns' Mothers in Mures County, Romania

“…Smoking is one of the major modifiable risk factors, responsible for the premature death of nearly 6 million people worldwide and considerable economic costs to health systems (1)(2)(3). Among women, smoking is associated with an increased risk of breast cancer, cervical cancer, ovarian cancer, infertility, and early menopause (4).…”