title: The co-occurrence of maternal depressive symptoms and smoking in a national survey of mothers.
abstract: BACKGROUND
  Both maternal smoking and depression are common and can adversely impact child health and functioning, yet few studies have explored their co-occurrence among mothers.
  
  
  OBJECTIVE
  To determine the prevalence and associations of depression and smoking among mothers in the United States.
  
  
  METHODS
  Random-digit-dial national telephone survey of 1530 households conducted in 2002. Respondents were asked about their sociodemographic characteristics, smoking status, and their children's receipt of Medicaid. A validated 3-item depression screen was administered. Bivariate and multiple regression analyses for maternal smoking and a positive depression screen were performed.
  
  
  METHODS
  National sample.
  
  
  METHODS
  Seven hundred two mothers with children aged less than 19 years living in their homes.
  
  
  RESULTS
  The response rate was 61%. Among mothers, 24.3% were smokers, 24.4% had a positive depression screen, 8.1% had both, and 40.6% were smokers and/or had a positive depression screen. All rates were greater among mothers whose children receive Medicaid (37.6%, 47.5%, 20.6%, and 64.5%) than those whose children do not receive Medicaid (21.1%, 19.0%, 4.8%, and 35.3%) (P < .001) for each. In multivariate analyses, maternal smoking was independently associated with a 70% increased risk of depressive symptoms (odds radio, 1.7; 95% confidence interval, 1.1-2.6).
  
  
  CONCLUSIONS
  This study highlights both the frequency and the co-occurrence of maternal smoking and maternal depressive symptoms, two negative influences on children's health and development, as well as their increased prevalence among mothers whose children receive Medicaid, thereby highlighting the economic disparities associated with both. These findings have significant implications for our nation's children, health care clinicians, and health care payers.
authors.affiliation: American Academy of Pediatrics, Rochester, NY 14620, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Kavanaugh
authors.forename: Robert C
authors.initials: RC
authors.lastname: McMillen
authors.forename: John M
authors.initials: JM
authors.lastname: Pascoe
authors.forename: Linda
authors.initials: L
authors.lastname: Hill Southward
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Winickoff
authors.forename: Michael
authors.initials: M
authors.lastname: Weitzman
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008484:Medicaid; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology