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


METHODS
Pregnant smokers (N = 257) were randomly assigned to a 10-week, intensive, depression-focused 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. Of the sample, 54% were African American, and 37% met criteria for major depression. Mean age was 25 years (SD = 5.9), and women averaged 19.5 weeks (SD = 8.5) gestation at study entry. We measured symptoms of depression using the Center for Epidemiological Studies-Depression Scale (Radloff, 1977).


RESULTS
At 6 months posttreatment, women with higher levels of baseline depressive symptoms treated with CBASP were abstinent significantly more often, F(1, 253) = 5.61, p = .02, and had less depression, F(1, 2620) = 10.49, p = .001, than those treated with HW; those with low baseline depression fared better in HW. 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.
Cinciripini
Paul M
PM
Department of Behavioral Science.
Blalock
Janice A
JA
Department of Behavioral Science.
Minnix
Jennifer A
JA
Department of Behavioral Science.
Robinson
Jason D
JD
Department of Behavioral Science.
Brown
Victoria L
VL
Department of Behavioral Science.
Lam
Cho
C
Department of Behavioral Science.
Wetter
David W
DW
0000-0002-6366-0108
Department of Behavioral Science.
Schreindorfer
Lisa
L
Department of Behavioral Science.
McCullough
James P
JP
Department of Psychology.
Dolan-Mullen
Patricia
P
Department of Health Promotion and Behavioral Sciences.
Stotts
Angela L
AL
Department of Family and Community Medicine.
Karam-Hage
Maher
M
Department of Behavioral Science.
D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000628:therapy*; D003866:Depressive Disorder / Q000150:complications / Q000628:therapy*; D005260:Female; D006266:Health Education; D006801:Humans; D016017:Odds Ratio; D011247:Pregnancy; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome; D014029:Tobacco Use Disorder / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome