title: 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.
  
  
  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.
authors.affiliation: Department of Behavioral Science.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Cinciripini
authors.affiliation: Department of Behavioral Science.
authors.forename: Janice A
authors.initials: JA
authors.lastname: Blalock
authors.affiliation: Department of Behavioral Science.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Minnix
authors.affiliation: Department of Behavioral Science.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Robinson
authors.affiliation: Department of Behavioral Science.
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Brown
authors.affiliation: Department of Behavioral Science.
authors.forename: Cho
authors.initials: C
authors.lastname: Lam
authors.affiliation: Department of Behavioral Science.
authors.forename: David W
authors.identifier: 0000-0002-6366-0108
authors.initials: DW
authors.lastname: Wetter
authors.affiliation: Department of Behavioral Science.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schreindorfer
authors.affiliation: Department of Psychology.
authors.forename: James P
authors.initials: JP
authors.lastname: McCullough
authors.affiliation: Department of Health Promotion and Behavioral Sciences.
authors.forename: Patricia
authors.initials: P
authors.lastname: Dolan-Mullen
authors.affiliation: Department of Family and Community Medicine.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Stotts
authors.affiliation: Department of Behavioral Science.
authors.forename: Maher
authors.initials: M
authors.lastname: Karam-Hage
mesh_terms: 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