title: Relationships between self-reported smoking, household environmental tobacco smoke exposure and depressive symptoms in a pregnant minority population.
abstract: This study sought to examine relationships between depressive symptoms and prenatal smoking and/or household environmental tobacco smoke exposure (HH-ETSE) among urban minority women. We analyzed private, audio computer-assisted self interview data from a clinic-based sample of 929 minority pregnant women in Washington, DC. Depressive symptoms were assessed via the Beck Depression Inventory Fast Screen. HH-ETSE, current smoking, and former smoking were assessed via self-report. Depression levels and demographic characteristics were compared: (1) among nonsmokers, for those reporting HH-ETSE versus no HH-ETSE; and (2) among smokers, for those reporting current smoking (in last 7 days) versus former smokers. Measures associated with HH-ETSE/current smoking in bivariate analysis at P < 0.20 were included in adjusted logistic regression models. HH-ETSE, as a possible indicator of a social smoking network, was assessed as a mediator for the relationship between depression and current smoking.
  
  
  RESULTS
  Non-smokers reporting moderate-to-severe depressive symptoms showed significantly higher adjusted odds of prenatal HH-ETSE (AOR 2.5, 95% CI [1.2, 5.2]). Smokers reporting moderate-to-severe or mild depressive symptoms showed significantly higher adjusted odds of current smoking (AOR 1.9, 95% CI [1.1, 3.5] and AOR 1.8, 95% CI [1.1, 3.1], respectively). Among smokers, HH-ETSE was a significant mediator for the association between moderate-to-severe symptoms and current smoking. In conclusion, health care providers should be aware that depressed urban minority women are at risk of continued smoking/HH-ETSE during pregnancy. Interventions designed to encourage behavior change should include screening for depression, and build skills so that women are better able to address the social environment.
authors.affiliation: Statistics and Epidemiology Unit, Research Triangle Institute, RTI International, 701 13th Street NW, Suite 750, Washington, DC 20005, USA. stan@rti.org
authors.forename: Sylvia
authors.initials: S
authors.lastname: Tan
authors.forename: Lauren P
authors.initials: LP
authors.lastname: Courtney
authors.forename: Ayman A E
authors.initials: AA
authors.lastname: El-Mohandes
authors.forename: Marie G
authors.initials: MG
authors.lastname: Gantz
authors.forename: Susan M
authors.initials: SM
authors.lastname: Blake
authors.forename: Jutta
authors.initials: J
authors.lastname: Thornberry
authors.forename: M Nabil
authors.initials: MN
authors.lastname: El-Khorazaty
authors.forename: David
authors.initials: D
authors.lastname: Perry
authors.forename: Michele
authors.initials: M
authors.lastname: Kiely
mesh_terms: D000328:Adult; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014505:Urban Population; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution