More than one in 10 pregnant women smoke and many of them may also suffer from depression, which makes kicking the habit even more difficult, new research suggests.
The new evidence suggests that decades-old "quit for your baby" messages are too simplistic an approach for many women — and that perhaps prenatal checkups should include screening pregnant smokers for mental health disorders that require care.
"These ladies all know, I promise you, about the health risks. That's not what it is," says Dr. Jan Blalock of the University of Texas M.D Anderson Cancer Center, which has begun a first-of-a-kind study, Project Baby Steps, to test whether non-drug depression therapy helps pregnant smokers quit.
"We should at least understand more about why these ladies don't quit. We should be looking more carefully instead of just saying, 'Whoop, got this group of hard-core smokers.'"
Certainly learning how dangerous smoking is to their developing baby can urge women to try to quit. It increases the risk of miscarriage, premature birth, low birthweight, death from SIDS, and learning and behavior disorders.
Dr. Renee Goodwin, a Columbia University epidemiologist, tracked more than 1,500 pregnant women who took part in a larger study of Americans' health. A surprising 22 percent smoked at some point during pregnancy, and about 12 percent were classified as nicotine-dependent.
Pregnant smokers were typically poor, less educated and had less access to health care.
But strikingly, 30 percent of the smokers had a mental health disorder, as did more than half who were nicotine-addicted -- and the vast majority suffered depression. The smokers were about three times as likely to have a disorder as pregnant nonsmokers, Goodwin recently reported in the journal Obstetrics and Gynecology.
Nicotine and other chemicals in cigarette smoke can act in the brain like weak antidepressants, says Dr. Nora Volkow, director of the National Institute on Drug Abuse.
"They are not just smoking to get the habit-forming aspects," Volkow explains. "On top of that, they are seeking the therapeutic effect. It comes at a very, very high cost."
Source: Xinhua/agencies
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