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Randomized Controlled Trial
. 2010 Feb;78(1):44-54.
doi: 10.1037/a0018168.

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

Paul M Cinciripini  1 , Janice A Blalock  1 , Jennifer A Minnix  1 , Jason D Robinson  1 , Victoria L Brown  1 , Cho Lam  1 , David W Wetter  1 , Lisa Schreindorfer  1 , James P McCullough  2 , Patricia Dolan-Mullen  3 , Angela L Stotts  4 , Maher Karam-Hage  1
Affiliations
Randomized Controlled Trial

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

Paul M Cinciripini et al. J Consult Clin Psychol. 2010 Feb.

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.

Method: 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.

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Figures

Figure 1
Figure 1
CONSORT Flow Diagram for patient entry and processing through the trial.
Figure 2
Figure 2
Illustration of the interaction between Treatment Group (CBASP and HW) and level of baseline depression as measured by the CES-D. The mean and plus or minus one standard deviation of the mean baseline CES-D scores are plotted on the X-axis. The Y-axis represents the predicted rate of prolonged abstinence at 6-months posttreatment for each of these points, based on the regression model described in the text. Baseline CES-D included as a covariate in the model.
See this image and copyright information in PMC

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