206960 Depressive Symptoms Increase Child SHS Exposure Risk among Maternal Smokers Intending to Quit

Wednesday, November 11, 2009: 12:48 PM

Bradley N. Collins, PhD , Department of Public Health, Temple University, Philadelphia, PA
Uma Nair, MS , Public Health/Kinesiology, Temple University, Philadelphia, PA
Nana Kwayke, BS , Department of Public Health, Temple University, Philadelphia, PA
Katherine F. Isselmann, PhD, MPH , Department of Public Health, Temple University, Philadelphia, PA
Karen Jaffe, LSW , Department of Public Health, Temple University, Philadelphia, PA
  
Background: Postpartum smokers have unique challenges to quitting smoking. A common challenge in this population includes depressive symptoms. The purpose of this study was to examine whether depressive symptoms mediated the relationship between intention to quit and child exposure to secondhand smoke (SHS) in a sample of underserved postpartum smokers.

Methods: Multivariate mediation analyses were performed on a sample of 335 smokers whose children were exposed to their SHS. Participants were recruited from pediatric primary care and WIC clinics, and enrolled at baseline in an ongoing counseling trial, Philadelphia FRESH (Family Rules for Establishing Smoke-free Homes). Exposure outcome was measured by maternal-reported exposure and child urine cotinine in two separate models. CES-D scores were dichotomized as 1 = “depressed” (scores above 16) and 0 = “normal”.

Results: More than 80% of moms were African American; > 50% were depressed. Intention to quit reduced risk of self-reported exposure (B = -0.122, p=.04) when controlling for other factors associated with exposure in bivariate analyses (education, child age, number of smokers in home, child illness, and income.) This effect was mediated by depressive symptoms (B = -.115, p = .06) such that depression eliminated the effect of intention to quit on exposure risk. Results were similar with cotinine as the outcome.

Conclusion: The findings suggest that depressive symptoms may undermine attempts to limit child exposure to SHS in this population. Interventions designed to reduce SHS exposure should assess postpartum smokers' potential co-morbid mood disorder and include mood management strategies

Learning Objectives:
Describe the mediating effect of depressive symptoms on child exposure to secondhand smoke among maternal smokers intending to quit smoking.

Keywords: Maternal and Child Health, Smoking Cessation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical health psychologist/researcher and am an Assistant Professor of Public Health and Pediatrics at Temple University. I have over 10 years of clinical and research experience in addiction (primarily tobacco) intervention research at the individual and community level. I am currently, or have been, PI on three funded intervention trials including two funded by NCI that focused on maternal smoking and child exposure to secondhand smoke. I have published my work in peer-reviewed journals, including the Journal of Clinical and Consulting Psychology, Journal of Pediatrics, Nicotine and Tobacco Research, and Addictive Behaviors. I also have presented annually at professional conferences for over 10 years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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