A Critical Combination: Household Secondhand Smoke and Depressive Symptoms in a Pregnant Minority Population

Objectives This study sought to examine relationships between depressive symptoms and prenatal household (HH-) ETSE among urban minority women.

Methods We analyzed private, audio computer-assisted self interview (A-CASI) data from a clinic-based sample of 467 non-smoking minority pregnant women in Washington, D.C. Depressive symptoms were assessed via the Beck Depression Inventory Fast-Screen (BDI-FS). HH-ETSE, defined as ETSE in the home at least 1 day in the past 7 days, was assessed via self-report. Bivariate analyses between women with or without HH-ETSE compared depressive symptoms, age, ethnicity, education, employment, and trimester of pregnancy. Measures associated with HH-ETSE in bivariate analysis at p<0.20 were included in adjusted logistic regression models. Individual sources of ETSE as possible indicators of women's social smoking network were also contrasted.

Results Women reporting moderate-to-severe depressive symptoms showed significantly higher adjusted odds of prenatal HH-ETSE (AOR 2.5, 95% CI [1.2, 5.2]). Individual sources of ETSE were higher among those reporting HH-ETSE than those who did not: living with a smoker (74.5% vs. 17.3%), smoking partner (59.6% vs. 35.0%), and/or visitors smoking in your home (52.2% vs. 6.9%) (p<.05 for each).

Conclusions Health care providers should be aware of possible correlations between depression and ETSE during pregnancy. Interventions designed to encourage behavior change to reduce exposure should include screening and counseling for depression, and build confidence and skills so that women are better able to address the social environment. Close attention should be given to women who report smoking in their immediate social networks.