Department of Pediatric Emergency Medicine, Virginia Tech Carilion School of Medicine, Carilion Roanoke Memorial Hospital, 1906 Belleview Avenue, Roanoke, VA 24014, USA.
Matern Child Health J. 2011 Jul;15(5):620-6. doi: 10.1007/s10995-010-0640-5.
Motherhood offers factors that may contribute to or confound attempts to quit smoking, including social cues around pregnancy, post partum depression, financial and other pressures of child rearing, being a role model and concern that secondhand smoke might affect their child's health. We sought to characterize a population of tobacco-using mothers in order to identify barriers to quitting that both mirror the general population and are unique to motherhood. A cross-sectional survey collected information in two urban emergency departments from women who smoked and were mothers of small children. The survey asked about tobacco use, including levels of addiction, attempts to quit, readiness and self efficacy for quitting, and other psychosocial risks. We hypothesized that mothers reporting psychosocial stressors and depression would be less motivated to quit and less likely to have attempted quitting. One hundred ninety-two smoking mothers enrolled, representing 433 children exposed to secondhand smoke. Nicotine addiction was moderate. Women reporting at least one form of stress (relationship, financial, work, emotional, family-related) had similar levels of addiction (Fagerstrom score 2.8 vs. 2.9, p = 0.63) and motivation to quit (Ladder of Contemplation 6.4 vs. 6.1, p = 0.26), but reported feeling less confident in their ability to quit than non-stressed counterparts (6.6 vs. 7.6, p = 0.04). Over half (51.3%) of smoking mothers reported symptoms of depression for more than 2 weeks in a row in the last year. Depressed mothers had similar levels of addiction (Fagerstrom score 2.9 vs. 2.8, p = 0.63), and readiness to quit (6.6 vs. 6.5, p = 0.89), and had attempted to quit at similar rates (78% vs. 82%, p = 0.58). However, depressed mothers were less confident in their ability to quit (6.4 vs. 7.4, p = 0.02) and were more than twice as likely to report they are "not at all confident" (22% vs. 9%, p = 0.03). Providers who encourage mothers to quit smoking must identify and be prepared to address psychosocial stressors and co-morbid depression.
母亲身份带来的因素可能会促进或阻碍戒烟尝试，包括怀孕时的社会暗示、产后抑郁、育儿的经济和其他压力、作为榜样以及担心二手烟可能会影响孩子的健康。我们试图描述一个吸烟母亲群体，以确定既反映一般人群又具有母亲身份独特性的戒烟障碍。一项横断面调查在两家城市急诊部门收集了吸烟且有年幼子女的女性的信息。该调查询问了有关吸烟的信息，包括成瘾程度、戒烟尝试、戒烟准备情况和自我效能感，以及其他心理社会风险。我们假设报告心理社会压力源和抑郁的母亲戒烟动机较低，且尝试戒烟的可能性较低。192 名吸烟母亲参与了调查，代表着 433 名接触二手烟的儿童。尼古丁成瘾程度中等。报告至少有一种压力形式（人际关系、经济、工作、情绪、家庭相关）的女性具有相似的成瘾程度（Fagerstrom 评分 2.8 与 2.9，p=0.63）和戒烟动机（阶梯考虑量表 6.4 与 6.1，p=0.26），但报告的戒烟信心低于无压力的对应者（6.6 与 7.6，p=0.04）。超过一半（51.3%）的吸烟母亲报告称，在过去一年中，连续两周以上出现抑郁症状。抑郁母亲的成瘾程度相似（Fagerstrom 评分 2.9 与 2.8，p=0.63），戒烟准备情况相似（6.6 与 6.5，p=0.89），尝试戒烟的比例相似（78%与 82%，p=0.58）。然而，抑郁母亲对自己戒烟的能力缺乏信心（6.4 与 7.4，p=0.02），并且报告自己“完全没有信心”的可能性是不抑郁母亲的两倍多（22%与 9%，p=0.03）。鼓励母亲戒烟的医务人员必须识别并准备解决心理社会压力源和共病抑郁。
