(AP)
Updated: 2007-09-11 19:44

What about alleviating depression to help them quit?

Antidepressants haven't been studied specifically in pregnant smokers. Generally, those drugs are reserved for severe symptoms during pregnancy, although recent studies suggest the risk of birth defects is low.

Enter Texas' Project Baby Steps. More than 250 pregnant smokers, and counting, are testing whether a form of cognitive therapy for depression helps them kick the habit better than anti-smoking counseling alone.

The psychological therapy is intense, teaching women to problem-solve so they can improve dysfunctional relationships that can fuel both the depression and the smoking, Blalock explains.

This is a high-risk group of poor, inner-city women. Almost half are currently suffering major depression, and Blalock says many also have a history of abuse or other trauma. But they volunteered for the study because they want to quit smoking.

It's not clear yet if depression plays a role for pregnant smokers in general, or is an added risk mostly for the poor, Blalock stresses.

Still, NIDA's Volkow says it's crucial to develop ways to help this uniquely vulnerable group.

"There's a lot of social disdain" for pregnant smokers, adds Columbia's Goodwin. "There aren't a lot of treatment programs. There's just advice ... not to smoke, but that's not going to do the job."

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