Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026
Pre-pregnancy depression, prenatal care, and e-cigarette/cigarette use during late pregnancy among adolescents.
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Wen Xiaozhong, Sabaratnam Premini, Huber Maria V, Malik Najum Z, Ruybal Andrea L, Stanton Cassandra A, McKinney Chelsea O, Vargees Comreen, Westling Erika, Hart Joy L, Abu-Taha Shawqi, Goniewicz Maciej L
Аннотация
INTRODUCTION: Although robust evidence shows a link between depression and tobacco use among adolescents, little information exists concerning pregnant adolescents. As such, we examined: 1) the association between pre-pregnancy depression and e-cigarette/cigarette use during late pregnancy, and 2) whether prenatal care visit frequency moderates this association.
METHODS: We analyzed data from 10 363 adolescents (ages 19 or younger) in the U.S. Pregnancy Risk Assessment Monitoring System (2016-2021), a national cross-sectional survey supplemented with birth certificates. Participants reported pre-pregnancy depression and e-cigarette and cigarette use in the last 3 months of pregnancy. Multivariable logistic regression models estimated 1) associations of depression with e-cigarette/cigarette use and 2) the interaction between depression and prenatal care visit frequency, adjusting for sociodemographic and pregnancy-related confounders.
RESULTS: Adolescents with pre-pregnancy depression were as likely to use e-cigarettes exclusively during late pregnancy as those without pre-pregnancy depression (3.21% vs. 1.66%; confounder-adjusted odds ratio [aOR], 1.33 [95% CI, 0.78-2.27]). However, those with pre-pregnancy depression were more likely to use cigarettes exclusively (12.72% vs. 4.81%; 1.94 [1.44-2.61]) or use both e-cigarettes and cigarettes (3.50% vs. 0.59%; 4.62 [2.18-9.81]) during late pregnancy. The association between pre-pregnancy depression and exclusive cigarette use was weaker (interaction p < 0.05) among adolescents with 9-11 prenatal care visits (1.38 [0.82-2.32]) and ≥ 12 prenatal care visits (1.77 [1.10-2.84]) compared to those with ≤8 prenatal care visits (3.86 [2.23-6.67]).
CONCLUSIONS: Pre-pregnancy depression was associated with cigarette smoking and dual use of e-cigarettes and cigarettes, but not exclusive e-cigarette use, in pregnant adolescents. Frequent prenatal care seemed to partially buffer the elevated risk of cigarette use associated with pre-pregnancy depression in this observational research.
METHODS: We analyzed data from 10 363 adolescents (ages 19 or younger) in the U.S. Pregnancy Risk Assessment Monitoring System (2016-2021), a national cross-sectional survey supplemented with birth certificates. Participants reported pre-pregnancy depression and e-cigarette and cigarette use in the last 3 months of pregnancy. Multivariable logistic regression models estimated 1) associations of depression with e-cigarette/cigarette use and 2) the interaction between depression and prenatal care visit frequency, adjusting for sociodemographic and pregnancy-related confounders.
RESULTS: Adolescents with pre-pregnancy depression were as likely to use e-cigarettes exclusively during late pregnancy as those without pre-pregnancy depression (3.21% vs. 1.66%; confounder-adjusted odds ratio [aOR], 1.33 [95% CI, 0.78-2.27]). However, those with pre-pregnancy depression were more likely to use cigarettes exclusively (12.72% vs. 4.81%; 1.94 [1.44-2.61]) or use both e-cigarettes and cigarettes (3.50% vs. 0.59%; 4.62 [2.18-9.81]) during late pregnancy. The association between pre-pregnancy depression and exclusive cigarette use was weaker (interaction p < 0.05) among adolescents with 9-11 prenatal care visits (1.38 [0.82-2.32]) and ≥ 12 prenatal care visits (1.77 [1.10-2.84]) compared to those with ≤8 prenatal care visits (3.86 [2.23-6.67]).
CONCLUSIONS: Pre-pregnancy depression was associated with cigarette smoking and dual use of e-cigarettes and cigarettes, but not exclusive e-cigarette use, in pregnant adolescents. Frequent prenatal care seemed to partially buffer the elevated risk of cigarette use associated with pre-pregnancy depression in this observational research.