Friday, July 13, 2007
This presentation is part of : Children's Mental Health
The Relationships of Maternal Smoking with Maternal Mental Health and Mothers' Reports of Children's Behavior Problems
Lynne A. Hall, RN, DrPH, Mary Kay Rayens, PhD, and Ann R. Peden, ARNP-CS, DSN. College of Nursing, University of Kentucky, Lexington, KY, USA
Learning Objective #1: describe the relationship between mothers’ smoking and their mental health.
Learning Objective #2: explain the linkage between mothers’ smoking and children’s behavior problems.

Background:  Exposure to environmental tobacco smoke (ETS) is associated with a variety of adverse health outcomes in children.

Purpose:  The specific aims were to: (a) Determine whether maternal smoking is related to mothers’ chronic stressors and depressive symptoms; and (b) Examine the associations of maternal smoking status and number of cigarettes smoked per day on children’s behavior problems.

Methods:  Cross-sectional data were collected from 205 single mothers with at least one child between two and six years of age. Inclusion criteria were: ≤ 185% of poverty level and not pregnant, suicidal, or receiving mental health treatment. In-home interviews were conducted using the Everyday Stressors Index, the CES-D Scale, the Child Behavior Checklist (on a single target child), and two questions about mothers’ smoking (yes/no; number of cigarettes smoked per day).

Results: Mothers’ chronic stressors and depressive symptoms did not differ by smoking status.  Number of cigarettes smoked was weakly correlated with both chronic stressors (r=.16, p=.02) and depressive symptoms (r=.14, p=.05). Mothers who smoked reported greater internalizing (t[204]=2.2, p=.03) and externalizing behavior problems (t[204]=2.8, p=.006) among their children than nonsmoking mothers. Number of cigarettes smoked was associated with internalizing (r=.20, p=.004) and externalizing behaviors (r=.25, p=.0004). In regression analysis, controlling for sociodemographic characteristics, smoking status did not predict child behavior, but chronic stressors predicted both types. Controlling for personal characteristics, the more cigarettes smoked per day, the greater the externalizing, but not internalizing, child behavior problems.

Conclusions:  Exposure to ETS may increase children’s behavior problems, particularly externalizing problems. Given that as many as 40% of children in the U.S. are exposed to ETS in the home, nurses have a major role in educating mothers about the adverse effects of smoking on their children.