B3481 - The relationship between socioeconomic deprivation psychiatric distress and persistence of smoking in pregnant women - 10/03/2020

B number: 
Principal applicant name: 
Lorna Hardy | University of Exeter (UK)
Dr Lee Hogarth
Title of project: 
The relationship between socioeconomic deprivation, psychiatric distress, and persistence of smoking in pregnant women.
Proposal summary: 

Only a small proportion of pregnant individuals will continue to smoke during their pregnancy. Identifying the key traits which predict this behaviour will allow the development of more efficient screening procedures and interventions for this vulnerable group, improving outcomes for both mother and foetus. While both psychological vulnerabilities (such as depression) and socioeconomic risk factors (such as material deprivation) have been considered individually in their relationship with smoking during pregnancy, the relative importance of psychological versus socioeconomic factors has not been determined. In addition, very few studies have considered the complex inter-relationships between socioeconomic status (SES) and psychological wellbeing, and how these might contribute to smoking in pregnancy. The purpose of the present project is to use the ALSPAC dataset to address these two issues. Pregnant women in this dataset will be classed as either continuing smokers (smoked prior to pregnancy and continued during second and/or third trimesters), quit smokers (smoked prior to pregnancy but not during second or third trimesters), and never smokers (did not smoke prior to pregnancy or during pregnancy). Differences between these groups in psychological variables (depression, anxiety, and experience of stressful events during pregnancy) and socioeconomic variables (educational attainment, financial difficulties and neighbourhood deprivation) will be tested using multiple logistic regression. The second phase of this project will use network outcome analysis to map the complex inter-relationships between psychological and socioeconomic risk factors and smoking in pregnancy. This will allow us to identify the best targets for intervention.

Impact of research: 
The broad impact of this programme of research would be to encourage psychological researchers to engage to a greater extent with the socioeconomic aspects of their work, such that socioeconomic status is considered in parity to psychological wellbeing in models of addiction and interventions. This would represent a significant ideological shift within the addiction field. A range of academic groups will benefit from the insights provided by the novel research in this project including: 1.Addiction theorists who seek to characterise the individual differences that contribute to tobacco dependence vulnerability, especially in pregnancy, or who seek to articulate general theoretical models of addiction. 2.Addiction theorists who are interested in behavioural economic models, in particular the role of deprivation and lack of alternative reinforcement as a key risk factor for addiction. 3.Researchers and clinical psychologists who are actively engaged in developing screening procedures and preventative therapies for substance dependence. 4.A number of psychological societies - including the Society for the Study of Addiction, the College on Problems of Drug Dependence, and the APA Society of Addiction Psychology- who seek to define mechanisms underpinning addiction. 5.A number of clinically-facing academic societies – including the British Thoracic Society, the Respiratory Medicine Section of The Royal Society of Medicine, and the Royal College of Psychiatrists – who seek to minimise the burden of disease stemming from smoking and addiction. 6.Antenatal services and general practitioners for whom this research would contribute to the development of screening procedures and preventative interventions for individuals identified as at high risk of smoking during pregnancy.
Date proposal received: 
Saturday, 7 March, 2020
Date proposal approved: 
Tuesday, 10 March, 2020
Social Science, Addiction - smoking. Psychiatric co-morbidity - depression, anxiety., Logistic regression; network outcome analysis, Smoking; addiction; pregnancy; depression; anxiety; socioeconomic markers