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

But strikingly, 30 percent of the smokers had a mental health disorder, as did more than half who were nicotine-addicted - and the vast majority suffered depression. The smokers were about three times as likely to have a disorder as pregnant nonsmokers, Goodwin recently reported in the journal Obstetrics and Gynecology.

Smaller studies also have linked depression to smoking during pregnancy.

Nicotine and other chemicals in cigarette smoke can act in the brain like weak antidepressants, says Dr. Nora Volkow, director of the National Institute on Drug Abuse.

"They are not just smoking to get the habit-forming aspects," Volkow explains. "On top of that, they are seeking the therapeutic effect. It comes at a very, very high cost."

It can be hard for the depressed to realize when they need help. And chances of relapse increase when would-be quitters feel worsening sadness, lethargy or other depression symptoms.

That makes the smoking more "a disease instead of a choice," Volkow says. "Society's responsibility is to provide a treatment. Because here you have two individuals that will be affected."

But how to treat pregnant smokers?

While many smokers turn to medication to ease quitting pangs, doctors hesitate to prescribe even nicotine patches during pregnancy. Studies so far haven't proven the patches' role in pregnancy, and some suggest pregnant women metabolize nicotine faster and thus need higher doses, raising fetal safety questions. A major study is beginning in Britain to try to settle those questions.

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