E-cigarettes and smoking cessation: a prospective study of a national sample of pregnant smokers

Abstract

Background Smoking during pregnancy has adverse health consequences for the mother and fetus. E-cigarettes could aid with smoking cessation but there is limited research on the prevalence and patterns of e-cigarette use, and their association with smoking cessation among pregnant smokers. Methods We conducted a secondary analysis of a randomized controlled trial of a text-messaging program for smoking cessation among a U.S. national cohort of pregnant smokers ( n = 428). Outcomes assessed were trajectories of e-cigarettes use from baseline to one-month follow-up, and longitudinal association between e-cigarette use at baseline and smoking cessation at one-month follow-up. Results At baseline, 74 (17.29%) pregnant smokers used e-cigarettes in the past 30 days and 36 (8.41%) used e-cigarettes in the past 7 days. The primary reason stated for using e-cigarettes during pregnancy was for quitting. E-cigarette use between baseline and 1-month was inconsistent. Of 36 dual-users at baseline, 20 (55.56%) stopped using e-cigarettes by the 1-month follow-up and 14 initiated e-cigarette use. There was no evidence of an association between e-cigarette use at baseline and the primary smoking cessation outcome, 7-day point prevalence abstinence [adjusted odds ratio = 0.79, 95% confidence intervals = 0.33–1.92]. Conclusions A secondary analysis of a national sample of pregnant smokers indicates that use of e-cigarettes is inconsistent and is not associated with improved smoking cessation outcomes. There is an urgent need to further examine the risk and benefits of e-cigarette use, especially during pregnancy. Electronic supplementary material The online version of this article (10.1186/s12889-019-7299-7) contains supplementary material, which is available to authorized users.

Analysis of the safety of using e-cigarettes during pregnancy. The literature review

“…E-cigarettes are one of the frequently chosen forms of smoking cessation aid, also by women of childbearing age [7,8] Part of the studies show their effectiveness in combating addiction or reducing cigarettes consumption [5,6,8,11]. However, other don't confirm that the use of e-cigarettes by pregnant women helps in smoking cessation [11].…”

“…NRT, e-cigarettes, bupropion or varenicline as an addiction treatment form for pregnant women [4,11,15]. Moreover, the WHO warns pregnant women against the use of ecigarettesthe most frequently chosen alternative to traditional cigarettes.…”

“…However, it is estimated that from 0.6 to 15% of pregnant women smoke e-cigarettes, and according to other studies 9% of pregnant women smoke both traditional cigarettes and e-cigarettes [11]. The percentage of women using e-cigarettes is higher in the period of 2-6 months after giving birth than during the third trimester of pregnancy [12].…”

“…They are also more often used by women of reproductive age compared to the general group of women and they are a frequently chosen form of smoking cessation aid in pregnant women [2,7,8,11]. Other reasons for using ecigarettes include their safety, the taste of stimulants, a higher level of safety for a child, and the curiosity of using them [11,12]. Pregnant women consider e-cigarettes safer than traditional cigarettes, which may be due to being advertised as a less harmful product compared to traditional cigarettes.…”

Smoking and pregnancy: The era of electronic nicotine delivery systems

“…Survey data have indicated a prevalence of ENDS between 5% and 7%, a number which is felt to be underestimated due to self-reporting bias. [33][34][35][36][37] Rates of under-reporting in pregnant women are as high as 22% (compared to 9% in non-pregnant women) and are likely secondary to the stigma assumed by the pregnant smoker. 38 The vast majority of pregnant women who use ENDS are dual users of cigarettes, which may confound many risk assessments.…”