Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy–evidence from a population-based maternity survey in England

Abstract

Objectives Exposure to tobacco products during pregnancy presents a potential harm to both mother and baby. This study sought to estimate the prevalence of vaping during pregnancy and to explore the factors and outcomes associated with vaping in pregnancy. Setting England. Participants Women who gave birth between 15th and 28th October 2017. Methods A cross-sectional population-based postal survey of maternal and infant health, the National Maternity Survey (NMS) 2018. The prevalence of vaping and patterns of cigarette smoking were estimated, and regression analysis was used to explore associations between maternal characteristics and vaping, and between vaping and birth outcomes. Outcome measures Unweighted and weighted prevalence of vaping with 95% confidence intervals, and unadjusted and adjusted relative risks or difference in means for the association of participant characteristics and secondary outcomes with vaping. Secondary outcome measures were: preterm birth, gestational age at birth, birthweight, and initiation and duration of breastfeeding. Results A total of 4,509 women responded to the survey. The prevalence of vaping in pregnancy was 2.8% (95%CI 2.4% to 3.4%). This varied according to the pattern of cigarette smoking in pregnancy: 0.3% in never-smokers; 3.3% in ex-smokers; 7.7% in pregnancy-inspired quitters; 9.5% in temporary quitters; and 17.7% in persistent smokers. Younger women, unmarried women, women with fewer years of formal education, women living with a smoker, and persistent smokers were more likely to vape, although after adjusting for pattern of cigarette smoking and maternal characteristics, persistent smoking was the only risk factor. We did not find any association between vaping and preterm birth, birthweight, or breastfeeding. Conclusions The prevalence of vaping during pregnancy in the NMS 2018 was low overall but much higher in smokers. Smoking was the factor most strongly associated with vaping. Co-occurrence of vaping with persistent smoking has the potential to increase the harms of tobacco exposure in pregnant women and their infants.

Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial

“…E-cigarettes are more popular than traditional NRT products among people who are trying to stop smoking 27 , 28 , and the first few trials comparing the two treatments in non-pregnant participants suggest that e-cigarette are more effective than NRT for aiding smoking cessation 29 , 30 . The use of e-cigarettes as a quitting aid has also increased in pregnant women who smoke 31 – 33 , although the efficacy and safety of such use is unknown.…”

Adverse Maternal and Infant Outcomes of Women Who Differ in Smoking Status: E-Cigarette and Tobacco Cigarette Users

“…To our knowledge, only one questionnaire-based observational study has compared the characteristics of pregnant women who used e-cigarettes to those of pregnant women who used tobacco cigarettes or did not smoke. Of the 4442 British women included in that research, the 2.8% who used e-cigarettes during pregnancy were mostly younger, of British origin, lived in deprived areas, had left full-time education at a younger age (≤18 years), and had a partner who also smoked when compared with non-smokers and tobacco users [26]. There is no comparable research in the Dutch population, which must be corrected to know where to target research and public health initiatives.…”

Análise dos riscos do uso de cigarros eletrônicos na gravidez: uma revisão integrativa

“…Dentre os principais riscos apresentados pela exposição ativa aos cigarros eletrônicos durante o período gestacional destacam-se alterações para os recém-nascidos, tais como: baixo peso ao nascer (Cardenas et al, 2019;Clemens et al, 2019), menores episódios de amamentação (Mcdonnell, Dicker & Regan, 2020;Opondo et al, 2021), maior nível de admissão em Unidade de Terapia Intensiva Neonatal (UTIN) (Mcdonnell, Dicker & Regan, 2020), e alteração na maturidade motora e redução do perímetro cefálico . Cardenas et al (2019), em sua coorte desenvolvida nos Estados Unidos, mostraram que o risco de crianças com baixo peso ao nascer em mulheres usuárias de cigarro eletrônico foi de 33,3% versus 23,1% naquelas que eram fumantes de cigarros tradicionais e 11,7% naquelas não fumantes.…”

“…Entretanto, o uso dos cigarros eletrônicos foi associado a uma redução de 12% a 33% dos episódios de amamentaçãoo que, num futuro próximo, pode impactar no desenvolvimento infantil. Para mais, aquelas que estavam nutrindo eram mais propensas a parar a amamentação mais cedo do que aquelas que não fumavam (Opondo et al, 2021). Opondo et al (2021), também indicaram que o uso de cigarros eletrônicos esteve mais presente nas mulheres jovens, com baixa renda, que conviviam com outro fumante, que não tiveram a gravidez planejada ou que possuíam um sentimento negativo em relação ao período gestacional.…”

“…Para mais, aquelas que estavam nutrindo eram mais propensas a parar a amamentação mais cedo do que aquelas que não fumavam (Opondo et al, 2021). Opondo et al (2021), também indicaram que o uso de cigarros eletrônicos esteve mais presente nas mulheres jovens, com baixa renda, que conviviam com outro fumante, que não tiveram a gravidez planejada ou que possuíam um sentimento negativo em relação ao período gestacional. Tal fato torna-se um fator de alerta, visto que, boa parte das gestações nas populações mais jovens não é planejada e acaba sendo permeada por mudanças complexas e densas barreiras a serem enfrentadas (Taborda et al, 2014).…”