New Vaping Research for Pregnant Women

Smoking in pregnancy increases the risk of a number of birth problems including, miscarriage, preterm birth, placental abruption, low birth weight and neonatal or sudden infant death.

Many women who are trying to give up smoking during pregnancy are prescribed nicotine patches (Nicotine Replacement Therapy or NRT) as they have been previously tested and deemed ‘safe’ to use in pregnancy as an alternative to smoking cigarettes.

However, according to the researchers from the Wolfson Institute of Population Health at Queen Mary University London, the pharmaceutical options of NRT (nicotine patches and gums) and bupropion (an antidepressant used for smoking cessation) have little effect in assisting pregnant women to stop smoking completely.

The trial

To test the effectiveness of e-cigarettes, the research team carried out a randomized controlled trial in 1,140 pregnant women who smoked. Of these 569 used refillable e-cigarettes (vaping) and 571 used nicotine patches (some members of the nicotine patches group also used e-cigarettes during the study).

The primary findings showed that prolonged smoking cessation rates among the two groups was not greatly different (and still relatively low). However, the safety outcomes, including adverse events during pregnancy and at birth, showed that e-cigarettes (vaping) did not increase the risk. In fact, low birth weight was less frequent in the e-cigarette group and other adverse events were similar across the two trial groups.

This led the researchers to determine that vaping is a safe alternative to nicotine patches for quitting smoking in pregnancy.

Vaping in pregnancy

The researchers described vaping as a form of NRT, although it is currently a consumer product only rather than a pharmaceutical product which can be prescribed.

The potential advantages of vaping over nicotine patches are that the individual is able to control the nicotine intake to their needs and, by enabling the use of different flavours, users can “retain a degree of enjoyment that they previously obtained from smoking”.

Trials on the effectiveness of the two methods for aiding smoking cessation in the general population show that e-cigarettes and vaping are the more popular aid and research has also shown an increase in vaping among pregnant women who smoke.

Limitations of the study

The research team acknowledged that the research had limitations and questions still remain about the harmful effects of nicotine in pregnancy. However, given that traditional tobacco cigarettes contain numerous other toxins with documented teratogenic effects (causing a structural or functional change to the fetus), methods of nicotine replacement therapy are currently seen as preferable to continued smoking throughout pregnancy.

The study authors state that “the findings do not suggest that e-cigarette use in pregnancy poses larger risks than the use of NRT, despite the fact that e-cigarettes were more likely to be used and were used for longer periods than NRT”.