Electronic cigarettes may be more successful than nicotine patches in assisting pregnant women to stop smoking while being just as safe.
It is not a good idea to smoke while pregnant. Women who smoke have a more difficult time getting pregnant and are more likely to never become pregnant. Smoking during pregnancy can cause tissue damage in the unborn infant, especially in the lungs and brain, and some studies indicate a link between maternal smoking and cleft lip.
If you smoke while pregnant, you are also more likely to have a premature birth. Premature birth is defined as a baby born three weeks or more before your due date. Babies born too soon lose out on critical development that occurs in the womb during the last weeks and months of pregnancy.
According to a recent study from the Queen Mary University of London, e-cigarettes are just as safe as nicotine patches for pregnant women and may help more women quit smoking. The research, published on May 16th in Nature Medicine, is the first to look at the safety and effectiveness of e-cigarettes among pregnant smokers.
While many women stop smoking when they get pregnant, others, especially those from low-income families, find it difficult to quit. So far, two stop-smoking medications have been tested on pregnant smokers: nicotine replacement treatments like nicotine chewing gum or patches, and bupropion, an antidepressant. Nicotine replacement had relatively minor impacts, while bupropion had none.
The new study finds that similar to non-pregnant smokers, e-cigarettes may be more successful than nicotine patches and offer no additional dangers to mothers or newborns during pregnancy.
The study involved 1,140 pregnant smokers who were randomly divided into two groups. One was given e-cigarettes, while the other was given nicotine patches. Quit rates in the two study arms were similar, but some successful quitters in the patch group stopped smoking using e-cigarettes rather than patches. When this was controlled for, the e-cigarette group had better-proven quit rates at end of pregnancy than the patch group (6.8% vs 4.4%, p<0.02).
These quit rates are low because they required that women post their saliva samples to confirm no smoking, and very few did that. Looking at self-reported abstinence at end of pregnancy, 19.8% vs 9.7% (p<0.001) were abstinent in the two groups. 34% of the women in the e-cigarette group and 6% in the patch group were using their products at the end of pregnancy.
Birth outcomes and adverse effects in women were similar in the two groups, apart from low birth weight (babies born weighing under 2.5kg), which was less frequent in the e-cigarette group (9.8% vs 14.8%), most likely because women in the e-cigarettes group smoked less.
Professor Peter Hajek, Director of the Health and Lifestyle Research Unit at the Queen Mary University of London, said: “While it is best for pregnant smokers to stop smoking without continuing to use nicotine if this is difficult, e-cigarettes can help smokers quit and are as safe as nicotine patches. Many stop-smoking services are already using e-cigarettes as an option for smokers generally. Such use can now be adopted in stop-smoking services for pregnant women as well”.
Reference: “Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial” by Peter Hajek, Dunja Przulj, Francesca Pesola, Chris Griffiths, Robert Walton, Hayden McRobbie, Tim Coleman, Sarah Lewis, Rachel Whitemore, Miranda Clark, Michael Ussher, Lesley Sinclair, Emily Seager, Sue Cooper, Linda Bauld, Felix Naughton, Peter Sasieni, Isaac Manyonda and Katie Myers Smith, 16 May 2022, Nature Medicine.