Study: "E-cigarettes more effective than drugs in helping pregnant women quit smoking"

In cases where expectant mothers are unable to quit nicotine during pregnancy, vejpning may be a better option than nicotine patches, according to new research. The study, published in Health Technology Assessment, suggests that pregnant women should consider e-cigarettes if they are unable to quit nicotine.

The research involved 1 140 pregnant women trying to quit smoking, who were divided into two groups. Half of the women were given e-cigarettes, the other half were given nicotine patches - which in many countries are the norm to offer as a substitute. Both approaches were considered equally safe, but the significant difference the researchers saw was that fewer women in the e-cigarette group had low birth weight babies. Low birth weight is defined as a baby weighing less than 2 500 grams. 

Low birth weight can lead to complications and risks in the first year of life.

Smokelessness itself mattered most

According to the researchers, the result is most likely due to the fact that e-cigarettes were more effective in reducing the use of conventional cigarettes.

"E-cigarettes were more effective than nicotine patches in helping pregnant women quit smoking. This in turn positively affects the outcome of the pregnancy," said researcher Peter Hajek, head of the Health and Lifestyle Research Unit at Queen Mary University of London, in a press release.

Similar outcomes were previously published in a study at the University of Dublin, something that Vejpkollen reported on 2020.

Different views on pregnancy and nicotine

Whether nicotine should be used for smoking cessation during pregnancy is controversial. A recently published Swedish study suggests that even newborn babies of those who use snus during pregnancy are at greater risk of sudden infant death syndrome than those who do not. According to the researchers in the Swedish study, the nicotine itself may be the cause.

Smoking harms the child more than nicotine

Meanwhile, the Swedish study, which includes statistical data between 1999 and 2019, shows that the risks are almost six times higher if the pregnant woman smokes more than 10 cigarettes per day during pregnancy, compared to those who do not use nicotine at all. Snuffing, and what is called light smoking (less than 10 cigarettes per day), increases the risk by 3 times. Sudden infant death syndrome is now very rare, affecting 1 in 5000 babies per year in Sweden. According to the Swedish National Board of Health and Welfare, this low number is primarily due to the recommendation to put babies on their backs when they sleep, which has been shown to significantly reduce the risks.

As safe as nicotine medicines

According to the UK study, the risks of e-cigarettes in pregnancy are similar to those of proven nicotine medicines. Unlike Swedish recommendations, nicotine medicines are included in the list of treatments that can be used during pregnancy. 

"It is not yet clear whether nicotine is harmful to foetal development," the British researchers write in Medical Express. "However, the major harms of nicotine use are much more likely to be associated with other toxins in cigarette smoke than nicotine. Therefore, the current recommendation is to consider nicotine replacement therapy when a pregnant woman is quitting smoking. The National Institute of Health and Care Excellence (NICE) recommends, for example, nicotine spray and chewing gum. Despite this, many pregnant women find it difficult to quit smoking", the British researchers write.

Sources for this article:

Study: Vaping Might Beat Nicotine Patches in Helping Pregnant Women Quit Smoking

UK authorities' recommendation on nicotine in pregnancy:
Recommendations on treating tobacco dependence in pregnant women

Swedish National Board of Health and Welfare recommendation on nicotine in pregnancy (sudden infant death syndrome) PDF
"Reducing the risk of sudden infant death syndrome"

Swedish study on smoking and snus during pregnancy:
Association of maternal snuff use and smoking with Sudden Infant Death Syndrome: a national register study



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