Pregnant women who use e-cigarettes or nicotine patches are not at increased risk of complications for either the woman or the baby. This is the result of recently published research, which may now influence advice on smoking cessation during pregnancy. At least in the UK.
A study from researchers at Queen Mary University of London published in the scientific journal Addiction, suggests that nicotine replacement therapies - such as e-cigarettes and nicotine patches - do not harm either the mother or the baby during pregnancy. The researchers suggest that these methods can be a good support for pregnant women trying to quit smoking.
The study involved over 1 100 pregnant smokers followed in hospitals in England and a smoking cessation service in Scotland. The results show that regular use of nicotine replacement therapy (NRT) is not linked to adverse pregnancy outcomes. The results showed the same for those who used e-cigarettes with nicotine.
- E-cigarettes helped pregnant smokers to quit without any recognisable risks to pregnancy, says lead researcher Professor Peter Hajek. It appears that damage from smoking is caused by other substances in tobacco smoke rather than nicotine itself.
Fewer respiratory problems
Almost half of the participants used e-cigarettes, while just over a fifth used nicotine patches. The researchers also found that e-cigarette users had fewer respiratory infections, which may be due to substances with antibacterial properties.
The researchers measured nicotine levels in saliva and collected data on participants' smoking habits, use of nicotine products, and the babies' birth weight and health at birth.
- Many pregnant women find it difficult to quit smoking, says co-researcher Professor Linda Bauld. Products such as nicotine patches and e-cigarettes can be an important support in this endeavour.
Similar birth weight
The results also show that women who combined smoking with nicotine replacement therapy gave birth to babies with similar birth weights to those who smoked alone.
Professor Tim Coleman, who co-led the study, emphasises that the findings are important from a public health perspective.
- Smoking during pregnancy is a major concern. This study provides further evidence that it is substances in tobacco smoke - not nicotine - that cause the damage. Therefore, using nicotine products to quit smoking is much better than continuing to smoke.
Swedish councils more restrictive
E-cigarettes are currently recommended by the UK NHS as a smoking cessation aid because they contain neither tar nor carbon monoxide - two of the most dangerous substances in cigarette smoke.
In Sweden, the recommendations are different. Here, healthcare is generally more restrictive on the use of both e-cigarettes and other nicotine products during pregnancy, with a focus on total abstinence from nicotine.
Part of a wider research debate
The differences reflect a broader disagreement within the scientific community. The issue is fundamentally about the role of harm reduction for nicotine users - whether it is better to replace smoking with less harmful alternatives, or to avoid nicotine altogether.
The debate is far from settled and has been highlighted in several contexts, not least in previous reporting in Vejpkollen. The new study is therefore likely to be another contribution to an ongoing scientific and political debate on how best to combat smoking - particularly during pregnancy.
