Vaping and Pregnancy Commentary
A commentary written by vaping and pregnancy experts has been published by Clinical and Translational Medicine journal
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by Dave Cross
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Due to a change in metabolism, pregnant smokers rapidly break down the nicotine in their blood stream, which is what makes cessation through the use of patches or gum very difficult.
“Stop-smoking treatments such as nicotine replacement therapy (NRT) and bupropion show only limited efficacy in this population while the third licensed stop-smoking medication, varenicline, is not recommended in pregnancy,” the authors say.
The usual suspects complained loudly in the media when it was suggested that vaping could play a role in combatting this problem. Gradually, minds that were influenced by them are being won over.
“There are concerns that [ecigs] may carry a degree of risk, although this is expected to be very small compared to risks of smoking,” state the group.
One key objection has been the citation of studies claiming to show the risks posed by nicotine to a developing foetus. The commentary team say the evidence of this is only available from animal studies with forced chronic high doses of nicotine.
They say: “Such effects have not been documented for nicotine doses taken voluntarily by humans. Indeed, NRT products to help pregnant smokers quit are approved by licensing authorities in most countries. EC aerosol, however, contains other chemicals in addition to nicotine and objective data on pregnancy outcomes in women who switch from smoking to EC use are urgently needed.
“We carried out the first randomised controlled trial that compared the effectiveness and safety of nicotine patches (combined with other NRT products if required) versus ECs in 1,140 pregnant smokers.”
The group found that supplied electronic cigarettes “were markedly more effective than patches in all abstinence outcomes.” The figures mask a possible greater success as they believe some women were dissuaded from trying to vape instead of smoke simply because they found the operating instructions confusing – meaning that clearer, easier to follow instruction may have provided incredible success rates for vaping.
Regarding safety, “mean birthweight and rates of adverse birth outcomes were similar in the two study arms, with one exception. There were more babies with low birth weight (<2.5 kg) in the group allocated to NRT use.”
“This could be a chance finding, but in a previous large study that compared nicotine and placebo patches, the nicotine arm had better birth and infant outcomes than the placebo arm 2 years after delivery. Both findings are likely the result of a larger reduction in smoking in the study arms with more favourable safety outcomes.”
They state that e-cigarette use during pregnancy “does not seem to pose larger risks than the use of NRT, despite the fact that [electronic cigarettes] were more likely to be used and were used for longer periods than NRT.”
They concluded that vaping can help pregnant smokers quit, poses no more risk than traditional approaches to smoking cessation in this group, and “may reduce the risk of having a low-birth-weight baby compared to the use of NRT.”
Dave Cross
Journalist at POTVDave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.
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