Preggers May2022
A new paper published in Nature Medicine looked at how well e-cigarettes worked for smoking cessation in and following pregnancy
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by Dave Cross
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Professor Linda Bauld, a respected expert in the area of pregnant women and tobacco harm reduction, celebrated the paper and its findings, and issued her gratitude to Professors Hajek, Griffiths, Przulj, Smith, Pesola, McRobbie, Naughton, Sasieni, and “our other colleagues involved at the 24 research sites”.
The study, conducted by a team based at Queen Mary University of London, was published in Nature Medicine and “is the first to examine the safety and efficacy of e-cigarettes among pregnant smokers.”
The team write: “While many women stop smoking when they become pregnant, some find it difficult to stop, particularly those from disadvantaged socio-economic backgrounds. Two stop-smoking medications have been tested with pregnant smokers so far - nicotine replacement treatments such as nicotine chewing gum or patches, and bupropion – an antidepressant. Nicotine replacement was shown to have only limited effects, while bupropion had none.
“The new study, funded by the National Institute for Health and Care Research (NIHR), shows that, as with smokers who are not pregnant, e-cigarettes may be more effective than nicotine patches and do not pose any greater risks to mothers or babies during pregnancy.
The study involved 1,140 pregnant smokers who were randomly divided into two groups.
“Birth outcomes and adverse effects in women were similar in the two groups, apart from low birthweight (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 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.”
Professor John Britton wasn’t involved in the study but commented: “This study is an important development in managing the sometimes seemingly intractable problem of helping pregnant smokers to quit. Smoking in pregnancy is a major health hazard to the unborn and new-born baby, causing the loss of up to 5000 babies every year and possibly impairing development throughout the child’s life. Methods to help pregnant women to quit are therefore urgently needed, particularly since conventional methods are of relatively low efficacy in this group.
“In this study, the relative efficacy on effectiveness is robust. The news that vaping is more effective than medicinal nicotine in this context offers another method to reduce this burden of disease.
“On safety, there are grounds for optimism here, but we need continued evaluation on this. In addressing concerns about the possible long-term hazards of vaping, which are unknown but likely, if anything, to be minor, it is important to bear in mind that smoking in pregnancy is lethal to children. Women who are pregnant and who have not been able to quit smoking should therefore be encouraged, as strongly as possible, to switch to vaping.”
Dr Francesca Pesola, a member of the research team commented: “Many pregnant smokers find it difficult to quit with current stop smoking medications including nicotine patches and continue to smoke throughout pregnancy.”
“We would only recommend the use of nicotine to smokers wanting to quit their regular cigarettes. But, using an e-cigarette poses no greater risk to the mother or baby than nicotine patches, which are both better options than continuing to smoke throughout pregnancy.”
References:
- Electronic cigarettes versus nicotine patches for smoking cessation in pregnancy: a randomized controlled trial - https://www.nature.com/articles/s41591-022-01808-0
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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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