E-cigarettes may be more effective than nicotine patches when used during pregnancy as an aid to stop smoking, suggests a UK study involving 1100 pregnant women.
Smoking during pregnancy increases the risk of premature birth, stillbirth, disabilities, low birthweight and sudden infant death syndrome or “cot death”, where babies that appear healthy die suddenly with no obvious cause. This is because cigarette smoke contains around 4000 chemicals, many of which are toxic, as well as carbon monoxide, which limits the oxygen supply to the fetus.
Guidelines from organisations such as the national health services in the UK discourage smoking during pregnancy, and suggest the use of nicotine replacement therapies. These include patches, gums and lozenges, which contain nicotine that helps wean smokers off the addictive substance.
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“We know that putting people on nicotine-containing treatments instead of tobacco helps them to stop smoking,” says at the University of Nottingham, UK. “But we know that with nicotine replacement therapies such as patches, people don’t really like using them very much, there’s a low adherence rate. [But] with e-cigarettes, people will go out and buy that for themselves, it seems to be much more likeable and useful.”
The health effects of vaping have come under intense scrutiny in recent years with . However, some researchers believe it may be a safer alternative to smoking, partly because e-cigarettes lack the tar found in standard cigarettes.
“We know very little about the health effects of e-cigarettes,” says Coleman. “They contain very low levels of some toxic chemicals found in tobacco cigarettes.”
Coleman and his colleagues recruited 1140 women who had been pregnant for around 15 weeks and smoked 10 cigarettes a day, on average, and randomly divided them into two groups that were either given e-cigarettes or nicotine patches as an aid to quit smoking during pregnancy.
At the end of pregnancy, either just before or after delivery, the women were asked whether they had quit smoking and if they were using the aids. The researchers found that 19.8 per cent of women who vaped during pregnancy said they had quit smoking by the delivery date, while just 9.7 per cent of women who used nicotine patches said they had quit smoking by the same time.
The team also found that babies born to the women who vaped were less likely to have a low birthweight compared with those born to women who used nicotine patches. Some 9.6 per cent of babies had a low birthweight among the women who vaped, compared to 14.8 per cent among the women who used nicotine patches.
“We find that the use of e-cigarettes compared to nicotine patches reduces the chance that babies have a low birthweight – defined as less than 2.5 kilograms,” says Coleman. “That’s really important, because if you’re talking about the sickest babies that are born, they will be ones who were much lower in birth weight than others.”
These benefits of vaping as an aid for quitting smoking could result from the fact that 34 per cent of the women in the e-cigarette group reported they were using the aid at the end of pregnancy, compared with just 6 per cent of those who were assigned nicotine patches.
“More women were using the e-cigarettes by the end, which likely explains why more of them had quit. Less tobacco use during pregnancy probably explains the benefits of vaping compared to patches on the babies’ birth weights,” says Coleman.
However, some participants who were assigned to use one of the aids also used the other and had to be excluded from this analysis.
“So it’s not a truly randomised sample because excluding participants who used a non-allocated treatment could be removing a certain kind of person who may have been more or less likely to quit smoking by the end of the study,” says Coleman. He adds that more studies will be needed to be sure the results can be replicated.
Nature Medicine
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