It is universally accepted that smoking during pregnancy harms developing babies, especially leading their growth and being born underweight. Current NHS guidelines recommend that pregnant smokers who find quitting difficult should be provided with nicotine replacements products like patches, sprays or gum and stop-smoking services usually recommend nicotine replacement patches.
The QMUL team says their research shows “pregnant women should also consider e-cigarettes.”
The team’s study included 1,140 pregnant women who were trying to quit. They were divided into two groups and half of the women received vapes with the other half being given nicotine patches.
The team said: “Both approaches were equally safe. The only meaningful difference was that fewer women in the e-cigarette group had children with low birthweight (weighing less than 2,500 grams).”
The researchers believe that the benefit of vaping over patch use is probably because vaping is “more effective in reducing the use of conventional cigarettes.”
At the end of pregnancy, women reported whether they had quit.
“However,” the team said, “some women had quit smoking using a product they were not assigned, mostly women given patches stopping with the help of e-cigarettes they had procured for themselves.”
When the researchers looked at successful quitters who only used the treatment they were allocated, almost twice as many women quit with e-cigarettes than with nicotine patches.
The researchers looked at safety outcomes, including low birthweight, baby intensive care admissions, miscarriage, stillbirth, and premature birth.
There remains a debate as to whether nicotine is harmful to developing babies.
National Institute of Health and Care Excellence (NICE) states that it is the existence of toxins within smoke that leads to most of the health problems and recommends that NRT products are used in conjunction with behavioural support.
“However, most pregnant women still struggle to quit,” the team states. “E-cigarettes can be seen as a form of nicotine replacement therapy, but they have an advantage over nicotine gum and patches in allowing smokers to select strength and flavours they like and make the transition to stopping smoking easier. This is most likely why e-cigarettes have been shown more effective than the traditional nicotine replacement therapy in people who are not pregnant.”
Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London said: “E-cigarettes seem more effective than nicotine patches in helping pregnant women to quit smoking and because of this, they seem to also lead to better pregnancy outcomes. The evidence-based advice to smokers already includes, among other options, a recommendation to switch from smoking to e-cigarettes. Such a recommendation can now be extended to smokers who are pregnant as well.”
- Helping pregnant smokers quit: a multicentre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy - https://www.journalslibrary.nihr.ac.uk/hta/AGTH6901/#/abstract