Rachel Mann and Fran Faflik explain the reasoning for conducting the study: “There is scant published evidence regarding electronic cigarette (EC) use during pregnancy and little is known in England, UK, about smoking cessation services policy and types of advice given to women about EC use during pregnancy.”
The pair share the concerns that advice given, to use traditional nicotine quit products, tends not to be followed by pregnant women. Also, those who do try to use pharmaceutical replacement therapies frequently stop. The National Institute for Health and Care Excellence (NICE) collates evidence of best practice and delivers advice on smoking cessation – but has no recommendation for health practitioners to give to pregnant women.
“This represents a significant evidential gap on smoking cessation policy and practice, particularly as there are no published UK-based studies on attitudes to ECs, and their use and outcomes, during pregnancy.”
The survey was dual-pronged; an online form was used to collate the view and opinions of the 82 smoking cessation services in England, and 30 pregnant women were invited to contribute an anonymised questionnaire (having been identified by a quit advisor in the North East).
Cessation services were asked to provide details about the person completing the form, and:
- Do you have a local service protocol or policy in place to advise pregnant women about using e-cigarettes in pregnancy?
- What advice does your service give pregnant women about using e-cigarettes during pregnancy?
- What policies, advice or evidence has your service used when formulating any advice for pregnant women about using e-cigarettes during pregnancy?
- If you think that you would like to be involved in some future research in this area, please complete your contact details (please note you do not have to give your contact details if you do not wish to, just the name of your service)
Pregnant women were asked:
- Their age, ethnicity, education, and employment status
- Information relating to the pregnancy
- Information about smoking behaviour
- Their knowledge of electronic cigarettes
The results showed that 60% of cessation services had no local service protocol or policy in place to advise pregnant women about the use of electronic cigarettes.
70% said that they advised pregnant women that vaping was a “personal choice”. Nine said they would recommend an approved licenced product, but would also support he personal choice to use a different device.
In coming to a decision on what advice to give, the first port of call for information cited was the Public Health England report. Another leading authority consulted was Action on Smoking and Health.
Of the pregnant women, fourteen said they smoked every day – and all of them reported that they were trying to quit smoking. Regarding vaping, “the majority of women had tried an e-cigarette (at least once) prior to pregnancy and 35% of women had considered using one since they found out they were pregnant. Of the 10 who had considered using an EC since they found out they were pregnant the most frequently endorsed reason for this was ‘E-cigs may help me quit smoking’.”
The team write: “pregnant women reported that they were concerned about the safety of EC use in pregnancy and were not sure if pregnant women should have the choice to use them.”
The pair conclude: “evidence from large-scale, well-designed mixed-methods research studies on the safety, outcomes and acceptability of EC use during pregnancy is required to inform pregnant women and health professionals who deliver smoking cessation advice.”