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expert reaction to study of impacts of vaping in pregnancy and comparison with smoking

A study published in Addiction compares the impacts of smoking and vaping during pregnancy. 


Prof Caitlin Notley, Professor of Addiction Sciences, Norwich Medical School, University of East Anglia (UEA), said:

“This paper presents high quality evidence, as a secondary analysis of data from the first UK trial of e-cigarettes for smoking cessation during pregnancy.

“Tobacco smoking is a major contributor to poor pregnancy outcomes, including stillbirth, miscarriage and low birthweight. Helping people to stop smoking completely, as quickly as possible, is the best way to improve pregnancy outcomes.

“In this study, the authors find that more people choose to use e-cigarettes than nicotine replacement therapy (NRT), suggesting that people who are pregnant prefer e-cigarettes as a way of quitting smoking. Preference is important because if people can choose something they like, they are likely to have a better chance of staying smokefree.

“It is really reassuring that people who quit smoking using an e-cigarette during pregnancy in this study had better pregnancy outcomes than women who continued to smoke tobacco, and did not have any worse outcomes than people who do not smoke at all. This provides reassurance of the safety of e cigarettes for smoking cessation during pregnancy. NRT is already recommended for use during pregnancy for smoking cessation. The findings of this study suggest that e cigarettes do not differ in safety profile from NRT. My reading of this evidence is that e-cigarettes could be viewed as a form of NRT and also can be recommended for smoking cessation to pregnant women, especially as tobacco smoking is so damaging.”


Prof Jamie Brown, Director of the Tobacco and Alcohol Research Group, and Professor of Behavioural Science, University College London (UCL), said:

“Smoking in pregnancy is dangerous, and many people want to quit and reduce these risks. E-cigarettes are an effective way for people to quit smoking and these new findings may ease some worries of pregnant smokers who want to use them to quit smoking.

“An earlier analysis of this trial found a similar safety profile between those who were randomly given e-cigarettes compared with those given nicotine replacement therapy to quit smoking, but this may have resulted from a difference in the actual usage of the two products. This new study analysed the comparative safety based on their actual use, although this meant the two groups were no longer randomly selected. Taken together, the similar sets of results across the two different approaches are reassuring.”




Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E-cigarettes and Patches (PREP) randomized controlled trial’ by Francesca Pesola et al. will be published in Addiction at 8am UK time on Wednesday 17 January 2024.


DOI: 10.1111/add.16422



Declared interests

Jamie Brown ‘has received unrestricted funding to study smoking cessation from Pfizer and J&J, who manufacture medically licensed smoking cessation treatments’.

Caitlin Notley ‘has received an honorarium from Vox media company for filming a ‘nicotine explainer’ on the role of nicotine in addiction’.

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