Cigarette Smoking Abstinence Among Pregnant Individuals Using E-Cigarettes or Nicotine Replacement Therapy

Area of Science:

• Public Health
• Reproductive Health
• Addiction Medicine

Background:

• Cigarette smoking during pregnancy poses significant risks to maternal and child health.
• Electronic cigarette (e-cigarette) use is increasing among pregnant individuals seeking smoking cessation alternatives.
• Assessing the efficacy of e-cigarettes versus traditional nicotine replacement therapy (NRT) is crucial for guiding public health recommendations.

Purpose of the Study:

• To compare smoking abstinence rates in pregnant individuals who used e-cigarettes versus those who used NRT.
• To evaluate the impact of e-cigarette use initiation timing on smoking cessation outcomes during pregnancy.

Main Methods:

• Secondary data analysis of the US Pregnancy Risk Assessment Monitoring System (2016-2020).
• Cohort study including pregnant individuals who smoked prior to pregnancy and used either e-cigarettes or NRT during pregnancy.
• Propensity score adjustment used to control for confounding factors in logistic regression models.

Main Results:

• Pregnant individuals using e-cigarettes had significantly higher smoking abstinence rates in late pregnancy compared to NRT users (50.8% vs 19.4%).
• Existing e-cigarette users who initiated use before pregnancy showed higher abstinence rates than NRT users (53.1% vs 19.4%).
• New e-cigarette users initiating during pregnancy had similar abstinence rates to NRT users (20.6% vs 19.4%).

Conclusions:

• E-cigarette use during pregnancy, especially by prior users, is associated with higher smoking abstinence rates compared to NRT.
• Replacing cigarettes with e-cigarettes may represent a viable harm reduction strategy for pregnant individuals.
• Further research is warranted to fully understand the long-term effects and optimal use of e-cigarettes in pregnancy.