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Published on: August 25, 2018
Behavioral Health and Substance Use Correlates of E-Cigarette Use in Early Pregnancy
Kelly C Young-Wolff1, Subarna Bhattacharya2, Sara R Adams2
1Division of Research, Kaiser Permanente Northern California, Pleasanton, CA; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA.
Introduction:
Rates of prenatal e-cigarette use are increasing, but little is known about whether behavioral health characteristics are associated with use during early pregnancy, when intervention may have greatest impact.
Methods:
This cross-sectional study examined pregnancies in a Northern California healthcare system (11/2020-12/2024) with universal screening for prenatal e-cigarette use, depression, intimate partner violence (IPV), and other substances (alcohol, cannabis, prescription opioids, stimulants, and other tobacco products). Adjusted prevalence ratios for e-cigarette use were estimated using modified Poisson regression. Analyses were conducted in 2025.
Results:
Among 180,350 pregnancies, 1.1% reported prenatal e-cigarette use. In mutually adjusted models, e-cigarette use was more prevalent among individuals with depression (aPR=1.72;95%CI=1.45-2.04); IPV (aPR=1.39;95%CI=1.15-1.66); and other substance use (aPRs=1.97-4.59;p<.05). Increasing frequency of alcohol, cannabis, and opioids was associated with higher e-cigarette prevalence.
Conclusions:
Prenatal e-cigarette use was uncommon but concentrated among individuals with behavioral health conditions and other substance use, highlighting the need for integrated, prevention-focused care in prenatal settings.
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