Vaping, Electronic Cigarettes, and Pregnancy

Woman with an e-cigarette

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As of Dec. 20, 2019, the new legal age limit is 21 years old for purchasing cigarettes, cigars, or any other tobacco products in the U.S.

Smoking during pregnancy is certainly well-known to be harmful to both the mom-to-be and the baby. Despite this, many women continue to smoke during their pregnancies. There are many organizations and programs that are aiming to lower this because most women say that lowering the number of cigarettes per day and eventually quitting is important to them.

Vaping While Pregnant

That’s where electronic cigarettes, also known as e-cigs, and vaping come in. The manufacturers have been purporting that this is a safer way to smoke and pregnant women seem to be believing the hype. A study unveiled at the American Congress of Obstetricians and Gynecologists (ACOG) Conference in May 2015 showed that about 40% of pregnant women believe that electronic cigarettes are safer than regular cigarettes.

E-cigarettes are still nicotine delivery systems that simply work differently than your regular cigarette. Though only 57% of the women in the study knew that e-cigarettes even had nicotine in them. It should then be no surprise when fewer than 67% of the women in the study thought that an e-cigarette was addictive.

Since these devices still contain nicotine, the harm to pregnancy and baby is still possible, even beyond addiction. The consequences include, but are not limited to preterm birth and low birth weight, some of the reasons that rank highly for reasons that babies die.

E-cigarettes are nicotine delivery devices and nicotine can be addictive. In addition, exposing a fetus to nicotine—which can pass from the mother through the placenta—can result in low birth weight and preterm birth.

Lack of Regulation

Historically, the Food and Drug Administration (FDA) hasn't regulated these devices. However, the FDA's latest policies now require e-cigarette companies to cease the manufacture and sale of flavored vaping products, with the exception of menthol and tobacco, by the end of January 2020.

The minimal regulation means that they can make claims, or neglect to include warnings, to vulnerable populations, like pregnant women. Women who see that there are no warnings on the packs assume that it is because they are not as harmful as regular cigarettes.

Of the 316 women studied at the University of Maryland by Dr. Katrina Schafer Mark clinic, only 13% had tried the e-cigarettes. Though 75% who had tried them said that they believed that they would be less harmful than traditional cigarettes.

The researchers noted that screening and education regarding electronic cigarettes should be included in prenatal care.

Vaping and Smoking Cessation

Many of those women who had tried the e-cigarettes said that they felt that vaping with e-cigarettes would help them quit smoking. The truth is that, in addition to not being regulated by the FDA, these devices have also not been studied in terms of cessation aids to help anyone quit smoking.

There are methods of smoking cessation that include nicotine replacement, through products like chewing gums and dermal patches, that your doctor or midwife can help you with before or during pregnancy. Vaping, the inhaling of gases from these e-cigarettes, is not on the approved list.

As with traditional cigarettes, the sooner you quit, the better off you and your baby are in terms of the risks associated with smoking in pregnancy.

If you want to quit, but aren’t sure where to start, you can talk to your doctor or midwife. If you do not feel comfortable doing that, you can also contact the Great Start Program of the American Legacy Foundation at (866) 667-8278.

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  1. Kapaya M, D’Angelo DV, Tong VT, et al. Use of Electronic Vapor Products Before, During, and After Pregnancy Among Women with a Recent Live Birth — Oklahoma and Texas, 2015. MMWR Morb Mortal Wkly Rep 2019;68:189-194. doi:10.15585/mmwr.mm6808a1

  2. U.S. Food and Drug Administration. FDA finalizes enforcement policy on unauthorized flavored cartridge-based e-cigarettes that appeal to children, including fruit and mint. Updated January 2, 2020.

  3. Mark KS, Farquhar B, Chisolm MS, Coleman-Cowger V, Terplan M. Pregnant Women's Knowledge and Attitudes Regarding Electronic Cigarettes. Obstetrics & Gynecology. 2015;125:101S. doi:10.1097/01.AOG.0000463568.21952.56

  4. Mark KS, Farquhar B, Chisolm MS, Coleman-Cowger VH, Terplan M. Knowledge, Attitudes, and Practice of Electronic Cigarette Use Among Pregnant Women. J Addict Med. 2015;9(4):266-272. doi:10.1097/ADM.0000000000000128

Additional Reading
  • Vaping in Pregnancy. May 2-6, 2015, presentation, American Congress of Obstetricians and Gynecologists, San Francisco, CA.

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