E-cigarettes in pregnancy: Reducing or introducing harm?

Abstract

Electronic cigarettes use has become increasingly prevalent with around 17.6% of population using these products. The serious harm to health caused by cigarette smoke is well publicised, and government advice has promoted the message that e-cigarettes are 95% safer; however e-cigarettes are not risk free. Given the high prevalence of e-cigarette usage, pregnant women are likely to look to midwives for guidance on whether e-cigarettes are safe, however advice to midwives is inconsistent. The current paper therefore explores whether e-cigarettes are suitable for pregnant women who want an alternative to traditional cigarettes.  There is a paucity of evidence to confirm the long-term impact of e-cigarettes in pregnancy but research indicates that their expose users to a number of harmful substances.  Nicotine and other chemicals including Diacetyl, Acetoin and 2,3-Pentanedione are detrimental to the health of both mother and child. Harm reduction methods aim to improve the health of individuals with an addiction where abstinence is not a feasible goal; this means that in the first instance pregnant women should be advised to quit smoking and avoid products containing nicotine. If women are unable to abstain from smoking, traditional nicotine replacement therapies (NRT) such as gums and patches are likely to be safer than e-cigarettes. E-cigarettes contain a greater number of harmful chemicals and are likely to provide a greater dose of nicotine.