Pesola, Francesca, Smith, Katie Myers, Phillips-Waller, Anna et al. (17 more authors) (2024) 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. Addiction. pp. 875-884. ISSN 1360-0443
Abstract
Aims: The aim of this study was to examine the safety of e-cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit. Design: A recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use. Setting: Twenty-three hospitals in England and a stop-smoking service in Scotland took part. Participants: The participants comprised 1140 pregnant smokers. Interventions: We compared women using and not using EC and NRT regularly during pregnancy. Measurements: Measurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers. Findings: Use of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end-of-pregnancy (EOP) reduced their salivary cotinine by 45% [49.3 ng/ml, 95% confidence interval (CI) = −79.8 to −10]. Only one abstainer used NRT at EOP. In dual users, cotinine increased by 19% (24 ng/ml, 95% CI = 3.5–68). In women reporting a reduction of at least 50% in cigarette consumption, cotinine levels increased by 10% in those using nicotine products and by 9% in those who did not. Birth weights in dual users and exclusive smokers were the same (3.1 kg). Birth weight in abstainers using either nicotine product was higher than in smokers [3.3 kg, standard deviation (SD) = 0.7] versus 3.1 kg, SD = 0.6; difference = 0.15 kg, 95% CI = 0.05–0.25) and not different from abstainers not using nicotine products (3.1 kg, SD = 0.8). Abstainers and smokers using nicotine products had no worse pregnancy outcomes or more adverse events than abstainers and smokers not using them. EC users reported more improvements than non-users in cough [adjusted relative risk (aRR) = 0.59, 95% CI = 0.37–0.93] and phlegm (aRR = 0.53, 95% CI = 0.31–0.92), controlling for smoking status. EC or NRT use had no association with relapse. Conclusions: Regular use of e-cigarettes or nicotine patches by pregnant smokers does not appear to be associated with any adverse outcomes.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | Funding Information: The study was funded by the National Institute of Health and Care Research, Health Technology Assessment Programme, ref: 15/57/85. The funder had no role in the study design; in the collection, analysis and interpretation of data; in the writing of the paper; or in the decision to submit the findings for publication. Publisher Copyright: © 2024 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction. |
Keywords: | Birth weight,e-cigarettes,nicotine,pregnancy,safety,smoking,vaping |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Chemistry (York) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Depositing User: | Pure (York) |
Date Deposited: | 19 Mar 2024 09:20 |
Last Modified: | 16 Oct 2024 19:50 |
Published Version: | https://doi.org/10.1111/add.16422 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1111/add.16422 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:210538 |
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Description: Addiction - 2024 - Pesola - Safety of e‐cigarettes and nicotine patches as stop‐smoking aids in pregnancy Secondary
Licence: CC-BY 2.5