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E-cigarettes may be better than nicotine patches in helping pregnant women stop smoking

Published: 02 August 2023

E-cigarettes (vapes) may be better than nicotine patches for pregnant women quitting smoking. That’s according to research funded by NIHR and led by Queen Mary University of London. 

Smoking in pregnancy can harm a baby's development, especially their growth. Current guidelines recommend pregnant smokers who find quitting difficult receive nicotine replacement products. Stop-smoking services usually recommend nicotine patches. This research, published in NIHR Journals Library, says pregnant women should also consider e-cigarettes.

The study included 1,140 pregnant women who were trying to stop smoking. They were split into two groups. Half received e-cigarettes and half received nicotine patches. Both approaches were equally safe. Fewer women in the e-cigarette group had children with low birthweight (under 2,500 grams). 

E-cigarettes better for cutting cigarette use 

Researchers suggest this could mean e-cigarettes are better for cutting conventional cigarette use. Low birthweight has been linked with poor health later in life. 

At the end of their pregnancy, women reported whether they had quit. Some women successfully quit smoking using a product they were not assigned. This was mainly women given patches stopping with the help of their own e-cigarettes. 

Researchers also looked at successful quitters using only the treatment they were allocated. Nearly twice as many women quit with e-cigarettes than with nicotine patches.

The researchers also looked at safety outcomes. These included:

  • low birthweight
  • baby intensive care admissions
  • miscarriage
  • stillbirth
  • premature birth

It is unclear whether nicotine is harmful to developing babies. The National Institute for Health and Care Excellence guidance states toxins other than nicotine in cigarettes cause most health problems. It recommends nicotine replacement therapy alongside behavioural support. But, most pregnant women still struggle to quit. 

E-cigarettes form of nicotine replacement therapy 

E-cigarettes can be seen as a form of nicotine replacement therapy. They have an advantage over nicotine gum and patches. Smokers can select strength and flavours they like, helping make quitting easier. This may be why e-cigarettes have proved more effective than traditional nicotine replacement therapy in smokers who aren’t pregnant.

Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, said: “E-cigarettes seem more effective than nicotine patches in helping pregnant women to quit smoking and because of this, they seem to also lead to better pregnancy outcomes. The evidence-based advice to smokers already includes, among other options, a recommendation to switch from smoking to e-cigarettes. Such a recommendation can now be extended to smokers who are pregnant as well.” 

This research has been funded by NIHR's HTA Programme. For more information, please visit the study page on our Funding and Awards website.

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