Abstract
Exposure to tobacco products during pregnancy presents a potential harm to both mother and baby. This study sought to estimate the prevalence of vaping during pregnancy and to explore the factors and outcomes associated with vaping in pregnancy. England. Women who gave birth between 15th and 28th October 2017. A cross-sectional population-based postal survey of maternal and infant health, the National Maternity Survey (NMS) 2018. The prevalence of vaping and patterns of cigarette smoking were estimated, and regression analysis was used to explore associations between maternal characteristics and vaping, and between vaping and birth outcomes. Unweighted and weighted prevalence of vaping with 95% confidence intervals, and unadjusted and adjusted relative risks or difference in means for the association of participant characteristics and secondary outcomes with vaping. Secondary outcome measures were: preterm birth, gestational age at birth, birthweight, and initiation and duration of breastfeeding. A total of 4,509 women responded to the survey. The prevalence of vaping in pregnancy was 2.8% (95%CI 2.4% to 3.4%). This varied according to the pattern of cigarette smoking in pregnancy: 0.3% in never-smokers; 3.3% in ex-smokers; 7.7% in pregnancy-inspired quitters; 9.5% in temporary quitters; and 17.7% in persistent smokers. Younger women, unmarried women, women with fewer years of formal education, women living with a smoker, and persistent smokers were more likely to vape, although after adjusting for pattern of cigarette smoking and maternal characteristics, persistent smoking was the only risk factor. We did not find any association between vaping and preterm birth, birthweight, or breastfeeding. The prevalence of vaping during pregnancy in the NMS 2018 was low overall but much higher in smokers. Smoking was the factor most strongly associated with vaping. Co-occurrence of vaping with persistent smoking has the potential to increase the harms of tobacco exposure in pregnant women and their infants.
Highlights
An estimated six million people die every year as a result of illnesses related to tobacco use [1]
Younger women, unmarried women, women with fewer years of formal education, women living with a smoker, and persistent smokers were more likely to vape, after adjusting for pattern of cigarette smoking and maternal characteristics, persistent smoking was the only risk factor
The National Maternity Survey (NMS) 2018 was the latest in a series of postal surveys of maternal and infant health and care which are periodically conducted in England by the National Perinatal Epidemiology Unit (NPEU) [26,27,28,29]
Summary
An estimated six million people die every year as a result of illnesses related to tobacco use [1]. Tobacco control is a key global health priority. Following a landmark international agreement [5], several countries have taken steps towards controlling tobacco use. The prevalence of cigarette smoking in the general population, which had been increasing through the 1970s and peaking in the mid 1980s [6], has gradually declined in most countries between 1990 and 2015 [7,8,9,10] and is projected to decline further for at least another decade beyond that [11]. Over the decade the prevalence of vaping continued to increase globally, followed by reports of morbidity and mortality attributed to vaping [15,16,17,18]
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