Abstract
Electronic vapor products (EVPs) comprise a diverse group of devices, including electronic cigarettes (e-cigarettes). EVP users inhale an aerosol that typically contains nicotine, flavorings, and other additives (1). Nicotine is a developmental toxicant that adversely affects pregnancy and infant outcomes (2). Data from the 2015 Pregnancy Risk Assessment Monitoring System (PRAMS) for Oklahoma and Texas were analyzed to estimate population-based EVP use among women with a recent live birth. EVP use before pregnancy (defined as >3 months before pregnancy) and around the time of pregnancy (defined as any time during the 3 months before pregnancy, the last 3 months of pregnancy, or 2-6 months after delivery), reasons for EVP use, and dual use of EVPs and cigarettes were assessed. Prevalence of EVP use was 10.4% before pregnancy and 7.0% around the time of pregnancy, including 1.4% during the last 3 months of pregnancy. Among women using EVPs during the last 3 months of pregnancy, 38.4% reported use of EVPs containing nicotine, and 26.4% were unsure of nicotine content. Among women who had used EVPs and cigarettes, dual use prevalence was 38.0% in the 3 months before pregnancy, 7.7% during the last 3 months of pregnancy, and 11.8% in the 2-6 months after delivery. The most frequently reported reasons for EVP use around the time of pregnancy were curiosity (54.0%), the perception that EVPs might help with quitting or reducing cigarette smoking (45.2%), and the perception of reduced harm to the mother, when compared with cigarette smoking (45.2%). Clear messages that EVP use is not safe during pregnancy are needed, and broad, barrier-free access to evidence-based tobacco cessation strategies need to be made available.
Highlights
In Oklahoma, Medicaid covers all treatment options except group counseling.§ In addition, the Oklahoma Tobacco Helpline (1-800-QUIT ), a statewide, free, 24/7 tobacco cessation helpline, offers various options to aid in cessation efforts
In Texas, the toll-free Quitline phone number, 1-877-YES-QUIT was part of the resource list provided to mothers selected for the 2015 PRAMS survey
Marketplace are required to cover tobacco cessation treatment; specific coverage varies by plan
Summary
EVP use >3 months before pregnancy was ascertained by counting the number of women who responded affirmatively to the question “Have you ever used electronic vapor products, even one time?” (excluding those who reported use 3 months before, during, and shortly after pregnancy). Reasons for EVP use were ascertained from a list of nine options.† Cigarette smoking around the time of pregnancy was assessed among women who reported any cigarette smoking in the past 2 years. Among women who reported having ever used EVPs and having smoked cigarettes in the past 2 years, dual use of EVPs and cigarettes was estimated for each of the three periods. The prevalence of EVP use around the time of pregnancy was 7.0% overall (10.3% in Oklahoma and 6.5% in Texas). A higher proportion of women who smoked cigarettes in the past 2 years used EVPs >3 months before pregnancy (29.8% versus 6.0%; p
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