Perceptions about e-cigarette safety may lead to e-smoking during pregnancy

Abstract

Electronic cigarettes (e-cigarettes) are nicotine-delivery devices that are increasingly used, especially by young people. Because e-cigarettes lack many of the substances found in regular tobacco, they are often perceived as a safer smoking alternative, especially in high-risk situations such as pregnancy. However, studies suggest that it is exposure to nicotine that is most detrimental to prenatal development. The authors studied perceptions of tobacco and e-cigarette health risks using a multiple-choice survey. To study the perceived safety of e-cigarettes versus tobacco cigarettes, 184 modified Global Health Youth Surveys (WHO, http://www.who.int/tobacco/surveillance/gyts/en/ ) were completed electronically or on paper. Age range, smoking status, and perceptions about tobacco cigarettes and e-cigarettes were studied. The results verified that younger people use e-cigarettes more than older people. Tobacco cigarettes were perceived as more harmful than e-cigarettes to health in general, including lung cancer and pregnancy. Although more research is necessary, the authors postulate that the perception that e-cigarettes are safer during pregnancy may induce pregnant women to use these devices more freely. Given that nicotine is known to cause fetal harm, pregnant mothers who smoke e-cigarettes could cause even greater harm to the fetus because e-cigarettes are perceived as being safer than tobacco cigarettes. Until more data about the effects of nicotine during pregnancy are available, the authors advocate for labeling of e-cigarettes as potentially harmful, at least during pregnancy.

Figure 1

Percent of “Yes” answers to the questions “Have you ever tried a tobacco cigarette, even one or two puffs?” (dark bars) and “Have you ever tried an e-cigarette, even one or two puffs?” (light bars) according to age range: 18–20 years old (n = 68), 21–30 years old (n = 55), 31+ years old (n = 61).

Figure 2

Percent of answers to three representative health-related questions, separated by age groups: A, Do you think that tobacco cigarettes (or e-cigarettes) can give you lung cancer?; B, Do you think that tobacco cigarettes (or e-cigarettes) are harmful for pregnant women to use?; C, Once someone has started smoking tobacco cigarettes (or e-cigarettes), how easy or hard do you think it is to quit? The p values were calculated by comparing the distributions using the Wilcoxon sign rank test.