Usher Institute

Vapes work better than patches in pregnancy trial

E-cigarettes may be more effective than nicotine patches for pregnant women trying to quit smoking, research suggests.

Hand holding electronic cigarette

A study of expectant women who were trying to stop smoking found that twice as many women quit with so-called vapes than with nicotine patches.

Researchers say pregnant smokers struggling to quit should consider e-cigarettes as an alternative to current health guidelines, which suggest nicotine replacement products.

Established replacement therapies such as patches, gums and mouth sprays are currently recommended alongside behavioural support – but most pregnant women still struggle to quit. 

The new study, led by Queen Mary University of London and involving Edinburgh researchers, focused on more than 1,000 pregnant women who were trying to stop smoking. 

Equally safe

The women were split into two groups – half of the women received e-cigarettes and the other half received nicotine patches. Both approaches were equally safe.

At the end of their pregnancy, women reported if they had quit and researchers looked at safety outcomes including low birthweight, intensive care admissions, miscarriage, stillbirth and premature birth. 

When the researchers looked at successful quitters, who only used the treatment they were allocated, almost twice as many women quit with e-cigarettes than with nicotine patches.

Some excluded

Some participants were excluded from the results as they had quit smoking using a product they were not assigned – mostly women given patches who stopped with the help of vapes. 

The results also showed that fewer women in the e-cigarette group had children with low birthweight – less than 2,500 grams – which has been linked with poor health later in life.  

This is most likely because e-cigarettes were more effective in reducing the use of conventional cigarettes, researchers say.

E-cigarettes have an advantage over nicotine gum and patches as they allow smokers to select the strength and flavours they like, and make the transition to stopping smoking easier. 

This is most likely why e-cigarettes have been shown more effective than the traditional nicotine replacement therapy in people who are not pregnant, experts say.

Growth affected

Smoking in pregnancy can harm developing babies, especially their growth, although it is not clear if nicotine is harmful to developing babies. 

The National Institute of Health and Care Excellence says most health problems are caused by toxins other than nicotine in cigarettes.

The study, published in NIHR Journals Library, was funded by the National Institute for Health and Care Research (NIHR).

Health challenge

Ideally, neither smoking nor vaping should occur in pregnancy. But the reality is that smoking during pregnancy continues to be a public health challenge that needs to be addressed. We need to find more and better routes to help women quit when they are pregnant, and our study found that e-cigarettes were a promising option. Of course, we need further studies to examine this issue but these results should provide women who are trying to stop smoking – and health professionals – with valuable evidence about vaping as a cessation aid.

Professor Linda BauldCo-Head of Centre for Population Health Sciences at the University of Edinburgh's Usher Institute

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.

Professor Peter HajekDirector of the Health and Lifestyle Research Unit at Queen Mary University of London

Related Links

Read the study in NIHR Journals Library


Image Credit: Rapeepong Puttakumwong via Getty Images