Increase of E-cigarette Use during Teenage Pregnancy

According to a study published online on December 13th in JAMA Network Open, the prevalence of e-cigarette use in late pregnancy among adolescents in the United States has increased from 0.8% in 2016 to 4.1% in 2021.

Researchers primarily analyzed data from the 2016-2021 Pregnancy Risk Assessment Monitoring System. They specifically focused on 10,428 teenagers aged 10-19 who had previously given birth to a singleton and provided information on their use of e-cigarettes or conventional cigarettes.

Although researchers found that the prevalence of exclusive e-cigarette use has increased by approximately five-fold, the percentage of pregnant women who only use conventional cigarettes has decreased from 9.2% in 2017 to 3.2% in 2021. The proportion of pregnant women who use both e-cigarettes and conventional cigarettes fluctuated between 0.6% and 1.6%.

There was no significant difference in the proportion of low birth weight among non-smoking or non-e-cigarette using adolescents (12.9%), e-cigarette only users (16.8%), or adolescents who used both cigarettes and e-cigarettes (17.6%). However, researchers found a significant association between smoking only and the proportion of low birth weight (24.6%).

In this study, Dr. Xiaozhong Wen, corresponding author from the Jacobs School of Medicine and Biomedical Sciences at the State University of New York, Buffalo, stated:

In our analysis, using only e-cigarettes and using both traditional cigarettes and e-cigarettes simultaneously appears to have no significant statistical association with lower birth weight. However, considering the lower prevalence of usage and limited sample size, this finding should be interpreted with caution.

The limitations of this study lie in the possibility that participants may underreport their use of e-cigarettes and traditional cigarettes out of concern for social stigma. Additionally, researchers lack information on the use of e-cigarettes during the first and second trimesters of pregnancy, exposure to secondhand smoke, marijuana use, and dietary habits.

This study was supported by the National Institute on Drug Abuse, the Center for Tobacco Products of the Food and Drug Administration, the National Heart, Lung, and Blood Institute, as well as the American Heart Association. One of the co-authors of the study has received grants from Pfizer Inc. and personal fees from Johnson & Johnson, the World Health Organization, and the Campaign for Tobacco-Free Kids.