In de RCT die in Nature Medicine was published, the researchers conclude that e-cigarettes are no less safe than nicotine patches, and may even be more effective in supporting pregnant women who want to quit smoking (2022;28:958-64). This surprised De Kanter: ‘Almost 95% of all women smoked until the end of their pregnancy in this study. So the effectiveness of the interventions that the study examined – nicotine patches and e-cigarettes – was very disappointing.’
Apart from the fact that the effectiveness of the e-cigarette is very limited, the long-term effects for both mother and child are also insufficiently known, emphasizes De Kanter. ‘It is therefore much too early to recommend this intervention. Interventions that have been shown to be effective in helping pregnant women who smoke are motivational interviewing, cognitive behavioral therapy and financial rewards.’
De Kanter also points out the danger of overly positive reporting about the possibility of quitting e-cigarettes; the tobacco lobby easily takes those messages out of context and misuses them as promotional material. Extra risky at a time when tobacco industry paid influencers are everywhere. De Kanter: ‘The first months of pregnancy are crucial for the development of a baby. Then you don’t want to take any risks. We already know from animal studies that nicotine causes predisposition disorders early in pregnancy.’
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