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In a breakthrough study led by researchers at the Wolfson Institute of Population Health, Queen Mary University of London, new evidence suggests that the use of nicotine replacement products (NRT) to aid smoking cessation during pregnancy is not associated with adverse events or poor pregnancy outcomes. The findings challenge existing perceptions and may provide a safer alternative for pregnant women looking to quit smoking.
Professor Peter Hajek, lead researcher of the study, stated, “Using nicotine products to stop smoking during pregnancy appeared safe,” as reported by Medscape News UK. The study, funded by the National Institute for Health and Care Research (NIHR), analyzed trends and outcomes related to the use of e-cigarettes and nicotine patches among pregnant women attempting to quit smoking.
Contrary to concerns raised by previous research, the study revealed that pregnant women who quit smoking cigarettes and utilized e-cigarettes and nicotine patches had infants with significantly higher birth weights compared to smokers. Moreover, the birth weights were comparable to infants born to abstainers who did not use nicotine products. The researchers emphasized that no risks to pregnancy were detected from the use of e-cigarettes or nicotine patches in smokers attempting to quit.
The prevalence of smoking during pregnancy has been on a declining trend, reaching a record low of 8.8% in 2022-2023. Despite the decrease, it remains higher than the government’s target of 6%. Public Health England’s landmark review in 2015 highlighted the potential of e-cigarettes to reduce smoking, leading to recommendations from both the Royal College of Obstetricians and Gynaecologists (RCOG) and the NHS for pregnant women to quit smoking entirely, with NRT suggested as an effective aid.
Professor Tim Coleman from the University of Nottingham, involved in the study, acknowledged some clinicians’ reservations about providing NRT or e-cigarettes during pregnancy. The study addressed concerns about large doses of nicotine in animal studies, emphasizing that self-regulated nicotine doses in humans did not translate to adverse pregnancy outcomes.
While knowledge gaps persist, a Cochrane review in 2020 found no evidence of positive or negative impacts on birth outcomes from NRT, and a 2021 systematic review suggested an association between NRT and higher risks of infantile colic and attention-deficit/hyperactivity disorder. However, the new study challenges these findings, emphasizing the safety and potential effectiveness of NRT during pregnancy.
Hazel Cheeseman, deputy chief executive at Action on Smoking and Health, stressed the importance of supporting pregnant smokers to quit and highlighted the study’s contribution to the growing evidence that e-cigarettes are safe and effective for pregnant women seeking smoking cessation. Cheeseman emphasized the need to dispel misperceptions about the risks of nicotine during pregnancy, emphasizing that vaping products and NRT do not increase the risk of harms and can be safely recommended for smoking cessation.
