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      Safety of e‐cigarettes and nicotine patches as stop‐smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E‐cigarettes and Patches (PREP) randomized controlled trial

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          Abstract

          Aims

          The aim of this study was to examine the safety of e‐cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit.

          Design

          A recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use.

          Setting

          Twenty‐three hospitals in England and a stop‐smoking service in Scotland took part.

          Participants

          The participants comprised 1140 pregnant smokers.

          Interventions

          We compared women using and not using EC and NRT regularly during pregnancy.

          Measurements

          Measurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers.

          Findings

          Use of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end‐of‐pregnancy (EOP) reduced their salivary cotinine by 45% [49.3 ng/ml, 95% confidence interval (CI) = −79.8 to −10]. Only one abstainer used NRT at EOP. In dual users, cotinine increased by 19% (24 ng/ml, 95% CI = 3.5–68). In women reporting a reduction of at least 50% in cigarette consumption, cotinine levels increased by 10% in those using nicotine products and by 9% in those who did not. Birth weights in dual users and exclusive smokers were the same (3.1 kg). Birth weight in abstainers using either nicotine product was higher than in smokers [3.3 kg, standard deviation (SD) = 0.7] versus 3.1 kg, SD = 0.6; difference = 0.15 kg, 95% CI = 0.05–0.25) and not different from abstainers not using nicotine products (3.1 kg, SD = 0.8). Abstainers and smokers using nicotine products had no worse pregnancy outcomes or more adverse events than abstainers and smokers not using them. EC users reported more improvements than non‐users in cough [adjusted relative risk (aRR) = 0.59, 95% CI = 0.37–0.93] and phlegm (aRR = 0.53, 95% CI = 0.31–0.92), controlling for smoking status. EC or NRT use had no association with relapse.

          Conclusions

          Regular use of e‐cigarettes or nicotine patches by pregnant smokers does not appear to be associated with any adverse outcomes.

          Related collections

          Most cited references26

          • Record: found
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          A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy

          E-cigarettes are commonly used in attempts to stop smoking, but evidence is limited regarding their effectiveness as compared with that of nicotine products approved as smoking-cessation treatments.
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            • Abstract: not found
            • Article: not found

            Determinants of tobacco use and renaming the FTND to the Fagerstrom Test for Cigarette Dependence.

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              Electronic cigarettes for smoking cessation

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                Author and article information

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                Journal
                Addiction
                Addiction
                Wiley
                0965-2140
                1360-0443
                January 17 2024
                Affiliations
                [1 ] Wolfson Institute of Population Health Queen Mary University of London London UK
                [2 ] Blizard Institute Queen Mary University of London London UK
                [3 ] National Drug and Alcohol Research Centre University of New South Wales Sydney Australia
                [4 ] Centre for Academic Primary Care University of Nottingham Nottingham UK
                [5 ] Division of Population Health Sciences and Education, St George's, University of London and Institute of Social Marketing and Health University of Stirling Stirling UK
                [6 ] Usher Institute and SPECTRUM Consortium University of Edinburgh Edinburgh UK
                [7 ] School of Health Sciences University of East Anglia Norwich UK
                [8 ] St George's University Hospitals NHS Foundation Trust London UK
                Article
                10.1111/add.16422
                38654602
                4d3b649c-631b-4578-aa26-dbe0759d9753
                © 2024

                http://creativecommons.org/licenses/by/4.0/

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