Pretty much every vaper must have seen a warning against vaping when pregnant. Some e-liquids and many device packages have a specific warning symbol for it. Many of them have wording to say not to vape if you are pregnant. Even Totally Wicked packaging recommends that you consult your doctor before vaping when pregnant. So vaping when you are expecting a baby is bad, right? Well actually, no, in many cases it can be an incredibly good thing. If you might be smoking instead, vaping is a much better choice. An expectant mother smoking just an occasional cigarette is a risk for their unborn child. Vaping instead dramatically reduces that risk.
Fake news leads to bad choices
Back in 2021, I was providing e-cigarette training to some healthcare workers that specialise in helping pregnant women. I was disturbed to learn that in many parts of the UK there is more stigma attached to vaping than there is to smoking the odd cigarette when pregnant. This is one of the more unpleasant effects of media feeding us so much incorrect information nowadays. Fake news can lead many people into making bad lifestyle choices. No matter how wrong it may seem, it is happening every day. The reality is that smoking is very bad for mothers-to-be[i]. In some ways, it is even worse for their developing baby. Vaping is a much better choice.
Tobacco smoke contains thousands of toxins. Many of these can cross the placenta and enter the baby's blood stream. The placenta actually increases the concentration of poisonous carbon monoxide, meaning the baby gets a greater dose of the poison[ii]. While nicotine also crosses the placenta when vaping, it is one of the least toxic elements of tobacco smoke[iii]. Of all the thousands of potential toxins in tobacco smoke, we only generally detect two in e-cigarette vapour. We only find them at levels that are a tiny fraction of their levels in tobacco smoke. This means that vaping is a much better choice, as the lesser of two bad things, and massively reduces the potential for harm
Vaping is a much better choice in pregnancy
Fortunately, in the UK we have great organisations and groups that are working hard to correct misperceptions about this. The Royal College of Midwives is part of the Smoking in Pregnancy Challenge Group. The whole of this group is firmly committed to making sure that pregnant women get to hear the truth about vaping in pregnancy. They all publish exceptionally well-researched and written material. As rational people following the science, they are of course very much in favour of people vaping when they would otherwise be smoking. After all, there is never a time when it is better to smoke than it is to vape. Vaping is a much better choice, and that includes when expecting a baby.
Totally Wicked has been working with a small number of health in pregnancy services recently. As with most quit service partnerships we engage in, the most popular products are the TW Skope S, Switz e-liquids, and occasionally the TW Byte disposable pod device. We are keen to support these pilot studies, as it will doubtlessly lead to the inclusion of vaping in pregnancy advice in the NICE guideline on tobacco. At the last review, there was not enough published evidence to make the recommendation. NICE will only make recommendations when they have gathered sufficient weight of sound evidence. That can take time, but it enabled them to recommend vaping as a quit aid in November 2021.
Smoke free family homes
The services that we are working with are providing long-term vaping support for expectant mothers that would otherwise smoke. The support goes on "postpartum", a new word for me that describes the term immediately after the birth. This is important. Returning home with a new baby is one of the times when the temptation to smoke can be greatest. Staying quit must be hard after such a long period of controlled behaviour.
The next challenge for the mother and new baby is often their partner. It is great if they are able to go outside and smoke. This enables a smoke-free house for a new baby's best start in life. However, even this leaves much greater temptation for a quick puff on a cigarette for a breastfeeding mum. We are working on a pilot with a service that is supporting couples to quit for good while expecting a baby, and for their onward lives. We think this could make for some amazing changes to many people's lives.
Best advice for expectant smokers: vaping is a much better choice
If you know a smoker that is trying for a baby, make sure to direct them to the Royal College of Midwives' advice. These are the important points:
- If you are pregnant, your partner is pregnant, or you are both trying for a baby, quit as soon as you can.
- Keep vaping if it helps you quit and stay smoke-free.
- If you are vaping and not smoking while pregnant or postpartum, make sure the midwife records you as a non-smoker. That is exactly what you are.
- Continue to vape while you are breastfeeding if it keeps you smoke-free. There is no reason to believe vaping has any adverse effects for nursing mothers or the babies they feed.
[ii] Hill EP, Hill JR, Power GG, Longo LD. Carbon monoxide exchanges between the human fetus and mother: a mathematical model. Am J Physiol. 1977 Mar;232(3):H311-23. doi: 10.1152/ajpheart.1977.232.3.H311. PMID: 842687. https://pubmed.ncbi.nlm.nih.gov/842687/
[iii] Mayer B. How much nicotine kills a human? Tracing back the generally accepted lethal dose to dubious self-experiments in the nineteenth century. Arch Toxicol. 2014;88(1):5-7. doi:10.1007/s00204-013-1127-0. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880486/