Pregnant women urged to avoid e-cigarettes

Public health

4 Jun 2019

Women who are pregnant, or who think they could be, should avoid using e-cigarettes because of a lack of evidence around their safety, an expert warns.

Writing in a viewpoint in the Lancet Respiratory Medicine Associate Professor Alexander Larcombe, Head of Respiratory and Environmental Health at the Telethon Kids Institute said many people believed that Electronic Nicotine Delivery Systems (ENDS), were either safe or at least far safer than tobacco smoking during pregnancy.

“There is this general perception that it’s either orders of magnitude safer or completely safe to vape during pregnancy, which is completely unfounded and almost certainly not true, because women and babies are still potentially getting exposed to nicotine and other potentially harmful chemicals,” Dr Larcombe said.

Recent research by Dr Larcombe and colleagues found six out of 10 ‘nicotine-free’ e-cigarette liquids purchased over the counter and online in Australia contained nicotine as well as an acutely toxic chemical typically found in pesticides and disinfectants.

“The literature suggests that it is the nicotine in traditional cigarettes and in nicotine replacement therapy that has the greatest impacts on an unborn baby’s health. We know that nicotine impacts brain development, so it affects the behaviour, memory and learning of the child. It also affects lung growth and development and affects the range of other organs in a negative way as well.

“That fact that people may be using e-cigarettes with nicotine during pregnancy probably means that those children are also going to have their health impacted.”

He also said there was a misconception that ENDS aerosols (particularly second-hand aerosols) were non-toxic, which may lead to parents using ENDS around their children more readily than they might smoke if they were smoking tobacco cigarettes.

“Emerging evidence also proposes that nicotine and other substances produced by ENDS can deposit onto surfaces, and subsequently be exposed to infants and children; a process known as third-hand exposure,” he wrote.

“ENDS are often refillable, and instances of accidental poisonings of children who drink nicotine-containing refills have occurred. Thus, there are a multitude of ways that, with respect to early-life exposures and health, ENDS are a cause for concern,” he added.

““What is needed now is a lot of research – we really don’t know the answers to a lot of the questions that people are asking about e-cigarettes.

“Hard data on the potential for ENDS to affect the health of pregnant mothers, their unborn babies, and young children are urgently required to guide policy makers and health-care workers,” Dr Larcombe concluded.

“Clinicians and health-care professionals must be able to give advice to expectant mothers, based on scientific evidence… We must be equipped to treat instances of e-liquid poisonings and do everything possible to safeguard the health of individuals who are unable to control their own health and wellbeing,” he added.

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