Factors influencing the uptake and use of nicotine replacement therapy and e-cigarettes in pregnant women who smoke: a qualitative evidence synthesis.

the following summarizes the findings:

1. Women's views on using e-cigarettes were less consistent and more uncertain in terms of safety compared to NRT (nicotine replacement therapy).
2. Of the 11 findings related to NRT, 4 had high confidence and 7 had moderate confidence.
3. Of the seven findings related to e-cigarettes, one was of high confidence, four of moderate confidence, and two of low confidence.
4. The lower confidence in e-cigarette findings was due to fewer studies and data.
5. Confidence in e-cigarette findings was downgraded for relevance issues when studies came from only one country or a few very similar countries.
6. Confidence in e-cigarette findings was also downgraded for adequacy when few studies contributed to the finding or when studies did not provide standardized information on NRT at the start of the trial.
7. The findings of this synthesis are less relevant to women's decisions about starting NRT in trials and more likely to help explain trial participants' adherence to NRT after starting it.
8. Findings on NRT use were assessed as being of higher certainty than those on e-cigarettes, as there is less evidence on how past experience influences future use of e-cigarettes.
9. The available data suggests a similar relationship between NRT and e-cigarettes, but more research is needed to confirm or refute this.
10. A Cochrane Review investigating the effectiveness of pharmacological treatments for smoking cessation, which included e-cigarettes, noted that participants believed e-cigarettes were generally safer than smoking, but they were less certain about their safety in pregnancy, which echoes findings of this QES.
11. The authors of the Cochrane Review highlighted the need for further research in this field due to the scarcity of evidence.

Overall, the findings suggest that while e-cigarettes are generally believed to be safer than smoking, there is less evidence and more uncertainty about their safety, particularly in pregnancy. There is a need for more research in this area to confirm or refute the relationship between e-cigarettes and NRT.

Campbell K, Coleman-Haynes T, Bowker K, Cooper SE, Connelly S, Coleman T. Factors influencing the uptake and use of nicotine replacement therapy and e-cigarettes in pregnant women who smoke: a qualitative evidence synthesis. The Cochrane database of systematic reviews. 2020;5:1. doi:10.1002/14651858.CD013629