Prevalence and Distribution of Electronic Cigarette Use Before and During Pregnancy among Women in 38 States of the United States.

Introduction:
This text provides an analysis of the prevalence and distribution of electronic cigarette use before and during pregnancy among women in 38 states of the United States. The study uses data from the Pregnancy Risk assessment Monitoring System (PRaMS) in the United States from 2016-2017. The study aims to examine the changing pattern of e-cigarette use from preconception to pregnancy.

Key Points:

* The weighted prevalence of e-cigarette use before pregnancy and during the last 3 months of pregnancy was 3.6% (95% confidence interval [CI] 3.4%--3.9%) and 1.1% (0.9%--1.2), respectively.
* The prevalence varied across states, ranging from 1.3% to 8.3% for e-cigarette use before pregnancy and from 0.1% to 3.4% for e-cigarette use during the last 3 months of pregnancy.
* among women who used e-cigarettes before pregnancy, 24.4% (21.7%--27.1%) continued to use e-cigarettes during pregnancy.
* Conventional cigarette use is a strong risk factor for e-cigarette use before and during pregnancy.
* Young women, non-hispanic whites, alcohol drinkers, smokers, and women who are unmarried or with low family income had a higher prevalence of e-cigarette use than others.
* among women who used e-cigarettes before pregnancy, 35.1% (32.1%--38.1%) were dual users of conventional cigarettes and e-cigarettes. among women who used e-cigarettes during pregnancy, 62.3% (56.5%--68.0%) were dual users.
* There were some changes in e-cigarette use from preconception to pregnancy. among the 69 508 women in this survey, 0.9% (0.8%--1.0%) used e-cigarettes both before and during pregnancy, 2.8% (2.6%--2.9%) used e-cigarettes before pregnancy but quit e-cigarettes during pregnancy, and 0.2% (0.1%--0.3%) did not use e-cigarettes before pregnancy but initiated e-cigarette use during pregnancy.

Main Message:
The study highlights the need for continued monitoring of the prevalence of e-cigarette use among pregnant women. The study also emphasizes the importance of addressing the use of conventional cigarettes as a strong predictor of e-cigarette use before and during pregnancy. The findings suggest that targeted interventions may be necessary to reduce e-cigarette use among pregnant women, particularly among those who are also using conventional cigarettes. Overall, the study underscores the importance of promoting evidence-based approaches to reduce tobacco use during pregnancy and improve maternal and child health outcomes.

Liu B, Du Y, Wu Y, et al. Prevalence and Distribution of Electronic Cigarette Use Before and During Pregnancy among Women in 38 States of the United States. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2021;23(9):1459-1467. doi:10.1093/ntr/ntab041