Use of Electronic Vapor Products Before, During, and After Pregnancy Among Women with a Recent Live Birth — Oklahoma and Texas, 2015

Introduction:
This text is a report from the Morbidity and Mortality Weekly Report (MMWR) published by the Centers for Disease Control and Prevention (CDC) regarding the use of electronic vapor products (EVPs) among women with a recent live birth in Oklahoma and Texas. The report highlights the prevalence of EVP use, reasons for EVP use, and dual cigarette and EVP use in a large population-based sample. The study also examines the differences in EVP use between cigarette smokers and nonsmokers.

Key Points:

* The study found that 7.0% of women with a recent live birth in Oklahoma and Texas reported using EVPs shortly before, during, or after pregnancy, with 1.4% reporting use during pregnancy.
* Among prenatal EVP users, 38.4% reported using EVPs containing nicotine, and 26.4% did not know if the EVPs they used contained nicotine.
* Nearly half of women who used EVPs around the time of pregnancy (45.2%) reported using the products because they perceived EVPs to be less harmful to them than regular cigarettes or that EVPs would help them with quitting or reducing smoking.
* The proportion of women who perceived EVPs to be less harmful than cigarettes or that EVPs would help them with quitting or reducing smoking was approximately twice that of those who had used EVPs >3 months before pregnancy (27.4%).
* Among women who smoked cigarettes in the past 2 years and had ever used EVPs, dual use of EVPs and cigarettes was higher in the 3 months before pregnancy and lower during the last 3 months of pregnancy and the 2-6 months after delivery.
* Behavioral intervention is a first-line treatment to help pregnant women quit smoking, and Food and Drug Administration-recommended pharmacotherapy products, including nicotine replacement therapy, can be considered during pregnancy with close supervision of a clinician.
* Variation in coverage provided by health insurance payers might prohibit access to effective treatment. In Texas, for example, women with Medicaid coverage have access to the full range of cessation interventions, with the exception of group and individual counseling, for which coverage varies by plan. In Oklahoma, Medicaid covers all treatment options except group counseling.

Main Message:
The study highlights the use of EVPs among women with a recent live birth in Oklahoma and Texas, with a substantial percentage using EVPs in an attempt to quit smoking cigarettes. The report emphasizes the need for clear communication of messages that EVPs are not safe to use during pregnancy and that nicotine adversely affects fetal development and infant outcomes. Health care providers can offer education, counseling, and evidence-based cessation treatment to prevent use of all tobacco products, including EVPs, by women before, during, and after pregnancy. The study also underscores the importance of ensuring access to evidence-based cessation treatment for all pregnant women, regardless of their insurance coverage.

Kapaya, Martha, Denise V. D’Angelo, Van T. Tong, Lucinda England, Nan Ruffo, Shanna Cox, Lee Warner, et al. “Use of Electronic Vapor Products Before, During, and After Pregnancy Among Women with a Recent Live Birth — Oklahoma and Texas, 2015.” MMWR. Morbidity and Mortality Weekly Report 68, no. 8 (March 1, 2019): 189–94. https://doi.org/10.15585/mmwr.mm6808a1.