Longitudinal Examination of Prenatal Tobacco Switching Behaviors and Birth Outcomes, Including Electronic Nicotine Delivery System (ENDS) and Dual Use.

Introduction:
This text provides an analysis of a study examining the impact of tobacco product switching behaviors during pregnancy on birth outcomes. The study focuses on conventional cigarette use, electronic nicotine delivery systems (ENDS) use, and dual use (conventional cigarettes and ENDS) during pregnancy and how these behaviors affect gestational age, birth weight, respiratory distress, and NICU admittance. The study aims to determine the relationship between switching behaviors and birth outcomes while controlling for potential confounding factors.

Key Points:

* The study included 218 pregnant women, with 48.6% using conventional cigarettes only, 41.7% using both conventional cigarettes and ENDS, and 10% using ENDS only.
* Most participants (62.4%) used the same tobacco product throughout pregnancy, while 26% reported switching behaviors between products.
* There were no differences in gestational age at delivery, respiratory distress, or NICU admittance between participants who switched products and those who did not.
* Infants born to participants who quit using tobacco products entirely weighed significantly more than those born to participants who did not switch products.
* The study controlled for potential confounding factors, including age, preterm birth, race, marital status, education attainment, household income, and employment status.
* The study found that women who use tobacco products in pregnancy are likely to continue using tobacco and may switch between conventional and ENDS products.
* Women's use patterns may be a critical component to consider during screening and treatment, and cross-sectional measurement of tobacco product use may no longer be adequate to characterize women's tobacco use behaviors in pregnancy.

Main Message:
The study emphasizes the importance of considering tobacco product switching behaviors during pregnancy and how these behaviors impact birth outcomes. While quitting tobacco use entirely is associated with better birth outcomes, switching between tobacco products during pregnancy does not appear to have a significant impact on gestational age, respiratory distress, or NICU admittance. However, women who use tobacco products in pregnancy are likely to continue using tobacco and may switch between conventional and ENDS products. Thus, women's use patterns may be a critical component to consider during screening and treatment, and cross-sectional measurement of tobacco product use may no longer be adequate to characterize women's tobacco use behaviors in pregnancy. The study's findings highlight the need for further research to inform clinical practice and policy-making around tobacco product use during pregnancy.

Ashford K, McCubbin A, Barnett J, et al. Longitudinal Examination of Prenatal Tobacco Switching Behaviors and Birth Outcomes, Including Electronic Nicotine Delivery System (ENDS) and Dual Use. Maternal and child health journal. 2021;25(8):1175-1181. doi:10.1007/s10995-021-03161-z