Original Research

Knowledge, Attitudes, and Practice of Electronic Cigarette Use Among Pregnant Women

Mark, Katrina S. MD; Farquhar, Brooke; Chisolm, Margaret S. MD; Coleman-Cowger, Victoria H. PhD; Terplan, Mishka MD, MPH

Author Information

From the University of Maryland (KSM, BF, MT), Johns Hopkins University School of Medicine (MSC), Battelle Public Health Center for Tobacco Research (VHC-C), and Behavioral Health System Baltimore (MT), Baltimore, MD.

Send correspondence and reprint requests to Katrina S. Mark, MD, Instructor of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, 11 S Paca St, Ste 400, Baltimore, MD 21201. E-mail: [email protected].

The authors declare no conflicts of interest.

Received October 02, 2014

Accepted February 28, 2015

Journal of Addiction Medicine 9(4):p 266-272, July/August 2015. | DOI: 10.1097/ADM.0000000000000128

Abstract

Objective:

Electronic cigarettes (e-cigarettes) are a relatively recent phenomenon, serving dual roles as an alternative vehicle for nicotine delivery and a smoking-cessation tool. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practice regarding electronic cigarettes.

Study Design:

A voluntary, anonymous survey was distributed to a convenience sample of pregnant women presenting to a university-based outpatient clinic. After survey completion, participants received information about smoking cessation and e-cigarettes. Data were examined using χ² and Fisher exact tests and analysis of variance. Stata was used for the analysis.

Results:

Of the 326 surveys distributed, 316 were completed (97%). Of the 316 participants, 42 (13%) reported having ever used e-cigarettes. Only 2 (0.6%) reported current daily use. Ever users were slightly older (27.3 years vs 25.4 years; P = 0.007) and more likely to be current smokers (43% vs. 14%; P < 0.001) compared with women who had never used electronic cigarettes. Knowledge of the harms of smoking was similar between the 2 groups. Overall, 57% of all respondents believed that e-cigarettes contain nicotine, 61% that e-cigarettes can be addictive, and 43% that e-cigarettes are less harmful to a fetus than traditional cigarettes. Among ever users, the most common reasons given for the use of e-cigarettes were the perception of less harm than traditional cigarettes (74%) and help with smoking cessation (72%).

Conclusions:

Misconceptions about e-cigarettes are common among pregnant women, potentially motivating use that may pose risks to both maternal and child health. Screening and education regarding e-cigarettes should be included in prenatal care. Future research in this area is necessary, including research examining pregnancy outcomes among women who use e-cigarettes.