Abstract：
BACKGROUND: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (a) characteristics of smokers who begin using ECs during pregnancy, (b) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (c) risk for neonatal health complications among smokers who initiate ECs during pregnancy.
METHODS: Pregnant women using CCs exclusively pre-pregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified as dual users (used both ECs and CCs) or EC replacers (used ECs exclusively).
RESULTS: Of 29,505 pregnant smokers, 1.5% reported using ECs during the last 3 pregnancy months. Among them, 29.7% became EC-exclusive users. EC initiators were disproportionately non-Hispanic White. Relative to quitters, EC initiators had lower income, were less likely to be married, have intended pregnancies, receive first-trimester prenatal care, and participate in a federal assistance program. Compared to CC-exclusive users, EC initiators overall, and dual users specifically, were more likely to reduce pre- and post-natal CC usage relative to pre-pregnancy levels. EC initiators\' risk for neonatal health complications fell between quitters and CC-exclusive users, though differences were not statistically significant.
CONCLUSIONS: Although EC initiators reduced CC use more than CC-exclusive users, only 29.7% reported complete CC cessation, and there was insufficient evidence of reduction in neonatal health complications relative to CC-exclusive users. Currently, ECs should not be considered a viable gestational smoking cessation strategy.
CONCLUSIONS: Health agencies have identified a critical need for research evaluating the use of e-cigarettes in supporting prenatal smoking cessation. Using the US Pregnancy Risk Assessment Monitoring System surveillance study data, we provide real-world evidence that prenatal e-cigarette initiation as a smoking cessation tool is used infrequently among pregnant combustible cigarettes smokers. Most using e-cigarettes in the last three months of pregnancy also used combustible cigarettes.
METHODS: Pregnant women using CCs exclusively pre-pregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified as dual users (used both ECs and CCs) or EC replacers (used ECs exclusively).
RESULTS: Of 29,505 pregnant smokers, 1.5% reported using ECs during the last 3 pregnancy months. Among them, 29.7% became EC-exclusive users. EC initiators were disproportionately non-Hispanic White. Relative to quitters, EC initiators had lower income, were less likely to be married, have intended pregnancies, receive first-trimester prenatal care, and participate in a federal assistance program. Compared to CC-exclusive users, EC initiators overall, and dual users specifically, were more likely to reduce pre- and post-natal CC usage relative to pre-pregnancy levels. EC initiators\' risk for neonatal health complications fell between quitters and CC-exclusive users, though differences were not statistically significant.
CONCLUSIONS: Although EC initiators reduced CC use more than CC-exclusive users, only 29.7% reported complete CC cessation, and there was insufficient evidence of reduction in neonatal health complications relative to CC-exclusive users. Currently, ECs should not be considered a viable gestational smoking cessation strategy.
CONCLUSIONS: Health agencies have identified a critical need for research evaluating the use of e-cigarettes in supporting prenatal smoking cessation. Using the US Pregnancy Risk Assessment Monitoring System surveillance study data, we provide real-world evidence that prenatal e-cigarette initiation as a smoking cessation tool is used infrequently among pregnant combustible cigarettes smokers. Most using e-cigarettes in the last three months of pregnancy also used combustible cigarettes.
摘要：
背景：卫生机构呼吁研究评估电子烟（EC）在支持产前戒烟中的使用。这项研究旨在描述（a）在怀孕期间开始使用EC的吸烟者的特征，（b）吸烟者减少或消除产前和产后可燃香烟（CC）使用的频率，和（c）在怀孕期间开始ECs的吸烟者中新生儿健康并发症的风险。
方法：孕妇在孕前使用CCs，他参加了美国的一项监视研究，根据他们报告的怀孕后期吸烟行为被归类为CC专属用户，EC发起者,或戒烟者。EC发起者进一步细分为双重用户（同时使用EC和CC）或EC替代品（仅使用EC）。
结果：在29,505名怀孕的吸烟者中，1.5%的人报告在过去3个月内使用ECs。其中,29.7%成为EC独占用户。EC发起人不成比例地是非西班牙裔白人。相对于戒烟者，欧共体发起人的收入较低，不太可能结婚，有意向怀孕，接受孕早期产前护理,并参与联邦援助计划。与CC独占用户相比，EC启动器整体,特别是双重用户，相对于孕前水平，更有可能减少产前和产后CC的使用。EC发起者新生儿健康并发症的风险在戒烟者和CC独占用户之间下降，尽管差异没有统计学意义。
结论：尽管EC发起者比CC独占用户减少了更多的CC使用量，只有29.7%报告完全停止CC，与CC专属使用者相比,新生儿健康并发症减少的证据不足.目前,ECs不应被视为可行的妊娠期戒烟策略。
结论：卫生机构已经确定了评估使用电子烟支持产前戒烟的研究的关键需求。使用美国妊娠风险评估监测系统监测研究数据，我们提供了现实世界的证据，即在怀孕的可燃香烟吸烟者中，很少使用产前电子烟作为戒烟工具。大多数在怀孕的最后三个月使用电子烟的人也使用可燃香烟。
方法：孕妇在孕前使用CCs，他参加了美国的一项监视研究，根据他们报告的怀孕后期吸烟行为被归类为CC专属用户，EC发起者,或戒烟者。EC发起者进一步细分为双重用户（同时使用EC和CC）或EC替代品（仅使用EC）。
结果：在29,505名怀孕的吸烟者中，1.5%的人报告在过去3个月内使用ECs。其中,29.7%成为EC独占用户。EC发起人不成比例地是非西班牙裔白人。相对于戒烟者，欧共体发起人的收入较低，不太可能结婚，有意向怀孕，接受孕早期产前护理,并参与联邦援助计划。与CC独占用户相比，EC启动器整体,特别是双重用户，相对于孕前水平，更有可能减少产前和产后CC的使用。EC发起者新生儿健康并发症的风险在戒烟者和CC独占用户之间下降，尽管差异没有统计学意义。
结论：尽管EC发起者比CC独占用户减少了更多的CC使用量，只有29.7%报告完全停止CC，与CC专属使用者相比,新生儿健康并发症减少的证据不足.目前,ECs不应被视为可行的妊娠期戒烟策略。
结论：卫生机构已经确定了评估使用电子烟支持产前戒烟的研究的关键需求。使用美国妊娠风险评估监测系统监测研究数据，我们提供了现实世界的证据，即在怀孕的可燃香烟吸烟者中，很少使用产前电子烟作为戒烟工具。大多数在怀孕的最后三个月使用电子烟的人也使用可燃香烟。
