Pregnant women’s use of e-cigarettes in the UK: a cross-sectional survey

K. Bowker*, S. Lewis, L. Phillips, S. Orton, M. Ussher, F. Naughton, L. Bauld, T. Coleman, L. Sinclair, H. McRobbie, A. Khan, S. Cooper

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: To estimate prevalence of vaping in pregnancy. Compare characteristics and attitudes between exclusive smokers and vapers, and between exclusive vapers and dual users (smoke and vape). Design: Cross-sectional survey. Setting: Hospitals across England and Scotland. Population: Pregnant women attending antenatal clinics in 2017. Methods: Women at 8–24 weeks’ gestation completed screening questions about their smoking and vaping. Current or recent ex-smokers and/or vapers completed a full detailed survey about vaping and smoking. Main outcome measures: The prevalence of vaping, characteristics and attitudes of women who vape and/or smoke. Results: Of 3360 pregnant women who completed screening questions, 515 (15.3%, 95% CI 14.1–16.6) were exclusive smokers, 44 (1.3%, 95% CI 1.0–1.8) exclusive vapers and 118 (3.5%, 95% CI 2.9–4.2) dual users. In total, 867 (25.8%) women completed the full survey; compared with smokers (n = 434), vapers (n = 140) were more likely to hold higher educational qualifications (odds ratio [OR) 1.51, 95% CI 1.01–2.25). Compared with exclusive vapers (n = 33), dual users (n = 107) were younger (OR 0.91 95% CI 0.85–0.98) and less likely to hold high qualifications (OR 0.43, 95% CI 0.20–0.96). Compared with smokers, dual users were more likely to be planning to quit smoking (OR 2.27, 95% CI 1.24–4.18). Compared with smokers, vapers were more likely to think vaping was safer than smoking (78.6% versus 36.4%). Conclusions: One in 20 pregnant women report vaping, and most also smoke. Dual users are more motivated towards stopping smoking than smokers. Where women have tried but cannot stop smoking, clinicians could encourage them to consider vaping for smoking cessation. Tweetable extract: One in 20 women report vaping during pregnancy but of those that do vape, most also smoke, despite having intentions to quit.

Original languageEnglish
Pages (from-to)984-993
Number of pages10
JournalBJOG: an International Journal of Obstetrics and Gynaecology
Issue number6
Early online date8 Nov 2020
Publication statusPublished - 9 Apr 2021

Bibliographical note

Funding Information:
This work was funded by Cancer Research UK, Tobacco Advisory Group Project (Grant number C53479/A22733).

Funding Information:
This work was funded by Cancer Research UK, Tobacco Advisory Group Project (Grant number C53479/A22733). The authors would like to thank all participants and staff at the NHS hospitals who were involved in this study. James Brimicombe, from the University of Cambridge, is also thanked for developing the study database, and the following administrative staff at the University of Nottingham: Rebekah Howell, Katarzyna Kowalewska, Tom Coleman-Haynes, Karen Daykin, Rachel Whitemore, Miranda Clark, Anne Dickinson and Darren Kinahan-Goodwin. Tim Coleman is a National Institute for Health Research (NIHR) Senior Investigator. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Publisher Copyright:
© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd


  • E-cigarettes
  • pregnancy
  • prevalence
  • smoking
  • vaping

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