Use of e‑cigarettes in pregnancy: A systematic review of evidence published from 2020‑2022

Aim This study synthesised evidence related to e-cigarette use in pregnancy published from 2020 to 2022.
Subject and methods Smoking cessation during pregnancy is a key public health focus given associations with adverse health and birth outcomes. E-cigarettes may facilitate quitting combustible cigarette use during pregnancy. A systematic search of online databases (MEDLINE, CINAHL, and PsycINFO) was conducted on 25 February 2022.
Results Thirty-seven studies investigating e-cigarette use in pregnancy were included in the review the majority of which were of ‘good’ quality (n=33). Included studies reported on one or more of; prevalence of e-cigarette use during pregnancy (n=27), birth and health-related outcomes of e-cigarette use during pregnancy (n=13), the impact of e-cigarette use on smoking cessation behaviours (n=11) and attitudes and perceptions around e-cigarette use during pregnancy (n=9). Prevalence
was found to range from 1.2% to 4.8%, whilst perceptions of e-cigarette use during pregnancy were found to be more positive than those towards combustible cigarette use. Findings regarding health and birth outcomes were notably mixed, and the efficacy of e-cigarettes as a smoking cessation tool remains unclear.
Conclusion The majority of studies published in the last two years were on prevalence of e-cigarette use in pregnancy. More high-quality evidence focusing on the effectiveness of e-cigarettes for smoking cessation, and the health implications of e-cigarette use compared with combustible cigarette use during pregnancy is needed to support the implementation of e-cigarettes as a harm-reduction approach in practice.