The use of tobacco products including cigarettes, smokeless tobacco and e-cigarettes during pregnancy is the most important modifiable risk factor associated with adverse maternal, fetal and neonatal outcomes. Screening for tobacco and e-cigarette use during pregnancy can be a powerful tool to assist patients with smoking cessation. Smoking during pregnancy, particularly of combustible tobacco products, is well-known to effect fetal development. What is not well-known is that the use of e-cigarettes does not eliminate the risk of harm to the fetus.
All pregnant women should be asked about smoking, including the use of e-cigarettes. The strong social norms against smoking during pregnancy lead many women to fail to disclose their true smoking habits. Tobacco can be used in ways other that smoking cigarettes. Cigars, pipes and water pipes are also commonly used, along with dissolvable tobacco products like chewing tobacco, snuff and snus, which are placed in the mouth where the nicotine and other chemicals can be absorbed.
Recently, the use of e-cigarettes has been added to the list of habits used by pregnant women continuing to satisfy their nicotine cravings. The thought by most of these women is that e-cigarettes offered a safer alternative to combustible tobacco primarily because e-cigarettes contain less of the harmful chemicals found in combustible tobacco smoke. It should be noted that this is a false sense of security for the developing fetus.