Use of Electronic Vapor Products Before, During, and After Pregnancy Among Women with a Recent Live Birth—Oklahoma and Texas, 2015

March 1, 2019 / Vol. 68 / 08

MMWR Introduction

Electronic vapor products (EVPs) comprise a diverse group of devices, including electronic cigarettes (e-cigarettes). EVP users inhale an aerosol that typically contains nicotine, flavorings, and other additives. Nicotine is a developmental toxicant that adversely affects pregnancy and infant outcomes. Data from the 2015 Pregnancy Risk Assessment Monitoring System (PRAMS) for Oklahoma and Texas were analyzed to estimate population-based EVP use among women with a recent live birth.

Messages that EVPs are not safe to use during pregnancy and that nicotine adversely affects fetal development and infant outcomes need to be clearly communicated. Health care providers can offer education, counseling, and evidence-based cessation treatment to prevent use of all tobacco products, including EVPs, by women before, during, and after pregnancy.

MMWR Highlights

EVP use before pregnancy (defined as >3 months before pregnancy) among women with a recent live birth, 2015

  • 10.4%.

EVP use around the time of pregnancy among women with a recent live birth, 2015

  • 7.0% at any point around the time of pregnancy, including:
    • 3 months before pregnancy: 5.8%.
    • Last 3 months of pregnancy: 1.4%.
    • 2–6 months after delivery: 2.1%.

Use of both EVPS and cigarette smoking among women who smoked cigarettes in the past 2 years and had ever used EVPs, 2015

  • 3 months before pregnancy: 38.0%.
  • Last 3 months of pregnancy: 7.7%.
  • 2–6 months after delivery: 11.8%.

Other Key Findings

  • EVP use was higher among smokers than non-smokers:
    • Among smokers, 29.8% used before pregnancy, and 25.1% used around the time of pregnancy.
    • Among non-smokers, 6.0% used before pregnancy, and 2.9% used around the time of pregnancy.
  • Among women using EVPs during the last 3 months of pregnancy:
    • 38.4% reported use of EVPs containing nicotine.
    • 26.4% were unsure of nicotine content.
  • Among women who reported smoking in the past 2 years and ever using EVPs, EVP use alone was highest during the 2–6 months after delivery (3.8%), and the prevalence of neither cigarette smoking nor EVP use was highest (61.9%) during the last 3 months of pregnancy.