Should you vape when pregnant? Does it harm your baby?

Are e-cigs and e-liquids safe to use when you're pregnant?

We don't truly know if it is safe to vape when you are pregnant or not – because so little specific research has been done. It's true to say that using e-cigs is currently considered less risky than smoking during pregnancy but that doesn't mean they're safe.

The vapour from an e-cigarette does undoubtedly contain potentially harmful chemicals – though at a lower dose than in cigarettes – but it's not clear if these chemicals can harm your unborn baby.

Recent research from Queen Mary University of London Hospital² has shown that women they studied who used e-cigarettes or nicotine patches during pregnancy had babies that did not differ in birthweight to women who did not smoke in pregnancy – unlike women who smoke in pregnancy whose babies are likely to be smaller at birth. Importantly, there also did not seem to be any adverse effects to either the pregnant woman or the baby from e-cigarettes or the nicotine patch.

However, they have been studies on rats³ suggesting that the nicotine present in many e-cig products could affect a baby's central nervous system in a way that makes them more susceptible to sudden infant death syndrome (SIDS) once they're born.

And we still need more research into the impact of both the nicotine and the vapour in e-cigarettes.

Is it safer to vape rather than smoke in pregnancy?

Yes, although doing neither is definitely the safest option.

If you need help giving up smoking in pregnancy and are thinking of vaping instead, your doctor or midwife will actually recommend you use nicotine replacement patches or gums (NRT), rather than e-cigs. That's because we currently know more about the safety and risks of NRT, while as yet there are many unanswered questions about the safety of e-cigarettes.

What is absolutely clear though, is that there are real risks to both you and your unborn baby by continuing to smoke during pregnancy.

Stopping smoking reduces the risk of pregnancy and birth complications, as well as reducing the risk of your baby being stillborn and born prematurely. It also decreases the risk of your baby having a low birthweight and reduces the risk of (SIDS).

The earlier in your pregnancy that you can stop smoking the better but it still makes a difference even if you don't have long to go until your baby is due.

Are nicotine patches safer than vaping in pregnancy?

As we've seen above, more is known about the safety and risks of nicotine replacement patches and gums, so health professionals will suggest them as the best option to help you quit smoking in pregnancy.

But if e-cigarettes help you quit smoking more effectively than NRT, it's better to vape than continue to smoke.

What exactly is in an e-cigarette?

It depends, as the exact ingredients will vary between brands. But ingredients often include:

Nicotine – which is highly addictive. It's important to know that many brands that state that they are nicotine-free have been found to contain some nicotine
Glycerin – often made from palm oil
Propylene glycol – a synthetic chemical, similar to alcohol
Flavourings and other chemicals

There has also been evidence that e-cigarettes contain small amounts of carcinogens (compounds which increase your risk of cancer), such as formaldehyde, as well as toxic metals, such as lead. These carcinogens may be present at lower levels than they are in cigarettes but they are still present.

Is it safe to vape around my baby?

Again, we don't truly know. We don't yet have the evidence to know if the vapour from vapes is safe or not, though it is likely to be safer than that of cigarettes. (There is clear evidence that passive smoking of cigarettes is a risk to babies and children – even if you smoke at the bottom of the garden.)

If anyone in your household vapes, it's really important that they keep their vapes in a safe place, well away from your child. If a child drinks the liquid in e-cigarettes – which is often appealingly sweet-flavoured – there is a risk of harm, particularly if they drink a significant amount.

Are e-cigarettes available on the NHS?

No, not currently. E-cigarettes aren't available on prescription, although NRT (nicotine patches or gums) is. However, over the next few years, there are plans to roll out a programme offering swaps from cigarettes to vapes.

Where can I get help about quitting smoking in pregnancy?

Your midwife can refer you to a smoking cessation clinic, or your GP surgery may have smoking cessation advice. If you're in England, you may also find it useful to call the National Smokefree helpline on 0300 123 1044; in Scotland, call Smokeline on 0800 848484; in Wales, call Help Me Quit Wales on 0800 0852219. The Northern Irish helpline has closed but you can find support at StopSmokingNI. You can also visit the NHS Smokefree Facebook page.

References:

^{1. Using e-cigarettes to stop smoking. NHS online}^{2. Safety of e-cigarettes and nicotine patches as stop-smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E-cigarettes and Patches (PREP) randomised controlled trial. Pesola et al. Addiction. First published 17 January 2024.}
^{3. Pre‐ and early postnatal nicotine exposure exacerbates autoresuscitation failure in serotonin‐deficient rat neonates. Stella Y Lee et al. J Physiol. 2018 Dec 1; 596(23): 5977–5991. Published online 2018 Jul 15. doi: 10.1113/JP275885}

Pic: Getty Images

Dr Philippa KayeGP

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice.