The prevalence of regular e-cigarette use among Australian females of reproductive age: Implications for unplanned pregnancies
Bethany Grice, Annelies L. Robijn, Mark Chambers , Hayden McRobbie, Alys Havard
Introduction
The safety of e-cigarettes in pregnancy remains uncertain, however, many e-cigarettes contain nicotine and other chemicals which may have important implications for fetal health. With 30% of pregnancies unplanned, regular e-cigarette use among females of reproductive age may lead to inadvertent fetal exposure to potentially harmful substances in e-cigarettes. We sought to measure the prevalence of regular e-cigarette use in Australian females of reproductive age and the extent to which e-cigarette use was for avoidance of tobacco smoking, given tobacco smoking is the leading cause of adverse pregnancy outcomes.
Methods
We conducted a cross-sectional study involving all females aged 14-44 years participating in the 2019 National Drug Strategy Household Survey (NDSHS), a nationwide survey conducted in Australia every 3 years. We calculated the prevalence of regular (at least weekly) e-cigarette use. We also measured the proportions reporting constructive motivations (to quit or prevent relapse of tobacco smoking) for using e- cigarettes, regular and ex-tobacco smoking status at e-cigarette initiation, and use of other quit-smoking strategies. All analyses incorporated NDSHS survey weights.
Results
Among 5,218 females aged 14-44 years, representing 5,321,317 females nationally, 1.3% (95%CI 1.0-1.7%) used e-cigarettes regularly. Among females with regular e-cigarette use, 83.0% (95%CI 74.5-92.5%) reported at least one constructive motivation for using e-cigarettes, and at the time of initiation of e-cigarette use, 72.3% (95%CI 59.0-82.5%) were regular smokers and 10.1% (95%CI 4.5-21.4%) were ex-smokers. Among females using e-cigarettes regularly with constructive motivations, 50.0% (95%CI 34.7-65.3%) used other quit-smoking strategies.
Conclusion
The low prevalence of regular e-cigarette use among females of reproductive age in 2019 is reassuring, given the high rate of unplanned pregnancies and potential effects on fetal health. Further, as most regular e-cigarette use in this population was for avoidance of tobacco smoking, the risks might be considered tolerable. Continued monitoring of e-cigarette use in this population is recommended as the background rate of e-cigarette use in Australia is increasing.