RESUMEN
BACKGROUND: Research suggests that pregnancy status (prior, current, and future intention) is associated with differences in perceived harm of e-cigarette use during pregnancy. However, perceptions of health outcomes attributed to cigarette and e-cigarette use during pregnancy have not been explored among a sample of pregnant women who smoke. OBJECTIVES: The purpose of this study was to explore differences in perceived harms of cigarette and e-cigarette use and perceived birth and health outcomes associated with cigarette and e-cigarette use during pregnancy among a sample of pregnant women who currently smoked. METHODS: Using a cross-sectional online survey, we examined perceptions about cigarette and e-cigarette use during pregnancy among a sample of U.S. pregnant women (n = 267) who smoked in the past 30 days. Participants were grouped into categories based on e-cigarette use status (current, past, and never e-cigarette users). Differences between e-cigarette use status and perceived harm (absolute of cigarettes, e-cigarettes, and relative of e-cigarettes) and perceived health outcomes attributed to smoking/e-cigarette use were examined. RESULTS: Among our sample, 45.7%, 39.7%, and 14.6% were current, ever, and never e-cigarette users, respectively. Associations existed between e-cigarette use status and absolute perceived harm of cigarettes, relative perceived harm of e-cigarettes, and perceived health outcomes. Current e-cigarette users believed pregnant women who smoked cigarettes were more likely to lose a child due to miscarriage or sudden infant death syndrome or give birth to a child with low birth weight, reduced lung function, cleft lip, reduced brain function, or attention-deficit/hyperactivity disorder than never e-cigarette users. No associations were found between perceived birth and health outcomes of e-cigarette use by e-cigarette user status. DISCUSSION: Pregnant women who smoked and used e-cigarettes had lower risk perceptions about e-cigarette use during pregnancy than those who only smoked. Health messages and research about the harms of nicotine exposure during pregnancy should address the risks of dual-use versus only e-cigarette use. Additionally, messages about the relative harm of e-cigarettes compared to cigarettes are needed for pregnant women who smoke and have trouble quitting.
RESUMEN
BACKGROUND: As of November 15, 2013, 22 states had passed laws explicitly addressing youth access to electronic cigarettes (e-cigarettes); by 2014, this increased to 41 states. Also in 2014, more than 13.4% of youth in the U.S. reported using e-cigarettes, making e-cigarette use more prevalent than conventional cigarette use (9.2%). METHODS: We examined 221 bills addressing youth access and exposure to e-cigarettes between January 1 and November 1, 2015. Text searches on individual state general assembly websites and secondary sources were employed for data collection. Laws were analyzed using seven measures identified to protect adolescents from nicotine initiation and use. RESULTS: Two states (MI, PA) and Washington D.C. do not regulate the sale or distribution of e-cigarettes to youth as of November 1, 2015. Additionally, seventeen states have passed laws requiring e-cigarettes to use child-safety packaging to minimize unintended poisoning. As of July 1, 2016, four states (KS, LA, MN, and NC) will tax e-cigarettes. Oregon prohibits the use of e-cigarettes in cars with children under 18years of age, and Wyoming requires the public health department to develop educational campaigns to better educate the state on the risks of nicotine and tobacco products. CONCLUSION: While states are closing the gap of youth nicotine exposure, there remains a need to protect youth from e-cigarettes access, which can cause adverse health effects of brain development, lung function and potentially lead to addiction. Recommendation for the FDA to regulate e-cigarettes federally would close this regulation gap and protect youth across the U.S.
