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J Okla State Med Assoc. 2018 Oct;111(8):812-816.

Examining pregnant smokers' attitudes toward cessation aids and electronic nicotine delivery systems.

Author information

Oklahoma Tobacco Research Center, Stephenson Cancer Center, Oklahoma City, OK.
Department of Psychology, Syracuse University, Syracuse, NY.
Department of Psychology, Oklahoma State University, Stillwater, OK.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK.



Tobacco remains one of the most commonly used substances during pregnancy. Despite the many health risks, pregnant women report low nicotine replacement therapy (NRT) adherence and associated quit rates due partially to perceptions of increased harm related to NRT use. The health risks coupled with the continuation of tobacco use reinforce the need for a greater understanding of these behaviors and attitudes towards NRT and electronic nicotine delivery systems (ENDS) in pregnant women. Therefore, the current study aims to understand pregnant smokers' attitudes towards cessation aids and various tobacco products.


Pregnant women who reported current cigarette smoking (N = 85) were recruited from a Perinatal Center. Participants completed a 19-item self-administered survey relating to tobacco use and NRT interest.


Overall, participants reported smoking fewer cigarettes per day since becoming pregnant. Those who had used NRT and/or ENDS prior were willing to use them during their current or future pregnancies. Overall, interest in ENDS use was high (50.6% during pregnancy, 53.5% after pregnancy), despite only 5.9% of participants currently reporting use.


This study is the first to find that pregnant smokers may be hesitant to use NRT and ENDS instead of combustible tobacco during pregnancy, potentially due to the perceived harmfulness of these products, but feel more willing to use products that they have used previously. Therefore, education and counseling by medical providers regarding varying levels of harm related to use of NRT and nicotine/tobacco products should be included in the routine healthcare of pregnant smokers.


e-cigarettes; pregnancy; tobacco


Conflict of interest statement

Conflicts of Interest and Disclosures The authors declare no pertinent conflict of interest and did not receive funding for this project.

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