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Use of E-Cigarettes and Cigarettes During Late Pregnancy Among Adolescents

Wen, Xiaozhong, Liu, Lufeiya, Moe, Aye A., Ormond, Isabelle K., Shuren, Chelsea C., Scott, I’Yanna N., Ozga, Jenny E., Stanton, Cassandra A., Ruybal, Andrea L., Hart, Joy L., Goniewicz, Maciej L., Lee, Dara, Vargees, Comreen·2023·JAMA Network Open
DOI 10.1001/jamanetworkopen.2023.47407PMC PMC10719752
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Abstract

Importance: Pregnant adolescents sometimes use cigarettes; however, little is known about e-cigarette use among pregnant adolescents, a population with increased health vulnerability. Objective: To examine yearly trends, sociodemographic and pregnancy-related determinants, and the association with small-for-gestational-age (SGA) birth of e-cigarette and/or cigarette use during late pregnancy among adolescents. Design, Setting, and Participants: This cohort study used existing data from the 2016-2021 Pregnancy Risk Assessment Monitoring System on 10 428 US adolescents aged 10 to 19 years who had a singleton birth with complete data on e-cigarette or cigarette use and SGA birth. Exposure: Adolescents reported e-cigarette and cigarette use during the last 3 months of pregnancy. Main Outcomes and Measures: SGA birth (birth weight below the 10th percentile for the same sex and gestational duration) was determined from birth certificates. Multivariable logistic regression was used to compare the odds of SGA birth across pregnant adolescents who exclusively used e-cigarettes, exclusively used cigarettes, used e-cigarettes and cigarettes, or did not use either. Results: Of the 10 428 pregnant adolescents, 72.7% were aged 18 or 19 years; 58.9% self-identified as White and 23.3% as Black; and 69.8% were non-Hispanic. The weighted prevalence of exclusive e-cigarette use during late pregnancy increased from 0.8% in 2016 to 4.1% in 2021, while the prevalence of exclusive cigarette use decreased from 9.2% in 2017 to 3.2% in 2021. The prevalence of dual use fluctuated, ranging from 0.6% to 1.6%. White pregnant adolescents were more likely than those who self-identified as another race and ethnicity to use e-cigarettes (2.7% vs 1.0% for American Indian or Alaska Native adolescents, 0.8% for Asian or other race adolescents, 0.6% for Black adolescents, and 0.7% for multiracial adolescents). Compared with those who did not use either product, adolescents who exclusively used e-cigarettes (16.8% vs 12.9%; confounder-adjusted odds ratio [AOR], 1.68 [95% CI, 0.89-3.18]) or who used cigarettes and e-cigarettes (17.6% vs 12.9%; AOR, 1.68 [95% CI, 0.79-3.53]) had no statistically significant difference in risk of SGA birth. However, adolescents who exclusively used cigarettes had a more than 2-fold higher risk of SGA birth (24.6% vs 12.9%; AOR, 2.51 [95% CI, 1.79-3.52]). Conclusions and Relevance: This cohort study suggests that pregnant adolescents increasingly used e-cigarettes, with the highest use among White adolescents. Results from this analysis found that, unlike cigarette use, e-cigarette use during late pregnancy was not statistically significantly associated with an increased risk of SGA birth among adolescents. Due to the uncertainty of this nonsignificant association, future research could benefit from a larger sample size.

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Figure. Prevalence of E-Cigarette (EC) or Combustible Cigarette (CC) Use During Late Pregnancy Among Adolescents by Birth Year, 2016-2021 The analytic sample size was 1693 in 2016, 1818 in 2017, 2028 in 2018, 1783 in 2019, 1673 in 2020, and 1433 in 2021. The trend test P values were P < .001 for exclusive e-cigarette use from 2016 to 2021, P < .001 for exclusive cigarette use from 2017 to 2021, and P = .38 for dual use from 2016 to 2021. Error bars indicate 95% CIs.
Figure. Prevalence of E-Cigarette (EC) or Combustible Cigarette (CC) Use During Late Pregnancy Among Adolescents by Birth Year, 2016-2021 The analytic sample size was 1693 in 2016, 1818 in 2017, 2028 in 2018, 1783 in 2019, 1673 in 2020, and 1433 in 2021. The trend test P values were P < .001 for exclusive e-cigarette use from 2016 to 2021, P < .001 for exclusive cigarette use from 2017 to 2021, and P = .38 for dual use from 2016 to 2021. Error bars indicate 95% CIs.CC BY · PubMed Central

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Citations

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Metadata

Authors
Wen, X., Liu, L., Moe, A. A., Ormond, I. K., Shuren, C. C., Scott, I. N., Ozga, J. E., Stanton, C. A., Ruybal, A. L., Hart, J. L., Goniewicz, M. L., Lee, D., & Vargees, C.
Affiliations
  • Division of Behavioral Medicine, Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo
  • Rochester Institute of Technology, Rochester, New York
  • Behavioral Health and Health Policy, Westat, Rockville, Maryland
  • Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland
  • Department of Communication, College of Arts and Sciences, University of Louisville, Louisville, Kentucky
  • Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York
  • New York Medical College, Valhalla
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2023-12-13
Volume
6
Issue
12
Pages
e2347407
ISSN
2574-3805
DOI
10.1001/jamanetworkopen.2023.47407
PMC
PMC10719752
Cited by
19
References
6
Language
en

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