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Cited by 34Smoking Behavior and CessationPrenatal Substance Exposure EffectsMaternal and Neonatal Healthcare

Dual use of cigarettes and electronic nicotine delivery systems during pregnancy and the risk of small for gestational age neonates

Cardenas, Victor Manuel, Ali, Mir Murtuza, Fischbach, Lori Ann, Nembhard, Wendy Nicole·2020·Annals of Epidemiology
DOI 10.1016/j.annepidem.2020.08.002
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Abstract

Purpose The purpose of this study was to estimate the effect of cigarette smoking and electronic nicotine delivery systems (ENDS) use during pregnancy on small for gestational age (SGA). Methods We used data from the 2016-2017 Arkansas Pregnancy Risk Assessment Monitoring System, estimated the risk ratio (RR) for SGA for maternal prenatal cigarette smoking-only use, cigarette smoking, and ENDS use (i.e., dual use), with no prenatal tobacco use as referent, accounting for the complex survey design. We also explored these effects for women who stopped smoking cigarettes during pregnancy among cigarette smokers and dual users. Results Estimated adjusted RR for SGA for cigarette-only users was 1.7 (95% confidence interval [CI]: 1.1, 2.7), and 1.8 (95% CI: 1.0, 3.4) for dual users. These RR estimates increased after correcting for tobacco use misclassification. Women who were dual users (cigarette smokers and ENDS users) and continued using ENDS but stopped smoking cigarettes had an increased risk for SGA compared with nontobacco users, 3.2 (95% CI: 1.5, 6.6). Conclusions Our results in a population representative sample are consistent with the hypothesis that exposure to both maternal cigarette smoking and ENDS use increased the risk of SGA. Dual users still had an elevated risk of SGA after smoking cessation.

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Crossref · 10.1016/j.annepidem.2020.08.002

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  • In 17 studies it was not assessed whether any of those counted as vaping used non-nicotine vapes.

    “and in 17 studies it was not assessed whether any of those counted as vaping used non-nicotine vapes [32, 35, 36, 38, 42, 43, 45, 46, 48–56].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [35]

  • One study reported that, compared with non-users, dual-users who switched to exclusive-vaping had an elevated risk of SGA.

    “Similarly, one study reported that, compared with non-users, dual-users who switched to exclusive-vaping had an elevated risk of SGA [35].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [35]

  • Eight of ten studies comparing SGA or MBC prevalence between exclusive-vapers and non-users reported no significant differences.

    “Eight of ten studies comparing SGA or MBC prevalence between exclusive-vapers and non-users reported no significant differences [32, 34, 35, 42, 46, 50, 53, 54].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [35]

  • The finding for the latter two PRAMS studies is inconsistent with six of the above PRAMS studies which found no group differences.

    “Similar to the findings for PTB/GA, the finding for the latter two ‘PRAMS’ studies is inconsistent with six of the above PRAMS studies which found no group differences [32, 35, 42, 50, 53, 54].”

    From Vaping during pregnancy: a systematic review of health outcomes. (2024) · cites this paper as [35]

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Authors
Cardenas, V. M., Ali, M. M., Fischbach, L. A., & Nembhard, W. N.
Affiliations
University of Arkansas for Medical Sciences (US)
Corresponding author
Cardenas, Victor Manuel
ORCID
Venue
Annals of Epidemiology
Publisher
Elsevier BV
Published
2020-12
Volume
52
Pages
86-92.e2
ISSN
1047-2797 (ISSN-L)
DOI
10.1016/j.annepidem.2020.08.002
OpenAlex
W3049611618
Cited by
34
References
11
Citations by year
2026: 7 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 5 · 2021: 5
FWCI
2.41
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Annals of Epidemiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
Centers of Disease Control
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
dual tobacco use, electronic cigarettes, cigarette smoking, pregnancy, small for gestational age, fetal growth restriction, smoking cessation, prenatal tobacco exposure
MeSH terms
Cigarette Smoking, Adolescent, Adult, Female, Humans, Infant, Newborn, Infant, Small for Gestational Age, Nicotine, Pregnancy, Prenatal Exposure Delayed Effects, Tobacco, Smokeless, United States, Cohort Studies, Smoking Cessation, Premature Birth, Term Birth, Young Adult, Tobacco Products, Electronic Nicotine Delivery Systems

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