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Public Health England and Vaping While Pregnant

Wednesday, 7 February 2018

Have you heard of the evidence review published by Public Health England (PHE) on e-cigarettes and heated tobacco products? Unless you're seriously into vaping (like we are), you'll be forgiven for not having read it.

But it is worth a read. You can find a summary of the whole document here. But here are some of the main points.

Smoking has decreased in popularity from about 25% ten years ago to 17% nowadays. But it remains the "leading preventable cause of illness and premature death" in the UK. Some of this decline can be attributed to the rise in popularity of e-cigarettes and vaping, which is addictive, PHE admits, but at least 95% less harmful than traditional cigarettes and tobacco products.

The review then spends a little time discussing the effects of nicotine on adults. ("Adolescent nicotine use (separate from smoking) needs more research."). PHE's view of nicotine is that adult smokers and e-cigarette users simply don't consume enough nicotine to put their health at risk.

It's the 70 smoke constituents of tobacco that cause the majority of the health risks. Needless to say, they aren't found in e-cigarettes.

Pregnant women, too

The PHE review also claims that "use of nicotine replacement therapy by pregnant smokers has not been found to increase risk to the foetus." By nicotine replacement therapy, it's likely they mean a nicotine patch, or nicotine gum.

But the practical effects are the same. Whether ingested from gum, through the skin, or in vapour, nicotine hasn't been shown to affect a foetus in a pregnant women.

Bear in mind that this doesn't mean that there are definitively no risks to vaping while pregnant. To use an analogy: just because you've never seen a black swan doesn't mean that all swans are definitely white. But the evidence would be compelling if a swan expert told you they'd never seen a black swan.

A caveat

In an editorial in The Lancet, a peer-reviewed medical journal, the writers of the PHE review explained their views on pregnant nicotine use.

They reminded the public that research on pregnant nicotine use is only just underway, so the results aren't definitive. But author Linda Bauld urged pregnant women to take a "pragmatic" approach. "The priority is that we don't want pregnant women smoking now, we want them to stop. We can't wait three years for the trial," the Telegraph reported.

A misinformation campaign

This agrees with a general sentiment found across the PHE review that many smokers have a negative view of e-cigarettes and feel that they're just as dangerous as traditional cigarettes.

For example, only a third of smokers—and that includes pregnant smokers—understand that e-cigarettes are safer than tobacco cigarettes. And most tend to overestimate the dangers of nicotine: "when adults in Great Britain are asked what proportion of the health harms of smoking is due to nicotine, the accurate response (most health harms are not caused by nicotine) is the least common response consistently chosen by 8 to 9%" (italics ours), the PHE review reports.

PHE also urges that better information campaigns about the safety of vaping be put in place. It advises that the standard nicotine warning label may be contributing to e-cigarettes' bad name, giving people the impression that they pose the same health risks as tobacco.

What about heated tobacco?

But the PHE review covers both e-cigarettes and heated tobacco, doesn't it? What does PHE have to say about that?

Long story short: burnt or not, tobacco will still kill you.

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