Tobacco, electronic nicotine delivery system, nicotine replacement therapy, and cannabinoid use during pregnancy: A descriptive cross-sectional survey

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Abstract

Introduction Tobacco smoking is associated with adverse health outcomes for both pregnant women and their offspring. Smoking cessation counseling is an effective method to help women quit smoking. Developing a targeted smoking cessation intervention could benefit those who struggle to quit tobacco and potentially reduce the harm due to any co-occurring tobacco use. Assessing the prevalence of tobacco, electronic nicotine delivery systems (ENDS), nicotine replacement therapy (NRT), and cannabinoid use in pregnancy is key to developing such interventions. Thus, we aimed to assess the prevalence and patterns of tobacco, ENDS, NRT, and cannabinoid use in pregnancy. We further aimed to assess the prevalence of smoking cessation counseling intervention. Materials and methods We conducted a cross-sectional survey among pregnant women attending regular clinical visits at Spitalzentrum Biel between February and May 2023 (n = 262). Frequency and proportion along with 95% confidence intervals (CI) were reported for tobacco, ENDS, NRT, and cannabinoid use in pregnancy. Results Tobacco use was reported among 7.6% (20/262, 95% CI: 4.2%−11.1%) of the included pregnant women. Tobacco cigarettes (conventional or roll-on) were used by 7.3% (19/262, 95% CI: 3.8%−10.7%) of the surveyed pregnant women, with 0.8% (2/262, 95% CI: 0.0%−3.4%) of them reporting use of cigarettes along with ENDS and 0.4% (1/262, 95% CI: 0.0%−3.8%) reporting use of the cigarettes with NRT. Cannabinoid use was reported by 3.8% (10/262, 95% CI: 1.1%−7.0%) of pregnant women and all of them used products with Cannabidiol (CBD) only. Additionally, only 25% (5/20, 95% CI: 10.0%−48.3%) of tobacco users had received smoking cessation counseling intervention. Conclusion The estimated prevalence of tobacco, ENDS, NRT, and cannabinoid use among the pregnant women in this survey was 7.6%, 0.8%, 0.4%, and 3.8% respectively. However, among tobacco users, only one-fourth received smoking cessation counseling intervention.

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Kandhasamy, S., Baggio, S., Mathis, J., Mattmann, Y., Maisonneuve, E., Auer, R., … Schoeni, A. (2025). Tobacco, electronic nicotine delivery system, nicotine replacement therapy, and cannabinoid use during pregnancy: A descriptive cross-sectional survey. PLOS ONE, 20(9 September). https://doi.org/10.1371/journal.pone.0332961

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