Electronic Cigarette Use in Reproductive Age Women

by: Jessica McLaughlin, MD

The use of electronic cigarettes, e-cigarettes or vaping, is becoming increasingly common.  The number of people who currently use e-cigarettes has increased from 0.3% in 2010 to 6.8% in 2013.  In a recent survey, 65% of respondent’s viewed e-cigarettes as being far safer than tobacco cigarettes. In addition, although 18% to 25% of women quit smoking when they are pregnant, many are replacing or supplementing with e-cigarette use.  This has not been proven to be safe or effective.

Previous data has linked tobacco cigarette smoking to poor pregnancy outcomes, but also infertility.  Women who smoke have a decreased chance of conceiving per month, increased risk of ectopic pregnancies and spontaneous abortions, and an increased risk of diminished ovarian reserve and advancement in the time to menopause.  Within the in vitro fertilization (IVF) population, smokers require nearly twice the number of IVF attempts to conceive as non-smokers.

Although we have less outcome data on e-cigarettes as compared to tobacco cigarettes, the evidence we do have does not offer any reassurance that they are less harmful than tobacco cigarettes.   In fact, data in animals demonstrates that uteri exposed to e-cigarettes caused delayed implantation, time to pregnancy and decreased fetal survival. The refill fluids in e-cigarettes have been found to be cytotoxic to human embryonic stem cells.  In a study looking at a nicotine metabolite in an e-cigarette user as a comparison to users of a nicotine patch and users of tobacco cigarettes levels  indicates e-cigarettes have at least the equivalent, if not higher nicotine levels than tobacco cigarettes ( Argarwal et. al. F&S, 2020).

E-cigarette use in reproductive age women is increasing and becoming a rising health concern. Prior to pregnancy, we encourage patients stop smoking that does include e-cigarette devices.  Our understanding of the full impact on reproductive health remains inconclusive, but evidence thus far suggests there are potential harmful effects.

If you’re struggling to get pregnant, call 843-883-5800 to make an appointment with one of our fertility specialists.