Is electronic cigarette (e-cigarette) use harmful during pregnancy or lactation (breastfeeding)?

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Last updated: April 2, 2025View editorial policy

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From the Guidelines

Vaping is harmful during pregnancy and breastfeeding, and should be avoided completely. The use of e-cigarettes during pregnancy has been associated with an increased risk of preterm birth, low birth weight, and birth defects, as nicotine crosses the placenta and can harm fetal brain development 1. Additionally, nicotine passes into breast milk, potentially affecting infant sleep patterns, heart rate, and development. Beyond nicotine, vaping liquids contain other chemicals like propylene glycol, vegetable glycerin, and flavorings that have not been proven safe for developing babies. The heating process in e-cigarettes can also create harmful compounds like formaldehyde.

Some key points to consider:

  • Nicotine replacement therapies (patches, gum) can be used under medical supervision during pregnancy, but vaping delivers unpredictable amounts of nicotine and additional chemicals 1.
  • Behavioral support programs specifically designed for pregnant women can be more effective than trying to quit without assistance.
  • The US Preventive Services Task Force recommends that pregnant persons who smoke should be offered behavioral counseling and other interventions to help them quit smoking, but notes that evidence on the effectiveness of these interventions during pregnancy is limited 1.
  • There is limited evidence on the harms of nicotine replacement therapy during pregnancy, but most studies suggest that it may be safer than smoking during pregnancy, as it does not contain many harmful substances found in cigarette smoke 1.

If you're currently vaping while pregnant or breastfeeding, it's essential to speak with your healthcare provider about safe cessation strategies. They can help you develop a plan to quit vaping and provide guidance on how to manage any potential withdrawal symptoms or other challenges that may arise during the quitting process. Quitting vaping is crucial to minimizing the risks associated with e-cigarette use during pregnancy and breastfeeding, and healthcare providers can offer valuable support and resources to help you achieve this goal.

From the FDA Drug Label

If you are pregnant or breast-feeding, only use this medicine on the advice of your health care provider. Smoking can seriously harm your child. Try to stop smoking without using any nicotine replacement medicine. This medicine is believed to be safer than smoking. However, the risks to your child from this medicine are not fully known.

  • Vaping is not directly mentioned in the label, but nicotine replacement medicine is, which can be related to vaping.
  • The label states that smoking can seriously harm the child, and while vaping is not the same as smoking, it may imply a potential risk.
  • The label advises to try to stop smoking without using any nicotine replacement medicine, suggesting caution with nicotine during pregnancy or breastfeeding.
  • It is stated that the risks to your child from this medicine are not fully known, which applies to nicotine replacement medicine and may be relevant to vaping by extension.
  • Given the information, it is prudent to exercise caution when considering vaping during pregnancy or breastfeeding, as the risks are not fully known 2.

From the Research

Vaping During Pregnancy

  • Vaping during pregnancy is a growing public health concern, with limited information available on its potential health effects on the mother and fetus 3, 4.
  • Some studies suggest that vaping during pregnancy may increase the risk of small for gestational age newborns 4.
  • Electronic cigarette aerosols may contain toxic compounds that can adversely impact both the mother and the fetus 3, 5.

Nicotine Replacement Therapy During Pregnancy

  • The use of nicotine replacement therapy (NRT) during pregnancy is controversial due to its potential effects on fetal health 6, 7.
  • Some studies suggest that NRT may be safe for use during pregnancy, particularly faster-acting formulations 6, 5.
  • However, the evidence is limited, and more research is needed to fully understand the risks and benefits of NRT during pregnancy 6, 7.

Breastfeeding and Vaping

  • There is no direct evidence available on the effects of vaping during breastfeeding.
  • However, it is known that nicotine and other toxic compounds can be passed to the infant through breast milk, potentially causing harm 5.

Research Gaps

  • More research is needed to understand the effects of vaping during pregnancy and breastfeeding on maternal and fetal health outcomes 3, 4.
  • Studies should investigate the systemic exposure and effects of vaping during pregnancy, as well as the long-term effects of prenatal vaping exposure 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Vaping During Pregnancy: What Are the Potential Health Outcomes and Perceptions Pregnant Women Have?

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2021

Research

Impact of Nicotine Replacement and Electronic Nicotine Delivery Systems on Fetal Brain Development.

International journal of environmental research and public health, 2019

Research

Safety of Nicotine Replacement Therapy during Pregnancy: A Narrative Review.

International journal of environmental research and public health, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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