Reacción a "Reactions to study indicating that neither e-cigarettes nor nicotine patch use are associated with adverse effects in pregnancy"

This paper presents high quality evidence, as a secondary analysis of data from the first UK trial of e-cigarettes for smoking cessation during pregnancy. 

Tobacco smoking is a major contributor to poor pregnancy outcomes, including stillbirth, miscarriage and low birthweight. Helping people to stop smoking completely, as quickly as possible, is the best way to improve pregnancy outcomes.  

In this study, the authors find that more people choose to use e-cigarettes than nicotine replacement therapy (NRT), suggesting that people who are pregnant prefer e-cigarettes as a way of quitting smoking. Preference is important because if people can choose something they like, they are likely to have a better chance of staying smokefree. 

It is really reassuring that people who quit smoking using an e-cigarette during pregnancy in this study had better pregnancy outcomes than women who continued to smoke tobacco, and did not have any worse outcomes than people who do not smoke at all. This provides reassurance of the safety of e cigarettes for smoking cessation during pregnancy. NRT is already recommended for use during pregnancy for smoking cessation. The findings of this study suggest that e cigarettes do not differ in safety profile from NRT. My reading of this evidence is that e-cigarettes could be viewed as a form of NRT and also can be recommended for smoking cessation to pregnant women, especially as tobacco smoking is so damaging.