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Experts say some women may incorrectly believe that e-cigarettes are a safe alternative during pregnancy. Getty Images

Doctors dole out a great deal of information when women find out they’re pregnant.

Drink less caffeine, eat better food, get more sleep — and certainly stop smoking.

It seems many American mothers have heard the pleas of their doctors to kick the tobacco habit.

But some may be picking up e-cigarettes as an alternative, believing them to be a better option.

Researchers from the University of Iowa, led by Dr. Wei Bao, an assistant professor of epidemiology, found that 14 percent of American women of reproductive age who are not pregnant smoke conventional cigarettes (the rolled tobacco kind).

Compare that to just 8 percent of pregnant women who still smoke conventional cigarettes.

But e-cigarette use among both pregnant and non-pregnant women of reproductive age is virtually identical.

The analysis, which was published in JAMA Pediatrics, found that 3.6 percent of pregnant women used e-cigarettes while 3.3 percent of non-pregnant women did.

This finding points to the possibility that expectant mothers may believe, despite emerging studies and advice to the contrary, that the new electronic nicotine delivery systems are indeed healthier than conventional cigarettes in some way — and that they’re a better alternative if you don’t want to quit entirely.

“Many women know that cigarettes are to be avoided in pregnancy. There are risks with smoking, including fetal growth restriction, placental abruption, aberrations in fetal development, and much more,” Courtney Martin, DO, OB-GYN and medical director of maternity services at Loma Linda University Children’s Hospital in California, told Healthline. “But, there are misconceptions today about e-cigarettes or ‘vaping’ being safe because they are not actually smoking.”

Although the e-products are pitched as a better alternative to conventional cigarettes, and in some cases as a smoking cessation tool, many experts still suggest pregnant women steer clear of e-cigarettes.

“Since there are no available studies that definitively prove whether it is safe or not, it’s impossible to say that vaping is safe in pregnancy,” Dr. Sherry Ross, OB-GYN and women’s health expert at Providence Saint John’s Health Center in California, told Healthline.

E-cigarettes are a fairly new product for review and study.

It’s been within the past 10 years that the product hit the market and found relatively easy success, especially among teens and young adults.

Indeed, between 2017 and 2018, e-cigarette use among America’s youth increased by 78 percent, according to the Food and Drug Administration and the Centers for Disease Control and Prevention.

Bao and his team say their study is the first to look at e-cigarette use nationally among women of reproductive age.

The researchers analyzed data from 27,920 women between the ages of 18 and 44. All women were participants in the National Health Interview Survey (NHIS). Of the more than 27,000 participants, 1,071 were pregnant at the time of the survey.

In addition to the percentage of total e-cigarette and conventional cigarette users, the report also demonstrated that nearly 39 percent of current e-cigarette users were once conventional cigarette users.

“It is possible that some pregnant women perceived e-cigarettes as a safe alternative to conventional cigarettes,” the researchers wrote in the final report. “In addition, some women who used conventional cigarettes might have switched to e-cigarettes in pregnancy as a means of smoking cessation.”

Though they did not draw any conclusions about the effects e-cigarette use had on the fetuses or mothers, their findings provides insight into future possible research.

“[E-cigarettes] are likely just as risky [as conventional cigarettes],” Martin said. “Nicotine, the addictive component in cigarettes is also present in e-cigarettes and vaping. It is actually the nicotine that is associated with the detrimental effects on pregnancy.”

Indeed, a 2018 study found that the marketing of e-cigarettes has led women to believe they’re safer to use, even in pregnancy, but “the amount of nicotine consumed in cigarette smoking is similar to the amount of nicotine consumed with e-cigarettes.”

The risks, this study and others point out, include potential damage to a developing fetus’ brain and lungs, an increased risk for low birth weight, withdrawal from nicotine, and an increased risk of sudden infant death syndrome (SIDS).

“More research needs to be done on this subject to help us elucidate what the risks truly are,” Martin said.

Cigarette use among pregnant women is lower than use among non-pregnant women, but the rates of e-cigarette use among the two groups are virtually identical.

That means women are heeding the call to kick their cigarette habit, but some may be turning to e-cigarettes as an alternative or not seeing the danger in their existing vaping habit.

That could have unintended consequences.

While the research for e-cigarettes is in its infancy, early studies suggest they are not harmless, especially to mothers with growing fetuses. For these people, smoking cessation is still a significant goal.

“Unfortunately, stopping products with nicotine is extremely difficult. It is highly addictive,” Martin said. “We understand that as physicians and want to help. The best thing to do is pick a quit date and try to stop smoking or vaping with support possibly before pregnancy. If pregnancy is unintended, working with your OB-GYN to quit after pregnancy is an important first step. Be honest with your physician so we can best help you achieve your goals.”