News Release

E-cigarettes may be better than nicotine patches in helping pregnant women stop smoking and in reducing the risk of low birthweight

E-cigarettes (vapes) may be more effective than nicotine patches for pregnant women trying to quit smoking, research led by Queen Mary University of London and funded by the National Institute for Health and Care Research (NIHR), has found

Peer-Reviewed Publication

Queen Mary University of London

Smoking in pregnancy can harm developing babies, especially their growth . Current guidelines recommend that pregnant smokers who find quitting difficult should be provided with nicotine replacements products and stop-smoking services usually recommend nicotine patches.

This research published in NIHR Journals Library, suggests that pregnant women should also consider e-cigarettes.

The study included 1,140 pregnant women who were trying to stop smoking who were divided into two groups. Half of the women received e-cigarettes; the other half received nicotine patches. Both approaches were equally safe. The only meaningful difference was that fewer women in the e-cigarette group had children with low birthweight (weighing less than 2,500 grams).

The researchers say this is most likely because e-cigarettes were more effective in reducing the use of conventional cigarettes. Low birthweight has been linked with poor health later in life

At the end of their pregnancy, women reported whether they had quit. However, some women had quit smoking using a product they were not assigned, mostly women given patches stopping with the help of e-cigarettes they had procured for themselves.

When the researchers looked at successful quitters who only used the treatment they were allocated, almost twice as many women quit with e-cigarettes than with nicotine patches.

The researchers looked at safety outcomes, including low birthweight, baby intensive care admissions, miscarriage, stillbirth, and premature birth.

It is not clear whether nicotine is harmful to developing babies. National Institute of Health and Care Excellence (NICE) states that most health problems are caused by toxins other than nicotine in cigarettes and therefore recommends that nicotine replacement therapy (such as nicotine patches, gum and mouth spray) is considered alongside behavioural support. However, most pregnant women still struggle to quit.  

E-cigarettes can be seen as a form of nicotine replacement therapy, but they have an advantage over nicotine gum and patches in allowing smokers to select strength and flavours they like and make the transition to stopping smoking easier. This is most likely why e-cigarettes have been shown more effective than the traditional nicotine replacement therapy in people who are not pregnant.

Peter Hajek, Director of Health and Lifestyle Research Unit, Wolfson Institute of Population Health, Queen Mary University of London said: “E-cigarettes seem more effective than nicotine patches in helping pregnant women to quit smoking and because of this, they seem to also lead to better pregnancy outcomes. The evidence-based advice to smokers already includes, among other options, a recommendation to switch from smoking to e-cigarettes. Such a recommendation can now be extended to smokers who are pregnant as well.’



Helping pregnant smokers quit: a multi-centre randomised controlled trial of electronic cigarettes versus nicotine replacement therapy.

Health Technology Assessment vol 27 no 10. 2023 HTA 15/57/85

(DOI to come) 10.3310/AGTH6901

Available here after the embargo lifts:




Lee Pinkerton

Faculty Communications Officer – Medicine and Dentistry

Queen Mary University of London


Tel: +44 (0) 7985 446 280



About Queen Mary University of London

At Queen Mary University of London, we believe that a diversity of ideas helps us achieve the previously unthinkable.

Throughout our history, we’ve fostered social justice and improved lives through academic excellence. And we continue to live and breathe this spirit today, not because it’s simply ‘the right thing to do’ but for what it helps us achieve and the intellectual brilliance it delivers.

Our reformer heritage informs our conviction that great ideas can and should come from anywhere. It’s an approach that has brought results across the globe, from the communities of east London to the favelas of Rio de Janeiro.

We continue to embrace diversity of thought and opinion in everything we do, in the belief that when views collide, disciplines interact, and perspectives intersect, truly original thought takes form.


The National Institute for Health and Care Research (NIHR) 

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: Funding high quality, timely research that benefits the NHS, public health and social care;

  • Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
  • Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
  • Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
  • Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
  • Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.

NIHR is funded by the Department of Health and Social Care. Its work in low- and middle-income countries is principally funded through UK Aid from the UK government.


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