Last update Oct. 31, 2023

Electronic cigarette, E-Cigarette, Vape, Vaping

Limited compatibility

Unsafe. Moderate/severe adverse effects. Compatible under certain circumstances. Follow-up recommended. Use safer alternative or discontinue breastfeeding from 5 to 7 T ½ . Read Commentary.

Electronic cigarettes or e-cigarettes are battery-operated smoking devices. The user inhales the vapor of a heating liquid containing nicotine, flavorings and other chemicals such as propylene glycol, ethylene glycol, polyethylene glycol, diacetyl and/or glycerol; and heavy metals such as nickel, tin and/or lead.

Vaporized liquid contains carcinogenic compounds, although in smaller quantities than tobacco smoke. In particular it contains carbonyl compounds (formaldehyde, acetaldehyde, acrolein, o-methylbenzaldehyde), volatile organic compounds (toluene, p,m-xylene), tobacco-specific nitrosamines (NNN and NNK) and heavy metals such as cadmium, nickel and lead. (Mother To Baby 2021, Goniewicz 2014, Carson 2013)

Nicotine is transferred to the infant through milk and harms the infant. (Mother To Baby 2021, ABM 2015, Rowe 2013, Sachs 2013, Dahlström 2008)

The frequency and duration of breastfeeding was higher in mothers who used e-cigarettes than in tobacco users and similar to mothers who neither smoked nor used e-cigarettes (Hamilton 2023), but the odds of breastfeeding for at least 3 months were significantly lower in women who used e-cigarettes during pregnancy compared to those who did not. (McBride 2021)

Evidence of its efficacy as a method of smoking cessation is lacking (Hartmann 2022, Baraona 2017, Drummond 2014, McRobbie 2014) being more effective than other nicotine replacement therapy products for some authors (Hajek 2019), and preventing smoking relapse after pregnancy (Orton 2022), although many mothers who vape during pregnancy and breastfeeding also smoke. (Bowker 2021, Opondo 2021)

Nicotine levels in the mother's plasma (and therefore in milk) are usually lower than those achieved by smoking tobacco, but given the existence of toxic chemicals in the electronic cigarette, the little known data on its health effects and the risk of ending up as a chronic substitute for tobacco, it cannot be recommended as replacement therapy during breastfeeding, with nicotine patches or gum being preferable. There is less nicotine passage if you wait to breastfeed about 2 hours after the last inhalation.

Alternatives

  • Bupropion-Hcl (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)
  • Nicotine Replacement Therapy (NRT) (Safe substance and/or breastfeeding is the best option.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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José María Paricio, founder of e-lactancia.
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Other names

Electronic cigarette, E-Cigarette, Vape, Vaping is also known as


Groups

Electronic cigarette, E-Cigarette, Vape, Vaping belongs to these groups or families:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 30 %
Molecular weight 162 daltons
Protein Binding 5 %
Tmax 2 - 4 hours
T½ 2 hours
M/P ratio 1.5 - 3 -

References

  1. Hamilton WN, Masud N, Kouambo C, Tarasenko YN. Perinatal Smoking and E-cigarette Use and Their Relationship with Breastfeeding: PRAMS 2015-2020. Breastfeed Med. 2023 Oct 30. Consulted on Oct. 30, 2023 Abstract
  2. Hartmann-Boyce J, Lindson N, Butler AR, McRobbie H, Bullen C, Begh R, Theodoulou A, Notley C, Rigotti NA, Turner T, Fanshawe TR, Hajek P. Electronic cigarettes for smoking cessation. Cochrane Database Syst Rev. 2022 Nov 17;11:CD010216. Abstract
  3. Orton S, Taylor L, Laing L, Lewis S, Ussher M, Coleman T, Cooper S. Are E-cigarettes associated with postpartum return to smoking? Secondary analyses of a UK pregnancy longitudinal cohort. BMJ Open. 2022 Apr 12;12(4):e061028. Abstract Full text (link to original source)
  4. McBride M, Haile ZT. Association Between Electronic Nicotine Delivery Systems Use and Breastfeeding Duration. Breastfeed Med. 2021 Nov;16(11):886-893. Abstract
  5. Bowker K, Lewis S, Ussher M, Naughton F, Phillips L, Coleman T, Orton S, McRobbie H, Bauld L, Cooper S. Smoking and vaping patterns during pregnancy and the postpartum: A longitudinal UK cohort survey. Addict Behav. 2021 Dec;123:107050. Abstract Full text (link to original source)
  6. Opondo C, Harrison S, Alderdice F, Carson C, Quigley MA. Electronic cigarette use (vaping) and patterns of tobacco cigarette smoking in pregnancy-evidence from a population-based maternity survey in England. PLoS One. 2021 Jun 4;16(6):e0252817. Abstract Full text (link to original source)
  7. Hajek P, Phillips-Waller A, Przulj D, Pesola F, Smith KM, Bisal N, Li J, Parrott S, Sasieni P, Dawkins L, Ross L, Goniewicz M, Wu Q, McRobbie HJ. E-cigarettes compared with nicotine replacement therapy within the UK Stop Smoking Services: the TEC RCT. Health Technol Assess. 2019 Aug;23(43):1-82. Abstract Full text (link to original source)
  8. Baraona LK, Lovelace D, Daniels JL, McDaniel L. Tobacco Harms, Nicotine Pharmacology, and Pharmacologic Tobacco Cessation Interventions for Women. J Midwifery Womens Health. 2017 Abstract
  9. ABM Protocolo clínico de la ABM n.º 21: Pautas para la lactancia y el consumo de sustancias o trastorno por consumo de sustancias, revisado en 2015. Breastfeed Med. 2015 Full text (link to original source) Full text (in our servers)
  10. ABM. Reece-Stremtan S, Marinelli KA. ABM Clinical Protocol #21: Guidelines for Breastfeeding and Substance Use or Substance Use Disorder, Revised 2015. Breastfeed Med. 2015 Abstract Full text (link to original source) Full text (in our servers)
  11. Hecht SS, Carmella SG, Kotandeniya D, Pillsbury ME, Chen M, Ransom BW, Isaksson Vogel R, Thompson E, Murphy SE, Hatsukami DK. Evaluation of Toxicant and Carcinogen Metabolites in the Urine of e-Cigarette Users Versus Cigarette Smokers. Nicotine Tob Res. 2014 Abstract Full text (link to original source)
  12. Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, Prokopowicz A, Jablonska-Czapla M, Rosik-Dulewska C, Havel C, Jacob P 3rd, Benowitz N. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control. 2014 Abstract Full text (link to original source)
  13. Besaratinia A, Tommasi S. Electronic cigarettes: the road ahead. Prev Med. 2014 Abstract
  14. McRobbie H, Bullen C, Hartmann-Boyce J, Hajek P. Electronic cigarettes for smoking cessation and reduction. Cochrane Database Syst Rev. 2014;(12):CD010216. Abstract
  15. Harrell PT, Simmons VN, Correa JB, Padhya TA, Brandon TH. Electronic nicotine delivery systems (\e-cigarettes\): review of safety and smoking cessation efficacy. Otolaryngol Head Neck Surg. 2014 Abstract Full text (link to original source)
  16. Drummond MB, Upson D. Electronic cigarettes. Potential harms and benefits. Ann Am Thorac Soc. 2014 Abstract Full text (link to original source)
  17. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  18. Carson KV, Brinn MP, Robertson TA, To-A-Nan R, Esterman AJ, Peters M, Smith BJ. Current and emerging pharmacotherapeutic options for smoking cessation. Subst Abuse. 2013 Abstract Full text (link to original source) Full text (in our servers)
  19. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  20. Dahlström A, Ebersjö C, Lundell B. Nicotine in breast milk influences heart rate variability in the infant. Acta Paediatr. 2008 Abstract
  21. Mother To Baby. E-cigarettes (Vaping). 2021 Oct 1. Mother To Baby | Fact Sheets [Internet]. Brentwood (TN): Organization of Teratology Information Specialists (OTIS); 1994-. Abstract Full text (link to original source)

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