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Safety of electronic cigarette use during breastfeeding: qualitative study using online forum discussions


Background: E-cigarettes are an increasingly popular alternative to smoking, helping to prevent relapse in those trying to quit, and with potential for harm reduction as they are likely to be safer than smoking. Many women return to smoking in the postpartum period having stopped smoking during pregnancy, and this can affect their decisions about breastfeeding, but little is known about women’s opinions on using e-cigarettes during this period.

Objectives: To explore online forum users’ current attitudes, motivators, and barriers to using e-cigarettes postpartum, particularly as a breastfeeding mother.

Methods: Data were collected via publicly accessible (identified by Google search) online forum discussions, and a priori codes identified. All transcripts were entered into NVivo for analysis; a template approach to thematic analysis was used to code all transcripts from which themes were derived.

Results: Four themes were identified: Use, Perceived risk, Social Support and Evidence, and a number of subthemes were identified within these broader themes. Women were using e-cigarettes to prevent postpartum return to smoking, however opinions on the safety of e-cigarettes was conflicting. Women were concerned about possible transfer of harmful products from e-cigarettes via breastmilk and second hand exposure. Women were actively seeking and sharing information on e-cigarettes from a variety of sources. Although some women were supportive of e-cigarette use, others provided harsh judgement for mothers who use them.

Conclusions: E-cigarettes have potential to reduce the number of women who return to smoking in the postpartum period, and potentially improve breastfeeding rates, if breastfeeding mothers have access to relevant and reliable information. Health care providers should consider discussing e-cigarettes with mothers at risk of returning to smoking in the postpartum period.

Journal Article Type Article
Publication Date Aug 12, 2019
Journal Journal of Medical Internet Research
Print ISSN 1438-8871
Publisher Journal of Medical Internet Research
Peer Reviewed Peer Reviewed
Volume 21
Issue 8
Article Number e11506
APA6 Citation Johnston, E. J., Campbell, K., Coleman, T., Lewis, S., Orton, S., & Cooper, S. (2019). Safety of electronic cigarette use during breastfeeding: qualitative study using online forum discussions. JMIR, 21(8),
Keywords e-cigarette; online forums; postpartum relapse; smoking; breastfeeding
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