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Are E-cigarettes associated with postpartum return to smoking? Secondary analyses of a UK pregnancy longitudinal cohort

Orton, Sophie; Taylor, Lauren; Laing, Libby; Lewis, Sarah; Ussher, Michael; Coleman, Tim; Cooper, Sue


Lauren Taylor

Clinical Trial Manager

Michael Ussher

Professor of Primary Care


Objectives: Postpartum return to smoking (PPRS) is an important public health problem. E-cigarette (EC) use has increased in recent years, and in a contemporary UK pregnancy cohort, we investigated factors, including ECs use, associated with PPRS.

Design: Secondary analyses of a longitudinal cohort survey with questionnaires at baseline (8–26 weeks’ gestation), late pregnancy (34–36 weeks) and 3 months after delivery.

Setting: 17 hospitals in England and Scotland in 2017.

Participants: The cohort recruited 750 women who were current or recent ex-smokers and/or EC users. A subgroup of women reported being abstinent from smoking in late pregnancy (n=162, 21.6%), and of these 137 (84.6%) completed the postpartum questionnaire and were included in analyses.

Outcome measures: Demographics, smoking behaviours and beliefs, views and experience of ECs and infant feeding.

Results: 35.8% (95% CI 28% to 44%) of women reported PPRS. EC use in pregnancy (adjusted OR 0.34, 95% CI 0.13 to 0.85) and breast feeding (adjusted OR 0.06, 95% CI 0.02 to 0.24) were inversely associated with PPRS, while household member smoking at 3 months post partum was positively associated with PPRS (adjusted OR 11.1, 95% CI 2.47 to 50.2).

Conclusion: EC use in pregnancy could influence PPRS. Further research is needed to confirm this and investigate whether ECs could be used to prevent PPRS.


Orton, S., Taylor, L., Laing, L., Lewis, S., Ussher, M., Coleman, T., & Cooper, S. (2022). Are E-cigarettes associated with postpartum return to smoking? Secondary analyses of a UK pregnancy longitudinal cohort. BMJ Open, 12(4), Article e061028.

Journal Article Type Article
Acceptance Date Mar 17, 2022
Online Publication Date Apr 12, 2022
Publication Date Apr 12, 2022
Deposit Date Apr 28, 2022
Publicly Available Date Apr 28, 2022
Journal BMJ Open
Electronic ISSN 2044-6055
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 12
Issue 4
Article Number e061028
Keywords General Medicine
Public URL
Publisher URL


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