By Henrylito D. Tacio
Smoking is hazardous to your health, especially if you are a pregnant woman.
“Smoking during pregnancy can cause tissue damage in the unborn baby, particularly in the lung and brain, and some studies suggest a link between maternal smoking and cleft,” said the US-based Centers for Disease Control and Prevention (CDC).
That’s not all. Studies also suggest a relationship between tobacco and miscarriage. Carbon monoxide in tobacco smoke can keep the developing baby from getting enough oxygen. Tobacco smoke also contains other chemicals that can harm unborn babies, CDC pointed out.
That’s why health experts are urging women to stop the habit. Now, if you are a pregnant woman and can’t stop smoking, you might as well use nicotine replacement products. New research has found that regular use of such products “to assist smoking cessation is not associated with adverse events or poor pregnancy outcomes.”
“Using nicotine products to stop smoking during pregnancy appeared safe,” Professor Peter Hajek of the Wolfson Institute of Population Health, Queen Mary University of London, and lead researcher of the study was quoted as saying by United Kingdom-based Medscape News.
The journal Addiction published the study which was funded by the National Institute for Health and Care Research (NIHR) and led by scientists at Queen Mary University of London.
Dr. Rob Hicks, who wrote the Medscape report, said the scientists who conducted the study found that pregnant women who stopped smoking cigarettes and used e-cigarettes and nicotine patches had infants with significantly higher birth weight than smokers, and “not different from abstainers not using nicotine.”
In their published report, the researchers wrote that they “did not detect any risks to pregnancy” from e-cigarettes or nicotine patches used by smokers trying to quit.
It must be recalled that in 2015, the King’s College London in a landmark review which was commissioned by Public Health England found that electronic cigarettes (e-cigarettes) had “the potential to reduce smoking.”
But the same study showed that “nearly half the population (44.8%) did not realize that e-cigarettes or vapes were much less harmful than smoking.”
However, health experts believe that nicotine replacement therapy (NRT) “can be an effective aid for pregnant women who want to stop smoking.”
The UK National Institute for Health and Excellence points out in its recommendations on treating tobacco dependence in pregnant women that “any risks from using NRT are much lower than those of smoking.”
“E-cigarettes contain some toxins, but at far lower levels than found in tobacco smoke,” said the Royal College of Midwives in a position statement in 2019. “If a pregnant woman who has been smoking chooses to use an e-cigarette (vaping) and it helps her to quit smoking and stay smokefree, she should be supported to do so.”
“Given the significant risks of smoking during pregnancy, it is vital that pregnant smokers are supported to stop,” Dr. Hicks quoted Hazel Cheeseman, deputy chief executive at Action on Smoking and Health.
The new study, she added, is another evidence that e-cigarettes are safe and effective for use by pregnant women to quit smoking.
“There are widespread misperceptions about the risks of nicotine in pregnancy,” Cheeseman said. “While smoking is deadly, nicotine on its own does not cause the same harms. These findings should provide reassurance that vaping products and nicotine replacement therapy do not increase the risk of harms during pregnancy and can be safely recommended for smoking cessation.”
But if you are not a smoker, don’t start doing so. As said earlier, smoking is dangerous to your health and to your unborn child. Both the Royal College of Obstetricians and Gynaecologists and National Health Services of the United Kingdom currently recommend that pregnant women stop smoking completely, ideally before the fact.
In Asia, two medical experts agree that smokers who cannot stop smoking really need help – or else they may not be able to kick the addictive vice.
“Smokers may be rightfully considered as victims of an addictive disease, and those who cannot quit remain part of the health equation of every nation, just as much as the healthy non-smokers,” says Dr. Rafael R. Castillo, a cardiologist and lifetime member of the Philippine Medical Association and Philippine Heart Association.
“They actually need more understanding, more attention, and more care from their physicians, who should aim for a treatment goal of at least partially protecting them from the cardiovascular and other health hazards of cigarette addiction,” explained Dr. Castillo, a professor in cardiovascular medicine.
For them to reduce the health hazards brought about by smoking, these smokers should be given some interventions they can lean on until they will be able to quit smoking altogether.
“Like many other interventions in daily life – seat belts in cars, motorcycle helmets, safe needle exchange in drug addiction, to cite a few – smokers should have some alternatives to tobacco which can) reduce health harms linked to smoking,” says Professor Tikki Elka Pangestu, former director of the research policy and cooperation at the World Health Organization (WHO).
Both medical experts call this as tobacco harm reduction (THR). “(It) is a strategy to mitigate the health risk in smokers who use conventional cigarettes,” Dr. Castillo explains. “Complete smoking cessation is still the primary goal but since this cannot be achieved in the far bigger majority of smokers we describe as recalcitrant, then a pragmatic middle-ground alternative should be offered to them.”
One such strategy is the use of e-cigarettes or vape. “E-cigarettes are way less harmful than cigarettes and they can and do help smokers switch if they can quit,” Dr. David Abrams, a New York University professor of social and behavioral sciences in the College of Global Public Health told CBS This Morning Tony Dokoupil some years back.
Singapore-based Prof. Pangetsu reported that in the United Kingdom, between 20,000 to 30,000 smokers quit each year when they switch to e-cigarettes. “In countries where these products are available, cigarette sales are falling dramatically,” he said.
Another is the use of heated tobacco products (HTPs). Like the vapes, HTPs do not burn tobacco. “As such, they are much less harmful,” Prof. Pangestu said, adding that these devices reduce as much as 90-95% of the harmful toxins which are released when a smoker lights and burns a cigarette.
By using e-cigarettes and HTPs, smokers breathed “significantly reduced levels” of the toxins released by tobacco that cause chronic diseases like carbon monoxide, tar, and harmful chemicals (benzene, arsenic, and formaldehyde, to name a few).
A review of data from 11 studies with over 2,600 people showed that most of those who switched from cigarettes to HTPs “had lower levels of exposure to harmful chemicals than those who kept smoking.”
In a report published in The Conversation, the American researchers who conducted the review noted: “The lower exposure was found across a number of harmful substances linked to cancers, heart disease, and respiratory problems. This means it is possible that switching from cigarettes to heated tobacco could reduce the odds of developing these diseases.”
Two systematic reviews and meta-analyses by Dr. Castillo and his research group at the CardioMetabolic Research Unit (CaMeRU) of the FAME Leaders Academy confirmed the aforementioned findings.
“(Our study showed) there is an improvement in some cardiovascular risk factor parameters such as less increase in heart rate, higher high-density lipoprotein (good cholesterol) and less constriction of arteries,” Dr. Castillo says. “Another study also showed significantly reduced harmful elements commonly obtained by conventional cigarette smoking.”
Unfortunately, there is no data yet that will prove HTPs could help smokers quit smoking – as studies require a longer time period for these to be conducted. But based on modeling techniques and considering the beneficial effects of THR with alternative tobacco products, Dr. Castillo believes “millions will be quitting cigarette smoking and scores of thousands of lives will be saved annually with reduction of smoking-related complications.”
The American researchers – Harry Tattan-Birch, Jamie Brown, and Jamie Hartmann-Boyce – have the same conclusion. “We know that most of the harmful effects of cigarettes – which kill half of all regular smokers – come from inhaling toxic chemicals made by burning tobacco,” they wrote.
As HTPs are designed to avoid burning tobacco, the researchers said they’d expect HTPs to pose a lower risk. “HTPs could benefit public health if they reduce risk and help people stop smoking normal cigarettes, without attracting people who would otherwise avoid tobacco entirely,” they stressed. – ###
