PROJECT ABSTRACT
Electronic cigarettes (e-cigarettes), since their first introduction in the world market in 2004, have been
advertised as a healthier alternative and a smoking cessation aid to existing tobacco products.
has
youth
E-cigarette use
been increased dramatically in the recent years, becoming the most commonly used smoking product in
and young adults since 2014. Itis particularly appealing to pregnant women smokers who are motivated
to change their smoking habits and to improve their and their fetus' health. However, the potential adverse
effects of e-cigarettes as shown in the recent outbreak, whether it poses an increased risk to women and their
developing fetus, is unknown. The overarching objectives of the study are 1) to determine the longitudinal
pattern of women's smoking from preconception to perinatal period and over time, 2) to determine the
association between pregnancy e-cigarette use and pregnancy, perinatal, and infant related adverse
outcomes, and 3) to determine the association between pregnancy e-cigarette use and metabolic profile
measured at birth. We propose to conduct a surveillance study of women who gave live births between 2016-
2018 and participated in the Centers for Disease Control and Prevention (CDC) initiated Pregnancy Risk
Assessment Monitoring System (PRAMS) survey. Detailed smoking information, including conventional
cigarette and e-cigarette use during preconception, 3rd trimester of pregnancy, and post-delivery have been
collected. We will further link PRAMS study of women from Tennessee and Iowa to newborn metabolic
screening (NBS) program data to identify and validate metabolic profile measured at birth that are associated
with secondhand in utero e-cigarette and conventional cigarette exposure. Our proposed study will address
important questions and will be of significant public health importance. It will provide much needed information
about pregnancy e-cigarette use. Results will certainly inform policy and drive public health initiative, providing
evidence for targeted
maternal-fetal
interventions in smoking cessation and in mitigating adverse effects of smoking on
outcomes. It may further provide insight in addressing recent outbreak of e-cigarette, or vaping,
product use associated lung injury (EVALI).
