title: Knowledge, Attitudes, and Practice of Electronic Cigarette Use Among Pregnant Women.
abstract: OBJECTIVE
  Electronic cigarettes (e-cigarettes) are a relatively recent phenomenon, serving dual roles as an alternative vehicle for nicotine delivery and a smoking-cessation tool. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practice regarding electronic cigarettes.
  
  
  METHODS
  A voluntary, anonymous survey was distributed to a convenience sample of pregnant women presenting to a university-based outpatient clinic. After survey completion, participants received information about smoking cessation and e-cigarettes. Data were examined using χ² and Fisher exact tests and analysis of variance. Stata was used for the analysis.
  
  
  RESULTS
  Of the 326 surveys distributed, 316 were completed (97%). Of the 316 participants, 42 (13%) reported having ever used e-cigarettes. Only 2 (0.6%) reported current daily use. Ever users were slightly older (27.3 years vs 25.4 years; P = 0.007) and more likely to be current smokers (43% vs. 14%; P < 0.001) compared with women who had never used electronic cigarettes. Knowledge of the harms of smoking was similar between the 2 groups. Overall, 57% of all respondents believed that e-cigarettes contain nicotine, 61% that e-cigarettes can be addictive, and 43% that e-cigarettes are less harmful to a fetus than traditional cigarettes. Among ever users, the most common reasons given for the use of e-cigarettes were the perception of less harm than traditional cigarettes (74%) and help with smoking cessation (72%).
  
  
  CONCLUSIONS
  Misconceptions about e-cigarettes are common among pregnant women, potentially motivating use that may pose risks to both maternal and child health. Screening and education regarding e-cigarettes should be included in prenatal care. Future research in this area is necessary, including research examining pregnancy outcomes among women who use e-cigarettes.
authors.affiliation: From the University of Maryland (KSM, BF, MT), Johns Hopkins University School of Medicine (MSC), Battelle Public Health Center for Tobacco Research (VHC-C), and Behavioral Health System Baltimore (MT), Baltimore, MD.
authors.forename: Katrina S
authors.initials: KS
authors.lastname: Mark
authors.forename: Brooke
authors.initials: B
authors.lastname: Farquhar
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Chisolm
authors.forename: Victoria H
authors.initials: VH
authors.lastname: Coleman-Cowger
authors.forename: Mishka
authors.initials: M
authors.lastname: Terplan
mesh_terms: D000328:Adult; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*