Electronic Cigarette Use among American Indian Women

摘要 怀孕期间吸烟与母亲及其婴儿的严重和不良后果有关。 美国印第安人/阿拉斯加原住民（AI/AN）妇女吸烟率较高， 与其他种族/民族人群相比，出生结果。吸烟的人越来越多地使用 电子香烟（e-cigarettes），以戒烟或减少香烟消费。由于电子烟 与香烟相比，某些毒素的水平大大降低，孕妇可能会转向这些 产品，以减少与吸烟有关的已知风险。虽然电子烟含有较少的毒素 与香烟相比，这些产品仍然含有可能对胎儿有害的元素，包括 尼古丁。然而，相对较少的研究评估了怀孕期间使用电子烟或电子烟的影响 用于分娩结果。此外，没有研究评估AI孕妇使用电子烟的情况， 受烟草相关不良生育结果影响的人口比例过高。这个观察性队列 这项研究将为电子烟的使用及其与出生结果的关系提供新的见解， 在切罗基接受产前护理的300名美国印第安妇女在怀孕期间的受益感受 国家卫生服务，使用有毒物质暴露和戒烟的生化验证，包括 可替宁、尼古丁代谢物、一氧化碳及调查数据。我们将采取以下具体措施， 探索性目的：1）描述电子烟和其他烟草使用的基线患病率，可替宁水平，以及 成年怀孕AI女性在头三个月使用电子烟的模式; 2）描述基线 关于怀孕期间使用烟草和电子烟的健康风险的看法，以及它们是如何影响健康的。 与烟草和电子烟使用模式相关; 3）在SA 1中使用 在基线或怀孕3个月内吸烟或电子烟，探索重新评估 吸烟和电子烟使用以及妊娠晚期的可替宁暴露。我们将探讨 在纵向研究中招募和保留AI孕妇的可行性，以评估产品转换， 每天吸烟量的变化，尼古丁暴露量的变化，以及通过 4）通过以下方式评估人工流产妇女所生婴儿的低出生体重和早产率： 电子烟和烟草使用状况。我们会探讨利用医疗纪录， 评估出生结果的整体和基线电子烟使用和吸烟状况。电子烟的使用可能 可能减轻一些与吸烟相关的健康影响。我们的项目有望 电子烟的使用模式及其与妊娠期有毒物质暴露和分娩结果的相关性 受烟草相关疾病影响不成比例的种族亚群。

Abstract Smoking during pregnancy is associated with serious and adverse outcomes for mothers and their infants. American Indian/Alaska Native (AI/AN) women have higher prevalence of smoking and poorer tobacco-related birth outcomes compared to other racial/ethnic populations. People who smoke are increasingly using electronic cigarettes (e-cigarettes) to quit smoking or reduce cigarette consumption. Since e-cigarettes have substantially lower levels of certain toxins compared to cigarettes, pregnant women may switch to these products in order to reduce the known risks associated with smoking. While e-cigarettes contain fewer toxins compared to cigarettes, these products still contain elements that may be harmful to the fetus, including nicotine. Yet, relatively few studies have evaluated e-cigarette use in pregnancy or the effects of e-cigarette use on birth outcomes. Further, no studies have assessed e-cigarette use among AI pregnant women, a population disproportionately affected by tobacco-related poorer birth outcomes. This observational cohort study will provide new insight into e-cigarette use and its association with birth outcomes, and harm versus benefit perceptions during pregnancy among 300 American Indian women receiving prenatal care at Cherokee Nation Health Services, using biochemical verification of toxicant exposure and smoking cessation, including cotinine, metabolite of nicotine, carbon monoxide, and survey data. We will pursue the following specific and exploratory aims: 1) Describe baseline prevalence of e-cigarette and other tobacco use, cotinine levels, and patterns of e-cigarette use among adult pregnant AI women in their first trimester; 2) Describe the baseline perceptions about the health risks related to tobacco and e-cigarette use during pregnancy and how they are associated with tobacco and e-cigarette use patterns; 3) Among the group of AI women in SA1 who used tobacco or e-cigarettes at baseline or within 3 months of pregnancy, explore the feasibility of reassessing smoking and e-cigarette use and cotinine exposures in the third trimester of pregnancy. We will explore the feasibility of recruiting and retaining pregnant AI women in a longitudinal study to assess product switching, changes in cigarettes smoked per day, change in nicotine exposure, and smoking cessation through pregnancy; 4) Assess the prevalence of low birth weight and preterm birth among infants born to AI women by e-cigarette and tobacco use status. We will explore the feasibility and acceptability of using medical records to assess birth outcomes overall and by baseline e-cigarette use and smoking status. E-cigarette use may potentially mitigate some of the health effects associated with cigarette use. Our project promises to illuminate patterns of e-cigarette use and its association with toxicant exposure in pregnancy and birth outcomes in a racial subpopulation disproportionately affected by tobacco-related diseases.