Electronic Cigarette Use among American Indian Women

摘要 怀孕期间吸烟会给母亲和她们的婴儿带来严重的不良后果。 美国印第安人/阿拉斯加原住民(AI/AN)女性吸烟率较高，与烟草相关的比例较低 与其他种族/民族人口的出生结局进行比较。吸烟的人越来越多地使用 电子烟(电子烟)，用于戒烟或减少香烟消费。因为电子烟已经 与香烟相比，某些毒素的水平要低得多，孕妇可能会改用这些 产品，以减少与吸烟相关的已知风险。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，评估怀孕期间使用电子烟或电子烟影响的研究相对较少。 对出生结局的影响。此外，还没有研究评估人工智能孕妇使用电子烟的情况 与烟草相关的不良生育结局对人口的影响不成比例。这一观察队列 研究将为电子烟的使用及其与出生结局的关联提供新的见解，以及危害与 切诺基300名接受产前护理的美国印度妇女孕期受益认知 国家卫生服务，使用毒物暴露和戒烟的生化核实，包括 可替宁，尼古丁、一氧化碳的代谢物，以及调查数据。我们将推行以下具体和 探索目标：1)描述电子烟和其他烟草使用的基线流行率、可替宁水平和 成年怀孕人工智能妇女在怀孕早期使用电子烟的模式；2)描述基线 对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 与烟草和电子烟的使用模式有关；3)在SA1中使用 在基线或怀孕3个月内吸烟或电子烟，探讨重新评估的可行性 吸烟和电子烟的使用以及妊娠晚期的可替宁暴露。我们将探索 在一项纵向研究中招募和留住怀孕的人工智能女性以评估产品转换的可行性 每天吸烟的变化，尼古丁暴露的变化，以及通过 怀孕；4)评估人工智能妇女所生婴儿中低出生体重和早产的发生率 电子烟和烟草使用状况。我们将探讨使用病历来 通过基线电子烟使用和吸烟状况来评估出生结局。电子烟的使用可能会 有可能减轻与吸烟相关的一些健康影响。我们的项目有望照亮 电子烟的使用模式及其与孕期毒物暴露和出生结局的关系 受烟草相关疾病影响较大的种族亚群。

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.