Perceptions of Electronic Cigarettes Among Medicaid-Eligible Pregnant and Postpartum Women

Objective: To describe perceptions and beliefs about electronic cigarette (e-cigarette) use during pregnancy among pregnant and newly postpartum women. Design: An exploratory, qualitative descriptive study. Setting: University-affiliated prenatal clinics. Participants: Twelve pregnant or recently postpartum women who reported use of tobacco and electronic cigarettes. Methods: Semistructured focus groups were audio recorded and professionally transcribed. The transcripts were coded to consensus and analyzed with MAXQDA software (version 11) using content analysis. Results: Four overarching themes emerged: (a) Attraction to E-Cigarettes as a Harm Reduction Strategy, (b) Uncertainty Regarding the Health Effects of E-Cigarettes; (c) Ambivalence Regarding Novel Product Characteristics; and (d) Behaviors Reflected Dual Use and Often Complete Relapse to Traditional Cigarettes. Conclusion: Pregnant women are initially attracted to e-cigarettes as a harm reduction strategy, but they often return to traditional cigarettes in the postpartum period. Nurses should counsel pregnant women on the adverse effects of fetal exposure to nicotine. Evidence-based nursing interventions are needed to prevent relapse during the postpartum period.