Evidence map›Paper›PMID 40576585›Full record

ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2025

Toxicant and Nicotine Exposure in Pregnant Smokers, Vapers, and Nicotine-Replacement Users: Cross-Sectional Study.

Michael Ussher, Sarah Lewis, Tim Marczylo, Ben Blount, Jamie Brown, Alexis Bailey, Tim Coleman, Sue Cooper, Jacqueline Marks, Mary George and 6 more

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In one paragraph

Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Michael UssherPopulation Health Research Institute, School of Health and Medical Sciences, City St George's, University of London, London, UK.ORCID 0000-0002-0995-7955
Sarah LewisFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Tim MarczyloToxicology Department, UK Health Security Agency, Oxford, UK.
Ben BlountNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Jamie BrownDepartment of Behavioural Science and Health, University College London, London, UK.ORCID 0000-0002-2797-5428
Alexis BaileyPopulation Health Research Institute, School of Health and Medical Sciences, City St George's, University of London, London, UK.
Tim ColemanFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.ORCID 0000-0002-7303-4805
Sue CooperFaculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK.
Jacqueline MarksPopulation Health Research Institute, School of Health and Medical Sciences, City St George's, University of London, London, UK.
Mary GeorgePopulation Health Research Institute, School of Health and Medical Sciences, City St George's, University of London, London, UK.
Deepak BhandariNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Lanqing WangNational Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.ORCID 0000-0001-6620-7096
Atallah El ZeinToxicology Department, UK Health Security Agency, Oxford, UK.
Adam LaycockToxicology Department, UK Health Security Agency, Oxford, UK.
Eugene Oteng-NtimDepartment of Women and Children's Health, Kings College London, London, UK.
Lion ShahabDepartment of Behavioural Science and Health, University College London, London, UK.ORCID 0000-0003-4033-442X

Funding

Cancer Research UK A28915
6 · The paper itself

Abstract

introductionGiven the increasing usage of vaping during pregnancy and limited longitudinal health-related data, there is an urgent need to assess the potential risks of vaping. AIMS AND

methodsA cross-sectional study was conducted among pregnant UK adults (n = 140). Five study groups were purposively recruited: exclusive-smokers (n = 38), exclusive-vapers (former smokers) (n = 35), dual users of smoking and vaping (n = 25), dual users of smoking and nicotine replacement therapy (n = 10), and "never-users" of nicotine or tobacco products (n = 32). Sociodemographic, smoking, and vaping characteristics were assessed. Participants' urine samples were analyzed for biomarkers of exposure to tobacco alkaloids, and toxicants, including 14 volatile organic compounds (VOCs), tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), heavy metals (cadmium, lead, chromium, nickel, copper, and tin) and a polycyclic aromatic hydrocarbon (2-naphthol). Regression analysis was used to compare biomarkers by group.

resultsNicotine levels varied across product users, but not significantly. After controlling for confounders, for most VOCs, biomarker levels were similar for exclusive-vapers and never-users and significantly lower than for exclusive-smokers and any dual users. There were generally no significant differences between groups for 2-naphthol or heavy metals. For NNAL, cadmium and chromium, a high percentage of values were below the limit of detection, making analyses unreliable.

conclusionsDuring pregnancy, former smokers who are established exclusive vapers, but not dual users, had levels of selected VOCs that were substantially lower than those for exclusive smokers and comparable with those who have never used nicotine or tobacco products. IMPLICATIONS: Based on the biomarkers assessed in this study, during pregnancy, on average, exclusive-vapers are likely to have similar levels of exposure to selected VOCs as never-users and far lower levels than exclusive-smokers or dual-users (although dual-vaping and smoking may result in less exposure than exclusive-smoking). This provides preliminary information about exposure to vaping during pregnancy and suggests that, for some biomarkers, exclusive vaping is likely to result in lower exposures than exclusive smoking or dual-use. There may be exposure to other vaping toxicants that were not explored in this study. Studies are needed to assess pregnancy and birth outcomes as well as early life effects.

Indexed as

NicotineSmokersSmokingTobacco Use Cessation DevicesVapingAdultBiomarkersCross-Sectional StudiesFemaleHumansNitrosaminesPregnancyUnited KingdomVolatile Organic CompoundsYoung AdultBiomarkersNicotineNitrosaminesVolatile Organic Compounds

Identifiers

PMID40576585
PMCPMC12453684

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.