2020年6月26日

SOVAPE在法国发布了有关妊娠期间电子烟和戒烟的第一个综合性文件

吸烟和怀孕：我们真的应该劝阻电子烟？

在法国，一半以上的孕妇在怀孕期间无法戒烟。面对这个重大的公共卫生问题，SOVAPE审查了有关使用电子烟作为帮助戒烟工具的研究和科学建议。

孕妇很难坚持到底

在与每天与孕妇接触的支持小组INFO VAPE的对话中，SOVAPE注意到对电子烟的反复担忧。不鼓励吸烟的人使用雾化作为辅助吸烟的手段，而那些通过雾化而设法戒烟的人受到侮辱，感到内疚，并“被召唤”以停止吸烟。

他们周围的人，包括医生、助产护士、妇产科医生和妇科医生所进行的这些“干预”，常常导致孕妇持续吸烟或吸烟复发。根据法国公共卫生的数据，当超过一半（54.2％）的吸烟孕妇尝试通过更传统的方法戒烟失败时，为什么要排除目前可用的最有效的戒烟工具之一？

SOVAPE今天发布的标题为“怀孕和电子烟”的文档研究了这个问题，专门针对这些妇女及其家庭和医疗队。

2020年可用研究综述

在编写文档时，SOVAPE考虑了现有的科学文献，研究和专业建议。由于吸烟的固有危险性已得到充分认识，因此遵守预防原则显然要求鼓励孕妇戒烟，其中包括电子烟。

最近的一份Cochrane评论强调了保健专业人员对孕妇戒烟的影响。当选择尼古丁替代品和/或雾化电子烟时，会给他们带来很大的心理负担。不鼓励使用电子烟，甚至建议戒烟，会减少成功戒烟的机会，并可能增加专门从事电子烟的女性复发的风险。施加的压力既不尊重她的选择自由，也不尊重“先不伤害”的原则。

法国国家妇产科学院（CNGOF）的危险建议

在进行我们的研究时，SOVAPE发现了2020年1月发表的CNGOF意见。该文件在解决烟草危害方面具有很高的质量，但是存在一个问题，即缺乏对现有电子烟研究的考虑，并且没有在电子烟产品和烟草产品（例如水烟和加热的烟草）之间进行区分。

通过建议已经通过抽烟停止吸烟的女性戒烟，CNGOF违反了预防原则。这项误导性的建议大大增加了吸烟复发的风险，SOVAPE认为这对妇女及其子女构成了明显的危险。

SOVAPE致信CNGOF及其合作伙伴

SOVAPE向CNGOF，SFT（意见共同编辑），法国公共卫生赞助商以及签署意见书的所有组织发送了一封详细信。根据不完全的证据提出建议的后果是增加了潜在的伤害，因为这可能会延长吸烟或导致以前使用电子烟戒烟的女性吸烟复发。考虑到在意见书的写作中被忽略的证据，研究和专家意见，有必要重新检查。目前，在寄出这封信的一个半月后，没有组织回复。

Smoking and pregnancy: should we really discourage vaping？

June 26, 2020

SOVAPE publish the first comprehensive document in France on vaping and smoking cessation during pregnancy

Smoking and pregnancy: should we really discourage vaping, at the risk of smoking?

In France more than half of pregnant women are unsuccessful in quitting smoking during their pregnancy. Faced with this major public health issue, SOVAPE have reviewed studies and scientific advice on the use of vaping as a tool to help quit smoking.

Difficult to stay the course among pregnant women

In conversation with INFO VAPE, a support group that is in daily contact with pregnant women, SOVAPE have noted recurring concerns about vaping. Those who smoke are discouraged from using vaping as an aid to quitting smoking, and those that have managed to quit by vaping are stigmatized, made to feel guilty, and “summoned” to stop vaping.

These “interventions” carried out by those around them, but also by doctors, midwives, obstetricians and gynaecologists, frequently lead to continued smoking or a relapsed to smoking. Why rule out one of the most effective smoking cessation tools available, when more than half (54.2%) of pregnant women who smoke are unsuccessful in their attempt to quit smoking by more traditional methods, according to data from Santé Publique France?

A document published today by SOVAPE, titled “Pregnancy and Vaping”, examines this issue. It is specifically intended for those women as well as their families and medical teams.

A review of studies available in 2020

In developing the document, SOVAPE has taken existing scientific literature, studies, and professional advice into account. As the inherent dangers of smoking are well established, adherence to precautionary principle clearly calls for the encouragement of pregnant women to stop smoking, which must include vaping.

A recent Cochrane review highlighted the influence of health professionals in attempts to stop smoking by pregnant women. When choosing nicotine substitutes and/or vaping, a significant psychological burden is placed on them. Discouraging the use of vaping, or even recommending its cessation, lessens the chances of successful cessation and can increases the risk of relapse for women who vape exclusively. The pressure exerted respects neither her freedom of choice nor the principle of "first do no harm".

A dangerous recommendation of the French National College of Gynaecologists and Obstetricians (CNGOF)

While carrying out our research SOVAPE discovered a CNGOF opinion piece published in January 2020. The document is of high quality when addressing the harms of tobacco, but it is problematic in that there is a lack of consideration of the available studies on vaping, and no differentiation is made between vaping products and tobacco products such as shisha and heated tobacco.

By recommending that women who have already stopped smoking by vaping should quit, the CNGOF contravenes the precautionary principle. This misguided recommendation greatly increases the risk of relapse to smoking, and in the opinion of SOVAPE, presents a clear danger to women and their children.

SOVAPE sent a letter to the CNGOF and its partners

SOVAPE sent a detailed letter to the CNGOF, as well as to the SFT (co-editor of the opinion), to Santé Publique France (patronage) and to all the organisations that co-signed the opinion piece. The consequences of making recommendations based on incomplete evidence is an increased potential for harm, as it could prolong smoking or cause relapse to smoking in women that had previously quit by using vaping. Considering the body of evidence, studies and expert opinion on this subject that have been neglected in the writing of the opinion piece, a re-examination of this piece is necessary. For the moment, one and a half months after this letter was sent, no organisation has responded.