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This summer, a French meta-analysis sounded the alarm that vaping is no less harmful than smoking for pregnant women.
It goes without saying that FIVAPE has never recommended vaping to nonsmokers, much less to pregnant women who do not smoke. Our position is clear: vaping is only for smokers who are in the process of quitting. But a new French study1 published in July 2025 claims that even for pregnant smokers, e-cigarettes are just as dangerous as tobacco. As reported by *Le Quotidien du Médecin*2, this claim is serious and warrants scrutiny, especially since the researchers themselves point out methodological biases.
What does this study say?
Dr. Vallée’s team at Foch Hospital in Suresnes analyzed 9, Studies s involving more than 400,000 pregnant women. Their conclusion: “exclusive vapers” have a 40% higher risk of preterm birth and a 49% higher risk of having a low-birth-weight baby. These are striking figures, but they raise questions when the presented data is analyzed.
A mix of groups that confuse vaping and smoking
An analysis of the 9, Studies s selected reveals that the “exclusive vapers” group in the meta-analysis actually combines:
- Vapers who have never smoked (very rare)
- Ex-smokers who have recently quit, including during pregnancy
- Women who still smoke in secret
- Declaration errors
As a result, the effects attributed to vaping may in fact be due to previous or current tobacco consumption (vapo-smokers).
Studies s that contradict the conclusions of the meta-analysis
However, several studies included in this meta-analysis show otherwise:
- The Irish study3 finds that birth weights are the same among vapers who have never smoked and non-smokers
- The American study4 on adolescent girls, however, found no increased risk
However, these favorable results disappear simply because all cases are indiscriminately mixed in a single group.
Study Conclusions vs. Actual Data
Subject | What the Study Says | What the data show |
Who are the "exclusive vapers"? | Women who only vapourize | In fact, most of them are ex-smokers and vapo-smokers. |
Is the excess risk real? | Yes, + 40% to + 49 | In fact, for several individual Studies : there is no increased risk associated with vaping alone |
Is nicotine the problem? | Yes, she's the designated culprit | However, nicotine replacement products are recommended for pregnant women. |
Are the data reliable? | Yes, 400,000 women studied | In fact, all groups of vapers are mixed, with very small numbers of never-smokers. |
The nicotine question
The study points to nicotine as the primary cause of the resulting health problems: premature birth and lower birth weight. Yet nicotine patches and gum are officially recommended for pregnant women who are unable to quit smoking. If nicotine were so dangerous, would these treatments be recommended? This striking contradiction raises doubts about the validity of the study’s conclusions.
What the data really reveal
When we distinguish the groups, the hierarchy of risks seems to be :
- Ideally, consume nothing
- Use medically recommended nicotine substitutes to stop smoking
- Be an exclusive vapourist with no recent tobacco use
- Cigarette smoking
- Cigarette smoking + vaping
What does this confusion entail?
This classic methodological bias, which mixes different profiles within the same group, significantly distorts the results of a study, leading to conclusions that are unclear or even misleading. Consequently, concluding here that vaping is just as harmful as smoking for pregnant women is akin to studying traffic accidents while conflating sober drivers with drunk drivers, and then deducing that “driving” is dangerous.
Science first
In light of this public health issue, FIVAPE calls for greater scientific rigor: the conclusions of a study must accurately reflect the available data. And the facts are clear: for a pregnant smoker who is unable to quit smoking completely, vaping is a much less harmful alternative than cigarettes. This distinction can be crucial in preventing a return to smoking and leading to successful cessation. Women and those around them need reliable, evidence-based information—for their own health as well as that of their children.
Advice from doctors specializing in smoking cessation
Reprinted in Le Quotidien du Médecin (Vaping During Pregnancy Is No Less Harmful Than Smoking, According to a French Meta-Analysis – August 8, 2025), the findings of this study prompted several experts to respond in the comments section of the article:
Marion Adler, general practitioner and tobaccologist, "It's not nicotine cessation that should be advocated, but rather cessation of tobacco smoke, whose CO - carbon monoxide - is toxic to the developing fetus." Nicotine substitutes are still recommended as first-line treatment for pregnant smokers, and vape is a less harmful alternative for those who are unable to quit.
Philippe Arvers, addictologist and tobaccologist, analyzes the figures and points out that the risk of having a low-weight baby is not attributable to the exclusive use of vaping compared with smoking, highlighting the great heterogeneity and bias of the profiles included in the "exclusive vapers" group.
- Maternal vaping and pregnancy adverse outcomes: A systematic review and meta-analysis - https://www.womenandbirth.org/article/S1871-5192(25)00085-X/abstract ︎
- Le Quotidien du Médecin - Vaping during pregnancy no less harmful than tobacco, according to a French meta-analysis - https://www.lequotidiendumedecin.fr/specialites/gynecologie-obstetrique/le-vapotage-pendant-la-grossesse-pas-moins-nocif-que-le-tabac-selon-une-meta-analyse-francaise ︎
- McDonnell et al, Electronic cigarettes and obstetric outcomes: a prospective observational study, 2020 - https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.16110 ︎
- Use of E-Cigarettes and Cigarettes During Late Pregnancy Among Adolescents - https://pmc.ncbi.nlm.nih.gov/articles/PMC10719752/ ︎