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 non-smokers, and even less so to non-smoking pregnant women. Our position is clear: vaping is only for smokers who are in the process of giving up smoking. But a new French study1 published in July 2025, claims that even for pregnant smokers, e-cigarettes are just as dangerous as tobacco. Relayed by Le Quotidien du Médecin2this claim is serious and deserves to be examined, even though the researchers themselves point to methodological biases.
What does the study say?
Dr Vallée's team at the Foch hospital in Suresnes analyzed 9 studies involving over 400,000 pregnant women. Their verdict: "exclusive vapers" were 40% more likely to give birth prematurely, and 49% more likely to have a low-birth-weight baby. Impressive figures, but they raise questions when we analyze the data presented.
A mix of groups that confuse vaping and smoking
An analysis of the 9 selected studies reveals that the "exclusive vaporizer" group in the meta-analysis actually mixes :
- 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 that contradict the conclusions of the meta-analysis
However, several studies included in this meta-analysis show otherwise:
- The Irish study3 found identical birth weights between never-smokers and never-smokers
- The American study4 on teenage girls, on the other hand, found no excess risk
However, these favorable results disappear simply because all cases are indiscriminately mixed in a single group.
Study conclusion vs. data reality
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, according to several individual studies, there is no additional 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 being largely responsible for the disorders caused: earlier delivery and lower child weight. Yet nicotine patches and gums are officially recommended for pregnant women who are unable to quit smoking. If nicotine were so dangerous, would these treatments be recommended? This astonishing contradiction justifies reservations about the quality of the conclusions reached.
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 in the same group, considerably distorts the results of a study where conclusions become confused, even misleading. As a result, concluding that vape is as harmful to pregnant women as tobacco is is akin to studying road accidents by confusing sober and drunk drivers, and concluding that "driving" is dangerous.
Science first
Given the public health stakes involved, FIVAPE is calling for greater scientific rigor: the conclusions of a study must accurately reflect the available data. And the facts are in: for pregnant smokers who are unable to quit completely, vaping is a far less harmful alternative to cigarettes. This distinction can be decisive in preventing smoking relapse and leading to successful cessation. Women and those around them need reliable, well-founded information, for their own health and that of their children.
Advice from doctors specializing in smoking cessation
Reprinted in Le Quotidien du Médecin (Vaping during pregnancy no less harmful than tobacco, according to a French meta-analysis - August 8, 2025), the conclusions of this study caused several experts to react in the article's comments:
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/ ︎