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A Preconception Cohort Study of Nicotine Vaping and Incidence of Spontaneous Abortion

Austen D Le, C. A. Zhang, Abby L. Chen, Satvir S Basran, Nicolas Seranio, Michael Scott, Shu-Feng Li, E. E. Hatch et al.

Nicotine & Tobacco Research, 2025

6,136 participants · 2 citations

Abstract

INTRODUCTION

We evaluated association of preconception nicotine vaping among female and male partners with spontaneous abortion (SAB) incidence, and the extent to which associations vary by cigarette smoking.

METHODS

In a prospective cohort study, 6136 participants assigned female-at-birth and 1688 of their partners assigned male-at-birth reported preconception nicotine vaping and cigarette smoking via online questionnaire. Female partners reported incident pregnancies and outcomes (e.g., SAB) on follow-up questionnaires completed every 8 weeks and in early and late pregnancy. We used multivariable Cox proportional hazards regression models estimated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for association between vaping and SAB incidence, overall and by smoking history.

RESULTS

Mean age was 30 and 32 for females and males respectively. Among females, 13% reported ever-vaping and 14% reported ever-smoking, while 19% of males reported ever-vaping and 24% reported ever-smoking. Relative to female never-vapers, aHRs were 1.03 for former vaping (95% CI 0.86-1.24) and 0.91 for current vaping (95% CI 0.61-1.36). Former and current vaping were also not appreciably associated with SAB rate among ever-smokers. In the couple-based cohort, relative to male never-vapers, aHRs were 1.00 for male former-vapers (95% CI: 0.74-1.35) and 0.67 for male current-vapers (95% CI: 0.35-1.25). Additional analysis of female participants after stratifying by finer categories of…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 6,136 participants or records.

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