Lakhasly

effects of nicotine alone derive primarily from animal studies, or can be inferred from the effects of smokeless tobacco, the striking similarity of findings in monkeys, mice, rats, sheep, and humans all support the direct effects of nicotine on lung development that mediate the deleterious effects of maternal smoking during pregnancy on offspring respiratory health.Limitations of this conclusion include a lack of comprehensive epidemiologic data on usage of e-cigarettes during pregnancy and limitations of animal models for asthma and SIDS.The effects of maternal smoking on lung development are mediated by nicotinic receptors, changes in airway geometry, effects on airway epithelial cell proliferation, and oxidative mechanisms.Similarly, animal models show that the effects of prenatal nicotine exposure are also mediated by these same mechanisms.

effects of nicotine alone derive primarily from animal studies, or can be inferred from the effects of smokeless tobacco, the striking similarity of findings in monkeys, mice, rats, sheep, and humans all support the direct effects of nicotine on lung development that mediate the deleterious effects of maternal smoking during pregnancy on offspring respiratory health. This comparison is summarized in Table 1, showing the comparable effects of conventional cigarettes and nicotine on lung development and disease. Thus, the findings summarized here strongly suggest that use of e-cigarettes during pregnancy will have the same effect on lung development and offspring lung health as does the use of conventional cigarettes.
The conclusion that nicotine mediates most of the effects of maternal smoking during pregnancy on lung development is supported not only by the similarity of effects but also by the similarity of underlying mechanisms of action. The effects of maternal smoking on lung development are mediated by nicotinic receptors, changes in airway geometry, effects on airway epithelial cell
proliferation, and oxidative mechanisms.
Similarly, animal models show that the effects of prenatal nicotine exposure are also mediated by these same mechanisms. Therefore, the likelihood that e-cigarettes affect lung development is supported by both descriptive and mechanistic data.
In expressing concerns about the effects of e-cigarettes on the developing fetus it is important to note that this is not a case of the lesser of two evils, as nicotine-replacement therapy during pregnancy
(6, 93) for smokers is often considered.
The safety of e-cigarettes during pregnancy must be compared with the use of no nicotine products during pregnancy, given the rapidly increasing numbers of e-cigarette-only users (1-3) and the addictive potential of nicotine that will likely drive a similar percentage of e-cigarette users to continue use during pregnancy, as is observed for smokers of conventional cigarettes. In addition, the perception of e-cigarettes as safe may also drive smokers to supplement cigarettes with e-cigarettes during pregnancy, thereby increasing nicotine exposure to the fetus.
Thus, in summary, the data presented here strongly support that e-cigarette usage during pregnancy will be as harmful to fetal lung development as is conventional cigarette usage. Limitations of this conclusion include a lack of comprehensive epidemiologic data on usage of e-cigarettes during pregnancy and limitations of animal models for asthma and SIDS. Nevertheless, the data are strong enough to raise major concerns, and it is hoped that education and regulation will prevent the effects of e-cigarettes on a new generation of infants. It is imperative that strong warnings about the dangers of e-cigarette use during pregnancy are imparted before this new generation of infants is affected.–