The use of alternative forms of nicotine have increased in recent years, but there are little data regarding the health effects of these agents in pregnant women. This according to a committee opinion on smoking cessation during pregnancy from the American College of Obstetricians and Gynecologists (AGOG) that has been updated to reflect a limited, focused change in electronic nicotine delivery system and pharmacotherapy references. Among the updated information and continued recommendations:

• The use of alternative forms of nicotine, such as e-cigarettes and vaping, have increased substantially in recent years, but there are little data regarding health effects of these agents, either in the general population or in pregnant women.
• A short counseling session with pregnancy-specific educational materials and a referral to the smokers’ quit line is an effective smoking cessation strategy.
• Knowledge and use of the 5A’s (Ask, Advise, Assess, Assist, and Arrange), health care support systems, and pharmacotherapy add to the techniques providers can use to support perinatal smoking cessation.