Non-nicotine vapes still function by heating a liquid solution, or e-liquid, to create an inhalable aerosol. The belief that these vapes are safe during pregnancy stems from the absence of nicotine, the substance most commonly associated with adverse birth outcomes. E-liquid typically consists of a base of Propylene Glycol (PG) and Vegetable Glycerin (VG), along with various chemical flavorings. However, removing nicotine does not eliminate all potential harm, as the other chemical components and the process of aerosolizing them introduce risks to both the pregnant person and the developing fetus.
Understanding the Components of Non-Nicotine Vaping
The e-liquid base consists primarily of two carrier solvents: Propylene Glycol (PG) and Vegetable Glycerin (VG). PG is an organic compound that carries flavor and produces a thin vapor, while VG is a thicker, sweet-tasting carbohydrate that creates large vapor clouds. Although both are designated as “Generally Recognized as Safe” for ingestion in food products, this designation does not apply to their safety when heated and inhaled into the lungs.
When heated by the device’s coil, these carrier liquids can undergo thermal decomposition, changing their chemical structure. This process generates toxic byproducts, including carbonyl compounds such as formaldehyde and acetaldehyde, which are known carcinogens. These compounds are created when PG and VG break down at the high temperatures produced by the heating element.
The third main component is the complex mixture of chemical flavorings, often aldehydes like benzaldehyde, vanillin, and diacetyl. Flavoring chemicals are generally tested for safety when eaten, but few have undergone toxicity testing for inhalation. Some of these chemicals, such as diacetyl, have been associated with severe respiratory diseases. Furthermore, many flavorings can break down under heat to form additional aldehydes, increasing the overall toxic load of the aerosol.
Maternal and Fetal Health Impacts
The inhalation of non-nicotine vapor introduces ultrafine particulate matter and chemical toxins that initiate an inflammatory response. Studies show that inhaled chemicals from e-vapors cause inflammation and irritation in lung cells, even without nicotine. This systemic inflammation can affect maternal tissues and compromise placental function.
Inflammation caused by these inhaled chemicals can lead to oxidative stress, a biological imbalance that harms cells and DNA. Oxidative stress in the pregnant person can impair placental function, potentially impacting the transfer of oxygen and nutrients to the fetus. This disruption can negatively affect the intrauterine environment crucial for development.
The heating element also contributes to the toxic profile of the aerosol. The metal coils used in vaping devices release heavy metals into the inhaled vapor. Once inhaled, these heavy metals can enter the bloodstream, and some are known to cross the placental barrier, posing a direct threat to developing fetal organs. Heavy metals released include:
- Nickel
- Chromium
- Lead
- Tin
Emerging research from animal models suggests that exposure to non-nicotine vapor during gestation can affect fetal development. Exposure to e-liquid vapor alone has been shown to cause long-term impairments in the lung structure and function of offspring in mouse models. Other studies indicate that the base solution can impair blood vessels and lead to cognitive issues and signs of premature aging in offspring, independent of nicotine exposure. The volatile organic compounds and flavor chemicals in the aerosol are thought to be responsible for these negative outcomes on fetal lung maturation and neurological development.
Current Medical Recommendations
Major health organizations universally recommend against the use of all vaping products during pregnancy, including those that are nicotine-free. The Centers for Disease Control and Prevention (CDC) states that e-cigarettes are not safe for pregnant women. The American College of Obstetricians and Gynecologists (ACOG) advises clinicians to recommend the cessation of all tobacco and nicotine use, which includes vaping in any form.
This unified guidance reflects the significant knowledge gap regarding the long-term effects of chronic exposure to aerosolized PG, VG, and flavorings on a developing fetus. Because the effects of inhaling these chemicals have not been studied extensively in human pregnancy, and known toxic compounds are present, medical bodies err on the side of caution. There is insufficient evidence to assess the balance of benefits and harms of e-cigarettes for tobacco cessation in pregnant persons.
Healthcare providers are directed to advise pregnant people to use cessation interventions with proven effectiveness and established safety, such as behavioral counseling. The safest choice for both the pregnant person and the baby is to stop using all vaping products completely. Quitting all forms of tobacco and nicotine is the most effective action to protect fetal health.