Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   44334   clinical trials with a EudraCT protocol, of which   7366   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Download PDF

    Clinical Trial Results:
    Helping Pregnant smokers quit: A multi-centre RCT of electronic cigarettes and nicotine patches

    Summary
    EudraCT number
    2017-001237-65
    Trial protocol
    GB  
    Global end of trial date
    24 Sep 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    21 Nov 2021
    First version publication date
    21 Nov 2021
    Other versions

    Trial information

    Close Top of page
    Trial identification
    Sponsor protocol code
    011822
    Additional study identifiers
    ISRCTN number
    ISRCTN62025374
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Queen Mary University of London
    Sponsor organisation address
    Queen Mary, University of London, Mile end Road, London, United Kingdom, E1 4NS
    Public contact
    Dr Dunja Przulj, Queen Mary University of London, +44 02078825949, d.przulj@qmul.ac.uk
    Scientific contact
    Dr Dunja Przulj, Queen Mary University of London, +44 02078825949, d.przulj@qmul.ac.uk
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    10 Jun 2021
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    24 Sep 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the study is to compare abstinence rates at end of pregnancy between the two different treatment arms: nicotine patches and EC.
    Protection of trial subjects
    Many women who miscarry can participate in follow up without upset; however, calls can occasionally be distressing. We did not routinely exclude women who miscarried from follow up, but the following minimised potential distress. The co-ordinating trial office sent the local research teams a list of participants to be followed up within the next fortnight; the local research team identified anyone known to have experienced an event which might make follow up distressing. In addition to this, a text reminder was sent to all participants the day before their follow up call was due. Participants could then text back if they did not wish to be called.
    Background therapy
    Participants in both arms were provided with up to 6 support calls on a weekly basis. The support provided followed that of usual advice given in the UK Stop-smoking services and was conducted by trained stop-smoking advisors.
    Evidence for comparator
    In the UK, nicotine skin patches are currently used routinely with pregnant smokers across the Stop-Smoking Specialist Services.
    Actual start date of recruitment
    01 Jan 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    United Kingdom: 1140
    Worldwide total number of subjects
    1140
    EEA total number of subjects
    1140
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    1140
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

    Close Top of page
    Recruitment
    Recruitment details
    Participants were recruited by research midwives or other appropriately trained staff (such as a specialist pregnancy stop smoking advisor) at NHS hospital sites across England and one stop-smoking service in Scotland. Recruitment ran between January 2018-November 2019.

    Pre-assignment
    Screening details
    Eligibility criteria: 18 years or over; daily smoker seeking help; 12-24 weeks pregnant; willing to be randomised to NRT or EC and receive follow-up calls; understands English. Exclusion criteria: allergic reaction to nicotine patches; currently using NRT or EC; taking part in a conflicting trial; high-risk pregnancy or serious medical condition.

    Period 1
    Period 1 title
    Baseline
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 1
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 2
    Period 2 title
    End of Pregnancy Follow up
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 2
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 3
    Period 3 title
    3 month post-partum follow up
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 3
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 4
    Period 4 title
    4 weeks post Target Quit Day
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 4
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 5
    Period 5 title
    1 week post target quit day
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 5
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 6
    Period 6 title
    2 weeks post target quit day
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 6
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571
    Period 7
    Period 7 title
    3 weeks post target quit day
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Nicotine Patch
    Arm description
    -
    Arm type
    Active comparator

    Investigational medicinal product name
    Nicorette Invisi Transdermal Patch 15mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Transdermal patch
    Routes of administration
    Transdermal use
    Dosage and administration details
    Participants were asked to wear one nicotine patch every day for up to 8 weeks. Participants were provided with a supply of 15mg patches but could reduce to 10mg if they wished.

    Arm title
    E-cig
    Arm description
    Electronic cigarette
    Arm type
    experimental (non-IMP)

    Investigational medicinal product name
    No investigational medicinal product assigned in this arm
    Number of subjects in period 7
    Nicotine Patch E-cig
    Started
    569
    571
    Completed
    569
    571

    Baseline characteristics

    Close Top of page
    Baseline characteristics reporting groups
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette

    Reporting group values
    Nicotine Patch E-cig Total
    Number of subjects
    569 571 1140
    Age categorical
    Units: Subjects
        In utero
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
        Newborns (0-27 days)
    0
        Infants and toddlers (28 days-23 months)
    0
        Children (2-11 years)
    0
        Adolescents (12-17 years)
    0
        Adults (18-64 years)
    0
        From 65-84 years
    0
        85 years and over
    0
    Age continuous
    Units: years
        median (inter-quartile range (Q1-Q3))
    27.3 (23.6 to 31.1) 26.6 (22.5 to 30.9) -
    Gender categorical
    All participants were female
    Units: Subjects
        Female
    569 571 1140
        Male
    0 0 0
    Education level
    Units: Subjects
        Further education/diploma
    273 288 561
        Higher education
    62 54 116
        Primary and Secondary School
    234 229 463
    Employment status
    Units: Subjects
        Employed
    257 274 531
        Unemployed/other
    312 297 609
    Ethnicity
    Units: Subjects
        White British
    495 513 1008
        Other
    74 58 132
    Past Treatment
    Previous smoking cessation treatment used
    Units: Subjects
        Yes
    302 299 601
        No
    267 272 539
    Tried EC
    Number who have tried an e-cigarette in the past
    Units: Subjects
        Tried E-cigarette before
    267 288 555
        Never tried EC
    302 283 585
    Lives with a smoker
    Units: Subjects
        Lives with a smoker
    328 342 670
        Does not live with smoker
    241 229 470
    Cigarettes per day
    Units: cigarettes per day
        median (inter-quartile range (Q1-Q3))
    10 (7 to 15) 10 (7 to 15) -
    FTCD
    Fagestrome Test of Cigarette Dependence
    Units: N/A
        arithmetic mean (standard deviation)
    4.3 ( 2.1 ) 4.0 ( 2.1 ) -
    Cotinine
    Units: ng/ml
        median (inter-quartile range (Q1-Q3))
    118 (73.9 to 176.0) 111 (75.8 to 165.0) -

    End points

    Close Top of page
    End points reporting groups
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette

    Subject analysis set title
    Abstainers using EC
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who were abstinent from smoking and regularly using the EC (regardless of randomisation arm).

    Subject analysis set title
    Abstainers not using nicotine
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who were abstinent from smoking and not using any form of nicotine.

    Subject analysis set title
    Abstainers using NRT
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants who were abstinent from smoking and regularly using NRT (regardless of randomisation arm).

    Primary: Validated prolonged abstinence

    Close Top of page
    End point title
    Validated prolonged abstinence
    End point description
    End point type
    Primary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    25
    39
    Statistical analysis title
    Validated prolonged abstinence at EoP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.55
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.95
         upper limit
    2.53

    Primary: Validated prolonged abstinence- per protocol

    Close Top of page
    End point title
    Validated prolonged abstinence- per protocol
    End point description
    Sensitivity analysis of primary outcome (per protocol)
    End point type
    Primary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    382
    483
    Units: Number of participants
        Abstinent
    23
    39
    Statistical analysis title
    Per protocol sensitivity analysis
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    865
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.34
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.82
         upper limit
    2.21

    Primary: Validated prolonged abstinence- multiple imputation

    Close Top of page
    End point title
    Validated prolonged abstinence- multiple imputation
    End point description
    Sensitivity analysis of primary outcome- multiple imputation. The counts given are an estimate obtained by averaging results from the 50 imputed datasets using Rubin's rules. They are only reported as a reference and should be interpreted with caution.
    End point type
    Primary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    41
    58
    Statistical analysis title
    Sensitivity analysis- multiple imputation
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.88
         upper limit
    2.21

    Primary: Validated prolonged abstinence- excluding abstinent contaminators

    Close Top of page
    End point title
    Validated prolonged abstinence- excluding abstinent contaminators
    End point description
    Sensitivity analysis of primary outcome- excludes abstainers who were using a non-allocated product
    End point type
    Primary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    564
    571
    Units: Number of participants
        Abstinent
    20
    39
    Statistical analysis title
    Sensitivity analysis excluding contaminators
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1135
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.93
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.14
         upper limit
    3.26

    Secondary: Self-reported prolonged abstinence at EOP

    Close Top of page
    End point title
    Self-reported prolonged abstinence at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    44
    63
    Statistical analysis title
    Self-reported prolonged abstinence at EoP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.43
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.99
         upper limit
    2.06

    Secondary: Validated point prevalence abstinence at EOP

    Close Top of page
    End point title
    Validated point prevalence abstinence at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    40
    58
    Statistical analysis title
    Validated point prevalence abstinence at EOP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.44
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.98
         upper limit
    2.13

    Secondary: Self-reported point prevalence abstinence at EOP

    Close Top of page
    End point title
    Self-reported point prevalence abstinence at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    78
    118
    Statistical analysis title
    Self-reported point prevalence abstinence at EOP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.51
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.16
         upper limit
    1.96

    Secondary: Validated abstinence for the past two months at EOP

    Close Top of page
    End point title
    Validated abstinence for the past two months at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    35
    46
    Statistical analysis title
    Validated abstinence for past two months at EOP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.31
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.86
         upper limit
    2

    Secondary: Self-reported abstinence for the past two months at EOP

    Close Top of page
    End point title
    Self-reported abstinence for the past two months at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    59
    68
    Statistical analysis title
    Self-reported abstinence for the past two months
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.83
         upper limit
    1.6

    Secondary: Self-reported abstinence at 4 weeks

    Close Top of page
    End point title
    Self-reported abstinence at 4 weeks
    End point description
    End point type
    Secondary
    End point timeframe
    4 wees post Target Quit Day
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    61
    89
    Statistical analysis title
    Self-reported abstinence at 4 weeks
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.45
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.07
         upper limit
    1.97

    Secondary: Validate 50% smoking reduction at EOP in non-abstainers

    Close Top of page
    End point title
    Validate 50% smoking reduction at EOP in non-abstainers
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    491
    453
    Units: Number of participants
        Reduced
    12
    12
    Statistical analysis title
    validated reduction at EOP in non-abstainers
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    944
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.08
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.49
         upper limit
    2.39

    Secondary: Self-reported 50% smoking reduction at EoP in non-abstainers

    Close Top of page
    End point title
    Self-reported 50% smoking reduction at EoP in non-abstainers
    End point description
    End point type
    Secondary
    End point timeframe
    End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    491
    453
    Units: Number of participants
        Reduced
    166
    192
    Statistical analysis title
    self-reported reduction at EOP in non-abstainers
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    944
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.06
         upper limit
    1.48

    Secondary: Self-reported 50% smoking reduction at EoP (abstainers included as reducers)

    Close Top of page
    End point title
    Self-reported 50% smoking reduction at EoP (abstainers included as reducers)
    End point description
    End point type
    Secondary
    End point timeframe
    End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Reduced
    198
    248
    Statistical analysis title
    self-reported reduction at EOP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.08
         upper limit
    1.44

    Secondary: Change in cotinine levels in abstainers using nicotine

    Close Top of page
    End point title
    Change in cotinine levels in abstainers using nicotine
    End point description
    Abstainers are defined as 7-day point prevalence
    End point type
    Secondary
    End point timeframe
    Change from baseline to End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    5
    37
    Units: ng/ml
        median (inter-quartile range (Q1-Q3))
    -7 (-108.2 to -0.2)
    -5.3 (-77.6 to 44.6)
    Statistical analysis title
    Change in cotinine levels
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    42
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    1.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -123.3
         upper limit
    110.3

    Secondary: Change in cotinine levels in 50% reducers using nicotine

    Close Top of page
    End point title
    Change in cotinine levels in 50% reducers using nicotine
    End point description
    50% reducers are those who reduced their smoking by 50%
    End point type
    Secondary
    End point timeframe
    Change from baseline to End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    69
    99
    Units: ng/ml
        median (inter-quartile range (Q1-Q3))
    6 (-44 to 59.0)
    6 (-27.2 to 82)
    Statistical analysis title
    Change in cotinine levels
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    168
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    0
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -28.9
         upper limit
    28.9

    Secondary: Change in cotinine levels in dual users

    Close Top of page
    End point title
    Change in cotinine levels in dual users
    End point description
    Dual users are those who have smoked in last 7 days and are still using nicotine products
    End point type
    Secondary
    End point timeframe
    Change from baseline to End of Pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    25
    87
    Units: ng/ml
        median (inter-quartile range (Q1-Q3))
    10 (-4.5 to 59)
    8 (-31 to 105)
    Statistical analysis title
    Change in cotinine levels
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    112
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -55.8
         upper limit
    51.8

    Secondary: Number who set Target Quit Day

    Close Top of page
    End point title
    Number who set Target Quit Day
    End point description
    End point type
    Secondary
    End point timeframe
    Baseline
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Set TQD
    394
    418
    Statistical analysis title
    Number setting quit day
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.06
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.98
         upper limit
    1.14

    Secondary: Support sessions completed

    Close Top of page
    End point title
    Support sessions completed
    End point description
    End point type
    Secondary
    End point timeframe
    4 weeks post Target Quit Day
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: number of sessions
        median (inter-quartile range (Q1-Q3))
    1 (0 to 2)
    1 (0 to 3)
    Statistical analysis title
    Support sessions completed
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    0
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.31
         upper limit
    0.31

    Secondary: Accessed local stop smoking services

    Close Top of page
    End point title
    Accessed local stop smoking services
    End point description
    End point type
    Secondary
    End point timeframe
    From baseline to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Accessed services
    34
    29
    Statistical analysis title
    Accessed local stop smoking services
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.85
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.53
         upper limit
    1.38

    Secondary: Current use of allocated product at EOP

    Close Top of page
    End point title
    Current use of allocated product at EOP
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Currently using
    32
    193
    Statistical analysis title
    Current use of allocated product at EOP
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    6.01
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    4.21
         upper limit
    8.58

    Secondary: Current use of non-allocated product at EOP

    Close Top of page
    End point title
    Current use of non-allocated product at EOP
    End point description
    non-allocated product refers to participants in the EC arm using NRT and vice versa.
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Currently using
    49
    4
    Statistical analysis title
    Current use of non-allocated product at EOP
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.08
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.03
         upper limit
    0.22

    Secondary: Used allocated product since last contact

    Close Top of page
    End point title
    Used allocated product since last contact
    End point description
    End point type
    Secondary
    End point timeframe
    1 week post target quit day to end of pregnancy
    End point values
    Nicotine Patch E-cig Nicotine Patch E-cig Nicotine Patch E-cig Nicotine Patch E-cig Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    569
    571
    569
    571
    569
    571
    569
    571
    Units: Number of participants
        Used product
    236
    371
    128
    228
    169
    232
    139
    213
    103
    187
    No statistical analyses for this end point

    Secondary: Duration of regular allocated product use

    Close Top of page
    End point title
    Duration of regular allocated product use
    End point description
    End point type
    Secondary
    End point timeframe
    From start of treatment to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    434
    465
    Units: weeks
        median (inter-quartile range (Q1-Q3))
    1 (0 to 5)
    8 (2 to 19)
    No statistical analyses for this end point

    Secondary: Duration of occasional allocated product use

    Close Top of page
    End point title
    Duration of occasional allocated product use
    End point description
    End point type
    Secondary
    End point timeframe
    From start of treatment to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    434
    465
    Units: weeks
        median (inter-quartile range (Q1-Q3))
    2 (1 to 4)
    0 (0 to 1)
    Statistical analysis title
    Weeks of occasional product use
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    899
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    -2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.16
         upper limit
    1.84

    Secondary: Duration of regular non-allocated product use

    Close Top of page
    End point title
    Duration of regular non-allocated product use
    End point description
    End point type
    Secondary
    End point timeframe
    From start of treatment to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    102
    21
    Units: weeks
        median (inter-quartile range (Q1-Q3))
    1 (0 to 2)
    1 (0 to 3)
    No statistical analyses for this end point

    Secondary: Duration of occasional non-allocated product use

    Close Top of page
    End point title
    Duration of occasional non-allocated product use
    End point description
    End point type
    Secondary
    End point timeframe
    From start of treatment to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    102
    21
    Units: week
        median (inter-quartile range (Q1-Q3))
    1 (0 to 1)
    1 (1 to 1)
    No statistical analyses for this end point

    Secondary: Type of NRT used

    Close Top of page
    End point title
    Type of NRT used
    End point description
    End point type
    Secondary
    End point timeframe
    from target quit day to end of pregnancy
    End point values
    Nicotine Patch
    Number of subjects analysed
    238
    Units: Number of participants
        Nicotine Patch
    220
        Combination NRT
    16
        Mouthspray
    1
        Inhaler
    1
    No statistical analyses for this end point

    Secondary: Type of EC used

    Close Top of page
    End point title
    Type of EC used
    End point description
    End point type
    Secondary
    End point timeframe
    from target quit day to end of pregnancy
    End point values
    E-cig E-cig
    Number of subjects analysed
    371
    344
    Units: Number of participants
        Refillable
    330
    324
        Cig-a-like
    0
    1
        Cartridge/Pod
    2
    1
        Missing
    39
    18
    No statistical analyses for this end point

    Secondary: E-liquid nicotine strength used

    Close Top of page
    End point title
    E-liquid nicotine strength used
    End point description
    End point type
    Secondary
    End point timeframe
    from target quit day to end of pregnancy
    End point values
    E-cig E-cig
    Number of subjects analysed
    371
    344
    Units: Number of participants
        0 mg/mL
    8
    7
        1-10 mg/mL
    77
    47
        11-20 mg/mL
    61
    199
        Missing
    225
    91
    No statistical analyses for this end point

    Secondary: E-liquid flavours used

    Close Top of page
    End point title
    E-liquid flavours used
    End point description
    End point type
    Secondary
    End point timeframe
    from target quit day to end of pregnancy
    End point values
    E-cig E-cig
    Number of subjects analysed
    371
    344
    Units: Number of participants
        Fruit
    97
    180
        Tobacco
    38
    24
        Mint/menthol
    19
    22
        chcocolate/dessert/candy
    17
    11
        Other
    24
    21
        Missing
    176
    86
    No statistical analyses for this end point

    Secondary: Birth Outcomes- singleton birth

    Close Top of page
    End point title
    Birth Outcomes- singleton birth
    End point description
    Birth outcomes in singleton births
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    549
    546
    Units: Number of participants
        Miscarraige
    3
    2
        Still birth
    0
    3
        Neonatal Death
    3
    2
        Post-neonatal death
    3
    0
        Maternal death
    0
    0
        Pre-term birth
    63
    46
        NICU admission
    46
    51
        Congenital abnormalities
    15
    25
        Terminations (due to abnormalities)
    2
    1
        Terminations (due to PROM)
    0
    2
        C-section delivery
    148
    131
    Statistical analysis title
    Miscarriage
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.67
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.11
         upper limit
    4
    Statistical analysis title
    Neonatal death
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.67
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.11
         upper limit
    4
    Statistical analysis title
    Preterm birth
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.73
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.51
         upper limit
    1.05
    Statistical analysis title
    NICU admission
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.11
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.76
         upper limit
    1.63
    Statistical analysis title
    Congenital abnormalities
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.68
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.89
         upper limit
    3.14
    Statistical analysis title
    Terminations due to Congenital abnormalities
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.51
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.25
         upper limit
    9
    Statistical analysis title
    C-section
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1095
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.89
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.73
         upper limit
    1.09

    Secondary: Gestational age- singleton births

    Close Top of page
    End point title
    Gestational age- singleton births
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    547
    545
    Units: week
        arithmetic mean (standard deviation)
    38.2 ( 3.1 )
    38.4 ( 3.0 )
    Statistical analysis title
    Gestational age
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1092
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.23
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.14
         upper limit
    0.59

    Secondary: Birth-weight- singleton births

    Close Top of page
    End point title
    Birth-weight- singleton births
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    541
    541
    Units: kilogram(s)
        arithmetic mean (standard deviation)
    3.1 ( 0.62 )
    3.1 ( 0.60 )
    Statistical analysis title
    Birthweight
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1082
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.03
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.04
         upper limit
    0.1

    Secondary: Birth Outcomes- including multiple births

    Close Top of page
    End point title
    Birth Outcomes- including multiple births
    End point description
    Sensitivity analysis inlcuding twin births
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    557
    564
    Units: Number of participants
        Miscarriage
    3
    3
        Stillbirth
    0
    2
        Neonatal death
    3
    2
        Post-neonatal death
    3
    0
        Maternal death
    0
    0
        Preterm Birth
    69
    56
        NICU admission
    46
    58
        Congenital abnormalities
    15
    26
        Terminations (due to abnormalities)
    2
    1
        Terminations (due to PROM)
    0
    2
        C-section delivery
    152
    145
    Statistical analysis title
    Miscarriage
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.99
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.2
         upper limit
    4.87
    Statistical analysis title
    Neonatal death
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.11
         upper limit
    3.93
    Statistical analysis title
    Preterm birth
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.56
         upper limit
    1.14
    Statistical analysis title
    NICU admission
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.25
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.85
         upper limit
    1.81
    Statistical analysis title
    Congenital abnormalities
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.71
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.92
         upper limit
    3.2
    Statistical analysis title
    Terminations due to Congenital abnormalities
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.48
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.25
         upper limit
    8.84
    Statistical analysis title
    C-section
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1121
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.94
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.77
         upper limit
    1.15

    Secondary: Gestational age- multiple births included

    Close Top of page
    End point title
    Gestational age- multiple births included
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    555
    562
    Units: week
        arithmetic mean (standard deviation)
    38.2 ( 3.1 )
    38.3 ( 3.1 )
    Statistical analysis title
    Gestational age- multiple births included
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1117
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    0.12
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.25
         upper limit
    0.49

    Secondary: Birth-weight- multiple births

    Close Top of page
    End point title
    Birth-weight- multiple births
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    549
    558
    Units: kilogram(s)
        arithmetic mean (standard deviation)
    3.1 ( 0.63 )
    3.1 ( 0.63 )
    Statistical analysis title
    Birth-weight- multiple births
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1107
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.01
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.07
         upper limit
    0.08

    Secondary: Nicotine use and birth-weight

    Close Top of page
    End point title
    Nicotine use and birth-weight
    End point description
    Effect of nicotine use on birth-weight, controlling for time since last cigarette.
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Abstainers using EC Abstainers not using nicotine Abstainers using NRT
    Number of subjects analysed
    62
    9
    18
    Units: kilogram(s)
        arithmetic mean (standard deviation)
    3.4 ( 0.57 )
    3.1 ( 0.62 )
    3.2 ( 0.55 )
    Statistical analysis title
    Birthweight
    Comparison groups
    Abstainers using EC v Abstainers not using nicotine
    Number of subjects included in analysis
    71
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.23
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.21
         upper limit
    0.66
    Statistical analysis title
    Birthweight
    Comparison groups
    Abstainers using EC v Abstainers using NRT
    Number of subjects included in analysis
    80
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.13
         upper limit
    0.53

    Secondary: Nicotine use and gestational age

    Close Top of page
    End point title
    Nicotine use and gestational age
    End point description
    Effect of nicotine use on gestational age, controlling for time since last cigarette.
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Abstainers using EC Abstainers not using nicotine Abstainers using NRT
    Number of subjects analysed
    63
    9
    18
    Units: week
        arithmetic mean (standard deviation)
    39 ( 1.7 )
    38.4 ( 2.3 )
    38.9 ( 1.6 )
    Statistical analysis title
    Nicotine use and gestational age
    Comparison groups
    Abstainers using EC v Abstainers not using nicotine
    Number of subjects included in analysis
    72
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.55
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.46
         upper limit
    2.56
    Statistical analysis title
    Nicotine use and gestational age
    Comparison groups
    Abstainers using EC v Abstainers using NRT
    Number of subjects included in analysis
    81
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Mean difference (final values)
    Point estimate
    0.03
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.51
         upper limit
    1.56

    Secondary: New respiratory symptoms

    Close Top of page
    End point title
    New respiratory symptoms
    End point description
    Reports of new respiratory symptoms since start of treatment
    End point type
    Secondary
    End point timeframe
    From baseline to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    79
    64
    Units: Number of participants
        New symptoms
    63
    54
    Statistical analysis title
    New respiratory symptoms
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    143
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.06
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.91
         upper limit
    1.23

    Secondary: Severe respiratory symptoms

    Close Top of page
    End point title
    Severe respiratory symptoms
    End point description
    Number of participants experiencing severe respiratory symptoms
    End point type
    Secondary
    End point timeframe
    From baseline to end of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    63
    53
    Units: Number of participants
        Severe symptoms
    12
    3
    No statistical analyses for this end point

    Secondary: Validated prolonged abstinence- effect of COVID

    Close Top of page
    End point title
    Validated prolonged abstinence- effect of COVID
    End point description
    Sensitivity analysis of primary outcome to check whether COVID had any effect on saliva sample return rate. In total, 5 saliva kits were posted to self-reported abstainers between 1st March and 5th May, during the period of pandemic lock-down in the UK (3 EC arm and 2 NRT arm). Of these, 2 were returned. The rate of sample return in pre-Covid period was 73.6% and 66.7% in the EC and NRT arms, respectively. The rate of passed validation observed pre-Covid was 92.1% and 100% in EC and NRT arms, respectively. Therefore, we assumed that 66.0% in the EC arm and 66.7% in NRT arm would be returned and pass validation. We estimated validation status (pass/fail) for the 3 non-responders for each arm separately and found that 2 could be expected to pass validation (1 in each arm).
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Abstinent
    26
    40
    Statistical analysis title
    Validated prolonged abstinence- effect of COVID
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1.53
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.95
         upper limit
    2.48

    Secondary: Validate 50% smoking reduction at EOP (abstainers included as reducers)

    Close Top of page
    End point title
    Validate 50% smoking reduction at EOP (abstainers included as reducers)
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    569
    571
    Units: Number of participants
        Reduced
    22
    22
    Statistical analysis title
    validated reduction at EOP
    Comparison groups
    E-cig v Nicotine Patch
    Number of subjects included in analysis
    1140
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.56
         upper limit
    1.78

    Secondary: Low birthweight- singleton birth

    Close Top of page
    End point title
    Low birthweight- singleton birth
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    541
    541
    Units: Number of participants
        Low birthweight
    80
    52
    Statistical analysis title
    Low birthweight- singleton births
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1082
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.65
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.47
         upper limit
    0.91

    Secondary: Low birthweight- multiple births

    Close Top of page
    End point title
    Low birthweight- multiple births
    End point description
    End point type
    Secondary
    End point timeframe
    End of pregnancy
    End point values
    Nicotine Patch E-cig
    Number of subjects analysed
    549
    558
    Units: Number of participants
        Low birthweight
    86
    63
    Statistical analysis title
    Low birthweight- multiple births
    Comparison groups
    Nicotine Patch v E-cig
    Number of subjects included in analysis
    1107
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Risk ratio (RR)
    Point estimate
    0.72
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.53
         upper limit
    0.99

    Adverse events

    Close Top of page
    Adverse events information
    Timeframe for reporting adverse events
    Adverse events were collected from when participants were posted out their products until the end of the study.
    Adverse event reporting additional description
    Adverse events were collected for participants and their infants. Although infant deaths occurred, these are not counted in the 'fatalities' count as no participants died during the trial.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.1
    Reporting groups
    Reporting group title
    Nicotine Patch
    Reporting group description
    -

    Reporting group title
    E-cig
    Reporting group description
    Electronic cigarette

    Serious adverse events
    Nicotine Patch E-cig
    Total subjects affected by serious adverse events
         subjects affected / exposed
    222 / 569 (39.02%)
    209 / 571 (36.60%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Spinal cord neoplasm
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vascular disorders
    Haematoma
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Surgical and medical procedures
    Ceasarean section
         subjects affected / exposed
    150 / 569 (26.36%)
    138 / 571 (24.17%)
         occurrences causally related to treatment / all
    0 / 150
    0 / 138
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    termination of pregnancy
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hospitalisation for further diagnosis
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cholecystectomy
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pregnancy, puerperium and perinatal conditions
    Miscarriage
         subjects affected / exposed
    3 / 569 (0.53%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Stillbirth
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Premature baby
         subjects affected / exposed
    35 / 569 (6.15%)
    18 / 571 (3.15%)
         occurrences causally related to treatment / all
    0 / 35
    0 / 18
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Birthweight low
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Premature rupture of membranes
         subjects affected / exposed
    5 / 569 (0.88%)
    5 / 571 (0.88%)
         occurrences causally related to treatment / all
    0 / 5
    0 / 5
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pre-eclampsia
         subjects affected / exposed
    3 / 569 (0.53%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Threatened labour
         subjects affected / exposed
    3 / 569 (0.53%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Haemorrhage in pregnancy
         subjects affected / exposed
    2 / 569 (0.35%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Premature labour
         subjects affected / exposed
    2 / 569 (0.35%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Jaundice neonatal
         subjects affected / exposed
    2 / 569 (0.35%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foetal growth restriction
         subjects affected / exposed
    2 / 569 (0.35%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypothermia neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foetal hypokinesia
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Poor weight gain neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Shoulder dystocia
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Postpartum haemorrhage
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Eclampsia
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gestational diabetes
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hyperemesis gravidarum
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Premature separation of placenta
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Preterm premature rupture of membranes
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Retained products of conception
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foetal Cardiac disorder
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Death neonatal
         subjects affected / exposed
    3 / 569 (0.53%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    death of child
         subjects affected / exposed
    3 / 569 (0.53%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Drug withdrawal syndrome neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Dehydration
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Reproductive system and breast disorders
    Vaginal haemorrhage
         subjects affected / exposed
    4 / 569 (0.70%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cervix inflammation
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    neonatal respiratory disorders
         subjects affected / exposed
    7 / 569 (1.23%)
    9 / 571 (1.58%)
         occurrences causally related to treatment / all
    0 / 7
    0 / 9
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Meconium aspiration syndrome
         subjects affected / exposed
    1 / 569 (0.18%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infantile apnoea
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Childhood asthma
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neonatal pneumothorax
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pulmonary thrombosis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Psychiatric disorders
    Alcoholism
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Investigations
    Haemoglobin decreased
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Skull fracture
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ureteric injury
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital, familial and genetic disorders
    Congenital abnormality NOS
         subjects affected / exposed
    1 / 569 (0.18%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ankyloglossia congenital
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Developmental hip dysplasia
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Heart disease congenital
         subjects affected / exposed
    2 / 569 (0.35%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypospadias
         subjects affected / exposed
    1 / 569 (0.18%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Talipes
         subjects affected / exposed
    1 / 569 (0.18%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cleft lip
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    cleft palate
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital aortic anomaly
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Deafness congenital
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Fallot's tetralogy
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastroschisis
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Inborn error of metabolism
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hernia congenital
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Laryngomalacia
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Otospondylomegaepiphyseal dysplasia
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Polydactyly
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Trisomy 13
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Anal atresia
         subjects affected / exposed
    2 / 569 (0.35%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital arterial malformation
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Congenital hydronephrosis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Holoprosencephaly
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Multiple congenital abnormalities
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Spina bifida
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Foetal cardiac arrest
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cardiac arrest neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Acute myocardial infarction
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Migraine
         subjects affected / exposed
    2 / 569 (0.35%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neonatal seizure
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Hypoxic-ischaemic encephalopathy
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    hypnagogic myoclonus
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Intraventricular haemorrhage neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Perinatal stroke
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral haemorrhage
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sciatica
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cerebral ventricle dilatation
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Epilepsy
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Blood and lymphatic system disorders
    Immune thrombocytopenia
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Ear and labyrinth disorders
    Neonatal deafness
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    1 / 569 (0.18%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infantile vomiting
         subjects affected / exposed
    2 / 569 (0.35%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal distension
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal pain upper
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Necrotising enterocolitis neonatal
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Diarrhoea
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastritis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Abdominal wall cyst
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Skin and subcutaneous tissue disorders
    Skin discolouration
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal and urinary disorders
    Genitourinary tract infection
         subjects affected / exposed
    4 / 569 (0.70%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 4
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nephrolithiasis
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal pain
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Renal cyst
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Hypertonia neonatal
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    Sepsis neonatal
         subjects affected / exposed
    0 / 569 (0.00%)
    4 / 571 (0.70%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 4
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tonsillitis
         subjects affected / exposed
    1 / 569 (0.18%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Viral infection
         subjects affected / exposed
    0 / 569 (0.00%)
    2 / 571 (0.35%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Beta haemolytic streptococcal infection
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Neonatal infection
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchiolitis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Bronchitis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Influenza
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Kidney infection
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Mastitis
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Puerperal pyrexia
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Sepsis
         subjects affected / exposed
    1 / 569 (0.18%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Wound infection
         subjects affected / exposed
    0 / 569 (0.00%)
    1 / 571 (0.18%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Cellulitis
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Endometritis decidual
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Lower respiratory tract infection
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pyelonephritis acute
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Tooth infection
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 569 (0.18%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Hypoglycaemia neonatal
         subjects affected / exposed
    0 / 569 (0.00%)
    3 / 571 (0.53%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Poor feeding infant
         subjects affected / exposed
    2 / 569 (0.35%)
    0 / 571 (0.00%)
         occurrences causally related to treatment / all
    0 / 2
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Nicotine Patch E-cig
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    105 / 569 (18.45%)
    81 / 571 (14.19%)
    General disorders and administration site conditions
    Application site irritation
         subjects affected / exposed
    50 / 569 (8.79%)
    2 / 571 (0.35%)
         occurrences all number
    51
    2
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    47 / 569 (8.26%)
    29 / 571 (5.08%)
         occurrences all number
    48
    30
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    8 / 569 (1.41%)
    50 / 571 (8.76%)
         occurrences all number
    8
    51

    More information

    Close Top of page

    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    05 Mar 2018
    Update to paper CRF storage; update to Sponsor representative; addition of questions to CRF.
    04 Jul 2019
    Replacement of ineligible participants; update to SAE procedure; addition of new outcomes; addition of CO measurement to verify abstinence.
    30 Jan 2020
    Add Professor Christopher Griffiths as new CI; update to saliva sample payments.
    12 May 2020
    Update to protocol to reflect statistical analysis plan. Inclusion of data analysis at completion of end of pregnancy.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Validation of smoking status via postal saliva sampling proved problematic. Almost half of participants did not provide usable samples, which led to low primary outcome abstinence rates and reduced the study power.
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Fri May 02 08:01:06 CEST 2025 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA