Vaping Cessation During Pregnancy Among Smoke-Free HOPE Participants: A Qualitative Thematic Analysis

Abstract Background Vaping during pregnancy has emerged as a growing public health concern, yet guidance for vaping cessation within prenatal care settings remains limited and inconsistent. Despite the expanding use of electronic nicotine delivery systems (ENDS), limited research has explored vaping cessation experiences during pregnancy or how pregnant individuals navigate cessation within structured support programs. This qualitative study aimed to explore pregnant women’s perceptions of vaping and their experiences with barriers, facilitators, and motivations related to vaping cessation within a tobacco cessation program. Methods This qualitative study employed reflexive thematic analysis to explore the experiences of pregnant women enrolled in Smoke-Free HOPE, a community health worker-led tobacco cessation program, who attempted or expressed a desire to quit vaping. Data sources included qualitative data collected from two online focus groups with six pregnant participants and transcripts from post-program key informant interviews with nine pregnant participants. Results Analysis identified four core themes: (1) reconstructing identity in pregnancy and motherhood, (2) vaping as emotional regulation, sensory gratification, and habitual regulation, (3) quitting within social worlds of influence and pressure, and (4) navigating institutional support and mistrust, alongside cross-cutting processes of ambivalence and nonlinear quitting. These themes highlighted the challenges participants faced in navigating perceptions of harm related to vaping and the role of relational support within the program in shaping cessation experiences. Conclusion These findings highlight the complexity of vaping cessation during pregnancy and the importance of integrating relational, context-sensitive, and pregnancy-specific support, as participants often identified their children or infants as a central motivation for quitting.