Vaping or using snus during pregnancy increases the risk of SIDS by up to three times, a study suggests.
Both e-cigarettes and snus – also known as “dip tobacco” or smokeless tobacco – have become increasingly popular among Americans looking to give up traditional cigarettes and are sold in most convenience stores in the US.
They are seen by many as a safer alternative to traditional cigarettes, but there is growing evidence that they themselves pose health risks.
Researchers in Sweden looked at the medical records of more than two million women and baby couples over 20 years. They found that people who used snus – which was invented in Sweden – during pregnancy increased the risk of their baby dying before the first birthday by 70 percent.
Lead study author Dr. Anna Gunnerbeck, a pediatrician at Sweden’s Karolinska Institutet, said all types of nicotine products should be avoided during pregnancy. “Given the dramatic rise in snus use among young women of childbearing age in Sweden in recent years and the growing popularity of e-cigarettes, women should be informed of the potential risk to fetuses and infants.
A single cartridge of some vaporizers contains the same amount of nicotine as approximately 50 cigarettes

The chart above, from a separate study, shows that e-cigarette prevalence has risen dramatically over the past three years in women aged 21 to 34 with peak fertility.
“Our research indicates that nicotine is a risk factor for SIDS, so we conclude that all types of nicotine products should be avoided during pregnancy.”
She said taking snus could be just as bad for babies as smoking up to nine cigarettes a day.
All types of nicotine products should be avoided during pregnancy, the researchers conclude.
With snus, nicotine enters the system through the inside of the cheeks. When vaping, it is inhaled through the lungs.
Nicotine is bad for baby’s development as it can damage the lungs and brain of unborn babies.
It’s not clear how many pregnant women vape or use snus in the US.
But a single cartridge of some vaporizers contains the same amount of nicotine as about 50 cigarettes.
Sudden infant death syndrome (SID), also known as SIDS, is the unexpected and unexplained death of an apparently healthy baby.
It is the leading cause of death in infants under one year of age in the US, with approximately 3,400 infants dying each year. In the UK it’s about 200.
The dangers of smoking during pregnancy have long been known, including increasing the risk of SIDS from second-hand smoke.
So few studies have been done on vaping, snus and other nicotine products in relation to SIDS.
Snus, also called “dip” or smokeless tobacco, is a moist, powdered tobacco pouch usually held in the mouth between the lip and gums, which releases nicotine into the bloodstream.
Unlike cigarettes, it does not contain any flammable ingredients, leading people to believe that snus, like vaping and other e-cigarettes, is not as bad for your health.
To address the lack of research, doctors in Sweden looked at records of more than two million babies born in the country between 1999 and 2019.
The study, published in the journal Pediatric Research, adjusted for risk factors of SID, such as socioeconomic status and maternal age.
Only two in 10,000 babies suffered from SID over the 20 years.
Just over one percent of mothers took snus and seven percent smoked when they registered for maternity care.
Taking snus was associated with a 70 percent increase in the risk of infant death before the baby’s first birthday, from any cause, and a 3-fold increase in SID.
The risks associated with taking snus were about the same as smoking one to nine cigarettes a day.
However, smoking more than ten cigarettes a day still puts the babies at the greatest risk.
And mothers were able to significantly reduce the risk of their baby dying if they stopped using snus before their first maternity appointment, compared with continued use.
The researchers noted that they can’t say for sure that nicotine use caused the children’s deaths, as other unknown factors may have contributed.
They also didn’t know how much snus the mothers-to-be used, whether mothers who quit smoking or using snus early in their pregnancy resumed their habits later, or how much nicotine is likely to harm the baby.
The study acknowledged that it is difficult to separate the risk to the fetus associated with snus and smoking from exposure to tobacco smoke and nicotine in breast milk after the baby is born.