Nicotine e-cigarettes are more effective than other alternatives for quitting smoking, study finds

Nicotine electronic cigarettes can help people stop smoking, working better than other replacement therapies such as patches or gum, a new review has found.

The Cochrane review analysed 80 studies, involving a total of 29,861 adults who smoked, comparing nicotine vapes with other options offered to help people quit.

“There is clear evidence that nicotine e-cigarettes increase smoking cessation rates at six months or longer compared to nicotine replacement therapy,” Jamie Hartmann-Boyce, senior author of the review at the University of Massachusetts Amherst, told reporters during a press briefing presenting the report, adding that nicotine vapes increase cessation rates by about 60%.

“Our certainty in that evidence is high, which means we do not think future studies are likely to meaningfully change these conclusions,” she added.

The review found that more people were able to quit smoking and remain smoke-free for at least six months with e-cigarettes than with nicotine replacement therapy (NRT), such as patches, gum and sprays.

“In our study population, we might expect six people per 100 to quit with nicotine replacement therapy. If they were given nicotine e-cigarettes, we might expect that number to increase to around 10 per 100,” Hartmann-Boyce said.

NRTs help smokers stop by supplying nicotine as a substitute, easing withdrawal symptoms, though even with this support, long-term quit rates remain low.

Meanwhile, people may also be more likely to stop smoking with nicotine vapes than with non-nicotine alternatives or behavioural support only, the study found.

Not all vapes are the same

Despite the evidence that nicotine e-cigarettes can be a useful alternative for smokers wanting to quit, the researchers warn that not all products are alike.

“The harms that we often hear about are overwhelmingly from unregulated vaping devices that contain ingredients that are known to be harmful for human health. They may contain psychoactive substances other than nicotine — for example, THC (the main chemical compound in cannabis,” Hartmann-Boyce noted.

She added that the products included in the review are part of controlled trials and regulated for sale on the market, which can differ from other products people encounter in everyday use.

The researchers also warned that more evidence is needed on the effects of newer types of vaping devices.

Towards quitting smoking

Tobacco dependence is caused not only by the effects of nicotine but also through broader social and behavioural aspects, the researchers noted.

Quitting tobacco is associated with substantial health benefits. However, despite most people who smoke wanting to quit, many find it difficult to succeed in the long term, the researchers added.

Almost half of the smokers who try to stop without support do not manage to stop for even a week, and fewer than 5% remain smoke-free a year after quitting.

In light of this, the researchers noted that there is a need for more research into alternatives.

“There is interest in developing smoking cessation products that not only help relieve the unpleasant effects of nicotine withdrawal, but that also act as effective substitutes for smoking behaviour and the rituals and sensations that accompany smoking, without the health risks associated with the inhalation of tobacco smoke,” they wrote.