- Nicotine vapes help more people quit smoking than nicotine replacement therapies such as patches or gum
- People using nicotine vapes are also more likely to quit than those using non-nicotine vapes or no support at all
- Rates of side effects and serious adverse events were similar across all groups
- Researchers found no evidence of serious harm from regulated nicotine vapes, but called for longer-term studies
A major scientific review has found that vapes containing nicotine are more effective at helping people quit smoking than traditional nicotine replacement products such as patches, lozenges or gum.
The updated Cochrane review, ‘Electronic cigarettes for smoking cessation’, published on 24 October 2025, analysed 104 studies involving more than 30,000 participants.
Researchers concluded there is “high-certainty evidence that nicotine EC increase quit rates compared to NRT,” and “moderate-certainty evidence that they probably increase quit rates compared to EC without nicotine.”
The findings are part of Cochrane’s ‘living systematic review’ – a continually updated analysis designed to incorporate new data as it becomes available. Fourteen new studies were added in this latest update.
Stronger evidence that vaping helps smokers quit
According to the review, people using nicotine vapes were about one and a half times more likely to quit smoking than those using nicotine replacement therapy. In practical terms, that could mean three additional quitters for every 100 people who try vaping instead of using NRT.
The authors also found that nicotine vapes “probably result in increased quit rates compared to non-nicotine EC,” and may help more people stop smoking than behavioural support alone or no treatment at all.
“This review provides the most reliable evidence available,” the authors wrote, noting that the conclusions are based on data from randomised controlled trials – the gold standard for medical research – as well as non-randomised studies that showed similar trends.
No sign of serious harm
The review found “no evidence of a difference in adverse events between nicotine and non-nicotine EC nor between nicotine EC and NRT.” Common minor side effects included throat or mouth irritation, cough, headache and nausea, but these “tended to dissipate with continued EC use.”
Serious adverse events were rare across all studies. The authors said there was “insufficient evidence to determine whether rates differ between groups” but added that “we did not detect evidence of serious harm from nicotine EC.” However, they cautioned that longer and larger studies are still needed to fully evaluate long-term safety.
The research looked only at regulated nicotine-containing vapes, not illicit or modified devices. “Illicit products and/or products containing other active substances (e.g. tetrahydrocannabinol (THC)) may have different harm profiles,” the authors warned.
Limitations and next steps
While the evidence for effectiveness is strong, the authors acknowledged that “the main limitation of the evidence base remains imprecision for some comparisons and for safety outcomes due to the relatively small number of RCTs contributing, often with low event rates.” Further clinical trials are already underway to address these gaps.
The review team screens new research each month and updates the analysis when fresh evidence becomes available. This approach aims to keep public health authorities, clinicians and policymakers informed with the latest data on vaping and smoking cessation.
What it means for smokers and policymakers
The findings reinforce a growing consensus that vaping can be an effective tool for adult smokers trying to quit, provided the products are properly regulated.
Public health agencies in the UK, New Zealand and other countries have already cited previous Cochrane reviews as key evidence supporting the use of nicotine vapes as a harm-reduction option.
Experts caution, however, that vaping is not risk-free and should not be taken up by non-smokers, particularly young people. The review did not address youth use or long-term health impacts beyond the context of quitting smoking.
Still, the evidence marks a clear shift in the weight of scientific opinion. In a news release following an earlier review, lead author Dr Nicola Lindson of the University of Oxford said: “E-cigarettes do not burn tobacco; and as such they do not expose users to the same complex mix of chemicals that cause diseases in people smoking conventional cigarettes.
“E-cigarettes are not risk free, and shouldn’t be used by people who don’t smoke or aren’t at risk of smoking. However, evidence shows that nicotine e-cigarettes carry only a small fraction of the risk of smoking.”
In January, Cochrane’s summary of its evidence said: “People are more likely to stop smoking for at least six months using nicotine e-cigarettes than using nicotine replacement therapy (7 studies, 2544 people), or e-cigarettes without nicotine (6 studies, 1613 people).”
The authors of the latest update also noted that they “did not detect evidence of serious harm from nicotine electronic cigarettes,” while emphasising that longer and larger studies are needed to confirm long-term safety.
The review was funded by Cancer Research UK.
