Smokers offered a vape starter kit without ongoing counselling were 76 per cent more likely to quit for six months than those sent NHS stop-smoking emails.
Six-month quit rates were 11.3 per cent with vapes alone, compared with 6.4 per cent with supportive messages. That’s around five extra quitters for every 100 people.
Adding telephone support increased the quit rate to 21.1 per cent, almost double the rate achieved with vapes alone.
At a year, quit rates remained higher in both vape groups, although the evidence for vapes alone versus emails was less certain at this later stage.
Giving smokers a vape starter kit can significantly improve their chances of quitting, even without regular counselling, a UK trial has found.
Smokers offered a refillable vape and brief instructions were 76 per cent more likely to achieve sustained quitting at six months than those receiving automated NHS stop-smoking emails.
The findings address a practical question for smokers who might struggle to attend regular appointments, or simply prefer to tackle quitting themselves. That is, can a vape still help without specialist support?
The study, published in NEJM Evidence, found that it could. Telephone support improved the chances further, helping around one in five participants quit for six months.
Senior author Peter Hajek said: “This trial adds to the strong evidence that e-cigarettes help people stop smoking, and clinicians can recommend them with confidence.”
A starter kit and a quit date
Researchers led by Queen Mary University of London recruited 1,170 adults who smoked daily and wanted help to stop. Their average age was 48, they smoked an average of 19 cigarettes a day, and most had previously tried stop-smoking treatments.
Participants were randomly assigned to three groups. One received NHS SmokeFree emails offering advice and daily motivational messages for 28 days. Another received a vape starter pack with brief, one-off instructions. The third received the same pack alongside telephone support.
The packs contained a refillable device, spare coils and two bottles of nicotine e-liquid, in tobacco and strawberry flavours. Supplies were expected to last around two weeks, with a leaflet explaining how to use the device and buy more.
Those offered counselling received a call on their quit date, followed by weekly calls for four weeks.
Researchers checked participants’ reports of quitting with breath tests measuring carbon monoxide, a marker of recent smoking. People who could not be followed up, or whose quitting could not be verified, were counted as still smoking.
At six months, 11.3 per cent of the vape-only group met the study’s sustained quitting measure, compared with 6.4 per cent of the email group.
That’s where the 76 per cent figure comes from. It’s the relative increase in the chance of success. In everyday terms, the difference amounts to around five additional people quitting for every 100 offered a vape rather than emails.
Help without compulsory appointments
Earlier trials have often paired vaping with regular behavioural support, making it harder to establish how well vapes work when smokers receive them without that ongoing help.
This trial separated the two. Its results suggest that access to a quitting aid need not depend on agreeing to a series of counselling sessions.
Lead author Katie Myers-Smith said: “One of the most important findings is that smokers don’t necessarily need specialist counselling to benefit from e-cigarettes, but when counselling is available, it can make a difference.”
In the group offered vapes and telephone support, 21.1 per cent achieved sustained quitting at six months, compared with 11.3 per cent offered vapes alone.
“In our trial, adding telephone support almost doubled the proportion of people who successfully quit,” Myers-Smith said.
“This suggests we shouldn’t make counselling a condition of receiving help to stop smoking, but we should make it [as] easy as possible for people to access that extra support.”
Co-author Hayden McRobbie said: “Not everyone who wants to quit smoking is able or willing to attend regular counselling sessions, and our results show that they can still benefit from simply being offered an e-cigarette.”
Some smokers found their own vapes
There was a complication that may have narrowed the gap between the groups, which is that some people assigned to NHS emails obtained vapes themselves.
At six months, 16 of the 25 verified quitters in the email group were also vaping. This means the main comparison included people who had successfully quit while using a treatment their group hadn’t been supplied.
When researchers excluded participants who used treatments outside their assigned group, the email group’s six-month quit rate fell to 2.7 per cent, compared with 11.3 per cent in the vape-only group.
That secondary analysis suggests the main result may underestimate the benefit of providing vapes. However, excluding people after randomisation makes the groups less directly comparable, so the original 76 per cent figure remains the appropriate headline finding.
What happened after a year?
At 12 months, sustained, verified quit rates were nine per cent with vapes alone, 5.4 per cent with emails and 16.8 per cent with vapes plus telephone support.
The pattern continued to favour vaping.
However, the statistical uncertainty around the vape-only comparison with emails included the possibility of no difference at 12 months. The clearest evidence for that comparison came from the trial’s main six-month result.
Among verified quitters in the two vape groups, 82 per cent were still vaping at a year. The trial therefore measured success in stopping smoking, rather than stopping all nicotine use.
Hajek said: “Clinicians should also take the opportunity to explain that vaping is far less harmful than smoking, and that ex-smokers can keep using an e-cigarette for as long as they need to feel sure they won’t go back to smoking.”
What the trial cannot tell us
The study has limitations. Carbon monoxide tests detect smoking mainly within the previous 24 hours, so they can’t independently verify everything someone reports about the preceding months.
The definition of sustained quitting also allowed up to five cigarettes from two weeks after the target quit date, provided participants had smoked none in the week before assessment.
Receiving a device through a research study might also have reassured smokers who would otherwise be reluctant to try vaping.
Funded by the National Institute for Health and Care Research, the trial provides evidence for offering smokers vape starter packs even when they do not take up ongoing support.
McRobbie said: “Stop smoking services are still needed to make both effective quitting aids and the additional support available as widely as possible.”