- Smokers using nicotine vapes were 61 per cent more likely to quit for at least six months than those using patches, gum or other nicotine replacement therapy.
- Around eight to 10 people in every 100 quit with nicotine vapes, compared with six using nicotine replacement therapy.
- The Cochrane review examined 80 randomised trials involving 29,861 people and rated the main finding as high-certainty evidence.
- Serious adverse events were similar for vaping and nicotine replacement therapy, although longer-term research is still needed.
Smokers who use nicotine vapes are 61 per cent more likely to quit for at least six months than those using nicotine replacement therapy such as patches or gum, a major review has found.
The updated Cochrane review, published on August 26, analysed 80 completed randomised controlled trials involving 29,861 people. Nine trials were added in the latest update.
Its clearest finding came from 11 trials involving 4,114 participants that directly compared nicotine vapes with conventional nicotine replacement therapy.
People assigned nicotine vapes were 61 per cent more likely to remain smoke-free for at least six months. Cochrane rated the finding as high-certainty evidence, its strongest level of confidence.
Four more smokers quit in every 100
In practical terms, Cochrane estimated that nicotine vaping would produce about four additional quitters for every 100 people making an attempt, although the plausible range was between one and seven additional quitters.
Its plain-language summary puts the likely success rate at eight to 10 quitters in every 100 using nicotine vapes, compared with six using patches, gum or other nicotine replacement products.
The 61 per cent figure describes the relative improvement in someone’s chance of quitting, rather than an extra 61 people in every 100 would stop smoking.
Dr Jamie Hartmann-Boyce, senior author of the review and a researcher at the University of Massachusetts Amherst, said: “We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking.
“Based on the consistency of the findings here, it’s clear that they are a proven and viable option for people wishing to quit traditional cigarettes. This update includes nine new trials and our main conclusions haven’t changed.”
Nicotine vapes also outperformed nicotine-free devices
Nicotine vapes were also 34 per cent more effective than non-nicotine vapes, based on seven trials involving 1,918 people.
Cochrane judged this evidence to be moderately certain and estimated that nicotine would lead to around two additional quitters in every 100.
Quit rates were also higher when nicotine vapes were compared with behavioural support alone or no support. However, the researchers had less confidence in this comparison because participants knew which treatment they were receiving, increasing the risk that expectations influenced the results.
More direct research is needed to establish how vapes compare with medicines such as varenicline and cytisinicline.
No increase in serious adverse events detected
Serious adverse events were uncommon across the trials. The review found moderate-certainty evidence that rates were probably similar among people using nicotine vapes and those using nicotine replacement therapy.
Researchers detected no evidence of serious short-term harm from nicotine vapes but said larger studies with longer follow-up periods were still needed to assess their full safety profile.
The finding also applies only to regulated nicotine-containing vapes. It should not be extended to illicit products or devices containing other substances, including THC, which may have different risks.
Hartmann-Boyce said: “Unlicensed e-cigarettes are potentially dangerous, with issues including unstable batteries and harmful chemicals. Anyone looking to use e-cigarettes to quit smoking should only purchase devices that have been tested and approved by their country’s regulatory body.”
Evidence supports UK quit-smoking guidance
The findings reinforce existing NHS guidance, which says vapes are likely to be far less harmful than cigarettes and can help people quit smoking. It warns that vaping is not risk-free, should not be taken up by non-smokers and provides its full benefit only when someone stops smoking cigarettes completely.
NICE guidance also places nicotine-containing vapes among the options more likely to help adults quit when combined with behavioural support. These include varenicline, cytisinicline and using short-acting and long-acting nicotine replacement together.
Dr Nicola Lindson, lead author of the review and a researcher at the University of Oxford, said: “Quitting smoking is hard and a lot of people who smoke will have tried many times to quit smoking and been unsuccessful. For that reason, it is important that there are a number of different options available to help somebody quit, which could encourage them to keep trying.
“Although nicotine vapes are unlikely to be completely risk free, they are less harmful than smoking and that is the most important comparison to make for people who are still smoking tobacco.”
The research forms part of a living systematic review, with the evidence regularly searched and updated as new trials become available. The latest findings include evidence published up to January 1, 2026.
