- Vaping leads to an extra four quitters per 100 compared to nicotine replacement therapy (NRT) such as patches and gum
- Nicotine vapes lead to an extra three quitters per 100 compared to nicotine-free vapes
- Nicotine vapes lead to an extra three quitters per 100 compared to behavioural support only/no support
- No evidence of serious harm found from vaping
Vapes are more effective than nicotine replacement therapy (NRT) at helping smokers to quit, a major new study review has found.
The Cochrane review of 90 studies in the UK, including 29,044 participants, found that vaping leads to an additional four quitters per 100 on average than NRT. The report regarded “quitting” as having stopped smoking completely for at least six months.
It said: “Nicotine EC (electronic cigarette) results in increased quit rates compared to nicotine replacement therapy (NRT) (high-certainty evidence).
“In absolute terms, this might translate to an additional four quitters per 100.”
Nicotine vapes more effective for quitting smoking than non-nicotine
The review, carried out by the Cochrane Tobacco Addiction Group and funded by a range of leading health institutions, also found there is “moderate certainty” that nicotine vapes are more effective at helping smokers quit than non-nicotine vapes.
It said: “Nicotine EC probably results in increased quit rates compared to non-nicotine EC. In absolute terms, this might lead to an additional three quitters per 100.”
Compared to behavioural support only/no support, nicotine vapes led to an additional four quitters per 100, although this finding was “less certain.”
No significant serious adverse effects from vaping
The review found that incidences of serious adverse effects were low across all groups. “Serious adverse effects were rare, and there is insufficient evidence to determine whether rates differ between groups,” it said. “..We did not detect evidence of serious harm from nicotine EC, but longer, larger studies are needed to fully evaluate EC safety.”
Meanwhile, “little to no difference” was found in the rate of adverse effects between the groups.
It said the most commonly reported adverse effects from vaping were throat/mouth irritation, headache, cough, and nausea, which “tended to dissipate” with continued use.
The authors highlighted that the review looks only at regulated vapes and the results from illicit products – which are becoming more common with increased legislation – could be more harmful.
The study said: “Our included studies tested regulated nicotine-containing EC; illicit products and/or products containing other active substances (e.g. tetrahydrocannabinol (THC)) may have different harm profiles”.
A live review
The Cochrane review, which is updated as new studies are added, is recognised as the highest standard in evidence-based healthcare. It brings together primary research data to help legislators make evidence-based choices about health interventions.
Its objective is to “examine the safety, tolerability, and effectiveness of using EC to help people who smoke tobacco achieve long‐term smoking abstinence, in comparison to non‐nicotine EC, other smoking cessation treatments, and no treatment.”
It said: “To ensure the review continues to provide up-to-date information to decision-makers, this is a living systematic review. We run searches monthly, with the review updated when relevant new evidence becomes available. Please refer to the Cochrane Database of Systematic Reviews for the review’s current status.”
For this update, researchers searched the Cochrane Central Register of Controlled Trials up to 1 February 2024 and the Cochrane Tobacco Addiction Group’s Specialised Register up to 1 February 2023. They checked references and contacted study authors.
Vaping as effective as ‘stop smoking’ drugs
Last year a Cochrane Review found that vaping is as effective as ‘stop-smoking’ drugs varenicline and cytisine at helping people quit.
Dr Nicola Lindson, lead author and a Senior Researcher and Lecturer based within Oxford’s Nuffield Department of Primary Care Health Sciences, said: “Our research dives deep into the world of smoking cessation.
“By pulling together data from hundreds of studies and over 150,000 people, we can see that when people use the medicines licenced for quitting smoking or nicotine e-cigarettes, they are more likely to quit than if they do not use these aids.”
