Vaping Better Than NRT to Quit Smoking, Says Cochrane Review

An updated Cochrane review says that vaping nicotine is more effective for smoking cessation than using nicotine gum or patches. The new publication, which is the second update of a 2014 review, included results from 50 studies, including 26 randomized control trials (RCTs).

The Cochrane organization systematically organizes and analyzes evidence on nearly every health care intervention, producing “gold-standard” reviews depended upon by millions of doctors and academic researchers around the world.

Researchers from the Cochrane Tobacco Addiction Group found “moderate‐certainty evidence” that smoking quit rates were higher in trial participants randomized to vaping products than to those assigned nicotine replacement therapy (NRT) products like gum or patches.

Because there have been few RCTs that included vaping, much of the clinical evidence is based on studies whose participants used early (and often ineffective) e-cigarettes. However, even with that limitation, the Cochrane researchers found vapes are likely superior to NRT products. And data from non-randomized studies showed results consistent with RCTs, the researchers said.

The review “provides definitive confirmation that electronic cigarettes offer smokers an effective means of quitting, and perhaps even more so than some licensed stop smoking medicines,” according to Dr. John Britton, an emeritus professor of respiratory medicine at Nottingham University, who wasn’t involved in the review.

The review also found short-term (up to two years) users of vaping products did not report more serious health issues than NRT users or people using no quit aid at all. Common complaints were throat and mouth irritation, headache, cough, and nausea, which generally "dissipate over time with continued use.”

“E-cigarettes are a form of nicotine replacement that is more attractive to smokers and that seems more effective than [NRT] products,” said Dr. Peter Hajek, a senior author on the new review and director of the Tobacco Dependence Research Unit at Queen Mary University of London. Hajek also led the most recent clinical study comparing vaping with NRT as a quit-smoking aid.

“The results of this new review of randomised trials of vaping tally with other evidence from cohort and epidemiological studies, suggesting that for many smokers, e-cigarettes represent an effective tool for quitting smoking,” Hajek added.

However, even a Cochrane review may fail to persuade many American doctors to recommend vaping to their smoking patients. A recent study showed that 80 percent of medical specialists that treat diseases common to lifelong smokers believe that nicotine causes cancer, heart disease, or COPD.

The Cochrane Tobacco Addiction Group team that authored the review is made up of 11 researchers from Australia, New Zealand, the United Kingdom and the United States. The lead author is Jamie Hartmann-Boyce of the University of Oxford, U.K.