Nicotine vaping helps more people quit smoking than nicotine patches or gum, according to a major update of the best-known systematic review of vaping for smoking cessation.
The updated Cochrane review, announced Aug. 26 by University of Oxford researchers, analyzed 80 randomized controlled trials involving 29,861 participants. Nine trials were added in the latest update.
The researchers found high-certainty evidence that nicotine e-cigarettes produce higher quit rates than traditional nicotine replacement therapy (NRT), including patches and gum. For every 100 people attempting to quit, vaping produced about four additional successful quitters compared with NRT.
Nicotine vapes also produced about two more quitters per 100 than e-cigarettes without nicotine. They even performed better than behavioral support or no support, although the researchers rated that particular evidence as less certain because of study-design limitations.
The results reinforce findings Cochrane has reported for years. Its previous evidence summary found that roughly eight to 11 of every 100 people using nicotine vapes successfully stopped smoking, compared with about six using NRT.
That advantage isn't trivial for smokers who have already failed with conventional cessation products. For smokers who decide to switch, choosing a vape to quit smoking that is simple and satisfying can also make the transition away from cigarettes easier.
Lead author Nicola Lindson said the evidence supports giving smokers multiple options. Senior author Jamie Hartmann-Boyce said regulated nicotine vapes are a "proven and viable option" for smokers trying to quit.
"Quitting smoking is hard and a lot of people who smoke will have tried many times to quit 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 review found no evidence that using e-cigarettes for smoking cessation increased serious harms, although the authors said longer-term research is still needed. The findings apply to regulated nicotine vaping products, not illicit products or devices containing substances such as THC.
British medical guidance is already broadly consistent with that evidence. The National Institute for Health and Care Excellence (NICE) lists nicotine-containing e-cigarettes alongside cytisinicline, varenicline, and combination NRT among the options more likely to help smokers quit when combined with behavioral support.
Meanwhile, vaping has overtaken smoking in Great Britain. The latest Office for National Statistics estimates put current e-cigarette use at about 5.4 million adults in 2024, compared with about 4.9 million current smokers using the same survey measure.
The new Cochrane update adds even more weight to a conclusion that has become increasingly difficult to ignore: for smokers who want to stop smoking, vaping is not merely an alternative to approved cessation methods. It is one of the most effective options available.
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