Nicotine e-cigarettes help four more people per 100 quit than patches or gum

by Cochrane

edited by Gaby Clark, reviewed by Andrew Zinin

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Nicotine e-cigarettes are more effective at helping people quit smoking than many conventional methods, including nicotine gum and patches, behavioral support or no support at all, an updated Cochrane review finds.

Smoking is the leading cause of preventable disease and death, resulting in more than 7 million deaths per year, including 1.6 million nonsmokers who are exposed to secondhand smoke, according to the World Health Organization (WHO).

The analysis, part of an ongoing living systematic review that is updated as new evidence becomes available, examined 80 randomized controlled trials involving 29,861 participants, 9 of which were new to this update.

Vaping 'a proven and viable option'

The review found high-certainty evidence that nicotine e-cigarettes led to higher quit rates than nicotine replacement therapy (NRT), such as patches and gum, resulting in about 4 more quitters per 100 people. Nicotine e-cigarettes also outperformed non-nicotine e-cigarettes, resulting in about 2 more quitters per 100.

Compared with no support or behavioral support (such as individual counseling and group programs), quit rates were still higher when people were also provided with e-cigarettes, though this evidence is less certain because of the risk of bias in the study design.

"We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking," says Dr. Jamie Hartmann-Boyce, senior author of the review from the University of Massachusetts Amherst. "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 9 new trials and our main conclusions haven't changed."

A transition away from traditional cigarettes

The review found no evidence of increased serious harm from using e-cigarettes to quit, though researchers say longer-term studies are still needed. The findings also apply specifically to regulated, nicotine-containing e-cigarettes; illicit products or those containing other substances, such as THC, may carry different risks.

"It's worth highlighting that our review looks at regulated e-cigarettes containing nicotine, but many of those available on the market do not meet these standards," Hartmann-Boyce says. "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. Lists of regulated devices are available from the FDA in the U.S. and MHRA in the U.K."

Many major health organizations and bodies, including the WHO, caution that e-cigarettes still expose users to nicotine and other chemicals that can be harmful. There are also concerns that e-cigarette use by children and youth can lead to nicotine addiction and smoking tobacco products.

The authors caution that e-cigarettes aren't necessarily the best way for everyone looking to quit smoking and that people should contact stop-smoking support services or their clinicians for guidance. Vaping also comes with health risks, but the authors say those risks pale in comparison with the dangers of smoking.

Dr. Nicola Lindson, lead author of the review based 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."

Hartmann-Boyce sees the switch as a transition rather than an endpoint. "For somebody who is already addicted to nicotine through cigarettes, having a safer alternative like an e-cigarette is something worth considering, especially when other quit aids have proven unsuccessful. We are currently working on a review of interventions to help people quit vaping, which could be the next step along for people looking to transition to a lower-harm product before quitting nicotine altogether."

Publication details

Electronic cigarettes for smoking cessation, Cochrane Database of Systematic Reviews (2026). DOI: 10.1002/14651858.CD010216.pub11

Journal information: Cochrane Library

Key medical concepts

smoking cessation therapyNicotine Replacement Therapy

Clinical categories

Preventive medicineCommon illnesses & PreventionHealthy living Provided by Cochrane Who's behind this story?

Gaby Clark

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Citation: Nicotine e-cigarettes help four more people per 100 quit than patches or gum (2026, August 25) retrieved 25 August 2026 from https://medicalxpress.com/news/2026-08-nicotine-cigarettes-people-patches-gum.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.