Cochrane: Quitting Easier with Vapes

Quitting combustibles is easier with e-cigarettes, according to the most recent Cochrane Review on e-cigarettes. An update to the think tank’s ongoing review of the topic, the latest research includes 17 additional studies that conclude that smoking cessation works significantly better with e-cigarettes than with other nicotine-replacement therapy (NRT) products.

“Electronic cigarettes have generated a lot of misunderstanding in both the public health community and the popular press since their introduction over a decade ago,” lead author Jamie Hartmann-Boyce said. “For the first time, this has given us high-certainty evidence that e-cigarettes are even more effective at helping people to quit smoking than traditional nicotine-replacement therapies, like patches or gums.”

The total Cochrane analysis of e-cigarettes now includes 78 studies with over 22,000 participants. The body of evidence overwhelmingly supports the current update’s findings.

The just-released Cochrane review also indicates that e-cigarettes containing nicotine are more effective than e-cigarettes without nicotine or smoking cessation without aids containing nicotine. However, there is less data for these comparisons, which is why the authors rate the reliability of the evidence as only moderate.

Co-author Nicola Lindson from the University of Oxford and managing editor of the Cochrane Tobacco Addiction Group said that while not risk-free, e-cigarettes containing nicotine only pose a fraction of the risk of smoking. 

“However, due to the lack of data on possible harmful effects from long-term use of nicotine-containing electronic cigarettes, i.e., over a period of more than two years, questions remain about the long-term effects,” Lindson said.

According to the authors, the study’s key messages include:

• Nicotine e-cigarettes can help people to stop smoking for at least six months. Evidence shows they work better than nicotine-replacement therapy and probably better than e-cigarettes without nicotine.
• E-cigarettes may work better than no support or behavioral support alone, and they may not be associated with serious unwanted effects.
• However, more evidence is needed, particularly about the effects of newer types of e-cigarettes that have better nicotine delivery than older types of e-cigarettes, as better nicotine delivery might help more people quit smoking.

The Cochrane Review already found in 2016 that e-cigarettes were more likely to help smokers quit than nicotine patches or gum, but the available body of evidence at that time was slimmer.

“This comprehensive evidence review confirms, once again, that nicotine e-cigarettes help smokers to quit smoking and that these products are more effective than medically licensed nicotine-replacement therapies,” said John Britton, emeritus professor of epidemiology at the University of Nottingham. “All smokers should therefore try vaping as a means to end their dependency on smoking tobacco.”