Cochrane review finds nicotine e-cigarettes improve quit rates versus nicotine replacement

An updated Cochrane living systematic review assessed nicotine e-cigarettes for smoking cessation against nicotine replacement therapy (NRT), non-nicotine products, and behavioral or no support. According to the supplied Cochrane summary, the update included 80 randomized controlled trials involving 29,861 participants, including nine newly added trials. Outcomes included smoking cessation and serious harms.

The review found high-certainty evidence that nicotine e-cigarettes increased quit rates compared with NRT, including patches and gum, corresponding to approximately four additional quitters per 100 people. Nicotine e-cigarettes also yielded approximately two additional quitters per 100 compared with non-nicotine products. Quit rates were higher than with behavioral support or no support, although confidence in that comparison was lower because of potential study-design bias.

Researchers found no evidence of increased serious harm when e-cigarettes were used for cessation, but emphasized the need for longer-term research. This does not establish that vaping is risk-free. The authors said the conclusions concern regulated nicotine-containing products, not illicit products or those containing other substances such as THC. For clinicians counseling people who smoke, the findings support discussing nicotine e-cigarettes among cessation options while addressing ongoing nicotine dependence and safety uncertainty. The supplied summary does not provide follow-up durations, confidence intervals, or detailed adverse-event estimates.