Vaping may help more people quit smoking than patches, gum, study finds

Nicotine e-cigarettes, commonly known as vapes, may be more effective at helping people quit smoking than conventional methods such as nicotine gum and patches, according to an updated Cochrane review.

Dig deeper:

The review found that nicotine e-cigarettes led to higher quit rates than nicotine replacement therapy, or NRT, which includes patches and gum. They also performed better than non-nicotine e-cigarettes and quitting with behavioral support or no support.

The review found high-certainty evidence that nicotine e-cigarettes resulted in about four additional quitters for every 100 people compared with NRT.

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Nicotine e-cigarettes also led to about two additional quitters per 100 people compared with non-nicotine e-cigarettes.

Quit rates were also higher among people who used e-cigarettes along with behavioral support, such as individual counseling or group programs, compared with those who received no support or behavioral support alone. However, researchers said that evidence was less certain because of potential bias in the studies.

Big picture view:

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

The analysis is part of an ongoing systematic review that is updated as new evidence becomes available. Researchers examined 80 randomized controlled trials involving 29,861 participants. Nine of the trials were new to the latest update.

What they're saying:

"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 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."

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What's next:

The review found no evidence of an increased risk of serious harm from using e-cigarettes to quit smoking. However, researchers said more long-term studies are needed.

The findings apply specifically to regulated e-cigarettes containing nicotine. Illicit products and devices containing other substances, such as THC, may pose different risks.

Why you should care:

Major health organizations, including the WHO, caution that e-cigarettes expose users to nicotine and other potentially harmful chemicals.

Health officials have also raised concerns that e-cigarette use among children and teenagers can lead to nicotine addiction and later use of traditional tobacco products.

The review’s authors said e-cigarettes may not be the best option for everyone trying to quit smoking. They encouraged people to contact smoking-cessation services or health care professionals for guidance.

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While vaping carries health risks, the researchers said those risks are significantly lower than the dangers associated with smoking traditional cigarettes.

Dr Nicola Lindson, lead author of the review based at the University of Oxford, reflects that: "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."

Dr Hartmann-Boyce said switching to e-cigarettes should be viewed as a possible transition away from traditional cigarettes 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."

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