Regulated nicotine e-cigarettes help more people stop smoking traditional cigarettes than conventional nicotine replacement therapies like patches or gums, according to an updated scientific review published by the Cochrane network.
The findings, reported by Science Daily, analyzed 80 randomized controlled trials that included 29,861 participants across the globe. Researchers incorporated nine newly published trials into the analysis as part of an ongoing “living” review, which continuously evaluates emerging data on smoking cessation.
Better Outcomes Than Traditional Therapies
The researchers reported high-certainty evidence that nicotine-containing electronic devices produced better quit rates than traditional replacement options. For every 100 people attempting to kick tobacco, using nicotine e-cigarettes led to roughly four more successful quitters than relying on patches or chewing gum, Science Daily reported.
The devices also outperformed nicotine-free electronic cigarettes, resulting in about two additional people per 100 who successfully quit. Furthermore, smokers provided with e-cigarettes quit at higher rates than those receiving either no help or only behavioral support, such as individual or group therapy. However, the study authors expressed less certainty about that comparison because of possible bias in how some earlier trials were conducted.
Tobacco smoking remains the top cause of preventable death and sickness worldwide. The World Health Organization estimates that smoking is responsible for more than seven million deaths each year, which includes 1.6 million nonsmokers exposed to secondhand smoke.
“We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking,” Dr. Jamie Hartmann-Boyce, the review’s senior author from the University of Massachusetts Amherst, said in remarks reported by Science Daily. “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.”
Safety Warnings and Regulatory Oversight
The investigators found no data showing that using e-cigarettes to stop smoking led to serious health harm, but they noted that long-term studies remain critical. Crucially, the authors emphasized that their conclusions apply solely to regulated devices with nicotine. Unregulated items or devices featuring substances such as THC could introduce severe risks.
Hartmann-Boyce cautioned that many products sold in retail stores do not adhere to proper standards, pointing to hazards like unstable batteries and dangerous chemical compounds. She advised smokers seeking cessation aids to purchase only devices authorized by government regulators, such as the Food and Drug Administration in the U.S. or the Medicines and Healthcare products Regulatory Agency in the U.K.
Major public health agencies, including the WHO, continue to warn that e-cigarettes deliver toxic chemicals, including formaldehyde, and can foster long-term nicotine dependence among teenagers and young adults.
“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. Nicola Lindson, the lead author from the University of Oxford, told Science Daily.
The Challenge of Kicking Nicotine
While vaping can serve as a stepping stone away from combustible tobacco, health professionals point out that breaking away from nicotine altogether remains notoriously difficult. Many users who switch to vapes struggle to quit the electronic devices later, W Magazine reported.
A 2025 review cited by Yahoo Health noted that prescription medications like varenicline may assist people attempting to quit vaping, although evidence remains limited. Hartmann-Boyce said researchers are currently conducting a separate review of treatments designed specifically to help vapers stop using nicotine entirely.
