Smokers attempting to quit face significantly better prospects when using nicotine e-cigarettes compared with conventional cessation methods, according to a comprehensive analysis by the Cochrane team.
Researchers examined 80 major trials encompassing nearly 30,000 participants and determined that nicotine vapes substantially outperformed traditional approaches including patches, gum, and behavioural support programmes. The findings showed a marked improvement in success rates—rising from approximately six in every 100 people successfully quitting to one in every 10, representing roughly a 60% increase in quit rates.
Non-nicotine vapes proved less effective than their nicotine-containing counterparts, though researchers suggest transitioning to non-nicotine devices afterwards could facilitate gradual weaning from nicotine. The evidence also indicates that nicotine vapes may surpass the recently developed anti-smoking medication cytisine, which the NHS has begun distributing, though additional research is required to confirm this comparison.
More recent analysis has expanded the evidence base considerably. A newer Cochrane review encompassed 78 studies and over 22,000 participants, incorporating 22 additional studies since the previous update in 2021. According to clinical consensus recommendations from the University of Maryland, healthcare professionals are now advised to discuss e-cigarettes as a cessation option with tobacco-dependent patients, with nicotine e-cigarettes, varenicline, and cytisine identified as the most effective interventions, achieving quit rates of 10 to 19 per 100 users.
How safe are e-cigarettes compared to smoking?
Although vaping carries some risk, experts emphasise it is substantially safer than smoking. The review examined only regulated vapes that undergo quality testing and comply with stringent safety standards, excluding unregulated devices that may contain dangerous substances such as spice or THC.
The analysis found no evidence of increased serious harm risk from using e-cigarettes for smoking cessation. However, the long-term health effects of vaping remain unclear, and the NHS maintains that children and non-smokers should never use vapes.
Dr Jamie Hartmann-Boyce, one of the review's authors, issued a warning:
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.
Medical professionals have raised concerns that vaping could cause health damage in young people and should be made less appealing to them. These concerns have prompted policy responses: a UK law on tobacco and vapes has been enacted, explicitly aiming to reduce youth vaping while keeping vapes available for adult smokers attempting to quit.
What is the broader context of smoking-related illness?
Smoking remains the leading preventable cause of disease and mortality globally. The World Health Organization reports that smoking kills more than seven million people annually. According to the charity Action on Smoking and Health, approximately two in three long-term smokers will die from a tobacco-related condition.
Quitting smoking substantially reduces the risk of serious conditions including heart disease, lung cancer, and stroke. In the UK, vape usage has now surpassed cigarette smoking among adults over 16. Current figures indicate approximately 5.3 million people, or 10% of the adult population, smoke cigarettes, while around 5.4 million use vapes either daily or occasionally.
Context from a review of 81 studies by the Royal College of Paediatrics and Child Health published in August 2026 linked vaping to respiratory problems and potential harm to developing babies, intensifying calls for stricter UK controls on flavours and packaging to protect young people.
Where can smokers access support?
Nearly every local NHS stop smoking service now provides vapes or alternative support to assist people in quitting. Individuals can locate their nearest service online by entering their postcode.
The Cochrane review on smoking cessation forms part of a broader living evidence programme that continuously monitors nicotine e-cigarettes over time, meaning the research base will be regularly updated as new evidence emerges rather than through fixed announcement dates.
