E-cigarettes more effective than nicotine replacement therapy for smokers 

E-cigarettes more effective than nicotine replacement therapy for smokers 
© iStock/Yaroslav Litun

In the latest Cochrane review, evidence shows that nicotine e-cigarettes are more effective than traditional nicotine replacement therapy in helping people quit smoking.    

The researchers led by the University of Oxford, and funded by Cancer Research UK, find strong evidence that e-cigarettes help people quit smoking better than traditional nicotine replacement therapy, such as patches and gum. 

Smoking is a significant global health burden. Figures have shown that in 2020, 22.3% of the global population used tobacco, despite it having deadly effects. By stopping smoking using either natural methods, nicotine replacement therapy or e-cigarettes, reduces the risk of lung cancer, heart attacks and many other diseases.  

The full paper can be found in the Cochrane Library. 

What are e-cigarettes and nicotine replacement therapy?

E-cigarettes, also known as a vape, heat liquids with nicotine and flavourings, allowing the user to ‘vape’ the nicotine instead of smoking. They have quickly become a popular method to quit smoking as they are less harmful and are tightly regulated for safety and quality.  

Alternatively, nicotine replacement therapy substitutes the source of nicotine to “replace” the nicotine from cigarettes. Options include nicotine gum, minis, nasal spray, inhalator patch and many more.  

E-cigarettes are a more effective option for smoking cessation

The evidence showed with high certainty evidence that people are more likely to quit smoking for at least six months using nicotine e-cigarettes, than using nicotine replacement therapy. Evidence also suggested that nicotine vapes had higher quit rates than e-cigarettes without nicotine or no smoking intervention, but less data was found supporting this. The Cochrane review includes 78 studies with over 22,000 participants.  

Furthermore, the researchers found that if six in 100 people quit using nicotine replacement therapy, eight to 12 would quit using e-cigarettes containing nicotine.  

Dr Jamie Hartmann-Boyce, Associate Professor at Oxford’s Nuffield Department of Primary Care Health Sciences, Editor of the Cochrane Tobacco Addiction Group, and an author of the new publication, said: “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. These misunderstandings discourage some people from using e-cigarettes as a stop-smoking tool. Fortunately, more and more evidence is emerging and providing further clarity. With support from Cancer Research UK, we search for new evidence every month as part of a living systematic review. We identify and combine the strongest evidence from the most reliable scientific studies currently available.” 

In the studies comparing nicotine e-cigarettes to nicotine replacement therapy, significant side effects were rare.  

Dr Nicola Lindson, University Research Lecturer at Oxford’s Nuffield Department of Primary Care Health Sciences, Cochrane Tobacco Addiction Group’s Managing Editor, and author of the publication said: “E-cigarettes do not burn tobacco, and as such, they do not expose users to the same complex mix of chemicals that cause diseases in people smoking conventional cigarettes. E-cigarettes are not risk-free, and shouldn’t be used by people who don’t smoke or aren’t at risk of smoking. However, evidence shows that nicotine e-cigarettes carry only a small fraction of the risk of smoking. In our review, we did not find evidence of substantial harm caused by nicotine-containing electronic cigarettes when used to quit smoking. However, due to the small number of studies and lack of data on long-term nicotine-containing electronic cigarette usage – usage over more than two years – questions remain about long-term effects.” 

“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 researchers concluded that more evidence, specifically on the effects of newer e-cigarettes with better nicotine delivery than older ones, is needed.  

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