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Cochrane Systematic Review: Strongest evidence yet that e-cigarettes help people to quit smoking better than traditional nicotine replacement therapies



The Cochrane Library is a vast collection of databases which contain a variety of different types of high-quality, independent medical data. This data is used to inform healthcare decisions made by professionals, governments advisory bodies and more: the Cochrane Library is a vital resource for the worldwide medical industry.

Cochrane reviews this data regularly and publishes their findings to assist the medical world in its treatment methods and developments. A recently published study into the ‘effectiveness, tolerability, and safety of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long‐term smoking abstinence’: the findings are positive news for electronic cigarette developers and consumers alike.

Cochrane Library used randomized controlled trials (RCTs) and randomized cross-over trials to establish their findings. In total 22,052 participants (all smokers) were randomized to an EC or alternative nicotine replacement therapy. Cochrane’s findings provided data to support the idea that E Cigarettes are a more effective method of quitting smoking than other traditional nicotine replacement methods. There was high certainty that smoking quit rates were higher in people randomized to nicotine ECs than in those randomized to nicotine replacement therapy: in absolute terms, this translates to an additional four quitters per 100.

Furthermore, the study showed a moderate certainty that quit rates were higher in people randomized to nicotine EC than non‐nicotine EC, leading to an additional seven quitters per 100. Broadly, subjects trended toward preferring EC’s to traditional nicotine replacements and nicotine-based ECs were preferred to non- nicotine containing devices.six in 100 people quit using nicotine replacement therapy, eight to twelve would quit using electronic cigarettes containing nicotine. This means an additional two to six people in 100 could potentially quit smoking using nicotine-containing electronic cigarettes.

“With support from Cancer Research UK, we search for new evidence every month as part of a living systematic review.” Said Dr. Jamie Hartman-Boyce, Editor of the Cochrane Tobacco Addiction Group and an author of the studycontinued, “we identify and combine the strongest evidence from the most reliable scientific studies currently available. 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.”

This is the strongest evidence provided by Cochrane yet to support ECs as credible, effective methods of quitting smoking. The updated Cochrane review includes 78 studies with over 22,000 participants – an addition all 22 studies since the last update in 2021.

Dr Nicola Lindson, Cochrane Tobacco Addiction Group’s Managing Editor, and author of the study said of the results: “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 harms caused by nicotine containing electronic cigarettes when used to quit smoking.”


Source: ONS 2020

Smoking is one of the leading causes of death and illness in the UK, smoking contributes to
around 80,000 deaths annually, and many suffer from debilitating smoking-related illnesses. Smoking can increase your risk of developing over 50 separate, serious health conditions, so a reliable and effective method of quitting smoking is a must.

In the UK alone, around 14% of adults are still smokers, and smoking-related illnesses cost the NHS over £2.5 billion every year: statistics like these are why proven, effective methods of quitting smoking are vital for public health.

You can read the full Cochrane Systematic Review here: