Cochrane Review: “High Certainty” E-Cigarettes Help Quit Smoking

  • Cochrane Review shows e-cigarettes help people quit smoking
  • E-cigarettes more effective that NRT

As another crazy year draws to a close, there are a few constants that we can all count on: Great end-of-year lists, Christmas decorations going up too early, and more solid evidence that vaping helps people quit smoking. The latest piece of research that won’t come as a surprise to current vapers comes from the excellent Cochrane Library. In no uncertain terms, they state that “electronic cigarettes with nicotine increase quit rates compared to nicotine replacement therapies.”

Interestingly, they also go on to say that they could not find clear evidence of harm from e-cigarettes when used to quit smoking. However, they did add the caveat that their longest follow-up was over the course of two years.

What is the Cochrane Library?

The Cochrane Library is an esteemed database of scientific studies and reviews. The organisation works to collect data from a variety of studies and combines them into more extensive meta-analyses. The results of studies can produce a lot of variance due to study sizes and conditions, so collecting them together can help the public access more reliable information.

How the Cochrane Review selected the studies to include

As mentioned above, the Cochrane Library combined various studies where subjects used electronic cigarettes as smoking cessation aids. These studies included:

  • Randomised controlled trials
  • Randomised crossover trials
  • Uncontrolled intervention studies where subjects were given an e-cigarette

Cochrane used 78 different studies, 40 of which were randomised controlled trials. Overall, these studies had a combined total of more than 22,000 subjects.

What were the authors trying to find out?

This literature review was motivated by three particular questions.

A) How many people in these trials stopped smoking for at least six months

B) How many people experienced adverse side effects as a result of these interventions

C) How did e-cigarettes compare with other stop-smoking methods

What did the study compare e-cigarettes with?

The study sought to compare e-cigarettes against several different ways that people use to quit smoking. 

These methods were:

  • Nicotine replacement therapy (NRT), like gum or patches
  • Varenicline, a currently withdrawn medicine that helps people stop smoking
  • E-cigarettes containing no nicotine
  • Behavioural support or counselling
  • No support for quitting smoking

What were the conclusions of the Cochrane Review?

The conclusions from the review were pretty straightforward.

Cochrane found:

  • Subjects were more likely to stop smoking for six months or more if they used e-cigarettes
  • E-cigarettes helped more people stop smoking than no support or some behavioural support
  • E-cigarettes were more effective than nicotine replacement therapy

Why is the Cochrane Review study important?

The results won’t be a massive shock to anyone interested in vaping. However, there are some interesting conclusions that we can draw from them.

Firstly, if e-cigarettes are more effective than other methods to help quit smoking, there should be more support from the medical community. 

While some parts of the NHS and other UK health bodies have broadly supported vaping, making e-cigarettes available on prescription is essential in the public battle against smoking. Currently, regulators are working with manufacturers to assess products for use by the NHS.

Secondly, some anti-vaping groups criticise vapes because they contain nicotine. However, there isn’t any conclusive evidence that it causes people harm, as evidenced by this and other reports. 

However, if nicotine was the real problem for these groups, where are the constant articles about banning nicotine gum, patches, lozenges, sprays, and so on? If they’re convinced that nicotine is harmful, surely all forms of nicotine should fall under their remit? It can only be because of the frequently debunked claim that vaping is a gateway to smoking.


The Cochrane Review is an excellent resource for collecting data on many health issues, including vaping. They’ve highlighted more data that shows the effectiveness of e-cigarettes when compared with other stop-smoking methods. If you think that e-cigarettes should be available on prescription on the NHS or you want to show your support for vaping, contact your local MP and show show your support.