Nicotine e-cigarettes help adults quit smoking more effectively than most other methods, according to a new analysis published on Mar. 26 in the journal Addiction. The study was co-led by Jamie Hartmann-Boyce, assistant professor of health policy and management at the University of Massachusetts Amherst.
The review examined findings from 14 systematic reviews that included a total of 109 primary studies conducted between 2014 and 2023. Across all 21 meta-analyses reviewed, smokers who used nicotine e-cigarettes were consistently found to be more likely to quit compared to those using other cessation aids.
The research showed that nicotine e-cigarettes are linked with quit rates about 20% to 40% higher than traditional nicotine replacement therapies such as patches or gum for quitting attempts lasting at least six months. When compared with non-nicotine e-cigarettes or placebo devices, the quit rates were at least 46% higher for those using nicotine products.
"We set out to determine if scientists agree on whether nicotine e-cigarettes help people quit smoking," Hartmann-Boyce said. "Based on the consistency of the findings here, it's clear that they do." She also cautioned that this does not mean e-cigarettes are always the best option for everyone and noted that vaping still carries health risks—though these are less severe than those associated with smoking tobacco.
Hartmann-Boyce pointed out additional factors behind vaping's effectiveness: "If you look at neuro-imaging studies, the addiction often isn't just to the nicotine," she said. "There are the sensory cues around it that really feed into those addiction pathways. Vaping fulfills some of those cues in a way that a patch doesn't—including the throat hit, the hand-to-mouth motion and the visible exhale." However, she warned these same features make youth uptake a serious concern: "The primary concern about e-cigarettes is their use among people who don't smoke and wouldn't have otherwise smoked," she said.
Comparisons between nicotine e-cigarettes and prescription drugs like varenicline (marketed as Chantix) remain unclear due to limited data. Hartmann-Boyce said: "We don't have enough studies to compare these drugs to nicotine e-cigarettes to say whether one is better than the other for helping people quit smoking."
She hopes this analysis will clarify public perceptions about vaping's role in helping smokers quit while acknowledging ongoing concerns over safety and youth usage: "We know e-cigarettes are not risk free, but they are so much less harmful than smoking," Hartmann-Boyce said.
