Home > Electronic cigarettes for smoking cessation.

Hartmann-Boyce, Jamie and McRobbie, Hayden and Lindson, Nicola and Bullen, Chris and Begh, Rachna and Theodoulou, Annika and Notley, Caitlin and Rigotti, Nancy A. and Turner, Tari and Butler, Ailsa and Hajek, Peter (2021) Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews, (9), Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub6.

PDF (Review - plain language summary)
PDF (Review - briefing for health care workers and policy makers)

External website: https://www.cochranelibrary.com/cdsr/doi/10.1002/1...

What are electronic cigarettes?

Electronic cigarettes (e‐cigarettes) are handheld devices that work by heating a liquid that usually contains nicotine and flavorings. E‐cigarettes allow you to inhale nicotine in a vapor rather than smoke. Because they do not burn tobacco, e‐cigarettes do not expose users to the same levels of toxins that we know can cause smoking‐related diseases in people who use conventional cigarettes. Using an e‐cigarette is known as 'vaping'. Many people use e‐cigarettes to help them to stop smoking tobacco. 

What are the results of our review?

More people probably stop smoking for at least six months using nicotine e‐cigarettes than using nicotine replacement therapy (4 studies, 1924 people), or nicotine‐free e‐cigarettes (5 studies, 1447 people).

Nicotine e‐cigarettes may help more people to stop smoking than no support or behavioural support only (6 studies, 2886 people).

For every 100 people using nicotine e‐cigarettes to stop smoking, 9 to 14 might successfully stop, compared with only 6 of 100 people using nicotine‐replacement therapy, 7 of 100 using nicotine‐free e‐cigarettes, or four of 100 people having no support or behavioural support only.

We are uncertain if there is a difference between how many unwanted effects occur using nicotine e‐cigarettes compared with nicotine replacement therapy, no support or behavioural support only.  There was some evidence that non‐serious unwanted effects were more common in groups receiving nicotine e‐cigarettes compared to no support  or behavioural support only. Similar low numbers of unwanted effects, including serious unwanted effects, were reported for other comparisons. There is probably no difference in how many non‐serious unwanted effects occur in people using nicotine e‐cigarettes compared to non‐nicotine e‐cigarettes.

The unwanted effects reported most often with nicotine e‐cigarettes were throat or mouth irritation, headache, cough and feeling sick. These effects reduced over time as people continued using nicotine e‐cigarettes.

How reliable are these results?

Our results are based on a small number of studies, and in some the  data varied widely.

Item Type
Publication Type
International, Review
Drug Type
Tobacco / Nicotine
Intervention Type
Drug therapy, Treatment method
September 2021
Identification #
Art. No.: CD010216. DOI: 10.1002/14651858.CD010216.pub6
John Wiley & Sons, Ltd
Place of Publication
Accession Number
HRB (Electronic Only)
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