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Lindson, Nicola and Butler, Ailsa and McRobbie, Hayden and Bullen, Chris and Hajek, Peter and Begh, Rachna and Theodoulou, Annika and Notley, Caitlin and Rigotti, Nancy A. and Turner, Tari and Livingstone-Banks, Jonathan and Morris, Tom and Hartmann-Boyce, Jamie (2024) Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews, (1), https://doi.org/10.1002/14651858.CD010216.pub8.

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 flavourings. E‐cigarettes allow users to inhale nicotine in a vapour rather than smoke. Because they do not burn tobacco, e‐cigarettes do not expose users to the same levels of chemicals that can cause diseases in people who smoke conventional cigarettes. 

What are the results of our review? People are more likely to stop smoking for at least six months using nicotine e‐cigarettes than using nicotine replacement therapy (7 studies, 2544 people), or e‐cigarettes without nicotine (6 studies, 1613 people). Nicotine e‐cigarettes may help more people to stop smoking than no support or behavioural support only (9 studies, 5024 people). 

For every 100 people using nicotine e‐cigarettes to stop smoking, 8 to 10 might successfully stop, compared with only 6 of 100 people using nicotine‐replacement therapy, 7 of 100 using e‐cigarettes without nicotine, or 4 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. Low numbers of unwanted effects, including serious unwanted effects, were reported in studies comparing nicotine e‐cigarettes to nicotine replacement therapy. There is probably no difference in how many non‐serious unwanted effects occur in people using nicotine e‐cigarettes compared to e‐cigarettes without nicotine. 

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

How reliable are these results? Our results are based on few studies for most outcomes and, for some outcomes, the data varied widely. 

We found evidence that nicotine e‐cigarettes help more people to stop smoking than nicotine replacement therapy. Nicotine e‐cigarettes probably help more people to stop smoking than e‐cigarettes without nicotine, but more studies are still needed to confirm this. 

Studies comparing nicotine e‐cigarettes with behavioural or no support also showed higher quit rates in people using nicotine e‐cigarettes, but provide less certain data because of issues with study design. 

Most of our results for the unwanted effects could change when more evidence becomes available.


Item Type
Publication Type
International, Open Access, Review, Article
Drug Type
Tobacco / Nicotine
Intervention Type
Drug therapy, Treatment method
January 2024
Identification #
John Wiley & Sons, Ltd
Place of Publication
Accession Number
HRB (Electronic Only)
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