What does this research mean for the field?

Nicotine electronic cigarettes increase long-term smoking cessation rates compared to nicotine replacement therapy and non-nicotine electronic cigarettes, with no evidence of increased serious adverse events in the short term. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the safety, tolerability, and efficacy of electronic cigarettes for achieving long-term tobacco abstinence compared with non-nicotine electronic cigarettes, alternative cessation therapies, or no support.

August 28, 2026Cochrane library

Electronic cigarettes for smoking cessation

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Authors

NLNicola Lindson JLJonathan Livingstone-Banks ABAilsa R Butler

Discussion

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Overview

Systematic review of randomized trials reveals higher quit rates with nicotine electronic cigarettes in tobacco smokers, indicating greater efficacy than traditional nicotine replacement therapy.

Key Points

To evaluate the safety, tolerability, and efficacy of electronic cigarettes for achieving long-term tobacco abstinence compared with non-nicotine electronic cigarettes, alternative cessation therapies, or no support.
Searched CENTRAL, MEDLINE, Embase, and PsycINFO through January 2026, identifying 80 randomized controlled trials encompassing 29,861 tobacco smokers.
Evaluated tobacco abstinence at six months or longer, adverse events, and serious adverse events using Cochrane RoB 1 and GRADE frameworks with random-effects meta-analyses.
Nicotine electronic cigarettes significantly increased quit rates compared to nicotine replacement therapy (RR 1.61, 95% CI 1.23 to 2.12; I² = 55%; 11 trials, N=4,114; high-certainty evidence), yielding an additional 4 quitters per 100 participants (95% CI 1 to 7).
Quit rates were higher with nicotine electronic cigarettes compared to non-nicotine electronic cigarettes (RR 1.34, 95% CI 1.05 to 1.69; I² = 0%; 7 trials, N=1,918; moderate-certainty evidence) and compared to behavioral or no support (RR 1.75, 95% CI 1.39 to 2.20; I² = 13%; 11 trials, N=7,214; low-certainty evidence).
Serious adverse events were rare and did not differ significantly between nicotine electronic cigarettes and nicotine replacement therapy (risk difference 0.01, 95% CI -0.01 to 0.02; I² = 0%; 10 trials, N=4,045; moderate-certainty evidence) or non-nicotine electronic cigarettes (risk difference 0.00, 95% CI -0.01 to 0.01; I² = 0%; 11 trials, N=1,786; low-certainty evidence).

Cite This Study

Lindson et al. (2026) studied this question.

synapsesocial.com/papers/6a914599d15324a1df3a8d8d https://doi.org/10.1002/14651858.cd010216.pub11

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August 28, 2026Cochrane library

Electronic cigarettes for smoking cessation

View Full Paper

Ask AI

Bookmark

Authors

NLNicola Lindson JLJonathan Livingstone-Banks ABAilsa R Butler

Discussion

Member takes

Overview

Systematic review of randomized trials reveals higher quit rates with nicotine electronic cigarettes in tobacco smokers, indicating greater efficacy than traditional nicotine replacement therapy.

Key Points

To evaluate the safety, tolerability, and efficacy of electronic cigarettes for achieving long-term tobacco abstinence compared with non-nicotine electronic cigarettes, alternative cessation therapies, or no support.
Searched CENTRAL, MEDLINE, Embase, and PsycINFO through January 2026, identifying 80 randomized controlled trials encompassing 29,861 tobacco smokers.
Evaluated tobacco abstinence at six months or longer, adverse events, and serious adverse events using Cochrane RoB 1 and GRADE frameworks with random-effects meta-analyses.
Nicotine electronic cigarettes significantly increased quit rates compared to nicotine replacement therapy (RR 1.61, 95% CI 1.23 to 2.12; I² = 55%; 11 trials, N=4,114; high-certainty evidence), yielding an additional 4 quitters per 100 participants (95% CI 1 to 7).
Quit rates were higher with nicotine electronic cigarettes compared to non-nicotine electronic cigarettes (RR 1.34, 95% CI 1.05 to 1.69; I² = 0%; 7 trials, N=1,918; moderate-certainty evidence) and compared to behavioral or no support (RR 1.75, 95% CI 1.39 to 2.20; I² = 13%; 11 trials, N=7,214; low-certainty evidence).
Serious adverse events were rare and did not differ significantly between nicotine electronic cigarettes and nicotine replacement therapy (risk difference 0.01, 95% CI -0.01 to 0.02; I² = 0%; 10 trials, N=4,045; moderate-certainty evidence) or non-nicotine electronic cigarettes (risk difference 0.00, 95% CI -0.01 to 0.01; I² = 0%; 11 trials, N=1,786; low-certainty evidence).

Cite This Study

Lindson et al. (2026) studied this question.

synapsesocial.com/papers/6a914599d15324a1df3a8d8d https://doi.org/10.1002/14651858.cd010216.pub11

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