Nicotine E-Cigarettes Surpass Patches and Gum for Smoking Cessation

Nicotine e-cigarettes have demonstrated higher effectiveness in aiding smoking cessation compared to nicotine replacement therapies and behavioral support, based on a comprehensive analysis of global research.

The study synthesized data from fourteen systematic reviews published between 2014 and 2023, aiming to clarify the relative efficacy of various smoking cessation methods. These methods included nicotine patches, gum, lozenges, non-nicotine e-cigarettes, and behavioral programs.

Reviews of the highest quality consistently indicated superior smoking cessation outcomes for users of nicotine e-cigarettes. In contrast, lower-quality reviews showed less consistent and less precise findings. When isolating the best-quality evidence, nicotine e-cigarettes repeatedly outperformed nicotine replacement therapy, non-nicotine e-cigarettes, and other approaches.

Researchers also created an Evidence and Gap Map (EGM) to highlight areas lacking sufficient scientific data. The review identified an absence of high-quality systematic comparisons between nicotine e-cigarettes and treatments such as cytisine, bupropion, or nicotine pouches.

Comparative evidence between nicotine e-cigarettes and varenicline was found to be scarce, with only one small study available, which carried a high risk of bias.

The EGM further revealed inconclusive data concerning serious adverse events associated with e-cigarette use. Moreover, most research to date has been conducted in high-income countries, limiting the generalizability of findings.

Future research is recommended to monitor potential serious adverse events related to e-cigarettes and to expand investigations within low- and middle-income countries.

Dr. Angela Difeng Wu, Senior Researcher and Lecturer at the Nuffield Department of Primary Care Health Sciences, University of Oxford, stated, “We hope this overview and Evidence and Gap Map can lay to rest some claims that evidence is ‘mixed’ regarding the impacts of nicotine e-cigarettes on smoking abstinence. In fact, the evidence is clear and consistent across all of the meta-analyses we consulted: e-cigarettes are effective at helping people stop smoking.”