Recently, the UK-based Cochrane Collaboration conducted 78 studies involving 22,052 smokers, comparing the use of electronic cigarettes with the following factors:
Nicotine replacement therapy (such as patches or gum);
Varenicline, a medication that helps people quit smoking;
Nicotine-free electronic cigarette;
Other types of electronic cigarettes that contain nicotine (such as pods);
Actions of support, such as advice or consultation.
The research was mostly conducted in the United States (34 studies), United Kingdom (16 studies), and Italy (8 studies).
Key Conclusion
Using nicotine-containing e-cigarettes is more effective than using nicotine replacement therapy or non-nicotine e-cigarettes for quitting smoking. The most common adverse effects of using e-cigarettes with nicotine are throat or oral irritation, headaches, coughing and nausea. As people continue to use nicotine e-cigarettes, these effects become lessened over time.
Research summary
There is strong evidence to suggest that nicotine-containing e-cigarettes are more effective for smoking cessation than NRT, while moderate quality evidence suggests that nicotine-containing e-cigarettes are more effective for smoking cessation than non-nicotine e-cigarettes. Comparing nicotine replacement therapy to standard care or no treatment also shows benefit, but with lower certainty and requiring further research to confirm the effect. In most cases, the confidence intervals for data on AEs, SAEs, and other safety indicators are broad, with no differences observed between nicotine and non-nicotine e-cigarettes in terms of AEs, or between nicotine e-cigarettes and NRT. The overall incidence rate of SAEs was low across all study groups. No evidence was found for serious harm from nicotine e-cigarettes, but the longest follow-up period was two years and the number of studies was limited. The primary limitation of the evidence base continues to be imprecision due to limited numbers of RCTs and typically low event rates, but further RCTs are currently ongoing. To ensure that this review continues to provide up-to-date information for decision-makers, it is a living system review. Searches are conducted monthly and the review is updated when new relevant evidence becomes available. Please refer to the Cochrane Systematic Reviews Database for the current status of this review.
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