A Cochrane Review found that nicotine e-cigarettes help 8 to 10 out of 100 smokers quit compared to 6 out of 100 using nicotine patches or gum, according to The Independent.
The effectiveness of nicotine e-cigarettes in helping smokers quit has been reaffirmed by a major review, with evidence showing they are more successful than traditional nicotine replacement therapies like patches and gum. Dr. Nicola Lindson, lead author of the review based at the University of Oxford, emphasized that while e-cigarettes are unlikely to be completely risk-free,
they are less harmful than smoking
.
Effectiveness of E-Cigarettes in Smoking Cessation
The study, published in the Cochrane Database of Systematic Reviews, highlights that nicotine e-cigarettes offer a proven and viable option for people wishing to quit traditional cigarettes.
Dr. Jamie Hartmann-Boyce, senior author of the review from the University of Massachusetts Amherst, stated that regulated nicotine e-cigarettes are substantially less harmful than smoking.
The research also noted that vapes containing nicotine outperformed those without, with eight to 10 smokers successfully quitting out of every 100 using vapes, compared to six out of 100 using nicotine-replacement therapy.
The Dual Use Dilemma
A separate study from Duke University School of Medicine revealed a critical gap in e-cigarette research: the lack of data on “dual use,” where smokers continue to use both cigarettes and e-cigarettes. Researchers reviewed 71 clinical trials and found that over 80% of studies did not report on dual use, which complicates the assessment of e-cigarettes’ true efficacy. Joseph McClernon, senior study author and professor at Duke, noted that dual users often remain highly dependent on nicotine and face health risks closer to those of cigarette smokers than to exclusive vapers.
The study, published in Nicotine and Tobacco Research, found that among participants, dual use averaged 42.6% four weeks after starting e-cigarettes. McClernon explained that vaping’s accessibility and lack of prescription requirements make it easier for users to continue nicotine consumption in settings where smoking is prohibited. While quit rates remain the primary metric, the research underscores the need for clearer definitions of dual use to fully evaluate e-cigarettes’ impact.
Nicotine Pouches Emerge as a New Quitting Tool
Meanwhile, a 2025 study in JAMA Network Open suggested that nicotine pouches—such as Velo and Zyn—are gaining traction as a harm-reduction strategy. Lead researcher Cristine Delnevo of Rutgers University found that adults who recently quit smoking were nearly four times more likely to use nicotine pouches. The study, which analyzed data from over 110,000 Americans, noted that pouches are not marketed as cessation aids but are increasingly used to avoid smoking.
Nicotine pouches may be playing a role in some smokers’ attempts to quit,
Delnevo said. Mary Hrywna, an associate professor at Rutgers School of Public Health, added that the findings offer a snapshot of use patterns
that could inform future public health strategies. However, the U.S. Delnevo cautioned that while pouches could reduce harm for existing smokers, they should not be used by non-smokers.
While public health agencies in England have embraced vapes as a harm-reduction tool, the U.S. regulatory framework remains more restrictive. Dr. Hartmann-Boyce of the University of Massachusetts Amherst noted that not everything is either entirely harmful or beneficial,
emphasizing the need for nuanced policies that balance risks and benefits.
