Electronic Cigarettes for Smoking Cessation: A Meta-Analysis

Bottom line: In a review of 50 studies, this meta-analysis concludes with moderate-certainty evidence that cigarette smoking quit rates are higher in people who use electronic cigarettes than those using nicotine replacement therapy. In absolute terms, this e-cigarette advantage translates into an additional four to six successful quitters per 100 smokers.

All three comparisons in this study -- e-cigarettes vs. non-nicotine e-cigarettes, e-cigarettes vs. nicotine replacement therapy, and e-cigarettes vs. behavioral support -- found that nicotine e-cigarettes increase smoking cessation. Pooled data from three studies, all of which were rated at low risk of bias, showed higher quit rates in people randomized to nicotine e-cigarettes.

This study finds that for every 100 people using nicotine e-cigarettes to stop smoking, 10 might successfully stop, compared with only six of 100 people using nicotine-replacement therapy or nicotine-free e-cigarettes, or four of 100 people having no support or behavioral support only. In other words, e-cigarettes help an additional four to six out of 100 people quit smoking than competing cessation methods.

This Cochrane Review aligns with but updates the conclusions of the 2018 U.S. National Academies of Science, Engineering, and Medicine‘s Consensus Study Report, Public Health Consequences of E-cigarettes. This update includes a further 35 studies compared with the previously published version, with changes to conclusions showing moderate-certainty evidence of increased quit rates among those using e-cigarettes. Evidence of adverse events was of low to very low certainty across all comparisons.

This update captures data from the past four years, up to January 2020. Subsequent monthly updates will keep this review current.

Access the full study HERE.