Nicotine vapes found more effective than NRTs

We all know that quitting smoking can be a difficult task, and for most the help of an alternative nicotine source like a vape kit is a key part of a successful quit attempt. The latest Cochrane review has found that nicotine vapes may offer a more effective route to stopping smoking than traditional nicotine replacement therapies (NRTs), giving smokers a better chance at success.

So, what exactly did the researchers find, and what could this mean for smokers considering vaping as a way to quit?

What did the latest Cochrane review look at?

The Cochrane review, Electronic cigarettes for smoking cessation, can be thought of as a living systematic review, meaning that the researchers involved continually monitor new evidence and update their findings as relevant studies become available.

The review, published in August 2026, looked at 80 randomised controlled trials involving almost 30,000 adult smokers. When nicotine-containing e-cigarettes were compared with NRTs such as nicotine patches and gum, the researchers found that people using nicotine vapes were more likely to remain smoke-free for at least six months than those using an NRT.

The studies included compared nicotine-containing e-cigarettes with a range of alternatives, including NRT, non-nicotine e-cigarettes, behavioural support and no support.

How was quitting measured?

One important point when looking at smoking cessation research is how researchers decide whether someone has actually quit.

The Cochrane review's main focus was smoking abstinence for at least six months, confirmed by a follow up six months or longer after the start of the intervention. To ensure accuracy, researchers treated participants who dropped out or missed follow ups as still smoking, ensuring that the numbers for abstinence were only those confirmed as remaining smoke-free.

Where available, the researchers preferred biochemically verified abstinence rather than relying solely on participants' own reports, which involves tests to measure carbon monoxide or other markers of tobacco exposure.

The studies did not all follow participants for exactly the same amount of time. The review included trials with follow-up periods extending beyond six months, including some longer-term follow-up, but six months was the minimum threshold for the review's primary smoking cessation outcome.

Nicotine vapes over 60% more effective long-term

The Cochrane review found high-certainty evidence that nicotine-containing e-cigarettes increase quit rates compared with NRT.

Across the 11 studies included in this comparison, people assigned to nicotine e-cigarettes were more likely to achieve smoking abstinence than those assigned to NRT.

The researchers estimated that, for every 100 people using NRT, around six might successfully quit, compared with around 10 out of 100 using nicotine vapes. This equates to approximately four additional people quitting for every 100 people treated with nicotine e-cigarettes, a 61% higher relative quit rate.

The researchers rated this particular evidence as high certainty. In Cochrane terminology, this means they are very confident that the true effect is close to the estimate produced by the analysis.

That doesn't mean every smoker who switches to a nicotine vape will quit. Nor does it mean vaping is guaranteed to work better for every individual. Rather, across the populations and treatments studied, nicotine e-cigarettes produced higher quit rates than NRT.

How do nicotine vapes compare with nicotine-free vapes?

The review also looked at whether nicotine itself makes a difference. When nicotine-containing e-cigarettes were compared with otherwise similar e-cigarettes that did not contain nicotine, the researchers found that nicotine vapes probably resulted in higher quit rates.

However, the certainty of this evidence was lower than for the comparison with NRT. The review rated it as moderate-certainty evidence, partly because the data was less precise.

The analysis included seven studies involving 1,918 participants. The researchers estimated that nicotine e-cigarettes might result in around two additional quitters per 100 people compared with non-nicotine e-cigarettes.

This suggests that the nicotine component isn't simply incidental when vaping is being used as a smoking cessation tool. Nicotine can help manage cravings and withdrawal symptoms, while the act of vaping can also replace some of the sensory and behavioural aspects associated with smoking.

That distinction may be particularly relevant to adult smokers who find that traditional NRT doesn't fully address the habits and routines associated with smoking.

Why might vaping work differently from NRT?

NRT has been used for decades and is a well-established smoking cessation treatment. Products like nicotine patches, gum, lozenges and inhalators deliver nicotine without the toxic substances produced when tobacco is burned.

As the Cochrane review explains, traditional NRT primarily addresses nicotine withdrawal. It doesn't necessarily replicate the physical act of smoking, such as taking a puff, holding something in the hand or experiencing a sensation in the throat.

Vapes can provide nicotine while also replicating some of these behaviours and sensations. Modern devices can also deliver nicotine more effectively than some of the earlier generations of e-cigarettes studied in the past, which has helped vaping become such a popular choice among adults trying to move away from cigarettes.

According to Action on Smoking and Health (ASH), 10% of adults in Great Britain currently vape, equivalent to an estimated 5.5 million people. More than half of current vapers are ex-smokers, while 32% both smoke and vape, using their vape as a way to cut down on their tobacco use. ASH estimated that 2.5 million adults in Britain have quit smoking with the help of a vape over the last five years.

What did the review find out the safety of vapes?

The Cochrane review found that the proportion of participants experiencing adverse effects when using nicotine vapes were similar in number to those using NRT, a finding that has previously been recognised in other studies.

The review did not detect evidence of any serious short-term harm from nicotine e-cigarettes in these trials. However, the researchers did make it clear that longer and larger studies are still needed to properly assess longer-term effects, with vapes still being a relatively new technology compared to some NRT options.

It is also important to note that all of the studies involved in the review were based on the use of compliant and regulated vapes. UK regulations place strict limits on nicotine strength and require legally sold nicotine-containing vapes and refills to meet safety and quality requirements and be notified to the Medicines and Healthcare products Regulatory Agency (MHRA). Illicit vapes which are not compliant with UK law could be a very different story, as they have not been subject to the appropriate safety checks, which is why it is important to always ensure you are purchasing from a reputable retailer.

What does this mean for smokers?

For an adult smoker considering their options, the latest Cochrane review adds to the ever-growing evidence that nicotine vaping can be an effective way to quit smoking.

The key point isn't that everyone should vape, but rather that for people who currently smoke, vaping may be a more effective option for achieving a successful quit attempt than more traditional NRT options.

Evidence also suggests that the use of an alternative nicotine source during a stop smoking attempt is aided by stop smoking support. So, if you are considering making a stop smoking attempt it is always a good idea to look into your local stop smoking services or consult your GP, to give yourself the greatest chance at success. Take a look at our Stop for good, not just October guide for more information.  

What do the findings tell us about vaping and quitting smoking?

The latest Cochrane review represents a substantial body of evidence, with 80 randomised controlled trials and nearly 30,000 participants.

Its most important finding is straightforward: nicotine-containing e-cigarettes resulted in higher smoking quit rates than NRT. As with any attempt to quit smoking, what works best for an individual can vary. But the latest Cochrane evidence gives adult smokers another reason to consider vaping as a viable smoking cessation option.

If you’re thinking about making the switch from smoking to vaping and would like help or advice, pop in to your local Evapo store or reach out to our Customer Service team to speak with an NCSCT stop smoking trained member of our team.

Sources

cochranelibrary.com 26/08/2026

ash.org.uk 2026

bbc.co.uk 26/08/2026