Massive Study Says Vaping Really Is The Most Effective Way to Quit Smoking – But There's a Catch

Nicotine e-cigarettes may be the most effective option for people trying to quit smoking, when compared to nicotine gums, patches, and behavioral support like counseling, according to a new review.

There are many, many caveats to these findings, which we'll get into. But the current evidence suggests that for people who are already smoking on a regular basis, switching to vaping can result in a higher quit rate than other methods.

Whether that quit rate is worth the possible long-term, harmful effects of vaping remains to be seen.

We know tobacco use kills more than 7 million people each year, with more than 1.6 million of those deaths being non-smokers who were exposed to secondhand smoke.

If doctors can offer people reliable methods to stop smoking, we could bring those numbers down, though obviously, this is easier said than done.

"Quitting smoking is hard and a lot of people who smoke will have tried many times to quit smoking and been unsuccessful," says the study's lead author, smoking cessation expert Nicola Lindson of the University of Oxford.

"For that reason, it is important that there are a number of different options available to help somebody quit, which could encourage them to keep trying.

"Although nicotine vapes are unlikely to be completely risk-free, they are less harmful than smoking and that is the most important comparison to make for people who are still smoking tobacco."

Vapes, e-cigarettes, and Juuls are all the same thing: an electronic device that vaporizes liquids into an aerosol (which may or may not contain nicotine), which is then inhaled.

Doctors and health researchers, however, will often refer to them generally as e-cigarettes, which is what they have done in this review.

Importantly, however, the review's findings apply only to regulated nicotine e-cigarettes: not those dodgy disposables from under the smoke shop counter, or vapes with other substances, like THC, in the mix.

"Unlicensed e-cigarettes are potentially dangerous, with issues including unstable batteries and harmful chemicals," says health policy expert Jamie Hartmann-Boyce, from the University of Massachusetts Amherst.

"Anyone looking to use e-cigarettes to quit smoking should only purchase devices that have been tested and approved by their country's regulatory body. Lists of regulated devices are available from the FDA in the US and MHRA in the UK."

The international team of scientists behind this review pooled data from 80 'gold standard' randomized controlled trials for smoking cessation approaches and re-analyzed them together.

That means the results are based on data from almost 30,000 smokers from around the world.

One reason this study is such a big deal is that it's a living systematic review, published in the Cochrane Database.

These studies are known for bringing together the ongoing, existing evidence, and assessing how confident we can be in the studies' results, to inform the practical application of evidence-based medicine.

(AleksandrYu/Getty Images)

The team found high-certainty evidence that about 4 extra quitters in every 100 smokers will find success by using e-cigarettes containing nicotine, compared with nicotine replacement therapy options like patches and gum (which, for decades, have been the main tools doctors would recommend to help people quit).

Nicotine e-cigarettes were also more effective than non-nicotine cigarettes when it comes to quitting success rates, resulting in about 2 more quitters per 100.

"We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking," says Hartmann-Boyce.

"Based on the consistency of the findings here, it's clear that they are a proven and viable option for people wishing to quit traditional cigarettes."

While the review suggests vapes are an effective way to stop smoking, it doesn't address whether those people actually go on to quit vaping, or kick the underlying nicotine habit.

"We did not investigate the issues around use of e-cigarettes in people who don't smoke, nor of the issues related to becoming dependent on e-cigarettes and how best to quit using them," says Chris Bullen, an author of the study and population health expert from the University of Auckland in New Zealand.

"These are genuine concerns that require separate evidence reviews."

This research also can't speak to the benefits versus the risks of vaping as a quit-smoking tool.

There are decades of evidence for the long-term effects of smoking cigarettes; the same cannot be said for vaping.

No serious short-term harms were detected in these studies, but the authors note that longer, larger trials are essential to assess the safety of vapes fully.

Related: Concerning Levels of Uranium And Lead Found in The Urine of Teens Who Frequently Vape

There's plenty of emerging evidence that vapes can be harmful: it even seems likely they can cause cancer. The question, when it comes to using vapes to quit smoking, is whether those risks outweigh the benefits in the long-term.

Only time (and ongoing, rigorous scientific research) will tell.

Funding for the systematic review came from Cancer Research UK, the National Cancer Institute of the National Institutes of Health, and the FDA Center for Tobacco Products.

The research was published in the Cochrane Database of Systematic Reviews.