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For adults trying to quit smoking, nicotine e-cigarettes helped more people stop smoking than nicotine replacement therapy (NRT), including patches and gum, in Cochrane’s current review. The review estimates about four additional quitters per 100 people using nicotine e-cigarettes rather than NRT. That is an average across reviewed trials—not a prediction for an individual, proof that vaping is safe, or a recommendation for every smoker.
How much more effective was vaping than patches or gum?
Cochrane’s living systematic review finds high-certainty evidence that nicotine e-cigarettes help more adults quit smoking than NRT. Its plain-language summary estimates that about 8–10 people per 100 quit with nicotine e-cigarettes, compared with about 6 per 100 with NRT. The estimated difference is about four additional quitters per 100.
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These are review-level averages from the trials, not personal success rates. The review’s evidence is current to 1 January 2026, and Cochrane published an update summary on 26 August 2026. The update covered 80 randomized controlled trials involving 29,861 participants, with nine trials new to that update; not all 80 trials compared vaping directly with patches or gum. Read Cochrane’s review and evidence summary and its 26 August 2026 update summary.
The result concerns quitting rates in the studies. It does not establish that every vape, nicotine concentration, or way of using an e-cigarette works equally well, or that vaping is safer over the long term.
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Are patches and nicotine gum still effective?
Yes. Cochrane finds that licensed NRT forms, including patches and gum, improve the chance of quitting. A head-to-head finding that favors nicotine e-cigarettes on average does not mean NRT is ineffective.
Using a patch with gum or a lozenge
For some people, combining a steady-delivery product such as a patch with a short-acting product such as gum or a lozenge is more likely to help than using just one NRT form. The right choice can depend on smoking patterns, health circumstances, and personal preference. Cochrane explains evidence on ways to use NRT.
Does the higher quit rate mean vaping is safe?
No. The cessation comparison does not settle long-term safety. Serious unwanted effects were uncommon in studies comparing nicotine e-cigarettes with NRT, but few events occurred and evidence for several safety outcomes remains uncertain. The CDC says the long-term health effects of e-cigarettes are still uncertain and that e-cigarette aerosol is not harmless. It states, “There are no safe tobacco products, including e-cigarettes.” See the CDC’s e-cigarette information.
Complete substitution is different from dual use
In the United States, the CDC says adults who smoke and are not pregnant may potentially benefit if they completely replace smoked tobacco with e-cigarettes. Continuing to smoke while vaping—dual use—is not an effective way to safeguard health. The CDC also advises adults who use e-cigarettes to quit smoking to plan to quit vaping as well. These qualifications matter: the possible benefit described by the CDC depends on fully replacing cigarettes, not adding vaping alongside them. Read the CDC’s guidance on vaping and quitting.
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Are e-cigarettes approved as quit-smoking medicines?
In the United States, no e-cigarette product has FDA approval as a smoking-cessation aid, according to the CDC. That regulatory status does not negate the Cochrane finding about trial quit rates; it means vaping should not be presented as an FDA-approved cessation medicine. Rules and product authorization differ by country, so check the guidance that applies where you live.
How should you choose a quit plan?
The evidence can inform a discussion, but it cannot determine the safest or most suitable option for a particular person. A health professional or local cessation service can help weigh NRT, other available cessation support, and the implications of vaping in your jurisdiction. In the United States, the CDC recommends counseling together with medication to support quitting. WHO also points to advice from health professionals, national toll-free quitlines, and mobile or digital cessation services.
- If you prefer NRT, ask whether a patch plus gum or lozenge is appropriate rather than assuming one product is your only option.
- If you are considering e-cigarettes, discuss how to avoid continued cigarette smoking and how you would approach quitting vaping.
- Ask a clinician or cessation service to tailor support to your health circumstances and local rules.
CDC guidance for clinical tobacco-cessation interventions and WHO information on e-cigarettes describe support options and the need to consider local circumstances.
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