Public health

Nicotine vapes more effective than NRT: Cochrane


Electronic cigarettes containing nicotine are more effective than licensed nicotine replacement therapies (NRT) at helping people quit smoking, an updated Cochrane review has concluded.

Six studies involving 2,378 participants provided “high-certainty evidence” that vapes with nicotine increase quit rates versus NRT (RR 1.63), potentially equating to an extra four quitters per 100, the research team noted.

There was moderate-certainty evidence that nicotine e-cigarettes boost quit rates versus e-cigarettes without nicotine (RR 1.94), from five studies involving 1,447 participants, which might translate to an extra seven quitters per 100.

The data also suggested that compared to behavioural support only/no support, there were higher quit rates for participants randomised to nicotine e-cigarettes (RR 2.66; seven studies, 3,126 participants), representing an additional two quitters per 100. However, this finding “was of very low certainty, due to issues with imprecision and risk of bias,” the Cochrane reviewers noted.

The research team found no evidence of serious harm from nicotine containing vapes, but also noted that the longest data period was two years and that most studies were small.

The incidence of adverse events was similar for nicotine and non-nicotine e-cigarettes and NRT, the most commonly reported being throat/mouth irritation, headache, cough, and nausea, but these tended to dissipate with continued use.

The findings “strongly support making e-cigarettes available as one of the options to help [cigarette smokers] to quit”, said Professor Nicholas Hopkinson, Professor of Respiratory Medicine and Honorary Consultant Physician, National Heart and Lung Institute.

Smoking cessation services “can continue to be confident supporting smokers to switch to e-cigarettes,” he noted, but also added that such services are “woefully underfunded”.

“A polluter-pays levy on tobacco industry profits would bring in around £700 million to the Department of Health to fund these and other public health measures.

“The government must move swiftly to implement this and other recommendations from Javed Khan’s review “making smoking obsolete” to deliver on its Smokefree 2030 ambition.”

Read the review in full here

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