The strongest evidence yet that vapes help smokers quit has just landed. Cochrane’s updated systematic review published 26 August 2026 in the Cochrane Database of Systematic Reviews concludes that nicotine-containing vapes increase smoking cessation rates compared to nicotine replacement therapy (NRT), with the finding rated high certainty.
The numbers
- 80 randomized controlled trials, involving 29,861 adult smokers
- 34 studies reporting quit outcomes at six months or longer
- 9 new RCTs added in this update and the primary conclusions remain unchanged
- Research teams from the University of Oxford, Queen Mary University of London, the University of Auckland, the University of Michigan, Harvard Medical School, Massachusetts General Hospital, Monash University and others
The analysis is part of an ongoing living systematic review. The headline effect size: nicotine vapes produced approximately four more quitters per 100 people than NRT like patches and gum and around two more quitters per 100 than non-nicotine e-cigarettes. There was no evidence of increased serious harm from using e-cigarettes to quit, though the authors note longer-term studies are still needed. The findings apply specifically to regulated, nicotine-containing e-cigarettes.
Why it matters
Cochrane reviews are the gold standard of evidence synthesis and “high certainty” is their strongest rating. For the 24 million-plus American adults who still smoke, and millions more in the UK, this is the clearest signal yet that vapes are the most effective widely available quit aid.
The finding also reframes the policy debate: regulations that make vapes harder to access or more expensive than cigarettes risk pushing smokers away from the tool most likely to get them off combustible tobacco. (See how vaping compares to smoking on the evidence.)
The caveats
High certainty applies to quitting smoking in adults not to vaping being harmless. The review also analysed adverse events across 35 studies and serious adverse events across 48. And none of this changes the youth picture: e-cigarettes are not for non-smokers or under-18s.
If you’re a smoker considering the switch, start with our guide to the best disposable vapes and talk to a clinician about a quit plan.
Source: The Pharmaceutical Journal