Meta-analysis finds vapes boost smoking quit rates by up to 40%, with ‘striking’ scientific consensus

A comprehensive new meta-analysis has found strong and consistent evidence that nicotine e-cigarettes can help adults quit smoking, with researchers reporting higher success rates compared with traditional nicotine replacement therapies.

Published in the journal Addiction, the “review of reviews” analysed 14 systematic reviews encompassing 109 primary studies conducted between 2014 and 2023. Across 21 separate meta-analyses, every pooled estimate showed that smokers using nicotine vapes were more likely to quit than those using most alternative cessation methods.

The research, co-led by experts at the University of Oxford, Queen Mary University of London, the University of East Anglia and the University of Massachusetts Amherst in the US, was funded by Cancer Research UK.

Senior author Jamie Hartmann-Boyce, assistant professor of health policy and management at UMass Amherst said the findings demonstrate a rare level of agreement across the scientific community.

“We set out to determine if scientists agree on whether nicotine e-cigarettes help people quit smoking,” she said. “Based on the consistency of the findings here, it’s clear that they do.”

The findings reinforce earlier evidence from a November 2025 review published in the Cochrane Database of Systematic Reviews, widely regarded as a gold standard for evidence-based healthcare. That analysis, which assessed 104 studies involving more than 30,000 adults, concluded that nicotine e-cigarettes remain the most effective aid for smoking cessation, outperforming traditional nicotine replacement therapies such as patches and gum, and are likely more effective than non-nicotine alternatives in helping smokers remain abstinent for at least six months.

According to the latest analysis, nicotine vapes were associated with quit rates approximately 20 to 40 per cent higher than traditional nicotine replacement therapies such as patches or gum for smoking cessation lasting at least six months. When compared with non-nicotine vapes or placebo devices, the difference was even more pronounced, with quit rates at least 46 per cent higher.

The study suggests that the effectiveness of vaping products may extend beyond nicotine delivery alone. Researchers point to behavioural and sensory factors, including the “throat hit”, hand-to-mouth action and visible exhalation, which mimic aspects of smoking that are not addressed by conventional therapies.

“If you look at neuro-imaging studies, the addiction often isn’t just to the nicotine,” Hartmann-Boyce explained. “There are the sensory cues around it that really feed into those addiction pathways. Vaping fulfills some of those cues in a way that a patch doesn’t.”

Despite the positive findings, the authors stress that e-cigarettes are not without risk and may not be the most effective option for all smokers. Hartmann-Boyce cautioned that while vaping carries health risks, these are significantly lower than those associated with combustible tobacco.

“We know e-cigarettes are not risk free, but they are so much less harmful than smoking,” she said.

The study also highlights ongoing concerns around youth uptake, noting that the same features that make e-cigarettes effective cessation tools for adults may also increase their appeal to non-smokers.

“The primary concern about e-cigarettes is their use among people who don’t smoke and wouldn’t have otherwise smoked,” Hartmann-Boyce said. “That doesn’t mean these devices don’t help people quit smoking.”

The analysis found insufficient evidence to determine whether nicotine e-cigarettes are more or less effective than prescription treatments such as varenicline, marketed as Chantix in the US and Champix in the UK.

Researchers hope the findings will help inform ongoing policy and public debate, particularly as perceptions of vaping have been shaped by concerns over youth marketing and past cases of lung injury linked to illicit THC vaping products.

With around half of lifelong smokers dying from smoking-related causes, Hartmann-Boyce emphasised the importance of evidence-based approaches to cessation.

“It’s not just the person who smokes who is affected by their smoking,” she added. “It’s the people around them who are affected by secondhand smoke, and secondhand vaping is nowhere near as harmful as secondhand smoking either.”

The study also included an Evidence and Gap Map to assess the strength of existing research and identify areas needing further investigation. The authors found that higher-quality systematic reviews, using more rigorous methodologies and bias assessments, consistently showed nicotine e-cigarettes to be more effective for smoking cessation, while lower-quality reviews produced more mixed results.

“We hope this overview and Evidence and Gap Map can lay to rest some claims that evidence is ‘mixed’ regarding the impacts of nicotine e-cigarettes on smoking abstinence,” said Angela Difeng Wu, senior researcher and lecturer in the Nuffield Department of Primary Care Health Sciences at Oxford.

“In fact, the evidence is clear and consistent across all of the meta-analyses we consulted: e-cigarettes are effective at helping people stop smoking.”

The researchers noted that evidence on serious adverse events remains inconclusive, with some analyses suggesting a possible increase but based on limited data, and highlighted key gaps including a lack of high-quality comparisons with treatments such as cytisine, bupropion and nicotine pouches, as well as limited evidence against varenicline.