Analysis of over 300 studies and 150,000 participants, concludes nicotine e-cigarettes most effective

A new Cochrane analysis has compared the results of 319 smoking cessation clinical trials involving 157,179 people and found that nicotine e-cigarettes are the most effective tool for helping people quit smoking.

Researchers concluded nicotine e-cigarettes, varenicline and cytisine are the most effective options currently available for helping smokers quit long-term (more than six months) after data showed that for every 100 people, 10 to 19 are likely to quit using an e-cigarette; 12 to 16 using varenicline; and 10 to 18 using cytisine.

Dr Nicola Lindson, the lead author has stressed the importance of pulling together such a large data set involving over 150,000 people. The results clearly show e-cigarettes increase the likelihood of people quitting smoking.

“This clinical outcome combined with harm reduction advice supports the rationale that e-cigarettes should be a front-line smoking intervention,” says Jonathan Devery, Chair, the Vaping Industry Association of New Zealand (VIANZ). “Access to varenicline and cytisine pose challenges to smokers attempting to quit. Unfortunately, our health system is under significant strain with many hampered by a lack of doctor’s appointments and the associated costs. And, while varenicline is available on prescription in New Zealand, cytisine is not Pharmac approved and remains unavailable.”

According to Lindson, this comprehensive analysis “offers clarity, providing people who smoke, healthcare professionals and policymakers with reliable data to make informed decisions”. Importantly, the study not only looked at treatment effectiveness it also assessed the treatments safety profile with researchers noting no significant adverse effects and the fact that nicotine replacement therapies have been used since the 1980s.

Co-author Dr Jamie Hartmann-Boyce goes on to say, “Smoking remains the leading cause of preventable disease and death worldwide, and though many people want to quit smoking, it can be hard to do so. Our findings provide clear evidence of the effectiveness of nicotine e-cigarettes.”

“This study carries significant weight because systematic reviews carried out by Cochrane are recognised worldwide as the highest standard in evidence-based healthcare,” says Devery. “Cochrane reviews are independent of commercial bias and are often used in the development of evidence-based guidelines as a tool to support clinical decision making.

“For healthcare providers across Aotearoa, and consumers, this study provides strong evidence of the safety and efficacy of e-cigarettes. It provides the strongest rationale to date that e-cigarettes are the most effective smoking cessation tool, and the fact nicotine has been used for smoking cessation since the 1980s hopefully offers a greater level of comfort for many.”