E-cigarettes found to be more effective than nicotine replacement treatments

Image Credit: Lindsay Fox, ecigarettereviewed.com.

A clinical trial led by Queen Mary University of London found that e-cigarettes are nearly twice as effective as nicotine replacement treatments at helping smokers quit

It is the first study of its kind to assess the effectiveness of e-cigarettes in helping smokers quit.

A total of 886 participants underwent randomization. There were two groups:

  • Those who used e-cigarettes, and
  • Those who used nicotine replacement therapies of their choice (including patches, gum, lozenges, sprays, inhalators, or a combination of products). 

The two groups also received additional behavioural support.

The 1-year abstinence rate among the e-cigarette group was 18.0%, compared to 9.9% in the nicotine-replacement group.

There were “no significant between-group differences in the incidence of wheezing or shortness of breath.”

Participants using e-cigarettes reported more throat/mouth irritation (65.4 per cent vs 50.8 per cent), while nicotine replacement participants reported more nausea (37.8 per cent vs 31.4 per cent).

After 52 weeks, the e-cigarette group reported greater declines in cough and phlegm production compared to the nicotine replacement group.

The study, funded by The National Institute for Health Research and supported by Cancer Research UK, was published in The New England Journal of Medicine (citation below).

The researchers added that the reasons e-cigarettes were found to be more effective could be because of better tailoring of nicotine dose. 

Lead researcher, Professor Peter Hajek, from Queen Mary University of London said:

“This is the first trial to test the efficacy of modern e-cigarettes in helping smokers quit. E-cigarettes were almost twice as effective as the ‘gold standard’ combination of nicotine replacement products.

“Although a large number of smokers report that they have quit smoking successfully with the help of e-cigarettes, health professionals have been reluctant to recommend their use because of the lack of clear evidence from randomised controlled trials. This is now likely to change.”

Martin Dockrell, Tobacco Control Lead, Public Health England, commented on the findings:

“This landmark research shows that switching to an e-cigarette can be one of the most effective ways to quit smoking, especially when combined with face-to-face support. All stop smoking services should welcome smokers who want to quit with the help of an e-cigarette.”

Specialist stop smoking services “more likely to include e-cigarettes among treatment options”.

Study author Dunja Przulj from Queen Mary University of London said:

“The UK specialist stop smoking services will now be more likely to include e-cigarettes among their treatment options, and health professionals will feel more comfortable in recommending e-cigarettes as a stop-smoking intervention. This may ultimately further accelerate the reduction in smoking and in smoking related diseases.”

Clear evidence that e-cigarettes are more effective than nicotine replacement therapy, says Hywel Williams

Professor Hywel Williams, Director of the NIHR Health Technology Assessment Programme, said:

“This groundbreaking NIHR-funded study provides clear evidence that e-cigarettes are almost twice as effective as nicotine replacement therapy for helping smokers to quit. Cigarette smoking is still a major cause of ill health and death in the UK, so this study will provide much needed evidence to help people and policy makers to make informed choices.”


“A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy” Peter Hajek, Ph.D., Anna Phillips-Waller, B.Sc., Dunja Przulj, Ph.D., Francesca Pesola, Ph.D., Katie Myers Smith, D.Psych., Natalie Bisal, M.Sc., Jinshuo Li, M.Phil., Steve Parrott, M.Sc., Peter Sasieni, Ph.D., Lynne Dawkins, Ph.D., Louise Ross, Maciej Goniewicz, Ph.D., Pharm.D., et al. The New England Journal of Medicine. January 30, 2019. DOI: 10.1056/NEJMoa1808779