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Electronic cigarettes for smoking cessation

N. Lindson, A. Butler, H. McRobbie, Christopher R. Bullen, P. Hajek, Angela Difeng Wu, R. Begh, Annika Theodoulou et al.

Cochrane Database of Systematic Reviews, 2025

30,366 participants · 15 citations

Abstract

Abstract Rationale Electronic cigarettes (EC) are handheld electronic vaping devices that produce an aerosol by heating a liquid. People who smoke, healthcare providers, and regulators want to know if EC can help people quit smoking, and if they are safe to use for this purpose. This review update was conducted as part of a living systematic review. Objectives To examine the safety, tolerability, and effectiveness of EC for helping people who smoke tobacco achieve long‐term smoking abstinence, in comparison to non‐nicotine EC, other smoking cessation treatments, and no treatment. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and PsycINFO to 1 March 2025, reference‐checked, and contacted study authors. Eligibility criteria We included trials randomising people who smoked to an EC or control condition. We also included uncontrolled intervention studies where all participants received an EC intervention. Studies had to measure an eligible outcome. Outcomes Critical outcomes were abstinence from smoking after at least six months, adverse events (AEs), and serious adverse events (SAEs). Important outcomes were biomarkers, toxicants/carcinogens, and longer‐term EC use. Risk of bias We used the RoB 1 tool to assess risk of bias for each study and GRADE to assess evidence certainty. Synthesis methods We followed standard Cochrane methods for screening and data extraction. Where appropriate, we pooled data using…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 30,366 participants or records.

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