Highest chance of quitting smoking using vapes

A new Cochrane review has been released, revealing e-cigarettes to be as effective as stop smoking medications like varenicline at helping smokers successfully quit smoking.

E-cigarettes as effective as smoking cessation pharmacotherapies
Cochrane reviews are a systematic analysis of all eligible data, evidence, and research, in this case focusing on the efficacy and safety of different smoking cessation tools available to adult smokers.

This particular review compared e-cigarettes with the pharmacological options varenicline and cytisine, analysing 319 trials published between April 2012 and April 2022, which included data from over 150,000 participants.

It identified that there is no clear difference in the effectiveness of e-cigarettes compared with that of the smoking cessation medicines, as well as being no clear difference in their health risks. Analysis revealed that 10–19% of people were likely to quit smoking using an e-cigarette, 12–16% using varenicline and 10–18% using cytisine. Meaning that e-cigarettes, a widely available and cost-effective option, are just as effective as an aid to quitting smoking as the medicines which are only available on prescription.

A previous Cochrane review found that vaping is twice as effective during a quit smoking attempt as nicotine replacement therapies (NRTs) like nicotine patches and gum, which we covered in our blog post ‘E-cigarettes proven to be twice as effective as other NRTs’.

Are e-cigarettes a safe alternative to smoking?
In their Nicotine vaping in England: 2022 evidence update summary the Office for Health Improvement and Disparities found vaping to be at least 95% less harmful than smoking, and the Government recently announced plans to offer 1 million smokers an e-cigarette to help them to quit smoking in their new ‘swap to stop’ scheme.

E-cigarettes can be considered a clean way to use nicotine, as they do not contain the many harmful substances and toxic chemicals like tar and carbon monoxide which are released in cigarette smoke. Nicotine itself does not cause cancer and is relatively harmless, having a similar effect on the body as caffeine. However, it is highly addictive, and is the reason that many smokers find it so hard to quit smoking.

Effectively managing nicotine cravings is an important part of making a quit attempt, as it helps avoid unpleasant withdrawal symptoms like headaches, irritability, and trouble sleeping. We took a closer look at the effects of nicotine in our post ‘Is nicotine harmful to the body?’

Speaking on the findings of the review, Jon Foster, Policy Manager at Asthma and Lung UK, said:

“Vaping can be a helpful way to give up smoking. There is really clear evidence that swapping tobacco for vaping leads to a substantial reduction in exposure to substances that can cause cancer, lung disease and heart disease.”

What makes vaping so effective?
E-cigarettes are used as a form of nicotine replacement therapy, which helps those attempting to quit smoking manage their nicotine dependence and stave off withdrawal symptoms.

A variety of nicotine strengths
Unlike most NRTs, the e-liquids used in e-cigarettes are available in a wide variety of different nicotine strengths, which allows users to match the strength of their vape liquid to their previous nicotine intake from tobacco smoke, ensuring they are using the strength that will most effectively satisfy their cravings. We have lots of information on choosing how much nicotine you need in our blog post 'Which strength e-liquid should I use?'

Vaping also offers users the opportunity to reduce their nicotine intake over time, by gradually lowering the strength of their vape juice, whether just to reduce their nicotine use or with the aim to quit vaping altogether.

Replicating the feel of cigarette smoking
Another reason that e-cigarettes are an effective smoking cessation tool, is because using a vape kit accurately replicates the feel of cigarette smoking. Not only are you repeating the hand to mouth action, but you are also inhaling a vapour in the same way you would when smoking cigarettes, and starter vape kits are designed to replicate the draw of a cigarette in order to feel familiar to new users. This helps also address the physical habit of smoking, along with the nicotine addiction.

A wide range of flavour options
As well as being available in different strengths, e-liquids are available in a wide variety of different flavours, which can help make the experience more enjoyable.
Having a flavour you enjoy makes you more likely to continue to pick up your vape in place of returning to smoking traditional cigarettes.

Affordable and accessible
One of the best things about e-cigarettes is that they are accessible, as there is no prescription needed and they are available to all adult smokers. They are a low cost alternative to smoking, with a University College London study finding that those who make the switch from smoking to vaping could save £780 per year. Additionally, research from Brunel University London found that if 50% of current smokers made the switch to vaping it would save the NHS £518 million on average per year.

Weighing in on the findings, Deborah Arnott, Chief Executive of Action on Smoking and Health, expressed that stop smoking services should be more widely utilising e-cigarettes for patients, saying:

“E-cigarettes are the best option for smokers wanting help to quit. Not only are they as effective as varenicline and cytisine, but more to the point, they’re widely available and cheap,”

“The government has promised 1 million free vapes to smoking cessation services and while the scheme’s not yet up and running, there’s no need for stop smoking services to wait.”

What are smoking cessation pharmacotherapies?
Smoking cessation pharmacotherapies refer to medications which are prescribed to assist the patient with a stop smoking attempt. Both of these medications work by reducing nicotine cravings as well as reducing the rewarding feeling of smoking.

Cystine is not currently used in the UK, but is widely used in many European countries and is involved in trials in the US and Australia. However, varenicline, more commonly known as Champix, was available on prescription in the UK until recently. It is currently unavailable having been withdrawn as a precaution due to an impurity found in the medicine, and it is not known if or when it will become available again.

At a glance
·A new Cochrane review has found e-cigarettes to be as effective for smoking cessation as pharmacological options varenicline and cytisine

·"There is really clear evidence that swapping tobacco for vaping leads to a substantial reduction in exposure to substances that can cause cancer, lung disease and heart disease.” - Jon Foster, Asthma and Lung UK

·"Not only are [e-cigarettes] as effective as varenicline and cytisine, but more to the point, they’re widely available and cheap” - Deborah Arnott, Action on Smoking and Health