A significant review of e-cigarette safety has concluded that switching from traditional cigarettes to vapes does not place users at risk of serious harm, advocating for their use as a smoking cessation treatment. The findings, published in the Cochrane Library, suggest that doctors should be reassured about the safety of e-cigarettes for smokers seeking to quit.
The review analyzed 80 studies involving nearly 30,000 adult smokers and found that e-cigarettes are at least two-thirds more effective at helping individuals quit smoking compared to nicotine gum and patches. Approximately 10% of smokers using vapes successfully quit for at least six months, a rate significantly higher than the 5% who quit with no support or behavioral support alone. Nicotine e-cigarettes showed higher quit rates than nicotine gums and patches, resulting in about four additional quitters per 100 people.
Authors of the review argue that the risks associated with vaping "pale in comparison" to those of smoking. Dr. Jamie Hartmann-Boyce, a senior author from the University of Massachusetts Amherst, stated that the evidence consistently shows vapes are substantially less harmful than smoking and serve as a proven option for those wishing to quit traditional cigarettes. Data indicates that one in two smokers will die from smoking-related diseases, such as lung cancer, COPD, heart disease, and stroke.
These conclusions emerge amidst contrasting findings and ongoing concerns about vaping's health implications, particularly for young people. A separate review published a week prior linked vaping to respiratory problems including wheezing and coughing, as well as depression, panic disorders, allergies, and sleep and eye symptoms in young users. Dr. Mike McKean of the Royal College of Paediatrics and Child Health (RCPCH) noted that much remains unknown about the long-term impact on children and young people, but a "clear and concerning picture is emerging." Paediatrician Professor Will Carroll warned that vaping "should not be seen as a harmless part of growing up" and is "clearly linked with respiratory symptoms and nicotine dependence."
Critics, like Professor Carroll, suggest that the new report overlooks the risks to young people, stating that "one person's exit from the perils of tobacco smoking might be a child's entry into a lifetime of nicotine addiction and subsequent poorer health." Evidence from another study involving over 4.5 million ex-smokers, published in Nature Medicine, found that switching to vapes might not reduce the risk of lung cancer, and could even increase it compared to quitting entirely.
The review authors acknowledged that their study focused on regulated e-cigarettes and noted that the harms often reported are associated with unregulated devices, which may contain substances like THC. They also conceded that their follow-up period of two years might have missed longer-term complications. Despite these caveats, the researchers stressed that while vaping is not risk-free, it is considerably less harmful than smoking.
In the United Kingdom, new regulations are set to take effect on October 29, making it illegal to sell any nicotine or vape product to individuals under 18. This includes nicotine-free vapes and nicotine pouches. Adults purchasing or attempting to purchase these products for minors will also face penalties. Additionally, vaping in cars carrying anyone under 18 will be banned in England.
Around 5.4 million adults in the UK currently use e-cigarettes daily or occasionally, surpassing the 4.9 million who smoke. The National Health Service (NHS) began offering nicotine vapes in 2023 as a smoking cessation tool for patients.
Dr. Hartmann-Boyce emphasized the importance of addressing misconceptions, noting that "people who switch entirely from smoking to vaping an e-cigarette are likely to substantially improve their health." The advice from the review suggests that combining vaping with behavioral support offers smokers the best chance of quitting successfully.