October 14, 2020

expert reaction to a Cochrane review of e-cigarettes for smoking cessation, as published in the Cochrane Database of Systematic Reviews 2020

A review, published in the Cochrane Database of Systematic Reviews 2020I, looked at the use of e-cigarettes for smoking cessation.

Prof Lion Shahab, Professor of Health Psychology and Co-Director of the UCL Tobacco and Alcohol Research Group, University College London (UCL), said:

“This review from the Cochrane Collaboration, one of the main stalwarts of evidence-based medicine, confirms their earlier finding that e-cigarettes are an effective smoking cessation aid which are safe to use, at least in the short term.

“This review, conducted by a of well-respected international experts, now expands on previous conclusions by finding that e-cigarettes not only increase quit rates compared with placebo but also with active treatment, namely standard nicotine replacement therapy (NRT) such as nicotine patches. This is reassuring as there is very strong evidence that NRT is effective, further underlining the utility of e-cigarettes as tool for smoking cessation. Updating their confidence in these findings from previously low- to now moderate certainty evidence, the authors also did not detect evidence of serious harms from electronic cigarettes, which should reassure policymakers and health bodies that electronic cigarettes have an important role to play in reducing the burden from combustible tobacco use.”

Prof John Britton, Emeritus Professor of Respiratory Medicine, University of Nottingham, said:

“This comprehensive review of all data on the efficacy of electronic cigarettes in helping people to quit provides definitive confirmation that electronic cigarettes offer smokers an effective means of quitting, and perhaps even more so than some licensed stop smoking medicines. It therefore endorses the UK policy of promoting electronic cigarettes as a consumer product that can help smokers quit smoking completely, and supports the recommendation of electronic cigarettes in the NHS. Questions over their long-term safety will not be resolved until these products have been in use for many years, but all the available evidence indicates that any long term adverse effects are likely to be far smaller than those of smoking tobacco.”

Prof Peter Hajek, contributing senior author to the Cochrane review and Director of the Tobacco Dependence Research Unit at Queen Mary University of London (QMUL), said:

“We know from over 100 randomised trials that nicotine replacement treatments, such as nicotine gum or patches, help smokers quit. E-cigarettes are a form of nicotine replacement that is more attractive to smokers and that seems more effective than the earlier products. The results of this new review of randomised trials of vaping tally with other evidence from cohort and epidemiological studies, suggesting that for many smokers, e-cigarettes represent an effective tool for quitting smoking. It is also important to note that the studies detected no evidence of harm from vaping in people using e-cigarettes for up to two years.” 

‘Electronic cigarettes for smoking cessation’ by Jamie Hartmann-Boyce et al. was published in the Cochrane Database of Systematic Reviews 2020 at 12 noon UK time on Wednesday 14 October 2020.

DOI: 10.1002/14651858.CD010216.pub4

Declared interests

Prof Shahab “has received honoraria from pharmaceutical companies that make smoking cessation products. He has never received personal fees or research funding of any kind from electronic cigarette or tobacco companies.”

Prof Hajek is a contributing author to the review.

None others received.