E-cigarettes and smoking cessation
E-cigarettes and smoking cessation
E-cigarettes are the most common aid used by people to help them stop smoking8 and quit attempts involving a vaping product have been associated with the highest success rates.8
For every 100 people using nicotine e-cigarettes to stop smoking, 9 to 14 might successfully stop, compared with only 7 using nicotine-free e-cigarettes, 6 using nicotine-replacement therapy, and 4 having no support or behavioural support only.6
Current Guidance on e-cigarettes
In recent years, there has been increasing evidence to support the use of e-cigarettes in smoking cessation.
Click on each of the organisations below to find out what their current guidance and recommendations are.
Office for Health Improvement and Disparities(Previously Public Health England)
2022: Nicotine vaping in England: 2022 evidence update main findings8
- Vaping products generally provide lower nicotine levels to users than smoking does. However, people who are experienced vapers can achieve nicotine levels similar to people who smoke.
- Evidence suggests that the risk and severity of nicotine dependency from vaping is lower than for smoking.
- There is no significant increase of toxicant biomarkers after short-term second-hand exposure to vaping among people who do not smoke or vape.
- Vaping is not risk-free, particularly for people who have never smoked.
- The higher absolute exposure from vaping compared with not using any nicotine products reinforces the need to discourage never smokers from taking up vaping (or smoking).
Royal College of Physicians
2021: Smoking and health 2021: a coming of age for tobacco control15
- Recommends that:
- The NHS provides opt-out smoking cessation services to all smokers at any point of contact with the NHS.
- E-cigarettes are an effective treatment for tobacco dependency and their use should be included and encouraged in all treatment pathways.
- Health warnings on e-cigarette packs include a statement that e-cigarette vapour is likely to be substantially less harmful than tobacco smoke.
- Campaigns to support the use of e-cigarettes as a quitting aid or harm reduction alternative to smoking are carried out and false perceptions about the safety of e-cigarettes are redressed.
- The use of e-cigarettes in public spaces does not fall within the remit of smoke-free legislation because they do not emit smoke.
National Institute for Health and Care Excellence (NICE)
2022: Tobacco: preventing uptake, promoting quitting and treating dependence13
- Inform people who smoke that a range of interventions is available to help them stop smoking, including behavioural interventions, medicinally licenced products, nicotine-containing e-cigarettes, and Allen Carr’s EasyWay in-person group seminar.
- When nicotine-containing e-cigarettes are used for stopping smoking, combining this with behavioural support is more likely to be successful than vaping on its own.
- Provide clear, consistent and up-to-date information about nicotine-containing e-cigarettes to adults interested in using them to stop smoking. Advise them that:
- E-cigarettes are not licensed medicines but are regulated by the Tobacco and Related Products Regulations (2016),14
- There is not enough evidence to know whether there are any long-term harms from e-cigarette use,
- The use of e-cigarettes is likely to be less harmful than smoking, and
- Any smoking is harmful, so people using e-cigarettes should stop smoking tobacco completely.
- Discuss with them:
- How long they intend to use e-cigarettes for,
- Using e-cigarettes for long enough to prevent a return to smoking, and
- How to stop vaping when they are ready to do so.
- Explain the importance of getting enough nicotine to overcome withdrawal symptoms.
- Ask them to share any side effects or safety concerns that they may experience and report these to the MHRA Yellow Card Scheme. Customers can also report directly.
National Centre for Smoking Cessation and Training (NCSCT)
2021: Incorporating e-cigarettes into your Stop Smoking Service:
Making the case and addressing concerns16
- Vaping is positively associated with quitting smoking successfully.
- Frequent use of e-cigarettes is more strongly associated with successful quitting of tobacco.
- Gives advice, guidance and examples to stop smoking services making e-cigarettes available to their clients.