New Hajek Cessation RCT

Posted 14th July 2021 by Dave Cross
A team featuring Peter Hajek has published a paper documenting a new randomised controlled trial (RCT) looking at the use of e-cigarettes for smoking cessation. It was focussing on vaping versus nicotine replacement treatment (NRT) as a harm reduction intervention for smokers who find quitting tobacco use difficult.

The team:

  • Katie Myers Smith, Queen Mary University of London
  • Anna Phillips-Waller, Queen Mary University of London
  • Francesca Pesola, Queen Mary University of London
  • Hayden McRobbie, National Drug and Alcohol Research Centre, University of New South Wales
  • Dunja Przulj, Queen Mary University of London
  • Marzena Orzol, Queen Mary University of London
  • Peter Hajek, Queen Mary University of London

The researchers write: “Among smokers seeking help, most do not achieve smoking cessation even with intensive treatments. Some 80% of smokers treated in clinical trials where various selection criteria apply, and over 80% of those receiving intensive treatment in routine care, smoke one year later.

“A question arises as to whether smokers unable to quit with the current best treatments could benefit from approaches that offer a means to reduce the harm from smoking without ceasing nicotine use, with an option to stop nicotine use as well later on.”

They noted that NRT has a number of associated problems: Firstly, it is costly; the quit rates that NRT generates are low; quitting smoking with NRT tends only to be achieved with regular behavioural support and monitoring. Moreover, “it is seldom used”.

As many on the Planet of the Vapes forum can attest too, NRT is rarely successful when used without expert cessation support. With the boom in vaping, the authors wondered if e-cigs could help with smokers who are unable to quit with licensed stop smoking medications.

Premier Ecigs

They reference a previous study, often referred to as The Hajek Study, “that has shown [electronic cigarettes] to be more effective than NRT when accompanied by intensive face-to-face counselling.”

The team concluded: “In smokers with a history of unsuccessful quitting, [electronic cigarettes] were more effective than NRT both in terms of CO-validated reduction in smoking of at least 50% and in terms of smoking cessation.”

Then, with a statement to bring joy to the heart of every tobacco harm reduction advocate, they write: “The trial results suggest that when treating smokers who failed with stop-smoking medications previously, recommending a refillable EC with an e-liquid of strength and flavours of patient’s choice is a more effective approach than prescribing combination NRT.

Leading tobacco harm reduction expert Clive Bates, Director of Counterfactual, commented: “Very interesting study showing considerable success for vaping relative to NRT in smokers cutting down. A good question is what would happen beyond 6 months - do some of those vaping and smoking gradually migrate to exclusive (or mainly) vaping? I hope further follow-up is planned.”


  1. Targeted smoking cessation for dual users of combustible and electronic cigarettes: a randomised controlled trial -

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, dog walker
Liberty Flights