Cochrane Updates Info on Vape Efficacy

Posted 26th August 2021 by Dave Cross
The Cochrane Tobacco Addiction Group (Cochrane TAG) conducts a monthly review of studies looking at the use of e‐cigarettes to help people stop smoking. It has issued an updated briefing that contains the new information gathered from April 2021.

The briefing document updates current knowledge with the most up to date information on the effect and safety of using electronic cigarettes to help people who smoke achieve long‐term smoking abstinence.

Cochrane TAG is a highly respected non-profit organisation that reviews all the evidence regardless of findings. Its conclusions feed into decision making processes, helping people to construct evidence-based policy decisions.

The briefing is available in two forms: one for professionals and policy makers (1) and the other as a plain English version for those with an interest in the subject (2).

Cochrane TAG says: “We want to be able to include all the evidence as it becomes available to ensure that the findings are as comprehensive as possible. With support from Cancer Research UK, we are searching monthly for new evidence for our Cochrane review of electronic cigarettes for smoking cessation (a ‘living systematic review’ approach).”

The briefing covers an additional 56 studies in 12,804 adults who smoked.


The key findings:

  • The review showed “more people probably stop smoking for at least six months using nicotine e‐cigarettes than using nicotine replacement therapy, or nicotine‐free e-cigarettes.”
  • Nicotine e-cigarettes “may work better than no support for quitting smoking, or than behavioural support alone.”
  • Nicotine e-cigarettes “may not be associated with serious unwanted effects.”
  • The unwanted effects reported most often with nicotine e‐cigarettes “were throat or mouth irritation, headache, cough and feeling sick. These effects reduced over time as people continued using nicotine e‐cigarettes.”
  • However, “we need more, reliable evidence to be confident about the effects of e‐cigarettes, particularly the effects of newer types of e‐cigarettes that have better nicotine delivery.”

It is important to note that Cochrane TAG are weighing up sometimes conflicting findings and therefore coming to a balanced judgement. In this sense, the key findings are hugely positive as they come down firmly on the side of vaping as a smoking quit tool.

The evidence the Cochrane TAG experts assess received one of four ratings:

  • High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
  • Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  • Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  • Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect


  1. Briefing for healthcare professionals and policy makers -
  2. Plain language briefing -

 Dave Cross
Article by Dave Cross
Freelance writer, physicist, karateka, motorbikes, and dog walker