New study s in Australia: Vaping Is Three Times More Effective Than Nicotine Replacement Therapies for Low-Income Smokers

A recent study conducted in Australia and published in the *Annals of Internal Medicine* reveals that e-cigarettes are significantly more effective than nicotine replacement therapies in helping people quit smoking, particularly for those in vulnerable situations.

Smokers from disadvantaged backgrounds are often highly addicted to nicotine, and face greater difficulties in successfully quitting than the rest of the population. To assess the effectiveness of different approaches, Australian researchers conducted a randomized clinical trial¹ involving over 1,000 participants. Two strategies were compared: one based on nicotine substitutes, the other on the use of electronic cigarettes with nicotine e-liquids. After six months, almost 29% of participants in the vape group had quit smoking, compared with less than 10% of those using nicotine substitutes.

Vaping vs. nicotine substitutes 

In this study, participants were divided into two groups. The first group, the vapers, could choose and use one of two vaping devices: a tank filled with e-liquid containing 18 mg/mL of nicotine or a pod containing liquid with 40 mg/mL of nicotine. Both devices were available in three different flavors—tobacco, menthol, or fruit—and participants could choose to use one or combine them. The second group, the NRT users, were provided with traditional nicotine replacement therapies: 4 mg nicotine gum or mint lozenges, depending on their preferences.

The authors' clear conclusions 

“Given the difficulties these socially disadvantaged populations face in quitting, e-cigarettes represent a promising treatment option for this priority group.” The results of this study demonstrate that access to these products is crucial. Vaping is now emerging as an essential tool for smoking cessation and a vital source of support for those who wish to quit smoking.

What Cochrane already said

In January 2025, a Cochrane review showed that nicotine-containing e-cigarettes are more effective than conventional nicotine replacement therapies (NRT)². Cochrane also ranked nicotine-containing e-cigarettes among the most effective methods for smoking cessation³, alongside varenicline and cytisine. In conclusion, Dr. Jonathan Livingstone-Banks stated:“It’s hard to quit smoking, and some people find it harder than others […] so it’s important to seek help to quit. There are various effective forms of support for smoking cessation, and cytisine, varenicline, and e-cigarettes are all evidence-based methods that significantly increase the chances of successfully quitting smoking.”

Reducing inequality: a challenge in France

In France, despite a significant decline in smoking over the past several years, significant social disparities persist⁴. The prevalence of daily smoking is significantly higher among people with the lowest incomes—28.9%—compared to 17.3% among those with the highest incomes, a gap of 12 percentage points⁵. The Australian study once again confirms the value and effectiveness of e-cigarettes in helping people quit smoking, particularly among vulnerable populations. In France, where smoking remains a major public health issue (75,000 deaths per year), easier access to e-cigarettes is a key tool for reducing these inequalities.

1. Vaporized Nicotine Products for Smoking Cessation Among People Experiencing Social Disadvantage: A Randomized Clinical Trial - https://www.acpjournals.org/doi/10.7326/ANNALS-24-03531 ︎
2. Can electronic cigarettes help people quit smoking, and do they have any adverse effects when used for this purpose? https://www.cochrane.org/fr/evidence/CD010216_can-electronic-cigarettes-help-people-stop-smoking-and-do-they-have-any-unwanted-effects-when-used ︎
3. How effective are medications and e-cigarettes for quitting smoking, and which works best? https://www.cochrane.org/fr/evidence/CD015226_how-effective-are-medications-and-e-cigarettes-quitting-smoking-and-what-works-best ︎
4. Santé publique France - Prevalence of smoking in hexagonal France in 2023 among 18-75 year olds (results of EROPP OFDT survey)-https://www.santepubliquefrance.fr/determinants-de-sante/tabac/documents/enquetes-studys/prevalence-du-tabagisme-en-france-hexagonale-en-2023-parmi-les-18-75-ans ︎
5. OFDT - Tabagisme et arrêt du tabac en 2023 (rapport détaillé avec focus sur les inégalités sociales et usage de la cigarette électronique)-https://www.ofdt.fr/sites/ofdt/files/2024-05/tt_24bil.pdf ︎