A recent study conducted in Australia and published in Annals of Internal Medicine reveals that the use of e-cigarettes is significantly more effective than nicotine substitutes in helping people to stop smoking, particularly those in precarious 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, vapers, were given the opportunity to choose and use a vaping device from two options: a tank filled with an e-liquid dosed at 18 mg/ml nicotine, or a pod containing a 40 mg/ml liquid. Both devices were available in three different flavors - tobacco, menthol or fruit - and participants could decide whether to use one or a combination of them. The second group, the NRT group, used traditional nicotine substitutes: 4 mg gum or mint lozenges, according to their preference.
The authors' clear conclusions
"Given the cessation difficulties faced by these socially disadvantaged populations, electronic cigarettes represent a promising treatment option for this priority group." The results of this study demonstrate that access to these products is crucial. Today, the use of vape is an essential tool in smoking cessation and a major support for those wishing to stop smoking.
What Cochrane already said
In January 2025, a Cochrane review demonstrated that electronic cigarettes containing nicotine are more effective than conventional nicotine replacement therapy (NRT)2. Cochrane also ranked electronic cigarettes with nicotine among the most effective methods for smoking cessation3alongside varenicline and cytisine. In concluding the study, Dr Jonathan Livingstone-Banks said: "Quitting smoking is difficult, and some people find it harder than others [...] so it's important to seek help to stop smoking. There are various effective forms of smoking cessation support, and cytisine, varenicline and e-cigarettes are all evidence-based methods that greatly increase the chances of successfully quitting smoking."
Reducing inequality: a challenge in France
In France, despite a significant reduction in smoking over the past few years, major social disparities persist.4. The prevalence of daily smoking is significantly higher among people with the lowest incomes, at 28.9%, compared with 17.3% among those with the highest incomes, a difference of 12 points.5. The Australian study once again confirms the value and effectiveness of e-cigarettes in helping people to stop smoking, particularly those in precarious situations. In France, where smoking remains a major public health issue (75,000 deaths a year), easier access to e-cigarettes is an essential lever for reducing these inequalities.
To remember
28.4% of vape users quit smoking after six months, compared with only 9.6% in the group using NPTs.
Vaping also showed a much lower rate of premature cessation of treatment (2.2% vs. 23.2% for substitutes).
The availability of e-liquids with a range of flavors (tobacco, menthol, fruit) makes them easy to take.
- 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 ︎
- 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 ︎
- 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 ︎
- 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-etudes/prevalence-du-tabagisme-en-france-hexagonale-en-2023-parmi-les-18-75-ans ︎
- 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 ︎