Please note this application is under active development. If you spot any errors or something isn't working, please contact us at evidence.service@wales.nhs.uk.
Systematic Review
To examine the safety, tolerability and effectiveness of using electronic cigarettes (ECs) to help people who smoke tobacco achieve long-term smoking abstinence, in comparison to non-nicotine EC, other smoking cessation treatments and no treatment.
There is high certainty that nicotine EC increases quit rates compared to nicotine replacement therapy (NRT) (RR 1.59, 95% CI 1.29 to 1.93; I2= 0%; 7 studies, 2544 participants). In absolute terms, this might translate to an additional four quitters per 100 (95% CI 2 to 6 more).
There is moderate-certainty evidence, limited by imprecision, that nicotine EC increases quit rates compared to non-nicotine EC (RR 1.46,95% CI 1.09 to 1.96; I2 = 4%; 6 studies, 1613 participants). In absolute terms, this might lead to an additional three quitters per 100 (95% CI1 to 7 more).
Due to issues with risk of bias, there is low-certainty evidence that, compared to behavioural support only/no support, quit rates may behigher for participants randomized to nicotine EC (RR 1.88, 95% CI 1.56 to 2.25; I2 = 0%; 9 studies, 5024 participants). In absolute terms,this represents an additional four quitters per 100 (95% CI 2 to 5 more).
There is high-certainty evidence that ECs with nicotine increase quit rates compared to NRT and moderate-certainty evidence that theyincrease quit rates compared to ECs without nicotine. Evidence comparing nicotine EC with usual care/no treatment also suggests benefit,but is less certain due to risk of bias inherent in the study design.