A major study found that e-cigarettes were twice as effective in helping people quit smoking than nicotine replacement therapies—such as patches, gum, and nasal spray—when both methods were accompanied by behavioral support. The randomized study involved 886 adults who were attending the U.K. National Health Service stop-smoking services.

Study participants were randomly given either nicotine-replacement products of their choice for up to 3 months or an e-cigarette starter pack, which consisted of a second-generation refillable e-cigarette and one bottle of nicotine e-liquid (with 18 mg per milliliter). The e-cigarette group was told to purchase further e-liquids of the flavor and strength of their choice. The participants using the nicotine-replacement products could use multiple products.

The study compared abstinence levels, which were validated biochemically, after one year.  For those in the e-cigarette group, the one-year abstinence rate was 18.0% and, for those in the nicotine-replacement group, it was 9.9%. Among the participants that did not achieve full abstinence, those in the e-cigarette group were more likely than those in the nicotine-replacement group to reduce their smoke intake at the one-year point.

Funded by the National Institute for Health Research and Cancer Research UK, the study took place between May 2015 and February 2018. The authors pointed out that this study showed a stronger effect of e-cigarettes than previous trials. They suggested one possible reason was, previous trials provided limited or no face-to-face support. Both groups in the UK study were provided smoking-cessation treatment, which included weekly behavioral support for at least 4 weeks.

Results of the study, A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy,  were published in the New England Journal of Medicine, on January 30, 2019 (see here).