Does vaping help you quit smoking? Cochrane keeps a living review on that question, “Electronic cigarettes for smoking cessation”, and its current version was published on 26 August 2026 with evidence up to 1 January 2026. Pooling randomised controlled trials in adults who smoked, Cochrane reports high-certainty evidence that nicotine e-cigarettes help more people stop smoking for at least six months than nicotine replacement therapy (NRT).
The review covers 80 completed trials and 29,861 participants. For the comparison with NRT it pooled 11 trials and 4,114 people, with a risk ratio of 1.61 (95% confidence interval 1.23 to 2.12), which Cochrane says might mean about four more people quitting in every hundred. The limits come with the finding: every participant was an adult who smoked, the products tested were regulated ones, no trial was run in Malaysia, and the safety evidence is short term. This is a summary of published findings for readers aged 18 and above, not medical advice and not a suggestion that anyone should start vaping.
What the review is
The review includes only randomised controlled trials, in which people who smoke are randomised to an e-cigarette or to a comparison condition. It is a living review: the authors run and screen searches every month and update it when relevant new evidence becomes available. The current version, CD010216.pub11, added nine new trials and no longer includes single-arm studies, in which every participant receives an e-cigarette.
The review was funded by Cancer Research UK, with some new outcomes supported by the US National Cancer Institute and the FDA Center for Tobacco Products. It states that the funders were not involved in the decision to submit it for publication.
What it found
Quitting, in this review, means not smoking for at least six months. Cochrane reports three main comparisons, and the certainty differs for each.
- Nicotine e-cigarettes against NRT: high certainty. Risk ratio 1.61 (1.23 to 2.12), from 11 trials and 4,114 participants. In Cochrane’s summary table, about 6 in 100 people quit with NRT and about 10 in 100 with nicotine e-cigarettes. The 6 in 100 is Cochrane’s assumed quit rate with NRT and limited behavioural support, not a measured Malaysian figure.
- Nicotine against nicotine-free e-cigarettes: moderate certainty. Nicotine e-cigarettes probably increase quit rates, with a risk ratio of 1.34 (1.05 to 1.69) from 7 trials and 1,918 participants.
- Nicotine e-cigarettes against behavioural support only, or no support: low certainty. Quit rates may be higher, with a risk ratio of 1.75 (1.39 to 2.20) from 11 trials and 7,214 participants. Cochrane is less sure of this result because participants knew which treatment they were getting.
“High certainty” has a set meaning in the grading system Cochrane uses: “We are very confident that the true effect lies close to that of the estimate of the effect.” It applies to the comparison with NRT only. In Cochrane’s plain-language summary: “We are confident in the evidence that nicotine e-cigarettes help more people to stop smoking than nicotine replacement therapy, but we need more evidence about e-cigarettes without nicotine.”
On side effects, reported after at least one week of use, Cochrane finds that against NRT the proportion of people with adverse events may be similar (low certainty) and with serious adverse events is probably similar (moderate certainty). Against behavioural support or no support, people given nicotine e-cigarettes may be more likely to have non-serious adverse events, but Cochrane rates that evidence very low certainty.
What it does not establish
Anything about people who do not smoke. All the studies were conducted in adults who smoked. The review says nothing about people who have never smoked, or about young people.
Long-term safety. Six months without smoking is not a lifetime outcome. In Cochrane’s own words: “We did not detect evidence of serious short-term harm from nicotine EC, but longer, larger trials are needed to fully evaluate safety.”
Unregulated or drug-laced products. Cochrane notes that the studies tested regulated nicotine e-cigarettes, and that illicit products, or products containing other active substances such as THC, “may have different harm profiles.” Police seizure data cited by Health Minister Datuk Seri Dr Dzulkefly Ahmad recorded 402 cases of vape devices and liquids mixed with synthetic drugs up to April 2026 (Bernama, 20 June 2026), and the National Poison Centre logged 76 poisoning cases linked to vape liquids between 2020 and 2024 (Bernama, 4 June 2025). The research says nothing about unregistered or drug-laced products. Our consumer guide sets out what a compliant product carries.
Results from Malaysia. Forty of the trials were run in the United States and 16 in the UK, across 13 countries in all. Malaysia is not on Cochrane’s list. That does not show the results would differ here, only that no trial was run here. Cochrane also notes, as a general point, that differences in e-cigarette regulation between countries may affect how strong an effect a study observes.
A uniformly strong evidence base. Cochrane rated 12 of the 80 trials at low risk of bias, 41 at high risk and the rest unclear. It names imprecision in some comparisons as the main limitation, and says further trials are underway.
What came after it
On 1 September 2026, JAMA published a Special Communication by a working group of the Society for Research on Nicotine and Tobacco, “Nicotine E-Cigarettes for Cigarette Smoking Cessation: Recommendations to US-Based Clinicians”. Its one overarching recommendation is to “integrate e-cigarettes into conversations on the risks and benefits of all evidence-based pharmacologic treatments for smoking cessation.”
It is a position paper for clinicians in the United States and presents no new data. At least three of its authors (Lindson, McRobbie and Rigotti) also wrote the Cochrane review, so it is not independent confirmation. It says nothing about Malaysia, about people who do not smoke, or about young people.
The evidence on the other side
A systematic review led by the Royal College of Paediatrics and Child Health, published online in Archives of Disease in Childhood on 19 August 2026, examined 81 studies on vaping and children and young people. Its authors conclude that vaping “has significant short and medium-term adverse health consequences” for them, that the longer-term consequences are unknown, and that a stronger legal framework is required to protect them. It covers a different population, mostly aged 12 to 19, in mostly observational studies, and it is the reason the Cochrane finding should never be read as applying to minors. Adults deserve an honest choice. Children should be protected.
A cohort study of more than 7 million South Korean adults, published in Tobacco Control on 30 September 2026, found that people who used heated tobacco products and e-cigarettes had higher odds of quitting cigarettes, but also higher odds of starting and relapsing, and lower odds of giving up all tobacco products. Its authors conclude that “these products drive higher rates of CC initiation and relapse and lower rates of complete tobacco cessation”, and that the net public health impact in Korea “remains uncertain”. It draws on health-screening records, so it shows association.
A 2021 meta-analysis by Barufaldi and colleagues found that former smokers who use e-cigarettes are more likely to relapse: about twice the risk before adjustment, and 1.38 times after. It sits in our evidence library under “Sources that argue against us”. The criticisms we respond to are on The case against us, and Why we publish the case against us explains why.
Where this sits in Malaysia
The Ministry of Health takes a more cautious position. In June 2023, the Director-General of Health, Datuk Dr Muhammad Radzi Abu Hassan, said vaping is not an alternative way to quit smoking (Focus Malaysia, 14 June 2023).
The Ministry’s quit service is JomQuit, and since March 2026 the Ministry has also run Cik Era AI, a quit-support app (Bernama, 20 June 2026). Anyone who wants to stop smoking should speak to a health professional or use JomQuit.
No trial in the review was run in Malaysia, so we cite foreign reviews as foreign reviews, and not as a picture of Malaysian smokers. See also our Learn and Research pages.
How to cite it
Cite Cochrane, not MOVE, and name the version: CD010216.pub11, published 26 August 2026, which supersedes earlier versions. Carry the limitations with the finding. The 95% figure is a separate question. It is Public Health England’s 2015 estimate, and it is contested. The Cochrane review is about quitting, not a safety review. The figure is covered in The 95 per cent figure.
The position described here is as at 23 October 2026.