Vape.ch Knowledge Switzerland
Smoking Cessation with Nicotine E-Cigarettes: Study Evidence
A factual classification of Cochrane data, Swiss research, Public Health England, Health Canada and important limits of the evidence.
Smoking cessation Nicotine e-cigarettes Cochrane Swiss research Switzerland
In short
Nicotine e-cigarettes are studied in research as a possible support for smoking cessation.
The evidence concerns adult smokers, not non-smokers, young people or pregnant women.
Switching away from tobacco smoke does not automatically mean being nicotine-free.
Important note
This article is intended for adult smokers. It does not replace medical advice and is not a guarantee of successful smoking cessation. Anyone with health questions or using medication should discuss smoking cessation with medical professionals.
Nicotine e-cigarettes have been studied for years as a possible support for smoking cessation. The current evidence suggests that they can help adult smokers fully switch away from tobacco cigarettes.
At the same time, one point remains important: e-cigarettes are not risk-free and should not be used by non-smokers, young people or pregnant women.
What does the Cochrane review say?
The Cochrane review on electronic cigarettes and smoking cessation summarises many studies. The analysis concludes that nicotine e-cigarettes can help more people stop smoking for at least six months than conventional nicotine replacement products such as patches or gum, as well as e-cigarettes without nicotine.
According to Cochrane, out of 100 people using nicotine e-cigarettes for smoking cessation, around 8 to 11 people may successfully remain smoke-free for at least six months. By comparison, the summary found about 6 out of 100 people with nicotine replacement therapies or nicotine-free e-cigarettes.
Core message
The core message is not: “E-cigarettes are harmless.” The factual message is: nicotine e-cigarettes can help adult smokers stop smoking, but they remain nicotine products.
Can e-cigarettes help with smoking cessation?
For adult smokers, nicotine e-cigarettes can play a role in smoking cessation when they fully replace tobacco cigarettes. The device alone is not decisive; what matters is the combination of suitable nicotine strength, suitable draw behaviour, realistic expectations and consistent avoidance of tobacco cigarettes.
Study reviews such as Cochrane and health bodies such as the NHS classify nicotine vaping as a possible support for smoking cessation. At the same time, vaping is not risk-free, can be addictive and is not intended for non-smokers, young people or pregnant women.
The benefit comes from fully stopping smoking. Anyone who continues to smoke and additionally vapes does not reduce exposure to tobacco smoke to the same extent as someone who completely replaces tobacco cigarettes.
What does Swiss research say?
A Swiss study led by the University of Bern also classified e-cigarettes as a possible aid for smoking cessation. At the same time, the study showed an important point: switching can reduce or end tobacco cigarette smoking, but it does not automatically mean that nicotine dependence disappears.
For adult smokers, this difference is crucial. Ideally, smoking cessation means no longer consuming tobacco cigarettes. Anyone who then continues using nicotine through an e-cigarette has avoided tobacco smoke, but is not automatically nicotine-free.
Avoiding tobacco smoke
A complete switch away from tobacco cigarettes can be a relevant step for adult smokers.
Nicotine remains relevant
Anyone who continues using nicotine through e-cigarettes is not automatically nicotine-free.
Not for non-smokers
E-cigarettes and nicotine products are not suitable for non-smokers, young people, pregnant women or breastfeeding women.
Public Health England 2021: vaping and smoking cessation
Public Health England published another evidence update on vaping in England in February 2021. The report examined, among other things, the use of e-cigarettes among adults and young people, and the role of vaping in smoking cessation and smoking reduction.
The central classification was: alternative nicotine products such as e-cigarettes can play a role in reducing the major health burden caused by tobacco smoking. At the same time, it was not claimed that vaping is risk-free or suitable for non-smokers.
For adult smokers, the complete replacement of tobacco cigarettes is especially decisive. Anyone who continues to smoke and additionally vapes remains in dual use and does not reduce smoke exposure to the same extent as with complete smoking cessation.
Today’s NHS communication remains in this line: nicotine vaping is less harmful than smoking and is one of the effective tools for smoking cessation, but it is not harmless. Children, young people and non-smokers should not vape.
For Vape.ch, this study is therefore most useful as part of a broader, neutral study overview: vaping can be relevant for adult smokers when switching, but it does not replace medical advice and should not be presented as a lifestyle product for non-smokers.
Canada: what does Health Canada say about vaping and smoking cessation?
Health Canada cautiously classifies nicotine vaping as a possible support for adult smokers. The authority writes that the science continues to develop, but that the evidence suggests nicotine vaping can help adults stop smoking.
The exact wording is important: Health Canada does not generally recommend vaping for everyone. The classification is mainly this: if approved smoking cessation methods have already been tried and someone continues to smoke, fully switching to nicotine vaping is less harmful than continuing to smoke.
At the same time, Health Canada clearly warns about risks. Nicotine vaping can be addictive, may contain harmful chemicals and is not intended for young people or people who do not smoke. It is therefore not a harmless lifestyle method.
For classification, this is also important: nicotine vaping products are not approved in Canada as official smoking cessation medicines. Canadian guidelines therefore tend to see e-cigarettes as an option in certain situations, not as the first standard recommendation for all smokers.
For Vape.ch, this information fits best into a neutral study overview: vaping can be relevant for adult smokers when fully replacing tobacco cigarettes, but it should not be presented as risk-free, medically guaranteed or suitable for non-smokers.
What was the Manila Declaration 2022?
The Manila Declaration 2022 was published in the context of the fifth Asia Harm Reduction Forum in Manila. It was supported by representatives of the tobacco harm reduction movement and called for lower-risk nicotine products such as e-cigarettes to be more strongly included in tobacco control policy.
In content, the declaration referred to the WHO Framework Convention on Tobacco Control and criticised that harm-reducing alternatives were, in the view of the signatories, given too little consideration. However, such declarations are not medical guidelines and are not a substitute for independent evidence reviews.
For classification, this is important: tobacco harm reduction is a controversial field. There are health bodies that classify a complete switch by adult smokers to vaping as less harmful than continuing to smoke. At the same time, WHO-oriented actors and tobacco control organisations warn about nicotine dependence, youth use, industry influence and insufficient long-term data.
For Vape.ch, this declaration should therefore not be used as a standalone advertising or evidence page. A more sensible approach is a sober classification within a larger study and smoking cessation page: vaping is not harmless, but for adult smokers fully replacing tobacco cigarettes it can have a different risk profile.
More vapers worldwide: what do current estimates say?
The Global State of Tobacco Harm Reduction estimated the global number of vapers for 2021 at around 82 million. In the newer 2024 analysis, the number for 2023 was estimated at around 114 million. These figures show that nicotine vaping has become much more visible internationally.
However, such figures should be classified carefully. From a harm reduction perspective, an increase is only positive if adult smokers fully switch from tobacco cigarettes to less harmful alternatives. An increase among young people or non-smokers, however, is not a positive signal.
Programmes such as the British “Swap to Stop” initiative have additionally shaped public discussion. In 2023, the British government announced that up to one million smokers would be supported with vape starter kits for smoking cessation. However, such programmes are linked to counselling, target groups and a smoking cessation context, not to general lifestyle consumption.
For Switzerland and for Vape.ch, a sober classification is therefore important: vaping is not intended for non-smokers, young people or pregnant women. For adult smokers, a full switch to e-cigarettes can have a different risk profile than continuing to smoke, but this should not be presented with trivialising advertising or blanket enthusiasm.
The statement “more vapers worldwide” is therefore not in itself an SEO-strong or medically relevant message. What matters is whether fewer people smoke, whether adults switch completely, and whether youth protection and product safety are observed.
Who is this information relevant for?
The evidence is mainly relevant for adults who already smoke and are looking for an alternative or support with smoking cessation.
It should not be understood as a recommendation for non-smokers to start. E-cigarettes are not suitable for young people, pregnant women, breastfeeding women or non-smokers.
What is important when stopping smoking?
1
The goal should be to fully replace tobacco cigarettes, not to use both permanently in parallel.
2
The right nicotine strength can help avoid relapses back to cigarettes.
3
A clear plan is more sensible than uncontrolled switching between smoking and vaping.
4
Medical advice should be sought for health questions, pregnancy or medication use.
5
In the long term, reducing nicotine strength can also be a goal, if this fits the individual situation.
What does this mean for consumers in Switzerland?
In Switzerland, e-cigarettes are regulated products. Since the Tobacco Products Act, requirements apply for youth protection, sale, advertising, labelling and product information. Adult smokers should therefore pay attention to reputable retailers, correct product information and suitable advice.
Conclusion
The current evidence suggests that nicotine e-cigarettes can help adult smokers stop smoking. However, the statement must be classified clearly: e-cigarettes are not risk-free lifestyle products, not a recommendation for non-smokers and not a guarantee of a nicotine-free everyday life.
For many adult smokers, however, fully switching away from tobacco cigarettes can be a relevant step.
Frequently asked questions
Do nicotine e-cigarettes help with smoking cessation?
The Cochrane review shows that nicotine e-cigarettes can help adult smokers stop smoking more often than nicotine replacement therapies or nicotine-free e-cigarettes.
What does Public Health England say about vaping and smoking cessation?
Public Health England classified vaping as a possible instrument for reducing the health burden caused by tobacco smoking. The decisive point remains the complete replacement of tobacco cigarettes.
What does Health Canada say about vaping?
Health Canada describes fully switching to nicotine vaping for adult smokers as less harmful than continuing to smoke, if other approved smoking cessation methods have already been tried and smoking continues.
What was the Manila Declaration 2022?
The Manila Declaration 2022 was a declaration from the context of the tobacco harm reduction movement. It is not a medical guideline, but should be classified as the position of a specific interest group.
Does more vaping worldwide automatically mean less smoking?
No. Rising vaping numbers are only positive if adult smokers fully move away from tobacco cigarettes. Vaping among young people or non-smokers is not a positive signal.
Are you automatically nicotine-free after switching?
No. Switching can help avoid tobacco cigarettes, but it does not automatically mean that nicotine dependence has ended.
Are e-cigarettes suitable for non-smokers?
No. E-cigarettes and nicotine products are not suitable for non-smokers, young people, pregnant women or breastfeeding women.
Sources and further information
University of Bern: Vapes help to stop smoking, but not necessarily stop using nicotine
GOV.UK / Public Health England: Vaping in England: 2021 evidence update summary
Health Canada: Vaping and quitting smoking
Global State of Tobacco Harm Reduction: Global State of THR 2024
Philippine News Agency: Group calls on gov't to support drive vs. tobacco
Swiss smoking cessation support: stopsmoking.ch
