E-cigarettes can help adults quit smoking even without ongoing behavioural support, with a UK clinical trial finding that smokers given vaping products were 76% more likely to quit than those receiving automated stop-smoking messages alone.
The randomised controlled trial, led by researchers at Queen Mary University of London's Wolfson Institute of Population Health (WIPH) and published in NEJM Evidence, found that 11.3% of 1,170 adults offered e-cigarettes without additional support successfully stopped smoking for six months.
This compared with 6.4% of participants who received automated NHS stop-smoking messages.
The findings suggest that e-cigarettes can provide an effective quitting aid for smokers who cannot access specialist counselling or do not wish to participate in regular support sessions.
However, the study also highlighted the additional benefits of behavioural support, with 21.1% of participants offered e-cigarettes alongside counselling successfully quitting for six months.
The research was funded by the National Institute for Health and Care Research (NIHR) Health Technology Programme.
Previous research has established that e-cigarettes can help people stop smoking, but most clinical trials have provided vaping products alongside ongoing behavioural support. The latest study examined whether they could also be effective when offered without that additional intervention.
The researchers found that the benefits continued at 12 months. Sustained smoking quit rates were 16.8% among participants receiving e-cigarettes and counselling, 9% among those receiving e-cigarettes alone, and 5.4% among those receiving automated supportive messages.
Most participants who successfully quit smoking with e-cigarettes were still vaping a year later.
Counselling should remain accessible
Lead author Katie Myers-Smith said the findings demonstrated that specialist counselling should not be a prerequisite for smokers to receive e-cigarettes as a quitting aid.
“One of the most important findings is that smokers don’t necessarily need specialist counselling to benefit from e-cigarettes, but when counselling is available, it can make a difference,” she said.
The trial found that adding telephone support almost doubled the proportion of participants who successfully quit compared with offering e-cigarettes alone.
Myers-Smith said this suggested that counselling should be made as accessible as possible without becoming a condition of receiving help to stop smoking.
Hayden McRobbie, co-author of the study, said the findings had important implications for stop-smoking services.
“Not everyone who wants to quit smoking is able or willing to attend regular counselling sessions, and our results show that they can still benefit from simply being offered an e-cigarette,” he said.
“At the same time, the extra benefit we saw from telephone support still matters. Stop smoking services are still needed to make both effective quitting aids and the additional support available as widely as possible.”
The researchers said the results supported the government's Swap and Stop initiative, which provides free vaping starter packs to help smokers quit.
The initiative encourages participants to access behavioural support through UK stop-smoking services but does not make counselling mandatory.
Continued vaping and smoking relapse
The study also highlighted the importance of continued vaping for some people who have stopped smoking.
While vaping is not completely risk-free, the researchers said it poses only a small fraction of the risks associated with smoking.
They also noted that continued e-cigarette use could help protect former smokers against post-cessation weight gain, mood changes and relapse to smoking.
Senior author Peter Hajek said the trial added to the evidence supporting e-cigarettes as a smoking cessation tool.
“This trial adds to the strong evidence that e-cigarettes help people stop smoking, and clinicians can recommend them with confidence,” he said.
Hajek added that clinicians should explain to smokers that vaping is considerably less harmful than smoking and that former smokers could continue using e-cigarettes for as long as they needed to feel confident they would not return to cigarettes.