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Nicotine-containing e-cigarettes may help more people quit smoking than traditional nicotine replacement therapies, behavioral support, or attempting to quit without assistance, according to an updated review of 80 clinical trials involving nearly 30,000 participants.

The review included 29,861 participants and nine newly added trials. Researchers found that regulated nicotine e-cigarettes consistently improved smoking cessation rates compared with several established approaches. However, they emphasized that vaping is not risk-free and that more research is needed to understand its long-term effects.

Researchers found high-certainty evidence that nicotine e-cigarettes helped more people stop smoking than nicotine replacement therapy, including patches and gum. For every 100 people attempting to quit, e-cigarettes helped approximately four additional people succeed.

Compared with non-nicotine e-cigarettes, nicotine-containing devices resulted in about two additional successful quit attempts per 100 people. They also appeared more effective than receiving no support or behavioral assistance, although researchers expressed less confidence in those comparisons because of potential biases in the studies.

Dr. Jamie Hartmann-Boyce, a senior author of the review at the University of Massachusetts Amherst, said the findings reinforce regulated nicotine e-cigarettes as a viable option for people trying to quit traditional cigarettes.

The review found no evidence that using e-cigarettes to quit smoking increased serious adverse events. However, the researchers cautioned that the available evidence cannot establish that vaping is harmless, particularly over longer periods.

The findings specifically concern regulated, nicotine-containing e-cigarettes. Illicit devices and products containing other substances, including THC, may carry different risks.

Health authorities, including the World Health Organization, continue to warn about nicotine addiction and exposure to potentially harmful chemicals in e-cigarette aerosols. Concerns are particularly significant for young people who do not already smoke.

Dr. Nicola Lindson, the review’s lead author at the University of Oxford, noted that quitting smoking can require multiple attempts. Having several options available may help smokers find an approach that works for them.

The researchers recommend that people considering e-cigarettes to stop smoking consult healthcare professionals about suitable cessation strategies. They also advise purchasing only products approved by the relevant regulatory authority.

Although nicotine e-cigarettes may offer an advantage over conventional quitting methods, the ultimate goal remains moving away from both smoking and nicotine dependence. Further research will help clarify the long-term safety of vaping and the best ways to help users eventually quit nicotine altogether.