E-Cigarettes help smokers quit, even without specialist support

28 October 2026

The randomised controlled trial found that in 1170 adults given e-cigarettes without other support, 11.3% successfully quit smoking for six months. Compared with a control group who received automated NHS stop-smoking messages, in which 6.4% stopped smoking, the adults given e-cigarettes without support were 76% more likely to quit. The researchers also found that more than two-thirds of participants who successfully quit in the NHS supportive messages group were using e-cigarettes at six months.

Previous research has shown that e-cigarettes can help smokers quit, but most clinical trials have provided them alongside ongoing behavioural support. This work shows that e-cigarettes remain effective when specialist counselling is unavailable or unwanted. In this study, 21.1% of participants who received e-cigarettes alongside counselling successfully stopped smoking for six months.

The benefits were also evident at 12 months, with sustained quit rates of 16.8% among those receiving e-cigarettes and counselling, 9% among those receiving e-cigarettes alone, and 5.4% among those receiving supportive messages.

Most participants who successfully quit smoking with e-cigarettes were still vaping a year later. While vaping is not completely risk-free, it poses only a small fraction of risks of smoking, and can protect ex-smokers from post-cessation weight gain and mood changes, and from relapse back to smoking.

The findings strongly support the government Swap and Stop initiative, which provides free vaping starter packs to help smokers quit. The initiative encourages smokers to enlist with the UK stop-smoking services for behavioural support but does not make it mandatory. E-cigarettes help smokers quit, even without ongoing counselling, but behavioural support increases their efficacy further.

Lead author, Katie Myers-Smith, said: “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. In our trial, adding telephone support almost doubled the proportion of people who successfully quit. This suggests we shouldn’t make counselling a condition of receiving help to stop smoking, but we should make it easy as possible for people to access that extra support.”

Hayden McRobbie, co-author on the study, said: “These findings matter 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. 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.”

Senior author Peter Hajek said: “This trial adds to the strong evidence that e-cigarettes help people stop smoking, and clinicians can recommend them with confidence. Clinicians should also take the opportunity to explain that vaping is far less harmful than smoking, and that ex-smokers can keep using an e-cigarette for as long as they need to feel sure they won’t go back to smoking.”

Myers Smith K, Przulj D, Pesola F, Ladmore D, McRobbie HJ, Phillips-Waller A, McAlpine K, Ricketts W, Sasieni P, Parrott S, Li J, Bauld L, Dobbie F, Miller M, Hajek P. E-Cigarettes with and without Behavioral Support for Smoking Cessation. NEJM Evid. 2026 Nov;5(11):EVIDoa2600065. doi: 10.1056/EVIDoa2600065. Epub 2026 Oct 27. PMID: 42937426