Vaping is more effective for smoking cessation than nicotine gum and lozenges

Findings from a randomized controlled trial suggest that vaporized nicotine products (vapes) are more effective than nicotine replacement therapies for smoking cessation in a low socioeconomic status population.

The study appeared on July 14, 2025 in the Annals of Internal Medicine.

The authors said, “Findings indicate that VNPs [vaporized nicotine products] were more effective than NRT [nicotine replacement therapies] for smoking cessation in this population. Given the challenges for cessation among these socially disadvantaged populations, VNPs present a promising treatment option for this priority group.”

The study was a two-group, open-label, randomized trial conducted in Australia between March 2021 and December 2022.

The investigators enrolled 1045 adults who smoked daily, who were willing to quit smoking, and who were receiving a government pension/allowance (proxy for social disadvantage).

They randomized the subjects (1:1) to receive either a free 8-week supply of nicotine replacement therapy or an 8-week supply of vaporized nicotine products.

The nicotine replacement therapy group had the choice of receiving either nicotine gum or lozenges.

The vaporized nicotine products group received an 8-week supply of nicotine e-liquid to use in either a tank device or a pod device. Subjects using vaporized nicotine products could receive the e-liquid in tobacco, menthol, and fruit flavors.

All subjects received behavioral support via automated text messages for five weeks

The primary outcome of the study was 6-month continuous smoking abstinence verified by a carbon monoxide breath test at 7-month follow-up.

The verified 6-month continuous abstinence rate was 9.6% (50 of 523) in the nicotine replacement therapy group and 28.4% (148 of 522) in the vaporized nicotine products group.

Self-reported adverse events occurred less frequently in the vaporized nicotine products group (355 events among 237 subjects) compared with the nicotine replacement therapy group (442 events among 278 subjects.)

“The results suggest VNPs [vaporized nicotine products] may have a role in promoting smoking abstinence among groups experiencing socioeconomic disadvantage, as well as the general population,” the authors said.