A large systematic comparison of 50 international scientific studies makes it clear: The e-cigarette is the most effective means of smoking cessation
Every year over 8 million people die prematurely from the effects of smoking worldwide.

Quitting smoking in good time therefore lowers the risk of dying from lung cancer and other serious diseases. However, despite all the known dangers, many people find it difficult to quit smoking.

The potential for addiction to nicotine, in combination with the ubiquitous presence of smoking in many areas of society, means that only a small percentage of all attempts to quit are actually successful in the long term.

Therefore, more and more smokers hope to finally get rid of their unhealthy vice with the help of so-called nicotine replacement therapies such as nicotine chewing gums and patches or e-cigarettes.

However, despite increasing scientific evidence, there are still ambiguities with regard to the potential benefits and possible risks of these individual nicotine replacement therapies, which in an international comparison lead to different health policy strategies.

Different countries, different customs – what we Germans can learn from the British on the subject of (non-) smoking
While the health authorities and doctors in Great Britain, for example, have for years attested that vaping e-cigarettes compared to smoking conventional tobacco cigarettes have significantly lower health-damaging consequences and therefore officially recommend it for smoking cessation, there have been interest groups in Germany in the past that , citing the perceived lack of evidence of effectiveness and safety, cast doubts about the supportive effects and health benefits of the e-cigarette.

And as it turns out, these different national strategies have far-reaching consequences. Because while in the UK only 15% of the population smoke according to official statistics, in Germany 26% still regularly use the smoldering stick – according to a current ranking of the “Tobacco Control Scale”, Germany is in the last of 36 places in a European comparison.

Until the fog clears – as a large-scale meta-study tries to shed light on
An updated meta-study, which was carried out for the first time in 2014, compared a total of 50 scientific studies with a total of 12,430 test subjects to find out whether the use of e-cigarettes can actually effectively help people to quit smoking, and whether People who use e-cigarettes for this purpose are at risk of adverse health consequences.

A short spoiler first: This meta-study now seems to confirm the British health authorities in their approach and shows that smoking cessation with nicotine replacement products is actually more effective and that e-cigarettes in particular promise strong support in quitting smoking.

Before we present the central results of the comparative study, however, we would like to take a brief look at the conduct of the study and the further development context of this comparative study.

So what exactly was the Cochrane Review looking at? What was the aim of this study? And who is behind this investigation?

On the background, goals and actors of the “Cochrane Study”
The executive body of this study was the independent international research network Cochrane, which creates the basis for evidence-based health care through systematic reviews.

The primary aim of the study was a systematic comparison of previous scientific work, all of which dealt with the use of e-cigarettes in the context of quitting smoking, in order to check the effectiveness of e-cigarettes in comparison to other nicotine replacement therapies.

The aim was to determine how many people – with and without nicotine replacement therapy – managed to quit smoking for at least six months and whether there were people in whom the nicotine replacement therapy showed undesirable side effects.

For this purpose, primarily randomized controlled studies were examined, which validated the results of e-cigarettes and / or other nicotine replacement therapies with regard to their effectiveness in supporting smoking cessation, in a direct comparison with a control group that did not use these methods. In addition, studies were also examined in which all test subjects were supported by such therapies in their smoking cessation.

All studies on this topic published up to January 2020 were taken into account.

This was a total of 50 studies with 12,430 subjects. The studies took place in the USA (21 studies), Great Britain (9), Italy (7), Australia (2), New Zealand (2), Greece (2) and one study each in Belgium, Canada, Poland, South Korea, South Africa, Switzerland and Turkey.

In the studies, e-cigarettes – with and without nicotine – were compared with nicotine replacement therapies such as patches or chewing gum, with drugs for smoking cessation (varenicline), with psychotherapeutic support, and with smoking cessation without any support. Some studies also tested NRT and e-cigarette use together.

So what are the main results of this systematic and extensive review?

E-cigarettes are almost twice as effective as alternative nicotine replacement therapies
It has been shown that more people managed to quit smoking for at least six months when using nicotine replacement therapy than when they did not. E-cigarettes have been by far the most effective means of smoking cessation.

For people who received either no or only psychotherapeutic support, only 4 out of 100 people made it. In the forms of therapy that allowed the test person to continue to take in nicotine (chewing gum, plasters), there were already 6 people. The use of e-cigarettes, in turn, resulted in 10 out of 100 people being able to give up cigarettes for at least 6 months. This means that e-cigarettes are almost twice as effective in quitting smoking as other nicotine replacement therapies.

The most common undesirable effects reported with e-cigarettes were sore throat or mouth, headache, cough, and nausea. However, these initial habituation effects continuously decreased over time and then mostly disappeared completely.

The study’s authors expressed confidence that e-cigarettes with nicotine would help more people quit smoking than other nicotine replacement therapies.

In this regard, Jamie Hartmann-Boyce, lead author of the study, said:

“[There is] clearer evidence that electronic cigarettes containing nicotine can increase the chances of successfully quitting smoking compared to nicotine gum or nicotine patches. […] The scientific consensus is that e-cigarettes are much less harmful than traditional cigarettes, but they are not risk-free. “

Why the e-cigarette is the most effective means of quitting smoking and what it means for our health policy
The reason is literally on, or in, the hand. Because while nicotine chewing gums and patches only facilitate physical withdrawal from the cigarette by continuing to supply the person with nicotine, e-cigarettes manage to mimic the experience of cigarette smoking itself, so that behavior-related aspects can also be substituted.

For example, smokers who, despite all the known dangers, can or want to part with their daily routines and habits only with difficulty, can continue to do so through the e-cigarette with a significantly reduced health risk. Because the e-cigarette still enables a consumption and enjoyment experience that is comparable in many ways.

Thus, the great benefit that e-cigarettes undoubtedly emanate from e-cigarettes in the fight against the smoldering stick should now be communicated more intensively from the public side. It is important to drop prejudices in favor of facts and to use the advantages of the e-cigarette in order to counteract the great damage that smoking causes to our society more effectively.