Consider e-cigarettes only if other quitting attempts fail; nonsmokers should not start
Switching to nicotine e-cigarettes helped about 60% more people quit than nicotine replacement, with strong evidence for that result. E-cigarettes are not harmless, and long-term safety data remain unavailable. They offer no benefit to someone who does not already smoke.
What it takes
Devices and cartridges cost tens to hundreds of renminbi monthly in China. Only tobacco flavors can legally be sold, through retailers holding a tobacco retail license.
What you may gain
A living review included 80 randomized trials and 29,861 participants. Nicotine e-cigarettes improved cessation by about 61% versus nicotine replacement (RR 1.61, 95% CI 1.23–2.12; high certainty; 11 trials, 4,114 people). In absolute terms, about 4 extra people per 100 quit, with a range of 1–7. Serious adverse-event rates were similar: risk difference 0.01, 95% CI −0.01 to 0.02, moderate certainty. Compared with behavioral support alone or no support, cessation was 75% higher (RR 1.75, 95% CI 1.39–2.20; low certainty).
Context & considerations
Policy differs. WHO does not recommend e-cigarettes for cessation because of insufficient long-term safety data and the risk of introducing young people to nicotine; the UK includes them in cessation services. China regulates rather than entirely bans sales: tobacco flavors only, no fruit flavors or refillable products, and purchases through licensed physical retailers. Sales through other websites, online shops or social media outside the national trading platform are unlawful, as are sales to minors. Available fruit-flavored products therefore come through illegal, unregulated channels; synthetic-cannabinoid cartridges can circulate this way. See do not accept someone else's cartridge. The review tested regulated nicotine products, not unknown e-liquids. Try cessation medicines first; the source regards their evidence as stronger and their cost as lower.
Research & references
Lindson N, Livingstone-Banks J, Butler AR, et al. (2026). Electronic cigarettes for smoking cessation. Cochrane Database of Systematic Reviews, 8, CD010216. https://doi.org/10.1002/14651858.CD010216.pub11 ; State Tobacco Monopoly Administration of China (2022). Measures for the Administration of Electronic Cigarettes, Announcement No. 1 of 2022, effective May 1, 2022. Article 18 requires a tobacco retail license; Article 22 prohibits sales to minors; Article 23(2) prohibits online sales outside the designated e-cigarette trading platform; Article 26 prohibits non-tobacco flavors and products that users can refill themselves. http://www.gov.cn/gongbao/content/2022/content_5697988.htm