Individual-level effectiveness of vaping and other SNPs for smoking cessation

At the individual level, evidence indicates that some SNPs, particularly vaping products, can be effective tools for helping people who smoke to quit combustible cigarettes. Randomised controlled trials and longitudinal observational studies from high-income settings consistently show that vaping performs at least as well as, and often better than, traditional nicotine replacement therapy (NRT) for smoking cessation among adults who smoke [^1], [^2].

Clinical trials comparing vaping with NRT have found higher quit rates among participants assigned to vaping, especially when products are used with behavioural support. Importantly, vaping appears to be particularly effective for people who smoke who have previously failed with abstinence-only or pharmacotherapy-based approaches, suggesting that product acceptability, sensory substitution, and behavioural reinforcement play a role alongside nicotine delivery.

While most trial evidence comes from high-income countries, the mechanisms underlying effectiveness, nicotine delivery without combustion, user satisfaction, and the ability to substitute smoking rituals, are not context-specific. This has important implications for LMICs, where access to cessation clinics and medications is often scarce. In such settings, SNPs may function not as a second-line option, but as a primary, pragmatic cessation pathway for people who smoke who would otherwise continue smoking.

It is important to note that non-combustible oral nicotine products, such as snus and modern nicotine pouches, are likely to carry even lower health risks than vaping, with risk profiles broadly comparable to licensed NRT [^3]. However, evidence for their direct use as cessation tools varies by context and cultural acceptability. Their greatest contribution may be in displacing smoking entirely, rather than in formal quit attempts.