Vaping more effective at helping socially disadvantaged people quit smoking than NRT
- Alan Gor
- 1 day ago
- 2 min read
15 July 2025
Authors: Ryan J. Courtney, PhD https://orcid.org/0000-0003-1339-3221, Bridget C. Howard, BS Hons, Daniel Barker, PhD https://orcid.org/0000-0002-9707-4465, Dennis Petrie, PhD https://orcid.org/0000-0002-3882-2531, Ron Borland, PhD https://orcid.org/0000-0003-0059-178X, Anthony Shakeshaft, PhD https://orcid.org/0000-0002-5472-0930, Coral Gartner, PhD, Colin Mendelsohn, MBBS (Hons) https://orcid.org/0000-0001-9367-8870, Veronica C. Boland, PhD, Alexandra Henderson, MPH https://orcid.org/0000-0001-5471-8219, Robyn L. Richmond, PhD https://orcid.org/0000-0003-2897-4109, Piotr Tutka, MD, Felix Naughton, PhD https://orcid.org/0000-0001-9790-2796, Wayne Hall, PhD https://orcid.org/0000-0003-1984-0096, Nicholas Zwar, PhD https://orcid.org/0000-0001-6462-9121, Michael Farrell, MB https://orcid.org/0000-0001-7008-8130, Richard P. Mattick, PhD, and Hayden McRobbie, PhD
Background:
Vaporized nicotine products (VNPs) are more effective than nicotine replacement therapy (NRT) for smoking cessation in general populations, but their effectiveness among low socioeconomic groups is largely unknown.
Objective:
To examine whether VNPs are more effective than NRT for smoking cessation among people experiencing social disadvantage.
Design:
Two-group, open-label, randomized trial with blinded outcome ascertainment. (Australian New Zealand Clinical Trials Registry ACTRN12621000076875)
Setting:
Australia, between March 2021 and December 2022.
Participants:
1045 adults who smoked daily, were willing to quit smoking, and were receiving a government pension/allowance (proxy for social disadvantage).
Intervention:
Participants were randomly assigned (1:1) to either a free 8-week supply of NRT or VNPs, and all participants received text-message support.
Measurements:
The primary outcome was 6-month continuous smoking abstinence verified using a carbon monoxide breath test at 7-month follow-up. Analysis included randomly assigned participants in accordance with Russell Standard criteria and the intention-to-treat principle.
Results:
Among 1045 randomly assigned participants, 866 (82.9%) completed final follow-up. The verified 6-month continuous abstinence rate was 9.6% (50 of 523) in the NRT group and 28.4% (148 of 522) in the VNP group (posterior risk difference estimate, 18.7% [95% credible interval, 14.1% to 23.3%]; >99% posterior probability that VNP is superior). Self-reported adverse events occurred less frequently in the VNP group (355 events among 237 participants) compared with the NRT group (442 events among 278 participants; incident rate ratio, 0.75 [95% CI, 0.65 to 0.88]; P < 0.001).
Limitations:
Biochemical verification method tested short-term exposure to cigarette smoke.
Conclusion:
Findings indicate that VNPs were more effective than NRT 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.