Evaluating Vaping as a Smoking Cessation Tool: Insights from New Clinical Trial

A new clinical trial conducted by UNSW’s National Drug and Alcohol Research Centre (NDARC) has found nicotine vapes to be significantly more effective than traditional nicotine replacement therapies (NRT)—specifically gum and lozenges—for helping disadvantaged smokers quit.

The findings, published in the Annals of Internal Medicine, come as Australia continues to navigate a complex regulatory environment around vaping products and their role in smoking cessation.

Key Findings at a Glance

• Trial cohort: 1045 daily smokers on government pensions or allowances in the Sydney area.

• Intervention: Eight-week supply of either regulated nicotine vapes or NRT (gum/lozenges).

• Abstinence rate after seven months:

  • Vape group: 28.4%

  • NRT group: 9.6%

• 58% of those who quit cigarettes using vapes were still vaping at follow-up.

These results suggest that, particularly in socially disadvantaged populations, vaping may offer a more effective first-line approach to smoking cessation than some traditional forms of NRT.

Industry Experts: Vapes as a Tool, Not a Solution

While the data is compelling, experts urge a measured and individualised approach.

“Vapes are not a magic cure, but they are a promising treatment option that leads to higher quit rates than nicotine gum or lozenges for those experiencing social disadvantage,”
— Associate Professor Ryan Courtney, Lead Researcher

Dr. Hester Wilson, Chair of RACGP Specific Interests Addiction Medicine, highlighted that while regulated vapes are likely much less harmful than combustible tobacco, they still represent a form of nicotine dependency and must be managed accordingly:

“For GPs, this means applying the same principles we use for smoking cessation—supporting patients wherever they’re at, and helping them take progressive steps toward nicotine freedom.”

Dr. Wilson also raised questions about the study design, pointing out the absence of combined NRT protocols, such as patches paired with fast-acting products like gum or lozenges, which have been shown to improve quit rates in other settings.

Implications for Health Professionals and Policymakers

This study adds to the growing body of evidence that regulated nicotine vaping can play a legitimate role in smoking cessation, particularly for hard-to-reach or high-risk populations. However, it also underscores several critical considerations:

1. Vaping should be seen as a transitional aid, not a permanent solution. Ongoing support may be required to help patients eventually discontinue vaping.

2. Comprehensive cessation support remains key. The most effective interventions combine behavioural support with pharmacotherapy, whether that’s NRT or vaping products.

3. Regulation matters. The recent seizure of over $1 million in assets linked to illicit vape sales by the AFP highlights the continued need for a tightly controlled legal supply chain that prioritises safety, product quality, and access through appropriate medical channels.

4. Clinical guidance is evolving. The RACGP’s updated Supporting smoking and vaping cessation: A guide for health professionals reflects the growing complexity of nicotine cessation in a dual-smoking and vaping landscape.

Findings from the Trial

As smoking rates continue to decline across the general population, disadvantaged groups remain disproportionately affected. This trial demonstrates that regulated vaping products can offer a viable cessation pathway for these individuals, but also reinforces the need for nuanced, long-term support strategies within primary care.

For practitioners, the takeaway is clear: smoking and vaping cessation is not a one-size-fits-all process. Whether using NRT, vaping, or a combination approach, supporting patients means meeting them where they are—and helping them progress at a sustainable pace toward a nicotine-free future.

For access to clinical guidelines and tools, consult the RACGP’s smoking and vaping cessation resources.