Vaping helps smokers quit – but there are risks to young people

Yet a review by RCPCH raises concerns about how vaping effects children and young people, worsening respiratory health, and increasing subsequent cigarette smoking

Vaping can help people give up smoking, but new evidence of its impact on children and young people is strengthening concerns about the health risks of nicotine e-cigarettes.

An updated Cochrane review of 80 randomised controlled trials involving 29,861 people found high-certainty evidence that nicotine e-cigarettes result in higher quit rates than nicotine replacement therapy (NRT), such as patches and gum. For every 100 people using them, around four more successfully quit than those using NRT. 

The review also found higher cessation rates among people using nicotine e-cigarettes compared with non-nicotine e-cigarettes, while rates were also higher when e-cigarettes were used alongside behavioural support or no support, although this evidence was less certain.

“We have very strong evidence that regulated nicotine e-cigarettes are substantially less harmful than smoking,” said Dr Jamie Hartmann-Boyce, senior author of the review, University of Massachusetts Amherst. “Based on the consistency of the findings here, it’s clear that they are a proven and viable option for people wishing to quit traditional cigarettes.” 

The findings apply specifically to regulated, nicotine-containing e-cigarettes, with the researchers stressing that longer-term studies are still needed. Dr Nicola Lindson, lead author of the review, based at the University of Oxford, said, “Although nicotine vapes are unlikely to be completely risk free, they are less harmful than smoking and that is the most important comparison to make for people who are still smoking.” 

However, a separate review by the Royal College of Paediatrics and Child Health (RCPCH) has highlighted concerns about the impact of vaping on children and young people. The RCPCH review examined more than 14,000 published articles, assessed 325 full-text studies and synthesised evidence from 81 studies across eight health and social domains. It found consistent evidence linking vaping among young people with poorer respiratory health, including cough, wheeze, bronchitis symptoms and asthma exacerbations.

“The evidence shows clear links [between vaping and] respiratory symptoms, nicotine dependence and subsequent cigarette smoking…”

Longer-term studies also provided strong evidence that young people who vape are significantly more likely to subsequently smoke cigarettes. The review identified further associations with oral and dental health and poorer mental health outcomes, while evidence is emerging around possible effects on sleep, eye health, allergies and infants exposed to nicotine during pregnancy.

“Vaping should not be seen as a harmless part of growing up,” said Professor Will Carroll, co-author of the RCPCH review. “The evidence shows clear links with respiratory symptoms, nicotine dependence and subsequent cigarette smoking, while concerns about wider impacts on young people’s health continue to grow.” 

Figures from ASH Smokefree survey data in 2026 show that 10% of adults in Great Britain aged 18+ vape (an estimated 5.5 million people), which is unchanged from last year, while

11% of adults aged 18+ smoke, a fall from 13%, a decrease from the steady rate of 13% recorded between 2021 and 2025. Among adults who currently vape, 60% used to smoke but have now given up (3.3 million people). 

The RCPCH said recent measures to restrict the appeal of vapes to children were welcome but called for tighter controls on flavours as well as flavour names and packaging. 

The contrasting findings underline the distinction between vaping as a harm-reduction tool for adults who already smoke and its use among children and young people. The Cochrane evidence suggests regulated nicotine e-cigarettes can help smokers move away from tobacco, while the RCPCH findings point to potential harms when vaping becomes established among a new generation of nicotine users.