Only consider e‑cigarettes if you’ve already tried quitting; non‑smokers should avoid them

The device plus cartridges cost anywhere from a few dozen to several hundred yuan per month. In China, only tobacco‑flavored e‑cigarettes are legally sold, and only at stores holding a tobacco retail license.

This up‑to‑date review includes 80 randomized trials involving 29,861 participants. Compared with nicotine replacement therapy, e‑cigarettes raise the quit rate by about 61% (RR 1.61, 95% CI 1.23–2.12; high‑certainty evidence based on 11 trials with 4,114 participants). In absolute terms, that translates to roughly 4 extra quitters per 100 users (range: 1–7). The rate of serious adverse events is similar between groups (risk difference 0.01, 95% CI −0.01–0.02; moderate‑certainty evidence). Compared with behavioral support alone or no support at all, e‑cigarettes improve quit rates by about 75% (RR 1.75, 95% CI 1.39–2.20; low‑certainty evidence).

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；国家烟草专卖局 (2022). 电子烟管理办法（国家烟草专卖局公告 2022 年第 1 号，2022 年 5 月 1 日施行）第十八条：从事电子烟零售业务，要向烟草专卖行政主管部门申领烟草专卖零售许可证。第二十二条：「禁止向未成年人出售电子烟产品。」第二十三条第二款：「任何个人、法人或者其他组织不得通过本办法规定的电子烟交易管理平台以外的信息网络销售电子烟产品、雾化物和电子烟用烟碱等。」第二十六条：「禁止销售除烟草口味外的调味电子烟和可自行添加雾化物的电子烟。」. http://www.gov.cn/gongbao/content/2022/content_5697988.htm；World Health Organization (2023-12-14). Urgent action needed to protect children and prevent the uptake of e-cigarettes：「E-cigarettes as consumer products are not shown to be effective for quitting tobacco use at the population level」「it is not recommended that governments permit sale of e-cigarettes as consumer products in pursuit of a cessation objective」「Whilst long-term health effects are not fully understood」. https://www.who.int/news/item/14-12-2023-urgent-action-needed-to-protect-children-and-prevent-the-uptake-of-e-cigarettes；Department of Health and Social Care (2023-04-11). Smokers urged to swap cigarettes for vapes in world first scheme：「almost 1 in 5 of all smokers in England will be provided with a vape starter kit alongside behavioural support」. https://www.gov.uk/government/news/smokers-urged-to-swap-cigarettes-for-vapes-in-world-first-scheme；最高人民检察院 (2021). 江苏苏州吴江区：办案检察官揭秘披着潮流外衣的新型毒品：「这种“上头”电子烟内含有被国家整类列管的合成大麻素成分」. https://www.spp.gov.cn/spp/zdgz/202110/t20211011_531831.shtml

Controversy. In 2023, the World Health Organization stated that selling e-cigarettes as ordinary consumer products has not been shown to help people quit smoking at the population level. It does not recommend that governments liberalize e-cigarette sales for smoking cessation; if used, they should be regulated as medicine. It also stated that long-term health effects are not fully understood, expressing concern that children and young people may start smoking because of them. Conversely, starting in 2023, England has been providing starter e-cigarette kits along with smoking cessation counseling to approximately one million smokers. In China, there is no total ban on e-cigarette sales, but they are strictly regulated, with rules written in the "Measures for the Administration of E-cigarettes." Only tobacco-flavored products are permitted for sale; fruit-flavored products and those that allow users to add their own e-liquid are prohibited. They can only be purchased in physical stores that hold a tobacco monopoly retail license. Aside from the national unified e-cigarette transaction management platform, selling on other websites, online stores, and social media software is illegal. Sales to minors are also prohibited. Therefore, fruit-flavored e-cigarettes that are still available are moving through illegal channels and are outside of regulation. This is how "intoxicating e-cigarettes" laced with synthetic cannabinoids leak out; see Section 22, Item 4 (do not accept pods offered by others). The products tested in the review are all regulated nicotine-containing products; e-liquids of unknown origin are not included. In terms of sequence, try Item 3 of this section (smoking cessation medication) first; the evidence there is stronger and also cheaper.