CATEGORY: DISEASE PREVENTION
Most people who try to quit smoking never sit across from a counselor. A British trial of 1,170 smokers asked what happens if you skip that step entirely: mail people an e-cigarette starter kit and let them get on with it. Six months later, 11.3% of the kit-only group had verifiably quit, compared with 6.4% of smokers who received only encouraging emails from the NHS stop-smoking program. Adding five phone calls to the kit nearly doubled the quit rate again, to 21.1%.1
Three Groups, Checked by Breath Test
Everyone in the trial smoked daily and wanted to stop. A computer split them three ways at random: automated supportive emails for a month, an e-cigarette starter kit sent by mail with phone instructions and nothing more, or the same kit plus five short calls, one on quit day and then weekly for four weeks. Quitting wasn’t taken on anyone’s word. It meant staying off cigarettes for months and passing a carbon monoxide breath test, and anyone who couldn’t be reached was counted as still smoking. Britain’s National Institute for Health and Care Research paid for the study, which appeared this week in NEJM Evidence.
The Gap Was Still There a Year Later
At twelve months, 16.8% of the kit-plus-calls group remained verifiably quit, against 9% with the kit alone and 5.4% with emails alone. Picture 100 smokers in each group. A year on, about five of the email group have stopped, nine of the kit group, and seventeen of those who also got the calls. Most successful quitters were still vaping at the one-year mark. The researchers note that vaping isn’t risk-free, though it carries a small fraction of smoking’s dangers. One wrinkle says a lot about real life: among the email-group members who did quit, more than two-thirds had gone out and bought e-cigarettes on their own.
What Earlier Trials Couldn’t Say
A landmark 2019 trial found e-cigarettes nearly twice as effective as nicotine-replacement therapy, patches and gum, at 18% versus 9.9% quit at one year, but everyone in it got weekly counseling.2 That left open whether the vaping itself was doing the work, or vaping plus a professional at your elbow. This trial answers it in two directions at once. The kit helped on its own, and the counseling still roughly doubled its effect. Support helps when people can get it. The kit works even when they can’t.
Key Takeaways
- Support made the biggest single difference: an e-cigarette kit with five phone calls got 21.1% of smokers to a verified quit at six months, versus 11.3% for the kit alone.
- The kit alone still beat encouraging emails, 11.3% to 6.4%, and the advantage held at a year.
- Quitting was confirmed with breath tests, and dropouts were counted as smokers, so these rates aren’t inflated by wishful self-report.
- Most people who quit were still using e-cigarettes a year in, a trade-off the researchers describe as far less risky than continuing to smoke.
References
- Myers Smith K, Przulj D, Pesola F, et al. E-Cigarettes with and without Behavioral Support for Smoking Cessation. NEJM Evidence. 2026;5(11):EVIDoa2600065. link
- Hajek P, Phillips-Waller A, Przulj D, et al. A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy. New England Journal of Medicine. 2019;380(7):629–637. link