Continuing use of e-cigarettes after stopping smoking and relapse: Secondary analysis of a large randomised controlled trial

Peter Hajek, Dunja Przulj, Katie Myers Smith, Jinshuo Li, Peter Sasieni, Louise Ross, Hayden McRobbie, Maciej Goniewicz, Francesca Pesola

This secondary analysis of a large UK randomised controlled trial explored whether continued use of e-cigarettes after quitting smoking influences relapse rates. Researchers followed 886 participants who had successfully stopped smoking using either e-cigarettes or nicotine replacement therapy (NRT).

The study found that people who continued to use e-cigarettes after quitting were significantly less likely to relapse to smoking at 12 months than those who used NRT or stopped using all nicotine products. These findings support the role of e-cigarettes not only as an effective quitting aid, but also as a harm-reduction tool that can help former smokers maintain long-term abstinence from combustible tobacco.

Why this matters: Relapse remains one of the biggest challenges in smoking cessation. Evidence that ongoing e-cigarette use can reduce relapse risk reinforces the importance of allowing adults who quit smoking to continue using lower-risk nicotine alternatives without unnecessary barriers.

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