E-cigarettes are used by some people trying to quit smoking, but to date there has not been a robust study to compare the efficacy of this approach to the utility of nicotine replacement products as smoking-cessation treatments. In a head to head trial, subjects were randomly assigned to support with nicotine-replacement products of their choice, including product combinations, provided for up to 3 months, or an e-cigarette starter pack (a second-generation refillable e-cigarette with one bottle of nicotine e-liquid [18 mg per milliliter]), with a recommendation to purchase further e-liquids of the flavor and strength of their choice. Participants were also offered weekly behavioral support for at least 4 weeks. The primary outcome was sustained abstinence for 1 year (validated biochemically at the end point). Secondary outcomes included participant-reported treatment usage and respiratory symptoms. The 1-year abstinence rate was 18.0% in the e-cigarette group,  and 9.9% in the nicotine-replacement group (relative risk, 1.83; 95% confidence interval [CI], 1.30 to 2.58; P<0.001). However, amongst those achieving abstinence for one year, people using e-cigarettes were more likely to be using their assigned product after 52 weeks (80% [63 of 79 participants] vs. 9% [4 of 44 participants]). Throat/mouth irritation was more common amongst those using e-cigarettes, whereas nausea was more frequently encountered for those using NRT. The e-cigarette group reported greater declines in the incidence of cough and phlegm production from baseline to 52 weeks than did the nicotine-replacement group (relative risk for cough, 0.8; 95% CI, 0.6 to 0.9; relative risk for phlegm, 0.7; 95% CI, 0.6 to 0.9). There were no significant between-group differences in the incidence of wheezing or shortness of breath. The study was independently funded by the National Institute for Health Research and Cancer Research in the UK. More details can be viewed here