TOPLINE:

The "Swap to Stop" scheme in England, which provided free electronic cigarette (e-cigarette) starter kits for smoking cessation, demonstrated a 4-week quit rate of 34.3% among recipients, with an estimated product cost per 4-week quit of £113.17.

METHODOLOGY:

• Researchers evaluated early data from the first 12 months of England's national Swap to Stop scheme from October 2023 to October 2024.
• The study analysed a sample of 115 expressions of interest (EOIs) submitted by local authorities out of 218 total submissions to receive e-cigarette starter kits alongside behavioural support to people aged 18 years or older who smoked.
• Outcomes measured included 4-week quit rates, the proposed delivery settings, the type and length of support, targeting of priority populations, and product cost per 4-week quit.
• Four-week quit rates were calculated using aggregate NHS England Digital Quarterly Returns data from April to September 2024 across 107 local authorities.
• The product cost per 4-week quit was estimated from the 4-week quit rates and product cost, with self-reported quits not necessarily carbon monoxide verified.

TAKEAWAY:

• Among 29,844 people who received a vape starter kit from April to September 2024, 10,227 achieved 4-week quits, yielding a quit rate of 34.3% (95% CI, 33.7%-34.8%); for those whose quit attempt was recorded by stop smoking services, the quit rate was 53.7% (95% CI, 53.0%-54.4%).
• Most EOIs (75.7%) proposed supplying kits via existing local government-funded stop smoking services, followed by physical healthcare settings (37.4%), with all services offering ongoing behavioural support and 30.4% also offering very brief advice.
• Thirty-two percentage of EOIs described specific services exclusively for certain populations, most commonly pregnant women (14.8%) and people experiencing deprivation (13.9%), and 60.0% of EOIs proposed "targeted" services accessible to all but prioritising specific groups.
• The average kit cost was £38.78 (standard error, 0.11), with a mode of £40.00, giving an estimated overall product cost per 4-week quit of £113.17, excluding additional costs incurred by service providers for delivery and behavioural support.

IN PRACTICE:

"Swap to Stop in England demonstrated significant variation in the types of services offering free vapes, yet the early quit rates and consequently the product-cost per quit, were comparable to those observed in similar schemes," the authors wrote.

"There is potential for further targeting of free vapes to priority groups, however, this should be accompanied by targeted support designed to overcome the lower quit rates often seen in these populations," they added.

SOURCE:

This study was led by Esther Moore, The University of Sheffield, Sheffield, England. It was published online on May 10, 2026, in Addiction.

LIMITATIONS:

The study was limited by its reliance on a sample of EOIs that oversampled early adopters and outlined intended service plans rather than actual clinical implementation. Furthermore, researchers could not assess recipient characteristics or determine whether vapes were used alongside cigarettes or other cessation aids. Finally, the economic evaluation lacked counterfactuals and excluded local delivery costs and long-term quit benefits from the financial data.

DISCLOSURES:

This project received funding through the National Institute for Health and Care Research Policy Research Unit in Addictions. The authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.