Ho-ho-ho! Gather ’round, my merry friends, for I have a tale that’s quite the stocking stuffer for those curious about the world of electronic cigarettes, or ECs as they’re known in the bustling workshops of science. You see, there’s been quite the hustle and bustle to find out if these high-tech puffing gadgets can help the tobacco-smoking elves quit their habit and if they’re safe to use while they’re at it.

In the spirit of giving, researchers have updated their review, checking it twice, to see if ECs are naughty or nice. They’ve searched through the Cochrane Tobacco Addiction Group’s Specialized Register, all the way up to February 1, 2023, and other scholarly lists, to find studies that could help answer these burning questions.

They’ve included a sackful of 88 studies, with 10 fresh ones added to this update, involving 27,235 participants. Now, not all studies were as shiny as a new ornament; some were a bit more like tangled Christmas lights, but they still provided valuable insights.

With a jolly “Ho-ho-ho,” they found that nicotine ECs are more likely to help smokers quit than nicotine replacement therapy (NRT), with high certainty. It’s like finding a few more presents under the tree, with an additional four quitters per 100. And when it comes to adverse events, or AEs, those pesky little elves that can cause a ruckus, there seems to be no significant difference between the groups.

Serious adverse events, or SAEs, were as rare as a quiet night at the North Pole, and there wasn’t enough evidence to say if there’s a difference between the groups. But when comparing nicotine ECs to non-nicotine ones, it seems the former might lead to a few more successful quitters.

Now, when ECs were pitted against just a pat on the back or no support at all, the evidence suggested that nicotine ECs might just have the upper hand, though this finding was a bit like a snow globe—pretty to look at but a bit shaky.

The most common AEs reported were throat and mouth irritation, headaches, coughs, and nausea, but these tended to settle down, much like the excitement of Christmas Eve. And while the evidence for other outcomes was as limited as the daylight on a winter’s solstice, the researchers are committed to keeping this review as fresh as the season’s first snowfall, updating it whenever new evidence comes dashing through the snow.

So, in conclusion, my dear friends, there’s high-certainty evidence that ECs with nicotine can increase quit rates compared to NRT and moderate-certainty evidence they’re better than their non-nicotine counterparts. And while we don’t have a sleigh full of evidence on long-term safety just yet, the researchers will continue to work away, not quite like elves in a toy workshop, but with the same dedication to bring joy—or in this case, knowledge—to all the good folks out there. Keep your eyes peeled on the Cochrane Database of Systematic Reviews for the latest updates, faster than Rudolph on a clear Christmas night!