e-Cigarettes have not been marketed as cessation aids (as doing so would have implications for US Food and Drug Administration regulation) but have been advocated for this purpose, and many smokers have purchased these products as a way to stop smoking. Despite anecdotal reports that suggest effectiveness, there is not good evidence to suggest that e-cigarettes are superior to traditional, US Food and Drug Administration-approved approaches to smoking cessation. As an extension of their previous nonrandomized pilot study, Caponnetto et al5 conducted a clinical study of electronic nicotine delivery system devices in cigarette smokers not intending to quit. The investigators randomized 300 subjects to one of three arms, then followed subjects for eight visits over 52 weeks to assess for a ≥ 50% reduction in smoking, abstinence, and adverse events. The groups were as follows: (1) 12 weeks of 7.2-mg nicotine e-cigarettes; (2) 6 weeks of 7.2-mg nicotine, followed by 6 weeks of 5.4-mg nicotine, e-cigarettes; and (3) 12 weeks of placebo e-cigarettes which looked like the nicotine-containing e-cigarettes but contained only the carrier liquid. Under the intention-to-treat analysis, there were no significant differences between the groups in terms of cessation rates or reduction in the number of cigarettes smoked at 52 weeks. Bullen et al6 conducted a pragmatic randomized controlled trial to assess the efficacy of e-cigarettes for smoking cessation compared with nicotine replacement therapy. Six hundred fifty-seven smokers desiring to quit were randomized to receive 16-mg e-cigarettes, 21-mg nicotine patches daily, or placebo e-cigarettes in a 4:4:1 ratio. Though at 1 month there was a significant difference in continuous abstinence favoring e-cigarettes (relative risk, 1.46; 95% CI, 1.04-2.04), this difference did not persist at 3 and 6 months. Given inadequate safety data and other concerns, and the lack of evidence of superior efficacy, we would be remiss in recommending e-cigarettes over other approaches to smoking cessation.