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Introduction: New approaches to electronic cigarettes (e-cigarettes) as a form of nicotine replacement therapy (NRT) may reduce the rates of tobacco-related disease and mortality. Therefore, we investigated the effect of e-cigarettes on smoking cessation compared with nicotine gum., Methods: A total of 150 subjects were randomly assigned to 2 groups and each was allocated a 12-week supply of either e-cigarettes or nicotine gum. The continuous abstinence rate, 7-day point prevalence of abstinence, smoking reduction rate and amount, and tolerability were evaluated., Results: There were no statistically significant differences in the effectiveness-related parameters of smoking cessation, such as 9- to 12-week, 9- to 24-week, and 12- and 24-week point prevalence of abstinence, between the 2 groups. However, although the reduction in cigarette smoking was similar, the proportion of subjects who showed smoking reduction at 24 weeks was higher in the e-cigarette group than the nicotine gum group. In addition, adverse events were significantly less frequent in the e-cigarette group than in the nicotine gum group., Conclusions: In our study, the effect of e-cigarettes on smoking cessation was similar compared with that of nicotine gum, a well-documented NRT. In addition, e-cigarettes were well tolerated by the study population. Therefore, the use of e-cigarettes as an NRT may be considered for smoking-cessation purposes. A large-scale prospective randomized controlled trial is necessary to clarify our results., Competing Interests: Conflict of interest: none declared., (© Copyright 2019 by the American Board of Family Medicine.)