The prevalence of tobacco smoking in the United States has declined to 14.0% but still exceeds 25% among high-risk subgroups.^1,2 Electronic cigarettes (e-cigarettes) are not approved by the Food and Drug Administration (FDA) for smoking cessation, but Americans trying to quit smoking use these products more frequently than FDA-approved cessation aids.³ Comparative-effectiveness trials are needed to learn whether smokers have a better chance of quitting with e-cigarettes. Previous trials have had methodologic shortcomings, used first-generation e-cigarettes, or did not assess long-term outcomes. Hajek et al.⁴ now report in the Journal the results of a multicenter, pragmatic, randomized trial of e-cigarettes, . . .