A new study reveals that an increasing number of adults in England are both smoking and vaping, a practice known as “dual use”. Researchers suggest this is often a stepping stone for smokers attempting to quit or reduce their habit.
The study, conducted by University College London (UCL), found that in 2016, around 3.5% of adults in England were dual users of cigarettes and vapes, a figure that rose to 5.2% in 2024. The research, which has been tracking smoking and vaping habits since 2016 through a series of questionnaires, has so far involved 128,588 adults in England as part of the Smoking Toolkit Study.
The latest analysis shows that the proportion of smokers who also vape remained relatively stable at about 19% until mid-2021 when disposable vapes became more popular. By April 2024, this figure had risen to 34%.
The most significant increase was among young adults, with nearly three out of five young smokers (59%) also vaping, up from 19.6% at the start of the study. The data suggests that dual use may be associated with a decrease in smoking and an increase in vaping.
Over time, the percentage of smokers who smoked daily and vaped occasionally dropped from 32% to 15%, while those vaping daily and smoking non-daily more than doubled from 8% to 22%, reports Surrey Live.
The uptick in younger smokers who vape more and smoke less compared to older adults might be driving the trend, according to researchers. However, the study authors expressed concern that “misconceptions” about vaping’s risks could be thwarting smokers’ efforts to quit.
They observed that daily vaping was predominant among dual users who perceived e-cigarettes to be as harmful or less harmful than traditional cigarettes, or were uncertain of the risks. “In England, vaping prevalence has increased rapidly among adults who smoke since 2021, which was when disposable e-cigarettes started to become popular,” noted the scholarly article in the journal Addiction.
“Since 2016, patterns of dual use have shifted away from more frequent smoking towards more frequent vaping. This may be the result of increasing prevalence of dual use among younger adults, who are more likely than older dual users to smoke non-daily and vape daily.”
Dr Sarah Jackson from UCL’s Institute of Epidemiology and Health Care, the lead researcher, commented: “Dual use of vapes and cigarettes is often a transitional state as people seek to quit smoking or reduce their smoking. Therefore, it is not necessarily bad for people’s health over the long term, if it helps people move away from smoking.”
Researchers discovered that individuals who both smoke and vape are increasingly favouring vaping over smoking. According to the study’s findings: “In our study, we found a shift in the behaviour of dual users away from more frequent smoking to more frequent vaping. This may be good news, as dual users can reduce the harm they are exposed to by vaping more and smoking less. However, it is important that people quit smoking completely to get the full health benefits.”
Notably, 44% of participants who both smoke and vape mistakenly believe that vaping is equally or more harmful than smoking.
Professor Jamie Brown, the study’s senior author, stressed the need for accurate information: “Accurate messaging about the relative harms of smoking and vaping is needed so that people can make informed decisions about the products they are using.”
Brown also highlighted the importance of government-backed media campaigns in achieving a smoke-free generation. Hazel Cheeseman, chief executive of Action on Smoking and Health (ASH), echoed this sentiment: “Action is needed to ensure all dual users fully switch. Too many believe vaping is as harmful as smoking and don’t understand that completely switching will protect their health.”
Cheeseman urged the government to continue investing in initiatives that encourage smokers to switch to vaping and to address misconceptions through targeted communications.
Alizee Froguel, the prevention policy manager at Cancer Research UK, which backed the study, remarked: “Tobacco causes around 160 cases of cancer every day in the UK. If you smoke, the best thing you can do for your health is to stop completely. Research shows that legal vapes are far less harmful than tobacco and can help people quit for good.”
She also stressed the necessity of controlling access to vaping products, stating: “While it’s important that they’re accessible to people trying to stop smoking, they shouldn’t fall into the hands of children or be used by people who have never smoked. To help end cancers caused by tobacco, the Government must provide sustained funding for stop smoking services.”