One in 20 adults in England smoke and vape – study

A rising proportion of adults in England both smoke and vape, according to a new study.

Researchers said that so-called “dual use” is often a “transitional state” when smokers are trying to quit smoking or cut down on their use.

A new study by experts from University College London (UCL) found that in 2016, some 3.5% of adults in England were dual users of both cigarettes and vapes.

This rose to 5.2% in 2024, they found.

Researchers have been performing a series of questionnaires since 2016 to track smoking and vaping habits in the population.

So far some 128,588 adults in England have taken part in the Smoking Toolkit Study.

The latest analysis highlights how the proportion of smokers who also vaped was “relatively stable” – at around 19% – until mid-2021 when disposable vapes saw a bump in popularity.

In April 2024, this figure stood at 34%, they found.

The greatest rise was in young adults, with almost three in five (59%) of young smokers also vaping – a leap from 19.6% at the start of the study.

The findings suggest that dual use may be linked to some people smoking less and vaping more.

Over time the proportion of smokers who smoked daily and vaped occasionally halved from 32% to 15%, while the proportion vaping daily and smoking non-daily more than doubled from 8% to 22%.

This may be down to dual use among younger smokers who are more frequent vapers and less frequent smokers than older adults, the researchers said.

Nonetheless, the research team raised concerns that “misconceptions” around the harms of vapes may be hampering smokers’ attempts to quit.

They found that daily vaping was more common among dual users who thought e-cigarettes were less/equally harmful as cigarettes, or were unsure.

“In England, vaping prevalence has increased rapidly among adults who smoke since 2021, which was when disposable e-cigarettes started to become popular,” the authors wrote 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.”

Lead author Dr Sarah Jackson, from UCL’s Institute of Epidemiology and Health Care, said: “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.

“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.”

Some 44% of dual users said they they believed that vapes were equally harmful or more harmful than cigarettes.

Senior author Professor Jamie Brown added: “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.

“Mass media campaigns should play a key role in this. Government investment in campaigns is critical to realising the potential of the smoke-free generation policy.”

Hazel Cheeseman, chief executive of the charity Action on Smoking and Health (ASH), said: “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.

“Government should maintain investment in swap-to-stop scheme for vapes and counter these misperceptions through targeted communications.”

Alizee Froguel, prevention policy manager at Cancer Research UK, which funded the study, said: “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.

“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.”