One in 20 are Dual Users

“Trends and patterns of dual use of combustible tobacco and e-cigarettes among adults in England: a population study, 2016-2024” was produced by Sarah Jackson, Sharon Cox, Lion Shahab, and Jamie Brown.

According to the research team, the increase in dual use was greatest among young adults, with nearly two thirds of 18- to 24-year-olds who smoked also vaping in 2024 compared to one in five in 2016.

The team also found that there had been a shift away from more frequent smoking to more frequent vaping, with the proportion smoking daily and vaping non-daily halving from 32% to 15%, while the proportion vaping daily and smoking non-daily more than doubled from 8% to 22% - good news for everyone concerned about reducing the harm posed by smoking.

Lead author Dr Sarah Jackson (UCL Institute of Epidemiology & 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.”

For the study, researchers used data from the Smoking Toolkit Study, an ongoing survey that interviews a different representative sample of adults in England each month. They looked at data collected between 2016 and 2024 from 128,588 adults (18 and over) in England.

The team found that dual users who mistakenly believed that e-cigarettes were as harmful as or more harmful than cigarettes were less likely to vape daily. This is important, the researchers said, as vaping daily is linked to successfully quitting smoking, while non-daily vaping is not, so misperception of harms may be preventing these dual users from reducing or quitting smoking.

Nearly half of dual users (44%) wrongly believed that e-cigarettes were equally harmful or more harmful than cigarettes

Senior author Professor Jamie Brown (UCL Institute of Epidemiology & Health Care) said: “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.”

Alizée Froguel, Cancer Research UK’s prevention policy manager, 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.”

The NHS advises that vaping can help people to quit smoking and that, while vaping is less harmful than smoking, people who do not smoke should not vape.

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Dave Cross

Journalist at POTV

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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.