Study: One in 20 adults in England use both cigarettes and vapes, with shift away from frequent smoking

Just over one in 20 adults in England both smoke and vape, according to a new study by UCL researchers.

The study, published in the journal Addiction and funded by Cancer Research UK, found that the proportion of people both smoking and vaping rose from 3.5 per cent (about one in 30) to 5.2 per cent (about one in 20) between 2016 and 2024, with a sharp rise from 2021, when disposable vapes first became popular.

The increase 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 research team also found that, among dual users, 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 per cent to 15 per cent, while the proportion vaping daily and smoking non-daily more than doubled from 8 per cent to 22 per cent.

This might be down to the increase in dual use among young adults, who are more frequent vapers and less frequent smokers than older adults, the researchers 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,” lead author Dr Sarah Jackson, of UCL Institute of Epidemiology & Health Care, said.

“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.”

Perceptions of harm

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 per cent) wrongly believed that e-cigarettes were equally harmful or more harmful than cigarettes.

“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,” senior author Professor Jamie Brown, of UCL Institute of Epidemiology & Health Care, said.

“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.”

Despite the recent increases in daily vaping and non-daily smoking, the most common pattern of dual use overall remained daily smoking and daily vaping, reported by 45 per cent of dual users in 2024. This pattern was more common among dual users who were older, less advantaged, mainly smoked hand-rolled cigarettes, and had stronger urges to smoke.

Non-daily smoking and daily vaping was more common among those who had been vaping for more than a year. This finding is consistent with the possibility that vaping, even outside of a formal quit attempt, may support people to transition away from smoking, the researchers said.