Two Million Former Smokers Now Vape in England, Study Reveals

About 2.2 million ex-smokers in England are now vaping, representing one in five people who have successfully quit smoking for over a year, according to a study led by researchers at University College London (UCL). The findings, published in BMC Medicine, shed light on the growing prevalence of vaping among former smokers and its implications for public health.

E-Cigarettes: A Key Tool in Quitting Smoking

The study analyzed data from the Smoking Toolkit Study, a large ongoing survey of adults in England. Between October 2013 and May 2024, researchers examined the smoking and vaping habits of 54,251 adults who had quit smoking or attempted to quit.

Lead author Dr. Sarah Jackson from UCL’s Institute of Epidemiology & Health Care highlighted the role of e-cigarettes in helping smokers quit.

“The increase in vaping among ex-smokers is in line with what we might expect, given the increasing use of e-cigarettes in quit attempts,” Jackson said. NHS guidance supports the gradual reduction of vaping after quitting smoking to minimize the risk of relapse.

Notably, the study found that e-cigarettes were used in 41% of quit attempts in 2024, up from 27% in 2013, reflecting the growing reliance on vaping as a cessation tool.

A Rise in Vaping Among Long-Term Ex-Smokers

The study also revealed a rise in vaping among people who had quit smoking long before e-cigarettes gained popularity. Among those who stopped smoking prior to 2011, the proportion of vapers increased from 0.4% in 2013 to 3.7% in 2024—equivalent to 212,000 individuals.

Senior author Professor Lion Shahab raised concerns about this trend.

“For those who might otherwise have relapsed to smoking, vaping is the much less harmful option,” Shahab said. “But if relapse would not have occurred, these individuals are exposing themselves to more risk than not smoking or vaping at all.”

Key Findings: Who Is Vaping?

The increase in vaping prevalence is not uniform across demographics. The study found notable differences by age and lifestyle factors:

• Age Groups: Younger ex-smokers are vaping more than older ones. By May 2024, 59% of 18-year-olds who had quit smoking more than a year earlier were vaping, compared to just 11% of 65-year-olds.
• Heavy Drinkers: Among the heaviest drinkers who quit smoking, 35% reported vaping in 2024, compared to lower prevalence among moderate drinkers.
• Long-Term Quitters: In the group that quit smoking before 2011, 10% of 35-year-olds were vaping, compared to only 3% of 65-year-olds.

These trends suggest that vaping uptake is influenced by both social and behavioral factors.

The Role of Disposable E-Cigarettes

The rise in vaping prevalence has been particularly sharp since 2021, coinciding with the popularity of disposable e-cigarettes. By 2024, one in five ex-smokers who quit more than a year earlier were vaping, a figure that had remained stable before this surge.

Uncertain Implications for Relapse Risk

The long-term impact of vaping on relapse rates among ex-smokers remains unclear.

“Vaping long term may increase ex-smokers’ relapse risk due to its behavioral similarity to smoking and through maintaining—or reigniting—nicotine addiction,” Shahab explained. Alternatively, vaping could reduce relapse risk by offering a less harmful way to satisfy nicotine cravings.

Further studies are needed to determine whether vaping prolongs dependence or provides a protective buffer against smoking.

Balancing Harm Reduction and New Risks

The study underscores the dual nature of vaping’s role in public health: while it remains a key tool in smoking cessation, its use among long-term ex-smokers raises questions about the potential risks of sustained nicotine use.

As vaping continues to gain popularity, especially among younger people and heavy drinkers, understanding its long-term implications will be critical for shaping future health policies.