A new study led by UCL researchers and funded by Cancer Research UK has found that approximately one in five people who have stopped smoking for more than a year in England currently vape, equivalent to 2.2 million individuals. The study, published in the journal BMC Medicine, analyzed survey data collected between October 2013 and May 2024 from 54,251 adults (aged 18 and over) in England who reported having stopped smoking or tried to quit.
The increased prevalence of vaping among ex-smokers was largely driven by the growing use of e-cigarettes in attempts to quit smoking. However, the researchers also discovered a rise in vaping uptake among people who had already stopped smoking, with an estimated one in 10 ex-smokers who vape having quit smoking prior to 2011, when e-cigarettes started to become popular. Some of these smokers had quit for many years before taking up vaping.
Younger Age Groups and Heavy Drinkers Show Highest Vaping Prevalence
The study found that the increase in vaping prevalence was greatest among younger age groups, with more than half (59%) of 18-year-olds who quit smoking more than a year earlier reporting vaping in May 2024, compared to 11% of 65-year-olds. The increase was also larger among ex-smokers who drank heavily, with more than a third (35%) of the heaviest drinkers who stopped smoking more than a year earlier reporting vaping.
Among ex-smokers who quit smoking prior to 2011, the proportion who reported vaping increased from one in 250 (0.4%) in 2013 to one in 27 (3.7%) in May 2024, equivalent to 212,000 people. The largest increases in vaping within this group were also found among younger people and heavier drinkers.
Implications of Long-Term Vaping Remain Unclear
Lead author Dr. Sarah Jackson from the UCL Institute of Epidemiology & Health Care stated that while the general increase in vaping among ex-smokers aligns with expectations given the increasing use of e-cigarettes in quit attempts, it is concerning to see a rise in vaping among people who had previously abstained from nicotine for many years. She emphasized that if relapse to smoking would not have occurred otherwise, these individuals are exposing themselves to more risk than not smoking or vaping.
Senior author Professor Lion Shahab from the same institute noted that the implications of these findings are currently unclear. Long-term vaping may increase ex-smokers' relapse risk due to its behavioral similarity to smoking and through maintaining or reigniting nicotine addiction. Alternatively, it might reduce the risk of relapse by allowing people to satisfy nicotine cravings through e-cigarettes instead of seeking out harmful cigarettes. Further longitudinal studies are needed to assess which of these options is more likely.
