A groundbreaking study from University College London (UCL) has revealed that one in five individuals in England who have successfully quit smoking for a year or more now use e-cigarettes.
Published in BMC Medicine and funded by Cancer Research UK, the research underscores the significant role vaping plays in supporting long-term smoking cessation and preventing relapse.
The study analysed data from over 54,000 adults in England, collected between 2013 and 2024, focusing on individuals who had either quit smoking or attempted to do so.
Findings indicate that the rise in e-cigarette use is closely tied to the growing adoption of vaping as a quitting aid.
While the NHS advises against rushing to stop vaping immediately after quitting smoking, it highlights the importance of gradually reducing usage to lower the risk of relapse.
Dr Sarah Jackson, the study’s lead author from UCL’s Institute of Epidemiology and Health Care, noted that the increase in vaping among ex-smokers aligns with its growing use as a cessation tool.
Previous studies have demonstrated that many individuals who quit smoking with the help of e-cigarettes continue to vape long after their initial quit attempt.
Dr Jackson emphasised that while long-term vaping may pose some risks, it remains a far safer alternative to returning to smoking.
She said: “The general increase in vaping among ex-smokers is in line with what we might expect, given the increasing use of e-cigarettes in quit attempts.
NHS guidance is that people should not rush to stop vaping after quitting smoking, but to reduce gradually to minimise the risk of relapse.
“Previous studies have shown that a substantial proportion of people who quit smoking with the support of an ecigarette continue to vape for many months or years after their successful quit attempt.”
“However, it is a concern to see an increase in vaping among people who had previously abstained from nicotine for many years.
“If people in this group might otherwise have relapsed to smoking, vaping is the much less harmful option, but if relapse would not have occurred, they are exposing themselves to more risk than not smoking or vaping.”
The study also identified distinct patterns among ex-smokers who vape. Younger age groups and heavier drinkers were more likely to take up vaping.
For instance, 59 percent of 18-year-olds who had quit smoking over a year earlier reported vaping, compared to just 11 percent of those aged 65 or older.
Similarly, 35 percent of heavy drinkers who had quit smoking more than a year ago now vape. These findings suggest that vaping serves as a crucial alternative for groups particularly at risk of smoking relapse.
Among individuals who quit smoking before 2011, when e-cigarettes first gained popularity, the prevalence of vaping has risen significantly.
In 2013, only 0.4 percent of this group reported vaping, but by 2024, this figure had increased to 3.7 percent—equating to around 212,000 people.
For these long-term quitters, vaping offers a less harmful way to manage nicotine cravings or satisfy behavioural habits associated with smoking.
Professor Lion Shahab, a senior author of the study, highlighted the ongoing debate about vaping’s long-term impact on relapse risk.
While some argue that the behavioural similarities between vaping and smoking could maintain nicotine dependency, others contend that vaping reduces relapse risk by offering a less harmful alternative to cigarettes.
Further research is needed to determine which outcome is more prevalent.
As the debate continues, the study reinforces the importance of vaping as a harm-reduction tool, offering hope to millions of ex-smokers seeking to avoid relapse while minimising health risks.
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