When Vaping Overtook Smoking in Great Britain: What This Could Mean for Harm Reduction

A notable shift has taken place in Great Britain's nicotine landscape. In a recent commentary published in the International Journal of Public Health, we discuss a milestone that would have seemed unlikely not long ago: in 2024, for the first time since national records began, more adults in Great Britain used e-cigarettes than smoked tobacco cigarettes. UK Office for National Statistics data showed that 10.0% of adults aged 16 years and over were current e-cigarette users, compared with 9.1% who smoked tobacco. This crossover occurred in the context of a long-term decline in smoking, which the same paper describes as falling from 20.2% in 2011 to 10.6% in 2024.

The key public health question is not simply whether nicotine use exists, but whether more people are moving away from the form of nicotine use that causes the greatest harm: combustible tobacco.

This matters because the key public health question is not simply whether nicotine use exists, but whether more people are moving away from the form of nicotine use that causes the greatest harm: combustible tobacco. Our paper does not claim that these observational trends prove causation. But it argues that the pattern is consistent with harm reduction operating alongside conventional tobacco control policies in reducing smoking at the population level.

Who is vaping, and why it matters.

A major part of the interpretation depends on who is vaping. The paper highlights that vaping in Great Britain is concentrated mainly among people with a smoking history. According to the commentary, 32.8% of current smokers also use e-cigarettes, equivalent to about 3.0% of all adults. It also cites Action on Smoking and Health data indicating that among e-cigarette users, about 55% are ex-smokers, 40% are dual users, and around 5% are never-smokers. ONS estimates further suggest that only 2.7% of never-smokers report vaping.

Taken together, these figures suggest that vaping is functioning primarily as a substitute for smoking rather than a large new source of nicotine uptake among people who would otherwise have remained nicotine-free.

Dual use: not always a failure.

The paper also stresses that dual use should not always be dismissed as failure. For some smokers, dual use may represent a transitional stage in a substitution pathway rather than a fixed endpoint. Biomarker studies discussed in the commentary show that adults who switch completely from smoking to electronic nicotine delivery systems can experience large reductions in exposure to harmful toxicants, while smoking reduction through dual use may still provide partial benefit compared with continued exclusive smoking. At the same time, the paper is careful not to overstate certainty: persistent dual use exists, and long-term outcomes still need further study.

The equity question.

Another important issue is equity. Smoking remains far more common in disadvantaged groups, with ONS data cited in the paper showing prevalence of 18.8% in routine and manual occupations compared with 6.5% in managerial and professional groups. If safer alternatives are accessible and acceptable to disadvantaged smokers, harm reduction could help narrow inequalities. But that outcome is not guaranteed. The benefits will depend on regulation, affordability, access, and whether policy is designed to support adult smokers without increasing youth uptake.

Tobacco control should remain focused on reducing smoking-related harm. If more smokers are switching away from combustible tobacco, that is not a side issue. It is a development public health should take seriously.

Regulation as a trade-off.

This is why the paper discusses the UK's June 2025 ban on disposable vapes as a genuine policy trade-off. Protecting young people matters. But regulation also needs to avoid making it harder for adult smokers to access products that may help them move away from cigarettes.

The broader message is simple: tobacco control should remain focused on reducing smoking-related harm. If more smokers are switching away from combustible tobacco, that is not a side issue. It is a development public health should take seriously.

Yusuff Adebayo Adebisi

Pharmacist and epidemiologist advancing equity-driven, policy-relevant public health research. PhD Researcher at the University of Glasgow. Director of Research at Global Health Focus.

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