Dual Use of Vapes and Cigarettes May Support Smoking Cessation, New Research Finds

Dual Use of Vapes and Cigarettes May Support

, New Research Finds

A recent study conducted by Queen Mary University of London is reshaping how public health experts view the simultaneous use of cigarettes and e-cigarettes, commonly referred to as “dual use.” Contrary to the belief that dual use undermines quitting efforts, the research suggests it can play a meaningful role in reducing harm and increasing the likelihood of quitting smoking over time.

The study was published in Nicotine & Tobacco Research and provides evidence that smokers who combine vaping with continued cigarette use after a failed quit attempt are more likely to stop smoking later compared with those who rely solely on cigarettes.

Study Background and Design

The research team analyzed data from a large, year-long randomized trial involving 886 adult smokers. The trial was funded by the National Institute for Health and Care Research (NIHR) and Cancer Research UK (CRUK). Participants were offered either e-cigarettes or traditional nicotine replacement therapy (NRT), such as patches or gum, to support smoking cessation.

Rather than focusing only on immediate quitting success, the study examined longer-term outcomes, including smoking reduction, toxic exposure, nicotine use patterns, and urges to smoke.

Dual Use and Long-Term Quitting Outcomes

One of the key findings was that smokers who continued smoking but also used e-cigarettes were significantly more likely to quit later. Dual users at one week were far more likely to be smoke-free by four weeks compared with smokers who did not vape. This trend extended over time, with dual users at four weeks and six months showing a much higher chance of achieving substantial reductions in cigarette consumption by one year.

Importantly, even those who did not quit completely showed meaningful benefits. Dual users smoked fewer cigarettes and had objectively lower intake of harmful chemicals associated with cigarette smoke, indicating real harm reduction rather than stalled progress.

Reduced Urges and Changing Nicotine Use

The study also found that e-cigarettes were more effective than NRT at controlling cravings. Participants who quit smoking but continued using e-cigarettes reported lower urges to smoke during the early weeks of their quit attempt compared with those using traditional nicotine replacement products.

Nicotine use patterns evolved over time as well. Most participants started vaping with higher nicotine strengths but gradually reduced their intake. By the end of one year, around 10 percent of vapers had transitioned to nicotine-free e-liquids, suggesting a natural tapering process.

Flavor Preferences and Their Impact

Flavor choice emerged as another important factor. Tobacco-flavored e-liquids were used less frequently and were linked to lower quit rates. In contrast, fruit and other non-tobacco flavors were more popular and appeared to support better long-term smoking cessation outcomes.

These findings suggest that flavor variety may play a functional role in helping smokers distance themselves from the taste and sensory cues of cigarettes.

Implications for Harm Reduction

According to lead author Dr. Francesca Pesola, while quitting smoking as soon as possible remains the ideal outcome, vaping can serve as a practical stepping stone for smokers who struggle with abrupt cessation. Gradual reduction, supported by e-cigarettes, may be a more realistic pathway for many individuals.

Co-lead author Dr. Peter Hajek emphasized that the results challenge the idea that dual use should be discouraged if immediate quitting does not occur. Instead, the data indicate that dual use can promote meaningful harm reduction and support eventual smoking cessation.

Public Health Relevance

With nearly 12 percent of adults in the UK still smoking, these findings provide valuable insights for smoking cessation strategies. Rather than viewing dual use as a failure, policymakers and healthcare providers may need to recognize its potential role as part of a broader, flexible approach to quitting smoking.

Overall, the study reinforces the idea that vaping, particularly when combined with gradual behavior change, can help smokers reduce harm and move closer to quitting altogether.