December 10, 2025

expert reaction to study of dual use of cigarettes and vapes

A study published in Nicotine & Tobacco Research looks at outcomes from dual use of cigarettes and vapes.

Prof Caitlin Notley, Professor of Addiction Sciences at University of East Anglia, said:

“This paper reports a secondary analysis of data collected as part of a large randomised controlled trial that assessed smoking cessation outcomes for people assigned to receive either NRT or nicotine containing e-cigarettes as smoking cessation aids.

“The analysis reported focuses specifically on people who did not quit smoking early in the trial, at 1 and 4 weeks, but were ‘dual using’, meaning they were both smoking and vaping. The findings are important because they show that dual use is associated with achieving long term smoking abstinence 12 months later.

“There has been legitimate concern that dual using may encourage people who smoke to continue smoking, but this study provides evidence for an alternative explanation – that dual using can help people to quit smoking.

“The study supports previous qualitative evidence that has suggested dual use as a potentially helpful behavioural approach to smoking cessation, which may work for people who prefer to make a gradual switch rather than abruptly stopping smoking.

“A further key practical finding from this observational study is that tobacco flavoured e-liquids were unpopular. Those starting vaping with tobacco flavour quickly switched to fruit flavours. This supports existing and emergent evidence that flavours are an important part of the sensory experience of vaping that may help people to switch fully from tobacco smoking to vaping.

“Full switching, i.e. stopping cigarette smoking completely, should be the long-term goal of smoking cessation support. This study provides useful evidence to help guide advice for people using vaping as a means of quitting smoking.”

Prof Linda Bauld, Bruce and John Usher Professor of Public Health, University of Edinburgh, said:

“This study suggests that replacing some cigarettes with another nicotine product is often a pathway to stopping smoking all together – something we also know from smokers who cut down while using nicotine replacement therapy.  Stopping smoking has well-established health benefits.

“It should be strongly emphasised that the study did not include pregnant smokers – a priority group for smoking cessation for whom these findings are not relevant and should not be used to inform clinical advice in pregnancy.”

‘Patterns of e-cigarette use and smoking cessation outcomes: Secondary analysis of a large RCT to inform clinical advice’ by Francesca Pesola et al. was published in Nicotine & Tobacco Research at 10am UK time on Wednesday 10 December. 

Declared interests

Caitlin Notley: “I am Editor in Chief of Nicotine & Tobacco Research.  I can confirm that I receive no funding from the tobacco, e-cigarette or any other industry. I have previously co-authored a scientific paper on another trial with the lead author of this paper.”

Linda Bauld “is Chief Social Policy Adviser to the Scottish Government, a part time secondment. This comment is provided in her academic role only – as Professor of Public Health at the University of Edinburgh.”