New Research Confirms: Dual Use of Cigarettes and Vapes Reduces Harm and Helps Smokers Quit

For years, opponents of vaping have warned that “dual use”—smokers using cigarettes and e-cigarettes at the same time—offers no benefit and may even delay quitting. But a major new study from Queen Mary University of London has delivered a clear message: dual use is not a failure. It’s often a meaningful step toward quitting smoking and reducing toxic exposure. 

Published in Nicotine & Tobacco Research, the study tracked 886 adult smokers over the course of one year, offering participants either e-cigarettes or traditional nicotine replacement therapies (NRTs) as part of a structured quit attempt. What the researchers found directly contradicts long-standing misconceptions about vaping and quitting. 

 

Dual Users Were More Likely to Quit—At 4 Weeks and at 1 Year 

Smokers who started using an e-cigarette, even if they continued smoking initially, were: 

• More likely to quit smoking at 4 weeks 
• More likely to remain smoke-free at one year 
• Far more likely to significantly cut back on smoking, even if they did not fully quit 

In contrast, smokers who attempted to quit but did not vape showed lower quit rates and higher chemical exposure. 

Dual use, the researchers conclude, is not evidence of failure—it’s a harm reduction pathway. 

 

Reduced Intake of Harmful Chemicals 

 

One of the most important findings: smokers who vaped while continuing to smoke had substantially lower levels of toxic chemicals associated with cigarette smoke. 

These reductions were objectively measured, adding strong credibility to the harm-reduction benefits of switching—even partially—to vapor products. 

As lead author Dr. Francesca Pesola explains: 

“For those who find it difficult to stop smoking abruptly, vaping can help with doing it gradually over time.” 

This counters the long-held fear that dual use “locks people in” to smoking. In reality, dual users move toward quitting—not away from it. 

 

Expert Commentary: Dual Use Should Not Be Discouraged 

 

Co-author Dr. Peter Hajek, a widely respected figure in smoking-cessation research, addressed common concerns head-on: 

“Some believe smokers should stop using e-cigarettes if they don’t quit smoking immediately. These results show the opposite—dual use promotes genuine harm reduction and can be an important step toward stopping smoking altogether.” 

This is a powerful message for clinicians, public health leaders, policymakers, and retailers who often misunderstand how smokers transition away from cigarettes. 

 

Three Additional Insights From the Study 

 

1. Vaping Reduced Cravings Better Than NRT 

Participants using e-cigarettes reported lower urges to smoke than those using nicotine patches, gum, or lozenges. This helps explain why vaping consistently outperforms NRT in quit-smoking trials. 

2. Most Users Reduced Nicotine Strength Over Time 

A strong majority began with higher nicotine levels and gradually stepped down. 
After one year: 

• ~10% were using nicotine-free e-liquids 
• Many others had moved to lower strengths 

This progression demonstrates that vaping can support a self-paced, gradual reduction in nicotine dependence—a fact rarely acknowledged in policy discussions. 

3. Tobacco Flavors Were the Least Effective 

Although all participants were initially provided tobacco flavor: 

• Most switched to fruit and other non-tobacco flavors quickly 
• Those who stayed on tobacco flavor were less likely to remain smoke-free at one year 

This reinforces what consumers already know: flavors matter, and non-tobacco flavors play a critical role in helping adult smokers move away from cigarettes. 

 

Why This Matters for Public Health 

 

With just 11.9% of UK adults still smoking, continued progress requires accurate messaging and evidence-based strategies. This study adds to a growing body of science showing: 

• Vaping is an effective quitting tool 
• Dual use can be part of the quitting process—not a barrier 
• Harm can be reduced long before smokers fully stop 
• Flavors and nicotine strengths play important roles in transitioning away from cigarettes 

Public health communications that dismiss dual use—or discourage smokers who haven’t quit immediately—risk undermining successful quit attempts. 

 

Final Takeaway 

 

This study shows that, for many smokers, dual use may not be a dead-end—it may serve as a bridge toward long-term smoking cessation. 

As the science continues to evolve, it’s essential that policymakers, clinicians, and quit-smoking services align their messaging with evidence—not misc