People are switching from vaping to cigarettes in an attempt to quit using e-cigarettes, surveys in the UK and New Zealand suggest, prompting warnings that public health messaging may be obscuring the much greater risks of combustible tobacco.
An Action on Smoking and Health (ASH)-commissioned survey in New Zealand found that 14% of 623 current smokers and 1,070 former smokers said they had used smoking to try to stop vaping. In a separate ASH survey of 940 UK adults, 19% said they had tried to quit vaping with cigarettes, making it the second most popular strategy reported.
Ben Youdan, director of ASH, described the findings in the New Zealand report as evidence of serious misinformation. “This is not just a trivial misunderstanding,” he said. “It’s misinformation to the point of significant harm. Public health needs to urgently get back on track with clear, honest communication.”
The findings do not indicate that cigarette smoking is broadly returning to its former levels. In the US, 9.1% of adults smoked cigarettes in 2025, compared with 42.4% in 1965, while about 7% used e-cigarettes.
Warnings over vaping and smoking messages
Michael Siegel, a professor of public health and community medicine at Tufts University School of Medicine, said the trend could reflect an overcorrection in the way the dangers of vaping have been communicated compared with those of smoking.
“This to me suggests that there’s a lot of youth who have been misled by the public statements and messages that have been sent by the public health community and especially anti-smoking groups,” he said. “Because there’s really no comparison. Smoking is orders of magnitude higher-risk than vaping.”
Smoking causes about 480,000 deaths in the US each year, or roughly one in five deaths, according to the Centers for Disease Control and Prevention. The main causes include lung cancer, chronic obstructive pulmonary disease, heart disease and stroke.
Vaping has been associated with increased risks of chronic obstructive pulmonary disease and asthma, but the number of deaths linked to vaping is lower. In February 2020, vaping was linked to 2,807 cases of lung injury and 68 deaths attributed to that injury.
Public health campaigns initially focused on the harms of e-cigarettes after they were introduced to the US market in 2006, with attention increasing following the launch of Juul in 2015. The products had largely been developed as a harm-reduction tool to help smokers move away from combustible tobacco.
As more young people gained access to e-cigarettes, the US Food and Drug Administration expanded its youth-focused Real Cost campaign to cover vaping. The agency said the campaign prevented more than 444,000 American young people from starting to use e-cigarettes between 2023 and 2024.
However, research published by UT Southwestern Medical Center in March 2026 found a sharp change in perceptions. Among 20,771 respondents, the proportion who considered e-cigarettes more harmful than cigarettes rose from 3% in 2012 to 30% in 2022, while the share viewing e-cigarettes as less harmful fell from 51% to 17%.
Smoking rates among young people
The shift in perceptions comes amid renewed visibility of cigarettes in popular culture, including paparazzi images of celebrities smoking and depictions in television programmes. But Siegel said the available data did not show that smoking was becoming more common among young people.
“The data doesn’t show it,” he said. “We’re not seeing any kind of uptake in youth smoking.”
The US National Youth Tobacco Survey found that current tobacco use among middle and high school students fell from 8.1% to 7.2% in the latest figures cited. E-cigarette use also declined, from 5.9% to 5.2%.
Siegel said his main concern was that people already addicted to nicotine might regard smoking and vaping as equally harmful. That could make cigarettes appear less risky and discourage some from trying to stop using nicotine altogether.
He argued that public health communications should state more clearly the difference in risk, while allowing e-cigarettes to seek approval as products that could help reduce the harms caused by smoking. “From a messaging point of view, I think we need to stop lying to kids,” he said. “I think that youth are sophisticated enough to be able to handle the truth.”
