Dual smokers are those who run the most risks

Dual smokers are people who use two nicotine products simultaneously, usually traditional cigarettes and e-cigarettes (vapes), or traditional cigarettes and heated tobacco.

This category is rapidly increasing, and unfortunately it is also the one that runs the greatest health risks, as they do not simply add together (through double use), but multiply.

Scientific studies indicate a few things:

1. Combined exposure to toxins
   • Traditional cigarettes contain thousands of toxic substances, some of which are carcinogenic.
   • E-cigarettes contain irritants and, in some cases, heavy metals.
   • Anyone who uses both is exposed to a broader mix of harmful substances, not necessarily in higher quantities of nicotine, but with cumulative effects.
2. Difficulty quitting
   • Some studies show that dual smokers have more difficulty quitting than those who use only one of the two products.
   • The illusion that vaping is “safe” can lead to continued smoking traditional cigarettes, increasing the overall risk.
   In particular, a 2022 study titled  Patterns of dual use of cigarettes and e-cigarettes and cessation outcomes in US adults: Findings from the PATH Study shows that adults who use both traditional cigarettes and e-cigarettes (dual users) have a significantly lower likelihood of quitting smoking within 12 months compared to those who only smoke cigarettes.
3. Cardiovascular and pulmonary risk
   • The data is still evolving, but early research indicates that dual smokers show more marked signs of cardiovascular stress and lung damage compared to exclusive cigarette or vape smokers.
4. Compensatory behavior
   • Some dual users smoke more heavily when using a cigarette, because they feel “already partially replaced” by the vape, increasing the cumulative risk.

In practice, the body is exposed to a very severe double stress: on the one hand, the products of combustion, and on the other, the substances generated by vaping. This increases the toxins to manage, and the presence of nicotine in both cases only reinforces the addiction and makes the decision to quit smoking more difficult.

Read also:

• How to use the electronic cigarette
• What to know about electronic cigarettes
• Quit smoking in 10 steps