Vaping trends raise alarm for underwriters

It took decades for insurers to fully recognise smoking as a major health risk, but now vaping is starting to demand attention from underwriters.

The number of e-cigarette users has surged from 800,000 in 2012 to 5.6 million today, according to Action on Smoking and Health (ASH), a public health charity founded by the Royal College of Physicians.

Alarmingly, the highest prevalence of vaping is now seen in younger people, particularly those the in 16 to 24 age group.

“Cigarettes were introduced in the 1890s, but their carcinogenic effects weren’t clear until the 1950s, and it took decades for the insurance industry to adopt smoker and non-smoker rates,” says Nicky Bray, chief underwriter for UK life at Zurich.

“Actuaries now say that while we don’t know the full impact of vapes, and they appear to be safer than tobacco, they are still likely to be harmful to health and life expectancy. We likely won’t know for certain until today’s vapers reach their 60s.

“Do we wait that long, or do we start assessing the potential risks now? Underwriting is about predicting what will happen 20 to 40 years down the line.”

Worrying trend

Vapes – electronic devices that deliver vapour containing nicotine – were initially seen as a tool for tobacco users to quit smoking and were even supported by the NHS’s ‘Stoptober’ campaign.

And they appear to be effective in helping people quit. The success rate for individuals trying to stop smoking has nearly doubled, rising from 14.2% in 2019 to 27.6% in 2025, according to top-line findings on smoking in England from the smoking toolkit study.

While the overall prevalence of cigarette smoking has remained relatively stable in recent years, it has dropped significantly over the past two decades, from 24.1% in 2007 to 14.1% in 2025. In contrast, the use of e-cigarettes has surged.

Until January 2020, the use of e-cigarettes and heated tobacco products remained steady at around 5%. Since then, it has increased steeply – to nearly 13% in 2024 – largely driven by the rise of disposable e-cigarettes.

This trend has also led to another concerning issue. Data obtained by Zurich Municipal through freedom of information requests to fire and rescue services across the UK reveals that fires caused by vapes and e-cigarettes have more than doubled in the past two years, primarily due to the discarding of disposable vapes, which contain lithium-ion batteries.

There is significant interest in whether the new law coming into effect from 1st June 2025 will reverse any of these trends when it becomes illegal for businesses to sell or supply any single-use or ‘disposable’ vapes. This applies to shops and online suppliers and to all vapes whether or not they contain nicotine.

Much of the increase in vaping has been driven by individuals who have never smoked traditional tobacco products, particularly younger generations.

“Until around 2021, e-cigarette use was primarily limited to former smokers, but the latest data reveals that about 3-4% of people are nicotine users but have never smoked,” says Bray.

“This trend is especially noticeable among those under 44, with the most significant increase occurring in young adults – nearly one-quarter of 16 to 24-year-olds now vape.”

The use of e-cigarettes in this age group has surged from 3.5% at the start of 2020 to over 28% in January 2025.

Since 2021, the use of higher-strength e-liquids has also risen, with more than half of those who have never smoked now using e-liquids with a concentration of 20mg or more. Meanwhile, ex-smokers and dual users (those who both smoke and vape) tend to favour lower-strength e-liquids.

Nicotine pouches, or ‘snus’, have also emerged. Like vapes, they come in various flavours – such as berry, citrus, and peppermint – which may appeal to younger users. The popularity of snus is further fuelled by its visibility in English professional football.

Significant risk

While e-cigarettes are generally considered less harmful than traditional cigarettes, the nicotine they contain remains a risk.

Nicotine affects the entire body, raising blood pressure and heart rate, and narrowing arteries, which can increase the risk of heart attack.

Research from the US found that the impact on cardiovascular health among vapers is similar to that of smokers, even though e-cigarette users tend to be younger.

Although the long-term health risks may take decades to fully emerge, modelling presented at the Institute and Faculty of Actuaries conference last year suggests that lifelong vaping could reduce life expectancy by between 1.5 to 12.3 years.

The chemicals in e-cigarette vapour have been linked to lung damage and death. In 2019, the US reported more than 2,800 non-fatal and 60 fatal cases of e-cigarette or vaping-associated lung injury (EVALI), mostly due to vitamin E acetate in counterfeit vape liquids.

In the UK, one EVALI-related death has been recorded, and by January 2020, the Medicines and Healthcare products Regulatory Agency (MHRA) had logged 244 vaping-related adverse events, including four fatalities.

E-cigarettes are also linked to nicotine poisoning, which can cause seizures and brain damage, particularly in younger users.

“This is partly due to them being the demographic most likely to use counterfeit and illegal products, but it may also be linked to ongoing brain development in children and young adults,” says Bray.

Nicotine can impair the developing brain, leading to issues like impulsivity and cognitive problems in young users.

Highly addictive

Nicotine is highly addictive, and the cycle of withdrawal and temporary relief makes it difficult to overcome dependence.

Short-term abstinence can lead to heightened mood-related symptoms, including anxiety and depression. Additionally, nicotine use can increase the risk of addiction to other substances.

Vapes containing spice, a class of synthetic drugs often marketed as legal cannabis alternatives, are becoming an increasing concern in the UK, particularly among school children.

While vaping is typically associated with nicotine use, the presence of spice or other synthetic substances introduces serious risks, as these compounds can be highly unpredictable and dangerous.

Spice is known to cause severe physical and psychological effects, including dizziness, breathing problems, heart palpitations, paranoia, hallucinations, violent behaviour, psychosis, seizures, and, in extreme cases, death.

“It’s also highly addictive, increasing the risk of young people becoming dependent, with usage patterns potentially continuing into adulthood – turning them into potential risks for the insurance industry,” says Bray.

Tobacco & Vapes Bill

Subject to approval from Parliament, the age of sale restrictions for tobacco will come into force on 1 January 2027, when those born on 1 January 2009 turn 18. Once in force, it will raise the age-of-sale for all tobacco products by one year every year, meaning that tobacco can never be legally sold to anyone born on, or after, 1 January 2009.

The Bill will also seek to reduce the level of use of vapes and nicotine products by:

• Extending the current age restrictions on vapes, making it illegal to sell or provide any vaping product to individuals under 18;
• Making it illegal for adults to purchase vaping products on behalf of those under 18 – also known as ‘proxy purchasing’;
• Banning the advertising and sponsorship of vapes and nicotine products;
• Limiting the appeal of nicotine and non-nicotine vapes to children by regulating flavours, descriptions, packaging, and point-of-sale displays;
• Making it illegal to give out free samples of, and/or allow a vending machine to be used for, such products.

The implementation date for these other measures being introduced via by the Bill will be set out in secondary legislation.

Smoking and nicotine questions

Currently, Zurich treats all forms of nicotine consumption the same, but the rising trends in vaping are prompting some reconsideration.

At present, Zurich asks potential customers about their use of cigarettes, roll-ups, vapes, e-cigarettes containing nicotine, cigars, pipes, and other tobacco or nicotine products, including patches and gum. Nicotine pouches and snus are not explicitly mentioned in this list but do count as being a “nicotine product” and therefore should be disclosed by customers.

For vapes, e-cigarettes and nicotine replacement products, no detail about daily consumption is required. For other products, users must specify the type and average amount smoked per day.

“We may need to start asking about consumption levels given the high nicotine content in some of these products – a 20mg vape delivers the same amount of nicotine as an entire pack of cigarettes,” says Bray.

“What we once thought might be a concern in five- or ten-years’ time is now impacting the insurance-buying population.”

Bray also wonders if the industry phrasing of the questions, including on quotes portals, may inadvertently put more emphasis on smoking rather than the newer variety of nicotine products, which could lead to misrepresentation issues. This is something advisers should be mindful of, especially as wealth transfers down through the generations and they acquire younger clients.