Vaping and socioeconomic inequalities in smoking cessation and relapse: a longitudinal analysis of the UK Household Longitudinal Study

Publication type

Journal Article


Publication date

August 31, 2022


Background: Smoking is a key cause of socioeconomic health inequalities. Vaping is considered less harmful than smoking and has become a popular smoking cessation aid. However, there is currently limited evidence on the impact of vaping on inequalities in smoking.

Methods: We used longitudinal data from 25,102 participants in waves 8-10 (2016-2020) of the UK Household Longitudinal Study to examine how vaping affects socioeconomic inequalities in smoking cessation and relapse. Marginal structural models were used to investigate whether vaping mediates or moderates associations between educational attainment and smoking cessation and relapse over time. Multiple Imputation and weights were used to adjust for missing data.

Results: Respondents without degrees were less likely to stop smoking than those with a degree (OR: 0.65; 95% CI: 0.54-0.77), and more likely to relapse (OR: 1.67; 95% CI: 1.26-2.23) but regular vaping eliminated the inequality in smoking cessation (OR: 0.99; 95% CI: 0.54-1.82). Sensitivity analyses suggested that this finding did not hold when comparing those with or without any qualifications. Inequalities in smoking relapse did not differ by vaping status.

Conclusions: Vaping may help reduce inequalities in smoking cessation between those with and without degree-level education and policy should favour vaping as a smoking cessation aid. Nevertheless, other supports or aids may be needed to reach the most disadvantaged (i.e. those with no qualifications) and to help people avoid relapse after cessation.

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Open Access

The copyright holder for this preprint is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY 4.0 International license.

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