More than 60 years after the U.S. Surgeon General's landmark warning on smoking, a new nicotine reversal is showing up in survey data. In New Zealand, an ASH-commissioned survey by Talbot Mills Research found that 14% of 623 current smokers and 1,070 former smokers reported using smoking to quit vaping.
A separate ASH survey in the UK found that 19% of 940 adults said they had tried to quit vaping using cigarettes as a quitting aid, making it the second most popular strategy in that sample. The numbers come first: a product once sold as a harm-reduction path is now, in some cases, being used as a bridge back to combustible cigarettes.
U.S. smoking remains far below historic levels. CDC data show 9.1% of American adults smoked cigarettes in 2025, compared with 42.4% in 1965. About 7% of American adults vape. But experts quoted in the report say the issue is not a broad return to smoking; it is confusion over relative risk.
'It’s misinformation to the point of significant harm,' ASH Director Ben Youdan said in the New Zealand report. 'Public health needs to urgently get back on track with clear, honest communication.'
Michael Siegel, a professor of public health and community medicine at the Tufts University School of Medicine, said the trend looks like an overcorrection in warnings about vaping. 'There’s really no comparison. Smoking is orders of magnitude higher-risk than vaping,' he said.
CDC data say smoking causes one in five deaths in the U.S. annually, or about 480,000 deaths, mainly from lung cancer, COPD, heart disease and stroke. Vaping is associated with increased COPD and asthma risk, but related deaths are fewer. In February 2020, vaping was linked with 2,807 cases of lung injury and 68 deaths attributed to that lung injury.
The shift matters because policy and public messaging shape consumer behavior. The administrative state and public health apparatus can either clarify risk or blur it. When warnings become indistinct, markets do not correct the error on their own; people do, often with worse outcomes.
Capital rewards clear rules, and health guidance should work the same way. If consumers are told that very different products are basically equal, the incentive structure gets distorted. That does not protect the public. It can push people toward the wrong choice, and the taxpayer eventually pays for the fallout.
