Dual Use of Tobacco Products

Some people try to cut back on smoking cigarettes or work toward quitting smoking completely by using electronic cigarettes (e-cigarettes), smokeless tobacco, or other tobacco products in addition to regular cigarettes. This is called “dual use.” Dual use is not an effective way to safeguard health.

Because smoking even a few cigarettes a day can be dangerous1, quitting smoking completely is very important to protect your health. If you’ve never smoked or used other tobacco products, including e-cigarettes, don’t start.

Health Risks of Smoking

Smoking even a few cigarettes a day can be dangerous and can lead to serious health problems.1,2,3

  • People who smoke fewer than 5 cigarettes a day can have early signs of cardiovascular disease.
  • Just cutting back on cigarettes may not protect someone from early death. People who smoke heavily and reduce their cigarette use by half still have a very high risk for early death. On average, people who smoke die 10 years earlier than people who don’t smoke.
  • People who reported smoking in social situations rather than on a daily basis – a behavior referred to as “social smoking” – have similar blood pressure and cholesterol levels of people who smoke regularly.4

Quitting Can Improve Your Health

Quitting smoking completely improves both your health and your quality of life. This is true regardless of your age or how long you have been smoking.5

When you quit smoking completely:5

  • After 1-2 years, your risk of heart attack drops sharply and continues to drop over time.
  • After 5-10 years, your risk of stroke decreases.
  • After 5 years, your risk for cancers of the mouth, throat, and voice box drop by half.
  • After 10-15 years, your risk of lung cancer drops by half.

People who quit smoking completely live longer than those who keep smoking. The earlier you quit, the lower your risk for early death. Even quitting at age 50 cuts your risk in half for early death from a smoking-related disease.

Help for Quitting Smoking

Quitting smoking can be hard, but it is possible. Today in the United States, there are more people who quit smoking cigarettes than people who currently smoke.5 It often takes several tries to quit smoking – the important part is to keep trying and not give up. Using proven quitting treatments, such as medications and counseling, can double your chances for success. Many of these treatments may be available to you free of charge or may be covered by your insurance.

Free help to quit smoking is available in the Quit Guide on this website and by calling 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers). Quitline coaches can answer questions, help you develop a quit plan, and provide support for your smokefree life.

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At age 33, Kristy G., a heavy smoker and mother of three, tried using e-cigarettes as a way to cut back on cigarette smoking, but she continued to smoke regular cigarettes. Eventually, she stopped using e-cigarettes, went back to smoking only cigarettes, and later had a collapsed lung.

“I could never get completely off regular cigarettes until I wound up in the hospital.”

Today I start my quit journey. Free resources provided by smokefree.gov

More information about electronic cigarettes (e-cigarettes)

No e-cigarette has been approved by the U.S. Food & Drug Administration (FDA) as a cessation aid. Learn what the science says about e-cigarettes.


  1. Bjartveit K, Tverdal A. Health Consequences of Smoking 1-4 Cigarettes Per Dayexternal icon. Tobacco Control 2005;14(5):315–20 [accessed 2021 July 13].
  2. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2021 July 13].
  3. Tverdal A, Bjartveit K. Health Consequences of Reduced Daily Cigarette Consumptionexternal icon. Tobacco Control 2006;15(6):472–80 [accessed 2021 July 13].
  4. Schane R, Glantz S, Ling P. Social Smoking: Implications for Public Health, Clinical Practice, and Intervention Researchexternal icon. American Journal of Preventive Medicine. 2009; Vol 37, Issue 2.
  5. U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020. [accessed 2021 July 13].