Why Are Vapers Still Paying Smoker Life Insurance Rates? An Industry’s Harm Reduction Blind Spot

For years, British public health authorities have encouraged smokers who cannot quit entirely to switch to less harmful alternatives such as vaping products. The UK’s health agencies, including the former Public Health England and now the Office for Health Improvement and Disparities, have repeatedly concluded that vaping is substantially less harmful than smoking combustible cigarettes. Yet there is one sector that appears stubbornly resistant to this reality: the life insurance industry.

A number of life insurers in the UK still treat vapers, nicotine pouch users, and other non-combustible nicotine consumers just like cigarette smokers, which, for obvious reasons, tobacco harm reduction experts find very frustrating. This approach leads to financial penalties that can cause life insurance premiums to double, triple, or even quadruple. This is happening despite a growing body of scientific evidence suggesting that smoke-free nicotine products are significantly less risky than smoking. Such a gap really underscores a larger issue in tobacco harm reduction around the globe. Even though public health science has advanced rapidly over the last ten years, many institutions continue to rely on outdated assumptions from the time when cigarettes were the primary source of nicotine use.

Life insurance underwriting is supposed to be built on risk differentiation. Insurers routinely examine blood pressure, cholesterol, occupation, family history, and recreational activities when calculating premiums. Yet with nicotine use, none of this seems to apply.

Most providers divide applicants into two categories: smokers and non-smokers. To qualify for non-smoker rates, applicants must show complete nicotine abstinence for at least 12 months. Anyone using nicotine—through cigarettes, vapes, nicotine pouches, or other smoke-free products—is placed in the smoker category. This outrageous approach remains widespread among major insurers despite mounting evidence that nicotine is not the primary cause of smoking-related disease.

Over the past decade, evidence supporting smoke-free nicotine alternatives has expanded considerably. Public Health England published landmark reviews stating that vaping is much less harmful than smoking, and independent researchers in the UK, New Zealand, and other places have backed this view. Recently, reviews from King’s College London and University College London reinforced the idea that smokers who fully transition to vaping see a significant drop in their exposure to harmful substances. Nicotine pouches have generated similar findings.

The UK’s overall approach to tobacco control is starting to align more with these realities. The NHS still sees vaping as a viable choice for smokers who find it tough to stop using traditional methods, and government-supported programs even give out vape starter kits as smoking cessation aids. Against this backdrop, treating a former smoker who uses nicotine pouches the same as a pack-a-day cigarette smoker is increasingly difficult to justify.

The industry’s defence is relatively straightforward. Insurance models rely heavily on long-term mortality data. Smoking risks have decades of evidence, while many modern nicotine alternatives have existed for a shorter time. Insurers favour caution, especially when estimating risks that may not appear for decades.

Perhaps more justifiable is the issue of behavioural history. Many vapers and nicotine pouch users are former smokers, and insurers may see them as carrying residual health risks from past tobacco use. While some underwriting models also consider the possibility of relapse to smoking. However, critics argue that these concerns do not explain why insurers often make no distinction between smoking and smoke-free nicotine use. If risk assessment is evidence-based, the insistence is that substantial differences in risk should translate into meaningful differences in pricing.

Sadly, similar patterns are seen worldwide. In India, Amarnath Saxena, Chief Technical Officer – Commercial at Bajaj General Insurance, believes that the lack of differentiation is justified. “Research indicates that vaping can cause arterial stiffness and inflammation, raising cardiovascular risks similar to those seen in cigarette smokers,” he said.

These, of course, are arguments which have been dispelled by science. And hopefully, as vaping grows globally, insurers will increasingly face pressure to revisit classifications developed long before nicotine pouches, modern vaping devices, and other reduced-risk products became widely available.

One unintended consequence of current underwriting practices is that they may reduce incentives for smokers to switch from cigarettes. Those smokers who switch to safer alternatives always report health gains, but find their life insurance costs remain unchanged. This disconnect also creates confusion and doubt.

Public health policy has begun adapting to that reality. Scientific evidence continues to accumulate. Smoking rates continue to decline as more smokers switch to smoke-free alternatives. Life insurance underwriting, however, remains stuck in an older model.

Until insurers begin recognising the difference between smoking and smoke-free nicotine use, many former smokers will keep paying premiums based on risks they no longer face. For a sector built on accurate risk assessment, this is a puzzling contradiction in modern tobacco policy.

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