Both smoking and vaping are big business. Nicotine is well known for its addictive capacity. Once started, it is very hard to give it up again. For many decades we devote considerable efforts and costs to encourage people to give up on smoking or, better, not to start smoking in the first place. The young are particularly vulnerable as damages persist for a longer time. Progress has been made to reduce passive smoking of children and people in restaurants, at work and public spaces. The relatively recent trend of vaping instead of smoking is considered less harmful, but scientific long-term evaluations, whether these effects are lasting for several years, are still missing.
A repeated cross-section study in England (Tattan-Birch et al. 2024) has revealed that the declining trend of nicotine use has already been reversed among youth due to the rise in vaping. Vaping seems to move from the fashionable niche product to the popular mainstream among youth. The addicts are only cost-sensitive on the margin. The relative prices of smoking and vaping might play a role to put people on different health trajectories. The question is not between either smoking or vaping, but for some it is both, although it should be none of both. The question of smoking yes/no is likely to be framed as either vaping/or smoking. The re-framing of the question shows the harmful potential in the longer run. We shall have a hard time to convince people and particularly youth not to be tempted by either/or but to focus on their long-term health trajectory and potential. (Image: Extrait from Arnold Böcklin, Self-portrait with death playing the violine 1872, Alte Nationalgalerie Berlin) 
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