Health Insurance

52% of Those Who Smoke or Vape Lie to Their Health Insurer About It

23% of consumers confess to driving while under the influence of cannabis, while 34% have been a passenger in a car operated by someone high.
Cigarette and vape.
Cigarette and vape. Source: Getty Images

Though smoking cigarettes has become increasingly less popular since the 2000s, many adults still smoke tobacco products and/or cannabis. Meanwhile, vaping has become a popular alternative, especially among young adults.

Health insurance providers often ask policyholders whether they smoke or use tobacco and, depending on the state, may be able to hike prices accordingly, given the mounting evidence that such habits can cause various health problems. As such, 52% of those who vape or smoke haven’t informed their insurance provider, according to a ValuePenguin survey of more than 2,000 consumers.

The inherent risks of smoking and vaping can vary depending on the substance being consumed and the method of consumption, but health insurance providers might lump all the behaviors together to classify customers as smokers and charge higher premiums.

Key findings

  • Nearly 1 in 3 Americans have vaped nicotine or cannabis, and 55% of Americans have smoked cigarettes or cannabis. More than half of vapers and smokers — 52% — lie to their health insurance provider about their habit. Among baby boomers who vape or smoke, this jumps to 63%.
  • 24% of vapers have experienced health issues they suspect were caused by vaping, such as shortness of breath or coughing. Gen Zers who vape are most likely to notice health issues (33%).
  • Gen Zers are most likely to vape but least likely to smoke. While 53% of Gen Zers say they’ve never smoked cigarettes or cannabis, only 49% of them say the same about vaping.
  • Though one of the main reasons vapers started their habit was to quit smoking cigarettes, 30% of vapers say it would be difficult to stop. Among Gen Zers, this figure rises to 45%.
  • The danger isn’t just in the smoke, as 23% of consumers admit to driving under the influence of cannabis. An additional 34% have been a passenger in a car operated by someone high.

Where there’s smoke, there are higher premiums

It’s well-known that long-term tobacco smoking can cause a series of health problems, and mounting evidence shows vaping may increase the risk of asthma and other issues, too. Still, 32% of consumers have tried vaping nicotine or cannabis, while 55% of folks have tried smoking tobacco or cannabis.

This is a graph of nicotine or cannabis usage

Given the research showing the risks of smoking, it’s somewhat reasonable that most health insurance providers would discourage policyholders from picking up or continuing the habit. Insurance providers compliant with the Affordable Care Act (ACA) can’t reject smokers from coverage, but they can increase premiums by up to 50% — but that’s if they know the policyholder uses tobacco.

The Centers for Medicare & Medicaid Services (CMS) defines tobacco use as "the use of a tobacco product or products four or more times per week within no longer than the past six months by legal users of tobacco products (generally those 18 years and older) and includes all tobacco products." Meanwhile, the Food and Drug Administration (FDA) includes vaping devices in its definition of tobacco products. So folks vaping cannabis or nicotine may be subject to the same premium increases as smokers.

Overall, 48% of those who smoke or vape have informed their health insurance provider about their habit, meaning most consumers who smoke or vape may be lying to their health insurance provider about it. But smokers and vapers from each generation other than baby boomers are more likely to be up front about their habits. Baby boomers — ages 56 to 75 — are most likely to keep quiet about their vices, with 63% smoking or vaping without their insurer’s knowledge.

This is a graph about lying about vaping or smoking

Should your health insurer find out you have misrepresented your health habits in the application or renewal stages, you could at the very least risk an increase in monthly premiums. The harshest consequences for this type of insurance fraud could mean losing your plan or facing legal action, including probation, community service or even jail time.

The costs of smoking and vaping

Even those looking for cheap health insurance options who manage to avoid increased premiums are paying a hefty toll for their smoking or vaping habits. Between cannabis and tobacco, consumers who use either spend an average of $661 a year on the habits.

That figure jumps above $1,000 for Gen Zers — ages 18 to 24 — who use nicotine products and Gen Xers — ages 41 to 55 — who use cannabis.

This is a graph about annual spending on nicotine, cannabis

It might also go without saying that long-term use of tobacco products, including electronic vaping devices, may lead to health problems that can be incredibly costly to your wallet and well-being.

In fact, 24% of those who vape say they’ve experienced health problems they suspect were caused by vaping. Gen Z folks who vape have increasingly had these issues, with 33% suspecting a health problem has arisen from vaping.

Smoking is a daily habit, vaping less so

In the nearly 60 years since the U.S. surgeon general first recognized the link between smoking and lung cancer, public opinion and acceptance of smoking have changed dramatically. The arrival of electronic cigarettes, or e-cigarettes, in the U.S. in 2006 may have been the beginning of a new tobacco-related debate that has led to more recent concern over a vaping epidemic, particularly among youth.

Gen Z does, in fact, appear to be the generation of consumers most likely to vape daily, with 18% vaping nicotine or cannabis daily. Millennials — ages 25 to 40 — come close, with 17% reporting vaping every day. Just 2% of baby boomers say they vape daily.

This is a graph of vaping frequency by generation

Overall, consumers are more than twice as likely to smoke daily than vape. Gen Z stands out as the only generation whose consumers appear to prefer vaping, with just 17% of the young demographic reporting daily smoking. Gen Xers prefer smoking to vaping and smoke daily at a higher rate than those of other generations, with 31% smoking every day.

This is a graph of smoking frequency by generation

Consumers who smoke either tobacco or cannabis report daily smoking slightly more often than those who vape. Of the 32% of adults who have tried vaping either cannabis or tobacco, just 35% report daily use. Contrarily, of the 55% of consumers who have tried smoking either substance, 43% say they smoke daily.

Smoking may lead to vaping

While e-cigarettes and vaping devices are sometimes marketed as smoking cessation tools, the FDA — and health insurance industry — disagrees. While the current science might conclude that vaping regulated products is generally healthier than smoking, it’s not a harmless habit, and nicotine dependence actually increases among some users who go from smoking to vaping.

Of those adults who vape, 34% claim they do it to help quit smoking cigarettes. This figure spikes for baby boomers, 49% of whom are trying to make the switch from cigarettes.

Regardless of whether vaping has helped in that regard, many users do claim to vape for relaxation, with 34% of vapers citing this as their motive. Gen Zers most often name relaxation as the primary reason for vaping, with 44% of the young vapers just looking to chill out.

A notable 28% of vapers like the taste, which can be just about anything from tobacco-flavored to cotton candy — part of what many believe has made vaping so popular among younger folks. The ValuePenguin survey found, however, Gen Xers are more likely to vape for the taste, with 34% naming this reason, versus 30% of Gen Z vapers.

Overall, consumers have various reasons for choosing to vape:

  • It helps me relax: 34%
  • I'm trying to quit smoking cigarettes: 34%
  • Just to see what it was like: 33%
  • I like the taste: 28%
  • To get high/feel good: 19%
  • There's no odor: 17%
  • In social settings when others are doing it: 16%
  • It feels less harmful than smoking: 14%
  • It's cheaper than smoking cigarettes: 14%
  • It looks cool: 11%
  • It's easier to vape without getting caught: 8%
  • I feel ill without vaping : 2%
  • Other reason: 3%

Trading one habit for another

Whatever the reason for starting to vape, many now say it would be difficult to quit, with 30% of those who vape saying quitting would be at least somewhat difficult. Gen Zers might have the hardest time quitting, with 45% saying quitting would be difficult to some degree.

Vaping might be helping baby boomers — who are most likely to try vaping to quit smoking — with 61% of those who vape saying it would be extremely easy to quit.

Taking habits on the road

Though smoking while driving may not be as inherently dangerous as drunken driving, any distraction can certainly lead to dangerous accidents. The nicotine in cigarettes or vaping devices may not impair driving, but the distraction itself poses a hazard. Thus, it’s fairly good news to see just 25% of consumers admit to smoking or vaping nicotine while driving.

Smoking cannabis, however, has been shown to impair judgment, coordination and reaction time, all of which can come in handy while driving. Still, 23% of consumers confess to driving while under the influence of cannabis.

The generation of consumers most likely to have ever smoked or vaped cannabis is also the generation with the consumers most likely to have driven while high. Despite being the generation with the youngest and presumably least-experienced drivers, Gen Z has the highest share of consumers who admit to driving under the influence of cannabis.

Young drivers like those who fall in the Gen Z range may already be at higher risk of causing an accident, yet 35% of Gen Z respondents have driven under the influence of cannabis at least once, with 9% admitting to doing this frequently — more than double the rate of consumers overall.

This is a graph about driving under the influence of cannabis

While they may not drive under the influence themselves, 34% of consumers say they’ve ridden in a car driven by someone under the influence of cannabis. Again, members of Gen Z find themselves most likely to have taken this risky action, with 46% affirming.

Driving under the influence (DUI) laws vary by state, especially driving under the influence of cannabis.

For example, drivers in Colorado — where recreational cannabis use is legal for adults — may have up to 5 nanograms of THC (the psychoactive ingredient in cannabis that makes users feel "high") in their blood before they’re charged with a DUI. This gives a bit of room for folks to legally use cannabis when they aren’t planning on driving, as blood content with higher than 5 nanograms of THC allows law enforcement to infer that the driver is under the influence — regardless of whether their driving showed it. Drivers exhibiting observable impairment may be at risk of a DUI charge even if their blood shows an amount of THC within the legal limit.

Other states like Arizona have a zero-tolerance policy regarding cannabis and driving, where a driver with any trace of THC or cannabis metabolites in their system may be subject to a DUI charge. Arizona does have guidance that allows for legal medicinal users to dispute impairment through medical testing.

Additionally, many states allow health insurance providers to deny coverage for injuries sustained while under the influence of drugs or alcohol or while committing an illegal act. Florida, for example, allows insurance companies to deny claims associated with the consumption of alcohol or illegal drugs. California, however, prohibits these types of exclusions.

Thus, if recreational cannabis use is not legal in your state or your health insurance policy has a drug exclusion clause, those who drive under the influence could be on the hook for their medical bills should they cause an accident.

Health and safety first

When it comes to saving money on health insurance and medical bills, one of the best ways to avoid additional costs is to keep yourself as healthy as possible. Of course, smoking and vaping are habits and — in some cases — addictions that aren’t always easy to quit, even for health’s sake.

ACA-compliant health insurance plans must cover treatment for substance use disorder, including reliance on nicotine and cannabis. Quitting may not be easy, but you don’t have to do it alone.

Remember there are even more benefits than saving on health insurance, such as:

  • More money for things you love: Those who smoke or vape can save an average of $661 a year if they quit entirely. That’s more than an extra $55 a month that can go toward your savings goals or a fun activity that isn’t detrimental to your health.
  • Better life insurance rates: It’s not just health insurance — ValuePenguin research shows smokers can be charged an average of 215% more annually for life insurance than nonsmokers. Plus, lying about smoking on your life insurance application can mean denied claims for your beneficiary.
  • Fewer medical bills: While nonsmokers may incur higher lifetime medical expenses, much of that is due to the fact that they generally live longer than smokers. Year over year, however, smokers tend to have medical expenses as much as 40% higher than nonsmokers.


ValuePenguin commissioned Qualtrics to conduct an online survey of 2,046 U.S. consumers from Aug. 20 to 23, 2021. The survey was administered using a nonprobability-based sample, and quotas were used to ensure the sample base represented the overall population. All responses were reviewed by researchers for quality control.

We defined generations as the following ages in 2021:

  • Generation Z: 18 to 24
  • Millennial: 25 to 40
  • Generation X: 41 to 55
  • Baby boomer: 56 to 75

While the survey also included consumers from the silent generation (those 76 and older), the sample size was too small to include findings related to that group in the generational breakdowns.