Health insurance for smokers: how much more does it cost?
Smokers, vapers and other nicotine users can pay a little more for private health insurance, though the gap is smaller than most people expect. The extra cost can be a smoker surcharge, the loss of a good-health discount reserved for non-smokers, or both, according to myTribe’s analysis of insurer terms.
Richard Eagling is the Senior Editor at myTribe, with 25+ years in personal finance journalism and a CII Certificate in Financial Services. Previously at Moneyfacts and NerdWallet UK, his work has featured in The Guardian, BBC and The Telegraph.
Full BioSmoking and health insurance explained
Whether smoking affects your premium, and by how much, depends largely on the insurer. The key points are:
- How much smokers pay varies widely by insurer: some charge no more than non-smokers, while others add a straightforward smoker loading.
- Where insurers do charge more, myTribe’s analysis of insurer quotes puts the increase at around 5% to 10%.
- Some insurers, such as Aviva and Bupa, offer a good-health discount that smokers do not qualify for.
- The smoking period insurers ask about typically covers the past 1 to 2 years.
- “Smoker” usually means more than cigarettes: vaping, cigars, pipe tobacco and even nicotine replacement such as patches and gum can count, though definitions differ by insurer.
How much more do smokers usually pay for health insurance?
Smokers typically pay around 5% to 10% more for private health insurance than non-smokers on the same plan, though some insurers charge no extra at all. On the plans myTribe compared, smokers paid roughly £51 to £102 per year more with insurers that load premiums.
Example smoker and non-smoker premiums
To show the difference, myTribe ran identical quotes for a 50-year-old man in good health, on a moratorium basis with £1,000 outpatient cover, a £250 excess and a guided consultants option, changing only his smoker status. The table shows the providers that load premiums for smokers and the price difference.
The table shows that a smoker pays 5% more than a non-smoker with Bupa and WPA, 7% more with AXA Health on its Personal Health plan and 10% with The Exeter.
On the same quote, Vitality, Freedom and Aviva charged a smoker exactly the same opening premium as a non-smoker. As set out below, though, an Aviva smoker would separately miss out on a good-health discount, so the headline price does not tell the whole story.
An important point to stress is that health insurance pricing varies widely between insurers, so a provider that loads premiums for smokers may still be cheaper than one that doesn’t. For instance, in our example quote AXA Health’s Personal Health plan offered the cheapest smoker premium of the four insurers in the table, despite adding around 7% for smokers.
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Why do some health insurers charge smokers more?
Insurers that load premiums for smokers do so because smoking raises the long-term risk of claims for conditions such as heart and lung disease.
myTribe’s analysis shows that several of the largest providers, including AXA Health (on its Personal Health plan), Bupa, The Exeter and WPA, apply a smoker loading, so a smoker pays more than a non-smoker for the same cover. Others, including Freedom, Saga and Vitality, apply no smoker loading at all, charging the same opening premium whether or not you use nicotine.
The good-health discounts that smokers miss out on
Some insurers do not add a smoker loading but instead reserve a good-health discount for non-smokers, which means a smoker pays the standard price while a non-smoker pays less. Aviva, for example, offers a good-health discount (called My Healthy Discount) of up to 15% in the first year for people who meet its criteria, including not smoking, vaping or using nicotine replacement in the last 12 months. That discount falls to 10% and then 5% at the next two renewals and then ends, but a smoker does not qualify for it at all.
Bupa goes further than most insurers: as well as charging smokers a higher premium, it withholds its 10% health and lifestyle discount, which non-smokers in good health can earn, from anyone who has used tobacco in the last two years. A smoker with Bupa therefore feels the effect twice: a higher base premium and no discount.
A few insurers, such as Vitality, base good-health discounts on other factors entirely (such as no recent symptoms or treatment) rather than on smoking, so giving up nicotine would not bring those back.
You can compare prices from the leading health insurance providers by requesting a quote through myTribe.
How many people in the UK smoke or vape?
Smoking in the UK has fallen to a record low while vaping has risen sharply, so millions of adults are weighing how nicotine use affects their health cover. Office for National Statistics figures show around 4.9 million adults, or 9.8%, smoked cigarettes in 2025, the lowest proportion since this ONS series began in 2011, when it was 20.2%.
In Great Britain in the same year, about 5.4 million adults used an e-cigarette daily or occasionally. On the same survey, the proportion who vaped was higher than the proportion who smoked (9.9% against 8.7%). Whether you smoke, vape or use patches or gum, the same health insurance pricing questions may apply to you.
What counts as smoking or nicotine use?
What insurers count as smoking varies more than most people expect. All ask about cigarettes and other tobacco, but they diverge on vaping and nicotine replacement.
Aviva’s question is the broadest, covering tobacco, e-cigarettes, vaping and nicotine replacement products such as gum. The Exeter also asks about nicotine replacement, and WPA about vaping, while Bupa asks only about tobacco products. AXA Health goes furthest the other way, stating expressly that e-cigarettes and vaporisers are not classed as tobacco, so vaping alone would not count.
The look-back period varies too. Aviva, AXA Health and The Exeter ask about the past 12 months, Bupa about the past two years, and WPA simply asks whether you smoke or vape at all.
What each insurer asks about smoking
Giving accurate answers about nicotine matters because an undisclosed habit could affect a future claim. If you are unsure how a particular insurer defines a smoker, check its application question before you apply; the table above shows the wording for five insurers.
Do vapers pay more for health insurance?
Whether vaping affects your price depends on the insurer. Some, such as Aviva and WPA, treat it as nicotine use and factor it in; others focus on tobacco, with AXA Health expressly excluding e-cigarettes, so vaping alone would not raise your price there. Where vaping does count, the effect is usually small and, as with cigarettes, comes down to a modest loading, the loss of a good-health discount, or both.
Long-term evidence on vaping is still limited, so insurers tend to be cautious. Unless you are fully nicotine-free, you may not qualify for a non-smoker discount, and nicotine replacement products such as patches and gum are often treated the same way while you are still using them.
How smoking affects your premium at renewal
Smoking can affect your renewal premium more than your first one, because private health insurance is repriced each year around your age, your claims and your no-claims discount. A new policy usually starts with a no-claims discount of around 65% to 70%, and a smoking-related claim can reduce that discount and lift your renewal.
The larger long-term cost of smoking, then, tends to be the risk of claims for smoking-related conditions rather than the opening price. Reviewing your cover and insurer every couple of years can help you keep that cost in check, as our guide to the average cost of private health insurance explains.
Why the smoker effect is smaller than it is for life insurance
The smoker effect on private health insurance is usually far smaller than it is on life insurance because health insurance is priced one year at a time and reflects the treatment you might claim for in that year. Life insurance prices the risk of death over decades, where smoking weighs much more heavily.
A smoker shopping for both products will usually see a much wider gap on life cover than on health cover. Our guide to life insurance for smokers covers that different product in detail.
Does quitting reduce your health insurance premium?
Quitting can reduce your private health insurance premium over time, because stopping smoking for the period an insurer requires may let you qualify for a lower price. Check whether a discount is available to new customers or at renewal: Aviva’s My Healthy Discount is a new-policy offer and is unavailable if you have held Aviva private medical insurance in the preceding 12 months. Bupa’s health and lifestyle discount may change or be unavailable at renewal.
Once you have met an insurer’s non-smoker definition, tell your provider or compare quotes again. Check all the eligibility conditions, including whether vaping or nicotine replacement products count.
Read next
See 2026 prices by age, check if you can switch without new exclusions and compare leading UK insurers.
How to find the best health insurance for smokers
Smokers can usually get the best price by comparing several insurers because the way providers treat nicotine use, and whether they load premiums or offer a good-health discount, varies widely. A plan with no good-health discount may suit a smoker as well as a comparable one that offers it, since a smoker would not qualify for the discount either way.
The other levers that cut premiums apply to smokers and non-smokers alike, including choosing guided consultants, a higher excess, or less outpatient cover, as our guide to saving money on health insurance sets out. Comparing quotes shows how each insurer treats nicotine use, so you can find the plan that fits your circumstances and budget.
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Frequently Asked Questions
Will I be refused private health insurance if I smoke?
Smoking does not normally stop you getting private health insurance. Insurers cover smokers and other nicotine users, and most reflect smoking through pricing, or by withholding a good-health discount, rather than by declining cover.
Do I have to declare vaping when I apply for health insurance?
You may have to declare vaping when you apply for private health insurance, because some insurers ask about all nicotine use, not only cigarettes. Giving accurate answers about vaping protects you if you later need to claim.
Will I need a medical or nicotine test to get health insurance as a smoker?
You will not usually need a nicotine test to get private health insurance. Insurers normally rely on the answers you give when you apply, whether on a moratorium or full medical underwriting basis, rather than testing for nicotine.
How long do I need to have stopped smoking to count as a non-smoker?
The smoke-free period needed to count as a non-smoker varies by insurer. Some treat you as a non-smoker after around 12 months nicotine-free, while certain good-health discounts look back further still. Checking the specific insurer’s definition is the surest way to know where you stand.
Do I have to tell my insurer if I start smoking after taking out a policy?
Tell your insurer if your smoking habits change and ask how this affects your cover and premium. Bupa says members need to tell it about changes to their smoking habits; if you do not, it may refuse claims connected to smoking. Other insurers’ requirements may differ, so check your policy terms.
Does my smoking affect the cost of adding my partner or children?
Your smoking can affect the cost of a joint or family policy, though how depends on the insurer. Your own share may carry a smoker loading, and good-health discounts are handled in one of two ways. Some insurers, such as Bupa, assess the discount per person, so a non-smoking partner can still earn their 10% even if you cannot. Others, such as Aviva, apply it across the whole policy, so one smoker reduces the discount for everyone on it. The base cost of covering more people is set out in our guide to family health insurance.
Is smoking treated the same as a pre-existing medical condition?
Smoking is not treated as a pre-existing medical condition on private health insurance. Smoking may cost you more or make you ineligible for a good-health discount, whereas pre-existing medical conditions are usually handled separately through your underwriting terms.
More questions? Search our site to find the answers
Disclaimer: This is general information, not personal advice. Speak to a qualified broker before making a decision. Our broker partners compare policies from a panel of leading UK health insurers, but not all insurers may be available.