Health insurance for smokers: how much more does it cost?

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.

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.

To see how much private health insurance would cost you please request a comparison quote here.

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 offered the cheapest smoker premium despite adding around 7% for smokers.

Insurers that load premiums for smokers do so because nicotine use 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.

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. That discount tapers at each renewal and disappears by the third year, but a smoker does not qualify for it at all.

Bupa goes further than most. As well as charging smokers a higher premium, it withholds its health and lifestyle discount of 10% a year, that non-smokers in good health can earn. 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 personalised quote through one of our partner brokers.

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 5.3 million adults, or 10.6%, smoked cigarettes in 2024, the lowest proportion since records began in 2011.

In the same year, about 5.4 million adults used an e-cigarette daily or occasionally, overtaking the number of cigarette smokers for the first time. Whether you smoke, vape or use patches or gum, the same health insurance pricing questions may apply to you.

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.

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, a broker can check before you apply. To get expert help from an experienced health insurance specialist please complete our form.

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.

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 nicotine for the period an insurer requires may let you shed a smoker loading or requalify for its good-health discount. myTribe's analysis shows discounts such as Aviva's and Bupa's depend on being a non-smoker, so a settled smoke-free record could bring your premium down at renewal or when you switch.

Once you have met an insurer's non-smoker definition, it is worth telling your provider or comparing the market again. Keep in mind that good-health discounts based on other factors, such as Vitality's, would not be restored by quitting alone.

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. A broker can compare how each insurer treats nicotine use and find the plan that fits your circumstances and budget.

To get a comparison quote from all of the UK's leading health insurers based on your own situation please click here.