This study examines whether having health conditions or concerns related to smoking is associated with use of vaping products. Data came from the 2016 wave of the International Tobacco Control Four Country Smoking and Vaping Survey. Smokers and recent quitters ( = 11,344) were asked whether they had a medical diagnosis for nine health conditions (i.e., depression, anxiety, alcohol problems, severe obesity, chronic pain, diabetes, heart disease, cancer, and chronic lung disease) and concerns about past and future health effects of smoking, and their vaping activities. Respondents with depression and alcohol problems were more likely to be current vapers both daily (Adjusted odds ratio, AOR = 1.42, 95% confidence interval, CI 1.09-1.85, < 0.05 for depression; and AOR = 1.52, 95% CI 1.02-2.27, < 0.05 for alcohol) and monthly (AOR = 1.32, 95% CI 1.11-1.57 for depression, < 0.01; and AOR = 1.43, 95% CI 1.06-1.90, < 0.05 for alcohol). Vaping was more likely at monthly level for those with severe obesity (AOR = 1.77, 95% CI 1.29-2.43, < 0.001), cancer (AOR = 5.19, 95% CI 2.20-12.24, < 0.001), and concerns about future effects of smoking (AOR = 1.83, 95% CI 1.47-2.28, < 0.001). Positive associations were also found between chronic pain and concerns about past health effects of smoking and daily vaping. Only having heart disease was, in this case negatively, associated with use of vaping products on their last quit attempt (AOR = 0.72, 95% CI 0.43-0.91, < 0.05). Self-reported health condition or reduced health associated with smoking is not systematically leading to increased vaping or increased likelihood of using vaping as a quitting strategy.