CDC Belatedly Reveals That Smoking by Teenagers Dropped While Vaping Rose

Last September the CDC
noted with alarm that the percentage of teenagers who had
tried electronic cigarettes doubled between 2011 and 2012. “Many
teens who start with e-cigarettes may be condemned
to struggling with a lifelong addiction to nicotine and
conventional cigarettes,” CDC Director Tom
Frieden worried. In a Medscape interview a
few weeks later, Frieden suggested that fear had already
materialized, asserting that “many kids are starting out with
e-cigarettes and then going on to smoke conventional cigarettes.”
Yet the CDC’s data, which came from the 2012 National Youth Tobacco
Survey (NYTS), did
not support that claim. In fact, nine out of 10 high school
students who reported vaping in the previous month were already
cigarette smokers, suggesting that the increase in e-cigarette
consumption might signal successful harm reduction. Last week the
CDC
reported additional NYTS data that further undermine Frieden’s
claim, showing that smoking among teenagers fell as vaping
rose.

Between 2011 and 2012, when the share of middle school students
who reported using e-cigarette in the previous month rose from 0.6
percent to 1.1 percent, the share reporting past-month consumption
of conventional cigarettes fell from 4.3 percent to 3.5 percent.
Among high school students, past-month e-cigarette use rose from
1.5 percent to 2.8 percent, while past-month consumption of tobacco
cigarettes fell from 15.8 percent to 14 percent. Although these
trends do not necessarily mean e-cigarettes are responsible for the
decline in smoking, the numbers hardly seem consistent with the
story Frieden is eager to tell: that the availability of
e-cigarettes is leading to more smoking than would otherwise occur.

Since the numbers showing an increase in vaping come from the
very same survey as the numbers showing a decrease in smoking, it
is puzzling that the CDC decided to highlight the first trend two
months before the latter one, especially since the smoking data
suggest Frieden’s fear, which was repeated and amplified by various
activists and politicians pushing for
strict e-cigarette regulation, is misplaced. But the omisision
is puzzling only if you assume the CDC is mainly interested in the
truth, as opposed to scientific-sounding justifications for an
irrational anti-vaping prejudice. Boston University public health
professor Michael Siegel, who sees e-cigarettes as a valuable harm
reduction tool,
comments: 

This decline in cigarette smoking was not reported in the
earlier CDC report on the increase in electronic cigarette use, nor
was it mentioned in any of the multitude of interviews or news
articles regarding the increase in youth e-cigarette use….

The opportunity to see the data on trends in cigarette smoking
would have helped the public to see that there was no scientific
support for the CDC’s conclusion. I thus find it curious that these
important data were not reported until weeks after the media [had]
already disseminated the conclusion that e-cigarettes are a
dangerous gateway to cigarette smoking. The CDC officials certainly
had plenty of opportunity to let the public know that there was no
discernible increase in cigarette smoking among youth concomitant
with the observed increase in e-cigarette use. It seems to me that
this is a critical finding to report.

My impression remains that there is, for some reason (perhaps
related to ideology), a pre-determined conclusion that e-cigarettes
are evil. Instead of fairly reporting all of the evidence, only the
evidence that supports the pre-determined conclusions [is] being
shared. 

Does the gateway effect Frieden fears—a switch from e-cigarettes
to conventional cigarettes among people who otherwise would never
smoke—show up after high school? Not according to a
recent survey of college students, in which only 3.3 percent
said e-cigarettes were the first form of nicotine they’d tried. Of
those, only one (2.3 percent) later started smoking conventional
cigarettes. “It didn’t seem as though it really proved to be a
gateway to anything,” the lead researcher said.

[Thanks to Bill Godshall for the tip.]