Tuesday, December 13, 2016

Claims that Youth E-Cigarette Use Leads to Smoking are Destroyed; 2016 Monitoring the Future Survey Shows Steep Decline in Smoking

The claims of anti-tobacco groups and health agencies -- including the Surgeon General's Office -- that youth e-cigarette experimentation leads to smoking have been essentially destroyed after this morning's release of results from the 2016 Monitoring the Future Survey.

The 2016 survey finds that from 2015 to 2016, current cigarette smoking among 8th and 10th grade students dropped by the greatest amount in history. For 8th graders, current smoking dropped from 3.6% to 2.6%. Among 10th graders, smoking dropped from 6.3% to 4.9%.

Smoking among 12th graders also declined, although not as sharply as from 2013 to 2014, dropping from 11.4% to 10.5%.

From 2013 to 2016, a period during which e-cigarette use among youth skyrocketed, current smoking among 12th graders dropped from 16.3% to 10.5%. Among 10th graders, current smoking during this period dropped from 9.1% to 4.9%.

The survey also found that rates of past 30-day vaping itself among 10th and 12th graders dropped for the second consecutive year, falling from 16.2% to 12.5% among 12th graders and from 14.0% to 11.0% among 10th graders.

The Rest of the Story

At this point, it is clear that whatever the risks of youth vaping may be, one of them is not the risk of progressing to smoking. If this hypothesis were true, we would simply not be seeing the historic declines in youth smoking that are occurring. Quite clearly, smoking continues to be de-normalized, not re-normalized as anti-tobacco groups and many health agencies have claimed. It appears that a culture of vaping is largely replacing a culture of smoking.

If anything, it appears that the advent of e-cigarettes has accelerated the de-normalization of smoking by largely replacing it. Increases in vaping are mirrored by corresponding declines in youth smoking. Vaping appears not to be making smoking more cool, as claimed by the Surgeon General, the CDC, and anti-tobacco groups, but to be making smoking less cool.

It also appears that there has been a plateau and now a decline in the rising fad of youth vaping, which should help ease the concerns of anti-tobacco groups that an entire generation of kids is going to be addicted to nicotine.

These data are cause for celebration. They show that smoking continues to be less cool among teenagers and suggest that the new vaping culture has contributed further to the de-normalization of smoking. Given the high potential of smoking during adolescence to lead to a lifetime of cigarette addiction and its resulting disease and premature death, it appears that the phenomenon of youth e-cigarette experimentation has been a net positive for the public's health, or at very least neutral. This does not mean that youth vaping should be promoted, but it does mean that the claims of health agencies, including the Surgeon General's office, are simply not standing up to scientific scrutiny.

If the science matters in tobacco control - which apparently it doesn't - this should put an end to the Surgeon General, the CDC, and others claiming that youth experimentation with e-cigarettes will lead to a progression to smoking and to a re-normalization of smoking among youth. What we need is not a further campaign of lies and deception about how tobacco use "in any form," including e-cigarettes, is horrific, but a truthful campaign that acknowledges different levels of risk of nicotine-containing products, informs youth that e-cigarettes do not contain tobacco and are therefore not a form of tobacco use, and explains that most e-cigarettes do contain nicotine and may also expose them to other chemicals which could be harmful with long-term use.

It is interesting that the Surgeon General released his report just prior to the release of these new data. Perhaps he realized that once these data came out, his "story" about the scourge of e-cigarettes would be destroyed, so he wanted to get it in so it could have the maximum media impact. Even if it is purely a coincidence, it is going to be difficult to undo the damage caused by the Surgeon General's report.

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