Monday, January 06, 2014

If Electronic Cigarettes are a Gateway to Smoking, then Why Were Youth Smoking Rates at an All-Time Low in 2013?

The Centers for Disease Control and Prevention (CDC) is telling the public that electronic cigarettes are a gateway to youth smoking. The CDC has alarmed the public about a concerning doubling of the use of electronic cigarettes by teenagers from 2011 to 2012. Although I pointed out that most of this use occurred among smokers, the CDC nevertheless concluded that electronic cigarettes are leading to increased smoking rates among youth.

Late last month, the University of Michigan released the results of the 2013 Monitoring the Future survey, a national study of youths in grades 8, 10, and 12. Despite the CDC's sirens about how e-cigarettes are leading to an increase in youth smoking, the data show that youth smoking rates reached a record low in 2013.

As summarized by the Campaign for Tobacco-Free Kids: "overall youth smoking declined significantly in 2013, and smoking rates fell to record lows for all three grades surveyed (grades 8, 10 and 12). This is the third year in a row that this survey has found a significant annual decline in youth smoking, which is highly encouraging after several years in which progress had nearly stalled. For all three grades combined, the percentage of students who reported smoking cigarettes in the past month fell from 10.6 percent in 2012 to 9.6 percent in 2013. Smoking declined from 17.1 to 16.3 percent among 12th graders, from 10.8 to 9.1 percent among 10th graders and from 4.9 to 4.5 percent among 8th graders. The declines were statistically significantly for 10th graders and for all three grades combined."

The Rest of the Story

These results hardly seem consistent with the CDC's statements that electronic cigarette use is causing an alarming increase in youth smoking.

Interestingly, it is also possible that electronic cigarettes could have exactly the opposite effect. It is possible that some youths who might have initiated smoking will instead try electronic cigarettes. Further, it is plausible that after using electronic cigarettes, youth may be much less likely to progress to cigarette smoking because compared to the taste and sensation of vaping, the experience of cigarette smoking will not be appealing.

In fact, many vapers have reported that after switching to electronic cigarettes, they have lost the desire to return to smoking because the taste of tobacco cigarettes is no longer pleasant after having experiencing the flavors of electronic cigarettes. It is possible, then, that electronic cigarettes do not serve as a gateway to tobacco smoking but instead, serve as a sort of barrier to tobacco smoking.

While research is clearly needed to understand the trajectory of youth use of electronic cigarettes, the Monitoring the Future survey data do not support the CDC's conclusion that these products are serving as a gateway to youth smoking.

Let's not forget that spurred on by the CDC's report and alarming public statements, politicians have told the public that e-cigarettes are causing youth smoking and eventual cigarette addiction and death:

Senator Richard Blumenthal stated that: ""tobacco companies are using the same despicable tactics with e-cigarettes that they used in previous decades with traditional cigarettes to lure youth down a path of nicotine addiction and eventual death."

Senator Dick Durbin stated that: "the use of e-cigarettes among our nation's kids is ... closely linked to the deadly use of cigarettes."

Senator Ed Markey stated that: "e-cigarettes are a gateway to tobacco use by children and teens...".

The CDC has done enough damage with its irresponsible and untruthful propaganda about electronic cigarettes. It is time that policy decisions be guided by science rather than politics. And the science is now in. It indicates that youth smoking levels are at record lows, which casts serious doubt on the hypothesis that electronic cigarettes are fueling an alarming increase in youth smoking.

Hopefully, 2014 will mark the return of evidence-based tobacco control practice.

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