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2. No Smoke, Yet Ire
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."
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 month 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 (which is part of a long-term trend), 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.
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.
Yet politicians calling for a crackdown on e-cigarettes commonly cite the CDC's survey numbers, ignoring the continued decline in smoking by teenagers. When the New York City Council voted to ban the use of e-cigarettes in public places last week, one of the main rationales was preventing an increase in underage smoking. Councilman James Gennaro, a co-sponsor of the ban, warned that "just seeing people smoking things that look identical to cigarettes in subway cars, colleges and public libraries will tend to re-normalize the act of smoking and send the wrong message to kids." As usual, the kids don't seem to be listening.
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