E-cigarettes

Did Vaping Stop the Downward Trend in Adolescent Smoking?

One survey shows cigarette use holding steady, while another shows it continuing to fall.

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Survey results published this week indicate that cigarette smoking was about as common among high school students last year as it was in 2017. Is this evidence that the surge in adolescent vaping is finally reversing the decline in adolescent smoking that began in the late 1990s? Probably not.

In the 2018 National Youth Tobacco Survey (NYTS), which is sponsored by the U.S. Centers for Disease Control and Prevention (CDC), 8.1 percent of high school seniors reported smoking cigarettes in the previous month, compared to 7.6 percent in 2017. The difference was not statistically significant. Meanwhile, as the Food and Drug Administration revealed last fall, 20.8 percent of high school students reported past-month e-cigarette use in 2018, up from 11.7 percent in 2017.

NYTS

"Cigarette smoking rates have stopped falling among U.S. kids," the Associated Press says, "and health officials believe youth vaping is responsible." A.P. quotes CDC spokesman Brian King, who says, "We were making progress, and now you have the introduction of a product that is heavily popular among youth that has completely erased that progress."

King is being tricky here. The "progress" has been "completely reversed" only if you count vaping, which does not involve tobacco or combustion, as a kind of "tobacco use" and ignore the huge difference in health hazards between the two forms of nicotine consumption. The CDC, notwithstanding its supposed focus on minimizing morbidity and mortality, habitually obscures these important distinctions. From a public health perspective, a situation in which 20 percent of high school students are vaping while 8 percent are smoking is vastly preferable to a situation in which 0 percent are vaping and 29 percent are smoking (as the NYTS found in 1999).

While the NYTS indicates that past-month cigarette smoking has been flat among high school students since 2016, another government-sponsored survey, the Montoring the Future Study, which also detected a big increase in vaping last year, shows a continuing decline in past-month smoking among 12th-graders:

Monitoring the Future Study

Past-month cigarette smoking also continued to fall among 10th-graders in that survey, although it ticked upward among eighth-graders (from 1.9 percent in 2017 to 2.2 percent in 2018).

This week Food and Drug Commissioner Scott Gottlieb reiterated his determination to reverse the upward trend in adolescent vaping, even if that means making it harder for adult smokers to quit by switching to e-cigarettes. "As a society, we've made great strides in stigmatizing cigarette use among kids," he said. "The kids using e-cigarettes are children who rejected conventional cigarettes, but don't see the same stigma associated with the use of e-cigarettes. But now, having become exposed to nicotine through e-cigs, they will be more likely to smoke."

In other words, Gottlieb worries that vaping is leading to smoking by teenagers who otherwise never would have experimented with tobacco. But if that pattern is common, it's hard to explain why smoking has fallen to record lows among both teenagers and young adults in recent years, or why the downward trends accelerated as vaping became more popular. By contrast, the hypothesis that teenagers who otherwise would be smoking are instead vaping is consistent with the data we've seen so far.

Maybe Juul, the leading e-cigarette, changed everything by offering better nicotine delivery in a discreet and convenient device. But it is hard to fathom why someone who likes Juul and its imitators would be attracted to products that are not only dirtier, smellier, and much more hazardous but also more expensive. If Gottlieb is right, last year's 78 percent increase in vaping by teenagers should be followed by a substantial increase in smoking among teenagers and young adults within the next few years.

A.P. notes that some researchers "had linked e-cigarettes to an unusually large drop in teen smoking a few years ago, and they say it's not clear to what extent the decline in smoking has stalled or to what degree vaping is to blame." One those researchers, Georgetown's David Levy, warns that "it's not clear yet what's going on, and it's best to not jump to any conclusions."

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23 responses to “Did Vaping Stop the Downward Trend in Adolescent Smoking?

  1. “”Did Vaping Stop the Downward Trend in Adolescent Smoking?”‘

    I’m going with the idea that adolescents today can’t operate a lighter.

    1. IIIIII’m inclined to agree with this assessment.

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  2. Vaping is not smoking and nobody does both things. More disingenuous manipulation of numbers.
    Of course vaping is reducing smoking, vaping is new and cool, smoking is old and not cool.

  3. Sullum, with all due respect, according to your own article King did not say “completely reversed”…he said “completely erased” according to your quote of him in the prior sentence. “erased” and “reversed” are not equivalent terms

  4. Maybe Juul, the leading e-cigarette, changed everything by offering better nicotine delivery in a discreet and convenient device. But it is hard to fathom why someone who likes Juul and its imitators would be attracted to products that are not only dirtier, smellier, and much more hazardous but also more expensive.

    I’m a social smoker. In my case, that means I only smoke when I’m around other real smokers and am offered a cigarette. In practice, that means I can go weeks or months without having a cigarette, then sometimes will have a cigarette or two per day for days or in some cases, a few weeks at a time. I’ve never felt or even understand what the pang of cigarette withdrawal is (even if I have a couple of cigarettes a day for three weeks, then stop cold turkey).

    I’ve also vaped.

    For whatever reason, I find smoking cigarettes (or small cigars) more satisfying. Curious what others think.

  5. But it is hard to fathom why someone who likes Juul and its imitators would be attracted to products that are not only dirtier, smellier, and much more hazardous but also more expensive.

    Because people who become addicted to nicotine, and teenagers, and especially teenagers who become addicted to nicotine, are known for sound judgment?

    1. This is the best assessment of the resultant effects of nicotine addiction I’ve ever read.

  6. Those graphs are of such different things (students vs. seniors only), and with such different X and Y scales, that they might as well be incommensurable anyway?

    (If you spot-check 2011-2018, they seem to be within a few percent of each other, which makes sense for a survey of sliiighlty different but related populations.

    Might be better to say that we just don’t know, and that it makes no real difference if acutal-smoking rates flattened out, because there’s no obvious reason it must be Because Teh Evul Vapez.)

    1. (I mean, visually incommensurable; same-scales on both axes are what you need for that.

      Edward Tufte is crying because you didn’t re-graph the raw data.)

      1. I’m a big fan of averaging the averages. But that’s just me.

  7. This whole article is really just a waste of time. If parents don’t want their children to vape of smoke, they should make sure their kids don’t vape or smoke. It’s a parents responsibility to take care of the children they made, not mine or anybody else’s. It doesn’t “Take a village” to raise children. Just responsible parents.I vape now because I made the decision that it was a better uptake method than smoking to get the nicotine I enjoy. But I’m an adult. But now I have to pay an extra tax to vape here in California to help educate parents and children about the so called dangers of vaping and smoking. Not my responsibility as far as I’m concerned.

  8. You’d expect the line to flatten out somewhere above 0, wouldn’t you? It’s awfully low now, how much lower would you expect it (or anything) to go?

  9. Right. It makes you wonder what Rebublicans like Mitch McConnell are thinking.

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  10. Or maybe the government should stop trying to social engineer its citizens. Maybe it’s none of the government’s business.

    1. Maybe you’re on the wrong website

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  15. Vaping may have caused less smoking cigs but in 2011 around 17% said they did either vaping or smoking and now that’s up to around 28%. I agree that vaping is better but it doesn’t just seem like everyone is converting, but also that people are going straight to vaping.

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