The Bitter Truth: CDC’s Numbers on Flavored Tobacco Don’t Add Up

Tobacco opponents routinely focus their ire on flavorings.  The CDC recently launched the latest attack, based on its analysis of the 2014 National Youth Tobacco Survey.  The agency reported that “Among middle and high school students in 2014, an estimated 1.58 million used a flavored e-cigarette, 1.02 million used flavored hookah tobacco, 910,000 used flavored cigars…in the past 30 days”

The survey asked students about past 30-day use of each product; in a separate section, students were queried on their use of flavored e-cigarettes, hookah and cigars.  Here are the numbers:

Number of Middle and High School Students Who Used Selected Tobacco Products and Flavored Products in the Past 30 Days
		Number of Students
E-Cigarettes	Flavored E-Cigarettes
Yes	No	920,000
Yes	Yes	1,580,000
NO	YES	360,000
Hookah	Flavored Hookah
Yes	No	660,000
Yes	Yes	1,020,000
NO	YES	310,000
Cigars	Flavored Cigars
Yes	No	530,000
Yes	Yes	910,000
NO	YES	240,000

The data is full of contradictions: 360,000 students reported that they had used flavored e-cigarettes in the past 30 days, but they hadn’t used e-cigarettes in the past 30 days.  Twenty three percent (310,000) who reported using flavored hookah in the past 30 days also said they had not used hookah in the past 30 days. Twenty-one percent (240,000) who reported using flavored cigars in the past 30 days also said they had not used cigars in the same period.

How did the CDC deal with these discrepencies?  The agency briefly mentioned them as a limitation and said those students were not counted.

The inconsistencies cannot be so easily ignored, particularly as contradictory responses were not restricted to the flavor questions.  For example, of the 1.68 million students who reported smoking cigarettes in the past 30 days, almost 12% responded in other questions that they had never smoked or had not smoked in the past 30 days.    

Kids may say the darndest things, but their survey results should not be spun by the CDC into national tobacco control policy.  Rather, the agency should issue a comprehensive report on the internal consistency and relative validity of the NYTS data.