High School Smoking Almost Gone, Vaping Way Down Too

 

Recently the U.S. Food and Drug Administration released data from the 2024 and 2025 National Youth Tobacco Surveys (NYTS).  A few specialty media articles reported some general findings (here, here and here), but otherwise the release was a non-event.

I downloaded the NYTS data and conducted an analysis of high school vaping and smoking, seen in the chart at left.  This explains the lack of media coverage: the teen vaping crisis is over.

The chart clearly shows that exclusive smoking among high schoolers was almost extinct in 2025, at 0.5%.  In fact, it’s getting so rare that it’s hard to attach labels.  Dual smoking-vaping (1.2%) and exclusive vaping (4.7%) were also much lower in 2025 than just five years earlier (3.6% and 16% respectively).

Where is the celebration?  We are close to achieving a smoke-free generation of youth and young adults, which in a few decades will transition to a smoking-disease-free generation of older adults. 

For years I complained about CDC manipulation of the NYTS numbers as it withheld the data and spun the narratives (examples here, here, here, here and here).  I am grateful that the FDA released the NYTS data without spin or fanfare, a big departure from previous releases when the CDC Office of Smoking and Health was the source. 

 

 

Announcing a New Lecture Series on Tobacco Harm Reduction

 

I am pleased to announce a new lecture series on the medical and scientific evidence for tobacco harm reduction.

This week, I am publishing “Nicotine, Correcting Misperceptions.”  The lecture is divided into an introduction and six easily digestible segments; run time and links are below. 

Nicotine, Correcting Misperceptions

Introduction     2:45  (link here)         

Comparing nicotine with caffeine, and contrasting positive and negative effects of nicotine on the brain, in the context of addiction     3:43  (link here)

Comparing nicotine delivery among combustible, smoke-free oral and aerosol tobacco and medicinal nicotine products         14:35  (link here)

Distinguishing the health effects of nicotine from those of combustible and smoke-free tobacco     14:35  (link here)

Weighing the evidence of nicotine use during pregnancy     4:00  (link here)

Investigating how the medical facts about nicotine have been exaggerated and distorted     5:00  (link here)

Valuing long-term nicotine maintenance and tobacco harm reduction     4:46  (link here)

 

You might think that you already know everything about nicotine.  So go ahead…TEST YOUR KNOWLEDGE OF NICOTINE by taking a short quiz!

You’ll get immediate feedback on your score, and the answers might prompt you to watch some of the segments.  Enjoy!

Note: While I originally created these lectures as a continuing medical education (CME) course (more information here), they do not presently convey CME credit, but are available to all who are interested in safer tobacco products for themselves, their families and friends.

I will publish the remaining topics soon.

Washington Post Attack on E-Cigarettes Deserves Emergency Room Treatment

 

Dr. Leana Wen, an emergency physician and Washington Post columnist, attacked tobacco harm reduction in a Post column last week, “The New Nicotine Product Replacing e‑Cigarettes to Addict Teens” (paywalled).  It dealt mainly with Zyn nicotine pouches, but it touched on the gamut of safer cigarette substitutes. 

Matt Holman, Ph.D., Chief Scientific and Regulatory Strategy Officer at U.S. Philip Morris International, has responded (here) with an accurate point-by-point rebuttal of Dr. Wen’s numerous misstatements. 

I’d like to focus on one especially egregious statement in Wen’s article: “Mitch Zeller, former director of the FDA’s Center for Tobacco Products, explained that as much as 70 percent of people who vape continue to smoke. He showed me industry data from two years ago that showed 84 percent of adult pouch users kept up cigarette use.”

I was astonished that Zeller would cite 70 percent, when he can readily access updated information from the gold standard CDC National Health Interview Survey (NHIS). In this chart of the smoking status of 17.8 million vapers estimated from the 2024 NHIS, the highest percentage were former smokers, while only 26 percent were current smokers.

While dual use is a transition period for many smokers, dual use has another, more ominous driver: misinformation from federal agencies and major medical organizations.  For example, Matt Holman noted: “under the helm of Mr. Zeller, [the FDA Center for Tobacco Products] authorized more than 2,800 cigarette products to be marketed while only authorizing 30 novel smoke-free products (heated tobacco products, Swedish snus, and vapes). These actions resulting in 100 times more authorizations for combusted tobacco than novel smoke-free products are in direct opposition of CTP’s stated mission ‘To protect the public health of the U.S. population from tobacco-related death and disease...’”

Additionally, in 2018, CTP director Zeller launched the FDA Real Cost E-Cigarette Campaign, which is a misinformation circus.  It ostensibly targets kids, but I calculated – using the FDA’s formula – that this campaign also dissuaded hundreds of thousands of smokers from switching to safer vape products (here).

The Washington Post should run a major correction for Dr. Wen’s article.