Thursday, January 14, 2021

High School Vaping: There’s Good News & Bad in the 2020 NYTS Data

Data from the 2020 National Youth Tobacco Survey (NYTS) (charted at the left) confirms the CDC finding that “19.6% of high school students (3.02 million) … reported current (past 30 day) e-cigarette use.” (here).  This is a reduction in high school vaping from peak prevalence of 26.3% (or 4.1 million) in 2019.  The survey also indicates that high school cigarette smoking declined to 4.6%.  That’s good news, but there’s also some bad in the following table.


High School Vaping, 2018-2020


High School Students14.8 million15.0 million15.5 million
Vaped Past 30 Days3.1 million4.1 million3.02 million

Legal (18+ years)600,000779,000546,000

Underage2.5 million3.32 million2.47 million
Other Tobacco1.7 million2.17 million867,000

Virgins807,0001.15 million1.61 million
Infrequent (1-19 days)712,000978,0001.12 million

Frequent (20+ days)95,000171,500486,500


The table documents that there was a 40% increase in underage “virgin” (i.e., not using any other tobacco products) high school vapers, from 1.15 million in 2019, to 1.61 million in 2020.  There was also a three-fold increase in frequent underage high school vapers – those who vaped for 20 or more days in the past month – from 171,500 to 486,500. 

The increase in frequent vaping, which is suggestive of dependence, is likely to be exploited by anti-vaping activists, but the NYTS data must be viewed in context.  For comparison, let’s run similar numbers for high school cigarette smokers.  In 2018, there were 1.31 million of the latter, 973,000 of whom were underage. Of that subgroup, 234,000 smoked frequently (20-30 days in the past month).  In 2020, there were only 714,029 current high school smokers, 561,375 of whom were underage, and only 93,000 of the latter group smoked frequently. 

The substantial drop in all of these smoking numbers, even as frequent vaping increased, is positive from a public health perspective.  Health risks for any high-schoolers who become addicted to vaping nicotine will be a tiny fraction of the risks associated with smoking.

Another major finding from the new NYTS is that high school vapers may not be vaping tobacco/nicotine.  As I noted before, most public health officials ignored the important disclosure in the 2018 NYTS of high rates of marijuana vaping.  This oversight was highly irresponsible in view of the fact that contaminated illegal marijuana vapes caused considerable lung injuries and deaths.  Marijuana wasn’t mentioned at all in the 2019 NYTS questionnaire, but it reappeared in the 2020 survey.  The next chart shows that marijuana vaping has become even more popular; for example, 83% of 1.17 million frequent high school vapers used marijuana in 2020.   


While no one should be comfortable with any underage teen drug use, moral outrage about nicotine use is entirely misplaced.  Instead, it should be directed at the use of alcohol and marijuana, addictive substances that are clearly associated with teen injuries and deaths.


Thursday, January 7, 2021

Mississippi Corrections Makes the Correct Call, Ends Tobacco Prohibition


Mississippi Corrections Commissioner Burl Cain made an extraordinary announcement on December 23, noting:

  • For the first time in 10 years, Mississippi prison inmates who smoke will be able to do so legally, beginning February 1, 2021.
  • Name brand cigarettes, cigars and smokeless tobacco products will be sold at current prices in prison canteens, along with snacks and toiletries.
  • Inmates who smoke are smoking anyway, but they’re having to smuggle in tobacco to do it.

Cain reported that the ban has forced inmates to pay “as much as $500 a pound” for cigarette tobacco.  The new policy, he said, “will save [them] money and the state will make money,” and, “By selling [cigarettes], we are breaking the contraband tobacco trade, designating smoking areas outside, clearing the air inside for the majority of inmates who don’t smoke, reducing inmate contraband violations, and recouping for taxpayers some of the dollars it takes to run prisons.”

Profits from tobacco sales will fund the system’s re-entry program and its high school and college credit courses.

This announcement will be criticized by tobacco prohibitionists, but it portends the widespread reversal of almost two decades of tobacco prohibition in American prison systems.  I predicted the disastrous consequences and ultimate failure of such prohibition in a 2004 Las Vegas Review Journal op-ed, reprinted below.

Monday, December 28, 2020

Senator Rand Paul Highlights Fake Heart Attack Study in Government Waste Report


U.S. Senator Rand Paul just released his Festivus Report 2020, describing some $55 billion in “government waste”.  One stand-out example he cites is a fake heart attack study authored by Dharma Bhatta and Stanton Glantz (exposed by me here, here and here). 

Senator Paul mentions that “the NIH’s Office of Research Integrity has a process for banning individuals for ‘research misconduct’.”  Actually, I called for a federal investigation in June 2019 (here), and I laid out all of the evidence in a medical publication (here).  Despite the fact that one of the co-authors of that study retired early this year, an investigation is justified and overdue.

Following is Senator Paul’s verbatim description of the fake study:

“In the summer and fall of 2019, reports began popping up that a new fad among youth, vaping, was hospitalizing people.  According to The New York Times, reporting in August 2019, ‘[M]ore than 215... [patients] with mysterious and life-threatening vaping-related illnesses [were being treated] this summer.’  That same summer, the Journal of the American Heart Association (JAHA) published a bombshell article entitled ‘Electronic Cigarette Use and Myocardial Infarction Among Adults in the US Population Assessment of Tobacco and Health.’  To produce it, researchers at the University of California, San Francisco used three grants from the National Institutes of Health (NIH), totaling $31,522,244 to fund their work.  There’s just one problem: according to peers, the researchers faked the study!

“Just a month after it was originally published, one researcher at the University of Louisville, Dr. Brad Rodu, caught the flaws and was able to determine that a majority of the sample  population  (just 38 people) had heart attacks years before they started using e-cigarettes - a decade on average - and alleged the UC,  San Francisco researchers conducting the original study faked results.  How was Dr. Rodu able to make this allegation?  The UC-SF team accessed a public repository of information to populate their study, so he simply went back and looked at the original data. 

“Dr.  Rodu, evidence in hand, galvanized prominent tobacco researchers from 16 prestigious institutions around the world, including NYU, Yale, Stanford, the University of Michigan, and the University of Chicago, as well as institutions in England, Canada, and Greece, to send a letter  to the publishing journal demanding a review of the article for its veracity.

“Particularly, the cadre of researchers requested JAHA retract its publication of the study given ‘the analysis provided...strongly suggests that the published findings are unreliable and that there is a case to answer.’  According to research guidelines, retraction would be appropriate in the face of evidence of the sort that Dr. Rodu discovered - that is, ‘clear evidence that the findings are unreliable, either as a result of misconduct (e.g. data fabrication) or falsification (e.g. image   manipulation) or honest error (e.g. miscalculation or experimental error).’ 

“Ultimately, JAHA conducted the review and retracted the study.

“This is hardly the first case of researchers allegedly faking studies, and I promise it will not be the last.  In fact, the NIH’s Office of Research Integrity has a process for banning individuals   for ‘research misconduct.’  According to ORI, “[R]esearch misconduct is defined as ‘fabrication, falsification or plagiarism in proposing, reviewing research, or in reporting research results,’ excluding honest errors and differences of opinion. 

“So do the UC, San Francisco professors fit this description?

“It’s actually impossible to figure out, at least for now.  As part of the retraction process, JAHA requested the researchers ‘conduct their analysis based on when specific respondents said they started using e-cigarettes.’  Reasonable enough, right?  Well, when faced with that request, the researchers said it ‘would require ongoing access to the PATH Wave 1 survey - a restricted-use   dataset - and...[they] have been unable to access that database.’  In other words, the UC-SF researchers are effectively claiming they cannot back up their claims because their subscription to a database has expired.

“Now, if I were a professional researcher accused of research misconduct, and all I had to do to clear my name was to access a dataset I had already accessed to prove my work, I would do anything I needed to do so I could refute the claims against my work. 

“But maybe that’s just me.”



Thursday, December 17, 2020

High School Seniors Vaping Less While Smoking, Drinking, Getting Drunk More


Just-released 2020 Monitoring the Future survey results (here) indicate that all forms of vaping among high school seniors declined (as seen in chart at left), even as alcohol use, getting drunk, and cigarette smoking all increased.

Prior to this year, the rate of current smoking (i.e., past 30 days) had been on a precipitous decline.  Smoking rates fell by half from 2015 to 2019, from 11.4% to 5.7%.  Unfortunately, smoking rose to 7.5% in 2020.  At the same time, general vaping declined from 31% to 28%, and nicotine vaping also dropped.

Past 30-day alcohol increased from 29% to 33%, accompanied by a similar rise in getting drunk.  The only good news for intoxicating drugs was a single percentage point decline in marijuana use.

Last year the Monitoring the Future survey reported JUUL use for the first time, noting that it was used by 20.8% of high school seniors.  JUUL use this year plummeted by almost 40%, to 12.9%.

Flavored products continue to be vaped far less frequently than marijuana and nicotine offerings, suggesting that teens vape primarily to get a buzz.