Miscounting Teen Perceptions of E-Cigarettes

The journal Pediatrics recently published a report based on the 2012 and 2014 National Youth Tobacco Surveys (here).  Stephen Amrock and coauthors from the Oregon Health Sciences University found that 51 percent of middle and high school students believed that e-cigarettes were less hazardous than cigarettes. 

Given the tsunami of e-cigarette misinformation generated by some in the public health community, it is downright impressive that even this many youths know the truth about these products.  Still, only 13 percent correctly believed that chew, dip or snus posed less danger than cigarettes.  

The media, in keeping with its general anti-tobacco, anti-e-cigarette bias, sensationalized the Pediatrics report with a negative spin. A HealthDay article on October 25 (here) featured three false statements:

• Headline: “3 in 4 Teens Think E-Cigarettes Safer Than Tobacco: Survey”

• Opening line: “Close to three-quarters of American teenagers believe e-cigarettes are less harmful or addictive than real cigarettes, a new study finds.”

• Paragraph 8: “...Amrock and his colleagues found that 73 percent of teens believed e-cigarettes were less harmful than cigarettes.”

All of the above are demonstrably false, as they transformed the 51 percent response rate to 73 percent.  Amrock himself misstated the 13 percent for smokeless tobacco as 20 percent.  How did this happen?

The “3 in 4” or 73 percent result was generated only after Amrock excluded 27 percent of students who reported that they “don't know enough” about e-cigarettes and 4 percent who were unaware of the products.  This is shown in Table 1 of the article. 

It was improper to omit these students in order to make the result almost one-half higher.  Amrock and his colleagues went on to use the altered figure as the principal finding in their abstract, and the media followed suit.  The altered figure was also prominent in an October 17 blog by the journal’s editor-in-chief, Dr. Lewis First (here).     

Only 13 percent of American students know that smokeless tobacco is safer than cigarettes and only 50 percent know the truth about e-cigarettes – a sorry commentary on education, the performance of our public health institutions and the credibility of some in the research community.