Wednesday, July 31, 2019

Panel Examines Youth Vaping ‘Epidemic,’ Overlooks Real Threats

Yesterday Inside Sources published my column on how Congress focused on the vaping “epidemic” while ignoring legitimate threats to American teens.  Read it here or at Inside Sources.

The House Committee on Oversight and Reform held two days of hearings last week on “JUUL’s Role in the Youth Nicotine Epidemic.” Make no mistake: the hearings were about congressional grandstanding, not a discussion of what really threatens American teens.

According to data from the Centers for Disease Control, the high school vaping rate is lower than that for marijuana and alcohol use. It’s about the same as binge drinking (four or five drinks within a couple hours).  And, as we know, these activities don’t typically occur in a vacuum. High school students frequently drive after marijuana use, ride with a driver who has been drinking, text or email while driving, have sexual intercourse, and consider suicide.

But despite these truly worrisome activities, tobacco prohibitionists like Campaign for Tobacco-Free Kids have convinced Congress, school boards and parents that e-cigarettes have created “a public health emergency.”  Former FDA Commissioner Scott Gottlieb and other government officials fueled this anxiety by referring to the rise in teen vaping as an “epidemic.”

The hysteria stems from the CDC’s National Youth Tobacco Survey, which federal officials refer to as the gold standard of information about teen vaping. But they tout these numbers without any context.  And that context is critical.

We frequently hear that 3 million high school students in 2018 were “current vapers.” But if you look closer at the data, 3 million teens had used an e-cigarette at least once in the past 30 days. And 600,000 of the high school vapers were 18 or older, so they could purchase tobacco products legally in most states. The rest were underage. Of the 2.5 million underage vapers, about 1.7 million had also smoked a cigarette, cigar and/or had used smokeless tobacco.

Of the 807,000 underage vapers with no history of other tobacco use, 70 percent had used e-cigarettes only one to five days during the month — the equivalent of trying one at a party. Only 95,000 students had used the products 20 to 30 days, suggesting that they might be addicted.  And this represents just 0.6 percent of the nation’s nearly 15 million high school students — a far cry from Gottlieb’s hysteria that we’re “hooking an entire generation of children on tobacco and nicotine.”

These estimates are based on the CDC’s youth tobacco survey, so they’re certainly not “underestimates.”  Yet the rabidly anti-tobacco Truth Initiative produced an estimate for 2018 that is nearly half that of the 3 million number touted by the CDC.

In addition to faulty data, the House hearing echoed the government’s false narrative blaming teen vaping on illegal retail sales and “kid-friendly marketing.”  But the FDA’s own research shows that more than 90 percent of teens who use e-cigarettes obtain them from social sources, such as friends or family. Only 10 percent of current teen vapers buy their own — and many of those are of age. Raising the purchasing age from 18 to 21 could potentially disrupt high school “black markets.”

Lawmakers also go after fears about nicotine. They reference the Surgeon General’s claim that nicotine is “very and uniquely harmful” to the developing brain, and that vaping can impair learning and memory in those up to age 25.  Scientific evidence to support this is non-existent. In contrast, there is unequivocal evidence linking youth football and other concussion-producing sports activities to chronic traumatic encephalopathy (CTE) (here, for example).  If Congress wanted to protect children’s brains, this would be a more productive area for their focus.

Nicotine is about as safe to use as caffeine, which is also addictive, but it doesn’t cause any of the many cancers, heart attacks, strokes and emphysema that come from the toxins released from burning tobacco.

Congress wants you to believe that the increase in teen vaping will lead to a surge in young adult smoking.  But the reality is just the opposite. Cigarette smoking dropped in half among young adults between 2014 and 2018. And while vaping increased, use of both products fell during the same period. Vaping is contributing to the evaporation of smoking among young Americans.

American teenagers are engaged in lots of risky behavior — but vaping, which the prestigious British Royal College of Physicians says is 95 percent less hazardous than smoking — is not one of them.

Congress should focus on how to really keep high school students safe.

Thursday, July 18, 2019

As Young Adult Smoking Evaporates, “Teen Vaping Epidemic” Appears Overblown

Federal officials have portrayed teen vaping as a pending disaster, creating a new generation of nicotine addicts heading for lifetimes of smoking and disease, culminating in early deaths.  The scenario is primarily based on a distorted and exaggerated interpretation of data in the National Youth Tobacco Survey. 

One way to judge the validity of these teen vaping claims is to look at what’s happening among young adults 18-24 years old.  If the government claims are accurate, we should see the disaster starting to unfold in this group.

The chart at left, based on the CDC’s National Health Interview Survey, shows the prevalence of current smoking and vaping among young adults from 2014 to 2018.  Exclusive smoking is in red, dual use is in pink, and vaping is in green (with former smokers in lighter green). 

The chart’s main message is seen in the sharp decline of red-pink.  Exclusive smoking prevalence dropped in half, from 13.3% to 6.1%, as did dual use.  Vaping increased, but only from 1.7% to 5.9%.  In fact, all use went from 18.3% in 2014, all the way down to 10.1% in 2018 – an impressive decline.  The clear takeaway is that smoking is evaporating among young Americans.

Some in Congress are intent on addressing the so-called crisis, as seen by Representatives Frank Pallone (D-NJ) and Donna Shalala’s (D-FL) June 20 call for co-sponsors for H.R. 2339, the Reversing the Youth Tobacco Epidemic Act of 2019.  In reality, the “epidemic” is already in reverse.

Thursday, July 11, 2019

With the National Health Interview Survey, Never Smokers May Have Smoked

Last week I revealed that, based on the 2018 National Health Interview Survey (NHIS), there were about 8.07 million American adult vapers, up from 6.9 million in 2017.  I noted that there were 1.71 million vapers who were never smokers, which is also a substantial increase from the prior year – and potentially troubling.  Let’s take a closer look.

First, it’s important to understand how the NHIS defines never smokers.  They are not necessarily cigarette virgins; they just never smoked 100 cigarettes in their life, which is the cutoff for ever smokers. 

The NHIS never smoker definition includes those who smoked up to five packs.  In contrast, the FDA-funded Population Assessment of Tobacco and Health (PATH) survey asks more detailed questions that allow us to distinguish between people who truly never smoked from those who smoked fewer than 100 cigarettes.  We called the latter group triers in our comprehensive study of e-cigarette users published in Nicotine & Tobacco ResearchWe documented that almost all so-called never smokers were, in fact, current or former cigarette triers.

Further examination of the 2018 NHIS reveals that about three-quarters of the so-called never smoking vapers (1.31 million) used the products some days; the rest were daily users.  About 70% were 18-24 years old, and 20% were age 25-34 years.  Thirty-one percent had smoked a cigar, 3.5% had used smokeless tobacco, and 12% had used both products.  Forty-one percent had at least one episode of binge drinking in the month prior to the survey (that is, 5+ drinks for men, and 4+ for women). 

In summary, many current vapers who never smoked in the 2018 NHIS were young, had used other tobacco products, probably had smoked cigarettes and consumed alcohol.  As I have noted previously, these characteristics refute the claim that vaping is attracting tobacco virgins and creating a new generation of nicotine addicts.