The Centers for Disease Control and Prevention recently
released data from the 2019 National Youth Tobacco Survey (NYTS). My analysis confirms the FDA claim of an
increase in vaping among high school students, as seen in the chart at left. The most dramatic change is that exclusive
use of cigarettes almost fell off the chart from 2018 to 2019, from 2.6% to
0.8%. This unprecedented rate of decline
suggests that the eradication of combustible cigarette use among high schoolers
is within reach.
Government health officials are finding in the NYTS some
added support for their claim of an e-cigarette epidemic. Exclusive current (past-30-day) use of
electronic cigarettes rose from 15.1% the year before to 22.4% in 2019. The following table breaks down the numbers
for both years, showing legal and underage vapers, those who
currently/previously used other tobacco products or were virgin vapers; and how
frequently virgin vapers used e-cigarettes.
| Comparison of High School Vaping in 2018 and 2019 | ||||
|---|---|---|---|---|
| 2018 | 2019 | |||
| U.S. High School Students | 14.8 million | 15.0 million | ||
| Current Vape | 3.1 million | 4.1 million | ||
| Legal (18+ yrs) | ↓ | 600,000 | ↓ | 779,000 |
| Underage | 2.5 million | 3.32 million | ||
| Used other tobacco | ↓ | 1.7 million | ↓ | 2.17 million |
| Vaping ”Virgins” | 807,000 | 1.15 million | ||
| Vaped 1-19 days past month | ↓ | 712,000 | ↓ | 978,000 |
| Vaped 20-30 days | 95,000 (0.6%) | 171,500 (1.14%) | ||
The 2019 numbers in all categories are higher than the year
before. Current vapers rose from 3.1 to
4.1 million, reflecting similar increases in both legal and underage
groups. Among the latter, virgin vapers
grew at a higher rate (13%) than those who had used other products (9.4%).
The number of frequent virgin vapers (using 20-30 days in
the past month) increased from 95,000 to 172,000. This means that 1.14% of underage American high school
students with no other tobacco use might be addicted to vaping nicotine. Although this is cause for concern, it is far
from “a public health crisis in which a new generation is becoming hooked on
nicotine,” as the New York Times put it (here).
High
rates of marijuana use via vaping was a very important finding in the 2018
NYTS that was ignored by federal authorities, which borders on irresponsible when
marijuana products were the cause of lung injuries and deaths. However, it gets worse: marijuana wasn’t
mentioned at all in the 2019 questionnaire, suggesting that CDC survey administrators
were uninterested in making a distinction between cannabis and tobacco.
In many previous posts about the NYTS, I have been reluctant
to connect the sharp increase in teen e-cigarette use with the historic decline
in cigarette smoking. However, there is
now no doubt that the two behaviors are directly related, a situation that will
produce a significant public health benefit in the long run. Even if a small fraction of these high
schoolers end up addicted to vaping nicotine, the health risk will be a tiny
fraction of the risks associated with smoking.
While no one should be comfortable with underage teen drug
use in any form, moral outrage about nicotine use is entirely misplaced. Society accepts the widespread enjoyment of the
addictive but largely benign drug caffeine – there is no Campaign for Caffeine
Free Children screaming for coffee and cola flavor bans, excise taxes, Coffee 21
and burdensome federal regulation, for example. Nicotine should be tolerated in
a similar fashion.
Moral outrage is best directed at alcohol and
marijuana, addictive substances that are clearly associated with teen injuries
and deaths.
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