Last week, five and a half months after the CDC and FDA published selective information on 2021 teen vaping (generating frightening “epidemic” headlines in major news media), the CDC finally released data from the 2021 National Youth Tobacco Survey (NYTS). I have confirmed the CDC finding that “11.3% of high school students (1.72 million) … reported current (past 30 day) e-cigarette use” (here). However, the CDC failed to mention that this is a 58% reduction in high school vaping from peak prevalence of 27.5% (or 4.1 million) in 2019. The survey also indicates that high school cigarette smoking declined to 1.9%.
As indicated in the chart, this represents a profound alteration from 2018, when the vaping rate among high schoolers increased substantially. The vaping rate rose again in 2019, but plummeted the next two years. Importantly, during that period the smoking rate fell 77%, from 8.3% to 1.9%. Tobacco prohibitionists’ claim that vaping would prove a gateway to smoking was without merit. In fact, it is now clear that vaping helped cancel smoking.
Let’s explore some gaps in the government’s representation of the 1.72 million high school vapers. First, about 519,000 of those vapers had also used other tobacco products, including cigarettes, cigars, pipes, hookah, smokeless tobacco, nicotine pouches and/or heat-not-burn (HNB) products. With respect to HNB, the NYTS has some odd data points. Roughly 316,000 high schoolers reported that they had ever used HNB, and 123,000 said they were current users. That is simply impossible. The only HNB sold in the United States was IQOS, but that product was taken off the market by a patent lawsuit. Additionally, Philip Morris International implemented strict controls that limited teens’ ability to obtain the products.
Of the 1.2 million “virgin” vapers with no other tobacco use, 732,000 used the products infrequently (19 days or fewer in the past month), and 467,000 vaped 20+ days. This means that up to 3% of American high school students with no other tobacco use could have become addicted to vaping nicotine, a drug that is not associated with any smoking-related disease. That number, while of concern, does not constitute an “epidemic,” even though anti-tobacco activists constantly use that term (here).
As I have noted previously, high school vapers are not just using tobacco/nicotine; they are vaping marijuana at high rates as well. The next chart shows a large majority of high school vapers, regardless of frequency, have vaped marijuana.
Government public health officials express moral outrage about youth nicotine use, but their concern ought to be directed at the real high school epidemics, evidenced by these statistics from the CDC:
39% text/email while driving
30% drink alcohol
20% use marijuana
17% ride with a driver who had been drinking
17% considered suicide in the past year
16% carry a weapon
14% binge drink
13% drive after marijuana use
Note to activists: Prioritize the activities putting teens at actual risk of injury and death.
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