Complicated Models Can’t Alter the Data: Smoking Among Youth and Young Adults Is Way Down

Smoking among high school students declined from almost 16% in 2011 to 9% in 2014 – a reduction of 43% in just three years.  That is according to data from the National Youth Tobacco Survey (NYTS) that I recently published (here). 

Now two researchers at the University of California San Francisco, Lauren Dutra and Stanton Glantz, torture the NYTS data to support a perceived “lack of a demonstrable acceleration in

the long-term rate of decline” in youth smoking after 2009. 

Dutra and Glantz analyzed smoking among children from 2004 to 2014.  They used a complicated model to determine the rate of decline from 2004 to 2009, then compared that to the 2011-2014 rate, when e-cigarette use was increasing among youths. 

The UCSF publicity statement on their work (here) states: “E-cigarettes …are actually attracting a new population of adolescents who might not otherwise have smoked tobacco products…”  Professor Glantz is quoted: “E-cigarettes are encouraging, not discouraging, youth to smoke and to consume nicotine, and are expanding the tobacco market.”  This resulted in headlines such as “Vaping encouraging youth to smoke” (here) and “E-cigarettes are creating a brand new generation of cigarette smokers” (here).

If Dutra-Glantz’s claims are true, we should see evidence of the “new generation” in the young adult population, particularly in current smoking rates among 18- to19-year-olds.  I used the CDC’s annual National Health Interview Survey to analyze two five-year periods: first, when e-cig use was minimal to nonexistent (2005-10), and then when e-cigs were in wide and growing use (2010-15).  I used the standard definition of current smokers: those who had smoked at least 100 cigarettes in their lifetime and smoke every day or some days.

The accompanying chart clearly illustrates that smoking declined among 18- to 19-year-olds during the first five years.  However, from 2010 to 2015 the rate dropped by over half among 18-19 year-old males, and by nearly two-thirds among females.

One fact is crystal clear: The decline of smoking in young adults is accelerating.

UCSF Study Falsely Links E-Cigarettes to Smoking

Academics at the University of California San Francisco have used the 2011 and 2012 National Youth Tobacco Survey to fabricate a claim that “e-cigarettes are likely to be gateway devices for nicotine addiction among youth, opening up a whole new market for tobacco.”  Lead author Lauren Dutra provided that quote to the media in a UCSF press release touting the study (here).  Dr. Stanton Glantz was a coauthor.  The study appears in the Journal of the American Medical Association Pediatrics.

The UCSF press release also contains a demonstrably false leading statement: “The study of nearly 40,000 youth around the country also found that e-cigarette use among middle and high school students doubled between 2011 and 2012, from 3.1 percent to 6.5 percent.”

These percentages DO NOT refer to current e-cigarette use, but to ever e-cigarette use, “even just one time.”  I have analyzed this data before (here and here).  E-cigarette use among middle and high school students did double between 2011 and 2012, from 1.0 to 2.0 percent.  The chart on the left provides a truthful picture of e-cigarette use.

 

The Dutra-Glantz study consisted of a dizzying array of statistical analyses that could not possibly support their claim that e-cigarettes are a gateway to cigarettes.  Unfortunately, the media is headlining this false claim around the globe. 

The only positive note in this otherwise dark story is that, for the first time, Dr. Glantz’s fabrication was called out by the American Cancer Society and the American Legacy Foundation.  The ACS’s Dr. Thomas Glynn said in the New York Times, “The data in this study do not allow many of the broad conclusions that it draws.” (here). 

Dr. David Abrams of the American Legacy Foundation confirmed that the data do not support the authors’ conclusion.  “I am quite certain that a survey would find that people who have used nicotine gum are much more likely to be smokers and to have trouble quitting, but that does not mean that gum is a gateway to smoking or makes it harder to quit,”

There is more.  My chart shows that although e-cigarette use increased, exclusive cigarette smoking plummeted, from 4% to 2.8% among middle school students, and from 14.6% to 11.8% among high school students.  This dramatic decline further undermines Dutra-Glantz’s claims.

Anti-tobacco extremists have won this media skirmish against e-cigarettes, but at a price – their integrity.