Another Engineered Study on Teen Vaping

 

Purdue, Ohio State and Penn State faculty, led by Brian C. Kelly, published an article in the April 2023 edition of Tobacco Control titled, “E-cigarette use among early adolescent tobacco cigarette smokers: testing the disruption and entrenchment hypotheses in two longitudinal cohorts.”  They concluded, “there is evidence e-cigarette use among early adolescent smokers in the UK and USA leads to higher odds of any smoking and more frequent tobacco cigarette use later in adolescence.” 

Lacking access to the U.K. data used by the authors, I focused on the findings from the U.S., which were based on the federal Population Assessment of Tobacco and Health (PATH) survey.  To clarify details of the authors’ methods, I reached out to them with some basic questions.

I telephoned and emailed the authors numerous times over seven weeks from April to June, and copied my last email request to journal editor Ruth Malone.  She responded, suggesting that I submit my questions via the journal’s Rapid Response system, which I did on June 12. On June 30, the authors finally responded, with less than full disclosure.

My questions are numbered, and they are followed by the authors’ responses in quotes, and then by my analysis in bold of what those responses mean for the study’s results and conclusions.

        1. Was public use or restricted PATH data used? This is important, since Table 2 contains a cell, n=7, that is not generally approved by NAHDAP.

            “…the analyses were based on the public use data from…the PATH Study.”

            It is critical to clearly identify the data used, which wasn’t the case in the article.

        2. Was the PATH cohort drawn from Waves 1 and 4, with follow-ups to age 17 years as needed from the other waves?

            “the PATH study sample was drawn from the original cohort, the replenishment cohort, and the shadow cohorts (see 1st and 2nd paragraphs of Methods Section).”

            The 1^st paragraph described the British cohort; it had nothing to do with PATH.  The 2^nd paragraph is a general description of the PATH youth survey, and while it mentions the replenishment and shadow cohorts, it does not state that the authors actually used them.

3. There were significant differences in youth smoking-vaping between Wave 1 (2013-14) and Wave 4 (2016-18) that might have affected the results. Was each wave analyzed separately as well as together?

            The authors didn’t answer this question.

4. The analysis included a variable relating to “parent(s) smoking of cigarettes, cigars, or pipes.” Did the analysis include other combustible tobacco product consumption by the subjects themselves?

The authors failed to respond to this question, or question #5 below.

5. Did the authors account for age at first smoking or vaping (public use, < 12 years and 12-14 years) or which product(s) had been used first?

            The authors instead provided the following statement:

“Regarding the remaining questions, please note that our stated goal was to make the MCS [the British dataset] and PATH analytical samples as comparable as possible when testing our hypotheses using both cohorts (3rd paragraph of Methods section).  As we note in the limitations section (5th paragraph of Discussion section), the MCS had relatively limited items on e-cigarette use and tobacco smoking compared to PATH. The MCS did not assess other combustible tobacco product consumption in early adolescence, nor did MCS measure the sequencing of early adolescent tobacco and e-cigarette use (noted in the limitation section).”

The 3rd paragraph of the Methods section says that they “restricted the PATH cohort to adolescents who were approximately the same age as youth in the MCS cohort.” 

While the authors noted the “limited items” and lack of “sequencing” in the MCS data, they did not specify that they stripped the rich PATH data of the comparable variables relating to #4 and #5 above.  Since the PATH and British datasets were entirely different, there was no scientific reason to strip PATH to make it “comparable” to the MCS.  It appears that the authors took this action only to support their predetermined finding.

In summary, this was another questionable article claiming that vaping leads to smoking.  The authors’ non-answers to my questions make it clear that they engineered this study to produce their desired result.

 

More Good News From the 2022 NHIS… But You Won’t Hear It from U.S. Health Authorities

 

Following on my post last week discussing dramatic improvement in vaping and smoking rates from the 2022 National Health Interview Survey (NHIS), today I present additional positive news from that survey.

The CDC last year counted 14.9 million current vapers, representing a 64% increase in just two years.  Importantly, 6.1 million vapers, or 41%, are former smokers.  This is the fourth NHIS survey in a row with 40+% of vapers having stepped away from the fire.  Can we prove that all of them used vapes to quit?  Of course not, but former means smoke-free, and it doesn’t matter how they quit, or how they stay that way. 

Following last week’s format, the next chart shows the number of current vapers according to smoking status and age.  The pattern here is crystal clear.  Young adults age 18 to 24 are not quitting smoking in high numbers by vaping, but 2.8 million, or 65%, of current vapers in that age group never smoked.  That is just as important, because never smoking is healthier than former smoking, regardless of vaping.  For all older age groups, the percentage of former smokers is around 50% or higher, which is vitally important since those are the ages when smoking-related diseases start kicking in, killing smokers.

 

The entire American health establishment, including the CDC and FDA, are obsessed with teen vaping.  A Google search for adult e-cigarette use in 2022 yields no results.  In other words, health authorities are turning blind eyes toward the nearly 15 million adults who enjoy nicotine and tobacco with little or no risk, as smoking inexorably – though still too slowly – declines.    

Imagine how fast sales and use of combustible cigarettes would disappear if public health leaders simply told smokers the tobacco truth – that vaping is 95% safer than smoking.

 

Astounding Smoking & Vaping Statistics in New CDC Data

 

The U.S. Centers for Disease Control (CDC) just released the full data set from the 2022 National Health Interview Survey (NHIS). Earlier, the agency published “Early Release of Selected Estimates Based on Data From the 2022 National Health Interview Survey,” a document that reflected the CDC’s propensity to cherry-pick data in order to portray all forms of tobacco as deadly and evil.

The chart at left shows the prevalence of smoking and vaping among American adults over the years the survey collected information on vaping -- 2014 to 2022.  Note that the smoking rate, denoted by the black and gray columns, started out at 16.8% and has since declined to 11.6%, for a drop of about 31%.  During that time, the vaping rate increased from 3.7% in 2014, to 6% last year.  One of the more noticeable trends is the increase in vapers who are former smokers, which I will examine in my next blog.

Now let’s look at the same statistics, but only for Americans age 18 to 24 years.  The smoking rate in 2014 was 16.6%, almost identical to that among all Americans, but then something extraordinary happened.  Smoking dropped a whopping 71%, to just 4.8% in 2022, while vaping increased substantially. 

 

The young adult numbers sync with those I’ve reported from the National Youth Tobacco Survey (here).  In short, smoking is a vanishing habit among teens and young adults in America.

Instead of celebrating this as a public health victory, anti-tobacco crusaders continue to denounce a nonexistent vaping crisis.  They decry another generation enslaved by nicotine, but ignore the millions of Americans who daily consume caffeine, which is also addictive and benign.  

While tobacco prohibitionists are, ironically, threatened by the fading of smoking, I have spent an entire career at major academic medical centers watching inveterate smokers pay a life-shortening price for being unable to quit the crusaders’ way, i.e., going nicotine-free.  Thankfully, today’s generation of smoke-free youth and young adults will enjoy a future devoid of the ravages of smoking, even as they continue to consume smoke-free tobacco products.