CDC Concludes that Advertising is What Has Caused Kids to Use Electronic Cigarettes

In an interview with WebMD, a CDC tobacco control expert concludes that the reason youth are using electronic cigarettes is the advertising of these products.

The CDC official stated: "We don’t like to see kids using any form of nicotine, because nicotine is not a good thing for a developing adolescent brain. ... It’s introducing them to a behavior that is very similar to smoking. The thing that got them interested was mass advertising that glamorizes the act of vaping."

The Rest of the Story

When I worked at CDC, in the Office on Smoking and Health (OSH), we did not even draw conclusions that cigarette advertising causes youth to initiate smoking without having scientific evidence to support that conclusion. In fact, most of my research at OSH was devoted to study of the relationship between cigarette advertising exposure among youth and adolescent smoking behavior. It would not have occurred to me to conclude that cigarette advertising is the cause of youth smoking in the absence of a single study supporting that conclusion.

Now, however, the CDC is apparently willing to draw a conclusion about the impact of electronic cigarette advertising on youth e-cigarette use without a single study on the topic. To be clear, there is no scientific evidence relating to the impact of e-cigarette advertising on youth vaping. There is not even a single study of the extent of youth exposure to e-cigarette advertising.

Is there a need for research on the potential effect of e-cigarette advertising on youth e-cigarette use? Yesterday, I would have said absolutely. But today, what is the point of doing such research, when a causal conclusion has already been reached and disseminated to the public?

Electronic cigarette advertising levels have not been particularly high and it is not clear how substantial youth exposure to such advertising has been. Another plausible hypothesis is that it is not advertising of the product, but general exposure to the product through the media that has contributed to youth awareness of and experimentation with the product. For all we know, more youth saw Katherine Heigl vape on Letterman than have ever seen a Blu advertisement. (This is a testable hypothesis, by the way, but what is the point of testing it since a conclusion has already been drawn?)

The answer to this important question has significant policy implications. Understanding the reasons for youth vaping, including the potential role of advertising, would be important to the FDA in promulgating regulations that govern e-cigarette advertising.

This appears to be another example of tobacco control practitioners disseminating the answer to a question before we have conducted research to provide an evidence-based answer. Does the answer really matter? It appears not. It appears that a pre-determined ideology that opposes electronic cigarettes is leading us to draw conclusions on the product without evidence. The CDC has already disseminated the conclusions that e-cigarettes are a gateway to youth smoking and that advertising is responsible for this effect, even though there is absolutely no research on either question.