Despite Drastic Increase in Electronic Cigarette Experimentation from 2011-2012, CDC Survey Finds Decline in Cigarette Smoking Among Youth

Despite what the CDC has called an alarming increase in electronic cigarette experimentation among youth between 2011 and 2012, the prevalence of cigarette smoking actually declined during the same period, according to a report released by the CDC yesterday.

Among middle school students, current use (at least once in the past 30 days) of electronic cigarettes increased from 0.6% to 1.1% from 2011 to 2012. However, current smoking during the same period declined from 4.3% to 3.5%.

Among high school students, current use of electronic cigarettes increased from 1.5% to 2.8% from 2011 to 2012. However, current smoking during the same period declined from 15.8% to 14.0%.

Of note, this decline in cigarette smoking was not reported in the earlier CDC report on the increase in electronic cigarette use, nor was it mentioned in any of the multitude of interviews or news articles regarding the increase in youth e-cigarette use.

The Rest of the Story

It appears from these data that overall use of electronic cigarettes and conventional cigarettes remained essentially unchanged from 2011 to 2012. Despite the rather drastic increase in e-cigarette use, there was no corresponding increase in smoking. Thus, these data do not provide evidence that e-cigarette use has served as a gateway to smoking.

It may be, for example, that most of the electronic cigarette use that occurred was among either established smokers, or among nonsmokers who would have progressed to become cigarette smokers. This suggests the hypothesis that electronic cigarette availability may actually have prevented some youths from smoking. In other words, it is possible that youths who might otherwise have initiated smoking were instead attracted to electronic cigarettes. This hypothesis appears to be more consistent with the CDC data than its own conclusion that electronic cigarettes are serving as a gateway to youth smoking.

It is concerning to me that the CDC did not report this important finding when it reported its original conclusion that e-cigarette use had drastically increased among youth and that these products were serving as a gateway to smoking. The opportunity to see the data on trends in cigarette smoking would have helped the public to see that there was no scientific support for the CDC's conclusion. I thus find it curious that these important data were not reported until weeks after the media has already disseminated the conclusion that e-cigarettes are a dangerous gateway to cigarette smoking. The CDC officials certainly had plenty of opportunity to let the public know that there was no discernable increase in cigarette smoking among youth concomitant with the observed increase in e-cigarette use. It seems to me that this is a critical finding to report.

My impression remains that there is, for some reason (perhaps related to ideology), a pre-determined conclusion that e-cigarettes are evil. Instead of fairly reporting all of the evidence, only the evidence that supports the pre-determined conclusions are being shared. Data can only support the pre-determined conclusion. No data can refute or conflict with that conclusion.