As Youth Smoking Rates Continue to Plummet, Anti-Smoking Advocates Continue to Claim E-Cigarettes are a Gateway to Youth Smoking

New data from the Florida Department of Health show that in 2015, smoking among Florida youth dropped to its lowest all-time level, with only 6.9% of high school students reporting past 30-day use of cigarettes. The sharp decline in youth smoking occurred contemporaneously with the tripling of e-cigarette use among Florida youth during the past two years.

Nevertheless, health officials continue to claim that e-cigarettes are a gateway to youth smoking and that e-cigarettes are normalizing smoking. According to an article in the Gainesville Sun:

"After decades of aggressive work to try to keep teens from picking up the deadly habit, health officials worry that e-cigs will undo that progress. ... the increase in e-cig use has the potential to normalize smoking again after decades of work to stigmatize it, the health department's Community Health Promotion Division Director Shannon Hughes said in a press release."

The Rest of the Story

The rest of the story is that the claims of anti-smoking advocates are simply not supported by the available data. If e-cigarette experimentation were a significant gateway to youth smoking, or if vaping normalized smoking, we would not expect to see youth smoking plummeting in the past two years, dropping to its lowest historic levels, at the same time as e-cigarette use among youth has tripled.

The truth is that the advent of e-cigarettes has made smoking even less attractive because there is a safer, cleaner, tastier alternative. Vaping is unquestionably contributing to a further denormalization of smoking. The truth is the exact opposite of what many anti-smoking groups are claiming.

It is time for anti-smoking advocates to recognize that the only thing vaping is normalizing is vaping. Although short-term use of electronic cigarettes does not appear to pose any significant health risk (other than to pregnant women), the spread of e-cigarette use among youth is still concerning. But it is not concerning because it is leading to smoking. It is concerning because many youth are now vaping. Ultimately, we don't want to see youth using nicotine at all. But the problem needs to be defined accurately.

What is contributing to the renormalization of smoking are the actions of anti-smoking groups, who have misled the public into believing that smoking is no more hazardous than using a non-tobacco-containing, non-combusted product. This has completely undermined the public's appreciation of the severe hazards of smoking. In fact, surveys have shown that a substantial proportion of the public actually believes that vaping is no safer than smoking. This is an untenable situation that normalizes smoking by demonizing electronic cigarettes and protecting cigarette sales. 

Health groups that continue to advise against the use of e-cigarettes in smoking cessation attempts, such as the American Academy of Family Physicians (AAFP), which recently issued a recommendation that physicians counsel against the use of e-cigarettes, are also contributing to the renormalization of smoking by helping to maintain cigarette use. The AAFP's recommendation, if followed by physicians, will lead to many smokers failing to quit and many ex-smokers returning to smoking because their doctors do not condone e-cigarette use.

Electronic cigarettes truly have the potential to be a game-changer in tobacco control. They could contribute to a massive transformation of the nicotine market in which combustible tobacco products eventually become obsolete. This is in fact the value proposition for all of the independent e-cigarette companies. But this transformation is being blocked by the unlikeliest of entities: the tobacco control movement itself.