New National Survey Shows that Youth Nicotine Product Use Has Dropped to an All-Time Low

Opponents of tobacco harm reduction (i.e., vaping) have argued for years that the dramatic declines in youth smoking we have observed in recent years have been offset by equally dramatic increases in youth vaping, such that the total use of nicotine products among youth has remained stable. A new analysis using more recent data from the National Youth Tobacco Survey has found that in contradiction with this common claim, the truth shows something quite different.

According to the article: 

"Past-30-day use of any nicotine product decreased from 24.5% (95% confidence interval = 22.5%–26.6%) to 19.6% (16.8%–22.4%) between 2014 and 2017, increased sharply, reaching 31.4% (29.0%–33.7%) in 2019 (driven by an increase in e-cigarette use), then fell to the lowest level at 12.5% (10.9%–14.1%) by 2023." 

"The proportion who reported symptoms of nicotine dependence was substantially lower, but followed a similar pattern of changes over time. For example, the proportion reporting strong cravings decreased from 7.8% (6.6%–9.0%) to 5.5% (4.3%–6.7%) between 2014 and 2017, increased to 7.9% (6.8%–9.0%) between 2017 and 2018 and remained stable up to 2020, then fell to the lowest level at 2.5% (1.9%–3.1%) by 2023." 

The paper concludes that: "The sharp rise in the prevalence of nicotine product use (in particular, e-cigarettes) among US high-school students in the late 2010s was short-lived and was not accompanied by a sustained increase in the overall population burden of nicotine dependence. By 2023, both nicotine product use and nicotine dependence had reached historic lows."

The Rest of the Story

This research dispels the myth that reductions in youth smoking have been completely offset by an increase in youth vaping. It is not the case that the total amount of nicotine product use among youth has remained steady. It has in fact declined and reached its lowest point to date in 2023, driven by dramatic declines in youth smoking over the past decade and by more recent declines in youth vaping.

It is important to point out that even if youth smoking had been completely replaced by youth vaping, it still would have been a positive public health achievement, as the long-term effects of cigarette smoking dwarf those of e-cigarette use and because lifetime use of cigarettes is very common while most youth do not appear to be retaining their vaping habits into middle adulthood. 

In light of these new findings, any health group that continues to pooh-pooh the dramatic decline in youth smoking and the unprecedented public health gains of this public health miracle is either ignoring the data, obsessed with demonizing electronic cigarettes, or heavily smoking a non-nicotine-containing product.  

 

 

American Medical Association Article Claims that Quitting Smoking by Switching to Vapes is Not Quitting

According to an article published two days ago by the American Medical Association, a person who quits smoking completely but still uses non-tobacco-containing vapes has not quit smoking. The article states: "Another major misconception is that switching to e-cigarettes or vaping is a way to quit smoking traditional cigarettes. Using any other tobacco product or any other product that contains nicotine is not actually quitting.” 

The article goes on to state: "A lot of vape companies want consumers to believe switching to other tobacco products, including vapes or e-cigarettes is a way to quit. However, it is not, and there are a lot of unproven health claims made by the e-cigarette or vape industry that is confusing people who actually want to quit smoking. This creates a lot of confusion for people who really want to quit typical cigarettes and they feel that going to e-cigarette will be a way to help, but that’s not exactly true."

The Rest of the Story

Based on this article, a person who quits smoking with the help of a nicotine patch has not actually quit smoking. I'm sure this will come as news to the hundreds of thousands of smokers who have used nicotine replacement as a way to quit. Well I hate to tell the American Medical Association this but electronic cigarettes are a form of nicotine replacement, just like nicotine patches!

However, there's one major difference between nicotine patches and e-cigarettes: 

Nicotine patches only work about 10% of the time, while e-cigarettes work at least twice that much. A number of clinical trials have demonstrated that switching to vaping is superior to using traditional nicotine replacement therapy in helping adults quit smoking. 

This shows how absurd it is that the American Medical Association accepts switching to a nicotine patch to be quitting smoking but apparently, switching to a nicotine vape is not quitting smoking. 

What is going on here? I'll tell you. It's called lifestyle control. The tobacco control movement has largely lost its focus on public health and instead is now focusing on lifestyle control. They promote smoking cessation, but only if you quit the way they want you to quit. They are the ones who get to define what "counts" as quitting smoking, not you. It makes no difference that you are literally saving your life by becoming an exclusive vaper. You are still using nicotine by a mechanism that they despise, so they get to tell you that you've actually not quit smoking, even though you most certainly have.

Talk about "creating confusion for people who really want to quit typical cigarettes!" It is not the vaping companies that are creating confusion. They are being quite clear about how their products can help you quit. Instead, it is the American Medical Association--through articles such as this one--which is creating massive confusion for people who want to quit smoking.

If it ended here, it would be devastating enough. However, the article goes on to make more fallacious claims. 

It states that: "they [e-cigarettes] are just as addictive and with the same or additional risk of lung injury as traditional cigarettes." So they are actually claiming that vaping is just as dangerous to the lungs, if not more dangerous, than cigarettes! This is absurd. Smoking causes about 3.2 million deaths from lung disease worldwide every year. In contrast, vaping has not even been established as a cause of COPD, and it has been shown that COPD patients who switch from cigarettes to vapes experience dramatic improvements in their lung health, both objectively and subjectively. 

The article also claims that "the nicotine within the e-cigarettes and vapes is synthetic." This also comes as news to me since there are only about six companies that manufacture synthetic nicotine and only a small number of synthetic nicotine-based vaping products on the market. The overwhelming proportion of e-cigarettes are made with nicotine that is derived from tobacco.

Unfortunately, it is apparently no longer important in the tobacco control movement to provide accurate information. When I worked for the Office on Smoking and Health at CDC, we would never have even thought about making a false statement to the public. Now, tobacco control practitioners and organizations are doing it daily and apparently without being even slightly troubled.