New Article in American Journal of Medicine Claims that Youths Who Use E-Cigarettes are 5 Times More Likely to Become Cigarette Smokers

I've only been back at this for one day and the very first new article that I came across makes the preposterous claim that use of e-cigarettes increases by 5-fold the initiation of cigarette smoking among youth. The article, published as a commentary in the American Journal of Medicine, states as follows: "E-cigarette use by adolescents increases by up to 5-fold their initiation of tobacco cigarette smoking."

The Rest of the Story

It is difficult to believe that anyone could look at the actual data on the prevalence of youth cigarette smoking in 2024 and make the claim that vaping by youth leads to a 5-fold increase in smoking initiation. If that were true, then given the tremendous rise in vaping that we have observed over the past decade, one would certainly expect to see that translate into a substantial increase in the prevalence of youth smoking. As I pointed out yesterday, an analysis by Dr. Brad Rodu demonstrated that in 2011, smoking prevalence among high school students was 15.7%, while the prevalence of vaping was just 1.4%. By 2022, the prevalence of vaping among high school students had skyrocketed up to 14.1%, yet smoking among high school students dropped to just 2.0%. And by 2024, smoking prevalence among high school students was only 1.7%.

These data definitively refute the contention that e-cigarettes are a gateway to smoking among youth and are completely inconsistent with the claim that e-cigarette use leads to a 5-fold increase in youth smoking initiation rates. 

Interestingly, the article in question fails to provide any citation or source for its preposterous claim that vaping is greatly accelerating the initiation of smoking by youth. Apparently, we are supposed to just take it on faith that this is true.

The article also makes two additional assertions that are hard for me to believe are still being made in 2024. 

First, the article claims that: "At least 4.5% of adults, 10% of high school students, and 4.6% of middle school students now use tobacco e-cigarettes." The problem with this statement is that there are no such things as "tobacco e-cigarettes." By definition and by intention, electronic cigarettes do not contain any tobacco. That is the entire point! If an e-cigarette did contain tobacco then I would not consider it to be an e-cigarette; it would be a heated tobacco product. Even the American Cancer Society admits that e-cigarettes do not contain tobacco. 

It has now been 17 years since e-cigarettes were first introduced in the United States. One would have thought that by now, smoking cessation experts of all people would appreciate the fact that the unique selling proposition for e-cigarettes is that they do not contain tobacco.

Second, the article claims that: "Nonetheless, in one trial, up to 80% of those who ceased tobacco cigarette smoking for 12 months with e-cigarettes continued to smoke e-cigarettes." This is apparently news to the authors of this commentary but you do not smoke an e-cigarette. You vape an e-cigarette. This is why e-cigarette use is referred to as vaping rather than smoking. E-cigarettes do not produce any smoke because they involve no combustion. Again, that is the entire point!  

It has now been 17 years since e-cigarettes were first introduced in the United States. One would have thought that by now, smoking cessation experts of all people would appreciate the fact that the unique selling proposition for e-cigarettes is that they do not involve any combustion and therefore do not produce any smoke; hence, you cannot smoke an e-cigarette. 

The question arises, then, whether the authors of this commentary are really so uninformed about the nature of e-cigarettes that they simply are not aware that these products do not contain tobacco and do not involve combustion, or whether they are intentionally using smoking-related terminology to create the impression that vaping and smoking are essentially equivalent.