Top Ten Ridiculous E-Cigarettes Cause Popcorn Lung Claims of 2024

Perhaps the most misleading and damaging claim that is still being made about e-cigarette use in 2024 is the contention that vaping e-cigarettes causes bronchiolitis obliterans, or "popcorn lung," which is a severe lung disease characterized by inflammation and scarring in the deepest airways of the lung. The most recent iteration of this fallacious claim appears to have originated, at least in part, from a widely-cited 2016 American Lung Association article entitled "Popcorn Lung: A Dangerous Risk of Flavored E-Cigarettes." The only evidence presented to support this claim was that low levels of diacetyl were detected in the e-liquids of a number of e-cigarette brands and that massive acute exposure to diacetyl has been linked to bronchiolitis obliterans in popcorn factory workers. The claim was not based on a single documented case of popcorn lung occurring in someone who used e-cigarettes.

Today, I list 10 of the most fallacious vaping-popcorn lung claims made in 2024. I only included claims if I could verify that they were made in 2024.

Top 10 Most Fallacious Claims About E-Cigarettes Causing Popcorn Lung -- 2024

1. University Hospitals (Cleveland, OH): On April 25, 2024, University Hospitals published an article entitled "Popcorn Lung: A Dangerous Risk of Vaping." The article definitively links vaping electronic cigarettes with popcorn lung, stating: "In recent years, there’s been a sharp increase in the use of e-cigarettes, also known as vaping. Many people believe that it is a safer alternative to smoking; however, the inhaled vapor contains more than 7,000 potentially harmful chemicals that can damage the lungs and lead to serious conditions, including popcorn lung." 

Reason for ranking: There is no evidence that vaping electronic cigarettes causes popcorn lung. This myth developed because e-cigarette aerosol in tests of a few brands detected diacetyl, which is the chemical which if inhaled in large doses can cause popcorn lung. But the level of diacetyl in e-cigarette vapor is on average 750 times lower than in a real cigarette. Yet cigarette smoking itself has not been recognized as a cause of popcorn lung. Moreover, there has not been a single, credible, published case of popcorn lung in an e-cigarette vaper that was attributable to the use of e-cigarettes. That's pretty definitive evidence that vaping e-cigarettes does not present a risk of popcorn lung. There have been reports of a condition similar to bronchiolitis obliterans (popcorn lung) occurring in patients who vaped THC vape carts that were laced with vitamin E acetate, a thickening agent that some black market wholesalers of THC vape carts were adding to the product to increase its street value. However, there is no evidence that nicotine e-cigarettes purchased from stores or vape shops have caused any cases of popcorn lung.

2. Public Health, Delta and Menominee Counties (Escanaba and Menominee, MI): According to this local health department's Facebook statement on November 5, 2024: "Vaping can cause popcorn lung, a respiratory condition that can cause your airways to become inflamed, damaged, and scarred." The health department simply states this as a fact, providing no references, citations, or explanatory reasons.

Reason for ranking: There is no evidence that vaping electronic cigarettes causes popcorn lung.

3. M.D. Anderson Cancer Center (Houston, TX): In a January 5, 2024 article, the M.D. Anderson Cancer Center claimed that: "Vaping has also been linked to a type of lung damage called bronchiolitis obliterans, or popcorn lung, which is caused by a chemical called diacetyl used to sweeten some vape liquids." 

Reason for ranking: There is no evidence that vaping electronic cigarettes causes popcorn lung.

4. MedicineNet: MedicineNet not only informs us that vaping causes popcorn lung; it also tells us the exact time course: "The symptoms of popcorn lung from vaping can appear anywhere from two to eight weeks after inhaling certain irritants." This article was medically reviewed on August 1, 2024.

Reason for ranking: There is no evidence that vaping electronic cigarettes causes popcorn lung.

5. WebMD: In an article reviewed on November 21, 2024, WebMD asks "How Else Can Vaping Affect Your Lungs" and then lists as the first entry "Popcorn Lung." 

Reason for ranking: There is no evidence that vaping electronic cigarettes causes popcorn lung.

6. Ask Dr. Zac (Australia): I don't know whether Dr. Zac is the Australian equivalent of Dr. Oz, but he is a physician trained at the University of Sydney. In his August 25, 2024 column, in response to a question from a woman whose husband uses e-cigarettes, Dr. Zac states: "Popcorn lung is very real, and will affect your husband eventually if he does not stop."

Reason for ranking: This one had to be included to represent the widespread misrepresentation of the health effects of vaping that is prevalent in Australia. It is quite a claim because not only does it tie e-cigarette use to popcorn lung, but it states that anyone who vapes will eventually get popcorn lung. That is news to the more than 20 million regular vapers in the U.S. who have not yet developed popcorn lung. Miraculously, Dr. Zac seems to believe that popcorn lung somehow evades smokers, even though their exposure to diacetyl is much higher. By the way, Dr. Zac goes on to say: "The only thing that should be in our lungs is air, nothing else. I like to compare vapes to a fast-food restaurant’s salad. It seems healthy compared to the other items on the menu but when you look closely, you realise it is just as bad as the other menu items." A side salad from Burger King with Ken's Lite Honey Balsamic Vinaigrette dressing has 230 calories, 16g of fat, and 15mg of cholesterol. In contrast, a Burger King's Texas Double Whopper delivers 1,090 calories, 75g of fat, and a whopping 195mg of cholesterol. So the side salad is no more healthy than the Texas Double Whopper? It's no surprise, I guess, that he believes that vaping is no more healthy than smoking.

7. Verywell Health: In an article posted on August 22, 2024, Verywell Health stated: "Research indicates that flavors that contain a sweetener known as diacetyl can lead to a serious lung condition known as bronchiolitis obliterans, also known as popcorn lung." 

Reason for ranking: There is no evidence that flavored e-liquids, even those that contain diacetyl, cause popcorn lung.   

8. Regional Cancer Care Associates (New Jersey, Connecticut, Maryland, DC): In answer to the question "What are the Health Risks of Vaping," the first effect listed is "Bronchiolitis Obliterans" (popcorn lung). The web site states: "Also known as popcorn lung, bronchiolitis obliterans can develop because of the presence of an organic compound called diacetyl that is found in e-cigarettes." This post is from February 21, 2024.

Reason for ranking: There is no evidence that e-cigarette use causes popcorn lung.

9. Houston Methodist: In a December 9, 2024 article, Houston Methodist asks "How else does vaping affect your lungs?" One of the answers is: "Also known as "popcorn lung," this condition is caused by the food additive diacetyl." This article is from just two weeks ago. The fallacious claim about e-cigarettes causing popcorn lung appears likely to be alive and well going into 2025.

Reason for ranking: There is no evidence that e-cigarette use causes popcorn lung.

10. Cancer Institute NSW (Australia): This cancer institute states on its website, dated 2024: "Experts are very concerned about flavouring chemicals found in vapes. These have been linked to ‘popcorn lung’ (bronchiolitis obliterans)." 

Reason for ranking: There is no evidence that flavored e-liquids, even those that contain diacetyl, cause popcorn lung.

"Quit Our Way or Die": Lifestyle Control in the Modern-Day Tobacco Control Movement

There is strong evidence that smokers who switch to e-cigarettes completely are more likely to succeed in quitting than smokers who use nicotine replacement therapy (NRT). There is similar evidence that smokers who try to quit using e-cigarettes are more successful than those who utilize smoking cessation counseling. In fact, the difference in effectiveness between the use of daily e-cigarettes and the use of nicotine replacement therapy is large: there is about a 2-fold difference. In other words, smokers who try to quit by switching completely to vaping are twice as likely to succeed than those who try to quit by using nicotine replacement therapy.

The Rest of the Story

In spite of the evidence establishing daily vaping as a highly effective method for smoking cessation, I was recently surprised to see that most health organizations--including smoking cessation clinics--are recommending that smokers should NOT attempt to quit smoking using electronic cigarettes, even if the individual is strongly motivated to quit by switching to vaping, specifically prefers vaping to nicotine replacement therapy or other medications, and has tried to quit using NRT or medications in the past but failed.

Here are just a few of the many health organizations and smoking cessation programs that don't want smokers to succeed in quitting by using e-cigarettes. It is what I call the "Quit Our Way or Die" approach to smoking cessation.

Partial List of "Quit Our Way or Die" Organizations

1. UCSF: The University of California at San Francisco provides a list of treatment options for smoking cessation, but daily use of electronic cigarettes (that is, switching completely to vaping) is not among the options. Shamefully and irresponsibly, their medical advice is based on a 2008 reference and apparently ignores all of the changes in scientific evidence in the past 16 years. Even in their current smoking cessation guidebook, e-cigarettes are not mentioned, even as a possible smoking cessation aid, and in fact, patients are specifically advised not to use e-cigarettes in a quit attempt (even though more than 3 million people have used this approach successfully). 

2. American Cancer Society: The American Cancer Society denies that electronic cigarettes can help people to quit smoking and recommends against their use in smoking cessation, even though more than 3 million people have used this approach successfully: "E-cigarettes are not approved by the FDA as aids to help people stop smoking. This is because there is not enough research to show they help people stop using tobacco. On the other hand, there are other proven methods that can help you quit using tobacco. This includes FDA-approved nicotine replacement and other medicines. There is a lot of evidence showing that these methods work. They are safe and effective, especially when combined with counseling. Some people choose to try e-cigarettes to help them stop smoking. But e-cigarettes have as much if not more nicotine as regular cigarettes and other tobacco products." The reason e-cigarettes are not approved by the FDA as aids to help people stop smoking is not because there is a lack of evidence that they can help people stop smoking, but because no company has ever applied for FDA approval of e-cigarettes as smoking cessation devices. Further, the fact that e-cigarettes have nicotine, just like regular cigarettes, is not a reason to avoid them; on the contrary, it is the exact reason why these products work. NRT products contain nicotine, but the American Cancer Society is not discouraging people from using those products.

3. American Lung Association: The American Lung Association denies that electronic cigarettes can help people to quit smoking and recommends against their use in smoking cessation, even though more than 3 million people have used this approach successfully. The American Lung Association states: "Despite what e-cigarette, vape and other tobacco product companies want you to believe, switching to use of any other tobacco product is not quitting. E-cigarettes are still tobacco products, and FDA has not approved any e-cigarette as a way to quit for good. In fact, the FDA must crack down on the unproven health claims made by the e-cigarette industry because it's confusing people who want to quit." Thus, the American Lung Association doesn't even consider single-use vapers as having quit smoking. This is absurd. If you have switched from smoking to vaping, then you have quit smoking. What the American Lung Association is telling vapers is that if you have quit smoking by switching completely to vaping, you might as well go back to smoking because what you did doesn't count.

4. American Heart Association: The American Heart Association also denies that electronic cigarettes can help people to quit smoking and recommends against their use in smoking cessation, even though more than 3 million people have used this approach successfully. The American Heart Association states: "E-cigarettes are sometimes marketed as a way to quit smoking, but there is not enough scientific evidence that it works. One study reported adult smokers who used e-cigarettes were 28% less likely to quit successfully. The American Heart Association recommends using proven methods to quit smoking." E-cigarettes are a proven way to quit smoking. And there is plenty of strong scientific evidence that they work; in fact, they work more effectively than NRT.

Final Thoughts

I have to seriously say that I have so much respect for people who have quit smoking by switching to vaping. To do this in an environment when health authorities all around them are urging them not to and telling them how dangerous it is, but to have the wisdom and insight to discount that advice and instead rely on their own research and the experiences of friends, family members, vape shop owners, and others in the vaping community is wise, courageous, and admirable.

But while I praise vapers who have quit smoking, so many of my tobacco control colleagues are lambasting them for it. Moreover, they are completely ignoring their experiences, calling them nothing but anecdotes. Of course, when you have 3 million anecdotes, you can call it rock solid evidence.

The rest of the story is that most of the major medical and health organizations have deviated from the practice of medicine and public health. Instead, they are practicing lifestyle control. You have to quit their way or you haven't actually quit. Who gives them the right to define what smoking cessation is? How can they possibly argue that quitting smoking by switching to e-cigarettes isn't quitting smoking? Apparently, it isn't the health of smokers that these organizations really care about. It is controlling people's lifestyles and telling them how they should be living their lives, regardless of whether that advice is in the best interests of the health of the public.

The Center for Tobacco Control Research and Education at UCSF is Not Sure Smoking is Any More Hazardous than Vaping

I recently read an article written by the director of the Center for Tobacco Control Research and Education at UCSF. What struck me most was the article's answer to the question "Is vaping safer than smoking?" The answer given was: "We don't know for sure."

OK, I realize that many years ago there was not a lot of research on the health effects of vaping and it had only been around for a short period of time, so perhaps we didn't know for sure that vaping was any safer than smoking. That was in 2008 - a full 16 years ago. Before criticizing the article, I thought I should check the date. Perhaps this was an old article that simply was not taken down from the web site and there was no reason to make a big deal out of this.

The Rest of the Story

It turns out that the article was published on December 18, 2024 -- three days ago!

So you're telling me that in late 2024, the tobacco control center at UCSF is still not sure that smoking is any more hazardous than vaping? 

Even the tobacco industry doesn't claim that smoking is no more hazardous than vaping. In fact, unlike UCSF's tobacco control center, the tobacco industry readily admits that smoking is far more hazardous to your health than vaping. 

There are numerous clinical studies demonstrating that vaping is much safer than smoking, both in terms of respiratory health and cancer risk. We know, for example, that switching from smoking to vaping results in a reduction in respiratory symptoms as well as measurable improvements in lung function. We also know that people who vape rather than smoke have substantially lower levels of carcinogen biomarkers. 

So in 2024, to claim that we don't know if smoking is any more hazardous than vaping is not only absurdly wrong, it is also terribly irresponsible. If a doctor were to tell her patient that there's really no difference between vaping and smoking as we're not sure that smoking is actually any more hazardous than vaping, that would represent medical malpractice in my opinion. Even Dr. Stanton Glantz - the prestigious founder of the tobacco control center at UCSF - has no hesitation in acknowledging that smoking is more hazardous than just vaping (not counting dual use here). I'm not going to go into the voluminous data demonstrating that vaping is much safer than smoking, as I actually did that about 15 years ago. And the evidence has only become stronger and stronger since then.

In my view, then, making a public claim in 2024 that smoking may be no more hazardous than vaping represents what I guess we should call public health malpractice.

There's More to the Story

If that were the only false claim made in the article, it would be enough. But it doesn't end there.

The article goes on to claim that: "popular vapes can easily have the nicotine content of three cartons or 600 cigarettes."

So let's examine this claim:

The highest concentration of nicotine in any e-liquid that I'm aware of that is typically used is 50 mg/mL. Typically, a cartridge contains 0.5mL or 1.0mL. To be conservative, let's use 1.0mL. Thus, the highest nicotine content in a vape cartridge is 50mg. 

OK, what about a cigarette? The average nicotine content of a cigarette is 12-15mg. Again being conservative, let's go with 12mg.

So a single vape cartridge has 50mg of nicotine and a single cigarette has 12mg of nicotine. This means that a vape cartridge has the nicotine content of about 4 cigarettes.

So the claim that a vape cart has the same nicotine content as 600 cigarettes is off by a factor of 150!

Now, let's give the writer of this article the benefit of the doubt and assume they meant to be comparing the nicotine yield of a vape cartridge with the nicotine yield of cigarettes. This is quite a benefit since the statement clearly says "nicotine content".

Nevertheless, the highest average measured yield of a Juul-like (pod-like) vape device, standardized across multiple studies, is 2.83mg per 15 puffs. Let's assume you can get 150 puffs out of a 1mL cartridge. So the nicotine yield of a vape cartridge, conservatively, is 28mg. A cigarette delivers approximately 1mg of nicotine. So even if we make the comparison based on nicotine yield, a single vape delivers the equivalent amount of nicotine as 28 cigarettes. Not 600. The estimate in this article is only off by a factor of 21!     

Finally, let's just make the assumption that the full 50mg of nicotine in a 50mg/mL cartridge is delivered. The nicotine delivery of a cigarette is approximately 1mg. So at the very highest, a vape cartridge could deliver the nicotine equivalent of 50 cigarettes. The claim of 600 cigarettes is still off by an order of magnitude!

There's Even More to the Story

If only it ended there. The article goes on to claim that: "Teens who vape are 3 to 5 times more likely to start smoking cigarettes than their peers."

I have already explained why this is not true. Briefly, 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 3-5-fold increase in youth smoking initiation rates.

The reason why all of these false claims are important is because they could well deter many smokers from trying to quit smoking using e-cigarettes and therefore, block a major pathway by which millions of smokers have successfully quit smoking completely. The author of the article herself has published data showing that perceptions of the harms of e-cigarettes are related to decreased success in smoking cessation. 

I'm not concerned about the false claims in this article merely because they are providing misinformation. I'm concerned because they may actually cause population health harm by deterring smoking cessation. After all, if we don't know that smoking is any more hazardous than vaping, then what is the rationale for switching from smoking to vaping? There is abundant evidence that the mistaken belief that smoking may be as harmful as vaping is a strong deterrent to smoking cessation on a population level. Why is this something the tobacco control center at UCSF would want to contribute to?

National Academies Report on Effects of Moderate Drinking is a Death Knell for Recommending Moderate Alcohol Consumption

The viability of recommending moderate alcohol consumption as a step to reduce all-cause mortality was given a death blow yesterday by the release of a report by a National Academy of Sciences expert panel which concluded that low-dose (moderate) drinking increases the risk of breast cancer and may increase the risk of colon cancer as well.

The long-awaited report concluded that although moderate drinking appears to reduce all-cause mortality, primarily through a reduction in cardiovascular disease, it also increases breast cancer risk and there is some evidence that it increases colon cancer risk as well. The panel concluded that there was moderately strong evidence that low levels of alcohol consumption increase breast cancer risk and some evidence, although not strong, that low levels of alcohol consumption increase colon cancer.

A major purpose of the report is to inform the next Dietary Guidelines for Americans. The alcohol industry has a vested interest in the Dietary Guidelines including a recommendation of moderate drinking as part of a healthy diet. They funded an ill-fated clinical trial of the health effects of moderate drinking which was halted by NIH after an investigation revealed impropriety in the NIAAA's solicitation of funding directly from the industry, which violates NIH policy.

The Rest of the Story

This report is a death knell for the alcohol industry’s hopes of ever having moderate drinking recommended as part of a health diet. The report concluded that moderate drinking increases the risk of breast cancer and may also increase the risk of colon cancer. Even though the report suggests that moderate drinking may lower all-cause mortality, there is no way that physicians—or any public health body—can issue a recommendation for healthy people to take an action that knowingly increases their risk of cancer, which could be fatal. 

A key principle of medicine is “to do no harm.” We do not recommend preventive measures that significantly increase the risk of one disease in order to prevent another disease. We cannot knowingly recommend that people consume a known, strong carcinogen as a method to reduce their risk of cardiovascular disease. There are other safe, effective, and proven ways to reduce cardiovascular risk without increasing your risk of cancer.

Recommending moderate alcohol consumption to reduce cardiovascular disease, in light of the findings of this report, would be unethical. 

Imagine walking into a doctor's office and asking your doctor for recommendations about how to decrease your risk of cardiovascular disease. And the doctor says: "Boy have I got the carcinogen for you. Take this carcinogen once or twice a day, depending on your sex, and your cardiovascular risk will go down." 

But this is precisely what would be happening if a physician--or a public health body such as the National Dietary Guidelines--recommended moderate alcohol use to reduce cardiovascular disease risk. 

The only time when we can recommend that people take a medication or product that is effective in treating a disease but may have side effects by increasing the risk of another disease is when the patient already has the disease. And in those circumstances, the FDA is very careful about weighing the risk levels, the alternative treatments available, and the severity of the disease. We absolutely cannot recommend that healthy people take a medication or product that is effective in preventing a disease but increases the risk of another disease. In other words, medication or product side effects can potentially be tolerated for medical treatment. But they are unacceptable in medical prevention. The reason is that with prevention, the patient is healthy and to expose them to a higher risk of cancer would be doing harm. This violates a central tenet of medicine and public health.

Knowing that this report concludes that the link between moderate drinking and a potentially fatal cancer is real, there is no way that any public health body can possibly recommend moderate drinking as part of a dietary guideline. Given the findings of this report, doing so would be a serious breach of medicine and public health ethics.

Misinformation By Parents Against Vaping E-Cigarettes Appears to Be Part of a Longer-Term Campaign of Deception

Yesterday, I reported that Parents Against Vaping E-Cigarettes (PAVE) is essentially lying on its website about the prevalence of daily e-cigarette use among youth. The site claims that "More than 1 in 4 youth use e-cigarettes daily." Using data from the 2024 National Youth Tobacco Survey (NYTS), I showed that the actual proportion of youth who use e-cigarettes daily is 1.6%, meaning that PAVE is exaggerating this statistic by a factor of 16.

I had assumed that this was just a one-time error and that PAVE was just misreporting data from the 2024 National Youth Tobacco Survey.

But how wrong I was.

The Rest of the Story

With the use of the Wayback Machine, I was able to find that PAVE made the identical fallacious claim nearly one year ago that it stated was based on the results of the 2023 National Youth Tobacco Survey. Their web site on February 11, 2024 stated: "More than 1 in 4 youth use e-cigarettes daily" and attributed this to the 2023 NYTS.

So it appears that this deception has now been going on through two cycles of the release of the NYTS. 

Unfortunately, this misinformation seems to be spreading rapidly, probably from PAVE to other organizations and even supposedly reputable health agencies. The PAVE misinformation appears to have first appeared on or around February 11, 2024. On March 1, 2024, the New Haven Health Department included this fallacious claim in a letter to the city council. The letter stated: "Nationally, more than 1 in 4 youth use e-cigarettes daily and almost 9 out of 10 use flavored e-cigarettes." The fact that the second claim follows the first on the PAVE website suggests that this may be where the New Haven Health Department obtained this erroneous information.

Beacon Mental Health appears to have picked up the claim shortly before November 7, 2024, and used it to promote a conference on vaping and youth that it was cosponsoring with the North Kansas City Hospital. In promoting this November 7 event, they asked: "Did you know that nationally, more than 1 in 4 youth use e-cigarettes daily?"

The Wilson Area School District (Easton, PA) picked up the same claim: "Teen vaping has become a serious health issue in the United States. According to the annual National Youth Tobacco Survey,  more than 1 in 4 youth use e-cigarettes daily and almost 9 out of 10 use flavored e-cigarettes."

The same claim was picked up by the Johnson County (KS) government: "More than 1 in 4 youth use e-cigarettes daily." This was almost certainly derived from PAVE, as they appear to have copied it directly from PAVE's web site.

This story shows how misinformation can spread rapidly over the internet and eventually come to dominate public "knowledge." This is why it is so important for public health organizations like PAVE to be honest and accurate in their communications.

Why Does Parents Against Vaping E-Cigarettes (PAVE) Have to Lie in Order to Scare Parents?

If I seriously thought that one-fourth of today's youth were vaping e-cigarettes daily, I would be quite alarmed. Daily use suggests possible addiction and so if 25% of all youth were vaping daily, we would be talking about 6.25 million middle-school and high-school students who are vaping every day. Moreover, the overwhelming majority of every day youth e-cigarette users are not just vaping nicotine, but they are also using THC vapes, mostly off the black market. So if this statistic were true, it would drastically change my assessment of the relative benefits of electronic cigarettes for adult smoking cessation compared to the risks for youth vaping and addiction.

Well, according to Parents Against Vaping E-Cigarettes (PAVE), this very statistic is in fact true! According to PAVE: "More than 1 in 4 youth use e-cigarettes daily." So it's actually more than 25% of youth who are daily e-cigarette users. This means there are well over 6 million youth daily vapers. Even worse, only 3.2% of adults vape daily, so the proportion of youth who vape daily is 8 times higher than the proportion of adults who vape daily. Perhaps even more alarming, this means that for 2 adult vapers, there is one youth daily vaper.

The Rest of the Story

There's only one problem with this statistic from PAVE ...

...

...

... It isn't true!

According to data from the 2024 National Youth Tobacco Survey, the proportion of youth who use e-cigarettes daily is not 25%, it is 1.6%. So PAVE is off by a factor of 16. Another way of saying this is that PAVE has inflated the proportion of youth who use e-cigarettes daily by 16 times its actual value in an apparent effort to create quite a scare among parents and the public at large.

Compare PAVE's "facts" with those of the FDA:

PAVE - More than 25% of youth use e-cigarettes daily.

FDA - Only 1.6% of youth use e-cigarettes daily. 

So how does PAVE get this 25% number? Well, you might call it sleight-of-hand. It turns out that of youth e-cigarette users, more than 25% are daily users (26.3%). However, only 5.9% of youth are e-cigarette users, so the proportion of youth who are daily e-cigarettes users is 26.3% times 5.9%, which is 1.6%.

The truth is that PAVE is not telling the truth when they claim that more than 1 in 4 youth use e-cigarettes daily. The truth is that 1 in 62 youth use e-cigarettes daily.

So why lie? 

Possibly it's because 1 in 4 youth sounds way more alarming than 1 in 62 youth. Somehow 1 in 62 youth doesn't quite have the same kick as 1 in 4. 

But why the need to lie in the first place? Possibly it's because the youth e-cigarette craze has subsided somewhat and the truthful statistics just aren't alarming enough to make youth vaping the kind of catastrophic problem that PAVE would like to promote it as.

The problem is that truth, honesty, and transparency are three important core values of public health. We do not misrepresent statistics in order to scare people. We do not provide false statistics to the public in order to increase public concern about public health problems. In other words, the ends of getting the public to take action do not justify the means of lying to or deceiving the public.