The CDC's Office on Smoking and Health (where I worked for two years as an EIS Officer in the Commissioned Corps of the U.S. Public Health Service) has just published an article that summarizes changes in smoking, tobacco use, and e-cigarette use over the past seven years (2017 to 2023). The astounding finding of the article was that cigarette smoking has reached its lowest point in 60 years and that from 2017 to 2023, the number of smokers (not counting dual users) decreased by 6.8 million people!
Since smoking is estimated to kill approximately half of all long-term users, this decline in cigarette smoking can be expected to save well over 3 million lives.
However, shockingly, rather than celebrating this enormous public health victory and acknowledging the immense prevention of disease, suffering, and death that these unprecedented reductions in smoking will bring, the CDC's headline was that there has been no change in overall tobacco product usage and that any gains from reductions in smoking have been offset by increases in youth vaping.
Here is the CDC's summary of the implications of these trends:
"While current cigarette smoking has decreased to the lowest level in 60 years, current tobacco product use among adults has not changed since 2017."
And here is CDC's primary conclusion:
"The decrease in number of adults who currently exclusively smoke cigarettes by approximately 6.8 million persons was offset by the increase in the number who currently use e-cigarettes exclusively (approximately 7.2 million)."
The Rest of the Story
You've got to be kidding me. What the CDC is actually saying is that the saving of more than 3 million lives is offset because an increasing number of youth are ripping vapes.
The Cambridge English Dictionary defines offset as meaning "to balance one effect against an opposing effect, so that there is no great difference as a result."
Thus, the CDC is telling the public that there is no net public health gain from the fact that cigarette smoking is at its lowest level in 60 years because many youth are now dragging cherry-flavored vapes instead of smoking Marlboros, Camels, and Newports.
Another way to say this is that the CDC would consider it to be a public health victory if there were an additional 6.8 million smokers in the U.S. but only a couple million youth were hitting vapes. The CDC doesn't see any advantage in switching people in massive amounts from combustible tobacco cigarettes to much less hazardous, tobacco-free, smokeless e-cigarettes. They would rather that people smoke real cigarettes than fake ones!
I find this disturbing not only because it completely distorts the science and misleads the public into thinking that smoking and vaping are equivalent in terms of health risks, but because it demonstrates a complete lack of compassion for adult smokers who are suffering debilitating disease and death due to their use of actual tobacco that is actually combusted. It also shows a profound disrespect for the millions of people who have overcome one of the strongest addictions (smoking) by switching to a much less hazardous product that likely saved their lives.
Finally, it is disingenuous to classify e-cigarettes as tobacco products simply to make it look like there has been no progress. That's an artificial decision that is not accurate or necessary. Vapes are not "tobacco products" because they do not contain tobacco. Yes, from a strictly legal standpoint they are defined as "tobacco products" but that is purely in the context of FDA regulation. There is no necessity to use that terminology outside of the FDA regulatory context. That is a decision that CDC is making. It is a choice. And they are making that choice for a reason: they truly want to paint a picture of no progress in tackling the problem of tobacco use. It provides an excuse for them to continue to be needed and to argue for continued funding. The same motivation, I believe, is driving groups like ALA, AHA, and ACS to make the same decision to treat a non-tobacco product as a tobacco product.