Reading Between the Lines
Youth vaping rates declined again in the first half of 2021. Prohibitionists doubled-down, and tobacco harm reductionists did some math. Does it matter?
On Thursday, September 30, the Centers for Disease Control and Prevention and the Food and Drug Administration released some data on youth vaping rates in 2021. There was a sharp decline, as seen in the new numbers culled from the 2021 National Youth Tobacco Survey (NYTS): The rate of current e-cigarette use among high school students, for example, fell from 19.6 percent in 2020 to 11.3 percent. (“Current” e-cigarette use is defined, ludicrously, as using at least once in the past 30 days.)
But that was not the headline from the US government. The FDA framed its press release, for instance, around the notion that “youth e-cigarette use remains serious public health concern amid COVID-19 pandemic” and “almost 85 percent of the more than 2 million US middle and high school students who used e-cigarettes used flavored e-cigarettes in 2021.” (They also provided the caveat that, since most kids weren’t really in school the past year, the data couldn’t be compared to years prior.)
Sure, that’s all one way to look at it. Or you can do some multiplication.
That’s what consumer advocates and tobacco harm reduction proponents did, who spent much of the morning either doing math or correcting the math of leading tobacco control groups and mainstream media outlets.
Take this example, from CNN:
That number is wrong: Instead, 43.6 percent of high school students who currently use e-cigarettes reported using e-cigarettes on 20 or more of the past 30 days. CNN later corrected the story, and it seems to have derived from a press release — that was also eventually fixed as well — from Truth Initiative.
It’s an easy mistake, of course, but one doesn’t need to subscribe malicious intent to call it sloppy. We’re dealing with percentages of percentages here, as many have pointed out. Because the current vaping rate among high-schoolers is 11.3 percent, that comes out to less than 5 percent of students. Some more quick math: As the FDA and CDC presented it, “more than 1 in 4,” or 27.6 percent, of high school students who used e-cigarettes used them daily. Again, the youth vaping rate among high-schoolers is now 11.3 percent. That translates to 3.1 percent of high-schoolers vaping daily.
As several others have explained, these youth vaping rates are now at “pre-JUUL” lows, before there was any talk of a youth vaping “epidemic.”
This is perhaps too much context to justify the main point I want to make: If the government wants to present the data in such an impenetrable way, I’m giving myself permission to read between the lines.
I’ll put it another way. If there was ever a youth vaping “epidemic,” there doesn’t appear to be much of one anymore. Like many in the industry who told me they scrolled through the government’s report searching for their company’s name, I decided to CTRL-F for the phrase youth vaping “epidemic.” A source had told me they couldn’t find it; I couldn’t either. Nor did I come across it in any corresponding press release from either agency.
This might not seem to be a remarkable observation, and it’s plausible the government doesn’t want to present youth vaping as an “epidemic” when we’re still living through a very real one.
Regardless, the language appears to have changed.
Here’s a quote from this year about the 2021 data: “This study shows that even during the COVID-19 pandemic, e-cigarette use among youth remains a serious public health concern,” said Karen Hacker, the director of CDC’s National Center for Chronic Disease Prevention and Health Promotion. (The emphasis is my own.)
And here’s a quote from last year about the 2020 data: “Although the decline in e-cigarette use among our nation’s youth is a notable public health achievement, our work is far from over,” said Robert R. Redfield, the former CDC director. “Youth e-cigarette use remains an epidemic, and CDC is committed to supporting efforts to protect youth from this preventable health risk.” (The emphasis is, again, my own.)
An “epidemic” seems much greater than a “concern” — just as, say, the percent 27.6 is much greater than 3.1. It strikes me, then, as a tacit acknowledgment that the (perceived) severity has lifted. Especially when paired with warnings like this from the Campaign for Tobacco-Kids:
Or this one, via Truth Initiative:
They may not be saying it outright, but calling attention to a potential “resurgence” or an “ending” implies we’re at least nearing a conclusion. (Even if they fear, naturally, that youth vaping rates might go up with kids back in school and socializing.)
I had previously tweeted that the government showing that youth vaping rates dropped doesn’t matter — that the data is purposely misinterpreted or abused by prohibitionists, and the battle remains cultural and ideological. I believe that: We stigmatized smoking so much in this country that reintroducing nicotine into “polite” society is no easy feat. I was a boy when Big Tobacco came under fire, so I admittedly do not have the same perspective as these dinosaurs who have litigated their way onto pedestals. I recognize the foe here is public perception, and one day people will have to come around to the idea that there are much safer ways to use nicotine.
Years ago, Scott Gottlieb, the old FDA commissioner, started throwing around the phrase youth vaping “epidemic.” That was the fear. At the moment, that seems to no longer be the case. Instead, what we have is the fear of a fear. Prohibitionists are panicking about panicking: The argument that dominates mainstream tobacco control and by extension much of the politics and culture in the US is that any acceptance of e-cigarettes as tobacco harm reduction runs the risk of harming children — and if not now, eventually. This is the flawed logic that must be pierced. (Even presenting reputable studies about flavor bans driving teens to smoking doesn’t do the trick.)
Data is important, of course. But I don’t think it’ll change anything overnight. The prohibitionist camp is too damn proud, and the enemy is forever changing: First it was JUUL, and now it’s Puff Bar.
Tomorrow, it’ll be something else entirely.