Few health stories garner so much hyperbolic or uncritical coverage as the claim that e-cigarettes are a “gateway” to smoking.
Any study or assertion supporting this claim is catnip to journalists. Credulous stories of e-cigarette flavors such as “cool cucumber” and “creme brulee” targeting children and ushering in an “epidemic” of teen vaping are rarely out of the headlines.
E-cigarettes, we’re told, are little more than a tobacco industry ploy to recruit the next generation of smokers. But even the most powerful of moral panics must, in the end, yield to data and evidence.
Last week, the Centers for Disease Control and Prevention released its Morbidity and Mortality Weekly Report, with the latest survey data on teen vaping and smoking. The survey defines current use as using the product at least once in the past 30 days and has been measuring e-cigarette use since 2011.
Seven years after the CDC first started collecting data on teen vaping, we should at least be seeing some signs of a resurgence in teen smoking if the gateway theorists are to be believed. But according to the CDC, high school smoking fell to a record-low of 7.6 percent in 2017, compared to eight percent the previous year and 15.8 percent in 2011.
As for vaping, following a 30 percent decline in 2016, current high school e-cigarette use rose from 11.3 percent in 2016 to 11.7 percent in 2017, substantially down from its high point of 16 percent in 2015. In spite of dire predictions, vaping remains less popular with high schoolers than either alcohol or marijuana, and teens appear stubbornly resistant to the alleged epidemic that’s been sweeping America’s schools.
With seven years worth of data, a clear trend has emerged: Smoking continues to fall year after year, whether teen vaping is up, down, or stable. The gateway effect refuses to manifest itself, and the vaping epidemic has yet to materialize.
Bewildered by the data, some public health experts reacted by arguing the survey may not have captured the full extent of teen vaping because it didn’t specifically mention the JUUL e-cigarette, which is claimed to be extremely popular in high schools. But as e-cigarettes were already defined in the survey, it’s unclear why the mention of JUUL should make any difference to the underlying data. Furthermore, when the survey was conducted, JUUL was in no way nearly as popular in the adult market as it is now, and there’s little reason it was any different for teens.
While it’s entirely possible teen vaping could increase in the future, it would have to do so substantially to match the highs of 2015. What no one disputes, however, is that teen smoking is down yet again. But instead of welcoming this news, the first response of anti-tobacco groups was to call for a crackdown on e-cigarettes.
“These findings underscore the need to prevent youth use of all tobacco products and keep products like e-cigarettes and cigars from addicting a new generation of kids,” said Matt Myers, president of Campaign for Tobacco-Free Kids.
“While fewer youth are using cigarettes and other combustible tobacco products, we must do more to address the disturbingly high number of youth who are using e-cigarettes and vaping products,” said Food and Drug Administration Commissioner Scott Gottlieb.
With no real-world evidence showing any gateway effect, e-cigarette critics are shifting the goalposts. If teen vaping goes up, it’s a public health crisis. If vaping declines, it’s no big deal because there are still too many teens vaping. If vaping remains stable, it’s evidence the FDA isn’t doing enough. If smoking continues to decline in any or all of these scenarios, it’s irrelevant.
The response of anti-e-cigarette campaigners to any data that contradicts their prejudices appears to be that if teen vaping is anywhere above zero, any regulation of e-cigarettes (no matter how it might affect adults trying to switch from smoking to vaping) is justified. The fact that e-cigarettes have been proved beyond doubt to be vastly safer than cigarettes and are helping millions of adults quit smoking is of no concern.
“When the CDC and FDA want to spin a narrative, they know that the establishment media is waiting and willing to repeat their claims without analysis,” says Gregory Conley, president of the American Vaping Association. “Rather than celebrating historical declines in youth smoking — decreases that no one predicted ten years ago — the CDC and FDA continue to pretend that there is a crisis that they need to solve.”
Despite the warm words about recognizing a “continuum of risk” in nicotine products, the FDA continues to trumpet all possible risks of e-cigarettes while ignoring all possible benefits. Scott Gottlieb has failed to reform regulations which are set to devastate the e-cigarette market, removing options for adults trying to quit smoking, all in the name of protecting children from an epidemic that doesn’t exist.
The fact that some teenagers drink alcohol or use marijuana is no excuse for prohibiting either product. The fact that an even smaller number occasionally vape is no an excuse for regulating a life-saving product out of existence.
This column originally appeared in the Washington Examiner.