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Why Can't the CDC Tell the Truth About Teen Smoking and Vaping?

The agency ignores lower trends in both types of nicotine usage, obscuring the significant distinction in the dangers they pose.

The pandemic has given Americans sufficient reason to be wary of the Centers for Disease Control and Prevention's claims (CDC). According to a news release published by the CDC today, the agency's propensity of misleading the public began long before anyone had heard of COVID-19.

According to the most recent National Youth Tobacco Survey (NYTS) statistics, "approximately 2.55 million U.S. middle and high school students reported current (previous 30-day) use of a tobacco product in 2021," according to the CDC. If you haven't been paying attention to the CDC's constant deception on this subject, you might be surprised to hear that the vast majority of those 2.55 million students did not use tobacco-containing products.

Despite the significant disparity between the hazards posed by vaping nicotine and the risks posed by breathing smoke from conventional cigarettes, the CDC consistently conflates e-cigarettes with "tobacco products." According to the press release, "approximately one-third" of the 2.55 million kids "used at least one form of combustible tobacco product," which means two-thirds did not. According to the CDC, 410,000 of the past-month "tobacco product" users, or only 16%, were cigarette smokers. However, the CDC argues that such distinctions are irrelevant because "youth use of tobacco products in any form—combustible, smokeless, or electronic" is dangerous.

The CDC, which purports to follow science and disseminate its conclusions to Americans who don't have time to study and digest pertinent data, is purposefully hiding the medically critical point that e-cigarettes are considerably less dangerous than traditional, combustible cigarettes. Statements like this one assist to explain why a sizable and growing proportion of the general population feels that vaping is just as deadly as smoking, if not more so.

Another thing that may surprise you, given the CDC's determination to ignore it: Smoking among teenagers has been declining since the late 1990s, and this tendency has intensified as vaping has grown in popularity. The substitution of vaping for smoking is undeniably better for "public health," which the CDC professes to promote. However, the agency portrays it as a serious threat to America's children.

NYTS

Less than 2% of high school students reported smoking cigarettes in the previous month in the 2021 NYTS, down from 4.6 percent in 2020, 8.1 percent in 2018, and 15.8 percent in 2011. The CDC entirely ignores this excellent news since it hinders the agency's efforts to raise public awareness of "tobacco use" among minors.

Between 2017 and 2019, the NYTS recorded a significant increase in past-month e-cigarette use among high school students, prompting numerous warnings about the "epidemic" of underage vaping. However, that rate, which peaked at 27.5 percent, declined to less than 20% in 2020 and about 11% in 2021.

The CDC notes that the 2021 figures "cannot be compared to prior NYTS surveys," which "were predominantly conducted on school campuses." Because of the epidemic, the 2021 survey was "delivered online, allowing eligible kids to complete the survey at home, school, or wherever." Half of the pupils completed the survey at school, with the other half completing it at home or elsewhere. According to the CDC, "we remain confident in our study results," although "reporting of tobacco use may change depending on the setting where the survey was conducted."

The CDC just cannot have it both ways. If the 2021 survey provides an accurate picture of "tobacco use" among middle and high school students, as the CDC claims, any bias introduced by the change in methodology must be minor.

"Differences in tobacco product use by survey completion setting may be caused by potential underreporting of behaviors, reduced access to tobacco products at home, or other unmeasured characteristics among students participating outside of the classroom," according to the CDC's NYTS report, published today in the agency's Morbidity and Mortality Weekly Report. The CDC appears to be implying that children who completed the survey at home were less truthful than pupils who completed it at school. While that is feasible, it is also likely that more privacy at home promoted candor.

In any case, according to the CDC's e-cigarette report, which was released in September, "15.0 percent of high school students who took the survey in a school building or classroom reported currently using e-cigarettes," which is still 23 percent lower than the rate in 2020 (19.6 percent) and 45 percent lower than the rate in 2019. (27.5 percent). The report made no mention of the declining trend. Here's how the survey results were summarized in the headline: "Amid the COVID-19 Pandemic, Youth E-Cigarette Use Remains a Serious Public Health Concern."

According to today's study, the overall percentage of "current tobacco product usage" among kids who completed the survey at school was 11.7 percent, a decrease from 16.2 percent in 2020 and 23 percent in 2019. The CDC makes no note of such drop, which would have been unaffected by the 2021 change in the settings where students took the survey.

One reason the CDC ignores drops in smoking, vaping, and general "tobacco use" is evident in today's report, which mentions "the availability of flavors" as a factor that "may continue to promote tobacco product use among U.S. kids." The report and press release advocate "restricting the sales of flavored e-cigarettes" as a tactic to "decrease tobacco product usage and initiation among all kids."

The Food and Drug Administration (FDA), which appears hell-bent on outlawing practically all vaping products now accessible in the US, has adopted this policy. The FDA, like the CDC, is wary about e-liquid tastes other than tobacco (and possibly menthol) because kids enjoy them. Adults, on the other hand, love the ostensibly immature flavors that anti-vaping lawmakers find repulsive.

If you are determined to ban those goods, it is uncomfortable to recognize that the outcome will very certainly be more smoking-related deaths than would otherwise occur, because fewer flavor options will make vaping less tempting as a harm-reduction alternative to smoking. It's also difficult to admit that the "epidemic" of underage e-cigarette usage is fading quickly, or that smoking among teens has declined to historic lows in recent years, a trend that is at least partially owing to the fact that some of them are vaping instead.

In summary, the CDC distorts the evidence to support its prior policy preferences. Does this sound familiar?

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