Are e-cig­a­rettes wip­ing out teen smok­ing?

Times-Herald (Vallejo) - - FRONT PAGE - By Matthew Per­rone

The smok­ing rate among U.S. high school­ers took its big­gest hit ever, fed­eral fig­ures show, fall­ing to a new low.

WASH­ING­TON >> In al­most any other year it would be hailed as a pub­lic health vic­tory: The smok­ing rate among U.S. high school­ers took its big­gest hit ever this year, fed­eral fig­ures show, fall­ing to a new low.

In­stead the mile­stone was rel­e­gated to a lone fig­ure at the bot­tom of a govern­ment press re­lease and went un­re­marked by an­ti­to­bacco groups that have spent decades work­ing to stamp out youth smok­ing.

It’s a new era in the to­bacco wars — one in which the alarm­ing rise of un­der­age va­p­ing has al­most com­pletely over­shad­owed a par­al­lel drop in tra­di­tional smok­ing. And the piv­otal ques­tion of whether elec­tronic cig­a­rettes are in­ad­ver­tently help­ing to wipe out smok­ing among young peo­ple has be­come a po­lar­iz­ing topic: em­braced by some ex­perts, dis­missed by oth­ers.

“Smok­ing is dis­ap­pear­ing among young peo­ple and it’s a great pub­lic health tri­umph that we are fail­ing to cel­e­brate, much less even note,” says Ken­neth Warner, pro­fes­sor emer­i­tus at the Univer­sity of Michi­gan’s school of pub­lic health.

E-cig­a­rettes typ­i­cally heat a so­lu­tion that con­tains nico­tine, the drug that makes to­bacco ad­dic­tive. They are gen­er­ally con­sid­ered less harm­ful than can­cer-caus­ing tra­di­tional cig­a­rettes. But there is lit­tle long-term re­search on the health ef­fects of va­p­ing.

With one in four teenagers now us­ing e-cig­a­rettes, un­der­age va­p­ing is uni­ver­sally con­demned, and the fed­eral govern­ment con­sid­ers it an epi­demic.

But Warner and some other re­searchers be­lieve re­cent trends con­tinue to show va­p­ing’s prom­ise as a tool to steer mil­lions of adults away from cig­a­rette smok­ing, the na­tion’s lead­ing cause of death.

That po­ten­tial makes the case for keep­ing e-cig­a­rettes read­ily ac­ces­si­ble for adults — even if a cer­tain level of teen use per­sists.

But that ap­proach is a non-starter for many to­bacco op­po­nents.

“When adults make pol­icy gains on the backs of chil­dren, that’s bad, and that’s what the ar­gu­ment boils down to here,” says Dave Dob­bins, an at­tor­ney with the anti-to­bacco non­profit, Truth Ini­tia­tive.

Even if e-cig­a­rettes were re­spon­si­ble for the smok­ing de­cline among teenagers — which Dob­bins says is un­likely — al­low­ing young peo­ple to get hooked on va­p­ing nico­tine is not a so­lu­tion.

“I don’t buy the ar­gu­ment that these things showed up and mag­i­cally changed the world,” says Dob­bins. In­stead,

he thinks the va­p­ing in­dus­try has in­creas­ingly pur­sued young peo­ple as smok­ing has fallen out of fash­ion.

But no one dis­putes the de­cline.

The per­cent­age of high school­ers who re­ported smok­ing fell to 5.8% in 2019 from the prior year, a 28% drop and the largest since the U.S. govern­ment be­gan sur­vey­ing teens, ac­cord­ing to pre­lim­i­nary num­bers re­leased in Septem­ber. The trend isn’t limited to one year or one sur­vey.

A sim­i­lar study con­ducted by the Univer­sity of Michi­gan shows smok­ing among 12th graders has plum­meted 50% since 2015, the largest drop of its kind in the sur­vey’s 40-year his­tory.

The smok­ing rate for adults is roughly 14% and has been fall­ing slowly for decades.

The de­cline among teens has been seized upon by va­p­ing pro­po­nents, who ar­gue it un­der­cuts the gravest ar­gu­ment against the nico­tine-emit­ting de­vices: that they act as a “gate­way” to tra­di­tional smok­ing.

That’s the con­clu­sion of a num­ber of short-term stud­ies that fol­lowed young peo­ple and sur­veyed their use of to­bacco and nico­tine. The pres­ti­gious Na­tional Acad­e­mies found “sub­stan­tial ev­i­dence” for the gate­way ef­fect in a 2018 con­sen­sus pa­per. And the Food and Drug Ad­min­is­tra­tion even uses the con­cept as the tagline in its anti-va­p­ing video ads: “Teens who vape are more likely to start smok­ing cig­a­rettes.”

For now, ex­perts on both sides ac­knowl­edge there is no de­fin­i­tive ev­i­dence link­ing e-cig­a­rettes to the de­cline in youth smok­ing. The ques­tion is clouded by too many long-term trends and com­pli­cat­ing vari­ables. Teen smok­ing has been de­creas­ing since the late 1990s and is in­flu­enced by govern­ment poli­cies, pub­lic opin­ion, chang­ing prod­ucts and to­bacco in­dus­try mar­ket­ing.


A woman us­ing an elec­tronic cig­a­rette ex­hales in May­field Heights, Ohio.

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