By: Dr. Michael Siegel
Countering the claims of anti-nicotine groups that electronic cigarettes are a gateway to smoking, data released yesterday from the National Youth Tobacco Survey indicate that while the rates of teen vaping continued to increase dramatically (from 21% in 2018 to 28% in 2019 and from 12% to 28% from 2017-2019), the rate of decline in youth smoking accelerated in 2019, dropping to its lowest level in recorded history. If vaping was a gateway to smoking among youth, one would expect to see some sort of positive correlation between youth vaping rates and youth smoking rates. And in fact, there is a HUGE correlation between the rates of youth vaping and youth smoking during the period 2011-2019. The Rest of the Story To cut to the chase, the rest of the story is that there is indeed a huge correlation between the rates of youth vaping and the rates of youth smoking, which is at the very high level of 0.89. In fact, this is about as close to a perfect correlation as you can get with public health surveillance data. So, you say, this proves – beyond a doubt – that the anti-nicotine groups were right and that e-cigarettes are a gateway to youth smoking. There’s just one thing I forgot to tell you … … I forgot the minus sign. The correlation between the youth vaping and youth smoking rates during this decade is actually —0.89 (that’s NEGATIVE 0.89). Here is the scatter plot (the smoking rate is the x-axis; the vaping rate is the y-axis): As you can see, there is a dramatic relationship here. The lower the vaping rate, the higher the smoking rate. And the higher the vaping rate, the lower the smoking rate. In other words, these data show that vaping is supplanting smoking, not supporting it. Vaping culture is not being transformed into smoking culture. It’s exactly the opposite. Vaping culture is almost completely replacing smoking culture. Thus, the truth is that e-cigarettes are not leading to an increase in youth smoking. E-cigarettes are actually accelerating the trend of declining youth smoking. If you actually stop to talk to kids, they will tell you this. I do educational workshops with youths who are caught vaping or Juuling. And they repeatedly tell me – especially the Juulers – that they wouldn’t even think \ about putting a cigarette in their mouths. They think it’s disgusting. And that’s a huge part of the appeal of the Juul – a cutting edge, modern, cool device that looks like a flash drive and allows you to emit a cool vapor cloud that dissipates almost instantly. The rest of the story is that vaping is not leading youth to smoking. Instead, what the data tell us is that a vaping culture is further decimating a smoking culture that is already on the decline.