Can We Rely on Youth Nicotine Pouch Use Figures?

Earlier this month, Martin Cullip wrote a great article on a paper titled How much does the absence of the ‘hidden population’ from United Kingdom household surveys underestimate smoking prevalence?.

The research suggests we could be undercounting the number of UK smokers by as much as 1.2 million people, which further underlines the stupidity of the government’s decision to ban disposable vapes.

That paper, and an tangentially-related but interesting thread on X, got me thinking about the reliability of youth nicotine pouch prevalence data.

Current nicotine pouch stats

ASH UK reports that around 1.2% of under-18s “currently use” nicotine pouches. Figures for daily use were not provided, presumably because they’re so low we don’t have the precision instruments to count them.

Across the pond, the CDC reported that 2.6% of youths used pouches over the last 30 days, with just 22% of that number (i.e., 0.5%) accounting for daily use.

Rebellious youths

Surveys rely on the honesty of participants. Unfortunately, self-report respondents aren’t always interested in providing good information, for a variety of reasons.

Quite often, people give the answer they presume the surveyor wants to hear, which was commonly cited as the reason why pollsters got the 2016 US General Election so wrong.

Anonymising surveys should address some of those problems, but even when that happens, some respondents will just put anything because they don’t really want to do the survey, and there is no penalty for messing around.

In one 2014 survey covered by the X thread linked above, where around 30% high-schoolers self-reported themselves as transgender, and also claimed similar figures for other statistically unlikely things, such as being part of a gang, carrying a gun at all times, having two or more children, being blind, deaf, freakishly tall, obese and so on.

Other notable observations from that X post included a Pew Research article that showed that around 12% of high school students claimed they were registered to operate a nuclear sub.

The consequence of troll answers

This paper recalls an older survey where around 2.6% of high schoolers reported bringing a gun to school each day. The press had a field day, and ostensibly serious groups and organisations reported this obviously ridiculous statistic for more than a decade.

The CDC is pretty upfront about their efforts to minimise the impact of what are known as mischievous responses. However, they also acknowledge the limitations of self-report surveys.

Anyone who has spent time with teenagers understands they are a) prone to wild exaggeration b) like to see themselves as being adult and engaging in adult activities.

It begs the question: are youths over-reporting their use of pouches?

It also makes me wonder if the 2019 peak of US vaping youth was a mirage. Have the past 30 days figures of 27.5% dropped by two-thirds because vaping was just a fad for youths, or was the data ever reliable in the first place?

Again, it all serves to highlight the problems of using data gleaned from unreliable respondents to determine or influence policies or, more pointedly, to ignite moral panics.

Final thoughts

ASH and the CDC presumably employ competent data scientists to mitigate the impact of mischievous respondents. However, these organisations also acknowledge the limitations of their data.

Some researchers suggest that bias for drug and alcohol use might inflate figures by as much as 2-3x.

Could it be that the 27.5% 30-day youth vaping use was, in reality, around 9% to 13%?

Similarly, are current figures for daily youth nicotine pouch use more like 0.18% to 0.27%?

If the figures are that low, it’s pretty remarkable, especially when you consider that much of this demographic are under the strain of operating nuclear submarines despite being deaf, blind, and raising a few kids of their own.