The CDC’s National Youth Tobacco Survey results are out. Once again, it’s excellent news: teen smoking and vaping rates are down. In fact, the numbers are so low that the CDC needed to load the dice by suggesting that using nicotine products at any time over the last 30 days now counts as “current use”.
In the past, surveys would include daily or frequent use alongside use within the last month. Then, the media could lump all the figures together to make the problem sound worse than it was. These days, the CDC kindly does that for them, ensuring the public gets a blurry, misleading picture.
But, I’m not here to talk about the fact that teen use of tobacco products has dropped by 20% since 2023. Or that vaping is down from 7.7% to 5.9% over the same period. Instead, I want to focus on the strange pessimism within the report and the even stranger Implications for Public Health Practice section.
There is a funny piece of theatre near the end of the report. The CDC say that yes, tobacco use is down, once again, but we need:
- Price increases.
- Mass media campaigns to educate youths about the harmful effects of all tobacco products.
- Implementation of comprehensive smoke-free policies that include e-cigarettes.
They say this as though the recommendations have anything to do with the 2024 data. If the figures were less rosy, they’d still recommend more taxes, more legislation that tackles vapes, and, perhaps most importantly, more of Mike Bloomberg’s money to waste on ineffective marketing campaigns.
This baroque pageantry is the future of tobacco control. As the “epidemic” continues to decline, they’ll still be there gaslighting the public and panhandling for funds, misty-eyed for the days when people smoked and they had the ear of public officials.
The implications for public health practice arguments
So, what is the real impact of these CDC figures? Three things.
#1. No more appeals to emotion like “think of the children”
Tobacco control has weaponised teen use to mess with vaping for too long. Too many politicians have been drawn in by this Helen Lovejoy “think of the children” argument. Well, that appeal to emotion has become a lot less easy to sell.
#2. No more gateway to smoking arguments
Sometimes, a simple question is enough to shatter a belief. In the case of the “vaping is a gateway to smoking” conspiracy theory, just asking, “where are all the smokers then?” unravels what was always and will always be a bad argument.
#3. No more epidemic
Epidemics go up— and quickly. They don’t slowly decline over the course of a decade. While it’s been totally invalid for a number of years, anyone who uses that term in relation to teen vaping in the US is exposing themselves as a charlatan.
What the CDC gets really wrong
“Multiple factors continue to influence tobacco product use and initiation among adolescents, including availability of youth-appealing flavored products, marketing, harm misperceptions, the emergence of new flavor types (e.g., ice flavors [flavors that combine cooling and fruit or sweet flavors, such as blueberry ice or strawberry ice]), and product features.”
The CDC sees the report and its results as justification for policy recommendations. They outline the reasons why they believe teens use nicotine products. However, they neglect many of the causes behind teen tobacco use, such as curiosity, peer pressure, and mental health.
If you want to resolve a supposed public health crisis, you need to be honest with both the public and yourself. Tobacco control is obsessed with things like marketing and messaging. To a large extent, this stems from the fact that they are in denial about the benefits of nicotine and think the only reason a person could use the stimulant is because they’ve been tricked somehow.
It’s like with public health people who talk about fast food. Their focus is on the lack of nutritional qualities and the adverse health effects of, say, eating too much-fried food. This bloodless worldview can’t understand that people enjoy fried chicken because it’s tasty, convenient, comforting, accessible, and inexpensive. Yeah, we should eat better, but life is for living.
However, more importantly, it’s well-established that people with ADHD, autism, or AuDHD are more likely to use nicotine.[1],[2] Likewise, people with anxiety or depression are overrepresented in tobacco use. [3]Data suggest that teen anxiety or depression has risen in the US by 33% since 2016, with the CDC’s own reports suggesting that around one in three students received treatment for mental health in 2023.
Tobacco control's persistent policy of not listening to people about WHY they use nicotine means they are poorly positioned to both understand and deal with the issues. The causal factors aren’t even on tobacco control’s radar, so they will always be grasping in the dark and never able to solve these problems, no matter how many social media ads they buy.
Final thoughts
Teen vaping and smoking continue to decline. How much more money should be wasted on these issues?
There are public health crises in the US that deserve this lavish funding for interventions, such as mental health, opioid misuse, and violence in schools.
Only 1.7% of high school students smoke cigarettes. The “crisis” and the gravy train it fuelled is over, but don’t expect tobacco control to admit it.
