Tuesday, April 21, 2015

Teens and E-Cigarettes: Dude, Don't Smoke.

More teens smoke e-cigarettes than ever before according to a new CDC report. In case you missed the headlines:

E-cig use soared, cigarette use fell among U.S. youth in 2014: CDC Reuters

CDC reveals "alarming" news about teen e-cigarette use  CBS News

Teen e-cigarette use tripled in the past year USA TODAY

Use Of E-Cigarettes Triples Among U.S. Teens NPR

Use of E-Cigarettes Rises Sharply Among Teenagers, Report Says NY Times 

E-Cig Use Spikes as Traditional Smoking Falls Among U. S. Youth NBS News 

NBC News anchor Lester Holt worked in both an “alarming new warning" and "dramatic jump" in the first three seconds of his on-air story.

The WashPo took a less dramatic, slightly different focus:

High school, middle school kids now use more e-cigs than tobacco: CDC Washington Post

How bad is this new public health threat? The WashPo, like all other media, reported the rising percentage of teens puffing on e-cigarettes: 

The latest survey found that the use of e-cigarettes increased from 1.1 percent in 2013 to 3.9 percent in 2014 among middle school students, and from 4.5 percent to 13.4 percent among high school students. That translates to a total of 450,000 middle school students now using e-cigs, alongside 2 million high school students. 

I hate smoking. I hate cigarette smoke. But. 

The e-cigarette is a relatively new device so I appreciate the figures above, I do. It’s not very useful though to know usage has “tripled” or risen “sharply” without being mindful that practically zero teens smoked e-cigarettes ten years ago. Nobody did. 

Naturally the media let slip the MILLIONS of at-risk youth. True, the CDC calculated the national estimates for everybody. As worrisome as these numbers appear, though, they reflect the number of kids who had smoked an e-cigarette in the past month, if only once. So they include kids who regularly smoked and those who might have just tried it once. CBS News went with the combined figure - the 2.5 million middle school and high-school students who used e-cigs last year. The New York Times reported “4.6 million young people altogether — used tobacco in some form last year.” That includes tobacco cigarettes, the old-fashioned kind.

Speaking of traditional cigarettes, their use dropped substantially over the past 3 years to what many media outlets described as an all-time low. True? 

About those other smokes -  from traditional cigarettes to hookah, chewing tobacco and cigars - the relationship between them and e-cigarettes has created some issues and some confusion. Here’s how the New York Times explained current tobacco trends:

The sharp rise of e-cigarettes, together with a substantial increase in the use of hookah pipes, led to 400,000 additional young people using a tobacco product in 2014, the first increase in years, though researchers pointed out the percentage of the rise fell within the report’s margin of error. 

Fell within the report's margin of error.

Straight outta Statistics 101. 

I don’t know why the NY Times didn’t bother to translate this into plain language...despite the apparent trend of increased tobacco use, it's not statistically significantly. Trends, are well, just trends and not meaningful differences. Sometimes they develop into significant changes over time, sometimes they are just flukes. They present problems for researchers and journalists alike. 

NBC didn’t mess with margins of error but simply noted “tobacco use among high school students grew to 24.6 percent from 22.9 percent.” Thus leaving the impression that tobacco use is definitely on the rise. Definitely.

So how to explain the relationship between e-cigarettes and regular smokes? There are several viable explanations. Some have suggested that kids who would have used traditional cigarettes have turned to the new gadgets instead. Some have argued teens are using e-cigarettes to help stop smoking. Others have claimed e-cigarettes are a gateway to traditional cigarettes, tempting teens that wouldn’t have smoked otherwise.

But at least one smoking (hot?) expert urged some caution in divining a relationship between the limited data on e-cigarettes and traditional ones. "There is no firm conclusion that one can draw from correlational data," Jed Rose, director of the Center for Smoking Cessation at Duke University Medical Center, told Reuters. 

The New York Times skipped any wild speculation about such matters. Clearly they are a serious and seriously informed source of knowledge, a venerable news organization delivering vital public health information. So, their status secure, they  gave the last word, in fact the last line, to an e-smoker who described his reaction to first seeing an electronic cigarette:
“I was like, ‘Dude, why do you have a light saber?’ ” he said. “And he was like, ‘No, that’s my e-cigarette.’ 
Even Jeff Spicoli circa 1982 couldn’t have delivered a better conclusion.  No one wants sobering health stats when we got stoned surfer dude. 


NOTE: The NY Times has published an update to their article. Comments from an 18-year were removed after he called to say he'd made some of it up and his name. Imagine. At first I thought the editor was going to amend the comments of stoned surfer dude (and possible sponsored content for tobacco)and add a disclaimer like "Kids, Do Not Smoke." 

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