Tuesday, December 03, 2013

According to CDC, the Fact that Some Nonsmoking Youth are Using Electronic Cigarettes Suggests that These Kids are Going on To Become Lifelong Smokers

If that seems like strange logic to you, then you have company. I do not understand the logic of extrapolating from the observation that some nonsmoking youth are experimenting with electronic cigarettes to concluding that these products are causing these youth to become addicted to smoking.

But sadly, this is precisely the logic that the CDC is using to try to convince the public that electronic cigarettes are a gateway to a lifetime of addiction to tobacco cigarettes.

According to the transcript of a CNN (nationally televised) interview with CDC's director in September, the observation that there are some nonsmoking youth who are experimenting with electronic cigarettes suggests that these products are leading to a lifetime addiction to smoking.

Based on the transcript, CDC's director told a national television audience that: "Well, if you start with e-cigarettes, there's a real likelihood that you'll become nicotine addicted, we found in CDC studies that 20 percent of middle school kids who used some -- who used e-cigarettes only used e-cigarettes, what that suggests to me, it's not proof, but what it suggests to me is that some kids are starting with e-cigarettes, getting hooked on nicotine and going on regular cigarettes and that's a real problem because those kids may well be getting condemned to a lifetime of nicotine addiction."

The Rest of the Story

What would suggest to me, as a scientist and 27-year tobacco control researcher, that "some kids are starting with e-cigarettes, getting hooked on nicotine, and going on [to] regular cigarettes" is evidence that some kids are starting with e-cigarettes and then going on to smoke real ones.

One would hope that our nation's leading prevention agency would demand that minimal level of scientific rigor before drawing a conclusion that would have profound implications for public health policy.

Those implications are so profound that if the CDC's conclusion were true, I would withdraw my support for electronic cigarettes as a smoking cessation strategy.

But it would be unwise (and possibly tragic) to base public health policy on the type of evidence that the CDC is using to scare the public into believing that electronic cigarettes are a gateway to a lifetime of cigarette addiction.

The fact that a number of nonsmoking youth -- even if it is a large number -- are experimenting with electronic cigarettes is concerning, but it in no way provides evidence that these youth are going on to become addicted to cigarette smoking. The only type of evidence which would support such a conclusion is longitudinal evidence showing that kids who initiate nicotine use with electronic cigarettes are going on to become cigarette smokers. That kind of evidence does not exist at the current time.

Many kids are chewing gum. But that provides no evidence whatsoever that these kids are initiating with chewing gum and then going on to try nicotine gum.

But this is precisely the nature of the evidence upon which the CDC is concluding that electronic cigarettes are serving as a gateway to a lifetime of cigarette smoking.

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