Another year, another National Youth Tobacco Survey (NYTS), and another outpouring of not unreasonable complaints from tobacco harm reduction advocates that the Centers for Disease Control and Prevention (CDC) makes the data deliberately difficult to unpick – in effect, forcing readers to follow the CDC’s narrative rather than allowing us to draw our own conclusions.
There is some truth in this, whether it’s deliberate or not, and the headline conclusions of the CDC are not surprising: tobacco products remain a menace to America’s kids, e-cigarettes particularly, flavoured ones most of all.
It doesn’t, in a way, entirely matter if this is true in every detail; the real significance of the NYTS is not what it tells us about the habits of young people but how it shapes the views of policy-makers and regulators.
There the CDC’s conclusions are pretty much continuations of the same ones that the US government public health establishment has been offering for a while (as have many of its counterparts in state and municipal government, in academia and so on).
For that reason, these latest NYTS figures are likely to encourage more of the same rather than any dramatic change in tobacco control priorities – and any egg that the CDC accumulated on its institutional face during the Covid pandemic is unlikely to rub off onto its tobacco research.
What they aren’t saying
Of course, what’s also notable is what is not said explicitly by the CDC: combustible cigarettes are once again confirmed as a relatively small part of the school tobacco scene in the US, relegated to the sidelines mostly by novel products.
Expecting this to make a difference is missing the point, though, because it’s only important if you believe that novel products are safer than combustibles…and the real battle for tobacco harm reduction in the US lies in making precisely that argument, not in debating the fine details of youth usage.
Even the lowest levels of youth use are – realistically – unlikely ever to be seen as a positive beyond the more extreme circles of harm reduction. The growth in vaping at the expense of smoking might logically be a success story, as might the still very low levels of heated tobacco and nicotine pouch use among minors, but it’s an impossible sell.
In realpolitik terms, then, the good news from the NYTS is not the ascendancy of the e-cigarette over the combustible.
For e-cigs, the good news is the fact that overall vaping levels in high schools and middle schools are not continuing to soar; for other products like heated tobacco (HnB) and pouches, the good news is their relative invisibility in the survey results. The good news is that there is no really bad news.
The many opponents of novel nicotine products may not find much to celebrate in the NYTS, but at least (despite an increase in the proportion of regular vapers, which could attract some rhetoric) there is not much to dramatically increase levels of alarm.
– Barnaby Page ECigIntelligence staff
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