Vaping ‘within five minutes of waking’ – the truth behind the click-bait headlines

Scientific knowledge on vaping is in its infancy – inevitably, as e-cigarettes themselves are in their infancy. How can anyone be absolutely confident about the long-term effects of anything that only came to market in any significant way around 16 years ago?

Still, scientists probe, as scientists will; then an abstract of their research is perhaps published in some reputable journal; someone then summarises that summary, cherry-picking the juicy bits; then a journalist, probably of strictly limited scientific understanding, rewrites and cherry-picks again; and then a headline-writer boils it all down to a tasty soundbite or click-bait item. Little wonder, after this game of Chinese whispers, if what reaches the ears of the public ends up being a little less than rigorously scientific. Yet this is what both the potential consumer and the regulator are going to base their possibly life-changing decisions on.

So here’s a headline that appeared last week in a respected health and lifestyle magazine (following similar ones a few days earlier in a range of publications): “More Teens Are Vaping Within 5 Minutes of Waking”.

Crikey – kids reaching for an e-cig within just five minutes of waking up? That’s a serious addiction problem. Parents and lawmakers should be rightly worried.

But hang on – what exactly is that statement based on, and what’s it really saying? “More” are doing this thing – but “more” could just mean two when it used to be one. And, as it turns out when you look at the report the reports are based on, there’s no discovery here at all. That shocking “five minutes” figure is a starting point, not a conclusion; it’s the measure the researchers decided on as their means of identifying addiction. So already we have the germ of a misleading idea – dare I say a deliberately misleading idea, on someone’s part? – making its sensationalist way out into the world.


Statistically illiterate – or deliberately twisting the truth?


But there could be a baby in this bathwater, so let’s not chuck it out without examining it a little more closely.

For a start, this isn’t exactly original research. It’s an analysis of an already published survey, the annual US National Youth Tobacco Survey (NYTS), which means that a) it’s based on an impressively wide sample of over 15,000 respondents; and b) it’s a partisan selection of what the “investigators” were most interested in among a wide range of facts and figures that might be teased out of it. Which is not to say it doesn’t provide valuable food for thought.

While it may be unduly sensationalist to talk of an “epidemic” of youth vaping, as many who should know better do including, as it happens, this research team (and ECigIntelligence has inveighed before against that particular misuse of language) there is legitimate concern at both parts of the finding that “age at initiation of e-cigarette use decreased and intensity of use and addiction increased between 2014 and 2021”.

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    It’s also interesting to learn that by 2019 more adolescents were addicted to vaping (on the basis of that “within five minutes of waking” measure) than to combustible cigarettes and all other tobacco products combined. Which you might think of as good news if you look at it as a decrease in addiction to smoking.

    You might have cause to worry if you believed the statement (“fact-checked”, apparently) in that health mag that “10.3% of youth were using their first e-cigarette within five minutes of waking”. In fact, that’s 10.3% of those who use e-cigarettes at all – a very different proposition and a far smaller number of individuals (and, incidentally, a typical example of an all-too-common way in which statistics are woefully misreported; are these journalists statistically illiterate, or are they deliberately distorting the facts?).


    Are flavours the wrong target?


    But where it all gets really interesting is in the figures showing that while the number of young vapers in the US has fallen since 2019, those who do vape are doing so more intensively, are more likely to be addicted (see above), and are on average taking it up at a younger age. And for all this (though quite how it relates to younger take-up eludes me), the researchers point the finger at protonated nicotine (otherwise known as nicotine salts), which is easier and more pleasant to inhale, and all those companies that produce “disposable flavored protonated nicotine e-cigarettes” in other words, the usual suspects.

    What their report addresses only glancingly is the part, if any, that nicotine concentration may play – though you might think it almost self-evident that the far higher nicotine levels common in the US than are permitted in Europe, for example, are more likely to get users hooked.

    Instead, while making no recommendation at all about nicotine itself, they repeat the familiar mantra about “the need for local, state, and federal comprehensive bans on the sale of flavored tobacco products”.

    Which raises the question whether this team (led, as it happens, by that familiar antagonist of vaping, retired professor Stanton Glantz) and the whole regulatory establishment of the US and beyond, obsessing about flavours, just might have got the wrong target in their sights.

    – Aidan Semmens ECigIntelligence staff

    Photo: Christo Anestev

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    Aidan Semmens