By Michael Siegel July 10, 2015

An article just published in the journal Addictive Behaviorspresented data from the 2014 Texas Youth Tobacco Survey. It reported that 14% of middle and high school students in Texas used electronic cigarettes in the past 30 days. The prevalence of past 30-day e-cigarette use among nonsmokers who had never used any type of tobacco product was 7.3%.

(See: Cooper M, Case KR, Loukas A. E-cigarette use among Texas youth: Results from the 2014 Texas Youth Tobacco Survey.Addictive Behaviors 2015; 50:173-177.)

Despite putting out alarming conclusions about the high rate of electronic cigarette use among youth and bemoaning the fact that the prevalence of past 30-day e-cigarette use (14.0%) was higher than that for smoking (11.7%), the paper fails to mention two very important facts: (1) that electronic cigarettes are much safer than regular cigarettes; and (2) that electronic cigarettes do not contain any tobacco. In fact, the study classifies e-cigarettes as tobacco products. Moreover, in the survey instrument itself, e-cigarettes are referred to as tobacco products, thus suggesting to youth that these products contain tobacco and are therefore probably just as hazardous as real cigarettes.

The Rest of the Story

This is yet another example of how current tobacco control research is failing to ask the proper questions regarding e-cigarette use. Instead of merely asking about past 30-day e-cigarette use, these types of surveys should ascertain the number of days in the past 30 that the subject used e-cigarettes. It is possible that many of the respondents were only experimenting with e-cigarettes and that they only used these products once or twice in the past month. Some may have just tried an e-cigarette once and not used it again. Moreover, previous data suggest that although e-cigarette experimentation among nonsmokers is significant, very few of these nonsmokers are becoming regular vapers. They tend to try or use e-cigarettes in social situations but not to progress beyond that. Without asking the key question, the Texas Youth Tobacco Survey is unable to provide any sense of whether e-cigarette use among nonsmoking youth is really a problem or not.

Furthermore, by omitting from the paper the facts that e-cigarettes are much safer than real cigarettes and that they contain no tobacco and involve no combustion, the article suggests that e-cigarette experimentation among smokers is a much larger problem than it actually is.

Given that most anti-tobacco organizations are obsessed with making sure that e-cigarettes are treated no differently than cigarettes, it is surprising that they are consistently treating these products differently in terms of the questions asked in surveys. These surveys only inquire about past 30-day use of e-cigarettes, but they ask about the actual frequency of use within the past 30 days for real cigarettes.

Why the discrepancy? I believe it is because they don’t want to compare daily and weekly use of e-cigarettes to daily and weekly use of e-cigarettes. They know this will destroy the story they want to tell, and it will reveal that e-cigarettes are much less addictive than the real ones. This truth is simply not a part of the story line.

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