FDA misleads public about DHHS survey data on teen vaping

[Bill Godshall]

Critically important 2017 NYTS data (which CDC and FDA have buried and ignored) found:
CDC - National Youth Tobacco Survey (NYTS) - Smoking & Tobacco Use
Tobacco Product Use Among Middle and High School Students...
Tobacco Product Use Among Middle and High School Students — United States, 2011–2017

- Half of 6th-12th graders who ever used an e-cig reported vaping THC, up from 38% in 2016.

- 41.5% of 6th-12th graders who vaped in past 30 days did so 1-2 days, and 61% vaped 1-5 days.

- Just 1.1% of 6th-12th graders vaped daily, and just 1.6% vaped 20+ of the past 30 days.

- 1.24% of 9th-12th graders were nonsmokers who vaped 20+ of past 30 days (which included many past smokers), while the 2015 NYTS found just 0.3% of never smokers in 6th-12th grade vaped on 20+ of past 30 days.

- 18.5% of 9th-12th graders who used an e-cig in the past 30 days were 18+ adults (not youth).

- 45% of 9th-12th graders who vaped 20+ of past 30 days were 12th graders (most who were 18+).

The 2017 NYTS also found:

- Past 30 day e-cigarette use by 6th-12th graders declined from 11.2% in 2015 to 8.2% in 2017.

- Ever use of e-cigarettes by 6th-12th graders declined from 26.6% in 2015 to 21.1% in 2017.

- Youth access to e-cigarettes declined significantly from 2015 to 2017.

- Since 2011, cigarette smoking by 6th-12th graders has sharply declined, including daily smoking (-64%), frequent smoking (-63%), past 30 day smoking (-52%), and ever smoking (-43%).


Marijuana vaping has skyrocketed among teens (as with adults) in recent years.

The 2017 NYTS found that 49.8% of 6th-12th graders who ever used an e-cigarette reported using an e-cigarette containing THC, marijuana, wax or hash oil, up from 38% in 2016.
2016 – 38.1% (.086/.226=.381)
2017 - 49.8% (.105/.211=.498)

The 2016 NYTS also found 46.5% of 6th-12th graders who ever used an e-cigarette reported using an e-cigarette for “any substance other than nicotine”, up from 35.7% in 2015.
2015 - 35.7% (.095/.266=.357)
2016 - 46.5% (.105/.226=.465)

Another DHHS survey that inquired about THC vaping (i.e. NIDA’s MTF Survey) found 30% of past 30 day vapers in 8th-12th grade vaped marijuana in 2017, up sharply from 5% in 2015. The 2017 MTF also found 67% of vapers in 8th-12th grade reported vaping “just flavoring”, similar to 63% in the 2015 MTF, both of which were greater than those who vaped “nicotine”.
Past 30 Day Vaping by 8th, 10th and 12th graders in US (2017 MTF)
8th 10th 12th 8th-12th
Any Vaping 6.6% 13.1% 16.6% 12.0%
Nicotine 3.5% 8.2% 11.0% 7.5%
Marijuana 1.6% 4.3% 4.9% 3.6%
Just Flavoring 5.3% 9.2% 9.7% 8.0%
http://monitoringthefuture.org/data/17data/17drtbl3.pdf
Vaping popular among teens; opioid misuse at historic lows
Monitoring the Future Study: Trends in Prevalence of Various Drugs
Monitoring the Future Figures 2015

Analysis of 2016 MTF data finds 12th grade smokers were far more likely to vape nicotine (61.3%) than nonsmokers (18.1%) and never smokers (14.3%); 12th grade never smokers (76%) and nonsmokers (69.6%) were far more likely than smokers (31%) to vape ‘just flavors’.
Students' Cigarette Smoking and the Perceived Nicotine Content of Their E-cigarettes. - PubMed - NCBI

Another 2017 DHHS survey (i.e. CDC YRBS) found Colorado had the highest past 30 day use of electronic vapor products by 9th-12th graders, and found 9 of 10 states with the highest past 30 day vapor product use (all >20%) had legalized marijuana. In sharp contrast, 9 of the 10 states with the lowest past 30 day vapor product use (all <12%) by 9th-12th graders had not legalized marijuana (and PA's law just went into effect in 2018)
Youth Risk Behavior Surveillance — United States, 2017 Supplementary Tables 52-93: Tobacco Use | MMWR
33 Legal Medical Marijuana States and DC - Medical Marijuana - ProCon.org
9th-12th graders who used an electronic vapor product in past 30 days (2017 YRBS, Table 67)
** State legalized marijuana; *State legalized medical marijuana
Highest Lowest
**CO – 26.2% UT - 7.6%
*HI – 25.5% IA – 9.0%
*NM – 24.7% NE – 9.4%
*NH – 23.8% TX – 10.3%
*MT – 22.5% KS – 10.6%
*LA – 22.2% MO – 10.9%
NC – 22.1% *PA – 11.3% (not available until 2018)
*ND - 20.6% TN – 11.5%
**MA – 20.1% WI – 11.6%
*RI – 20.1% VA – 11.8%
Note that 11 States AL, GA, IN, MN, MS, NJ, OH, OR, SD, WA, WY didn’t ask this question.


Many 9th-12th graders who vape are 18+ adults, and the 2009 TCA prohibits FDA from banning sales of cigarettes and other tobacco products to anyone 18 or older

Brad Rodu reveals the 2017 NYTS found that 18.5% of e-cigarette users in grades 9-12 (including 16% of exclusive e-cig users, and 23% of dual users) were 18+ adults
Tobacco Truth: Not All Teen Smokers & Vapers Are Lawbreakers

Meanwhile, the 2017 YRBS found 34% of 9th-12th graders who used a vapor product in the past 30 days were 18+ adults, as just 8.7% of 9th-12th graders <18 years used a vapor product in the past 30 day (compared to 13.2% of all 9th-12th graders). Note that CDC buried this important finding in a footnote in Table 72 at
Youth Risk Behavior Surveillance — United States, 2017

 

[Bill Godshall]

Daily and frequent vaping by 6th-12th graders was extremely low from 2014-2017

Daily (1.1%) and frequent (1.6%) e-cigarette use by 6th-12th graders remained virtually the same from 2014 to 2017, while experimental e-cigarette use declined from 2015 to 2017 (NYTS).
Days 2014 2015 2016 2017
0 89.3 87.4 90.0 90.6
1+ 8.8 11.2 8.4 8.2
3+ 4.5 6.2 4.9 4.8
6+ 3.0 4.2 3.1 3.2
10+ 2.3 2.8 2.2 2.5
20+ 1.4 1.7 1.4 1.6
All 30 0.9 1.1 1.1 1.1

Daily (5.2%) and frequent (7.6%) e-cigarette use by 6th-12th graders who ever used an e-cigarette remained very similar from 2014 to 2017, while experimental e-cigarette use declined (NYTS).
Days 2014 2015 2016 2017
1+ 45.4 42.1 37.2 38.9
3+ 23.2 23.3 21.7 22.7
6+ 15.5 15.8 13.7 15.2
10+ 11.9 10.5 9.7 11.8
20+ 7.2 6.4 6.2 7.6
All 30 4.6 4.1 4.9 5.2

The number of days 6th-12th graders (%) used an e-cigarette in their lifetime declined from 2015 to 2017 (NYTS).
Days 2015 2016 2017
0 74.3 77.1 78.3
1 7.3 6.5 6.4
>1 16.8 15.1 14.1
>10 9.3 8.3 7.5
>20 6.4 5.7 5.1
>50 3.8 3.6 3.1
>100 2.1 2.1 1.9

In 2017, 12th graders comprised 45% of 9th-12th graders who frequently used e-cigarettes (20+ of past 30 days), and most 12th graders were 18+. NYTS data provided by Christine Delnevo.
Grade Past-30-Days 20+ Days
9th 8.8 1.0
10th 11.4 2.0
11th 11.8 2.2
12th 15.2 4.4
9th-12th 11.7 2.3

The CDC YRBS found past 30 day use (%) of electronic vapor products by 9th-12th graders declined 45% from 2015 to 2017 (from 24.1% to 13.2%).
Grade 2015 2017
9 19.7 9.5
10 23.2 11.4
11 25.9 14.1
12 28.2 18.3
9-12 24.1 13.2
White 25.2 15.6
Black 18.0 8.5
Hspnc 26.3 11.4
https://www.cdc.gov/mmwr/volumes/65/ss/pdfs/ss6506.pdf (Table 41)
Youth Risk Behavior Surveillance — United States, 2017 Supplementary Tables 52-93: Tobacco Use | MMWR (Table 66)

The 2017 YRBS found 2.4% of 9th-12th graders vaped daily, and 3.3% vaped frequently, 12th graders were far more likely to use electronic vapor products daily, frequently and in past 30 days than 11th, 10th and 9th graders, and White students were more likely than Hispanics, who were more likely than Blacks.
Days Used an Electronic Vapor Product in Past 30 Days
Grade 1+ 20+ All 30
9 9.5 1.8 1.2
10 11.4 2.7 1.7
11 14.1 3.7 2.7
12 18.3 5.0 4.0
9-12 13.2 3.3 2.4
White 15.6 4.3 3.1
Black 8.5 1.4 1.0
Hspnc 11.4 2.1 1.7
Youth Risk Behavior Surveillance — United States, 2017 Supplementary Tables 52-93: Tobacco Use | MMWR
(See Tables 66, 68 & 70)

Brad Rodu reveals the 2017 NYTS found just 1.24% of high school students didn’t smoke cigarettes in the past 30 days and used e-cigarettes on 20+ of past 30 days (which included former smokers); The FDA’s Teen E-Cigarette-Addiction Epidemic Doesn’t Add Up
Tobacco Truth: The FDA’s Teen E-Cigarette-Addiction Epidemic Doesn’t Add Up

Brad Rodu reveals the 2017 NYTS found 74% of exclusive past 30 day e-cigarette users in 6-12th grades used e-cigarettes just 1-5 of past 30 days, compared to 56% who used e-cigarettes and cigarettes, 57% who used e-cigarettes and cigars, and 35% who used e-cigarettes, cigarettes and cigars in past 30 days.
Tobacco Truth: FDA Tobacco Center Exaggerates Number of Youth Tobacco Users
Rodu also reveals the 2017 NYTS found just 12% of 6th-12th graders who exclusively used e-cigarettes in past 30 days used them frequently (on 20+ days), compared to 20% who used e-cigarettes and cigarettes, 21% who used e-cigarettes and cigars, and 38% who used e-cigarettes, cigarettes and cigars in past 30 days.

Brad Rodu reveals the 2017 NYTS found 53% of past 30 day cigarette smokers in 9th-12th grade also used e-cigarettes in the past 30 days (.042/.079=.53), and accounted for 35% of 9th-12th graders who used an e-cigarette in the past 30 days (.042/.119=.35).
Tobacco Truth: Slight Teen Vaping Increase and A Continued Smoking Decline in 2017

Farsalinos et al analysis of 2015 NTYS data (among 6th-12th graders) found:
https://www.sciencedirect.com/science/article/pii/S074937971831626X
(note ‘frequent’ use = 20+ of past 30 days, and ‘infrequent’ use = <20 of past 30 days)
- just 0.3% of never smokers were frequent e-cigarette users,
- just 4.6% of never smokers used an e-cigarette in the past 30 days, and 59% of them did so just 1-2 days,
- frequent smokers were 84 times more likely than never smokers to vape daily (16.9% v 0.2%), while infrequent smokers were 36 times more likely (7.3% v 0.2%),
- frequent smokers were 73 times more likely than never smokers to vape frequently (21.8% v 0.3%), while infrequent smokers were 41 times more likely (12.2% vs 0.3%),
- frequent smokers were 14 times more likely than never smokers to vape in past 30 days (64.7% v 4.6%), while infrequent smokers were 11 times more likely (50.4% v 4.6%)
https://www.sciencedirect.com/science/article/pii/S074937971831626X

Villanti et al revealed the 2014 NYTS found <0.1% of never tobacco users in 6th-12th grades reported vaping on 10 or more of the past 30 days
Frequency of Youth E-Cigarette and Tobacco Use Patterns in the United States: Measurement Precision Is Critical to Inform Public Health

 

[Bill Godshall]

Cigarette smoking by 6th-12th graders dramatically declined from 2011 to 2017

Daily, frequent, occasional and past 30 day cigarette smoking by 6-12th graders (%) declined sharply from 2011 to 2017 (NYTS)
Days 2011 2012 2013 2014 2015 2016 2017
0 86.6 88.8 89.6 91.8 91.8 93.3 93.4
1+ 10.6 9.3 8.2 6.1 6.0 5.8 5.6
3+ 7.3 6.2 5.6 3.8 3.8 3.7 3.3
6+ 5.8 4.9 4.5 3.0 2.8 3.0 2.4
10+ 4.8 4.1 3.7 2.4 2.3 2.5 1.9
20+ 3.5 3.0 2.7 1.8 1.7 1.8 1.3
All 30 2.5 2.1 2.0 1.3 1.2 1.3 0.9

The number of cigarettes 6th-12th graders (%) smoked in their lifetime also declined sharply from 2011 to 2017 (NYTS).
Cigs 2011 2012 2013 2014 2015 2016 2017
100+ 5.5% 4.5% 4.3% 3.2% 2.9% 2.9% 2.2%
26+ 8.1% 6.9% 6.3% 4.7% 4.5% 4.3% 3.6%
16+ 9.8% 8.4% 7.6% 5.8% 5.6% 5.5% 4.4%
6+ 12.4% 10.9% 9.7% 7.8% 7.6% 7.3% 6.0%

6th-12th graders (%) who last smoked a cigarette (even one puff) “today”, during “past week” and during “past 30 days” also declined sharply from 2011 to 2017 (NYTS)
Last smoked a cigarette (even one puff)
2011 2012 2013 2014 2015 2016 2017
3.7 3.0 2.9 2.0 2.0 1.9 1.3 Today
7.8 6.6 6.0 4.3 4.4 3.9 3.3 Past Week
10.4 9.1 8.2 6.1 6.1 5.5 4.0 Past 30 Days


Cigarette smoking by young adults has declined almost as rapidly as by youth

CDC’s NHIS found a 52% decline in cigarette smoking by 18-24 year olds (%) from 2009 to 2017, compared to a 32% decline for all US adults (as more smokers switched to vaping).
Age Group
Year Total 18-24 25-44 45-64 65+
2009 20.6 21.8 24.0 21.9 9.5
2010 19.3 20.1 22.0 21.1 9.5
2011 19.0 18.9 22.1 21.4 7.9
2012 18.1 17.3 21.6 19.5 8.9
2013 17.8 18.7 20.1 19.9 8.8
2014 16.8 16.7 20.0 18.0 8.5
2015 15.1 13.0 17.7 17.0 8.4
2016 15.5 13.1 17.6 18.0 8.8
2017 14.0 10.4 16.1 16.1 8.2
Change-32% -52% -33% -26% -14%

2017 NHIS found 14.0% (34.3M) of US adults smoked cigarettes ‘everyday’ or ‘some days’, while just 10.5% (25.7M) of US adults smoked cigarettes ‘everyday’, both record lows.
Tobacco Product Use Among Adults --- United States, 2017

 

[Bill Godshall]

Youth access to e-cigarettes is primarily from social sources, and declined from 2015 to 2017

Brad Rodu reveals 2017 NYTS data for sources of vapor products among the 9.3% of 9th-12th graders <18 years who vaped in the past 30 days. “During the past 30 days, where did you get or buy the e-cigarettes that you have used? (Select one or more)”
64.0% - From a friend
5.8% - From family member
11.8% - A vape shop
4.7% - On the internet
4.0% - From some other person that is not a family member or friend
3.4% - A gas station or convenience store
1.2% - A drug store
1.4% - A mall or shopping center kiosk/stand
<1% - A grocery store
3.6% - Some other place not listed her
Tobacco Truth: Not All Teen Smokers & Vapers Are Lawbreakers

Brad Rodu reveals 2014-15 PATH data for sources of e-cigarettes by 12-17 year olds who used an e-cigarette in past 30 days
Tobacco Truth: FDA Is Targeting E-Cigarette Retailers, But They’re Not Teens’ Primary E-Cigarette Source
In the past 30 days, how did you usually get your own e-cigarette/cartridges and e-liquid?
46% - Someone offered me one
16% - Gave someone else money to buy them
9.9% - Bought them myself
9.7% - Asked someone to give me one
6.9% - Got them some other way
4.1% - Took them from a store or another person
3.2% - Bought them from another person
4.2% - Don’t know, refused to answer
100% - Total

The NYTS found access to e-cigarettes by 6th-12th graders (8% of whom were 18+) declined from 2015 to 2017. “During the past 30 days, where did you get or buy the e-cigarettes that you have used? (Select one or more)”
2015 2016 2017
10.1% 8.9% 7.6% - From a friend
4.2% 3.1% 2.1% - From family member
4.0% 3.0% 1.8% - A vape shop or other store that only sells e-cigarettes
1.9% 1.7% 1.1% - From some other person that is not a family member or a friend
2.5% 1.8% 1.0% - A gas station or convenience store
1.1% 1.2% 0.7% - On the internet
0.8% 0.5% 0.3% - A drug store
0.9% 0.6% 0.3% - A mall or shopping center kiosk/stand
0.5% 0.3% 0.1% - A grocery store
0.9% 0.7% 0.4% - Some other place not listed here


Youth engage in many far more harmful behaviors and activities than vaping

CDC 2017 YRBS data found many behaviors by high school students that are far more harmful than e-cigarette use, including
Youth Risk Behavior Surveillance — United States, 2017
https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf
Tobacco Truth: CDC Data Reveal Many Far More Dangerous Teen Behaviors Than Vaping
- 39.2% texted or e-mailed while driving in past 30 days
- 5.9% rarely or never used a seat belt when riding in a car driven by someone else
- 5.5% drank alcohol and drove in past 30 days
- 16.5% rode in a vehicle in past 30 days driven by someone who had drank alcohol
- 13.5% binge drank alcohol (i.e. 4+ drinks) in past 30 days
- 4.4% drank at least 10 alcohol drinks in a row during past 30 days
- 14.0% ever used prescription pain medicine without a doctor’s prescription
- 23.6% were in a physical fight in past year
- 7.4% reported ever being forced to have sexual intercourse when they did not want to
- 7.4% reported attempting suicide in past year
- 17.2% reported seriously considering attempting suicide in past year
- 14.8% were obese
- 15.6% were overweight

 

[Izan]

The governments lies? NO!!!!
Say it ain't so!

Thank you Mr. Godshall.
Cheers
I

 

[Ceejay0875]

Kinda figured this "epidemic" was pure bs, but just wow...

Vigilant as ever, thank you so much for everything you do for this community Mr. Godshall.

 

[Bill Godshall]

Yesterday, FDA and CDC released selective data from the 2018 NYTS (to confuse and scare the public to lobby for FDA's newly proposed flavored e-cig sales ban/restriction), which I have inserted in the charts below.

Unfortunately, FDA and CDC did not release any truly important data (for public health analysis), including:
- % of current, past and never cigarette smokers who vaped daily, frequently, and in the past 30 days,
- changes in daily, frequent and past 30 day cigarette smoking since 2017,
- % of e-cig users who reported vaping the illegal weed (which was 50% in 2017), and
- % of e-cig users who were <18 years of age (as 18.5% of high school vapers were 18+ in 2017).

Past-30-day cigarette / e-cigarette use by high school students (9th-12th grade)
Year - Cigarette / E-cigarette
2011 - 15.8% / 1.5%
2012 - 14.0% / 2.8%
2013 - 12.7% / 4.5%
2014 - 9.5% / 13.4%
2015 - 9.3% / 16.0%
2016 - 8.0% / 11.3%
2017 - 7.6% / 11.7%
2018 - ? / 20.8%

Past-30-day cigarette / e-cigarette use by middle school students (6th–8th grade)
Year – Cigarette / E-cigarette
2011 - 4.3% / 0.6%
2012 - 3.5% / 1.1%
2013 - 2.9% / 1.1%
2014 - 2.5% / 3.9%
2015 - 2.3% / 5.3%
2016 - 2.2% / 4.3%
2017 - 2.1% / 3.3%
2018 - ? / 4.9%

Frequent e-cigarette use (20+ of past 30 days) by 9th-12th graders
2017 - 2.3%
2018 - 5.8%

Frequent e-cigarette use (20+ of past 30 days) by 6th-8th graders
2017 - 0.43%
2018 - 0.79%

 

[sofarsogood]

The relationship between kids and ecigs or cigarettes is more subtle and nuanced than is being presented. Opportunities are overlooked because the only responses the anti tobacco folks consider are sledge hammers and whining.

Over and over I'll say I wish ecigs had been around when I was a kid.