The MMWR also reported that “ever use” of an e-cigarette increased from 3.3% in 2011 to 6.8% in 2012 (including 6.2% by “ever smokers” and .6% by never smokers”). The CDC, however, didn’t release corresponding NYTS data on cigarette smoking necessary for objective data analysis.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6235a6.htm?s_cid=mm6235a6_w
Then, despite no evidence that e-cigs have ever created daily dependence in any nonsmoker (youth or adult), despite no evidence e-cig use has preceded cigarette use in any smoker, and despite no evidence of daily e-cig use among teens, an accompanying CDC press release promoting FDA e-cig regulations (issued with a two day embargo to increase news coverage) quoted CDC Director Tom Frieden and CDC Office of Smoking and Health Director Tim McAfee claiming that e-cigs have addicted many youth and are gateways to cigarette smoking. And despite lots of evidence that e-cigs have helped many smokers quit smoking, CDC’s press release misleadingly stated “there is no conclusive scientific evidence that e-cigarettes promote successful long-term quitting.”
http://www.cdc.gov/media/releases/2013/p0905-ecigarette-use.html
The CDC’s Frieden and McAfee repeated these same claims about e-cigs to many different news media, which along with the press release, generated lots of news at.
http://www.nbcnews.com/video/nightly-news/52932213/#52932213
http://www.cbsnews.com/video/watch/?id=50154438n
http://online.wsj.com/article/SB10001424127887323893004579057080653155754.html
http://abcnews.go.com/WNT/video/teen-electronic-cigarettes-rise-20173228
http://www.npr.org/blogs/health/2013/09/04/219097263/kids-use-of-electronic-cigarettes-doubles
http://uk.reuters.com/article/2013/09/05/us-usa-health-e-cigarettes-idUKBRE9840X820130905
http://nypost.com/2013/09/05/more-children-smoking-electronic-cigarettes-study/
http://www.ktiv.com/story/23350405/study-childrens-use-of-e-cigarettes-increasing
A week later, Congressman Henry Waxman and other House Democrats repeated CDC’s claims about e-cigs in letters to FDA’s Margaret Hamburg (urging her to propose the “deeming” regulation and other e-cig regs) and to US House Energy and Commerce Committee Chairs (urging them to hold hearings).
The following week, 37 State Attorneys General repeated CDC’s claims about e-cigs in a letter urging FDA’s Margaret Hamburg to propose e-cig regs by the end of October.
http://naag.org/ags-urge-fda-to-regulate-sale-and-advertising-of-e-cigarettes.php
http://www.naag.org/assets/files/pdf/E%20Cigarette%20Final%20Letter%20(5)(1).pdf
But careful analysis of the NYTS data released by CDC and other DHHS teen survey data finds no evidence that e-cigs are addictive, have created daily dependence in any nonsmoking youth, or have preceded cigarette smoking in any smoker.
Since CDC hasn’t released NYTS data on cigarette smoking, 2012 USDUH data on 12-17 year olds (who are in grades 6-12) was utilized for analysis. According to Figure 4.2 http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#fig4.2
“past month” cigarette smoking declined from 7.8% in 2011 to 6.6% in 2012, indicating that teen smokers were 45 times more likely than nonsmokers to report use of an e-cig in “past 30 days” in 2102 (i.e. 24.2% of current smokers and .5% of nonsmokers, up from 10.3% and .3% respectively in 2011).
So the CDC’s NYTS actually found that highly addictive and lethal cigarettes are gateways to e-cigs for increasingly more teen smokers (just like adult smokers), and that the increase in e-cig use by teen smokers has occurred as cigarette smoking has declined significantly. If (as repeatedly claimed by CDC’s Frieden and McAfee) e-cigs were addicting youth and were gateways to cigarette smoking, “past 30 day” use of e-cigs by nonsmokers would be far greater than .5%, and cigarette smoking rates would have increased from 2011 to 2012.
In fact, 2012 USDUH and MTF surveys found that pack/day, half pack/day, daily, past month, past year initiation, and lifetime cigarette smoking rates ALL declined among teens, indicating that increased use of e-cigs has helped reduce teen cigarette smoking. http://www.samhsa.gov/data/NSDUH/2012SummNatFindDetTables/NationalFindings/NSDUHresults2012.htm#fig4.6
http://www.monitoringthefuture.org/data/12data/pr12cig_1.pdf
It is critically important to note that the FDA deeming regulation, per Section 910, would ban all e-cigs not on the market prior to February 15, 2007, including all e-cig products currently on the market.
Last week, another CDC study was published citing 2011 NYTS data
http://www.sciencedirect.com/science/article/pii/S1054139X13004151 that 9.2% of 6th-12th graders had reported cigar use in the “past 30 days” (including 3.3% who reported flavored cigar use) and that 11.9% reported cigarette use in the “past 30 days” (including 4.2% who reported flavored cigarette use), and concluded that “Efforts are needed to reduce flavored tobacco product use among youth.”
That same day, CDC issued a press release in which CDC Director Tom Frieden misrepresented “past-30-day” cigar use as “daily use” (just as occurred in CDC’s press release on e-cigs), claimed "The so-called small cigars look like cigarettes, addict as much as cigarettes and they kill like cigarettes," claimed flavored cigars “are more likely to result in get kids getting addicted,” and accused (without providing any evidence) tobacco companies and retailers of illegally target marketing tobacco to youth.
http://www.cdc.gov/media/releases/2013/p1022-flavored-cigarettes.html
Many news headlines and stories repeated Frieden’s claims about cigars and flavorings
http://hosted.ap.org/dynamic/stories/U/US_MED_KIDS_FLAVORED_CIGARS?
http://www.cnn.com/2013/10/24/health/kids-flavored-tobacco/
http://www.foxnews.com/health/2013/10/22/cdc-flavored-tobacco-products-luring-underage-smokers/
Although cigars aren’t effective tobacco harm reduction alternatives for cigarette smokers (because those who switch to cigars tend to smoke them the same way they smoked cigarettes), in sharp contrast to Frieden’s claims, the evidence consistently indicates that cigars are less addictive and less hazardous than cigarettes (since most cigar smokers don’t inhale the smoke, and most don’t smoke cigars daily), there is no evidence that flavored cigars are more addictive than nonflavored cigars, it’s illegal to sell cigars to minors in all 50 states, the TCA and 50 states prohibit cigarette sales to minors and the MSA prohibits companies from target marketing to youth.
Further, according to 2012 NSDUH, “past month” cigar use among 12-17 year olds declined from 4.8% in 2004 to 3.4% in 2011, and then declined to a record low 2.6% in 2012, for a 46% decline since 2004.
The CDC’s Youth Risk Behavior Survey YRBS similarly found that “past-30-day” cigar use by 9th-12th graders declined by 40% from 1997 to 2011.
http://www.cdc.gov/healthyyouth/yrbs/pdf/us_tobacco_trend_yrbs.pdf
So while the CDC claimed that use of flavored cigars and cigarettes is increasing, the CDC cited 2011 NYTS data instead of 2012 data (which the agency hasn’t released), and all other DHHS survey data found that cigar use among teens has declined significantly.
In sum, the CDC has misrepresented the scientific and empirical data on e-cigarettes, cigars and flavorings, including its own youth survey data to confuse and scare the public, and to lobby for FDA e-cig regulations that would ban the sale and otherwise restrict the marketing of e-cigs and many cigars to adults.
Since public health officials have an ethical duty to provide truthful and non misleading information about the known risks, benefits and usage patterns of different tobacco and nicotine containing products, CDC Director Tom Frieden should correct or clarify his and the agency’s many false and misleading claims about e-cigs, cigarettes, cigars, flavorings and youth.
US Congress also should hold public hearings to investigate the recent actions and claims by CDC Director Tom Frieden, as well claims and actions by FDA on e-cigs since 2009.
Bill Godshall
Executive Director
Smokefree Pennsylvania
1926 Monongahela Avenue
Pittsburgh, PA 15218
412-351-5880
[email protected]