Teen Smoking is Down — Due to E-Cigarettes?

The good news — no, make that the very good news — is that teen cigarette smoking has continued to decrease, according to the 2015 National Youth Risk Behavior Survey (YRBS).

In 1991, 28 percent of teens reported smoking at least one cigarette in the 30 days before taking the survey, while in 2015 that had dropped to 11 percent, as shown in the graph below.


Screen Shot 2016-06-10 at 12.03.15 PM Percent of High School Students Who Ever Tried Cigarette Smoking. 1991-2015 National Youth Risk Behavior Surveys

Since the majority of adult smokers began smoking and became addicted to nicotine as teens, these results should make public health advocates very happy. And to a certain extent it does, but members of the gloom and doom group still have their gripes.

Among them is Centers for Disease Control and Prevention director Dr. Tom Frieden, who complains that while reported levels of youth cigarette smoking are down, their use of alternate tobacco products such electronic cigarettes (e-cigarettes) has increased — 24 percent of high school students said they had used e-cigarettes in the 30 days prior to the survey.

Why not go into a panic, as we should if cigarette smoking were on the rise? Because e-cigarettes only provide nicotine, not the multitude of toxic carcinogens found in cigarettes. Frieden doesn't note that fact.

His is an interesting perspective, since the use of hookahs — in which tobacco smoke is drawn through water before being inhaled — is also up. In 2015, 2 percent of middle school students and 7 percent of high school students reported using hookahs. These are increases from the 2011 levels of 1 percent and 4 percent, respectively. Yet although hookah "smoking" also provides tobacco carcinogens as well as nicotine, Dr. Frieden doesn't single them out.

Of course, it would certainly be preferable for young people to avoid using any product that can potentially addict them — not just to nicotine, but to anything. Caffeine is certainly not getting a stamp of disapproval any time soon, though its addictive nature and potential harm in developing brains is well-known. Singling out one alternative to deadly cigarette smoking seems more than a little biased.

Teens like to explore — new foods, new clothing, and yes, new risks. That is unlikely to change. Certainly we must continue to educate them about the risks of smoking, but we need to give them the real facts about the alternatives, and not just lump all tobacco products under the heading of equally dangerous.