In September, the U.S. Food and Drug Administration (FDA) launched a new initiative designed to tackle the “growing spread of rumors, misinformation and disinformation about science, medicine, and the FDA.” Announcing the initiative, Commissioner of the FDA Dr. Robert Califf promised to make “combating misinformation one of [his] priorities.” Describing this move as “Rumor Control,” it was primarily aimed at myths and false information about COVID-19 vaccines. But, if Califf is serious about responsibly informing the public, the FDA should begin with sanctioning itself and the Centers for Disease Control and Prevention (CDC) for helping to spread wild falsehoods about youth vaping.
Each year, the CDC and FDA announce results of the National Youth Tobacco Survey (NYTS) and, once again, have done so by releasing the latest data in a way to confuse media and the public (deliberately or otherwise) as to the extent of youth use of vaping products.
In October the CDC published the 2022 NYTS results in a Morbidity and Mortality Weekly Report, which found that 9.4 percent of U.S. middle and high school students reported use of an e-cigarette in the past 30 days. However, the method the CDC employs to communicate the data led many news outlets to publish articles inaccurately claiming “more than 1 in 4 teenagers used electronic cigarettes daily,” which is, of course, impossible. The American Cancer Society also repeated this false claim.
The problem is that the CDC splits the frequency of use into proportions of that 9.4 percent, by stating “daily use was reported among 27.6% of current e-cigarette users” without expressing daily use as a fraction of all middle and high school students. The real figure is, therefore, 2.6 percent of teenagers which is 1 in 38, not 1 in 4.
The CDC is not alone in communicating youth use in this misleading way. In a toolkit about vaping and e-cigarettes on the FDA’s website, a graphic detailing use among youth rounds up the 27.6 percent and states that “30 percent use e-cigarettes every day” in bold lettering. This is not a singular error. Last year, the same website claimed that “about 1 in 4 [U.S. youth] use e-cigs daily” on a page detailing the results of the 2021 NYTS data when in reality, the real figure was 3.1 percent. If Dr. Califf is such a champion of eradicating misinformation, perhaps he could begin by ensuring data is presented more clearly on his own agency’s website.
It is abundantly clear that the CDC and FDA are guilty of presenting teen e-cigarette use data in a way that is demonstrably misleading to journalists, the public and, ultimately, members of state legislatures and Congress itself. Consequently, hundreds of thousands of Americans are being given an entirely false impression of regular youth vaping use which is, in reality, at very low levels.
This follows on from an astonishing CDC Zoom event in October which was more a form of collective activism with the CDC working in partnership with anti-vaping groups to perpetuate the falsehood of there being an “epidemic” of youth vaping in the media, rather than an exercise in information-sharing and impartial analysis.
It would help the public get a better overall picture if youth smoking rates were available for comparison, but the CDC has not released this information. Moreover, the CDC and FDA make no effort to distinguish what proportion of youths currently using e-cigarettes formerly smoked or currently still do. This would add a completely different dynamic to the data as their use of safer nicotine alternatives is a positive development for public health, rather than a negative. In the UK, only 0.5 percent of 11 to 17 year olds who regularly vape were not former smokers, it is likely to be similar in the U.S.
It is incumbent on public health agencies in the U.S. to accurately inform the public on survey data, yet they are distinctly failing to do so with youth vaping. Instead, we are seeing messaging from the CDC and FDA which seems almost deliberately designed to mislead.
It is true that misinformation and misrepresentation of science is rife in many areas. Sadly, the main perpetrators of misleading data in tobacco and nicotine policy are government agencies themselves. The FDA and CDC cannot lecture others on fake news and misinformation when their own communications seem ideologically driven rather than adhering to objective evidence.