THREAD
So... Here is the @US_FDA's original infographic. Let's take a good look at what they told the public about the National Youth Tobacco Survey 2020 (specifically March 2020, so just before the pandemic).

First, US high school vaping had dropped 29%
fda.gov/files/ctp-nyts…
(2)
Next... Unless you read this VERY carefully, you will not understand frequent use, and daily use, are given as a percentage of "current use."
(3)
One key to good infographics: They deliver facts clearly and need no translation.

This one from @FDATobacco needed translation. You have to do the math to find out how many US high school kids vaped frequent, or daily, in March 2020 (before the pandemic).
(4)
Now... March 2020 is over a year and a half ago. In the previous image, you may have noticed there is new data: 3 different surveys from late 2020, during the pandemic. All 3 show "youth" vaping dropped another 30% (@Stanford/@UCSF; @truthinitiative; @NIH/@NIDAnews MTF).
(5)
So I have added that 30% drop... after the 29% drop between 2019 & March 2020. These new surveys only cover up to November 2020. I called that "2021" as a fudge. I have added daily use as well, since that's publicly available in @CDCgov NYTS data.
cdc.gov/tobacco/data_s…
(6)
Obviously, US teen vaping plummeted 50% over the past two years. It is strange this is not in the news. By the end of 2020, 7 in 8 teens did not vape, and 32 in 33 did not vape daily.

What if we just look at daily use? If the public knew this, would they find it alarming?
(7)
Would the public find it alarming that in late 2020, US high school daily nicotine vaping had dropped to ~3% (from 5.7% in 2019, and 4.4% in 2020), if they understood the full context of all the psychoactive drugs teens use?
(8)
...but what about smoking? Vaping opponents are busy trying to convince the policy makers that vaping is a gateway to smoking. OK. Teens should not vape. But they have been vaping nicotine for 8 years now. Shouldn't we see that "gateway effect" by now?
(9)
...Actually, it's the opposite. Any 1st year epidemiology student can see there is an inverse relationship between teen vaping and teen smoking. When vaping increased, teen smoking plummeted. When vaping dropped, smoking stopped dropping. When vaping increased again...
(10)
The previous data were from the National Youth Tobacco Survey. So let's look at a different survey where we have data going back to 1975. The Monitoring the Future survey is conducted by the University of Michigan (my alma mater), and funded by @NIH/@NIDAnews.
(11)
Ok, ok. Let's go back to @CDC data, and yet ANOTHER huge national survey, the National Youth Risk Behavior Survey. They made a great infographic on that back in 2015. There's a similar one for 2013 with identical graphics. Strangely, they then stopped updating these.
(12)
Since I'm a good US citizen, I decided to update the graph for them. The updates are from the other huge national CDC survey, the National Youth Tobacco Survey. Here's the CDC link to the 2015 version.
cdc.gov/media/releases…

This image is updated only through March 2020.
(13)
And of course it's interesting to look even earlier. We have data going way back. Let's break this into 10 year periods. Since 1981, how fast has US high school SMOKING dropped?

1981-1991: 8% drop
1991-2001: 20% drop
2001-2011: 28% drop
2011-2020: 75% drop
(14)
US high school smoking has plummeted about 5X faster than historical trends over the past 8 years. Remember the 1970s and 1980s? Many US high schools had designated smoking zones. The legal smoking age was 16 in many states...
(15)
Now... Anti-vapers claim "nicotine harms developing brains." 15 past-Presidents of @srntorg say that's only "speculative," but whatever.
ajph.aphapublications.org/doi/pdf/10.210…

Teen smoking & vaping have both plummeted. So total teen nicotine use dropped 55% over the past 20 years.
(16)
So... where does this leave us?

Wondering why the USA is obsessed with teens while 480,000 adults die every year from smoking.

There are 18X more adults than high schoolers. Brain harms? 1 in 3 US adults used nicotine in their teens (current + former smokers). No harms.
(17)
Are e-cigarettes safer than smoking? Yes. Even @truthinitiative admits this.
docs.google.com/document/d/1Ty…

Do they help adult smokers quit? Yes.
cochranelibrary.com/cdsr/doi/10.10…

Are there 11 million US ADULT daily/regular vapers and less than 1 million teen frequent vapers? Yes.
(18)
>90% of Americans who own a device and buy e-cigarette products are adults. So the "target market" is them, plus 34 million US adults who smoke: 45 million legal adults with a demonstrated willingness to pay.

It would be insane to "target" teens-on-allowances.
(19)
480,000 US deaths from smoking. More than all Americans who died in all the wars of the entire 20th century. Every year.

If a smoker quits before age 35, they avoid all life-years lost. So, to maximize lives-saved, we should focus on helping adult smokers quit, right?

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More from @ChaunceyGardner

28 Sep
THREAD
@truthinitiative embraces tobacco #HarmReduction, but paints it as a tobacco & vape industry plot.

11 million US adults use #SaferNicotine vapes daily/regularly to quit or reduce smoking. We don't work for industry.

@robinkoval should talk to us.
truthinitiative.org/our-top-issues…
(2)
@truthinitiative paints tobacco #HarmReduction (THR) as a tobacco & vape industry plot.

15 past-Presidents of the Society for Research on Nicotine & Tobacco embrace THR. They are veterans of the fight against big tobacco. Not part of a "plot."
ajph.aphapublications.org/doi/pdf/10.210…
(3)
@truthinitiative embraces tobacco #HarmReduction, but falsely claims it's a tobacco & vape industry plot.

...then falsely claims the vape market is "focused on growth and acquisition of new users, most of whom are youth and young adults."
@robinkoval
truthinitiative.org/our-top-issues…
Read 10 tweets
7 Sep
Drug Abuse Resistence Education (D.A.R.E.)

A school-based education program. How well did it work? In 2001, US @Surgeon_General David Satcher placed the D.A.R.E. program in the category of "Ineffective Primary Prevention Programs."
en.wikipedia.org/wiki/Drug_Abus…

THREAD
👇👇👇
School-based drug "education" mistake, now being repeated with vaping.

1992: "Researchers at Indiana University found that those who completed the D.A.R.E. program subsequently had significantly higher rates of hallucinogenic drug use than those not exposed to the program."
(3) The school-based drug "education" mistake, now being repeated with vaping.

1994: RTI researchers found the program was ineffective. So D.A.R.E. leaders tried to get publication of the findings blocked.
en.wikipedia.org/wiki/Drug_Abus…
Read 7 tweets
20 Aug
THREAD
👇👇👇

15 past-Presidents of the world's leading Society for Research on Nicotine & Tobacco have issued a joint statement. It is a masterful review of evidence on nicotine vape safety, efficacy for smoking cessation, and teen use.
ajph.aphapublications.org/doi/pdf/10.210…
(2)
15 past-Presidents of @srntorg agree:

Vaping increases smoking cessation. This impact could be much larger if:

- public health paid more attention to adult smokers

- smokers received accurate information on relative risks

"That is not happening."
ajph.aphapublications.org/doi/pdf/10.210…
(3)
15 past-Presidents of @srntorg agree:

"The need to pay attention to ADLT smokers is particularly important from a #SocialJustice perspective."

Today’s smokers are disproportionately:
-lower income
-LGBTQ community
-People with #MentalHealth issues
ajph.aphapublications.org/doi/pdf/10.210…
Read 7 tweets
19 Aug
15 leading public health experts who cannot possibly accused be of being "corporate shills" or "not thinking of children." All share the byline. All former presidents of the Society for Research on Nicotine & Tobacco, THE preeminent professional society.
ajph.aphapublications.org/doi/pdf/10.210…
(2)
15 of the world's top tobacco control experts agree:

Public health organizations, the media & policymakers focus primarily on risks to youth

This has caused most of the public, including smokers, to believe e-cigarettes are as dangerous as smoking
ajph.aphapublications.org/doi/pdf/10.210…
(3)
15 of the world's top experts in tobacco control agree:

E-cigarette use is likely far less hazardous than smoking

Policies intended to reduce adolescent vaping may also reduce adult smoking cessation
ajph.aphapublications.org/doi/pdf/10.210…
Read 4 tweets
19 Aug
15 past Presidents of the Society for Research on Nicotine & Tobacco (THE preeminent professional society for global tobacco control) just published a broadside against #HarmReduction denial.

Perhaps @MikeBloomberg has been ill-advised? They disagree with him.

THREAD
👇👇👇
(2)
I have read the full text, but only the abstract is available to the public.

FFS American Journal of Public Health: Smoking causes more deaths/year than HIV, TB & malaria combined. THIS article should be open access.
@AMJPublicHealth
ajph.aphapublications.org/doi/10.2105/AJ…
(3)
15 of the world's top experts in the field of tobacco conrol agree:

Public health organizations, media coverage and policymakers have focused primarily risks to youth

This has caused most of the public, including smokers, to believe e-cigarettes are as dangerous as smoking
Read 6 tweets
6 Aug
Claim: "Nicotine harms developing brains."

#FactCheck: "Educational achievement did not differ within twin pairs discordant for smoking, in adults and adolescents."
@SetNicFree
tweelingenregister.org/nederlands/ver…
Claim: "Nicotine harms developing brains."

#FactCheck: “The [inverse] IQ–smoking association disappeared after adjustments for shared environment and genetics.”
@SetNicFree
gwern.net/docs/iq/2010-w…
Claim: "Nicotine harms deveping brains."

#FactCheck: “Past smoking was not associated with significantly poorer performance than never-smokers in any cognitive domain.”
@SetNicFree
research.ed.ac.uk/portal/files/1…
research.ed.ac.uk/portal/files/1…
Read 6 tweets

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