CDC Report Raises Concerns E-Cigarettes Could Be Hindering Efforts to Reduce Tobacco Use in U.S.

 

The CDC’s annual report on adult tobacco use shows that 14% of U.S. adults smoked cigarettes in 2019, essentially unchanged from 14% in 2017 and 13.7% in 2018. At the same time, e-cigarette use among adults rose to 4.5% in 2019, up from 2.8% in 2017 and 3.2% in 2018, and almost one in four e-cigarette users had never been smokers. It is troubling that declines in adult smoking appear to have stalled at the same time that e-cigarette use has increased – a finding that raises further questions about the effectiveness of e-cigarettes in helping smokers quit. Today’s report follows a comprehensive U.S. Surgeon General’s report earlier this year that found, “There is presently inadequate evidence to conclude that e-cigarettes, in general, increase smoking cessation.” 

 

Today’s report shows that the overall number of U.S. adults who use any tobacco product increased from 47.4 million in 2017 to 50.6 million in 2019. 

 

It is particularly concerning that e-cigarette use was highest among young adults aged 18-24 (9.3%), with over half (56%) of these young adults reporting that they had never smoked cigarettes. E-cigarette use among young adults increased by 79% between 2017 and 2019 (5.2% to 9.3%). Together with the meteoric rise in youth e-cigarette use in recent years, this is further evidence that e-cigarettes are introducing a new generation of young people to tobacco use and putting them at risk of nicotine addiction. The cause of the problem is clear: E-cigarette makers like Juul and its copycats have lured young people with appealing flavors and hooked them with massive doses of nicotine.

 

This report underscores the need for stronger and more effective FDA regulation of e-cigarettes, starting with the immediate elimination of all flavored products. The FDA is currently reviewing applications from makers of e-cigarettes and certain other tobacco products to keep their products on the market. The FDA should not allow the sale of any flavored and high-nicotine products that put young people at risk. The FDA must also require manufacturers to provide rigorous scientific evidence that a product will actually benefit public health before authorizing its sale – including demonstrating that the product will predominantly be used by smokers who would otherwise continue smoking, that they will switch completely to the new product, that the product will not deter people who would have otherwise quit using tobacco products entirely, and that using the product is significantly less harmful than using other tobacco products.

 

The CDC report also shows once again that there are large and unacceptable disparities in who still smokes and uses tobacco in the United States. Groups with high rates of smoking include people with lower income and less education; American Indians/Alaska Natives; lesbian, gay or bisexual adults; residents of the Midwest and South; and adults with generalized anxiety disorder. Adults who are uninsured or enrolled in Medicaid smoke at more than double the rates of those with private health insurance or Medicare. We also know that Black Americans die from smoking-caused diseases at high rates due in part to the tobacco industry’s predatory targeting of Black communities with marketing for menthol cigarettes.

 

To keep making progress against tobacco, policy makers at all levels must fully implement proven strategies and ensure they benefit all Americans, especially those with high smoking rates. These policies include significant tobacco tax increases, comprehensive smoke-free laws, well-funded tobacco prevention and cessation programs, hard-hitting mass media campaigns, and comprehensive, barrier-free health insurance coverage for smoking cessation treatments under Medicaid and private health plans. It is critical that the FDA take action to prohibit all flavored tobacco products, including flavored e-cigarettes and menthol cigarettes. Until the FDA acts, states and localities should step up their growing efforts to do so.

 

Today’s CDC report reminds us that the fight against tobacco use – the nation’s No. 1 cause of preventable death – is far from over and must remain a national priority. Despite our progress, 34.1 million U.S. adults still smoke cigarettes and 50.6 million adults still use some form of tobacco. This is a winnable battle, but only if policy makers at all levels fully implement proven solutions.