Youth Vaping: Going Up or Down?
Over the past month, the United States Centers for Disease Control (CDC) released two studies that made completely contradictory claims about how prevalent vaping is in high school. The first found that youth vaping is still on the rise; that 1 in 3 high schoolers is currently vaping (past month use), and 1 in 2 high schoolers has vaped at some point in their life. The second found that vaping has dropped for the first time in 3 years, claiming that 1 in 5 high school students is currently vaping.
Clearly, both of these conclusions can’t be true - what are we supposed to make of this?
The answer lies in the reason why it’s so important to wait for data to be replicated before we jump to conclusions: no data sample is perfect, nor type of statistical methodology, and the truth generally lies somewhere in the average of all the different studies on a particular topic. To get slightly technical for a second, whenever we’re trying to make a statement about everyone in a given category (like all high-school students), we’re trying to make a statement about the population. However, it’s not possible to actually ask everyone in that population, so instead we have to pull out a sample, and ideally a representative sample of the population we’re trying to describe (gender, race, age, socioeconomic status, etc.).
The problem is that samples can never be perfect representations of the population - there are always going to be variations. This picture from Cumberland County Schools sums it up really well:
The curve on the right side is called the “normal distribution” of the population - in our case, the true vaping positivity rate of high-schoolers. We can’t directly measure this, though, so instead we have to infer it from samples - the averages of those samples are the little dots on the bottom right - none are at exactly the same place, because each sample is different.
Different results from different samples is exactly what happened here: the data from the first study (that found a rising vaping rate) came from the Youth Risk Behavior Survey, and the second came from the National Youth Tobacco Survey. They’re both trying to be accurate to the population, but they asked different kids, so they got different results.
Now, there are other factors that can enter into this equation as well: poor sampling procedures and improperly completed statistical analyses, to name a couple. But if we give both organizations the benefit of the doubt, what we’re really looking at here is simply sampling variation.
So all that said, what does this mean for our kids? The bottom line is that we have what’s called “mixed evidence” from two reputable national surveys about whether or not vaping is still increasing or has declined somewhat. Given this, my opinion is we can’t assume anything has changed from the status quo: vaping continues to be a huge public health concern for our youth, vaping remains trendy and culturally appealing to youth, and we need to remain aggressive in our prevention efforts to keep the use rate from climbing.
As one final cautionary note from pulling back vaping prevention efforts, I’d encourage readers to consider what’s happened related to opioid overdoses during COVID-19. The progress we’d made on overdose death rates was completely reversed in a matter of months, with overdose rates rising in some areas by as much as 50%.
The future has no guarantees. We have to ensure to make the most of the circumstances we have - whether indicators are positive or negative along the way, we can’t get complacent and take our foot off the gas.
So please: keep up the good work, everyone. We’re off to an encouraging start, but this job is just getting started.
For more information on vaping, please visit my addiction resource list. If you need individual help, more information is available on my website related to working with me for online addiction counseling – in addition to my concierge therapy practice, I also have a small in-network practice with Equipoise Teletherapy in Chicago. I also provide non-clinical parent coaching services upon request. For any other questions, please feel free to reach out to me directly!