What about the adults? US FDA tobacco campaigns may be lacking data support

The latest nationwide survey on tobacco product consumption among US youth showed that high school students in the country are ditching vaping, which is definitely good news.

The 2023 National Youth Tobacco Survey (NYTS), whose results were recently released by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), also showed a decline in the use of tobacco and nicotine products among the same category of young people in the country.

Optimism on the tobacco consumption behaviour of high school students was only toned down by relatively worrying data on middle school pupils, whose overall use of tobacco products increased compared to the previous year.


Minding the children


Figures obtained through this annual survey on youth tobacco and nicotine product consumption are certainly crucial for the drafting and revision of tobacco policies, as far as under-age usage is concerned.

They may also provide the FDA with a useful tool to verify the efficacy of its education and prevention campaigns aimed at curbing smoking and vaping rates among young people.

This is the reason behind the FDA’s collaboration with the CDC to produce the survey, allowing for the research to be carried out every year since 2011, after it was conducted periodically from 1999 to 2009.

According to the FDA, the NYTS was conceived to provide national, long-term data for the design, implementation and evaluation of tobacco prevention and control programmes.

On its website the agency says: “The FDA is committed to a science-based approach that addresses public health issues associated with tobacco use.

“We collaborate with CDC on this nationally representative survey of middle and high school students that focuses exclusively on tobacco use behaviours and associated factors.”

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    Never mind the grown-ups?


    But looking at research conducted and published by the CDC and the FDA on adult tobacco and nicotine product consumption, it’s difficult to find surveys done on a regular basis and with the same focus on new products that may be entering the novel market.

    In 2009-2010, the CDC conducted the first National Adult Tobacco Survey (NATS) “to assess the prevalence of tobacco use, as well as the factors promoting and impeding tobacco use among adults”.

    While the first survey included questions on both smoking and smokeless tobacco, the second and last NATS survey, held in 2013-2014, also covered e-cigarette use as well as the tendency to dual use both e-cigarettes and traditional cigarettes in under-45s, which was flagged as particularly worrying.

    Earlier this year, following the publication of an academic research paper that highlighted a high level of misperception over tobacco product harmfulness among US adults, with only around 20% of them believing vaping was less dangerous than tobacco smoking, the FDA’s Center for Tobacco Products (CTP) director Brian King said that both government and non-governmental stakeholders should participate in efforts to “educate adult smokers about the relative risks of tobacco products, including e-cigarettes, using evidence-based approaches”.

    King’s statements made some believe that the FDA was finally opening up to considering reduced-risk products as a harm reduction instrument within its smoking prevention policies.

    At the same time, though, the CTP director’s comments appeared in conflict with the agency’s obsession with constantly warning young users of these alternatives of their “exaggerated harms”.

    While young consumers and the under-age public need to be monitored, educated and warned about the risks related to tobacco and nicotine products, the same effort put into retrieving scientific data to support youth campaigns should be dedicated to adult information and prevention policies.

    The agency’s fierce struggle against youth use may even be more effective if aided by a less contradictory and science-backed adult harm-reduction policy.

    – Tiziana Cauli TobaccoIntelligence staff

    Photo:  Vidar Nordli-Mathisen

    Tiziana Cauli

    Senior reporter/health & science editor
    Tiziana is an Italian journalist from Sardinia. She has worked for both international and local media in Italy, South Africa, France, Spain, the UK, Lebanon and Belgium. She also worked as a communications manager for several international NGOs in the humanitarian sector. Tiziana holds a degree in Political Science and a PhD in African Studies from the University of Cagliari and she’s a graduate of the Carlo De Martino school of journalism in Milan.