Youth smoking decline stalls, and vaping may be to blame
By MIKE STOBBE, AP Medical Writer
NEW YORK (AP) — Cigarette smoking rates have stopped falling among U.S. kids, and health officials believe youth vaping is responsible.
For decades, the percentage of high school and middle school students who smoked cigarettes had been declining fairly steadily. For the past three years, it has flattened, according to new numbers released Monday.
There may be several reasons, but a recent boom in vaping is the most likely explanation, said Brian King of the Centers for Disease Control and Prevention.
“We were making progress, and now you have the introduction of a product that is heavily popular among youth that has completely erased that progress,” King said.
The CDC findings come from a national survey conducted last spring of more than 20,000 middle and high school students. It asked if they had used any tobacco products in the previous month. Some of the findings had been released before, including the boom in vaping.
Experts attribute the vaping increase to the exploding popularity of newer versions of e-cigarettes, like those by Juul Labs Inc. of San Francisco. The products resemble computer flash drives, can be recharged in USB ports and can be used discreetly — including in school bathrooms and even in classrooms.
According to the new CDC data, about 8 percent of high schoolers said they had recently smoked cigarettes in 2018, and about 2 percent of middle schoolers did. Those findings were about the same seen in similar surveys in 2016 and 2017.
It also found that about 2 in 5 high school students who used a vaping or tobacco product used more than one kind, and that the most common combination was e-cigarettes and cigarettes. Also, about 28 percent of high school e-cigarette users said they vaped 20 or more days in the previous month — nearly a 40 percent jump from the previous year.
Smoking, the nation’s leading cause of preventable illness, is responsible for more than 480,000 deaths each year. The U.S. Food and Drug Administration bans the sale of e-cigarettes and tobacco products to those under 18.
E-cigarettes are generally considered better than cigarettes for adults who are already addicted to nicotine. But health officials have worried for years that electronic cigarettes could lead kids to switch to smoking traditional cigarettes.
“I think the writing is on the wall,” with research increasingly suggesting e-cigarettes are becoming a gateway to regular cigarettes, said Megan Roberts, an Ohio State University researcher.
There is, however, some split of opinion among health researchers. Some had linked e-cigarettes to an unusually large drop in teen smoking a few years ago, and they say it’s not clear to what extent the decline in smoking has stalled or to what degree vaping is to blame.
Cigarette smoking is still declining in some states. And another large survey found that smoking has continued to drop among 12th graders, though not in younger school kids.
“It’s not clear yet what’s going on and it’s best to not jump to any conclusions,” said David Levy, a Georgetown University researcher.
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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

As Democratic field expands, Biden waits on the sidelines
By JULIE PACE and THOMAS BEAUMONT, Associated Press
CEDAR RAPIDS, Iowa (AP) — Former Vice President Joe Biden will headline his first public event in about three weeks on Saturday— in Munich, Germany, nearly 5,000 miles from Iowa, site of the 2020 presidential campaign’s first contest.
As he weighs whether to jump into the race, Biden has been conspicuously absent from early voting states, making him an outlier among Democrats eyeing the White House. Nine Democrats have announced full-fledged campaigns, two have launched exploratory committees and several others are blanketing Iowa, New Hampshire and South Carolina as they decide whether to launch a campaign. A half-dozen made the rounds this past weekend alone.
In a wide-open race, Biden’s take-it-slow approach has given other candidates a head-start in fundraising, scooping up top-tier staff and perfecting their pitch to voters. It’s also given them a chance to chip away at what would be a central argument of a Biden campaign: that he is the only candidate who can defeat President Donald Trump in 2020.
Biden has said he’ll only run if he doesn’t believe Democrats have other viable options, and he’s privately raised doubts about the electability of some of his potential rivals, according to a person with knowledge of those conversations who spoke on condition of anonymity to talk about private discussions.
But some voters who have seen those candidates up close in recent weeks disagree.
“I like Joe. He’s a good man, and I like his character,” said Audrey Wolf, a 72-year-old retired teacher and devout Democratic caucusgoer from Mason City. “But I will say, I’m just really open to the new faces out there.”
Nick Maybanks, a 42-year-old Democratic voter from Cedar Rapids, said Biden’s wavering on whether to launch a campaign “puts him a couple of paces back.”
“While these others are here, I’m wondering if he would be committed to it,” Maybanks, a county prosecutor, said of Biden as he and his family gathered to hear New Jersey Sen. Cory Booker address Iowa voters.
The former vice president initially expected to make his decision by now. But he blew through a self-imposed January deadline without a campaign announcement, and some longtime allies say they simply don’t know when, or if, he’ll enter the race.
“He’s prepared, but he’s also doing his due diligence,” said Louisiana Rep. Cedric Richmond, the former chairman of the Congressional Black Caucus who has spoken to Biden in the past two weeks.
But for now, he doesn’t have plans to visit any of the early states. He heads to Michigan on Tuesday to deliver a eulogy at a funeral for Democratic Rep. John Dingell, the longest-serving member of Congress. On Saturday, he’ll speak at a high-profile national security summit in Germany.
Biden advisers say he can afford to get a later start. After eight years as vice president, he’s well-known to most voters and has deep ties to Democratic activists in the early primary states. His tight-knit group of senior advisers is ready to swiftly stand up a campaign operation if Biden gives them the go-ahead.
The former vice president would also bring a more moderate track record to a campaign that is so far being defined by liberal candidates pushing big government programs, like a Green New Deal to tackle climate change and “Medicare-for-all.” Biden hasn’t endorsed either concept.
Biden may also be the closest thing Democrats have to a front-runner in 2020, given his long history in politics. A recent CNN poll found about 6 in 10 Democrats said Biden should run, and 44 percent said they would be very likely to support him if he did — more than said this for any other potential Democratic candidate.
But the prospect of a Biden candidacy has not scared off other candidates.
California Sen. Kamala Harris has set the pace for the field, drawing an eye-popping 20,000 people to her campaign launch last month. Her early start has also helped her campaign bank crucial information on voters, including boosting its email list by 20 percent on Harris’ first day as a candidate, according to a campaign aide.
Lesser-known candidates are using the winter to start making introductions to voters. New York Sen. Kirsten Gillibrand’s team sought to maximize media attention by announcing an exploratory committee during a week in mid-January when no other major campaign announcements were planned. She followed that up with quick trips to each of the early voting states, including a three-day swing through South Carolina that wrapped up Sunday.
Although she’s only formed an exploratory committee at this point, Gillibrand has already hired 40 staffers.
Some Democratic strategists say the former vice president is letting valuable time slip away.
“You can’t get time back,” said Dan Pfeiffer, who advised Barack Obama’s two successful presidential campaigns. “The Iowa caucus, which is the most complicated election in the country, is a year away, and the candidates that wait very well may regret it.”
Obama is said to have made similar points to the many prospective candidates he’s met with so far, according to people with knowledge of the conversations. While the former president hasn’t recommended a specific timetable to candidates, he has emphasized the importance of investing early in the kind of ground operations in Iowa and elsewhere that helped catapult him to the nomination in 2008.
While most Democratic White House hopefuls have made their intentions clear by now, a handful of others share Biden’s slower strategy.
Beto O’Rourke, who shot to Democratic stardom with his narrow defeat in last year’s Texas Senate race, says he’ll make a decision before the end of the month. O’Rourke will headline a march in his hometown of El Paso on Monday night, about a mile away from where Trump will be holding a re-election campaign rally.
Former New York City Mayor Michael Bloomberg also plans to make a decision in February. The billionaire made a campaign-style stop in New Hampshire last month and headlined a climate change event last week in Florida, another crucial primary state.
Vermont Sen. Bernie Sanders hasn’t said when he’ll decide whether to launch a second presidential campaign. But he’s kept making high-profile appearances, including delivering a rebuttal to Trump’s State of the Union address last week.
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Beaumont reported from Des Moines, Iowa. Follow Julie Pace at http://twitter.com/jpaceDC and Tom Beaumont at http://twitter.com/tombeaumont