Ditching, Depression, and Doing the Right Thing
After seeing upsetting things, I finally saw a hopeful thing!
Meeting in the Middle
The January 2025 issue of Tobacco Control includes the study “Reducing e-cigarette use among youth and young adults: evidence of the Truth campaign’s impact." The study examines whether the Truth Initiative’s anti-vape campaigns reduce vape use among youth and young adults. Truth Initiative funded the study. The authors of this paper reported no conflicts of interest or financial disclosures. All four authors are part of the Truth Initiative’s Schroeder Institute.
The study states, “In response to the rising vaping epidemic among youth and young adults, the national truth campaign has aired numerous successive message executions designed to increase knowledge about the consequences of using e-cigarettes, change in attitudes about e-cigarettes, denormalise e-cigarette use and promote e-cigarette cessation behaviours.”
One of those previous campaigns used paid social media influencers in a “Ready to Ditch JUUL” crusade. The campaign encouraged youth to make videos of the creative ways they ditched their vapes by destroying them. In my opinion, such efforts normalize youth owning vapes even though they are age-restricted products.
While the Truth Initiative tries to convince young people that vaping is harmful, the campaign encourages kids to do dangerous things. Adults who vape and are aware of battery safety tried to warn Truth Initiative how dangerous this campaign was and were ignored by Truth Initiative. Abusing batteries in the ways shown in the videos could have led to explosions, resulting in fires, injury, and potentially death.
This latest study evaluates the “It’s Messing With Our Heads” initiative that features a fake vaping company called “Depression Stick.” The campaign led young people to believe that vaping can lead to or worsen symptoms of anxiety and depression. A press release by the Truth Initiative announcing the campaign claims, “Depression Stick! is fake but vaping’s contribution to the youth mental health crisis is real.“
A report about the potential connection between youth mental health and the use of nicotine was released by the Truth Initiative about the same time they launched their campaign. The report states, “Though it is unknown whether a causal relationship between nicotine and mental health conditions exists, there are troubling links between vaping nicotine and worsening symptoms of depression and anxiety, as well as higher odds of having a depression diagnosis among those who use nicotine.”
The study concluded, “A population-level measure of campaign exposure was associated with lower likelihood of intentions to use and current e-cigarette use among young people.”
It did not question if it is ethical to tell young people half-truths to influence their behavior. It also didn’t evaluate if there were any unintended consequences, such as convincing people who smoke that using vapes for smoking cessation would be a bad idea.
Or it might make some children curious about vaping…
In 2021, Caitlin Notley presented at the E-Cigarette Summit. Her presentation was titled “Depression Causes Vaping.” She gave an excellent analysis of the study on which the Truth Initiative based its mental health claims and expressed her concerns with the Depression Sticks ads. She talked about the consequences of campaigns based on fear instead of research evidence. She said that the Depression Sticks campaign scapegoats the behavior of vaping and ignores the very real and concerning issue of poor youth mental health.
I remember being upset with the Truth Initiative in 2021 about the Depression Stick ads. I was so upset that I emailed a letter to Robin Koval, who was Truth Initiative’s CEO and President, but never got a response. I went public with the letter by reading it in a video. Yes, I had to fight back the tears at the end. No, it didn’t change anything. Their Depression Stick videos remain on their YouTube channel to this day.
I wasn’t the only one upset. I found articles and collected tweets from people who thought the campaign was misleading or stigmatizing. Experts spoke up. People who live with depression spoke out against the ads.
You might wonder why I’m bringing up “old news” from 2021. The answer is easy. The study published this month reminded me that not much has changed since the launch of the Depression Stick ads. We still have an unbalanced conversation that focuses on youth use and ignores people who smoke—many of those people live with a mental health challenge. The dialogue is heavily peppered with moralistic views and misinformation.
I previously wrote in a piece published by Filter, “On average, people with a mental illness die up to 25 years younger than the general population, and many die from smoking-related chronic diseases. Tobacco-related diseases contribute to approximately 53 percent of deaths among people living with schizophrenia, 50 percent among people with depression, and 48 percent among people with bipolar disorder. It’s estimated that somewhere over 20 percent of people in the US live with a mental illness. But this population smokes almost half of all the cigarettes sold around the country each year. It’s past time that we prioritized their health.”
Don’t numbers like that break your heart?
While there’s a lot of talk about youth vaping, there is not enough talk about youth mental health. The young people that say they vape as a coping mechanism for anxiety, depression, and stress. That was over 40 percent of the young people who had used a vape at least once in the last 30 days when a survey was taken in 2021. While the rates of youth who smoke are at record lows, we must not forget the ones who do. Many of them probably live with depression.
Last week, the US Food and Drug Administration granted marketing orders to 20 ZYN nicotine pouch products. To my surprise, the Truth Initiative's press release was more balanced than I would have expected. In it, they said, “Helping adults who smoke and protecting youth are not competing priorities—they are shared responsibilities essential to advancing public health.” I hope to see more messages like that from public health groups.
I was grateful to see the Truth Initiative move the needle closer to the middle ground. That is progress and an improvement over the campaigns they have released in the past few years. I hope we see more of that kind of communication from the Truth Initiative in the future. They showed leadership that can help society make real strides in improving public health.
Until next time…
