Tobacco, The Ulitmate Dark Horse of Drugs

Almost immediately after posting a recent article about the roundly debunked "gateway drug theory", we at Twenty-One Debunked felt we should post another separate article about the particular case of tobacco, especially in the form of commercial cigarettes. While our organization does not generally view tobacco as a particularly high-priority issue, perhaps it is something we should be revisiting given both recent evidence as well as recent efforts to raise the smoking age to 21.

While the primary dangers of smoking tobacco (i.e. cancer, heart disease, stroke, emphysema, birth defects, etc.) have been well-known for decades, what has been much less appreciated is the neurotoxic properties of cigarettes.  The thing is, nicotine is a known neurotoxin, and it is likely that at least some of the thousands of other chemicals in cigarette smoke are also toxic to the brain as well.  One reported effect of nicotine is that it can "prime" the brain's reward system for addiction in general, including to other substances.  This seems to be particularly true for the early adolescent brain.  While these findings are based primarily on rodent studies, human studies seem to dovetail with this idea far more for tobacco than for cannabis or even alcohol.  Thus, the psychopharmacological aspect of the gateway hypothesis seems to hold true indeed for tobacco, and if there were such a thing as an actual gateway drug (which is a very big "if", if you ask us), tobacco would have to be it, hands down.

Additionally, tobacco is also emerging as a potential "dark horse" in the etiology of psychosis and schizophrenia as well.  This has been informally hypothesized for many years now while being overlooked by most researchers, and is only very recently beginning to be taken seriously by mainstream science.  Perhaps cannabis (which is often mixed with tobacco in many countries, and whose use is often predicted by prior and concurrent tobacco use in general) has been taking a major bum rap in that regard as well?  All while Big Tobacco has subtly and sedulously promoted tobacco smoking as "self-medication" for decades, of course.

That said, Twenty-One Debunked strongly opposes any attempts to raise the smoking age any higher than 18.  Instead, we (along with the TSAP) believe that we should deal with cigarettes the way we would deal with any other defective product such as the historical examples of the Ford Pinto, lawn darts (Jarts), leaded gasoline and paint, DDT, incandescent light bulbs, and old-style refrigerators.  Either 1) require the defects to be sufficiently fixed, or 2) failing that, remove such products from the market.  And yes, commercial cigarettes as they exist today are indeed defective by design in that they addict, enslave, and kill far more people than they have to.  Worldwide, they kill about 6 million people per year, hence the name of Robert N. Proctor's bombshell of a book, Golden Holocaust.

Since 2013, the endgame strategy that the TSAP (and Twenty-One Debunked) currently supports has been to let tobacco phase itself out by gradually reducing the nicotine content of cigarettes to a (relatively) non-addictive level.  Since 2009, the FDA now has the authority to set a legal limit on the nicotine content of tobacco products, as long as the limit is not zero.  Much research indicates that there is a threshold level of nicotine required to create and sustain addiction, and if all cigarettes were to fall below this threshold, smoking rates would plummet precipitously.  In fact, one tobacco executive was quoted as saying, "‘If our product was not addictive we would not sell a cigarette next week."  This idea was originally proposed by Henningfield and Benowitz in 1994, and has been endorsed by the American Medical Association and several other experts including Proctor himself.  Malcolm Gladwell also discussed it in his aptly-titled 2000 book The Tipping Point.   Thus, the TSAP recommends reducing the maximum nicotine content (not delivery) of cigarettes from the current level of 1-2% to less than 0.1% within 5 years, and doing the same for quasi-cigarettes (i.e. little cigars) and perhaps roll-your-own tobacco (but no other products).  That alone would reduce smoking prevalence by as much as 80% within a fairly short timeframe, with further reductions possible in the more distant future.  Alternatively (or in addition), the FDA could require the pH of such products to be raised to 8 or higher to discourage deep inhalation, as is naturally the case for most typical cigars and pipe tobacco currently.

The TSAP and Twenty-One Debunked also recommend that the following measures be taken as well:

• Ban the use of additives in cigarettes, especially those that are harmful or increase the addictiveness of tobacco.
• Ban the use of any radioactive fertilizers or harmful pesticides for growing tobacco.
• Phase-out the practice of flue-curing tobacco, which is a major resource hog and bad for the environment.
• Improve the quality control standards for tobacco products (and electronic cigarettes) to be at least as high as for food.
• End all government subsidies for tobacco farming and production.
• Divest completely from Big Tobacco at all levels of government.
• Vigorously enforce the current age limit of 18 for tobacco and e-cigarette sales to achieve 100% retailer compliance. 
• Continue to allow widespread availability of reduced-harm tobacco and nicotine products (i.e. snus, e-cigarettes, etc.) so that smokers can easily switch to less dangerous alternatives.
• Improve education and smoking cessation programs, funded by tobacco tax revenues.
• Give out free nicotine patches, gum, etc. to any smokers who want to quit.  NYC already does this. 

At the same time, the TSAP most certainly does NOT support outdoor smoking bans or any other policy that treats smokers like criminals or second-class citizens.  Smokers are NOT the villains here, as that dubious honor belongs to the merchants of death known as tobacco companies.  In fact, we have repeatedly pointed out that, far from being a drain on society, smokers actually save society money in the long run since they more than pay their way as far as taxes go.  Cigarette taxes, especially in NYC where they are extremely high, have basically become a "reverse Robin Hood" way to rob from the poor and give to the rich, since smoking has increasingly become a poor man's vice.  And the wide disparity in cigarette taxes across states has led to a serious black market for untaxed/low-tax/counterfeit/stolen cigarettes, with the main beneficiaries being organized crime syndicates and even terrorists.  Thus, we recommend that the handful of states with cigarette taxes higher than $2.00/pack reduce their tax to $2.00/pack or lower, and the states with taxes of less than $1.00/pack raise it to $1.00-$2.00/pack.  NYC should cut its tax in half.  At the federal level, we recommend no further tax hikes, but a national price floor of $5.00/pack including tax to discourage smuggling.

The tobacco industry has basically dug its own grave.  Time to push them in there, yesterday.

DARE Quietly Removes Cannabis From List of Gateway Drugs

Yes, you read that headline correctly.  The well-known drug and alcohol prevention program for kids, Drug Abuse Resistance Education (DARE), has quietly removed cannabis from its list of "gateway" drugs.  And they apparently have also stopped lying to kids about the purported dangers of cannabis in general as well.  That is probably because the recent evidence that debunked their previous propaganda has been overwhelming.  And that is a sign that "reefer sanity" is slowly starting to return to America.

DARE's current list of "gateway" drugs can be found on this page of their website.  Note that only two substances remain on that list:  1) tobacco, and 2) alcohol, in that order.  And even the part about alcohol, with warnings against the dangers of "underage" drinking, interestingly enough makes no specific mention of what the legal drinking age is or should be, as the actual words "twenty-one" and "21" are literally nowhere to be found in the text.  It does, however, note that 90% of young people will experiment with alcohol by age 18, and that only a small number abstain completely while an even smaller number become addicted and need help.  And the page encourages parents to, among other things, be good role models as far as alcohol and tobacco are concerned (which is important as that addresses the real pink elephant in the room).  Overall, DARE has really come a long way it seems, and we hope their recent progress continues.

We at Twenty-One Debunked should note, however, that we believe that the whole "gateway theory" (which should really be called the "gateway hypothesis") has been grossly overstated at best, even as far as alcohol and tobacco are concerned.  A few years ago, we wrote an in-depth article about this phenomenon, which the best evidence strongly suggests is really nothing more than a socially-constructed narrative.  Constructed by prohibition laws, disingenuous propaganda, and ageism/adultism, that is.

Is Alcohol Really a Gateway Drug?

While the "gateway drug" theory has historically been associated more with cannabis than any other substance, many of the theory's proponents have also fingered alcohol and tobacco as possible culprits in somehow inducing hapless youth to "graduate" to harder drugs and eventually become hopeless junkies, tweakers, and/or crackheads.  In this post we revisit the decades-old theory with a fairly new twist.

A new study of high school student survey data claims to find that alcohol, as opposed to cannabis or tobacco, is the real "gateway" drug.  The study found that of all of the numerous psychoactive substances asked about in the Monitoring the Future (MTF) survey, alcohol was the one that was the single most likely to predict (statistically) the use of the others with the greatest accuracy.  Ergo, if there is such a thing as a gateway drug, alcohol would most likely be it.

If there is such a thing, that is.  And that's a pretty big "if" if you ask us.  For starters, the historical background of the gateway theory has a rather tainted pedigree.  The gateway theory as applied to cannabis turns out to be a virtually whole-cloth fabrication in the early 1950s by Harry Anslinger (the man responsible for cannabis being federally banned in 1937) who needed a justification for its continued ban and even harsher laws against it after the original Reefer Madness claims (murder, rape, insanity, and death) had been debunked by the La Guardia Committee Report in 1944.  So he flip-flopped and claimed that cannabis led its users to heroin addiction, which even he himself actually said was not the case in the 1930s.  But it turns out that a more general version of the theory is even older than that.  It can be traced back to at least 1910, when it was believed that indulging in smaller pleasures (such as eating spicy food) would lead one to crave larger pleasures (such as opium).  And that in turn would eventually lead one to the drunkard's grave.   Thus, the latest manifestation of the gateway theory, besides being recycled garbage, has actually come full circle (with alcohol at the start of the sequence rather than the end).  And nearly every major study of drugs and drug policy for the past century has been far more likely to refute the theory than to support it.

If not a causal relationship between alcohol (or cannabis) and later use of harder drugs, what explains the apparently strong association between the two?  One study by RAND in 2002 found that there was a more parsimonious explanation based on a mathematical model of:  1) the age at which each substance was typically first available to an individual, 2) individuals' propensity to use substances, which varies and is assumed to be normally distributed among the population, and 3) chance or random factors.  This explanation was equally accurate at predicting drug use progression compared with a model that assumed a causal relationship.  In the case of cannabis, another likely alternative explanation of the supposed gateway effect is the black market itself, as users are exposed to harder drugs through many of the same dealers who sell them their weed.  This was one of the reasons why the Netherlands adopted their policy of tolerance for cannabis (which can be purchased in "coffeshops" in many towns), and to this day the Dutch have significantly less of a problem with hard drugs than the USA and many other Western nations. 

Additionally, when young people are lied to about the dangers of alcohol and cannabis, they may eventually assume that all anti-drug messages are bunk and experiment accordingly.  Unfortunately, honest alcohol and drug education is not nearly as commonplace as it should be in this country.

So where does the issue of the 21 drinking age figure into all of this?  For starters, the authors of the study that links alcohol with subsequent use of other substances predictably claim that the longer alcohol use is delayed, the fewer problems there will be with not just alcohol abuse but the abuse of other substances as well, and they recommend zero tolerance for teen drinking.  This study would thus most likely be seen as vindication for the pro-21 crowd.  However, one can also look at the study's results a bit differently and see that the supposed gateway effect occurs despite (or perhaps even because of) the 21 drinking age.  For example, forcing alcohol underground makes it more likely to be used in the same environment as other substances, thus increasing young drinkers' exposure to the other substances.  The fact that "underage" drinkers are already breaking the law may encourage them to break other laws as well.   Also, at least some 18-20 year olds may find other substances easier to get than beer, and will thus be more likely to use them as substitutes.  In fact, a recent study found that when alcohol retreats, cannabis advances (and vice versa), and that is discussed in a previous post on this blog.  Therefore, one could say that the 21 drinking age acts as a "social gateway" to other drugs in a somewhat similar manner as cannabis prohibition, albeit much more modestly since there is not much of a real black market in alcohol (save for the modern-day speakeasies known as frat houses).  Indeed, it may not be a coincidence that American teens are more likely to use illicit drugs than their European counterparts despite being less likely to drink or smoke cigarettes.

In other words, we ought not to put too much stock in the rather dubious gateway theory, except to note how it could be one more way that the 21 drinking age yet again does more harm than good.