Wednesday, January 23, 2013

If It Smells Like Junk Science, It Probably Is

The news of the latest study about the 21 drinking age now appears to be going viral.   According to this study, which is now available (only to subscribers) online ahead of print, folks who were young adults in states that allowed them to drink legally before age 21 at that time were statistically more likely to become more frequent "binge" drinkers later in life compared to those who were not allowed to drink legally until age 21.  The research, which used data from surveys in 1992 and 2002 taken by those who were born between 1949 and 1972 (i.e. were young adults in the 1970s and 1980s), interestingly found no difference in overall alcohol consumption or frequency between the two groups, but apparently found that those allowed to drink before 21 had more "binge" days and fewer "non-binge" days per month compared to those who were not allowed to drink until 21.  The former were 19% more likely to "binge" more than once per month compared with the latter, and the differences were largely (if not entirely) driven by men and those who never attended college.  So what should we make of this study, which is not yet available for the general public to read?

First of all, we at Twenty-One Debunked always put the term "binge drinking" in scare quotes when we are referring to the 5+ or 5/4+ drinks definitions, as we believe that such definitions are grossly inaccurate measures of the very real problem of truly dangerous drinking, and can potentially mask actual trends in the latter.  (More information about this issue can be found in our previous posts here and here)  And we know based on the article's summary that a 5+ drinks threshold is the one used in this study, as is the case in virtually every other pro-21 study out there.  Strike one.

Secondly, no information is provided about which, if any, confounding factors are controlled for.  This is crucial because there are numerous other differences between people who grew up in different parts of the country and/or at different times.  One should also note that the effect size is fairly small as well, with a relative risk (or odds ratio) of 1.19 overall (1.31 for men who never attended college).  In epidemiological research, relative risks below 2.0 are especially likely to be due to a combination of chance, bias, and/or confounding, and thus should be taken with at least a grain of salt (if not a whole pound).  Strike two.

Finally, the study really adds nothing else new to the scientific literature beyond what was mentioned above.  Zip, zilch, nada.  And nothing about whether there were any between-group differences in actual problem drinking.  The authors (as well as MADD member Ralph Hingson) refer to other past studies (including a 2009 study which we had debunked years ago) by other authors in an attempt to connect the dots.  But given enough dots, one can pretty much connect them any way to form any picture one chooses.  Strike three, you're out!

Thus, our preliminary analysis of the study (to which we were unable to gain full access--stay tuned for updates!) suggests that the study reeks of junk science, and clearly should not be used to set public policy.  However, let us be clear that even if it (and the 2009 study about increased risk of alcoholism) somehow were 100% true, which we seriously doubt, we at Twenty-One Debunked would still support lowering the drinking age to 18.  Why?  The 21 drinking age is nothing less than a hate crime against young people, plain and simple.  In our society we know, for example, that certain ethnic groups are statistically more prone to alcoholism than others, yet we do not arrest, jail, revoke privileges, or publicly humiliate members of such groups for the simple act of drinking alcohol in the name of "public health."   That, of course, would be illegal discrimination since it violates the 14th Amendment's guarantee of equal protection of the law, and no amount of "scientific" research can justify it.  And even known alcoholics over 21 are not jailed simply for being alcoholics--they simply hold too much political power for that.  But 18-20 year old men and women, despite being legal adults in virtually every other way, are apparently a much more acceptable target for "public health" fascism run amok, no matter how responsibly they drink.

The injustice must end NOW.  Let America be America again, and lower the drinking age to 18.  If you're old enough to go to war, you're old enough to go to the bar.  'Nuff said.

Saturday, January 19, 2013

A Better Alternative to Choose Responsibility's Proposal

Most people in the anti-21 movement are at least vaguely aware that the organization Choose Responsibility (with which we are NOT affiliated) has a proposal to lower the drinking age to 18, but with a notable catch:  in order to be allowed to drink alcohol, 18-20 year olds must take and pass an alcohol education course, and will be granted a "drinking license" that can be revoked for alcohol-related misbehavior.   While there may be some theoretical merits to the "drinking license" idea, there are several flaws that would become apparent upon any attempt to implement it:

1) It has become a lightning rod for criticism from both sides, especially the pro-21 groups like MADD and GHSA.
2) It makes the entire movement look quixotic (i.e. idealistic but impractical, like Don Quixote).
3) It makes the movement look ambivalent about lowering the drinking age and about whether 18-20 year olds can be trusted with alcohol.
4) It adds unnecessary complexity to the issue.
5) It would be a bureaucratic nightmare to actually enforce.
6)  As any libertarian (or even quasi-libertarian) would tell you, it kind of screams "Big Brother". (What's next, a license to breed?)
7) Other countries with a drinking age of 18 don’t have a drinking license rule.  (Dubai apparently does, but their drinking age is 21).
8) But most importantly, since it applies only to 18-20 year olds and not those over 21, it is just as ageist as the current 21 drinking age.

In contrast, our proposal for Twenty-One Debunked would allow 18-20 year olds the same drinking rights as people over 21 currently enjoy, with the following safeguards:

1) The age limit for the zero tolerance law for DUI will remain as it is now, at 21. That should alleviate any fears of increased DUI among 18-20 year olds.  In fact, it would be better if it was broadened to include all ages for the first 5 years of driving.
2) The purchase age for kegs, cases, and other large bulk quantities of alcohol will remain at 21 (or at least be no lower than 20). That should alleviate any fear of increased high school keggers.
3) DUI laws would be tightened for all ages and enforcement would be significantly increased.
4) Any person of ANY age who is convicted of DUI, drunk violence, drunk vandalism, furnishing to minors under 18, or repeated drunk and disorderly conduct would be blacklisted and banned from purchasing alcohol (or even entering a bar) for a year or until they turn 21, whatever is longer. And their ID would have to read “Do not serve alcohol under penalty of law” in big red letters. In addition, problem drinkers can also have themselves voluntarily added to the blacklist for a period of time, much like problem gamblers are currently allowed to do.
5) Alcohol education would be increased for all students at all levels.  Some successful models to follow can be found here and here.
6) In addition, the federal alcohol taxes should be raised and equalized to the inflation-adjusted 1991 spirits level ($21 per proof-gallon) for all alcoholic beverages, proportional to alcohol content.

Do all or even some of these things and there will really be no need to have a drinking license.  However, some folks in our movement may still be concerned about the absence of the alcohol education requirement as found in CR's proposal, especially for newly-legal drinkers in the first year or two of the new drinking age of 18.  That can easily be addressed by doing the following:

7)  Phase-down the general drinking age from 21 to 18 over a period of a few months, rather than immediately.  For example, lower it to 20 after 30 days, 19 after 60 days, and finally 18 after 90 days from the passage of the new law.
8)  For the first year or two of the new policy, require 18-20 year olds to obtain a certificate from an alcohol education course in order to be allowed to purchase alcohol or enter a bar.  The course should be an online one such as AlcoholEdu, which has shown dramatic results despite taking only a few hours to complete.  Simple, yet highly effective.
9)  For anyone who is currently 17 or younger, require such individuals to take and pass that alcohol education course before their 18th birthday (or very shortly after), whether they plan on drinking or not.  Those who do not fulfill this requirement would have their driver license or state ID card temporarily suspended or voided until they pass, and/or be prevented from graduating high school until they pass.  Take it as many times as you wish, but charge a fee for the third time and afterwards.

Note how this is very different from CR's proposal since there would be no special drinking license, and after the first year or two the right to buy alcoholic beverages would no longer be tied to the education requirement.  Also, the course would be a lot simpler and shorter than CR's proposed course, and far easier to implement.  We at Twenty-One Debunked are not wedded to any of these last three ideas (#7, 8, and 9), and would still support lowering the drinking age to 18 without them.  But it's still something to consider.  Not only would it help to change America's drinking culture, but it would also make it easier politically to lower the drinking age.

Thursday, January 3, 2013

Latest MTF Results Are In

The 2012 Monitoring the Future survey results are finally in.  We see that, in a nutshell, alcohol use and "binge" drinking* has reached historic lows for grades 8 and 10, while there has been a slight increase from the previous year's record low for grade 12.  Cannabis use has leveled off after rising for five straight years, use of most other substances either held steady or declined, and tobacco use has fallen to record lows.  In fact, cannabis is now more popular than tobacco (but still less so than alcohol) among today's youth, and has been for the past three years in a row.  Note that this reversal of rank was more due to a decrease in tobacco use rather than due to an increase in cannabis use, since the use of both substances are down from their respective peaks in the late 1970s.

So what should we make of these results?  While the pro-21 crowd would like to take credit for the massive decrease in alcohol consumption among teenagers since 1979, one must remember that teen drinking also plummeted in Canada (and more recently in the UK) despite not raising the drinking age to 21.  Also, tobacco continued its long-term decline while for alcohol there are some signs of a turnaround, despite the smoking age remaining at 18 in nearly all states.  Thus, the relationship between the drinking age (and its enforcement) and the levels of teen drinking is not nearly as cut-and-dried as the pro-21 crowd would like us to believe.  In fact, some studies have found that the opposite may be true for dangerous drinking practices among teens and young adults.

*We at Twenty-One Debunked always put the term "binge drinking" in scare quotes when we are referring to the 5+ or 5/4+ drinks definitions, as we believe that such definitions are grossly inaccurate measures of the very real problem of truly dangerous drinking.  More information about this issue can be found in our previous posts here and here.


Sunday, December 30, 2012

Have a Safe and Happy New Year

With the New Year's Eve festivities approaching, we at Twenty-One Debunked want to remind everyone to celebrate responsibly.  There is absolutely no excuse for drunk driving at any age, period.  We cannot stress this enough.  It's very simple--if you plan to drive, don't drink, and if you plan to drink, don't drive.  And there are numerous ways to avoid mixing the two.  Designate a sober driver, take a cab, use public transportation, crash on the couch, or even walk if you have to.  Or stay home and celebrate there.  Or don't drink--nobody's got a gun to your head.

Wednesday, December 5, 2012

Would a Price Floor Be a Good Idea Here?

Recently, UK Prime Minister David Cameron has begun to support the idea of setting a minimum price per unit of alcohol, which currently does not exist in Britain.  The rationale is that it would cut down on excessive drinking and related problems.  Clearly, Britain’s binge-drinking culture (affecting all ages, not just youth) is nothing short of outrageous, even by American standards, though it has improved somewhat in the past decade.   The alcohol taxes in the UK have actually risen faster than inflation in recent years, but supermarkets continue to get around that by selling cheap alcohol at a loss (aka "loss leading") to attract more customers, in a race to the bottom that the overtaxed and declining pubs can never possibly win.  So a price floor seems like a great idea, at least in the UK.

Would that also be a good idea on this side of the pond as well?  Certainly the proposed price floor of 0.40-0.50 pounds per British unit of alcohol (which would be $1.12-$1.42 per American standard drink) would be a bit steep, at least for off-premise alcohol.  A case of 24 beers would be at least $27, similar to the price in Ontario, Canada, and about double the current price for the cheapest beer in much of the USA.  Not only would that idea be unlikely to fly in this country, it may not even be necessary to make set the floor that high to reap significant public health benefits.  Alcohol prices are currently significantly lower in the USA than in the UK (mostly due to our very low alcohol taxes), and the cost of living is lower in the USA as well.  American teenagers and young adults are also significantly poorer than their British counterparts, at least those in the bottom 90%. 

Twenty-One Debunked currently supports (and has always supported) raising and equalizing the alcohol taxes to $21 per proof-gallon for all alcoholic beverages, the same level as the distilled spirits tax was in 1991 adjusted for inflation.  That would push up the price of beer by about $1.20 per six-pack and $4.80 per case, wine by $1.00 per 750-mL bottle, and liquor by $1.00 per 750-mL bottle.  Microbrewers would be exempt from any such tax hike, since their products are already pretty expensive and as small businesses they would be the least able to absorb a tax hike.   A price floor would probably be a good complement to such a policy, and $1.00 (at most) per standard drink would make sense for non-bulk alcohol.  For bulk alcohol (more than an 18-pack of beer or more than 1 gallon of wine or more than 750 mL of spirits), a floor of $0.50-$0.75 would be better, especially since we support keeping the purchase age at 20 or 21 for bulk alcohol while lowering it to 18 otherwise.  This combination of policies is really not all that different in principle from the main idea discussed in Kenkel (1993), yet far more practical and equitable overall.  And bars and restaurants would likely benefit, since pre-gaming with cheap off-premise booze would be reduced.
 

Wednesday, November 21, 2012

Happy Drink Nothing Day!

You have probably heard of Buy Nothing Day. Celebrated on Black Friday, the day after Thanksgiving and the biggest shopping day of the year, this self-explanatory holiday is meant to be a protest against consumerism. But perhaps you didn't know that the biggest drinking day of the year is the day before Thanksgiving. That's right, it's not New Year's Eve, but Thanksgiving Eve, also known as "Blackout Wednesday."

Thus, two years ago we at Twenty-One Debunked have decided to create our own protest holiday, Drink Nothing Day. It is designed as a way for people 21 and over to show solidarity with those under 21 by not drinking any alcohol that day. To observe this holiday, which can only logically be done by folks over 21, one must not drink any form of alcohol at all during the entire 24 hours of that date, as well as the following day until sitting down for Thanksgiving dinner (or until the sun goes down, whichever occurs earlier). Then, one may drink, but one must give thanks that prohibition no longer applies to him or her. Other ways to observe include wearing two black armbands: one to symbolize those soldiers who died before being able to drink legally in the very country they served, and another to symbolize those under 21 who were killed by a drunk driver over 21.

We will continue to observe this holiday until the drinking age is lowered to 18 in all 50 states.  And remember, whether you choose to observe it or not, never drink and drive.  It's just not worth the risk.

Wednesday, November 14, 2012

Will Saskatchewan Lower the Drinking Age?

In the Canadian province of Saskatchewan, there is now a movement to lower the drinking age from 19 to 18.  In that province, the drinking age was 21 until 1971, when it was lowered to 18, and was raised to 19 in 1976.  (The neighboring provinces of Alberta and Manitoba have had a drinking age of 18 since the early 1970s, as does Quebec.)    It is not clear whether the movement will succeed, but if it does it would certainly be good for our own movement to lower the drinking age to 18 in the USA.  While we think a drinking age of 19 is significantly better than 21, our ultimate goal is to lower the drinking age to 18 across the board.

Speaking of Canada, it appears that Alberta's tough new drunk driving laws are having a positive impact overall.  The early data show that in the first month of the new crackdown, police are finding fewer people driving under the influence.  As for the putative fear of lost liquor sales, many bars and restaurants are responding by offering more food on their menus and encouraging their patrons to eat.  Thus, overall revenues at such establishments do not appear to have been hurt significantly despite patrons being more cautious about mixing alcohol and driving.  We can really learn a lot from our neighbor to the north.

Friday, November 9, 2012

What About Weed?

This Election Day, two states (Washington and Colorado) made history as the first states to legalize cannabis (weed) for non-medical use since it was banned in the 1930s.  Notably, both states have chosen an age limit of 21 rather than 18.  Thus, it is worth discussing how Twenty-One Debunked stands on cannabis-related issues, which until now have really not been much of a priority for us.

In a nutshell, our creed shall apply to cannabis the same as it does for alcohol, provided that cannabis is already legal or just about to be legalized.  That means that we support an age limit of 18 rather than 21 for purchase and/or possession, and no criminal penalties or criminal record for anyone simply possessing or consuming it.  Passing around a joint or bong should be treated no differently than passing around a tobacco cigarette or a bottle of beer.  Growing one's own cannabis (within reason) should be treated no differently than growing one's own tobacco or brewing one's own beer or wine.  In addition, we support reasonable taxation, regulation, advertising restrictions, and strict quality control of any legally-sold cannabis, and we support tough penalties for driving under the influence. 

However, in states where cannabis is still illegal, our creed shall remain irrelevant and Twenty-One Debunked will not push for legalization in such states since we really have no dog in the fight.   We will leave that cause up to the True Spirit of America Party (TSAP), which strongly supports full legalization of cannabis in all 50 states and especially at the federal level.  But Twenty-One Debunked shall remain neutral on the issue of legalization of any substances other than alcohol.

Let us make it clear that you do NOT have to support legalization of cannabis to join our movement, which is primarily concerned with the drinking age and other alcohol-related issues.  For those pragmatists who do support legalization but believe the age limit should initially be 21 in order to get the bill or initiative to pass (and then lowered to 18 at some point in the future), we see no harm in you joining either.  But those ageists who strongly support legalization only for those over 21 (and harsh penalties for 18-20 year olds who indulge) are probably NOT going to be an asset to our movement to lower the drinking age to 18.  Liberty for "just us, not all" has never been our style, and never will be.

Wednesday, September 19, 2012

If it Ducks Like a Quack

After celebrating our recent victory in New Zealand, we almost forgot about the other country down under.  While there does not appear to be any real serious chance of Australia's drinking age being raised, the head of the Australian Medical Association just revealed himself as the king of quacks by calling for his country's drinking age to be raised to not 21, but 25.   Dr. Steve Hambleton claims that the brain continues to develop until age 25, and that exposure to alcohol before that age can change a person's addictive potential.   He also claims that raising the age limit would reduce drunken violence, which is apparently a serious problem in Australia.

But once again, theory collides pretty hard with reality.  First of all, the most recent studies have found that brain development (especially the prefrontal cortex) actually continues well into the 30s and 40s, and possibly even beyond that.  Secondly, as for the risk of alcoholism, the best study we have found that addresses the issue, Agrawal et al. (2009), finds that drinking before 18 (and especially before 15) does appear to increase the risk of later alcoholism, but there was no significant difference between those who began drinking at 18, 19, 20, 21, or even 23+.  So 21 or even 25 is completely arbitrary.  Thirdly, some states of India have a drinking age of 25 while others are 18 or 21 and a few are "dry" for all ages, and there is currently no evidence that the parts with higher drinking ages have fewer drinking problems than the parts with lower drinking ages.  In fact, the parts with an age limit of 25 find it VERY hard to enforce, with up to 90% of bar patrons on a busy night being "underage."  How Australia could possibly pull it off remains an unanswered question.  Finally, setting the drinking age seven years higher than the age of majority is serious violation of the civil rights of 18-24 year old legal adults, unless of course Dr. Hambleton is willing to raise the age of majority for everything else (good and bad) to 25 as well.  Which we think is unlikely, by the way.

If Australia really wants to solve its legendary drinking problem, which is almost as bad as New Zealand's and affects ALL ages, they would be better off keeping the drinking age at 18 and enforcing it better while raising the alcohol taxes, setting a price floor, reducing the number and density of alcohol outlets, improving alcohol education and treatment, and most importantly, cracking down VERY hard on DUI and especially drunk violence and disorderly conduct.  Australia has seen great success in reducing drunk driving fatalities, but drunk violence and extreme binge drinking remain serious problems.  It is mainly a cultural problem, which can really only be solved by changing the culture.  And raising the drinking age will NOT accomplish any beneficial culture change--in fact it will most likely make it worse, if the USA is any indication.

Thursday, August 30, 2012

Victory in New Zealand

Last night, the New Zealand Parliament apparently listened to reason and voted to keep the drinking age unchanged at 18.  This is the second time since 2006 that any attempt to raise the drinking age over there has failed.  While the rest of the Alcohol Reform Bill is still being hammered out, we can thankfully rest assured that the NZ drinking age will remain 18 for the foreseeable future.  As a result, we at Twenty-One Debunked hereby honor all of those who voted to keep it 18, especially Nikki Kaye (National) and all of the Greens.
 
To be honest, we at Twenty-One Debunked were a bit worried that New Zealand would actually go through with raising the drinking age to 20, and in doing so ruin any chances that we in the USA could lower our drinking age to 18.   After all, a good 3/4 of the adult population in NZ supported raising the drinking age to 20 or even 21, which is roughly the same percentage over here that favors keeping the American drinking age at 21.  That is, 18-20 year olds are an outvoted minority who would have been subject to tyranny of the majority had it been up to a popular vote alone.  But that's precisely why all modern democracies, even relatively direct ones like Switzerland and several US states, still have legislatures to make laws (and courts to interpret them) rather than literally put everything up to a popular vote.  Remember, what is popular is not always right, and what is right is not always popular.  Albert Einsten knew that quite well.

And it's not like raising the drinking age would have actually done much good.  Next time someone claims that lowering the drinking age to 18 in 1999 created a "crisis" in problematic drinking among teens and young adults that wasn't there before, be sure to show them this link to set them straight. Long story short: from 1996/1997 to 2006/2007 it did not significantly increase among 15-24 year olds, but did increase among people over 25. But I guess it's easier to scapegoat young people for adult problems rather than actually try to solve them.  Fortunately, the NZ Parliament was smart enough to see through the lies and do the right thing, at least as far as the drinking age is concerned.

As for the rest of the Alcohol Reform Bill still being debated, we at Twenty-One Debunked generally support those provisions, even though they may be rather weak.  There is still no definite provision for minimum pricing of alcohol, which according to international evidence would likely have had the largest impact on New Zealand's legendary drinking problem.  But some provisions, such as giving communities more say over alcohol outlets and reducing trading hours (currently 24/7), are clearly a step in the right direction.  Ultimately, New Zealand's drinking culture needs to change, and Parliament needs to step up to the plate and pass sensible laws that encourage that to happen, but without violating the civil rights of any individual or demographic group.  But will they have the intestinal fortitude to do so?