Is Drunk Walking Really More Dangerous Than Drunk Driving?

Or, "Why People Absolutely Need to Stop Citing Superfreaknomics, Yesterday"

Talk about losing the plot!

Only someone who has repeatedly read Superfreakonomics would really believe that.  (People are apparently still irresponsibly citing it to this day.)  In that rather tepid and disappointing sequel to Freakonomics by Levitt and Dubner, the authors claimed that, at least on a per-mile basis, a drunk person is a whopping eight times more likely (!) to be killed while walking than driving the same distance.  However, there are a number of flaws to that claim.  First, they assume that the proportion of total miles traveled while drunk is the same for walking as it is for driving.  This is dubious because drunk driving is far less common nowadays, and many who would have driven drunk a generation ago now choose to walk instead.  Secondly, it is more realistic to compare the risk per hour of traveling time rather than per mile, since far more miles are traveled by car rather than on foot.  Thirdly, the real-world relative risk for an alcohol-related pedestrian fatality does not rise to statistically significant levels until a BAC of about 0.15, while for driving deaths it begins to rise significantly at 0.05 or even lower, which is a very large difference.  To quote NHTSA in their Alcohol and Highway Safety 2001 report:

One interesting finding...was that the relative risk of involvement in a fatal pedestrian crash did not begin to rise until the pedestrians reached a BAC of .15 to .20. This is consistent with the hypothesis that safe walking is generally easier than safe driving, since the relative risk curve for fatal motor vehicle crashes starts to rise at a much lower BAC.

Finally, there is a significant qualitative difference between the two in that while a drunk pedestrian is unlikely to endanger innocent people, a drunk driver is very likely to do so.  That's precisely why the latter is illegal while the former is generally not, though some states do have laws against public drunkenness (which are typically only enforced if the drunk pedestrian is noticeably causing a nuisance or hazard to others).  We may never be able to determine exactly how risky drunk walking is to the drunk individual, and we certainly know that the risk is not zero.  In fact, the NHTSA report suggests that it can be quite significant at very high doses of alcohol.  There is also a risk of falls when one is "falling-down drunk," which can lead to serious or even fatal injuries.  But all things considered, drunk walking is still a better option than drunk driving at any BAC level. (Not that we are encouraging either!)

In other words, if you choose to harm or endanger yourself, that's your own business in a free society.  But the moment you significantly harm or endanger non-consenting others, such as driving under the influence on a public street or highway, it then becomes everyone's business.  Why is that still so hard for so many people to understand?

Never mind, we already know why.  Because too many people are apparently far too left-brain dominant to see the forest for the trees!  And the very same people who, upon reading or hearing about that questionable passage from Superfreakonomics, will inevitably see such specious reasoning as far more of a green light to drive drunk than as a red light to walk drunk.  Now I don't believe in censorship, but come on now:  if I was the editor of Superfreakonomics, I could see myself "accidentally" deleting that particular part of the book before it got published!

And finally, research has found that the best ways to reduce the number of drunk pedestrian casualties at the population level are basically the same strategies that would benefit all pedestrians (and cyclists) drunk or sober, most notably reducing speed limits and vehicle sizes, and otherwise improving infrastructure to be more pedestrian-friendly and bike-friendly in general.  We also need to crack down on and stiffen the penalties for hit-and-run crashes and distracted driving as well.  Anything else, in our view, is an Orwellian slippery slope just waiting to happen.

(Mic drop)

How America Lost The Plot

From the ageist and illiberal abomination that is the 21 drinking age and especially its authoritarian enforcement, to drunk driving, to drug policy, to transportation policy, to environmental policy, to foreign policy, to Tobacco 21, and so on, America has well and truly lost the plot long ago on so many issues.  How long ago, you may ask?  Well, roughly 40 years ago, if not even a bit earlier than that.  But how and why did it happen in the first place?  Why can't our "leaders" (and many of those who keep voting for them) ever seem to see the forest for the trees?

In the book, The Master and His Emissary:  The Divided Brain and the Making of the Western World by Iain McGilchrist (2009), the author delves into the familiar idea of the left vs right hemispheres of the brain.  Only unlike the usual surface-level analysis in that we see in pop neuroscience, this one is a real deep dive into the truly resounding implications of these brain differences for society and civilization.  Ten years later, it was even made into a documentary, The Divided Brain (2019), by McGilchrist himself along with award-winning documentary filmmaker Vanessa Dylyn, et al.

To summarize:  the two hemispheres of the brain each see the world and process information in fundamentally different ways:  the left brain is more reductionistic in thinking, while the right is more holistic in thinking.  The left is more logical, analytical and detail-oriented, while the right is more creative, intuitive, and sees the bigger picture.  The left is more linear, while the right is more non-linear.  The left sees the map, while the right sees the territory.  And so on.  While both sides are of course quite valuable and necessary, the brain functions best overall when the right brain is in charge.  The left is a great servant, but a terrible master, hence the title of the book.  And Western culture has, for thousands of years, oscillated between favoring the overall relative dominance of each of the two hemispheres.  In recent centuries and decades, as in some other historical periods as well, we have become far too left-brain dominant, with very negative consequences, according to the author.  Not only does the left not really know what the right is doing, but at least half the time the left doesn't even know what the left is doing!  The left brain has thus essentially hijacked society, and that in turn leaves us "increasingly incapable of grappling with critical economic, environmental, and social issues, ones that shape our very future as a species", as the documentary would put it.  I am largely oversimplifying what he said, of course, but that is the basic gist of it overall.

One obvious reason for this excessive left-brain dominance could be due to poorly-designed education, of course.  But another could be that the left brain is faster in terms of processing speed than the right, and the pace of life is undoubtedly much, much faster nowadays than even the recent past.  Though the latter would be more of a chicken-or-the egg question. 

(And to all of the political conservatives and reactionaries who try in vain to shoehorn all of this into their silly left-wing vs right-wing political spectrum, like that one guy on The Daily Sceptic did recently, please get your own ideas.  This book, by a renowned Oxford scholar, truly thoroughly transcends such a naive interpretation of politics.)

A-ha!  That really explains a LOT!

Clearly, the USA (and a good chunk of the world as well, but especially the USA), has only gotten more, not less, left-brain dominant since roughly 40 years ago.  We as a society have been reactively lurching from crisis to crisis, moral panic to moral panic, trend to trend, fad to fad, idol to idol, and propaganda to propaganda, throwing at each whatever left-brained nostrums seem like a good idea at the time without really thinking it through.  But try as they may, the map is NOT the territory.  And their reductionist "solutions" invariably affect not just this thing over here, but also that thing over there, and that other thing all the way over there, and so on.  Oops!

One thing's for sure:  As the late, great Buckminster Fuller famously said, you cannot solve a problem with the same kind of thinking that got us into that problem in the first place.  Unfortunately, not nearly enough people have gotten the memo, it seems.

UPDATE:  Looks like McGilchrist has a sequel to the aforementioned book, titled The Matter with Things, as well.  Food for thought. 

A brain divided against itself cannot stand.

Case Closed: Tobacco 21 Laws Don't Work

The latest study of Tobacco 21 laws shows they were a resounding....DUD in terms or reducing young adult smoking, vaping, or smokeless tobacco use rates in the USA.  Being published in a famously anti-tobacco journal, Tobacco Control, the authors of course wanted to put a positive spin on it though nonetheless, as shown below (emphasis ours):  

Results Although we did not find evidence that state T21 laws were associated with cigarette, smokeless tobacco or ENDS [i.e. vapes] use overall, the federal T21 law was associated with lower use of all three tobacco products by 0.39–0.92 percentage points. State flavour restrictions were associated with lower use of cigarettes by 0.68 (−1.27 to –0.09) and ENDS by 0.56 (−1.11 to –0.00) percentage points, but not with smokeless tobacco. A three-way interaction revealed that state and federal T21 laws together were associated with a lower prevalence of ENDS use among 18–20 years, but there were no differences in cigarette use from both policies combined versus either alone.

Conclusion State and federal T21 laws are broadly effective at reducing adult tobacco use, while state flavour restrictions specifically lower use of cigarettes and ENDS.

Got that? The state level laws were useless, period, but the federal Tobacco 21 law passed in December 2019 was somehow "broadly effective" because it appeared to trivially reduce tobacco/nicotine product use by not even a full percentage point.  Never mind that that latter was not enforced until well into 2020, enforcement still remained spotty for a while, and that its passage coincided with two major confounds:  1) the EVALI (vaping illness) outbreak that, while clearly due to adulterated black market THC vape products, was fearmongered by the mainstream media to include all vape products, and 2) the COVID-19 pandemic that, for better or worse, seemed to discourage smoking and encourage quitting, since many people feared that smoking made them more vulnerable to the virus.  But no, it HAD to be due to the Tobacco 21 law, because reasons.  Or something. 

Even flavor restrictions were more effective than Tobacco 21 laws!

So how many IQ points did YOU lose from the mental gymnastics of reading all for the above quoted article abstract beyond the stuff in bold?  The study was behind a paywall of course, so we couldn't delve further into it, granted.  But even a cursory reading of the abstract shows that the Tobacco 21 laws are a joke, and not a very funny one at that.  And worse, it may have even driven some young vapers (back) to smoking, which would clearly be a net public health loss.  But try convincing the zealots of that!

These unimpressive findings dovetail nicely with other studies as well.  As for whether raising the tobacco/nicotine age limit from 18 to 21 reduces the use of such products among people under 18, the evidence for that is very weak and mixed at best.

As for the few previous studies that did appear to find statistically and practically significant effects from the Tobacco 21 laws, those apparent results are most likely a result of short-term effects as well as an artifact of confounders like cigarette tax hikes.  

(Cigarette tax hikes, which mean higher prices, are in fact one of the most effective and cost-effective ways to reduce smoking at the population level, though they still have their limits of course.  And while they may be classist, at least they are not ageist, and they don't blatantly violate anyone's civil rights.)

Regardless, even if Tobacco 21 laws were ever proven to be effective, Twenty-One Debunked would still oppose them on principle, as we believe that in a free society worthy of the name, civil rights inherently supersedes "public health".  That is true in regards to tobacco, alcohol, cannabis, or anything else.  

(Mic drop)

UPDATE:  A few older studies have found modest but significant decreases in retail tobacco sales following the raising of the smoking age to 21 in early adopter states like California and Hawaii.  And another study found no change in overall ever or current smoking among California 18-20 year olds, but did find a modest decrease in daily smoking among that age group relative to 21-23 year olds (whose daily smoking actually increased three years later) in the same state.  This of course echoes Miron and Tetelbaum (2009) as well as Asch and Levy (1987 and 1990), Males (1986), and Dee and Evans (2001) in regards to the 21 drinking age.  That is, endogeneity, early-adopter effects, short-term effects, and seesaw/delay effects all appear to be at play here.  The supposed miracle turned out to be a mirage all along, in other words.  Thus, especially in light of the most recent study discussed in this article, there were really no benefits that cannot be alternatively achieved with higher cigarette taxes and/or better enforcement of the previous 18 age limit, and if anything the 21 age limit appears to be counterproductive in the long run.

UPDATE 2:  Even the CDC's very own 2022 study found mixed and ambiguous effects of Tobacco 21 laws, and such effects sometimes even appeared to differ by race as well (in favor of whites, with null or even perverse effects on young people of color).  Oops!