Why Do Small Alcohol Tax/Price Hikes Have Such Large Effects On Drunk Driving Casualties?

We have noted before how alcohol tax (and thus price) hikes have been proven time and again to save lives, whether from traffic deaths, other accidental deaths, violent deaths, as well as deaths from more direct alcohol-related conditions such as alcoholic liver disease.  The question remains, why such relatively small differences in price have such relatively large effects, that can sometimes even be large enough to strain the reader's credulity?

For things like liver cirrhosis, the answer is pretty straightforward:  cirrhosis is chronic and cumulative, but it is also progressive as well.  At any given time, some unknown number of people (and unknown to the people themselves as well) may be just one binge away from near-certain death.  And for them, even a very modest near-term reduction in drinking due to a price hike (which to a very heavy drinker, is not trivial, since they spend so much on alcohol) can very well save their life.

But what about less direct things like drunk driving casualties?  Well, one needs to think like an economist, that is, on the margin.  It is the last drink of any given drinking session that determines one's final BAC of the session, and it is the final BAC that determines how impaired one is in the event of driving home.  And we know that the fatal or serious crash risk rises exponentially with BAC, thus even a modest reduction (say, one fewer drink per session) would dramatically reduce the risk of such casualties, even though the risk still remains significantly elevated compared to not drinking at all before driving.  At on-premise locations like bars, a tax hike is likely to be passed through at a rate greater than one-to-one due to rounding up, so it is very plausible that at least some people will have one fewer drink per session as a result.  Or alternatively, they may drink before going out to save money, but that would make them more likely to plan ahead and not drive there, so they would be even less likely to drive back home as a result. 

Either way, the fairly recent examples of Illinois and Maryland seeing sizeable reductions in traffic deaths after relatively modest alcohol tax hikes in 2009 and 2011, respectively, definitely supports this hypothesis.  And it shows that this classic "tax-price-consumption-fatalities" relationship is still as relevant as ever now in the 21st century, even if it has been attenuated a bit since the 1980s.  And most of the gazillion studies on the matter have found that the effect is larger than that of the meretricious "crown jewel" of the neo-prohibitionist public health fascists and ageist bigots, namely the 21 drinking age, with the supposed lifesaving effect of the latter being most likely spurious, inconsequential, or even perverse in the long run.

In other words, it's really a no-brainer to raise alcohol taxes, yesterday.  Especially with alcohol being so dangerously cheap right now in America.  So what are we waiting for?

Sorry, Cannabis Legalization STILL NOT Crazy-Making, Or Deadly For That Matter

The latest fearmongering "Reefer Madness" study is making the rounds now.  This one insinuates (with the requisite hedging of language, of course) that cannabis legalization in Canada might have been linked to an increase in schizophrenia and other psychosis.  But the study doesn't actually say that at all.  A more careful reading of the study reveals that the incidence of schizophrenia proper has NOT actually increased overall following legalization.  Nor does the study actually show that the prevalence or incidence of psychosis in general has increased either (only the vague nebulous category of "psychosis not otherwise specified (NOS)" increased somewhat, and other psychosis diagnoses were not even looked at) for some reason. Natch.

The authors do concede that previous studies on both the USA and Canada have also repeatedly failed to find any significant link between medical or recreational legalization and either schizophrenia or psychosis in general.  But they laughably claim that such studies were too "underpowered" to detect anything.  Riiiiiight.  Perhaps because the supposed effect they were looking for was just noise all along?  

Occam's Razor, anyone?  Point is, if you torture the data enough, they will confess to anything.  And of course, one of the authors disclosed that they personally have ties to (surprise, surprise!) the pharmaceutical industry.

In other news, around the same time that was published, another Canadian study was published in the same journal that found that those who had emergency room visits or hospitalizations listed as related to "cannabis use disorder" were statistically more likely to die in the five years following such admissions.  That study made for some scary news headlines as well, but not only are such patients not even remotely representative of typical cannabis users, but as the requisite linguistic hedging reveals, no definitive casual link could be proven here either.  That is, it was impossible to rule out all alternative explanations even after attempting to adjust for known confounding factors.  

And regardless, clearly this study says nothing at all about legalization.  If weed legalization had somehow resulted in excess deaths in the general population, it certainly would have been all over the news, but it apparently didn't.

It seems like the standards for what gets published in medical and scientific journals these days are really approaching (if not already hitting) rock bottom.  When silly junk science (or approaching junk science) studies like these come out, the very best thing that we can do is to mercilessly mock them as far and wide as humanly possible.

Thomas Jefferson Predicted Exactly Why Minimum Unit Pricing Would Fail

Looks like good old Thomas Jefferson, the third President of the United States and one of America's Founding Fathers, had uncannily predicted long ago why the recent "Minimum Unit Pricing" of alcoholic beverages in Scotland and Wales would end up failing so miserably even on its own terms:

"No nation is drunken where wine is cheap; and none sober where the dearness of wine substitutes ardent [i.e. distilled] spirits as the common beverage. It is, in truth, the only antidote to the bane of whiskey."

And there you have it.  Substitute "beer" or "cider" for "wine" and it still makes just as much if not more sense, especially in the UK.  That is NOT to say that the price mechanism (via taxation or otherwise) is useless, far from it.  All else being equal, we know that higher alcohol prices = fewer alcohol-related problems and deaths, at least to a point.  But the Jeffersonian wisdom above DOES add a VERY important nuance, namely that the RELATIVE price of less-concentrated alcoholic beverages (beer, wine, cider) compared with the more-concentrated distilled spirits (hard liquor) is more important than the absolute prices of either.

Consider this:  the UK as a whole already had, and still has, fairly high but (until recently) very uneven taxes on alcohol to begin with.  Wine and especially cider have long enjoyed lower taxes (and thus lower prices per standard drink) compared with beer and hard liquor there.  Thus, the heaviest problem drinkers, especially poorer ones, often went for cheap and strong cider to get the most "bang for the buck".  Enter minimum unit pricing, a price floor across the board per standard drink which had a much larger effect on raising the price of cider compared with hard liquor.  The unintended consequence?  At least some of the heaviest drinkers likely at least partially switched to liquor as a result, and ended up getting drunker than they otherwise would, with predictable negative effects.

That said, in the USA where alcohol taxes are much lower, especially for distilled spirits, such a price floor may very well be a net benefit overall.  And even in the UK, changing it to a two-tier price floor where distilled spirits would have a higher minimum price per standard drink than non-distilled beverages may very well too.  But as it stands currently in Scotland and Wales?  It's generally pretty weak sauce at best as far as public health is considered.

Oh, and don't ever expect MADD to admit this either.  They have in the past at least half-heartedly called for higher beer taxes, of course, but remained strangely quiet about liquor taxes.  It's almost like someone is greasing their palms, or something.  Nah, that's crazy conspiracy talk, right?

Will There Be Nicotine Limits for Cigarettes?

Lately, there has been some talk of the outgoing Biden administration possibly doing an eleventh-hour Hail Mary, and officially propose a hard limit on nicotine levels in combustible cigarettes.  If done properly, this would make cigarettes less addictive or even non-addictive, and would be a major win for public health.  A randomized controlled trial of reduced nicotine versus full nicotine cigarettes in 2015 appears to back up that claim quite well.

Twenty-One Debunked is officially on the fence about this idea, cautiously supporting it in principle while also being wary of potential unintended consequences as far as creating a black market for full nicotine cigarettes.  If they do it, they would have to phase out the full nicotine cigarettes gradually, and also leave alone non-combustible alternative tobacco/nicotine products (except for capping the nicotine levels in vapes to European levels, which we support).  And even loose roll-your-own and pipe tobacco should be spared, as those are not the main drivers of the tobacco smoking epidemic.  Only ready-made combustible cigarettes and little cigars should be affected in our view.

Failing that, here is a "Cliffs Notes" style list on how to make cigarettes and other smokeable tobacco products less addictive and appealing WITHOUT banning it outright or nicotine below natural levels:

• First and foremost, BAN ADDITIVES!  No non-tobacco ingredients should be added, period.
• Adding extra nicotine deliberately should also be banned as well.
• Require the smoke pH to be 8 or higher to discourage deep inhalation of smoke, as it naturally was prior to the 20th century. 
• Phase out the pH-lowering and environmentally unsustainable practice of flue-curing tobacco. 
• Phase out cigarette "filters", which don't really filter, and merely provide a false sense of security to smokers, and inherently creates a major toxic waste littering problem to boot.

If they still want to reduce maximum nicotine levels to a non-addictive level in ready-made commercial cigarettes and little cigars, go right ahead.  But it would be best to do the other things on the list first.

(And of course, Twenty-One Debunked continues to strongly opposed the current age limit of 21, and believes it should be lowered back to 18 yesterday.)

Also, banning the use of radioactive (!) phosphate fertilizers to grow tobacco is really a textbook no-brainer in terms of tobacco harm reduction. 

Additionally, requiring all tobacco products to be sold only in dedicated tobacco stores, or other places where you have to be 18 or older to enter, would really not be a bad idea either.  It would certainly make it less ubiquitous, convenient, and tempting without the constant reminder in grocery stores, convenience stores, gas stations, pharmacies, etc.  Even then, to avoid unintended consequences to such stores, that should be phased out gradually as well.

So what are we waiting for?

What Will 2025 Bring for Youth Rights?

It's 2025 now, and things look pretty bleak for youth rights in general.  Not only is the 21 drinking age (and smoking age and toking age) not going away anytime soon, but now we have to deal with the latest social media bans and restrictions on young people.  Florida's literally goes into effect today, for example.  This law bans anyone under 14 from signing up for or maintaining a social media account at all, and for anyone over 14 but under 16 from doing so without verified parental consent.  How they plan to do it without it backfiring on older youth and adults is not clear, but either way, it is very wrong-headed at best.  And we know it won't stop there, as it won't be long before it gets raised to 18 and then 19 and then 21 and so on.  That is, slopes are MUCH, MUCH slipperier than they appear!

Fortunately, it is being challenged in court, and pending the outcome of such challenges, enforcement is unlikely to begin until at least February at the earliest.

And then of course we have Trump coming back into the office of POTUS for a second term on January 20th.  That alone will be a new dark age for America, especially with his puppet master Elon Muskrat pulling his strings.  Trump has not exactly been a friend of youth rights, as evident in his raising the federal smoking age to 21 in late 2019.  Just like DeSanctimonious did the same for Florida in 2021, after initially opposing it.  And of course, Trump and MAGA Republicans and Talibangelicals seeking to systematically revoke women's rights will of course not bode well for youth rights either, if history is any indication.

So buckle up, as it will be a VERY wild ride!