Tobacco 21 Laws' Benefits Are An Illusion

Another recent study found that while self-reported teen smoking and vaping rates declined after Tobacco 21 laws, biomarker exposure showed mixed evidence at best, implying that fewer young smokers are identifying as smokers (and similar findings for vaping).  Thus, the supposed reductions in smoking and vaping in surveys and sales data are at least largely an artifact of underreporting and cross-border shopping rather than real reductions.  Oops!

Looks like it was all just another mirage, kinda like with the 21 drinking age.  What next, a study that finds that water is wet and the sun rises in the east?

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!

UPDATE 3:  Another recent study found that while self-reported teen smoking and vaping rates declined after Tobacco 21 laws, biomarker exposure showed mixed evidence at best, implying that fewer young smokers are identifying as smokers (and similar findings for vaping).  Thus, the supposed reductions in smoking and vaping in surveys and sales data are at least largely an artifact of underreporting and cross-border shopping rather than real reductions.  Oops!

The Stupid Literally Burns Like Cigarettes

In Australia, there is quite a furor right now among the chattering classes in regards to a sharp increase in teen tobacco smoking from 2018 to 2023 after over two straight decades of decline.  And one of the things people are blaming is.....wait for it....vaping.  Because reasons.  Or something.  But there is one very glaring problem with this theory.  In Australia, vape products are technically legal, but ONLY if they do NOT contain any nicotine at all, thus kind of defeating the purpose.  That's right, nicotine vape products have never been approved for legal sales in Australia (and probably never will be any time soon), meaning anyone who wants to use them must either smuggle them in from abroad or buy them on the black market.  And interestingly enough, vaping itself also appears to be on the rise as well down under.  Thus, it truly takes a special kind of stupid to not only perversely create a situation where vaping and smoking both increase at the same time, but to then blame the increase in smoking on vaping.

Even more notable is the fact that in Australia, cigarettes have some of the highest taxes (and thus prices) in the world, plus so many other world-leading "best practices" tobacco control polices as well.  This additionally shows that while vice taxes and some other policies may work well to a point, all of these policies inherently have their limits in practice. 

Our working theory:  it is actually the banning of nicotine vaping, combined with the harmful effects of one of the strictest lockdown and Zero Covid regimes in the world, that ultimately snatched defeat from the jaws of victory in the long fight against tobacco smoking, particularly for youth.  And we must stress that while nicotine in any form is far from benign and definitely NOT for kids, banning or unduly restricting vaping (which is still significantly safer than the known deadly habit of smoking that it often displaces) is therefore a net public health loser of a policy.  And a policy like Australia's that perversely increases "dual use" of both is even that much worse still.

One could even argue that their truly massive cigarette black market created by their insanely high taxes, especially combined with their vaping black market from their nicotine ban, actually increased underage (under 18) use of both products since black market sellers typically don't ask buyers for ID.

Note also how the increase did not begin until 2020 (implicating the lockdowns as a contributing cause), and occurred for 14-17 year olds but interestingly NOT 18-24 year olds (putting the lie to the idea that their age limit of 18, as opposed to 21, was in any way related).  Also note that in England, where the age limit is still 18 and vaping is literally promoted by public health authorities, teen smoking continued its long decline through at least 2021.  New Zealand, where the age limit was still 18 (until very, very recently), smoking rates among 15-24 year olds nosedived as soon as nicotine vaping was officially legalized in 2020, despite an even stricter lockdown there.  Thus it seems to be the combination of 1) black markets, 2) vaping bans, and 3) lockdowns that is the cause of the jump in teen smoking in Australia.

But good luck trying to convince the nanny-state zealots to use even a little bit of common sense!

QED

How To Make Tobacco Less Appealing And Addictive Without Banning It Or Reducing Nicotine Below Natural Levels

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, raising the age limit any higher than 18, or even reducing 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.

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.

So what are we waiting for?

What's Worse Than Raising The Federal Smoking Age To 21? Forcing States To Do The Same As Well

There are a number of federal Tobacco 21 bills competing in Congress right now.  But the one that Big Tobacco and their shill Mitch McConnell both want, the Tobacco-Free Youth Act, would not only raise the federal tobacco and vape sale age from 18 to 21 (thus amending the Family Smoking Prevention and Tobacco Control Act of 2009), but also force states to raise their own legal sale age limit for tobacco and vaping products to 21 by changing "18" to "21" in the 1992 Synar Amendment as well.  Such coercion in the latter would revoke a portion of federal substance abuse prevention grants from states that choose to keep their age limits below 21, something that has been academic since 1993 (when all states raised their age limits to at least 18 to satisfy the Synar Amendment as written).  Sound familiar?  In 2000 the Supreme Court struck it down as unconstitutional since back then the FDA did not have legal authority over tobacco, the FDA now does, so any new challenge would have to be one that would also attack the federal drinking age coercion in the 1980s, whether on Tenth Amendment grounds or substantive due process / equal protection under the 14th Amendment.  (Such a challenge may be the only silver lining, assuming both get overturned as a result.)

History may not repeat itself, but it does rhyme.  And the odd thing is, if the federal age limit is raised to 21, coercing the states to do so is redundant at best, and counterproductive (for the feds, that is) since it opens the federal government up to legal challenges, and also makes it easy for Big Tobacco to extract special favors from states by giving them an unnecessary bargaining chip to play with.  And this flaw seems very likely to be deliberate.  So in their zeal to raise the smoking age to 21, the anti-tobacco movement becomes strange bedfellows with Big Tobacco.

Seriously.   Let that sink in.  And by the way, threatening to withhold substance abuse prevention grants from states as a cudgel during the opioid crisis is every bit as base and cowardly (if not even more so) as withholding federal highway funding while our infrastructure is rapidly decaying and crumbling.

All of these Tobacco 21 bills need to be vigorously fought against, period.  If any of these happen to pass, another little piece of America as we know it will die, and 21 will become the new 18 in so many other ways as well.  And then it would be only a matter of time before it becomes 25, and so on.

UPDATE:  Looks like as of June 26th, the bill advanced out of committee, and they apparently scrapped the part about forcing states to raise their own age limits for tobacco/vaping products.  But the bill still stinks to high heaven regardless, albeit slightly less.