The Journey-Destination Problem

What we call the "journey-destination problem" is the fact that journeys are often much more dangerous than destinations.  For example, there is the fear that lowering the drinking age to 18 would, even if better overall in the long run, would still have adverse unintended consequences in the short run.  And we at Twenty-One Debunked address that fear head-on in our proposal to lower the drinking age to 18.

First and foremost, lowering the drinking age from 21 to 18 (in line with the rest of the world, and a good chunk of American history) is NOT a radical change at all.  So any (real or imagined) fears related to lowering it even further below 18, or abolishing the age limit altogether, do NOT apply to lowering it to 18.

Secondly, it is NOT like the (real or imagined) fears of suddenly legalizing something that was previously completely illegal for everyone.  Alcohol in its various forms has been broadly legal, tolerated, and openly advertised for most of recorded history.  It is the "devil we already know", basically.   So "same as before, but without the arrests or injustices" is actually pretty close to accurate here.

Thirdly, simple and practical things like raising the alcohol taxes and cracking down harder on drunk driving, drunk violence, drunk and disorderly conduct, and stuff like that, would basically render any feared unintended consequences academic in practice. This is true whether the drinking age is lowered to 18 gradually OR suddenly.

Fourthly, it's not the 1970s or 1980s anymore.  America is almost a completely different country now in so many ways, including for drunk driving.  The original, albeit still fatally flawed, crisis-based justification for coercively raising the drinking age to 21 in the 1980s is itself grossly outdated and basically academic now in the 21st century, hence the need for the pro-21 crowd to invent new, ever more specious and spurious justifications (such as junk neuroscience, and a perversion of the precautionary principle) for keeping it at 21, because reasons.

And finally, it is ultimately a matter of principle, as it is fundamentally a civil rights issue, far more so than it is a public health and safety issue.  Not everything can be reduced to crude utilitarianism, after all.  "Let us do evil, that good may come" is always and everywhere a trap, a lesson that is unfortunately too often learned the hard way.

(Mic drop)

America Is Still Drowning In The Bottle

Americans are still drowning in the bottle to this day, and paying a heavy price for it.  While the pandemic and especially the lockdowns were clearly gasoline on the fire, that fire has been burning for a very long time before that.  The ageist abomination that is 21 drinking age, and all of its illiberal ancillary laws, has clearly done NOTHING to stem that tide in the long run.  And it's truly no coincidence that alcohol (of all types, but especially hard liquor) is now the cheapest it has been in many, many decades relative to inflation and (especially) income.  That's largely because alcohol taxes have greatly lagged behind and were thus eroded by inflation in recent decades, with the tax on distilled spirits lagging the very most of all.

To quote the latest CDC report on the matter:

Average annual number of deaths from excessive alcohol use, including partially and fully alcohol-attributable conditions, increased approximately 29% from 137,927 during 2016–2017 to 178,307 during 2020–2021, and age-standardized death rates increased from approximately 38 to 48 per 100,000 population. During this time, deaths from excessive drinking among males increased approximately 27%, from 94,362 per year to 119,606, and among females increased approximately 35%, from 43,565 per year to 58,701.

Thus, as Twenty-One Debunked has long advocated, we need to raise the alcohol taxes across the board, and harmonize them all based on alcohol content.  To raise just the beer tax alone, for example, would result in drinkers simply switching to liquor, similar to how minimum unit pricing in Scotland disproportionately affected strong cider and perversely incentivized switching to liquor.  MADD (Mothers Against Drunk Driving) has long heavily beaten the drum (though not so much recently) for raising the beer tax, but has also largely been strangely silent on the distilled spirits tax.  Perhaps some alleged palm-greasing from both the liquor industry and/or foreign beer industry may be at work here?  Things that (should) make you go, hmmmm.....

We advocate raising all federal alcohol taxes to about $30 per proof-gallon, equal to the inflation-adjusted value for the distilled spirits tax in 1991 (in 2023 dollars), the last time it was raised. That would add anywhere between one and two dollars (depending on alcohol content), to the price of a six-pack of beer, a gallon of wine, or a fifth of liquor, while also incentivizing reduced-alcohol beers and wines.  And while that may not be very much of a difference to a moderate drinker, for heavy drinkers it sure adds up, as it also does for the youngest drinkers as well.  And contrary to what some believe, the price elasticity of demand for alcohol is NOT zero or trivial, and the public health benefits of higher alcohol taxes and prices are well-known and established.

To sweeten the deal, we support a relatively reduced tax rate for the smallest producers, and we also support tax incentives for producers who fortify their beverages with thiamine (vitamin B1) and perhaps other vitamins as well.  And we would also support phasing in alcohol tax hikes a bit more gradually if that is the only way to get them passed.  But raise these taxes, we certainly must.

(And, of course, we also also lower the drinking age to 18 yesterday, full stop.  We are still Twenty-One Debunked, after all.)

It is true that Thomas Jefferson once famously said, "no nation is drunken where wine is cheap".  Granted.  But the second half of that very same quote was, "and none sober when the dearness [expensiveness] of wine substitutes ardent [distilled] spirits as the common beverage.  It is, in truth, the only antidote to the bane of whiskey."  And now in 2024, it would seem that ALL categories of alcoholic beverages are too cheap for America's own good, and a fortiori for ardent (distilled) spirits today.

America Is Still Drowning In The Bottle

Americans are still drowning in the bottle to this day.  While the pandemic and especially the lockdowns were gasoline on the fire, that fire has been burning for a very long time before that.  The ageist abomination that is 21 drinking age, and all of its illiberal ancillary laws, has clearly done NOTHING to stem that tide in the long run.  And it's truly no coincidence that alcohol (of all types, but especially hard liquor) is now the cheapest it has been in many, many decades relative to inflation and (especially) income.  That's largely because alcohol taxes have greatly lagged behind and were thus eroded by inflation in recent decades, with the tax on distilled spirits lagging the most of all.

Thus, as Twenty-One Debunked has long advocated, we need to raise the alcohol taxes across the board, and harmonize them all based on alcohol content.  To raise just the beer tax alone, for example, would result in drinkers simply switching to liquor, similar to how minimum unit pricing in Scotland disproportionately affected strong cider and perversely incentivized switching to liquor.  MADD has long heavily beaten the drum (though not so much recently) for raising the beer tax, but has also largely been strangely silent on the distilled spirits tax.  Perhaps some alleged palm-greasing from both the liquor industry and/or foreign beer industry may be at work here?  Things that (should) make you go, hmmmm.....

We advocate raising all federal alcohol taxes to about $30 per proof-gallon, equal to the inflation-adjusted value for the distilled spirits tax in 1991, the last time it was raised. That would add anywhere between one and two dollars (depending on alcohol content), to the price of a six-pack of beer, a gallon of wine, or a fifth of liquor, while also incentivizing reduced-alcohol beers and wines.  And while that may not be very much of a difference to a moderate drinker, for heavy drinkers it sure adds up, as it also does for the youngest drinkers as well.  And contrary to what some believe, the price elasticity of demand for alcohol is NOT zero or trivial, and the public health benefits of higher alcohol taxes and prices are well-known and established.

To sweeten the deal, we support a relatively reduced tax rate for the smallest producers, and we also support tax incentives for producers who fortify their beverages with thiamine (vitamin B1) and perhaps other vitamins as well.  And we would also support phasing in alcohol tax hikes a bit more gradually if that is the only way to get them passed.  But raise these taxes, we must.

(And, of course, we also also lower the drinking age to 18 yesterday, full stop.  We are still Twenty-One Debunked, after all.)

It is true that Thomas Jefferson once famously said, "no nation is drunken where wine is cheap".  Granted.  But the second half of that very same quote was, "and none sober when the dearness [expensiveness] of wine substitutes ardent [distilled] spirits as the common beverage.  It is, in truth, the only antidote to the bane of whiskey."  And now in 2024, it would seem that ALL categories of alcoholic beverages are too cheap for America's own good, and a fortiori for ardent (distilled) spirits today.

A Better Way To Tax Alcohol

We at Twenty-One Debunked have long supported hiking alcohol taxes as an alternative to illiberal (and highly inequitable) blunt-instrument policies like the ageist abomination that is the 21 drinking age.  And there is far more evidence in favor of tax and price hikes reducing alcohol-related problems than there is for the 21 drinking age.  But what is the best way to tax alcohol?

The answer is a single tax based on alcohol by volume (ABV), regardless of whether the beverage is beer, wine, cider, distilled spirits, alcopops, or whatever, similar to what the UK recently implemented.  Instead of having multiple, widely varying tax rates based on beverage type, it makes far more sense to simply tax all alcoholic beverages equally based on their actual alcohol content, period.  It can be either a flat rate or a graduated rate with multiple rate brackets (higher alcohol content brackets have higher tax rates), but either way, it is still a major improvement over the status quo in the USA and most other countries (or the status quo ante in the UK).

The UK's new alcohol duty system is more nuanced than that, of course, and one very important nuance is the Small Producer Relief (a reduced rate for the smallest brewers and such who produce beverages of 8.5% ABV or less) which we definitely support.  Purists may not like that, of course, but tough noodles for them.  Small businesses should not get unnecessarily kicked in the teeth just to appease the purists.

So what should the tax rate be in the USA?  Twenty-One Debunked has long supported raising and equalizing the federal tax on all alcoholic beverages to the 1991 inflation-adjusted value for distilled spirits.  In 2023 dollars, that would be $30.79 per proof-gallon (proportional to alcohol content).  One could have graduated rates, of course, but if we choose a flat rate that is the one that makes the most sense.  If graduated rates are chosen, the lowest bracket should be for beverages below 3.5% at less than half the above rate, while the highest bracket (wherever it is set) could in principle be significantly higher than the above rate (note that the 1951 distilled spirits tax would be a whopping $126.92 per proof-gallon in today's dollars).  So that's actually pretty tame in comparison, as it would translate to an extra dollar or two on a six-pack of beer or bottle of wine, or a few more dollars on a bottle of spirits.

Such substantial tax hikes can be phased in gradually over several steps to minimize any downsides that may come with large, sudden tax and price hikes, of course, but the weight of the evidence suggests that any such downsides would be fairly small overall in any case (and more than outweighed by the upsides).  Note that craft breweries are apparently thriving in high-tax Canada, and even Iceland, for example.

And for small producers, the relief could either be a reduced rate up front or a tax credit later.  Additionally, similar to the UK, we could perhaps also have another nuance, "Draught Relief", which is a reduced rate (or tax credit) specifically for on-premise draught (draft) beer and cider.  As long as overall rates on the cheapest beverages end up higher than they are now, such nuances would soften the blow but not actually detract from the benefits of the tax hike.

Twenty-One Debunked is well aware that alcohol tax hikes will likely be unpopular among a sizeable chunk of the population.  But as the saying goes, if the (relatively modest) price difference bothers you so much, perhaps you are drinking too much.

(Mic drop)

UPDATE:  Looks like at least some beverage makers in the UK are reducing their alcohol content somewhat in response to the tax change, especially for beer.  Alcohol giant Diageo predictably puts a negative spin on that, of course, but if that encourages moderation (and it almost certainly will), then it is a good thing on balance.  Keep in mind that, for most of recorded history, beer was on average significantly weaker in alcohol content than it has been in the past century or two, and wine was very frequently watered down as well.  So any marginal reductions in strength due to the tax would still put the product stronger than it was for most of recorded history. 

About That Finland Study

This year, a new study came out in The Lancet that looked at the long-term differences in alcohol-related morbidity and mortality between birth cohorts in Finland that either were or were exposed to the lowering of their legal drinking age from 21 to 18 on January 1, 1969.  That is, based on how old they were when the drinking age was changed.  The study and its interpretation had a clear pro-21 bias. 

While the results did show that, exposed cohorts did have higher morbidity and mortality later in life relative to the unexposed cohorts, the results were ultimately inconclusive since several other changes happened at the same time. For example, the lowering of the drinking age occurred in tandem with other alcohol liberalization policies (in a previously very stringent policy regime with fairly low alcohol consumption) that greatly increased alcohol availability in general and thus consumption in a short period of time.  Urbanization also increased rapidly as well.  Culture changes (especially of the drinking culture) also inevitably occurred as well against a backdrop of increasing general alcohol consumption, and those who came of age during or right after the change would logically have been more affected than those who already came of age just before it, regardless of the legal age limit.  So teasing out the specific effects of the legal drinking age change is really practically impossible in this case.

A cursory reading of the Wikipedia article about Finnish drinking culture will tell you all you need to know about why the age limit is largely irrelevant.

Previous studies on the very long-term effects of the 21 drinking age in the USA and elsewhere have been very scarce and ultimately inconclusive at best as well.  (At least one Swedish study seems to suggest a null effect though.)  And this new Finland study, quite frankly, adds very little.  Causation can thus neither be confirmed nor ruled out, in other words.

Regardless, in any case, even if it were partly causal, using a study like this to justify the ageist abomination that is the 21 drinking age is mission creep at best, and grasping at straws at worst, given that the original justifications for it are either debunked, obsolete, or both.  The idea that some vague conception of "public health", especially theoretically in the distant future, somehow trumps civil rights (and selectively for only one demographic group, no less) is the very worst of utilitarianism and health fascism, and has no place in a free society.

And as long as we are on the subject of Finland, that same country has also since shown us what can be done to rapidly decrease alcohol-related mortality and morbidity at very little cost to society at large and without trampling civil rights:  raising the tax/price of alcohol.  Even the pro-21 crowd, including the authors of the aforementioned study, seem to be willing to concede that.  But apparently that doesn't satisfy the ageists' desire for power and control.  Their libido dominandi seems to know no bounds in that regard.

QED

UPDATE:  And while we are at it, lest anyone speciously claim that Lithuania's raising of the their drinking age from 18 to 20 effective January 1, 2018 somehow saved lives, keep in mind that in 2017 they also greatly raised their alcohol taxes, banned alcohol advertising, and greatly cut trading hours for alcohol sales in 2018.  So once again, we see confounding.  In fact, one study found that once such confounders were adjusted for, any supposed lifesaving effect of the drinking age hike on 18-19 year olds disappeared, implying that it was a spurious effect.

Japan Actually Encouraging Young Adults To Drink More Alcohol

Concerned about falling alcohol tax revenue, as well company profits, the government of Japan is now literally encouraging young adults to drink more alcohol.  Yes, you read that right.  They are even going so far as to hold a contest.  Apparently, alcohol consumption among young people has been falling since the 1990s, and even more so recently, with tax and business revenues falling along with it.

But most surprisingly of all, they are still NOT planning on lowering their drinking age to 18 to match their new age of majority.  They lowered their general age of majority earlier this year from 20 to 18, but still kept their smoking and drinking ages at 20, because reasons.  Or something.  Yes, really.

Stranger than fiction indeed!  And not nearly enough (facepalm) in the world to cover this!

Americans Still Drinking Themselves To Death

With all the news about tobacco, vaping, opioids, and cannabis lately, Twenty-One Debunked had almost forgotten about the very substance that led us to our founding in the first place: alcohol.  And the news about alcohol these days is hardly anything rosy:  Americans are still drinking themselves to death, at an alarming and increasing rate.  And yet, such very bad news (among adults) is strangely banal and often seen as not particularly newsworthy.  As we like to say, it is our country's "pink elephant in the room".

Teen drinking specifically may be at or close to a record low now, as it is in many other countries as well, but the tragic truth is that Americans in general are currently drowning in the bottom of the bottle and paying a heavy price for it.

According to a recent article, there are indeed several proven strategies that can be implemented at federal, state, and local levels to help stem the tide and get a handle on America's drinking problem.  We KNOW how to do it, and have known for decades now.  And while they may not necessarily get at all of the deepest root causes, they are still known to work quite well in the meantime regardless:

• Raising alcohol taxes
• Restricting the number/density of alcohol outlets and/or the hours/days of sale
• Improving access to treatment
• Bolstering coping skills

And while the first two get the most "bang for the buck" in terms of cost-effectiveness, they are unfortunately a relatively tough sell in some places.  Nevertheless, all four of these strategies should be implemented yesterday--if only our "leaders" would have the intestinal fortitude to do so.

Notice also that there was no mention of the 21 drinking age in the article.  And that is probably because after maintaining such ridiculous and ageist laws in all 50 states and DC for at least three decades now, the supposed benefits of such laws are ringing more hollow than ever.  And if anything, it is becoming increasingly crystal clear now that the 21 drinking age is doing more harm than good by merely forcing young adult drinking underground and kicking the proverbial can down the road.

The Most (Cost-)Effective Ways to Reduce Alcohol-Related Harms

It has been three decades since the last state, Wyoming, raised their legal drinking age to 21 in 1988 under federal duress.  And since then, has it really led our culture to a healthier relationship with alcohol?  Hardly.  As Twenty-One Debunked has been noting for years now, the tragic truth is that Americans are drowning at the bottom of the bottle, and paying a heavy price for it.  It is the "pink elephant in the room" that no one wants to talk about, particularly for Americans over 21.  This despite the fact that alcohol continues to literally kill more people than the opioid epidemic, and yet the former has not been declared anywhere near a public health emergency the way the latter has been.  Gee, I wonder why?

And while teen drinking is currently at a record low (though not unique to the USA, so don't be so quick to give credit to the 21 drinking age), adult drinking is anything but.  What is most striking is how ageist (and cowardly) our culture's response has been to this epidemic of excessive drinking, essentially blaming young people for adult drinking problems.

As for what the most effective responses to America's drinking problem, the one that stands out as the lowest-hanging fruit of all in terms of both effectiveness and cost-effectiveness at reducing harm is raising alcohol taxes.  In fact a recent international study of 16 countries by researchers at the World Health Orgainzation (WHO) confirmed what we have basically known all along but for some reason have yet to implement fully despite reams and reams of research evidence supporting it.  Other close contenders in terms of the most "bang for the buck" include restrictions on alcohol advertising/marketing and hours of sale, but higher alcohol taxes/prices emerge as the most cost-effective measure of them all. Somewhat less cost-effective is tougher enforcement of BAC limits for DUI, but it is still highly effective as well.  And the least cost-effective, but still effective (and worth doing) albeit more expensive, measure is screening and brief intervention for alcohol problems by primary-care physicians.

And guess what was not mentioned at all?  You guessed it:  drinking age laws.   And for good reason:  the supposed "mountain" of evidence in favor of the 21 drinking age basically turned out to be a molehill all along, and a very shaky one at that.  But as an avid reader of Twenty-One Debunked, you already knew that, right?  One day we will all look at the pro-21 crowd the same way we do for flat-earthers and such.

So yes, we do need to implement these aformentioned measures, especially raising alcohol taxes.  Currently, in real dollars, alcohol is cheaper than ever in the USA.  Raising and equalizing all federal alcohol taxes to $24 per proof-gallon (i.e. the inflation-adjusted 1991 level for distilled spirits) would be a good idea, though even raising them to $16 per proof-gallon would still yield very large societal benefits as well.  That would not be much of a price hike to a moderate drinker, but to a heavy drinker it certainly would be.

And lowering the drinking age to 18 while implementing better and more honest alcohol education would most likely, at least over time, lead to a culturally healthier relationship with alcohol as well since it would no longer be a fetishized "forbidden fruit" that fosters a "go big or go home" attitude to drinking.  The status quo certainly hasn't helped America's drinking culture one bit.

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 ot the bar.  'Nuff said.

You May Not Like It, But Here's the Answer to (At Least Greatly Reducing) College Rape and Sexual Assault

As we had noted in a previous post four years ago, rape and sexual assault is a persistent epidemic in the USA, including (but not limited to) college campuses nationwide.  Lately, the chattering classes have been endlessly wringing their hands about it for years, but little real progress has been made in recent years, and since the Trump administration began we seem to have even regressed a bit in that regard, the #MeToo movement notwithstanding.

Most rapes and sexual assaults, especially those involving college students on or near campus, are committed by people known to the victim, and many if not most of those involve alcohol to one degree or another, whether by the perpetrator, the victim, or both.  We should first and foremost note that the only thing that actually causes rape is the rapists themselves, period.   While alcohol (among other substances) can indeed fuel it and is often used as a weapon to incapacitate victims, rape would simply not happen without rapists, period.  And the onus should always fall on men not to rape in the first place, instead of falling on women not to "get themselves raped".  The fact that so many people still deny such an obvious truth in 2018 shows just how far we have yet to go towards eliminating or even reducing this epidemic, and those who blame or otherwise put the onus on potential or actual victims are in fact part of the problem.

We seriously need to drain the proverbial swamp of rape culture, yesterday, and thus revoke the rapists' social license to operate.  Culturally, we need to tackle the root causes of sexual violence by rejecting the highly toxic "commodity model" of sexuality and replacing it with the "performance model" (while also avoiding the negative connotations and pitfalls of the word "performance"), and more generally rejecting the "dominator model" of society and replacing it with the "partnership model".  And for alcohol, we need to recognize that while adopting a "Prohibition-Lite" approach of any sort is most likely to backfire and would throw the proverbial baby out with the bathwater, its link with sexual violence still needs to be dealt with in the meantime as cultural changes can take much time to occur.

So what measures can be taken in the very near term to quickly reduce or at least take the dangerous edge off of this seemingly intractable epidemic?  The reader may or may not like the answer, but here goes:

1. Lower the legal drinking age to 18, yesterday, full stop.  The 21 drinking age makes drinking that much more dangerous than it has to be by forcing it underground, which can put young drinkers in more dangerous situations that increase the risk of sexual assault, and the law itself can be used as a cudgel to silence victims.
2. Raise the tax on alcoholic beverages, both federally as well as at the state and local level (especially in college towns), with extra levies on bulk alcohol such as kegs, cases, and handles. Studies have shown a significant inverse correlation between alcohol prices and rape in general.
3. Legalize cannabis for everyone 18 and older, yesterday.  Cannabis is clearly the safer choice in that regard, as it is highly unlikely to fuel violence or be used as a date-rape drug the way that alcohol all too often is.
4. Pass "Yes Means Yes" laws (aka affirmative consent laws) similar to California's.  If properly written, these laws will essentially eliminate the concept of so-called "gray area rape" by putting the onus on the initiator of sexual activity to be sure that they actually have consent before proceeding further.
5. Last but not least, hold the perpetrators accountable for a change, no matter how powerful or privileged they happen to be.  That includes enforcing both criminal laws as well as campus conduct policies to the fullest extent of the law.  No more Brock Turners.

As for the idea of colleges trying to influence upward the prices of cheap alcohol at parties (particularly Greek parties) that are typically $5 or so at the door for all-you-can-drink, that would be rather difficult to enforce in practice.  But if the drinking age was lowered to 18, most frats would likely end up having a "going out of business party" since their modern-day speakeasy services would no longer be necessary.  And those that remain would, in practice, throw less frequent parties and/or  ones with less beer (or liquor) to go around if the tax on such beverages is also hiked as well.

Doing these things will go a long way towards reducing the rape and sexual assault epidemic in the near term.  Anything less would be uncivilized. So what are we waiting for?

Do Alcohol Taxes Still Work to Save Lives?

Avid readers of our blog would note that Twenty-One Debunked supports raising the tax on alcoholic beverages almost as wholeheartedly as we support lowering the drinking age to 18.  And there are reams and reams of research evidence over many decades--locally, nationally, and internationally--that find that higher alcohol prices (and thus taxes) save lives both on and off the highways as well as reduce crime, violence, and other alcohol-related problems.   In contrast, the ageist abomination that is the 21 drinking age has not consistently demonstrated similar effectiveness in that regard, no matter what sort of pseudo-consensus exists in the minds of its most ardent supporters, and the best evidence thus far has exposed the specious claim of saving lives as little more than a mere statistical mirage all along.

That said, for the specific endpoint of alcohol-related traffic fatalities, among the reams of evidence there have been a few outlier studies that seem to cast doubt on the lifesaving effect of alcohol prices/taxes as well.  The most recent one in 2017 by McClelland and Iselin of the Urban-Brookings Tax Policy Center studied the effects of the Illinois alcohol tax hikes in both 1999 and 2009, and found no long-term lifesaving effect from either one in terms of drunk driving deaths.  In contrast, a previous 2015 study by Wagenaar et al. had found a fairly large drop in alcohol-related traffic deaths following the 2009 Illinois tax hike, even after controlling for the effects of the Great Recession.  The biggest difference between the two studies was that McClelland and Iselin used the Synthetic Control Method (SCM) while Wagenaar et al. did not, and while a good method, like all methods it too can have its own share of pitfalls.

As for the other outlier studies, most of those are dissected and discussed in a 2015 replication review by David Roodman, which still concludes that a true lifesaving effect is likely.  One such outlier study is by Dee (1999), whose control for state-specific time trends apparently removed too much useful variation in state-level beer taxes.  And while Roodman did not discuss our all-time favorite study by Miron and Tetelbaum (2009), we should note that this study in fact began by replicating Dee (1999) using more years of data and including Alaska, Hawaii, and DC, and in contrast to Dee they did apparently find a fairly strong inverse correlation between beer taxes and 18-20 year old traffic deaths even after adjusting for state-specific time trends.

Granted, it is true that for the specific endpoint of DUI deaths, the price of alcohol may not be quite as important as it once was.  Drunk driving is far less common and far less socially acceptable than it was a generation ago, and legal sanctions against it are much stiffer now as well.  And with alcohol prices currently at a record low in relative terms, and alcohol taxes generally being a small portion of the overall price, the link between the two may not be as salient or noticeable as it once was due to being swamped or masked by other factors.  But that does not mean that it is ineffective, given the fact that several more recent studies continue to find such effects, and the numerous studies that continue find fairly large benefits in terms of reducing non-traffic deaths and harms as well (cirrhosis, unintentional injuries, cancer, crime, violence, STDs, etc.).

Thus, the overwhelming weight of the evidence still continues to support the idea that raising alcohol taxes/prices is an effective (and especially cost-effective) public health policy in terms of saving lives both on and off the highways as well as reducing alcohol-related problems in general.  And if it is high enough, it is also justified on Pigouvian grounds as well.  So what are we waiting for?

Is Alcoholism on the Rise for Women?

A recent article in Prevention discusses a recent study by NIAAA, that finds that alcoholism (or clinically speaking, "alcohol use disorder") among women has apparently been on the rise lately, having nearly doubled since 2002.  And while at least some of what the NIAAA has to say (especially their rather low definition of "binge" drinking) should be taken with at least a grain of salt (if not a whole pound), there does unfortunately seem to be at least some truth here.

So why is this happening now?  The article does speculate that deteriorating work-life balance, increased stress and anxiety, and increasingly aggressive alcohol marketing towards women should take at least some of the blame.  And all of that is certainly true to one degree or another.  But truly the pinkest elephant in the room is that excessive drinking (and related consequences) has been increasing overall for both women and men during that timeframe, and while the gender gap has indeed narrowed, men continue to greatly exceed women in terms of alcoholism and alcohol-related problems, as they always have (despite some improvement in decades past until very recently).

Americans of all ages and genders are literally drinking themselves to death as we speak.  About 88,000 per year, in fact, die from alcohol-related causes (vs. 65,000 per year for opioid and all other drug overdoses combined), a number that has been increasing in recent years.  And that number, though staggering in itself, is merely the tip of a very large iceberg of injury, illness, crime, violence, motor vehicle crashes, family breakdown, addiction, and other social costs linked to this deadly yet ubiquitous substance.  Meanwhile, the powers that be are unfortunately--no, shamefully, responding to this epidemic with a collective shrug for the most part.

Fortunately, we know now after decades of reams of research evidence that there is in fact a very simple solution for reducing the death rates and other harms of excessive drinking.  And that solution is raising alcohol taxes.  The higher the price of alcoholic beverages, the fewer deaths and other alcohol-related problems occur, all else being equal.  Even modest increases seem to have a significant impact.   We know this, yet not only have the powers that be generally let the alcohol taxes lag behind inflation, but have actually moved to lower such taxes as a lesser-known part of the recent Republican tax bill.  This at a time when the relative price of alcohol is at an all-time record low already and still falling, while alcohol-related casualties continue to rise.

Also, we really need to legalize the safer choice, yesterday.  Cannabis is overall safer than alcohol, and generally tends to substitute for it.  Many studies strongly suggest that when one advances, the other retreats, albeit with some nuance of course.  Cannabis may even take a major bite out our nation's deadly and devastating opioid epidemic as well, according to some studies.  There's really no good reason to keep it illegal.  Zip. Zilch. Nada.

One thing is for sure.  Raising the drinking age to 21 in the 1980s, and increasing enforcement from the 1990s onward, appears to have done NOTHING to stem this tide, at least not for this most recent increase in alcohol-related problems, particularly among women.  Yet you can bet that the powers that be will predictably double down on this very ageist abomination and greatest alcohol policy failure since Prohibition.  Because reasons.  Or something.

The One Thing That Philip J. Cook and Wayland Ellis Both Agree On

Sometimes an idea comes along that is so compelling that even polar opposites of a particular ideological or public policy spectrum are willing to at least grudgingly embrace.  And sometimes that idea is not only not a new one, but has existed since practically forever yet has been largely underutilized all the same despite all the evidence in its favor.

Take the following two authors and researchers:  Philip J. Cook (author of Paying the Tab:  The Costs And Benefits of Alcohol Control) and Wayland Ellis (author of Abolish the Drinking Age:  The Conservative Case Against Alcohol Regulation).  The two can be considered to be each other's foil in many ways in regards to alcohol.  Cook is American, pro-21, pro-regulation, leans a bit more liberal than conservative, and leans more communitarian than libertarian.  In contrast, Ellis is British, anti-21, anti-regulation, conservative by British standards, and leans quite libertarian even by American standards.   

And yet, there is one thing that they both agree on:  the single most effective public policy measure to reduce alcohol-related harms is higher alcohol prices, such as through higher alcohol taxes.  Cook arrives at that conclusion enthusiastically while Ellis arrives at it perhaps a bit grudgingly, but the conclusion is the same regardless despite their otherwise polar opposite views on the drinking age and alcohol regulation in general.  Now that really says something!

And it pans out, given the reams upon reams of research evidence that arrive at that same conclusion in a wide variety of times, places, demographics, and functional forms.  Twenty-One Debunked generally agrees more with Cook than Ellis on most of the topics under discussion with the notable exception of the drinking age of course.  Especially since Cook's own 1984 study with Tauchen was one of the now-outdated studies that convinced the feds to force states to raise the drinking age to 21 in the first place.  We agree with Cook on some things, Ellis on others, and clearly agree with both on the issue of alcohol taxes.  Alcohol prices relative to inflation and income are currently at a record low in the USA, in no small part because taxes are at at a record low as well.  And there really is no overarching benefit to society for alcohol to be that cheap, while there is plenty of proven and serious harm from the excessive drinking (among all ages) that such cheap alcohol encourages.

Twenty-One Debunked supports lowering the drinking age to 18, while also raising and equalizing the federal alcohol taxes across the board to $24/proof-gallon, equal to the inflation-adjusted 1991 level for distilled spirits.  That would be a little more than an extra dollar for a six-pack of beer or an extra dollar on a fifth of liquor.  That could be done more gradually by first raising it to $16/proof-gallon and then to $24 a year later. Additionally, we would also be fine with (though not necessarily wedded to) the idea of setting a minimum price of $0.50-0.75 per standard drink or at least banning the practice of retailers selling alcohol below cost (already banned in many states).   Cook would support the latter idea of a price floor while Ellis would most likely not, but both would at least support higher alcohol taxes.

So what are we waiting for?

Would A Price Floor for Alcohol Be A Good Idea?

With the issue of alcohol taxes now coming to the forefront lately, there is also another policy measure designed to reduce the problems and externalities associated with excessive consumption of alcohol:  minimum unit pricing.  That is, a setting a minimum price per standard unit* of alcohol, which like excise taxes would increase the price of the cheap stuff (that is favored by heavy drinkers) but unlike taxes would have no effect on beverages whose price is already higher than the new minimum.  After all, the effect of taxes operates through the mechanism of higher prices, so the public health benefits should be similar for both taxes and a price floor, or some combination of the two.  The biggest differences would be in efficiency (who bears the costs) versus revenue (who gets it)--though even for taxes alone, the largest effect size, at the margins, would be on the heaviest drinkers as well, for obvious reasons.

One can see the effects of a price floor on both cheap alcohol in general as well as in bulk quantities.  Take a 40 oz. bottle of 8% ABV malt liquor that now costs $2.99.  That contains a whopping 5.3 standard American drinks*.  If the price floor was then set at $0.75 per standard drink, for example, the price would go up to $3.99, a small but significant jump that really would add up for a heavy (and/or very young) drinker.  A six-pack of 12 oz. cans of say, Budweiser (5% ABV) that sells for $5.99 per six-pack, already above that hypothetical price floor at $1.00 per standard drink--and that is a low-ball price for a six-pack in the USA--would be unaffected.  A 12-pack of the same product selling for $9.99 would still be unaffected, and an 18-pack could be sold for as little as $13.50.  But that 30-pack now on sale for $14.99?  Well, the price for that would go up to $22.50.  And that 15.5 gallon keg that currently sells for $100 or less, excluding deposit?  Well, that contains about 168 standard drinks, so the minimum price for that would jump to $126 per keg.  And those prices for bulk quantities would really add up for anyone who frequently throws or attends keggers or other large drinking parties--leading to somewhat fewer such occasions and/or less beer to go around at such parties.  And now combine that with even a modest tax hike and you get a marginal effect size that is greater than either measure alone.

What about the hard stuff?  Well, we see that while most of it would remain unafffected by a price floor, the cheaper end of the scale would be nonetheless be affected as well in a similar manner to beer.  Take a "handle" (i.e. a 1.75 L bottle) of the cheapest vodka, whiskey, or whatever that currently costs $12.99 in some places.  That contains about 40 shots of 1.5 oz each, so at 80 proof that would equal roughly 40 standard drinks per bottle.  If the minimum price were set at $0.75 per standard drink, that bottle would now cost about $30.  Even a mere $0.50 per drink floor price would raise the price of the cheap booze to around $20 or so.  So while distilled spirits would be the least affected category overall, they would in fact be even more affected than beer at the lower end.   And this would also lesssen the yawning disparity between on- and off-premise prices, thus reducing the urge to "pre-load" or "front-load" with cheap booze before going out to the bar, pub, or club.

So yes, Twenty-One Debunked would be fine with a price floor of $0.75 per standard drink, just as we would be fine with raising alcohol taxes across the board to as high as $24/proof-gallon for all beverage types.   A combination of both would also be good as well.  Given how moderate and responsible drinkers would barely be affected at all by either measure as noted (as long as the thresholds are not set much higher than the ones above), they hardly qualify as blunt instruments and are in fact highly efficient in practice.  That's a small price to pay for liberty.

* One "standard American drink" or "standard unit" of alcohol is equal to one measure of the following:  one 12 ounce can/mug/glass of beer at 5% ABV, one 5 ounce glass of wine at 12% ABV, or one 1.5 ounce shot of distilled spirits at 80 proof (40% ABV).  This is known as alcohol equivalence.  Contrary to popular opinion, these all contain the same amount of alcohol.  So keep this in mind if or when you drink.

Of Death And Taxes, Part Deux

While the opioid epidemic has recently been declared a public health emergency, what if we were to tell you that there is another drug epidemic that kills even more people (a whopping 88,000 per year vs. 65,000 per year for opioid and all other drug overdoses combined), a number that has actually been increasing in recent years?  And that number, though staggering in itself, is merely the tip of a very large iceberg of injury, illness, crime, violence, motor vehicle crashes, family breakdown, addiction, and other social costs linked to this deadly yet ubiquitous substance.  Meanwhile, the powers that be are responding to this epidemic with a collective shrug for the most part.  I think the reader would figure out by now that we are talking about alcohol.

And aside from its overall banality, what is particularly notable about the alcohol epidemic is how ageist our response has been.  While the epidemic clearly affects all ages, the powers that be have been focusing in laser-like fashion on people under 21 while largely ignoring people over 21, despite the fact that people over 21 make up the vast majority of this epidemic.  Not only does this scapegoat young people for largely adult problems, but it also hinders any real solutions to such problems as well.  It's basically the "pink elephant in the room".

Fortunately, we know now after decades of reams of research evidence that there is in fact a very simple solution for reducing the death rates and other harms of excessive drinking.  And that solution is raising alcohol taxes.   The higher the price of alcoholic beverages, the fewer deaths and other alcohol-related problems occur, all else being equal.  Even modest increases seem to have a significant impact.   We know this, yet not only have the powers that be generally let the alcohol taxes lag behind inflation, but have actually moved to lower such taxes as a lesser-known part of the new Republican tax bill.  

So what should the ideal alcohol tax be?  According to researchers, the externality costs of alcohol are estimated to be around $45-58 per proof-gallon, yet the federal tax on distilled spirits is $13.50 per proof-gallon, and for wine and beer it varies but tends to hover between $4 and $5 per proof-gallon.  And while state and local alcohol taxes vary, they are also generally very modest in most states, especially for beer.  So there is a very wide range by which such taxes can be raised while still being socially efficient.

Of course, those figures are now effectively even lower now that the Republican tax bill has lowered such rates even further for roughly the first 100,000 proof-gallons of all alcoholic beverage categories across the board.  But the aforementioned rates still remain the top rates above the respective thresholds in the now-tiered system.  Beer was always tiered with a reduced rate for the first 60,000 barrels, but now that reduced rate is even lower still, and for the first time ever distilled spirits now enjoy a reduced rate for the first 100,000 proof-gallons.  The rate structure is not inherently bad in itself, of course, but both the new and old rates are simply too low.

Twenty-One Debunked believes that, along with lowering the drinking age to 18, that alcohol taxes should be raised significantly.  Specifically, we support raising and equalizing the federal tax on all alcoholic beverages to the inflation-adjusted 1991 level for distilled spirits, which would be $24 per proof-gallon in 2016 dollars.  It should also be simplified by getting rid of all credits and lower tax rates, with perhaps the exception of ones for the first X number of proof-gallons produced by very small domestic producers.  At the state level, it would also be good to equalize alcohol taxes across all beverage types, while allowing localities to levy their own alcohol taxes (including sales and gross excise taxes) as they see fit.  The latter is especially important for college towns.

Even a smaller hike, such as to $16 per proof-gallon across the board, would likely save thousands of lives per year according to researchers.  And of course it would also raise more revenue.  As for job losses, the best research suggests that the net effect is actually neutral or even positive with respect to jobs overall.  So it should be a no-brainer.  A win-win-win situation for everyone but the alcohol industry, basically.

Oh, and by the way:  craft breweries (both macro and micro) not only exist in high-tax Canada, but actually appear to be thriving over there.  Ditto for even higher-tax Iceland as well.   Keep in mind that the tax hikes we propose would still leave American beverages cheaper than Canadian beverages.  So even if we raise such taxes dramatically without reduced rates or credits for small producers, they will likely continue to thrive here as well (at least if such tax hikes are phased in somewhat gradually).

Don't get us wrong, Twenty-One Debunked does not believe that alcohol is inherently evil or anything like that.   We are certainly not in league with the neo-dry lobby!  But when we as a society fail to appreciate that alcohol has a very real dark side for all ages, there are very serious consequences to doing so.  History speaks for itself.  So what are we waiting for?

Of Death And Taxes

While the opioid epidemic has recently been declared a public health emergency, what if we were to tell you that there is another drug epidemic that kills even more people (a whopping 88,000 per year vs. 65,000 per year for opioid and all other drug overdoses combined), a number that has actually been increasing in recent years?  And that number, though staggering in itself, is merely the tip of a very large iceberg of injury, illness, crime, violence, motor vehicle crashes, family breakdown, addiction, and other social costs linked to this deadly yet ubiquitous substance.  Meanwhile, the powers that be are responding to this epidemic with a collective shrug for the most part.  I think the reader would figure out by now that we are talking about alcohol.

And aside from its overall banality, what is particularly notable about the alcohol epidemic is how ageist our response has been.  While the epidemic clearly affects all ages, the powers that be have been focusing in laser-like fashion on people under 21 while largely ignoring people over 21, despite the fact that people over 21 make up the vast majority of this epidemic.  Not only does this scapegoat young people for largely adult problems, but it also hinders any real solutions to such problems as well.  It's basically the "pink elephant in the room".

Fortunately, we know now after decades of reams of research evidence that there is in fact a very simple solution for reducing the death rates and other harms of excessive drinking.  And that solution is raising alcohol taxes.   The higher the price of alcoholic beverages, the fewer deaths and other alcohol-related problems occur, all else being equal.  Even modest increases seem to have a significant impact.   We know this, yet not only have the powers that be generally let the alcohol taxes lag behind inflation, but are currently trying to lower such taxes.  

So what should the ideal alcohol tax be?  According to researchers, the externality costs of alcohol are estimated to be around $45-58 per proof-gallon, yet the federal tax on distilled spirits is $13.50 per proof-gallon, and for wine and beer it varies but tends to hover between $4 and $5 per proof-gallon.   And while state and local alcohol taxes vary, they are also generally very modest in most states, especially for beer.  So there is a very wide range by which such taxes can be raised while still being socially efficient.

Twenty-One Debunked believes that, along with lowering the drinking age to 18, that alcohol taxes should be raised significantly.  Specifically, we support raising and equalizing the federal tax on all alcoholic beverages to the inflation-adjusted 1991 level for distilled spirits, which would be $24 per proof-gallon in 2016 dollars.  It should also be simplified by getting rid of all credits and lower tax rates, with perhaps the exception of ones for the first X number of gallons produced by very small domestic producers.  At the state level, it would also be good to equalize alcohol taxes across all beverage types, while allowing localities to levy their own alcohol taxes (including sales and gross excise taxes) as they see fit.  The latter is especially important for college towns.

Even a smaller hike, such as to $16 per proof-gallon across the board, would likely save thousands of lives per year according to researchers.  And of course it would also raise more revenue.  As for job losses, the best research suggests that the net effect is actually neutral or even positive with respect to jobs overall.  So it should be a no-brainer.  A win-win-win situation for everyone but the alcohol industry, basically.

Oh, and by the way:  craft breweries (both macro and micro) not only exist in high-tax Canada, but actually appear to be thriving over there.  Keep in mind that the tax hikes we propose would still leave American beverages cheaper than Canadian beverages.  So even if we raise such taxes dramatically without reduced rates or credits for small producers, they will likely continue to thrive here as well (at least if such tax hikes are phased in somewhat gradually).

Don't get us wrong, Twenty-One Debunked does not believe that alcohol is inherently evil or anything like that.   We are certainly not in league with the neo-dry lobby.   But when we as a society fail to appreciate that alcohol has a very real dark side for all ages, there are very serious consequences to doing so.  History speaks for itself.  So what are we waiting for?