Is Teen Cannabis Use Really on the Rise?

The same FDA chief that has been freaking out over a supposed teen vaping "epidemic" (that is far more molehill than mountain, by the way), Scott Gottlieb, is now also freaking out about teen cannabis use and how it relates to legalization.   In fact, he says he is now more worried about weed than vaping, which really says something.  But is there any truth to his fears, particularly the idea that teen cannabis use is on the rise as a result of both medical and recreational legalization in more and more states?

The answer is apparently, not really.  California is practically ground-zero for both medical and recreational legalization, and their survey actually shows a decrease in teen cannabis use, particularly in the younger grades, from 2013-2015 to 2015-2017 despite medical legalization in 1996, expanded decriminalization in 2011, and recreational legalization via Prop 64 in November 2016.  And while the national Monitoring the Future survey showed a slight increase in teen use in 2017 compared with 2016, it had been previously dropping from 2011 to 2016 despite more and more states liberalizing their pot laws during that time.  Some epidemic, huh?  NOT.

In other words, there is no increase in teen cannabis use that can be unambiguously linked to legalization.  And teen use is still far below its 1978-1979 and 1997 peaks, with no indication that it will even come close.  Thus, another myth bites the dust.  Plus, alcohol, tobacco, and most other substances are at or close to record lows among middle and high schoolers, while the opioid epidemic rages among American adults along with the "pink elephant in the room".  So stop freaking out already, and see the forest for the trees.

UPDATE:  In terms of problematic use of cannabis, a new study finds that the legal status of cannabis is essentially irrelevant.  While that particular study focused on adults, it dovetails rather nicely with another study from last year finding no increase on problematic cannabis use among 12-17 year olds following the passage of legalization.  Thus, it looks like the legalization advocates were indeed correct all along, that legalization would result in modest increases in adult use, and negligible increases (or even decreases) in teen use or abuse at any age.  So put that in your pipe and smoke it!

Do Tobacco 21 Laws Really Work?

One preliminary study seems to think so about California's law that raised the age limit to buy tobacco and e-cigarettes from 18 to 21 as of June 9, 2016.  But the devil is really in the details.  The study did not, I repeat, did NOT, look at actual teen smoking rates, only the degree of retailer compliance as measured by decoys, which did in fact improve since then in terms of sales to people under 18.

The two problems with this logic are 1) it is not necessary to raise the age limit to 21 to discourage retailers from selling to people under 18, as simply better enforcement against scofflaw vendors would do the trick, and 2) survey data do not really show any decrease in teen smoking that can be unambiguously linked to the policy change, whether in California or elsewhere with a Tobacco 21 law.  Teen smoking dropped nationwide from 2015 to 2017, and while it dropped somewhat faster in California, keep in mind that California also raised their cigarette tax significantly during that time, by $2.00/pack, and Pennsylvania saw an even larger drop in teen smoking despite keeping the age limit 18 and a cigarette tax hike of $1.00/pack, only half as large.

As we have noted before based on survey data for the past few years, there is really no robust correlation between a state or local smoking age (whether 18, 19, or 21) and the teen (or adult) smoking rate.  The strongest predictors of both teen and adult smoking are the tax/price of cigarettes and the prevailing social attitudes towards smoking, and in fact prices seem to have a larger effect on young people than adults.  It is practically axiomatic.  Retailer compliance is also inversely correlated with smoking by people under 18, but again it has proven to be entirely possible achieve nearly 100% compliance without raising the smoking age any higher than 18, as long as there is the political will for it.  And it doesn't even require the criminal justice system at all, since the best tobacco-control success stories involved only administrative penalties (i.e. fines and/or tobacco license suspensions) against rogue vendors.  Nor does it require criminalizing young people themselves.

If anything, if NYC is any indication, retailer compliance actually deteriorated following their age limit hike from 18 to 21 in 2014.  This was in spite of heavy crackdowns against contraband tobacco during that time.  In any case, while teen smoking rates declined in NYC following the law change, they did not drop any faster than the rest of the state or the nation as a whole, in fact they declined at a slower rate in NYC compared with the control locations, and teen vaping actually increased despite the fact that the law applied equally to e-cigarettes as well as combustible cigarettes.  If that's "success", we would really hate to see what failure looks like.

And in fact, this also once again calls into question how effective the 21 drinking age (and now toking age in some states) is as well.  Spoiler alert:  not very.  Thus, if there is a silver lining to the recent hike in the smoking age to 21 in some states and localities, it is that re-running this same failed social experiment with a different age-restricted psychoactive substance only to see it fail yet again in more modern times, a fortiori, is probably the strongest evidence against the very concept of such ridiculously high age limits in general.  If you give the pro-21 crowd enough rope...

What Really Happened After Raising the Smoking Age to 21? (Updated)

In 2014, New York City became the first major city in the USA to raise the tobacco purchase age to 21.  Prior to that, it was 18, much like the rest of the country.   The law was passed by Mayor Bloomberg at the end of 2013, and it went into effect in May 2014.

Since then, five states (California and Hawaii in 2016, New Jersey in 2017, and Maine and Oregon in 2018) and Guam (2018) have also raised it to 21 and numerous counties and towns/cities did so as well from 2013-2018, though a few localities had also done so earlier as well.  When Needham, MA did so in 2005-2008, there was much praise from the pro-21 crowd when surveys showed that teen smoking rates had dropped much faster in Needham than in its surrounding communities (which were 18) from 2006-2010.  So it is very curious indeed that no one seems to be talking about what happened anywhere else since they raised their own smoking ages to 21.

We think we know why.  At first glance, it does appear to have had some effect.  According to the CDC's Youth Risk Behavior Survey (YRBS), teen smoking rates did in fact drop from 2013 to 2015 in NYC:

2005   11.2%
2007   8.5%
2009   8.4%
2011   8.5%
2013   8.2%
2015   5.8%
2017   5.0%

Those are the percentages of combined 9-12 grade students who reported any current cigarette smoking in the past 30 days.  Looks impressive at first:  a relative 29% drop from 2013 to 2015.  But take a look at the same data for the nation as a whole, for comparison:

2005   23.0%
2007   20.0%
2009   19.5%
2011   18.1%
2013   15.7%
2015   10.8%
2017     8.8%

As you can see, the nation as a whole also saw a similar (if even faster) drop in teen smoking at the same time, with a relative 31% decrease from 2013 to 2015, despite no change in the smoking age in most places.  And the teen smoking rate in NYC was already much lower before the law change, having dropped more dramatically than the rest of the USA prior to 2007 and then remaining at a low level since.

How about San Francisco, another major city that raised its age limit to 21?

2005   10.9%
2007   8.0%
2009   10.4%
2011   10.7%
2013   7.5%
2015   5.4%
2017   4.7%

They also saw a similar size drop from 2013-2015, to the tune of 28% (vs. 29% in NYC and 31% in the USA overall).  Just one problem though.  San Francisco did not raise their smoking age until 2016, so these data show that the drop in the smoking rate happened while it was still 18, before the age limit was raised.  Thus, it would actually be part of the no-change control group, not the experimental group.  And if you include the decrease since 2011, San Francisco in fact saw more progress than NYC.  In fact, when we look at the 2017 data, we see that while the smoking rate continued to drop after San Francisco's age hike to 21 (and California's a month later), it seems to have dropped at a slower rate afterwards.

What about state-level data?  California's data from 2015 and 2017 show the following (the YRBSS has no state-level data for California before 2015 for this question):

2015  7.7%
2017  5.4%

That is a 29.9% drop, compared with an 18.6% drop for the nation as a whole for that two-year period.  But keep in mind that California also raised their cigarette tax by a whopping $2 per pack, effective April 1, 2017.  The YRBSS was taken after that, since the survey was done in the fall semester.  And cigarette taxes are well-known to reduce smoking, especially among young people, who are more price-sensitive.  Thus, California's smoking rate would have likely dropped just as fast without the age hike.

New Jersey has no post age-hike data yet.  But what about Hawaii, who raised their smoking age to 21 in early 2016 (but with no tax hike at all since 2011)?

2005   16.4%
2007   12.8%
2009   15.2%
2011   10.1%
2013   10.4%
2015   9.7%
2017   8.1%

Here we see a drop of 16.5% from 2015 to 2017, slower than the 18.6% drop for the nation as a whole.  Not very impressive.

And what about Pennsylvania, with no change in the age limit (18) but a $1 per pack cigarette tax hike in 2016, now just slightly below California's tax rate?

2009   18.4%
2015   12.9%
2017     8.7%

Here we see a drop of 32.6% (nearly a third) from 2015 to 2017, faster than the national drop of 18.6%, despite no change in the age limit and a tax hike only half the size of California's a year later.  In Philadelphia particularly it dropped by more than half, from 7.2% to 3.5% in those two years.  And the statewide drop from 2009 was likely at least partly a result of the federal cigarette tax hike that year as well.

Game. Set. Match.

Thus, we can conclude that the decrease in teen smoking in NYC and elsewhere following the hike in the purchase age was most likely NOT causally linked to it, and would most likely have occurred regardless given the above counterfactual data.  Kinda like we at Twenty-One Debunked initially predicted back in 2013 after first learning of the law change being proposed.  So if that wasn't the cause, what was?  Well, we know that nationwide, as well as in NYC, the secular trend for the past four decades (except a brief increase from 1992-1997) has been downward for both teen and adult smoking.  This was due to a general combination of education/awareness, taxation, regulation, and advertising restrictions, and the resulting cultural changes.  And in very recent years, electronic cigarettes have gained popularity as an alternative to combustible cigarettes, and in fact overtaking the latter and becoming at least twice as popular among high-schoolers by 2015.  Note that this was also true in NYC despite the 21 age limit applying to e-cigarettes as well.  And according to another CDC survey, the National Youth Tobacco Survey, the massive increase in vaping from 2011-2016 was in fact slightly outweighed by the decrease in combustible cigarette and cigar smoking, indicating a net displacement and substitution effect.

Interestingly, while the YRBSS did not ask about vaping until 2015, the data for 2015-2017 are quite instructive.  While the nation as a whole saw a modest but significant decrease in vaping from 2015 to 2017, California saw a smaller decrease than average and NYC saw a slight increase, as did Hawaii.  Likewise, Pennsylvania saw a larger than average decrease, which is not surprising given that they also significantly hiked their vape tax as well in 2016.  Though there are only two years of data, for 2017 these data are more reliable than the Monitoring the Future (MTF) survey since unlike MTF, there was no change in the question for the YRBSS.

Bottom line:  it looks like the supposed benefits of raising the smoking/vaping age to 21 were, shall we say, all smoke and mirrors.  The supposed success of Needham, MA was likely a statistical fluke and/or a result of endogeneity, much like the "early adopter" effects of the first few states to raise the drinking age to 21 creating that particular mirage in the 1980s.  Or perhaps increased enforcement in general relative to neighboring towns did the trick regardless of the age limit, like it did in Woodridge, IL and several other communities the 1990s with an age limit of 18.  Studies show that whenever vendor compliance exceeds 90-95%, there is indeed a dramatic drop in teen smoking regardless, by as much as 50% compared with previously weak enforcement and low compliance rates, especially for the youngest teens.

This all should be food for thought for policymakers debating not just the age limit for tobacco, but also for alcohol, cannabis, or anything else for that matter.  And even if such benefits of the 21 age limit were real, we at Twenty-One Debunked would still not support an age limit any higher than 18, on principle alone.  Old enough to fight and vote = old enough to drink and smoke.  'Nuff said.

California Dreaming? More Like Disappointing

While Twenty-One Debunked is pleased that the fifth largest economy in the world, California, has fully legalized cannabis for recreational use and even finally has legal weed stores, nearly half a year later the promise of booming tax revenue seems to have been a letdown thus far.  While any cannabis legalization is better than prohibition, and any tax revenue is better than zero, of course, it still seems to have fallen a bit short of the promises.

How so, you ask?  Let us count the ways:

1. Taxes are too high.  When all of the several different taxes are added in, it adds up to as much as 45% of the before-tax price in some municipalities. 
2. That is, of course, if you can even GET any legal weed at all in one's municipality of choice.  Local option means that many towns and cities have chosen to locally ban (or delay indefinitely) the implementation of full retail legalization.
3. And last but not least, the age limit is 21.

Add all these factors up and you have a recipe for a thriving, if smaller, black market for cannabis.  Especially since the original pre-legalization black market was not yet eradicated.  Had the Golden State started out with significantly lower taxes, more municipalities allowing retail cannabis stores, and an age limit of 18 (though the first two factors seem to be the most important), they could have easily eradicated the black market within a few years and then been able to raise the taxes on cannabis to even a much higher level than they are now without the black market coming back anytime soon.  That is basically what Rear Admiral Luther E. Gregory found out after the repeal of alcohol Prohibition in Washington State.  And it worked.

So, in a nutshell, here is how California can solve this problem:

1. Lower the combined taxes on cannabis to no more than $10/ounce (or 10%, whichever is lower) for the first year or two.  And make cannabis retail licenses cheaper than liquor and tobacco licenses.
2. Remove excessively strict levels of local option or at least provide incentives for municipalities to allow retail weed stores.
3. Lower the age limit to 18.  Yesterday.
4. Crack down on any vendors who are caught flouting any of the new laws, and blacklist violators from getting any retail licenses in the future.
5. After the first year or two (or three), jack up the taxes on cannabis to as much as $50/ounce at the cultivation level and additionally 10-15% at the retail level.  Or make the tax proportional to THC content.

Problem solved.  Next.  But of course, that would make far too much sense, right?

Oh, and as long as we are talking about taxes, keep in mind that California's alcohol taxes are below the national average.  Raising those taxes would be a good place to start if they want more revenue quickly.

At least America's friendly neighbor to the north will not be repeating our mistakes.  Taxes in Canada will start out quite low, and the age limit will be 18 or 19 depending on the province.  Watch their economy boom faster than you can say, "O Cannabis!"

California Dreaming Has Finally Become A Reality

It seems that there was one silver lining to an otherwise disappointing election:  California, Nevada, Massachusetts, and Maine legalized cannabis for recreational use, joining Colorado, Washington, Oregon, Alaska, and DC, while a few other states such as Florida joined the already numerous states in which medical use is currently legal.  And it is only a matter of time before it becomes legal nationwide.

We at Twenty-One Debunked have mixed feelings about the legalization initiatives, primarily since all of them set the age limit at 21 rather than 18, among other flaws.  But those flaws can be ironed out after the fact.  And cannabis legalization is LONG overdue, so Twenty-One Debunked grudgingly supports these initiatives, as they probably would not have passed otherwise.  Going forward, we will work to get the age limit lowered to 18. 

Vote Green, Not Brown!

We at Twenty-One Debunked just seriously lost some respect for California, a state that we, until fairly recently, regarded as one of the least-worst states in the country (though the bar is set rather low to begin with) in terms of social policy in general.  Looks like the Golden State just joined Hawaii, NYC, San Francisco, and a growing number of localities in this country in raising the purchase age for tobacco to 21, with Governor Jerry Brown (remember him?) signing it into law on May 4, 2016.   The law change takes effect on June 9, 2016, just a few weeks later, when the age limit will rise from 18 to 21 overnight without even so much as a grandfather clause.  Brown also signed other bills on the same day restricting e-cigarette use (i.e. "vaping") in public and expanding the coverage of various no-smoking zones, among other things, but the one that really stood out the most (and rankles the most with us) is the 21 smoking age.  The one exception:  active-duty military members age 18-20 can still buy cigarettes and other tobacco products.  But this exception is a rather hollow way of addressing the fundamental injustice of being old enough to die for one's country but being too young to smoke (or drink for that matter), and doesn't make things much better.  So even with this exception, Twenty-One Debunked still opposes this new law regardless.

Hopefully, there will be a ballot measure in November that will undo the hike in the smoking age.  Until then, though, we might just want to boycott all things from California whenever possible.  That includes major Hollywood movies (which still feature omnipresent product placement from Big Tobacco) and fruits/vegetables grown with fracking wastewater thanks to the very same Governor Jerry Brown.  VOTE GREEN, NOT BROWN!!!

California Passes Social Host Law

Much to the chagrin of 21 Debunked and all those who love liberty and oppose the 21 drinking age, today California joined the majority of states and passed a social host liability law.  This means that if you furnish alcohol to someone under 21 and they happen to get killed or injured, you can be sued, and there appear to be no limits on how much you can be sued for. 

We have already discussed in previous posts why we oppose such laws.  First of all, it is just another attempt to prop up the greatest alcohol policy failure since Prohibition, the 21 drinking age.  Secondly, 18-20 year olds are legal adults in all other ways, and should be responsible for their own actions, drunk or not.  Third, such laws have not been proven to save lives, and would probably just force alcohol even further underground, leaving party hosting to only the bold and reckless. Finally, in a country without meaningful tort reform, it will enrich greedy trial lawyers while causing many families to possibly even lose their homes in lawsuits, as social host awards are typically in the millions of dollars.  We can just see them salivating like Pavlov's dog at the prospect.

We at 21 Debunked feel that suing the host (who is at most only peripherally involved, by definition) because the drunk driver does not have deep enough pockets is really quite low to say the least.  Parasitic even, especially when the dollar amounts are ludicrously high as they usually are.  The worst of all are those stupid drunk drivers who sue the host for their own injuries, a group for whom we have no sympathy.  Thus, we do not support social host laws of any kind.  But we do think that drunk drivers of any age who kill or seriously injure others should be sued for everything they have and, if that is still not enough to cover the damages, be forced to work off their debt in prison the rest of their lives.

Interestingly, social host laws (as well as dram shop laws, which are the same thing only applied to bars/restaurants instead) appear to exist in only two countries, the USA and Canada.  We Americans are well-known for our ethic of hyper-individualism, as opposed to a more communitarian or "brother's keeper" ethic found in most other countries, including many in Europe.  Thus, America is the last place one would expect to find such laws, but for some reason it is almost the only place they are found.  Perhaps the fact that our society is so litigious compared to the rest of the world, and increasingly so, is at least part of the reason.  Or maybe it is for the same asinine reasons that the drinking age is arbitrarily set at 21, a full three years higher than the age of majority.  Whatever the reason, such laws are un-American, obsolete, and incompatible with the values upon which our nation was founded, and should thus be stricken from the books at once.