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?

Do Tobacco 21 Laws Really Work?

A recent study claims that Tobacco 21 laws work to reduce teen tobacco use.  But upon closer examination, there is less here than meets the eye.  While this new nationwide study controlled for a host of other variables and spanned from 2012-2019, it still leaves the reader with more questions than answers.  

For example, the supposed effect in survey data in grades 8, 10, and 12 was statistically significant for combustible cigarettes, particularly for grade 12, but NOT for vape products at any grade level, while for the Nielsen sales data the apparent effect was much larger for vape products than combustible cigarettes.  How exactly can this glaring contradiction be explained away?  Also, no significant effect was observed on heavy smoking, which intuitively should have had the largest effect size of all due to heavy smokers facing the greatest "hassle costs" when cigarettes become even somewhat more difficult to obtain.  And even for cigarette smoking in general, the absolute difference-in-differences was a few percentage points at most, for a substance whose popularity and prevalence was already declining among all ages long before the age limit was hiked to 21 (in contrast to vaping, which increased dramatically among young people during this period).

Furthermore, the study did not look beyond the first two years post-enactment of such laws, so any observed effects may very well be merely short-term effects (cf. Miron and Tetelbaum 2009 for the 21 drinking age and alcohol-related traffic fatalities).

Interestingly, the study authors do concede that at least some of the observed effect on people under 18 is a result of increased ID checking and increased perception of risk of of tobacco products.  Of course, we know that it is not really necessary to raise the age limit higher than 18 to achieve such effects.

Overall, this nationwide Tobacco 21 study (the second of its kind) was rather less impressive that an earlier nationwide study by different authors, for reasons that are not entirely clear.  But it is very likely a repeat of what we like to call "The Incredible Shrinking Effect Size", a phenomenon that we have seen before with studies of the 21 drinking age over time.  Which means that it was most likely a statistical mirage all along, at least in the long run.

Regardless of what sort of effects, or lack thereof, that Tobacco 21 laws supposedly had, we at Twenty-One Debunked nonetheless oppose such laws on principle 100%, just like we oppose the 21 drinking age and toking age as well.  Let America be America Again!

UPDATE:  A recent pro-21 article made a Freudian slip about what happened since Texas raised their smoking age to 21 in 2019:

"Since then, the use of tobacco by teens decreased from 21.8% in 2019 to 19.1% in 2021, according to the CDC and the American Lung Association."

That is NOT a particularly large difference in teen tobacco use (which includes both smoking and vaping), especially since teen vaping had already peaked by 2019 and teen smoking had already been plummeting for decades.  Technically, the latter data were from the 2020 Texas School Survey, not 2021, and the 2019 data were from the CDC YRBS, as each survey is done only every other year.  But either way, the point still stands.  In fact, when compared to the 2018 TSS data, the 2020 TSS data are almost identical.

2023 UPDATE:  The study in question has been recently revised, but not in a way that materially alters any of the above conclusions or criticisms.  In fact, reading between the lines, not only does the results look even less consistent and statistically significant than before, but now the effect size on survey results seems to be much larger for vaping than for smoking at all grade levels, implying that some vapers have likely switched to smoking.  That makes the Tobacco 21 policy a net public health loser.

2024 UPDATE:  A 2021 study of California, one of the first two states to implement a statewide Tobacco 21 law in 2016, showed weak and unimpressive numbers in a difference-in-differences analysis.  Womp womp.

Pennsylvania Raises Smoking Age To 21

It's official, Pennsylvania just raised the legal age limit for tobacco products from 18 to 21, effective July 1, 2020, making them the 19th state (and counting) to do so.  And the new law also expands the legal definition of tobacco products to include vaping products as well, since apparently they didn't even have an age limit for vaping products at all (though the federal age limit of 18 applied by default from 2016 onwards).

The part about including nicotine vapes in the definition of tobacco products is totally reasonable.  But raising the age limit to 21 is really not justified at all.  And Pennsylvania had been seeing so much progress in reducing teen smoking and vaping already, mainly due to tax hikes on both.  It would really be a shame to risk derailing such progress now with such an utterly illiberal and ageist law.

Yes, there is an exception in the new law for active military and veterans, who only need to be 18 or older instead of 21 to buy tobacco products.  But that one silver lining does still not make it OK to deny adult rights to otherwise legal adults over 18 who are legally old enough to join the military, regardless of whether they are actually in the military or not.  Thus, the exception does not actually resolve the inherent ageism and hypocrisy of this otherwise bad law.

I like to joke about "the other Tri-State Area", where NY, NJ, and PA all meet.  Port Jervis, NY, Montague, NJ, and Matamoras, PA are all right next to each other, and Matamoras is basically "come for the fireworks, stay for the cigarettes", since fireworks are legal in PA to sell to nonresidents, cigarettes are cheaper in PA, and the age limit in PA for tobacco has been 18 (until July 2020) while it is 21 in NY and NJ.  Looks like the tobacco part of that equation will no longer be true, at least the age limit part, and the price difference is also narrower now for cigarettes, and reversed for vape products, due to the tax hikes.  And gas is also more expensive now in PA than either of the other two states, while NJ gas is almost as pricey as NY now.  Thus the whole microeconomic dynamics of "the other Tri-State Area" are fundamentally different now, except for the fireworks of course.

New Tobacco 21 Study Leaves Us With More Questions Than Answers

A new and very preliminary study of recently-passed Tobacco 21 laws appears to find that such laws significantly reduce tobacco smoking (both recent smoking and current and established smoking) by as much as 39% among 18-20 year olds.  The study looked at survey results of 1869 18-22 year old young adults in 2016-2017 in 48 states and DC (excluding New York and Massachusetts), and compared those in states and localities that raised the tobacco age to 21 versus those that did not, and further compared 18-20 year olds versus 21-22 year olds, after adjusting for potential confounders such as cigarette taxes as well as demographics and parental and peer smoking.

However, there are still reasons to be skeptical of these findings:

• Correlation is not causation, and there may still be selection bias, reporting bias, and residual or unmeasured confounding.
• Only a few states and localities had an age limit of 21 for tobacco in 2016-2017, especially when New York and Massachusetts are excluded.
• In some of these few Tobacco 21 states/localities, the number of individuals surveyed was in the single digits.
• Even if these results are 100% due to the hike of the age limit to 21, the study may only be measuring short-term effects since the laws are so recent and only data from 2016-2017 were used.  More longitudinal data are needed.
• Such "early-adopter" effects may not be generalizable or durable, as we saw with the 21 drinking age according to Miron and Tetelbaum (2009).
• Data were collected from November 2016 through May 2017, and yet New Jersey was listed a Tobacco 21 state even though their law didn't go into effect until six months later in November 2017.  Thus, we noticed at least one potential coding error.
• California raised the cigarette tax significantly as of April 1, 2017, within the period of the study.  And Illinois and Chicago have raised their cigarette taxes several times in the years before and after Chicago's Tobacco 21 law that was implemented in 2016.
• Smoking was already on the decline nationwide long before any Tobacco 21 laws were passed, and the data are not adjusted for pre-existing trends.
• Vaping was not examined in this study, and in any case all of the data was from before the JUUL craze came on the scene.
• And most importantly, the study did NOT look at people under 18 at all.

Thus, these results are preliminary at best and need to be taken with at least a grain of salt, if not a whole pound.  Especially since, as we previously reported, according to the YRBSS data there is really no robust correlation between high school smoking or vaping rates and whether the smoking/vaping age is 18, 19, or 21.  And even in this new study of 18-22 year olds, the effects were limited to only those who had already tried cigarettes before, and that typically occurs well before 18.  But wait, isn't the strongest pro-21 argument that Tobacco 21 laws would reduce smoking (and vaping) among people under 18?

And for what it's worth, there is no evidence that Tobacco 21 laws (all of which now apply equally to vape products, by the way) have done anything to reduce the JUUL craze that began in very late 2017 and apparently continues unabated to this day in all states and localities regardless of the age limit.

Also, it just so happens that yet another recent and preliminary study was done, this time longitudinally using BRFSS data of 18-20 year olds from 2011-2016 compared to 23-25 year olds, and comparing the local tobacco age limits by metropolitan/micropolitan statistical area (MMSA).  This study, which was driven by even earlier adopters (mainly city and county-level Tobacco 21 ordinances), did find statistically significant reductions in current established smoking by 18-20 year olds that were not found for 23-25 year olds.  But the devil is really in the details, since the effect size was rather small (1.2 percentage points, and at most 3.1 percentage points in some models) for practical purposes, and may still have been driven by reporting bias, selection bias, and/or differential sensitivity by age to tobacco tax hikes at the same time.  And given how effect sizes for later adopters of any given policies tend to shrink over time compared to earlier adopters, these results do not look particularly encouraging.  Especially since a cursory look at the trendlines in the study finds that the slight divergence in smoking rates that emerges in 2014-2015 re-converges and essentially disappears by 2016, suggesting that the findings are likely driven by short-term effects rather than longer-term effects.

Bottom line:  it looks like the supposed benefits of raising the smoking/vaping age to 21 were, shall we say, all smoke and mirrors, at least for people under 18.  The supposed success of Needham, MA, for example, 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.  More recent research bears this out as well, for teen smoking as well as vaping.   And keep in mind that those who make it to 18 without smoking are far less likely to take up this deadly habit later on.

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.

What Does Big Tobacco Really Hate? Hint: It's NOT Tobacco 21 Laws

Clearly, Big Tobacco (including the quisling JUUL Labs who sold out to them) does NOT oppose raising the age limit for tobacco and vaping products to 21.  In fact, they now openly support Tobacco 21 laws, including the latest attempt at the federal level.  It appears to be a cowardly, treacherous Trojan horse to scuttle and pre-empt any laws that they oppose.

But what laws and regulations DO they really, really vehemently oppose these days?  That is the real question here and the answer is:

• Higher tobacco taxes of any kind, especially on cigarettes but also on other tobacco and vaping products as well.
• Flavor bans of any kind, whether menthol cigarettes, flavored cigars, or fruity and candy flavors for vape products.

And it is very telling indeed that they oppose those laws so vehemently.  Additionally, as far as age limits go, they also historically have preferred purchase-use-possession (PUP) laws over sales-to-underage (STU) laws, since the former put the onus on young smokers/vapers themselves while the latter put the onus on vendors, and Big Tobacco really HATES the latter even if they pay lip service to it. This has been true with an age limit of 18, and probably will still be their quasi-official stance under an age limit of 21.

Given what we know about what Big Tobacco likes and dislikes, it should be pretty obvious how to combat them effectively.  Don't take the Tobacco 21 bait, Congress!  Keep it 18, and enforce it better by strengthening the Synar Program for retailer compliance checks, ban kid-friendly vape flavors, consider banning menthol cigarettes, cap nicotine levels of vape products down to European and Israeli levels, phase down nicotine levels in cigarettes to a non-addictive level, and raise the taxes on tobacco products (and add a more modest vape tax too).

To sum up Big Tobacco's thought process:

• Raise cigarette or other tobacco or vape taxes?  HELL NO!
• Flavor bans?  HELL NO!
• Restrictions on nicotine content?  HELL NO! 
• Raise the age limit for tobacco and vaping products to 21?  HELL YEAH!

Remember, anything that Mitch "Awkward Turtle" McConnell (and Big Tobacco) supports has to have some sort of sinister ulterior motives.  Twenty-One Debunked opposes raising the age limit any higher than 18 on principle, regardless of why they want to do it.  But now add in this sinister Big Tobacco dimension and it only becomes all the more repugnant overall.  It truly must be opposed.

Awkward Turtle! Mitch McConnell Wants To Raise Federal Tobacco And Vaping Age To 21

In 2019, there seems to be one thing that Big Tobacco, JUUL Labs (which sold out to Big Tobacco), most anti-tobacco groups, Sen. Elizabeth Warren (D-MA) and Sen. Majority Leader Mitch "Awkward Turtle" McConnell (R-KY) can all agree on.  And that thing is a federal Tobacco 21 law that raises the sale age limit for all tobacco and vaping products to 21 nationwide.  Politics certainly does make some very strange bedfellows indeed!

This would require an act of Congress, of course, as the FDA is explictly denied (as they should be!) the authority to raise the federal age limit any higher than 18.  And unlike the drinking age where the feds had to make an end-run around the Constitution to coerce states to raise their drinking ages to 21, this time they will not have to do so and can simply set a federal age limit of 21.  They already set a federal age limit of 18 as of 2009, so that law can very easily be amended.  Crucially, this law  only applies to the age limit for sales, and only sellers are targeted and penalized (unlike the drinking age in which public possession by young people is an offense), so this is still within Congress’s authority.  

Except, of course, for the substantive due process and equal protection argument invoking the 14th Amendment, since the age limit would be higher than the age of majority, but that is a separate issue from state's rights and the 10th Amendment.  And that can potentially be challenged in court, albeit as a VERY uphill battle.

Thus, this bill is likely to pass, unfortunately.  Write your Congresscritters and convince them to oppose it.  And point out all of the other things they can do instead:

• Raise the federal cigarette tax, apply it to the producer level, and set a national price floor to discourage interstate smuggling.
• Create a federal vape products tax on all nicotine-containing vape juices and pods, ideally proportional to nicotine content.
• Ban fruity and candy flavors in any nicotine-containing product.
• Cap the nicotine content of vape products down to European and Israeli levels.
• Give out free nicotine patches, gums, inhalers, etc. to any smokers who want to quit (NYC already does this.)
• Consider gradually phasing down the maximum allowable nicotine content of combustible cigarettes to a non-addictive level.
• Consider gradually phasing out menthol cigarettes like Canada did and the EU is in the process of doing.
• And last but but not least, enforce existing laws better in terms of the current 18 age limit for tobacco and vaping products.  In fact, amend the Synar Amendment and Program to raise the passing grade for retailer compliance checks from the currently low bar of 80% to 90% and then 95%, and include vape products.  

But do NOT raise the age limit any higher than 18.

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.

Oh, and about Chicago's supposed success, keep in mind that raising their age limit to 21 in 2016 was not the only new tobacco control law passed around that time in the Windy City.  And the cigarette taxes there also went up significantly shortly before the age limit hike to 21 as well.  Thus, there were too many variables to really tease out the effect of the Tobacco 21 law on teen and young adult smoking rates.

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...