Tobacco 21 Laws' Benefits Are An Illusion

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

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

Case Closed: Tobacco 21 Laws Don't Work

The latest study of Tobacco 21 laws shows they were a resounding....DUD in terms or reducing young adult smoking, vaping, or smokeless tobacco use rates in the USA.  Being published in a famously anti-tobacco journal, Tobacco Control, the authors of course wanted to put a positive spin on it though nonetheless, as shown below (emphasis ours):  

Results Although we did not find evidence that state T21 laws were associated with cigarette, smokeless tobacco or ENDS [i.e. vapes] use overall, the federal T21 law was associated with lower use of all three tobacco products by 0.39–0.92 percentage points. State flavour restrictions were associated with lower use of cigarettes by 0.68 (−1.27 to –0.09) and ENDS by 0.56 (−1.11 to –0.00) percentage points, but not with smokeless tobacco. A three-way interaction revealed that state and federal T21 laws together were associated with a lower prevalence of ENDS use among 18–20 years, but there were no differences in cigarette use from both policies combined versus either alone.

Conclusion State and federal T21 laws are broadly effective at reducing adult tobacco use, while state flavour restrictions specifically lower use of cigarettes and ENDS.

Got that? The state level laws were useless, period, but the federal Tobacco 21 law passed in December 2019 was somehow "broadly effective" because it appeared to trivially reduce tobacco/nicotine product use by not even a full percentage point.  Never mind that that latter was not enforced until well into 2020, enforcement still remained spotty for a while, and that its passage coincided with two major confounds:  1) the EVALI (vaping illness) outbreak that, while clearly due to adulterated black market THC vape products, was fearmongered by the mainstream media to include all vape products, and 2) the COVID-19 pandemic that, for better or worse, seemed to discourage smoking and encourage quitting, since many people feared that smoking made them more vulnerable to the virus.  But no, it HAD to be due to the Tobacco 21 law, because reasons.  Or something. 

Even flavor restrictions were more effective than Tobacco 21 laws!

So how many IQ points did YOU lose from the mental gymnastics of reading all for the above quoted article abstract beyond the stuff in bold?  The study was behind a paywall of course, so we couldn't delve further into it, granted.  But even a cursory reading of the abstract shows that the Tobacco 21 laws are a joke, and not a very funny one at that.  And worse, it may have even driven some young vapers (back) to smoking, which would clearly be a net public health loss.  But try convincing the zealots of that!

These unimpressive findings dovetail nicely with other studies as well.  As for whether raising the tobacco/nicotine age limit from 18 to 21 reduces the use of such products among people under 18, the evidence for that is very weak and mixed at best.

As for the few previous studies that did appear to find statistically and practically significant effects from the Tobacco 21 laws, those apparent results are most likely a result of short-term effects as well as an artifact of confounders like cigarette tax hikes.  

(Cigarette tax hikes, which mean higher prices, are in fact one of the most effective and cost-effective ways to reduce smoking at the population level, though they still have their limits of course.  And while they may be classist, at least they are not ageist, and they don't blatantly violate anyone's civil rights.)

Regardless, even if Tobacco 21 laws were ever proven to be effective, Twenty-One Debunked would still oppose them on principle, as we believe that in a free society worthy of the name, civil rights inherently supersedes "public health".  That is true in regards to tobacco, alcohol, cannabis, or anything else.  

(Mic drop)

UPDATE:  A few older studies have found modest but significant decreases in retail tobacco sales following the raising of the smoking age to 21 in early adopter states like California and Hawaii.  And another study found no change in overall ever or current smoking among California 18-20 year olds, but did find a modest decrease in daily smoking among that age group relative to 21-23 year olds (whose daily smoking actually increased three years later) in the same state.  This of course echoes Miron and Tetelbaum (2009) as well as Asch and Levy (1987 and 1990), Males (1986), and Dee and Evans (2001) in regards to the 21 drinking age.  That is, endogeneity, early-adopter effects, short-term effects, and seesaw/delay effects all appear to be at play here.  The supposed miracle turned out to be a mirage all along, in other words.  Thus, especially in light of the most recent study discussed in this article, there were really no benefits that cannot be alternatively achieved with higher cigarette taxes and/or better enforcement of the previous 18 age limit, and if anything the 21 age limit appears to be counterproductive in the long run.

UPDATE 2:  Even the CDC's very own 2022 study found mixed and ambiguous effects of Tobacco 21 laws, and such effects sometimes even appeared to differ by race as well (in favor of whites, with null or even perverse effects on young people of color).  Oops!

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

Why Banning Tobacco Is A Dumb Idea

The stupid literally burns like, well, cigarettes.  It's apparently hard to keep a bad idea down.  While New Zealand's new government is backing off from the previous government's phased tobacco ban and plans to reverse it, as Malaysia already did as well, the UK government under Rishi Sunak now wants to implement such a phased ban for anyone born after 2008.  Even Bhutan lifted their tobacco ban in 2021, as it was such a massive failure due to the massive black market it created.  (Hey, somebody answer the Clue Phone, as it is ringing loud and clear now!)  So should they go through with it, the UK now stands alone in the modern (or even semi-modern) world, leaving them in the good company of...wait for it...the Taliban and ISIL in that regard.  Only difference being that the UK is simply taking the scenic route there instead of simply making a beeline for it.  Gee, how very enlightened and progressive of them.

Hey, don't go getting any ideas, California, or any other state for that matter!  Seriously. 

Smoking tobacco, especially in this day and age, is dumb, but banning it is even dumber.  People who fail to learn from history are doomed to repeat it.  Prohibition didn't work then, and it doesn't work now.

Boris Johnson Talks Some Sense For Once

Here's a good one from across the pond: 

Former Prime Minister of the UK, Boris Johnson, recently wrote an good article in the Daily Mail in which he actually talks sense for once.  Or at least, for the very first time since before that fateful day on March 22, 2020.  In his article, he strongly and very rightly criticizes the government's proposal to implement a New Zealand style generational smoking ban (that is, a lifetime smoking ban on anyone born after some arbitrary point in time).  He goes right to the heart of just how ridiculous the whole thing is.  And of course, we at Twenty-One Debunked also strongly oppose such an idea, not least because it is essentially the most extreme version of the very sort of fundamentally ageist policies that we despise.  

It basically raises the age limit (currently 18 in the UK) by a year every year, and of course we oppose 100% any attempt to set the age limit higher than 18.  While Twenty-One Debunked does not recommend that anyone of any age take up smoking or otherwise using tobacco, as it is a very foolish and dangerous habit with practically no objective benefits, we still believe that legal adults should have the right to do what they will with their own bodies and minds.

Of course, the proposed ban's defenders would likely claim that Johnson is being hyperbolic in his criticism.  Truly, no one is calling for the newly disenfranchised smokers themselves to be arrested or otherwise punished for smoking, right?  It's only the sellers of tobacco to people born after that arbitrary date who will actually be on the hook, right?  Well, as history has infamously shown with less extreme age limits for other substances and/or in other places, there is absolutely no guarantee of that, especially when the measure isn't nearly as quick or effective as initially hoped for, and the zealots inevitably begin to get impatient.  And even if penalties are limited to sellers, it's still utterly ridiculous at best, and an unjust infringement of civil rights at worst.

Perhaps old Alexander Boris de Pfeffel Johnson is at least somewhat redeemable after all?

Cannabis Legalization Does NOT Increase Tobacco Use

A recent study pours cold water on another prohibitionist fear, namely that legalizing cannabis for recreational use will lead to more tobacco use via a "reverse gateway" effect.  Well, the study found the opposite:  a slight decrease in tobacco use as well as e-cigarette use.  While the decrease did not quite reach statistical significance, it was lagged and perhaps builds over time.  And at the very least, it certainly puts the lie to the tired old "reverse gateway" theory.

Thus, another myth bites the dust.

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.