Latest California Smoking Age Study More Smoke Than Fire

Last month, a new study looking at the results of California's smoking age hike from 18 to 21 in 2016 turns out to be less than meets the eye.  The study, looking at BRFSS survey data for 18-20 year olds pre versus post implementation, found that, compared to 21-23 year olds in California and to 18-20 year olds in the eight comparison states, 18-20 year olds did not see any significant change in the rate of decline of current or ever smoking, but did see significantly faster declines in the rates of daily smoking in the three years after the age limit was hiked to 21 versus before implementation.  Interestingly, vaping was not examined at all due to apparent data gaps at the time, so this study says absolutely nothing about vaping.

While the part about daily smoking sounds impressive on the surface, one should keep in mind that cigarette taxes were hiked by $2.00/pack in 2016 (effective April 2017), and generally the younger a person is, the more price-sensitive they are since they tend to have less disposable income, and furthermore the earlier they are in the course of their tobacco habits.  So it would stand to reason that the tax hike alone, which makes regular and especially daily smoking that much more of an expensive burden on the smoker, would have had a larger impact on 18-20 year olds than 21-23 year olds in California.  That would also explain why current or ever smoking (which were essentially not affected at all) would be much less affected than daily smoking as well.  

Of note, Pennsylvania had also raised their cigarette tax in 2016 yet still kept their age limit at 18 (until July 2020, that is), yet interestingly that state was NOT one of the eight comparison states.  The results of this study would thus likely have been very different if Pennsylvania was one of the comparison states.

Alternatively, some of the progression to daily smoking may simply have been delayed by a few years by the age limit hike, yielding no real long-run benefits, kinda like some studies have strongly suggested about drunk driving deaths when the drinking age was raised to 21.  Indeed, by 2019 the daily smoking rate among 21-23 year olds was actually a bit higher than it was in 2016.

And as we have previously noted, in NYC and elsewhere, raising the smoking age to 21 does not seem to actually reduce high school smoking rates compared with keeping it 18, so the "trickle-down" theory that is often used as a specious justification for Tobacco 21 laws is very unlikely to be the case in California (or anywhere else) either.

Thus, this study is more smoke than fire.  And regardless, we at Twenty-One Debunked would still oppose the 21 smoking age on principle regardless of its effects.  Young adults who are old enough to go to war, be tried as adults, etc. should NOT have the state dictating what otherwise legal substances they choose to put into their own bodies at all, period.  Seriously.

And that is a hill we will die on.

Et Tu, DeSantis?

Florida's controversial Governor Ron DeSantis (R) has been a bit of a mixed bag overall.  The True Spirit of America Party (TSAP) is, to put it mildly, not exactly a fan of Republicans in general and Trump supporters in particular, but has nonetheless generally agreed with his light-touch, focused protection handling of the COVID-19 pandemic, which has actually yielded a lower cumulative per capita death rate than the national average (and much lower than several lockdown states) despite Florida's significantly older and fatter population.  And in terms of excess all-cause mortality, wide-open Florida even did better than the overall strictest state of all, California.  There are some bad things about DeSantis of course, such as his latest Georgia-style voter suppression efforts and his heavy-handed and poorly-written anti-rioting law that arguably throws out the proverbial baby with the bathwater, but generally he is not too terrible by current low-bar Republican standards.

And of course, Twenty-One Debunked in particular has supported the fact that he was one of the most prominent holdouts in keeping the legal smoking age at 18 despite the trend towards raising it to 21 at the local, state, and eventually federal levels.  After all, he has previously opposed and vetoed every single attempt to raise Florida's smoking age any higher than 18.  Well, until now, that is.  Like most other governors, as of today, DeSantis has officially SOLD OUT and signed into law a bill that raises Florida's smoking and vaping age to 21, effective October 1, 2021.  True, this new law does have an exemption for military service members aged 18-20, making it a shade less bad than some other states, but we still oppose this law on principle like we oppose all inherently ageist Tobacco 21 laws, period.

One could argue that any state law that sets the age limit below 21 is effectively void since the federal smoking age has been 21 since December 2019, but that is beside the point.  A state that chooses to remain 18 in spite of the federal Tobacco 21 law is a principled state with integrity, and is at the very least NOT helping the federal government enforce such an ageist abomination.  Today, Florida lost that status.

DeSantis is now the 34th governor to raise the age limit for tobacco and vaping to 21, bringing it to now more than two out of three states who set it at 21.  With "allies" like him (and Trump, who raised the federal age limit to 21), who really needs enemies?

What About Tobacco, Again?

The Biden administration is currently considering two new sweeping FDA rules affecting combustible tobacco cigarettes:  1) banning menthol cigarettes and flavored cigars, and 2) reducing nicotine levels, presumably to a non-addictive level.  Where we stand on these two potential changes is as follows:

The first one, Twenty-One Debunked is on the fence about that, as we can see both sides of that issue, noting that Canada has already banned menthols and the EU has phased them out, while also noting the inconvenient truth of racism and how it intersects with this issue as well.   The flavored cigars we generally lean against banning, while for menthol cigarettes we believe that if they must do it for whatever reason, they should phase them out more gradually and allow existing stocks to be sold well after the designated "quit date" for selling newly manufactured menthols.  Also, possession and consumption of menthols should NOT be banned or punished, and police should NOT go out of their way to target the sale of menthols or "loosies" in underprivileged neighborhoods with people of color.

(For what it's worth, quit rates in Canada have improved significantly since their menthol ban, particularly among formerly menthol-preferring smokers.  That lends credence to the idea that menthol enhances the overall addictiveness of tobacco by making the high nicotine levels less harsh on the throat, which also makes it easier for young experimenters to pick up the habit in the first place.)

The second one, reducing nicotine levels, Twenty-One Debunked has cautiously supported since 2014, and we still do, provided that all of the following are true:

• The phasedown of nicotine to a non-addictive level is done gradually and stepwise over a period of at least a year, in at least three stages.
• The sale of existing domestic stocks of cigarettes above the nicotine cap can continue at least six months after the "quit date" for manufacturing and importing cigarettes above that cap (at each step of the phasedown).  
• The possession/consumption of cigarettes with nicotine levels above the cap is NOT banned or punished.
• The only other tobacco products subject to the same cap shall be little cigars (below a certain size), perhaps all cigars with a smoke pH below 8, and possibly loose roll-your-own cigarette tobacco and/or pipe tobacco with a pH below 8.  Nothing else, period.  We would be fine with, and would actually prefer, if only pre-rolled commercial cigarettes and little cigars (the size of cigarettes) were subject to the nicotine cap.  
• The addition of any harmful or addictive additives to all newly manufactured tobacco products is banned effective immediately as well.  All additives must meet the same standards as for additives to food.  Radioactive fertilizers for growing tobacco must also be banned as well.

While the effectiveness of the flavor ban is a bit questionable at best, the nicotine cap and phasedown would likely greatly reduce the prevalence of tobacco smoking and associated disease and death, simply by making this conveniently deadly product by design far less addictive.  More people would quit fairly quickly, and fewer people would take up the habit in the first place.  And people who miss the old high-nicotine smokes of yore would still be free to use alternative tobacco and nicotine products.

And doing it gradually enough will make it so there is no more of a black market for higher-nicotine cigarettes than there is for incandescent light bulbs.

As for vaping, Twenty-One Debunked does not support such a massive reduction in nicotine levels to that proposed for combustible cigarettes, but rather we support reducing the nicotine content in vape products to the maximum levels permitted in the EU, UK, and Israel.  That would nix the super-addictive ones that notoriously get young people hooked within seven days (JUUL, we're looking at you!) while still allowing plenty of nicotine for adult vapers who are trying to quit smoking.  (Twenty-One Debunked does NOT recommend anyone take up vaping, except as a last-ditch effort for truly hardened and refractory adult smokers who cannot quit any other way.)

Of course, we also think the smoking age should be lowered back to 18, just like we feel about the drinking age and toking age.  We are not called Twenty-One Debunked for nothing, after all.  Raising the age limit to 21 was at best useless, and is an ageist abomination.  In the meantime, though, the above is our nuanced and well-thought-out stance on the latest tobacco-related measures being proposed. 

FINAL THOUGHT:  By the way, the fact that they use the "think of the children!" argument to justify the banning of menthols and flavored cigars, is really just a tacit admission that raising the smoking age to 21 was essentially useless in keeping cigarettes and cigars from "trickling down" to people under 18.

The Kids Are Still (Mostly) Alright in 2019

The latest 2019 Montoring the Future survey results are in.  And while the mainstream media are hyping this year's significant increase in teen vaping (of both nicotine and cannabis), they seem to be glossing over the good news.  For example, teen alcohol and (combustible) tobacco use have both plummeted to record lows, prescription drug abuse (especially opioids and amphetamines) is way down (in contrast to adults), and nearly all other substances (even heroin, again unlike adults) have held steady this year at relatively low levels compared with previous decades.  The one notable exception is LSD (acid), which showed a modest increase this year, but still remains far lower than it was before 2000.

Even cannabis use in general held steady overall this year, and while "daily" (i.e. 20+ days/month) use did see a modest increase this year for grades 8 and 10, in grade 8 it was no higher than it was in 2011 (prior to recreational legalization in any state) and is still quite low.  And keep in mind that for grades 8 and 10, data only go back to 1991, unlike grade 12 which goes all the way back to 1975. Thus, one can extrapolate based on grade 12 data that "daily" use for grades 8 and 10 are also both most likely far lower than they were in the late 1970s and early 1980s, as we know to be the case for grade 12.  And actual, true daily use (i.e. literally every day) is likely even lower still as well.

Even the vaping data are a bit outdated now, since the MTF survey was taken in the spring of 2019, at least several weeks or months before the new "mystery" vaping illness (now called EVALI) outbreak was suddenly announced during the summer.  Since then, the widespread fear of this scary but fortunately now-waning epidemic has likely reduced the popularity of vaping in general, so next year's data will likely be significantly lower than it was in early 2019.

Additionally, the data from another survey, the NSDUH, show that past-year and past-month cannabis use in general has been stable or declining for years for 12-17 year olds nationwide, even as it has been modestly and steadily rising for both 18-25 and 26+ year olds in recent years, and as it has become increasingly legal and socially acceptable to use cannabis and admit to doing so.  The same survey also finds that rates of cannabis use disorder (i.e. abuse/dependence) have been steadily declining for 12-17 year olds since the pre-legalization era, and have been relatively stable for 18-25 (undulating plateau) and 26+ year olds (flat) overall since 2002.

But don't expect the fearmongering mainstream media to tell you that, of course.

The Federal Smoking And Vaping Age Has Been Raised To 21

Well, it's now official.  As part of a must-pass budget bill to avoid yet another government shutdown, Congress attached several provisions unrelated to spending, most notably a rider that hikes the federal age limit for the sale of tobacco and vape products from 18 to 21 nationwide.  And on December 20, 2019, Trump signed it into law, and even had the GALL to brag-tweet about it.  And while Republican Senate Majority Leader Mitch "Awkward Turtle" McConnell, a big supporter of the age limit hike, was no doubt very pleased with himself for his "victory", we need to remember that both duopoly parties overwhelmingly supported it.  Tyranny is apparently as bipartisan as it is whimisical--and very cowardly as well.

For practical purposes, the new age limit actually takes effect after 180 days plus an additional 90 days, meaning an effective delay of nine months from the date of signing.  Thus, by September 2020, Tobacco 21 will have been fully phased in nationwide.

The text of the new federal Tobacco 21 law does two things:  1) amends the Family Smoking Prevention and Tobacco Control Act of 2019 by changing "18" to "21", and 2) while it technically no longer forces states to change their own laws (unlike the original version), nonetheless amends what was once called the Synar Amendment by requiring states to enforce (against vendors) the new federal age limit of 21 for the sale of tobacco and vape products, in order to quailfy for certain substance abuse prevention grant monies.

Though weaker than its original version, it is that second provision that may prove to be the Achilles heel of this law if it were to be challenged in court, on both Tenth Amendment as well as Fourteenth Amendment.  And if such a challenge ever proves successful, it will no doubt also overturn South Dakota v. Dole, and the National Minimum Drinking Age Act along with it.  But until then, it is long past time to be very, very angry at what passes for "leadership" in America's long, dark night of the soul.

Winter is coming, in more ways than one.

UPDATE:  Looks like the FDA isn't wasting any time in raising the tobacco and vape product sale age to 21.  As of December 27, 2019, they officially noted on their website that it is now illegal to sell tobacco or vape products to anyone under 21.  FEH.

JUUL Is Circling The Drain

Looks like JUUL Labs just bit off far more than they could ever possibly chew, and they are now choking on it as we speak.  These quislings have asked for a ton of karma for years now, and now they seem to be getting it.  Their share price is in warp-speed decline right now.  As per the famously time-tested Seneca effect, their growth was relatively slow at first, but it looks like their ruin will be very, very rapid indeed.

First, they managed to get a new generation of young people hooked on nicotine with a sleek, deceptively seductive, fruity- and candy-flavored product (with excessively high nicotine levels, and more addictive than conventional cigarettes) and even more deceptive, Big Tobacco-style marketing, all while bragging about how supposedly "woke" they were.  Then they made a deal with the devil himself, Big Tobacco, when they literally SOLD OUT to them.  And then when these cowardly quislings were finally called out on their misdeeds, they threw 18-20 year olds under the bus by supporting the ageist abomination that is Tobacco 21 laws.  They even threw the rest of the vaping industry under the bus as well.  At the end of the day, they are really nobody's friends, never were, and never will be either.

And now with that mysterious vaping-related illness reaching epidemic proportions, albeit most likely driven by black-market products with questionable additives, as well as homebrew concoctions and modified devices (though JUUL still has yet to be exonerated), the moral panic around vaping that JUUL effectively helped to create has reached such a fever pitch that the Trump administration (and several states) are passing or at least considering flavor bans for vape products.  That will be the final kiss of death for JUUL, since most of these proposed bans will only allow tobacco-flavored products (yuck!) or unflavored products (meh), not even menthol or mint.  Even if the ban is later lifted, if (when) it passes they are basically dead and done by that point.

And if that itself doesn't ultimately bankrupt them, the mounting lawsuits against them sure will.

Now a corporate "person" without a country, what ever will they do?  (Plays the world's smallest violin)

Somebody call the coroner quick, JUUL is now circling the drain as we speak.  Let's hope they take their Big Tobacco parent company, Altria (aka Philip Morris) down with them as well.  And no, we will never, ever mourn their loss, not in a million years.

Good riddance! May your name and memory be forever blotted out, JUUL.

UPDATE:  As of September 25, 2019, their CEO, Kevin Burns, was essentially forced to resign, replaced with a Big Tobacco executive from Altria, and they pulled all advertising from the USA.  And the company agreed to accept the flavor ban as well.  And now they are embroiled in a criminal investigation as well.

About That Mysterious Lung Illness Related To Vaping

There have been recent reports of a mysterious lung illness that appears to be linked to vaping.  Fingers are being pointed all over the place right now, since it is still not clear exactly what (let alone which products) are causing it and why.

Here's what we do know so far.  As of the end of August 2019, there have been over 200 possible cases of severe lung illness and/or damage (and even one reported death) in the USA that may be linked to vaping, though the symptoms haven't always followed a consistent pattern.  Not all cases have been confirmed, and it all still needs to be fleshed out and other variables accounted for, but vaping of some sort is the only factor that we know is common to them all.  And it's not just young people either (though many of them are), as even people in their thirties have reportedly also succumbed to it as well.

Many, but by no means all, of the cases involved vape products containing THC (i.e. the primary psychoactive component of cannabis), and virtually all of those had been purchased on the black market (mostly in non-legalization states) based on what we know so far.  And as much as JUUL Labs wants to believe and assert it, this does NOT yet automatically exonerate nicotine-containing vape products such as theirs.  And no one should pretend that it does.

(Separately, there are also three recent reports of seizures thought to be linked to the JUUL brand specifically, presumably due to their very high nicotine content, so they really shouldn't be so smug.)

It is important not to create or fan the flames of a moral panic about vaping in general, as that is likely to be counterproductive.  Much more research is necessary until we know more.  So what advice should be given in the meantime?

• First and foremost, do NOT vape anything that you get from the black market, whether it's THC or otherwise.  They are inherently unregulated by definition, with no quality control, and thus you really don't know what you are getting.
• Especially avoid the pseudo-legitimate sounding (but actually always black market) THC brands "Dank Vapes", "Chronic Carts", and "West Coast Carts".  Avoid them like the plague!  (Ditto for the apparently very bad actor, gray market CBD brand "Diamond CBD" as well.)
• Do your research and due diligence before buying any vaping product on the legitimate market as well.  Google is your friend, but don't believe everything you hear or read.  This is true whether it is nicotine, THC, CBD, "just flavoring", or anything else for that matter.
• Avoid any oil-based vape products when possible, especially for unfamiliar brands.
• Do NOT modify vaping devices or use any homebrew products with vaping devices.
• And last but not least, if you are not currently addicted to nicotine, do NOT vape (or smoke) anything that contains nicotine.  Keep in mind that all JUUL brand products contain high levels of nicotine, as do many other brands as well.

That seems like sensible advice for now.  As for government officials, the best thing they can do right now is regulate the vaping industry better to quash bad actors and improve quality control, cap nicotine levels, and also legalize cannabis nationwide for everyone over 18 (while keeping the taxes low) in order to quash the black market as well.

Let's be adult about this, shall we?

UPDATE:  As of September 5, 2019, researchers seem to be zeroing in on the most likely cause: specific additives found in primarily black market THC vaping oils and cartridges.  Thus far, only one case has been possibly linked to a THC vape product (of undisclosed brand) purchased from a licensed dispensary (in Oregon), which could be a fluke or confounded by other products, but it is possible that even some legitimate products contain such harmful additives.  And while nothing has been ruled out as yet, the aforementioned advice still remains sound:  avoid all black market vape products, don't vape nicotine if you aren't already addicted, and do your research.

As of September 6, the number of possible (not all of which confirmed) cases of the mystery vaping illness has now reached at least 450, including four confirmed deaths and possibly a fifth one as well.  At this rate, we would hate to see what the casualty toll will ultimately climb to by Friday the 13th (next week).  Regulators really need to root out the questionable additives and bad actors, yesterday.

As of September 9, several theories abound as to what exactly is causing this now-epidemic mysterious illness, from questionable additives (such as Vitamin E oil) to black market products to home-made concoctions influenced by YouTube videos to even Chinese tariffs steering vapers towards cheaper and janky products (and this means nicotine too).  Again, it is still under investigation, but the above advice nonetheless remains sound for the time being. 

And for those who are still concerned:

If you currently vape nicotine, DO NOT go back to combustible cigarettes or any other combustible tobacco products!  If you are concerned about vaping, you can always switch to snus, lozenges, or any of the available nicotine replacement therapy products currently on the market (patches, gums, lozenges, and inhalers).  At the very least, stick to the top-shelf stuff.

If you currently vape "just flavoring", be sure that it really IS "just flavoring" (spoiler alert:  it usually is NOT, and all JUUL brand products contain high levels of nicotine).  But really, what's the point of that?

If you currently vape cannabis derivatives (whether it's THC, CBD, or both), and you don't have access to legal and licensed dispensaries where you live and/or you still don't trust the stuff on the shelves there, but you still don’t want to combust (smoke) weed, there are always dry-herb vaporizers out there (remember those?), as well as edibles, capsules, oils, and tinctures for using cannabis products orally.  Or at least stick to the top-shelf stuff for now.  But DO NOT vape, juul, or dab anything from the black market, the street, pop-up shops, or any homemade concoctions.  EVER.

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...

We Hereby Excommunicate JUUL Labs

(Editor's Note:  Twenty-One Debunked has never been affiliated in any way, shape or form with JUUL Labs or any other vaping, tobacco, alcohol, or cannabis company.  And we never will be, either.)

Dear JUUL Labs,

Since you were founded in 2015 as a spinoff from Pax Labs, you have always presented yourselves, at least publicly, as the underdog saving the world in the fight against the evil Big Tobacco.  Little did America know that you were about to pull the wool over everyone's eyes and make fools, and then cynics, of us all.

Why do we hate thee, JUUL?  Let us count the ways:

• You loudly proclaimed yourselves as the enemy of Big Tobacco, but you began to copy their playbook awfully quickly in terms of advertising to young people and cynically attempting to implement your own "anti-vaping" progams in schools. (You claimed that was just an oversight.)
• You chose a much higher nicotine level for your products than other vape brands, by far.  That was most likely to try to edge out the competition, and it worked--at the expense of a new generation of nicotine addicts, that is.
• You lowered your nicotine content when selling in the European Union and Israel (who by law set the maximum allowable nicotine content of vape products much lower than the American version of your products), but curiously still do not offer such reduced-nicotine products in the USA, or any nicotine-free products.
• Until very recently, you failed to adequately warn users that your products contain nicotine and are addictive.  Many young people did not even know that all JUULs contain nicotine, let alone such a high level of it.
• When the FDA finally blew the whistle on you, you responded in the most cowardly way possible.  You decided to throw young adults under the bus by calling for the age limit for vaping products to be raised from 18 to 21, and you banned 18-20 year olds from your website.  And you still made no significant changes to your highly-addictive products, save for the removal of a few flavors.
• And worst of all, you literally SOLD OUT to Altria Group (aka Philip Morris), whose name is literally synonymous with Big Tobacco.  You know, the evil industry you once claimed to be fighting against?  Your deal with the devil may have made you richer and bought you some temporary protection, but everything comes with a price, and your day will come very soon.

Thus, in light of the above grievances, we hereby excommunicate you.  Here is your bell, book, and candle, you cowardly quislings.  Now go take your crack nicotine and shove it!

We Already Know How To Reduce Teen Smoking and Vaping Without Raising Age To 21--So What Are We Waiting For?

A recent study in the medical journal Pediatrics only confirms what Twenty-One Debunked has been saying all along.   That is, tougher enforcement of the minimum sales age limit of 18, directed at vendors, does in fact lead to lower smoking as well as vaping rates among teens, and these lower usage rates apparently persist even after such youth reach the legal age to buy such products.

In this study, the proxy for tougher vendor enforcement was the grade (A through F) by the American Lung Association (ALA) on the strength of the local tobacco retail licensing (TRL) laws in the jurisdictions studied.  Strong TRL laws imply more frequent retail compliance checks with decoys, since such laws require licensing fees that make the program self-funding, and fines and penalties for violations such as failed compliance checks.  This in turn would lead to higher retailer compliance rates in adhering to the age limits for sales, and thus reduced access for youth below the age limit.  The study looked at various localities in California, in January-June 2014 and again in January 2015 through June 2016, while the age limit was still 18.

Unsurprisingly, jurisdictions with a grade of A (strong) for their TRL laws indeed had much lower teen smoking and vaping prevalence rates in the surveys compared to those with grades of D or F (weak).  At the same time, the ALA grades given for other local tobacco control laws (such as smoke-free laws) in place at the time did not seem to have much if any effect on youth smoking and vaping prevalence rates, and were statistically insignificant.

Thus, even though teens can still often manage to get cigarettes and such from their older friends and relatives (i.e. social sources), the net effect of restricted retail availability to people under 18 is significantly and persistently lower youth smoking and vaping rates.  Apparently generosity has its limits, and any forbidden fruit effect (reactance theory) of the age limit itself is outweighed in practice by greatly reduced access and convenience when retail compliance rates are very high, especially for younger and/or less mobile teens.  For example, if one in five retailers is willing to sell to people under 18, that is still pretty easy to get, but if only one in 20 retailers is willing to do so, that becomes very inconvenient to acquire and sustain a habit, especially in towns with only a few retail outlets.  Remember, a license to sell temptation goods like cigarettes and alcohol is practically a license to print money, and retailers would not want to jeopardize that by breaking the law when the law is strictly enforced with swift and certain sanctions for violations.

And while cigarette taxes were not studied here, since there would not have been within-state local variation in taxes, one should note that an older landmark study found that the two most important predictors of teen smoking rates over time (inversely) were 1) tax/price, and 2) retailer compliance rates.  This was particularly true for daily smoking rates.

Such results dovetail nicely with those of the famous studies of Woodridge, IL and Leominster, MA, in the 1990s that found that sustained tougher enforcement directed at vendors greatly reduces youth smoking rates without having to raise the age limit any higher than 18, and without having to involve the criminal justice system at all.  Now if only such logic would be applied to alcohol and cannabis as well.

And lest anyone claim that this would not apply to alcohol with a drinking age of 18, keep in mind that this is precisely what happened in the UK with both alcohol and tobacco upon implementing increased retail enforcement combined with higher tax rates on both substances.  So what are we waiting for?

To Governor Cuomo: Do NOT Raise Smoking Age to 21!

Dear Governor Cuomo,

First, we at Twenty-One Debunked, and I personally as a New Yorker, would like to thank you for supporting cannabis legalization, albeit with some nuance.  We also would like to thank you for standing up to Trump whenever possible thus far.

That said, we at Twenty-One Debunked simply cannot get behind your recent proposal to raise the age limit for tobacco and vaping devices from 18 to 21.  We believe it is an unnecessarily ageist policy to set the age limit any higher than the current age of majority, which is 18 in New York.  Thus, first and foremost, we oppose such a policy on principle--just as we feel the same way about the drinking age and the soon to be legal toking age as well.

And while there are already several counties, including NYC and its entire "backyard", such as Westchester County where I live, that have raised the smoking and vaping age to 21, there is really no hard evidence that it reduces youth smoking rates compared to keeping it 18.  The same goes for other states and localities that have raised their age limits in recent years.  In fact, to the extent that it makes vaping devices harder for 18-20 year olds to get, it could easily steer current vapers back to smoking, which would clearly not be good for public health.

So what can be done instead to further reduce already low and falling smoking rates for both youth and adults?

• Tobacco taxes can of course be hiked further, though in New York they are already the highest in the nation, and even higher still in NYC.  And there is already quite a black market for contraband cigarettes now.  
• The current age limit of 18 can of course be more vigorously enforced, as there is still room for improvement in terms of retailer compliance rates.
• Limit and reduce the number and density of outlets that sell tobacco products (for example, your plan to ban tobacco sales in pharmacies).
• Build on NYC's already successful smoking cessation program, with free nicotine patches and gum available for all smokers who wish to quit.
• Advertising restrictions to the greatest extent that the US Constitution will allow.
• Counter-advertising, such as the Truth campaign, has been shown to work wonders in other states like Florida and California.
• Consider phasing down the maximum allowable nicotine content of cigarettes to a non-addictive level.
• For e-cigarettes, cap the nicotine content of vape products down to European and Israeli levels (JUUL, we're looking at YOU).

Thus, we ask that you please reconsider your support for the 21 age limit for tobacco and vaping, and we hope you will realize that keeping it 18 is the right thing to do.

Sincerely,
Ajax the Great, Twenty-One Debunked

FDA and New York Take Aim at Flavored Vapes

After much saber-rattling with JUUL and other leading vape manufacturers, the FDA now plans to ban the sale of most flavored vape products (except mint and menthol) in retail stores and gas stations to reduce availability to young people.   Flavored vapes would only be allowed to be sold in vape shops and tobacco shops, and online sites with strict age verification measures.  New York State plans to go even further, banning the sale of flavored vapes entirely, much like San Francisco has already done.

Oh, and the FDA also apparently wants to ban menthol combustible cigarettes as well, because they are believed to be harder to quit than non-menthols (though that is probably due to their generally higher nicotine content, the harsher taste of which is masked by the menthol).  All other flavors have already been banned as of 2009.  This particular ban, however, will likely take much longer to finalize and longer still before it is actually enforced.

Twenty-One Debunked has mixed feelings about these bans.  On the one hand, they are in some ways still better than hiking the age limit to 21, and there is some truth to the idea that fruity flavors may make nicotine-containing vapes seem more benign than they actually are, increasing the likelihood of accidental addiction among young people.  On the other hand, these bans, though modest, can also be a slippery slope and even perhaps a boon to Big Tobacco.  So while we do not oppose these bans, we are still a bit wary about them nonetheless.

What would probably have the largest effect in terms of reducing the number of young people getting hooked on vaping is capping the maximum allowable nicotine content of vape products down to European and Israeli levels.  Over there, JUUL reduced their nicotine content so they can be sold in those markets, and such products remain effective smoking cessation devices with a somewhat lower likelihood of accidental addiction happening quickly  among young experimenters.  Meanwhile, in the USA, there is a joke that the unusually high-nicotine JUUL products sold here are kinda like the horror film The Ring: you will get hooked in seven days.  Not really far off the mark.

The best thing to stop the "epidemic" of teen vaping, of course, is to stop fanning the flames of moral panic.  After such modest bans like the ones discussed above are in place, hopefully the mainstream media will finally STFU about this supposed "epidemic".

UPDATE:  On November 13, 2018, JUUL announced that they will no longer restock any orders to retailers for any flavored vape pods other than tobacco or menthol, and will only continue selling them online to people 21 and older, and will also end all social media promotions as well.  So it looks like 18-20 year old vapers who prefer such flavors will need to stock up very fast at their local stores before they run out.

And as of November 15, the FDA will go ahead and pursue the aforementioned regulations.  The new regulations may not be fully implemented for months in the case of flavored vapes, and years in the case of menthol combustible cigarettes, but are essentially a foregone conclusion now.  Flavored vapes, except for mint, menthol, and tobacco, will only be sold in stores that do not allow people under 18 to enter or have separate sections that disallow people under 18. 

Thus, in their zeal to pre-empt regulators, it looks like JUUL is being unnecessarily ageist towards 18-20 year olds.  And why can't JUUL just offer a nicotine-free option for pods, and reduce their sky-high nicotine content in their current ones to European levels?