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.

The Stupid Literally Burns Like Cigarettes

In Australia, there is quite a furor right now among the chattering classes in regards to a sharp increase in teen tobacco smoking from 2018 to 2023 after over two straight decades of decline.  And one of the things people are blaming is.....wait for it....vaping.  Because reasons.  Or something.  But there is one very glaring problem with this theory.  In Australia, vape products are technically legal, but ONLY if they do NOT contain any nicotine at all, thus kind of defeating the purpose.  That's right, nicotine vape products have never been approved for legal sales in Australia (and probably never will be any time soon), meaning anyone who wants to use them must either smuggle them in from abroad or buy them on the black market.  And interestingly enough, vaping itself also appears to be on the rise as well down under.  Thus, it truly takes a special kind of stupid to not only perversely create a situation where vaping and smoking both increase at the same time, but to then blame the increase in smoking on vaping.

Even more notable is the fact that in Australia, cigarettes have some of the highest taxes (and thus prices) in the world, plus so many other world-leading "best practices" tobacco control polices as well.  This additionally shows that while vice taxes and some other policies may work well to a point, all of these policies inherently have their limits in practice. 

Our working theory:  it is actually the banning of nicotine vaping, combined with the harmful effects of one of the strictest lockdown and Zero Covid regimes in the world, that ultimately snatched defeat from the jaws of victory in the long fight against tobacco smoking, particularly for youth.  And we must stress that while nicotine in any form is far from benign and definitely NOT for kids, banning or unduly restricting vaping (which is still significantly safer than the known deadly habit of smoking that it often displaces) is therefore a net public health loser of a policy.  And a policy like Australia's that perversely increases "dual use" of both is even that much worse still.

One could even argue that their truly massive cigarette black market created by their insanely high taxes, especially combined with their vaping black market from their nicotine ban, actually increased underage (under 18) use of both products since black market sellers typically don't ask buyers for ID.

Note also how the increase did not begin until 2020 (implicating the lockdowns as a contributing cause), and occurred for 14-17 year olds but interestingly NOT 18-24 year olds (putting the lie to the idea that their age limit of 18, as opposed to 21, was in any way related).  Also note that in England, where the age limit is still 18 and vaping is literally promoted by public health authorities, teen smoking continued its long decline through at least 2021.  New Zealand, where the age limit was still 18 (until very, very recently), smoking rates among 15-24 year olds nosedived as soon as nicotine vaping was officially legalized in 2020, despite an even stricter lockdown there.  Thus it seems to be the combination of 1) black markets, 2) vaping bans, and 3) lockdowns that is the cause of the jump in teen smoking in Australia.

But good luck trying to convince the nanny-state zealots to use even a little bit of common sense!

QED

How To Make Tobacco Less Appealing And Addictive Without Banning It Or Reducing Nicotine Below Natural Levels

Here is a "Cliffs Notes" style list on how to make cigarettes and other smokeable tobacco products less addictive and appealing WITHOUT banning it outright, raising the age limit any higher than 18, or even reducing nicotine below natural levels:

• First and foremost, BAN ADDITIVES!  No non-tobacco ingredients should be added, period.
• Adding extra nicotine deliberately should also be banned as well.
• Require the smoke pH to be 8 or higher to discourage deep inhalation of smoke, as it naturally was prior to the 20th century. 
• Phase out the pH-lowering and environmentally unsustainable practice of flue-curing tobacco. 
• Phase out cigarette "filters", which don't really filter, and merely provide a false sense of security to smokers, and inherently creates a major toxic waste littering problem to boot.

If they still want to reduce maximum nicotine levels to a non-addictive level in ready-made commercial cigarettes and little cigars, go right ahead.  But it would be best to do the other things on the list first.

Also, banning the use of radioactive (!) phosphate fertilizers to grow tobacco is really a textbook no-brainer in terms of tobacco harm reduction. 

Additionally, requiring all tobacco products to be sold only in dedicated tobacco stores, or other places where you have to be 18 or older to enter, would really not be a bad idea either.  It would certainly make it less ubiquitous, convenient, and tempting without the constant reminder in grocery stores, convenience stores, gas stations, pharmacies, etc.

So what are we waiting for?

A Cautionary Tale

The modern day Prohibitionists, and even tobacco control advocates more generally, used to frequently laud the example of Bhutan back in 2004 and for many years after.  And yet now?  Almost nobody talks about them anymore.  So why is that?

Bhutan, the only country in the 21st century that had completely banned tobacco across the board, has failed so miserably in doing so (thanks to the black market and international smuggling, and despite very stiff penalties too) that they ended up reversing their ban in 2021, largely out of fear that rampant cross-border smuggling would.... increase the spread of Covid.  Seriously, you cannot make this stuff up!  This should really be a cautionary tale for anyone contemplating any new (old) forms of Prohibition, whether for tobacco or otherwise. 

And it's not like Bhutan is a historical anomaly either, as outright bans on tobacco products have been tried (and failed) before repeatedly for centuries in various countries, including right here in the USA at the state and local level from the late 19th century to 1927.

So much for the illusion of control. 

Twenty-One Debunked has repeatedly discussed in depth the quasi-special case of tobacco/nicotine and how highly nuanced it is.  And yes, it is far more nuanced than either side of the debate likes to admit.  Tobacco/nicotine straddles the fine line between soft and hard drugs, is both subtle and dangerous at the same time, and thus ultimately defies and transcends any simplistic solutions like "just ban it already!"

If alcohol, tobacco, and cannabis were all legal, and you had to pick ONE of those to ban, tobacco would logically have to be it, hands down.  It is, by far, the least useful and most harmful (and deadly) overall of the three.  It is the ONLY currently legal product that, when used as directed, will kill half of those who buy it.  It's thus not even a contest.  Additionally, it is NOT a truly recreational drug, and its inherent addictiveness actually tends to subtract from one's overall freedom and autonomy rather than enhance it.  And the majority of those who use it ultimately regret doing so.  That said, it still doesn't follow that a complete ban is a wise idea, in theory OR in practice. 

It is worth noting that even those who were serious about phasing out tobacco in the West have been, until very recently, gradual and gingerly about it.

Not only is this a cautionary tale regarding tobacco, but also by extension other substances and vices as well.  It is a historical truism that punishing the many for the excesses of the few has NEVER ended well at all, and ultimately does far more harm than good.  Those folks advocating new (old) forms of Prohibition need to be VERY careful what they wish for! 

It bears repeating:  vices are NOT crimes.  Any confusion of the two invites trouble. The late, great Lysander Spooner was a wise man indeed, and we ignore his timeless advice at our peril.

As President Ronald Reagan famously said, "Freedom is never more than one generation away from extinction".  And in light of the past few years alone, that quote doesn't really seem to be an exaggeration. 

UPDATE:  Apparently according to Wikipedia, Turkmenistan (since 2016) and Taliban-ruled Afghanistan (since 2022) have also banned tobacco.  Though the former has not fully gone into effect yet, and the latter is not exactly a good role model.

A Better Way To Phase Out Tobacco

California is now seeking to emulate New Zealand, Norway, Singapore, and the Philippines in phasing out tobacco products with a permanent generational ban on the sale of such to anyone born on after January 1, 2007.  Twenty-One Debunked has generally opposed such an idea on principle, as we had discussed previously.   Not only is it inherently ageist, and further promotes black markets, but it will drag it out and take decades to have the desired endgame effect.

Here's a better idea, that the FDA is already currently considering:  Reduce the maximum allowable nicotine levels in commercial cigarettes, and perhaps other combustible tobacco products, to a non-addictive or sub-addictive level.  This idea, or at least some flavor of it, has long been endorsed by many stakeholders and pundits the world over, from the American Medical Association to Robert N. Proctor to Malcolm Gladwell.  And Twenty-One Debunked has endorsed it since 2013, ideally keeping the legal age limit at 18 (which Congress and Trump unfortunately raised to 21 in late 2019, much to our chagrin).

By that, it means reducing nicotine levels by 95% or so from current levels, down to no more than 0.5 mg/g (0.05%) of tobacco.  Crucially, this would apply to nicotine content, not "delivery," as the latter can be gamed and manipulated too easily.

If done smoothly and gradually enough, and leaving noncombustible tobacco and nicotine products untouched, this will dramatically reduce smoking rates for all ages, and thus save thousands if not millions of lives without creating any more of a black market than already exists from high cigarette taxes alone.  Pairing it with a tax hike (within reason) would also increase its effectiveness as well.

Even if the new nicotine limits applied only to the sale of pre-rolled cigarettes and quasi-cigarettes like little cigars, and nothing else, it would likely still have the desired effect.  That is because those are the products that really drive the deadly tobacco epidemic.

It could be done in either one step with some lead time, or a few steps over a period of months to a year or two, for all cigarette manufacturing and importation going forward, plus an additional year to clear out excess inventory.  Doing it in a few steps would probably be better overall we think.  Either way would probably be fine though. 

Banning the use of additives, which are largely all about increasing the addictiveness of the products, would also make sense as well.  Michigan already has an excellent law on the books, that bans any "deleterious" ingredient or anything "foreign to tobacco" being added to cigarettes.  It needs enforcing.

Redesigning the cigarette to have a more alkaline smoke pH of 8 or higher, as it typically was prior to the 20th century, would make it less appealing and harder to inhale at least for new smokers.  Most cigars and pipe tobacco are already like that currently. 

And for the love of all that is good, ban the use of radioactive phosphate fertilizers yesterday!

Another good idea would be to only allow tobacco products to be sold in designated or dedicated tobacco-related stores (i.e. smoke and vape shops) and/or places that one needs to be 18+ to enter.

As for nicotine vapes, capping the maximum nicotine content at current European or Israeli levels (lower than USA levels but still generous) would reduce overall nicotine addiction rates without driving vapers back to smoking cigarettes.

Do these things and the desired endgame can be achieved in a matter of months to years, not decades.  But that would make too much sense, right?

FUN FACT:  Hemp-based, tobacco-free "blunt wraps" are now commercially available, so even the classic use of hollowed-out cheap tobacco cigars for rolling cannabis blunts is now thoroughly obsolete as well. 

UPDATE:  Apparently New Zealand will, starting in 2025, mandate that only very low nicotine cigarettes (VLNC) be sold, similar to what we advocate above.  Also, in 2024 they will sharply reduce the number of tobacco retail outlets by 90-95%, and ban the sale of cigarettes at kiosks, gas stations, or supermarkets.  This will be in addition to their generational ban for anyone born after January 1, 2009.  Thus, the generational ban is completely redundant and unnecessary, given the other two components.  And also the price of a pack of smokes there, $36 NZD, is the equivalent of over $20 USD (that is, more than a dollar per cigarette!) thanks to their already high taxes, making it a very expensive habit as it is.

And vape products would remain unaffected. 

Twenty-One Debunked's preferred plan, in a nutshell, is basically the New Zealand plan MINUS the generational ban and keeping the age limit at 18, plus a few other things above listed above.

UPDATE 2:  Bhutan, the only country in the 21st century that had completely banned tobacco across the board, has failed so miserably in doing so (thanks to the black market and international smuggling, and despite very stiff penalties too) that they ended up reversing their ban in 2021, largely out of fear that rampant cross-border smuggling would.... increase the spread of Covid.  Seriously, you cannot make this stuff up!  This should really be a cautionary tale.

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.

The Right Way, And Wrong Way, To Phase Out Tobacco

We are now officially in, or at least quickly approaching, the "endgame" of tobacco control, as they say.  In chess, the endgame is said to begin when queens begin to disappear, and thus checkmate is increasingly within reach.  In tobacco control, it roughly begins when 1) smoking prevalence drops low enough, 2) the best "cards" of existing tobacco policy measures have already been played enough, and 3) the Overton window has shifted far enough against smoking, that it is now becoming increasingly realistic to openly consider phasing out at least some types of combustible tobacco products (especially cigarettes) at some point in the future.

Various targets for reducing overall smoking prevalence have been floated by various experts, such as a goal of no more than 5% by 2025 or 2030, no more than 2% by 2050 or 2060, and so on.  And beyond simple aggregate numbers, another related goal is to reduce the massive (and often widening) inequalities by race, ethnicity, socioeconomic class, etc. within those numbers in various countries. 

Twenty-One Debunked acknowledges that there are some very good arguments for such a phaseout that even many libertarians can grudgingly concede, given how 1) cigarettes are the only legal product which, when used as directed, kill at least half of those who use it, making them defective by design, 2) most smokers admittedly dislike their habit and want to quit, but often have great difficulty doing so, 3) cigarettes rob people of their autonomy, 4) alternatives currently exist.  And that is before one even delves into the negative "externalities" that these products impose on others and the environment.

That said, there are right ways to further such a goal, and there are wrong ways.

A number of endgame strategies have been discussed, some of which have been implemented recently.  These include, 1) banning the sale of cigarettes, and possibly other combustible tobacco products, in a given jurisdiction completely from some future date onwards, after a reasonably long delay, 2) putting a gradually "sinking lid" on the number of tobacco retail outlet licenses, until the number of licenses drops to zero, 3) phasing down the maximum allowable nicotine content of cigarettes, and possibly other combustible tobacco products, to a non-addictive level, 4) hiking the excise tax by 10% every year, and 5) an age-based (or "generational") strategy that permanently bans the sale of tobacco products to anyone born after a specific year (say, 2000 or 2010), while still allowing it for those born before that year.

It is this last one that Twenty-One Debunked takes the most umbrage at of all.  We denounce this arbitrary discrimination by age for the same reasons that we denounce the Tobacco 21 laws.  We believe it is wrong on principle as it flies directly in the face of any idea of equal protection of the law, by denying individual rights to some group of legal adults relative to others.  And not only that, but it is a truly lousy endgame strategy that drags things out that much longer compared to, say, the first strategy on the aforementioned list (i.e. banning it for everyone).

Twenty-One Debunked prefers the third strategy on the list, namely phasing down the maximum allowable nicotine levels in cigarettes to a non-addictive level, and only for cigarettes and little cigars/cigarillos, and possibly roll-your-own cigarette tobacco.  Leave all other tobacco products alone, and keep vaping products on the market, albeit with the maximum allowable nicotine levels reduced to European or Israeli levels (which is still plenty strong).  We have preferred that strategy since 2013, in fact.  We do NOT prefer the first two strategies, but would still much rather have those than the last.  Even the tax hike strategy (which increasingly robs from the poor and gives to the rich) is head-and-shoulders better than that!

Another thing we would find at least somewhat acceptable would be to limit the types of stores that can sell tobacco products.  For example, they could only allow tobacco to be sold at dedicated tobacco/vape shops, or stores that one must be 18 or older to enter.  That would thus eliminate the most visual temptations for children and teens, and triggers for relapse that former smokers have to face every day, at convenience stores, grocery stores, etc.  Or at the very least, stop selling them at pharmacies.

One should note that commercial, pre-rolled cigarettes, more so than any other existing tobacco product, are by far the very biggest drivers of the tobacco epidemic of the past century, so even if those (plus little cigars) were the only targeted item for a tobacco endgame strategy, any switching to alternatives would not even come close to sustaining such an epidemic for long on the scale that it has been thus far.  All of the other combustibles (medium to large cigars, pipe tobacco, hookah/shisha) and smokeless tobacco (chew, dip, snuff, snus, lozenges, etc.) have always been basically niche products.  So let's not throw out the baby with the bathwater now.

But whatever strategy one follows, we must be sure to allow enough lead time for a just transition and to minimize the creation of black markets, and we must not criminalize possession or consumption of tobacco.  Any endgame strategy worth following must concentrate on the supply side, while also tackling demand by making quitting easier.  Vilification of smokers does not further that goal in the long run.

UPDATE:  The FDA is now moving to join Canada, the UK, and EU in banning menthol cigarettes (and perhaps flavored cigars too).  Twenty-One Debunked is kinda on the fence about that, but at this point we will not oppose it.  The reason why Big Tobacco adds menthol is because it masks the harsh taste of nicotine, making it easier to get hooked and harder to quit, particularly for young people.  And while the much-noted racial overtones and undertones of menthol cigarettes are practically unique to the USA, due to decades of aggressively race-targeted marketing by Big Tobacco, the sheer deadliness and addictiveness of these products makes them a net detriment to the Black community on balance.

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.

Our Position on Parental Notification

With the recent kerfuffle in New Jersey regarding their long-overdue cannabis legalization, particularly regarding parental notification for underage possession offenders under 21, we at Twenty-One Debunked thus see a need to clarify our position on parental notification for underage possession consumption of alcohol, tobacco, and cannabis.  We believe the age limit for all three should be 18 and not a day later (i.e. the Alberta Model), and regardless of the age limit we believe the following as well:

• For anyone over 18, parental notification should be prohibited, period, as 18 is the legal age of majority.  Why this is even the least bit controversial is truly mind-boggling.
• For anyone under 18, parental notification should NOT be mandatory, but rather should be discretionary, at least for first offenses of simple possession.  Even for subsequent offenses, there should still be nuance and proportionality.
• For younger teens/tweens under 15 or 16, parental notification may very well be the preferable go-to option in many cases, but for older teens it should be regarded as more of a "nuclear" option for serious or repeat offenders.
• Underage possession/consumption per se should be decriminalized.  That is, it should bypass the criminal justice system entirely, and should carry no arrest, no jail time, and no criminal record.  Rather, the penalties (if any) should include only a verbal or written warning, a modest civil fine (i.e. a parking or traffic-style ticket), a brief educational course, and/or confiscation of the contraband items.
• Any more serious penalties should be reserved solely for more serious and/or flagrant offenses that go beyond simple possession or sharing among peers, such as when impaired driving, violence, vandalism, theft, trespassing, obstructing traffic, disturbing the peace, and/or disorderly conduct is involved.  For ALL ages.  (Note that most of these are arrestable offenses.)
• No one should lose their driver's license for any non-driving related infractions.
• Rather than disproportionately targeting young people themselves, there should be a much greater focus on adults over 18 who sell or furnish such substances to people under 18, especially when there is a large age difference between the furnisher and furnishee.

None of these should be controversial at all.  If you honestly think these are extremist positions, you seriously need to have your head examined!

And You Thought They Would Stop At 21

Hawaii was the first state to raise the tobacco smoking and vaping age to 21, just four years ago in 2016.  While that may seem like only yesterday, and that is certainly bad enough, there is now a bill to raise the age limit to 25.  No, this is not The Onion, this has a very real chance of passing.  Additionally, there is another bill that by 2025 would raise the smoking age to...wait for it...100.  Yes, you read that right.

These bills had better not pass, lest it become contagious.  Just like Tobacco 21 laws have proven to be.  Alas, this evil train does NOT seem to stop at 21, nor will it stop at tobacco for that matter.  It is apparently an express train, with 25 being next, and other rights and privileges also in its sights as well.

Well, everything except going to war, of course, since the war machine apparently likes 'em young, fresh, and green, as they always have.  And of course the age of consent for sex (and you can probably also add porn and stripping, and even prostitution in Nevada) as well, since nothing says "adulto-patriarchy" like a little "droit du seigneur", apparently.  In other words, 18-24 year olds are only (non-)adults when it is convenient for those in power.  Thus, not only is tyranny as whimisical as it is bipartisan, but they clearly need to stop pretending that their concerns are moral ones, or even based on public health.

RIP Hawaii, paradise well and truly lost.

Most Young People Don't Vape, And Even Fewer Vape Regularly

Finally, an honest article about the teen vaping "epidemic", written by New York University (NYU).  Rather than fan the flames of moral panic, and increase teen vaping even further, they simply tell it like it is.  Based on the 2018 National Youth Tobacco Survey of middle and high school students:

• Over 80% of students, or more than 4 out of 5, did not use any tobacco or nicotine product at all in the past 30 days.
• Over 86%, or more than 6 out of 7, of students did not vape in the past 30 days.
• Only 3.6% of students, or fewer than one in 25, vaped regularly (i.e. on 20+ days per month), while
• A mere 0.4%, or one in 250, of tobacco-naive students vaped with that sort of frequency.
• All while combustible tobacco use is at a record low.

And that was in 2018, which was the year when the moral panic over teen vaping really began in earnest.  While the 2019 data for that survey showed a further increase in vaping since 2018, the full data had not been made public yet, so a detailed analysis could not be done as it was for 2018.

These are the kinds of articles that need to go viral, not the moral panic ones.  It's basically social norms marketing.  Young people often falsely believe that their peers are drinking, smoking, vaping, toking, or using other substances much more than is actually the case, and they feel pressure to conform to such inaccurate norms.  This is called "pluralistic ignorance".  By setting the record straight about the actual numbers, it tends to reduce the use of such substances overall.  In contrast, moral panics exaggerate the levels of use, which tends to increase the use of such substances, in what is known as a "deviancy amplification spiral".

Thus, the real public service message needs to be as follows: Over 4 out of 5 teens don't use tobacco or nicotine.  Over 6 out of 7 don't vape.  And even fewer vape regularly--24 out of 25 do not.  Join the majority!

The Federal Smoking And Vaping Age Is Now 21 (Part Deux)

As we had noted a little over a week ago, Congress raised the federal age limit for the sale of tobacco and vape products from 18 to 21 as part of a must-pass budget bill to avoid yet another government shutdown, 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 parties overwhelmingly supported it.  Tyranny is apparently as bipartisan as it is whimisical--and very cowardly as well.  And of course, Big Tobacco and Big Vape overwhelmingly supported it like the cowardly quislings that they are.

If that wasn't bad enough, it looks like the FDA isn't wasting any time in implementing the raising of 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.  They could have waited up to 180 days to formulate new regulations plus an additional 90 days before enforcing them, according to the new law, but apparently even that very small mercy is somehow beneath them.  And of course there is no grandfather clause either in this disgusting new law, nor will there be in the FDA regulations.  In other words, 18-20 year old young adults in a whopping 31 non-21 states (and several territories) who were legal to buy cigarettes and vapes just a week ago are suddenly banned from buying them now.  Talk about adding insult to injury!

And of course the new federal 21 law also applies just as much to our men and women in uniform, despite a few Tobacco 21 states having the small mercy to carve out an exception for them.  The new federal law has NO such exceptions, and is really a slap in the face of so many of our troops.  You know, kinda like the 21 drinking age has been for over three decades now.

The only silver lining to this ageist abomination is that it may very well anger enough Americans to challenge it in court, and if successful, we may get the two-for-one special of getting that other ageist abomination, the 21 drinking age, struck down as well.  And possibly even for cannabis too, though federally there is no such age limit (yet).  Otherwise, there is really no upside to this new law.  All it will do is effectively create an even more massive black market and greater disrespect for the rule of law.

In fact, it may very well drive many teen and young adult nicotine vapers back to smoking, since even with strict enforcement, regular cigarettes will be at least somewhat easier to get than vape products due to the difference in the size of the markets, general accessibility, and the design of the products.  Talk about a lose-lose proposition for public health!

As a wise man once said, "America will never be destroyed from the outside.  Rather, if we lose our freedoms, it is because we have destroyed ourselves from within."  That wise man, Abraham Lincoln, did not use those exact words it turns out, but his words came very close nonetheless.  And that (mis)quote turned out to be very prescient indeed, as America really seems to be rotting and rusting from within.

The song "21 Guns" by Green Day comes to mind, as does the song immediately following it on the same album, "American Eulogy".  And of course there's also Five Finger Death Punch, with "Stranger than Fiction":

"It's stranger than fiction, how [we've] decayed..."

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.