HALF Of America Now Has A Smoking/Vaping Age Of 21

As of July 2019, HALF of the American population now lives in jurisdictions with a tobacco/nicotine smoking/vaping age of 21 now.  It is a total of 18 states as of September 2019, and hundreds (if not thousands) of localities, and given the population distribution it adds up at least half of the population living in such places.  And now Pennsylvania, currently 18 statewide (with none of their localities setting it any higher), but soon to be surrrounded on all sides by states with an age limit of 21, unfortunately looks to join them as well.

That is a shame, since Pennsylvania has seen more progress than the national average in terms of reducing teen smoking (and less of an increase in teen vaping) in recent years, while the increase in teen vaping continues unabated nationwide regardless of the states who raised the age limit to 21 in recent years.  Pennsylvania raised their cigarette tax and implement a hefty vape tax on recent years, so that could be part of their relative success story.

UPDATE:  As of November 27, 2019, Pennsylvania raised their smoking age to 21, effective July 1, 2020.  And New York's hike to 21 has just gone into effect in November as well.  Thus, now MORE than half of the American population (and growing!) lives under a Tobacco 21 regime now.

In The UK, Cooler Heads Still Prevail When It Comes To Vaping

With all of this mass hysteria going on in the USA over vaping, we should keep in mind that our friends across the pond in the UK are generally NOT freaking out about it.  So what is so different over there?

First of all, regulation of advertising and promotion of vaping products is stricter in the UK.  Also, the nicotine content of such products is capped at a level significantly lower (as much as two-thirds lower) than the average of today's leading brands in the USA.  Even when those very same brands, most notably JUUL (aka "may their name and memory be forever blotted out"), are sold in the UK, they have to reduce their nicotine levels to be able to sell them there.  That, of course, is an EU-wide regulation, binding on all member states including the UK (at least until Brexit, just to Regrexit, if finalized).  The dose makes the poison, basically, and capping it greatly reduces (though does not eliminate) adverse side effects, not to mention the chances of young experimenters becoming addicted to nicotine so disturbingly quickly.

Also, the age limit is 18 over there (strictly enforced on vendors, just like regular cigarettes and alcohol), and there are no flavor bans either.  If anything, they seem to have an even wider variety of flavors.

Public Health England (PHE) certainly does NOT recommend that non-smokers ever take up the habit of vaping, but they do encourage current adult smokers to switch to vaping if they can't quit nicotine otherwise.  And they caution vapers not to vape any illicit or homemade products or add anything to the legitimate pods or liquid. Overall, authorities and the public health community keep a cool head about vaping, and guess what?  In the absence of moral panic, there does not seem be any real vaping epidemic among young people over there, and while there have been occasional reports of adverse reactions in general, there so far have not been any reported cases of the mystery vaping-related lung illness that the USA is currently grappling with.  (Of course, as we have already noted before, that mystery illness is primarily due to unregulated black-market vape products, especially THC ones, which often contain very questionable additives.)

That’s not to say that nobody is freaking out over there at all.  Every country has its share of that it seems.  But over in the UK at least, it currently seems to be confined to the tabloids for the most part.

We can really learn a lot from our friends across the pond.  So let's be adult about this, shall we?

Calling It QUITS

There is a new bipartisan bill in Congress now, called the Quell Underage Inhaling of Toxic Substances (QUITS) Act.  And to be honest, it is a mixed bag overall.  It would:

• Ban flavored e-cigarettes (i.e. vape products) and other flavored tobacco products, including menthol.
• Increase the federal cigarette tax from $1 per pack to $3 per pack.
• Create a tax on e-cigarettes equivalent to $3 per pack.
• Increase annual funding for the CDC's Office of Smoking and Health from $210 million to $500 million.

The first item on the list, the flavor ban as we have noted before, is too broad and largely due to the moral panic around vaping these days.  Throwing out the proverbial baby with the bathwater is likely counterproductive, and slopes are slipperier than they appear.  other items on the list are overall a good idea though.  At least all of these also apply to, and does not ignore, the real elephant in the room:  combustible cigarettes and other combustible tobacco products, which kill over 480,000+ Americans per year, while vaping has killed eight people so far in all of its history, and even then, mostly via black-market THC products rather than legitimate ones.  And while even one such death is one too many, compared to combustible cigarettes, that's essentially a mere rounding error in statistical terms.

Another strength is that it does not raise the age limit for tobacco or vaping products at the federal level.  And that, Twenty-One Debunked is happy about.

So what can be added to the bill to improve it, while also removing or narrowing the flavor ban?  Here are some of our ideas:

• Cap and reduce the maximum allowable nicotine content of vape products down to current European and Israeli levels. 
• In fact, while we're at it, cap and gradually phase down the maximum allowable nicotine content of combustible cigarettes down to a non-addictive level as well.
• Tax vape products in a manner that is directly proportional to nicotine content.
• Enforce better (targeting vendors) the current federal age limit of 18 for both vaping and combustible tobacco products.
• Restrict advertising of vape products, similar to how it is for combustible tobacco products.
• Actually REGULATE the vaping industry, and require quality control testing.
• Crack down on black-market and counterfeit vape products, and root out any bad actors in the legitimate market as well.
• Legalize and regulate cannabis at the federal level, and implement strict quality control standards as well for both cannabis as well as tobacco/nicotine products.
• Require ALL vape products, whether nicotine, THC, CBD, or otherwise, to transparently disclose all ingredients, and immediately ban the use of questionable additives believed to be linked to the outbreak of the mystery vaping illness.

Let's be adult about this, shall we? 

When It Comes To Vaping, Don't Throw Out The Baby With The Bathwater

In the wake of both the mysterious vaping-related lung illness epidemic, and also the recent increase in vaping among young people (something for which Tobacco 21 laws have apparently done NOTHING to stem the tide, by the way) both the federal government and several state and local governments are beginning to crack down on vaping to one degree or another.  Yes, Houston, we have a problem.  But it is important to keep a cool head and not throw out the proverbial baby with the bathwater.

The FDA plans to ban all flavored vape products other than tobacco (yuck!) or unflavored (meh), as is Michigan.  San Francisco, on the other hand, already passed a ban on ALL vape products regardless of flavor.  The state of New York just passed an emergency executive ban on all flavored vape products other than tobacco or menthol, effective October 4th.  And California's governor announced a crackdown on counterfeit vape products, though he lacks the authority to pass any flavor bans without the state legislature passing it.

Going too far with such bans would only increase the very black market that is the most likely cause of the mystery vaping illness (though with that it is mostly black-market THC products, though some appear to have been nicotine only).  At the same time, while vaping can help some adult smokers quit, it's not like there really is any overarching benefit society from nicotine that comes in fruity, candy, or dessert-like flavors either.  It really is a balancing act.

Twenty-One Debunked once grudgingly supported some degree of flavor bans in the past, mainly as an alternative to Tobacco 21 laws, but in light of current events, we no longer support such bans today.

New York's flavor ban--if there must be one at all--is somewhat more reasonable than the ones that don't even allow menthol.  And clearly counterfeit products need to be cracked down upon, and bad actors and questionable additives rooted out at once.  And capping and reducing nicotine levels of vape products down to European and Israeli levels would also make such products less addictive than they are currently.  But anything more stringent than these things would likely do more harm than good.  (That goes for setting the age limit any higher than 18 as well.)

As for cannabis vaping products, the best way to eradicate the sketchy and janky black and gray market products is to fully legalize and regulate cannabis nationwide, period, with an age limit of 18, strict quality control, and reasonable taxes on such products.  And again, crack down on counterfeit products and products with questionable additives.  But that would make too much sense, wouldn’t it?

So let's be adult about this, shall we?

UPDATE:  Looks like Michigan's emergency executive flavor ban contains a loophole that allows flavored nicotine-free e-liquids and pods, and also allows flavorless nicotine packets one can combine with such e-liquids (albeit sold separately).  So this particular ban is actually far more reasonable than meets the eye, while still having the intended effect of making it somewhat harder and less convenient for people under 18 to vape flavored nicotine.  And it will likely keep vape shops open for business for the foreseeable future, while JUUL will still get a swift kick in the margins now that their ready-made pods will be verboten if they have any flavor other than tobacco.

And at the other extreme, on September 24th, Massachusetts Governor Baker has literally banned ALL vape products for four months by an emergency executive action.  And that will just throw gasoline on the fire by dramatically growing the black market. DERP!  Didn't think that one through, did you Charlie?

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.

We Still Excommunicate JUUL Labs (Updated)

(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 sworn enemy of Big Tobacco, but you began to copy their playbook awfully quickly in terms of advertising to young people and cynically implemented your own "anti-vaping", "anti-tobacco", and "holistic health education" progams in schools and youth camps. (You claimed that was just an oversight.  Riiiiiiight.)
• Your sham "educational" programs even told teens that your products were "totally safe" yet for "adults only" (wink wink).  And some of your summer camp programs apparently targeted children as young as eight years old.
• You recruited social media influencers with slick advertising campaigns that at least gave the appearance of deliberately targeting young people in marketing your products.  You also went out of your way to target Native Americans with your addictive poison-peddling as well.
• You chose a much higher nicotine level for your products than other vape brands, by far.  And your patented nicotine salt formulation clearly gives a much bigger "kick" of nicotine as well.  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 JUUL 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.
• You gave your products various kid-friendly fruity, candy, and dessert flavors, because reasons.  Or something.  I mean, we all know that adults need their nicotine vapes to taste like candy in order to help them quit smoking, right?
• Until very recently, you failed to adequately warn users that your products contain nicotine and are highly addictive.  Many young people did not even know that all JUULs contain nicotine, let alone such a high level of it.  And some still may not know yet.
• In fact, if anyone were to deliberately design the most effective and efficient way to surreptitiously get young people hooked on nicotine in the 21st century, it would really look an awful lot like JUUL.
• When the FDA finally blew the whistle on you in late 2018, 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 in stores.
• 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.
• Finally, thanks primarily to you, young people are losing even more rights now.

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

We at Twenty-One Debunked urge everyone to #BoycottJUUL yesterday.  If you don't currently smoke, vape, or otherwise use nicotine, don't start!  You are far better off without this highly addictive poison in any form, period, even if vaping does reduce most of its other toxic chemical satellites and byproducts compared with smoking.  But if you currently do, make it any brand but JUUL, and give 'em a swift kick in the margins!  And best of all, JUULers who switch to other vape brands may find it easier to phase out and finally quit all forms of nicotine for good.

New Tobacco 21 Study Leaves Us With More Questions Than Answers

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

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

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

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

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

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

Bottom line:  it looks like the supposed benefits of raising the smoking/vaping age to 21 were, shall we say, all smoke and mirrors, at least for people under 18.  The supposed success of Needham, MA, for example, was likely a statistical fluke and/or a result of endogeneity, much like the "early adopter" effects of the first few states to raise the drinking age to 21 creating that particular mirage in the 1980s.  Or perhaps increased enforcement in general relative to neighboring towns did the trick regardless of the age limit, like it did in Woodridge, IL and several other communities the 1990s with an age limit of 18.  Studies show that whenever vendor compliance exceeds 90-95%, there is indeed a dramatic drop in teen smoking regardless, by as much as 50% compared with previously weak enforcement and low compliance rates, especially for the youngest teens.  More recent research bears this out as well, for teen smoking as well as vaping.   And keep in mind that those who make it to 18 without smoking are far less likely to take up this deadly habit later on.

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

New York Raises Smoking Age To 21

Governor Andrew Cuomo of New York had to be a big shot, apparently.  Today on July 16, he finally signed the bill that raises the age limit for tobacco and vaping products to 21, effective 120 days from today.

When the lights went out on Broadway last Saturday, that was certainly an ominous sign.  And lest anyone think there is a consolation prize, Cuomo failed to even get weed legalized last month since he apparently couldn't even muster up the votes in the legislature to pass it.

Many counties and cities in the state, including NYC and now all of its "backyard", already set the tobacco/vape age limit at 21.  That of course includes my home county of Westchester, which raised it from 18 to 21 last year, and even Putnam County too.

The only silver lining is that the new age limit of 21, like the old age limit of 18, will only apply to vendors, as it will still not be illegal for "underage" people to possess or consume tobacco or vaping products.   But that still does NOT mean we should support it one bit!

With the "bookend" states of California and New York now down, plus several other populous and not-so-populous states, not to mention hundreds of localities across the country, and even our nation's capital, is our movement lost for good?  We sure hope not.  It looked like the Tobacco 21 movement had stagnated last year, but now with New York, Utah, Virginia, Washington State, Illinois, and Texas next to jump on the bandwagon, and soon the federal government as well, we clearly got way too complacent last year.  It certainly does NOT bode well for any near-future attempt to lower the drinking and toking ages to 18!

Hindsight is 2020, both the year and the vision.  There is still a slim chance that the America we know and love is not completely lost yet.  But that window is closing very, very fast.

The Overton Window Has Shifted, And Not In A Good Way

With more and more states raising their smoking ages to 21 (and the federal government likely to follow very soon), along with a burgeoning movement to raise the "juvenile" injustice age to 20 or 21 (or perhaps even higher), one can conclude that the Overton window is currently shifting in the wrong direction.  That is, it is becoming increasingly politically acceptable to raise age limits higher than 18, while lowering age limits is becoming increasingly unacceptable these days.   And both corporate duopoly parties in government today seem to be equally affected/infected by this virulently ageist and illiberal trend towards higher and higher age limits.

Clearly, it doesn't take a rocket scientist to see that the odds of us successfully lowering the drinking age (and toking age) to 18 anywhere in the the USA have really never been lower than they are now.  Even the possible silver lining of a new showdown between the feds and states is exceeedingly unlikely now, since Mitch McConnell's "Tobacco-Free Youth Act" recently had that controversial section about withholding state grants removed before it got out of committee, and it looks likely to pass both houses without it.

Time and momentum are NOT on our side right now, in other words.  Slopes are MUCH slipperier than they appear, and we need to turn this ship of fools around before it's too late (assuming it isn't already too late).

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!

Say It Ain't So, Governor Cuomo! New York State To Raise Smoking/Vaping Age To 21

No, this is NOT an April Fool's Day joke.  New York State is now set to become the eighth (or ninth?) state to raise the age limit for tobacco and vaping products to 21.  The legislature passed it, and Governor Cuomo is expected to sign it.  If (really, when) he does, it will take effect in 120 days.  Which is very, very soon.

Many counties and cities in the state, including NYC and most of its "backyard", already set the age limit at 21.  That of course includes my home county of Westchester, which raised it from 18 to 21 last year.

The only silver lining is that the new age limit of 21, like the old age limit of 18, will only apply to vendors, as it will still not be illegal for "underage" people to possess or consume tobacco or vaping products.   But that still does NOT mean we should support it one bit!

With the "bookend" states of California and New York now down, plus several other populous and not-so-populous states, not to mention hundreds of localities across the country, and even our nation's capital, is our movement lost for good?  We sure hope not.  It looked like the Tobacco 21 movement had stagnated last year, but now with New York, Utah, and possibly Washington State next to jump on the bandwagon, perhaps we got too complacent last year.  It certainly does NOT bode well for any near-future attempt to lower the drinking and toking ages to 18!

Hindsight is 2020, both the year and the vision.

What's The Best Way To Reduce Teen Vaping? Teens Already Know The Answer

As bewildered chronological adults wring their hands and scratch their heads on how to best fight the teen vaping "epidemic", a recent article came out in Utah that actually asked teens themselves how to do it.  The answer was simple:  tax the hell out of it to make it more expensive.  Gee, who woulda thunk it?

Notice they did not say anything about raising the age limit, by the way.   America's experience with combustible cigarettes has shown that raising the price, via taxes or otherwise, seems to be the most effective and cost-effective way to do it.  And while it works for all ages, the effect size is larger for young people since they are more price-sensitive overall.

Of course, if vape taxes are raised, care must be taken to also raise combustible tobacco taxes so as not to inadvertently steer young people back to smoking.   And as long as vaping remains an available alternative, cigarette taxes can go much higher than they are now (except New York) without creating too much of a black market.   Thus vape taxes should go up, and cigarette taxes should be even higher still.  And only nicotine-containing vape juices and pods should be taxed significantly, ideally proportional to nicotine content.  (Hardware devices themselves should only be taxed modestly, if at all.)

Other effective measures we have noted include capping and reducing the nicotine content of vape products down to European and Israeli levels (JUUL, we're looking at YOU), strictly enforcing the 18 age limit on vendors for all tobacco and nicotine products, and perhaps also removing kid-friendly fruity flavors of nicotine-containing vapes from the market.  But raising the age limit any higher than 18 should quite frankly not even be considered.   Too bad Utah is now the latest state to NOT heed that last bit of advice.

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

The Kids Are (Mostly) Alright in 2018

According to the latest Monitoring the Future results for 2018, it was mostly good news.  The use of most substances is down or unchanged compared with 2017 among 8th, 10th, and 12th graders, including alcohol and combustible tobacco which are currently at record lows.  The opioid epidemic still does not seem to be engulfing teens the way it has for their elders--opioids are also down among teens.   And most notably, cannabis use did NOT increase in spite of increasingly widespread legalization, decriminalization, and medicalization in more and more states--and paired with the recent sharp decline in teen drinking, one could even argue that cannabis may be displacing alcohol a bit.

The bad news?  The second wave of the teen vaping surge from late 2017 through 2018 (after dropping from its previous peak in 2015 to a lower level in 2017) does in fact seem to be real.  And there was no similar increase in adult vaping at that time, in contrast to previous years.  But for that, we can thank the mainstream media and the FDA for fanning the flames of moral panic over teen vaping, which was probably the best (and free!) advertising that JUUL could ever possibly dream of.  And, of course, JUUL's unusually high nicotine content as well.  And, we repeat, teen smoking has continued to drop to a new record low.  As for the increase in vaping cannabis, that does not seem to have led to an overall increase in cannabis use, but rather a displacement of smoking weed to vaping it instead, much like was the case with tobacco from 2011-2017.

About That Tobacco Endgame Strategy

With all the fanfare about the FDA's crackdown on vaping, and then menthol cigarettes on the horizon as well, they have also been quietly mulling over another initiative since at least July 2017 if not earlier:  reducing the nicotine content of manufactured combustible cigarettes to a minimally addictive or non-addictive level.  This is something that Twenty-One Debunked has long discussed, and has generally supported, since 2013.  And it truly has the potential to be a game-changer.

However, Twenty-One Debunked also feels that there is a right way to do so, as well one or more wrong ways to do so.  Currently, as several anti-smoking groups caught wind of the FDA's still-tentative proposal, they have been making recommendations on how to do it--mostly in the direction of the wrong ways.  As for the right way, Twenty-One Debunked recommends the following:

• Phase the nicotine content limit down to 0.4 mg/g gradually rather than immediately, over of a period of at least one year but no more than five years.
• If decided to implement in a single step, have a delay of at least six months to a year between finalization of the rule and the effective date.
• Allow existing non-compliant inventories to be sold, applying the nicotine limits only to products manufactured or imported after the effective date of such limits.
• Exempt large cigars, defined by size or weight of tobacco, as well as pipe tobacco (which can be defined as having an alkaline pH that is a bit harder to inhale).  While still addictive and harmful, the tobacco epidemic is not driven by these products.
• And of course, exempt smokeless tobacco.
• For vape products, cap nicotine levels at current European and Israeli levels (but no lower).  Note that nearly all brands, with the notable exception of JUUL, would already be compliant.
• And of course, DO NOT raise the age limit for any of these products any higher than 18.  Ever.  Period. 

Why?  Because any quicker or stricter than the above would be practically begging for a black market and its attendant externalities, and can backfire royally.  And we really need that like a hole in the head.

Rather, we should think of manufactured combustible cigarettes and little cigars the same way we did with A19 incandescent lightbulbs effective 2014.  Did we really end up missing those?  Was there ever a black market for those?  Gee, I wonder why.   And now, four years later, the cost of LED bulbs has plummeted so much, to the tune of 90%, that they are now available in Dollar Tree and similar dollar stores.

Gradually and gingerly is the best way to do it.  And any fears of harmful compensatory behavior (i.e. puffing harder and deeper, and/or smoking more cigarettes) during the relatively brief phasedown period can be rendered moot by simply raising the federal cigarette tax a bit again, if we must.

Food for thought indeed.