Do Alcohol Taxes Still Work to Save Lives?

Avid readers of our blog would note that Twenty-One Debunked supports raising the tax on alcoholic beverages almost as wholeheartedly as we support lowering the drinking age to 18.  And there are reams and reams of research evidence over many decades--locally, nationally, and internationally--that find that higher alcohol prices (and thus taxes) save lives both on and off the highways as well as reduce crime, violence, and other alcohol-related problems.   In contrast, the ageist abomination that is the 21 drinking age has not consistently demonstrated similar effectiveness in that regard, no matter what sort of pseudo-consensus exists in the minds of its most ardent supporters, and the best evidence thus far has exposed the specious claim of saving lives as little more than a mere statistical mirage all along.

That said, for the specific endpoint of alcohol-related traffic fatalities, among the reams of evidence there have been a few outlier studies that seem to cast doubt on the lifesaving effect of alcohol prices/taxes as well.  The most recent one in 2017 by McClelland and Iselin of the Urban-Brookings Tax Policy Center studied the effects of the Illinois alcohol tax hikes in both 1999 and 2009, and found no long-term lifesaving effect from either one in terms of drunk driving deaths.  In contrast, a previous 2015 study by Wagenaar et al. had found a fairly large drop in alcohol-related traffic deaths following the 2009 Illinois tax hike, even after controlling for the effects of the Great Recession.  The biggest difference between the two studies was that McClelland and Iselin used the Synthetic Control Method (SCM) while Wagenaar et al. did not, and while a good method, like all methods it too can have its own share of pitfalls.

As for the other outlier studies, most of those are dissected and discussed in a 2015 replication review by David Roodman, which still concludes that a true lifesaving effect is likely.  One such outlier study is by Dee (1999), whose control for state-specific time trends apparently removed too much useful variation in state-level beer taxes.  And while Roodman did not discuss our all-time favorite study by Miron and Tetelbaum (2009), we should note that this study in fact began by replicating Dee (1999) using more years of data and including Alaska, Hawaii, and DC, and in contrast to Dee they did apparently find a fairly strong inverse correlation between beer taxes and 18-20 year old traffic deaths even after adjusting for state-specific time trends.

Granted, it is true that for the specific endpoint of DUI deaths, the price of alcohol may not be quite as important as it once was.  Drunk driving is far less common and far less socially acceptable than it was a generation ago, and legal sanctions against it are much stiffer now as well.  And with alcohol prices currently at a record low in relative terms, and alcohol taxes generally being a small portion of the overall price, the link between the two may not be as salient or noticeable as it once was due to being swamped or masked by other factors.  But that does not mean that it is ineffective, given the fact that several more recent studies continue to find such effects, and the numerous studies that continue find fairly large benefits in terms of reducing non-traffic deaths and harms as well (cirrhosis, unintentional injuries, cancer, crime, violence, STDs, etc.).

Thus, the overwhelming weight of the evidence still continues to support the idea that raising alcohol taxes/prices is an effective (and especially cost-effective) public health policy in terms of saving lives both on and off the highways as well as reducing alcohol-related problems in general.  And if it is high enough, it is also justified on Pigouvian grounds as well.  So what are we waiting for?

Is Alcoholism on the Rise for Women?

A recent article in Prevention discusses a recent study by NIAAA, that finds that alcoholism (or clinically speaking, "alcohol use disorder") among women has apparently been on the rise lately, having nearly doubled since 2002.  And while at least some of what the NIAAA has to say (especially their rather low definition of "binge" drinking) should be taken with at least a grain of salt (if not a whole pound), there does unfortunately seem to be at least some truth here.

So why is this happening now?  The article does speculate that deteriorating work-life balance, increased stress and anxiety, and increasingly aggressive alcohol marketing towards women should take at least some of the blame.  And all of that is certainly true to one degree or another.  But truly the pinkest elephant in the room is that excessive drinking (and related consequences) has been increasing overall for both women and men during that timeframe, and while the gender gap has indeed narrowed, men continue to greatly exceed women in terms of alcoholism and alcohol-related problems, as they always have (despite some improvement in decades past until very recently).

Americans of all ages and genders are literally drinking themselves to death as we speak.  About 88,000 per year, in fact, die from alcohol-related causes (vs. 65,000 per year for opioid and all other drug overdoses combined), a number that has been increasing in recent years.  And that number, though staggering in itself, is merely the tip of a very large iceberg of injury, illness, crime, violence, motor vehicle crashes, family breakdown, addiction, and other social costs linked to this deadly yet ubiquitous substance.  Meanwhile, the powers that be are unfortunately--no, shamefully, responding to this epidemic with a collective shrug for the most part.

Fortunately, we know now after decades of reams of research evidence that there is in fact a very simple solution for reducing the death rates and other harms of excessive drinking.  And that solution is raising alcohol taxes.  The higher the price of alcoholic beverages, the fewer deaths and other alcohol-related problems occur, all else being equal.  Even modest increases seem to have a significant impact.   We know this, yet not only have the powers that be generally let the alcohol taxes lag behind inflation, but have actually moved to lower such taxes as a lesser-known part of the recent Republican tax bill.  This at a time when the relative price of alcohol is at an all-time record low already and still falling, while alcohol-related casualties continue to rise.

Also, we really need to legalize the safer choice, yesterday.  Cannabis is overall safer than alcohol, and generally tends to substitute for it.  Many studies strongly suggest that when one advances, the other retreats, albeit with some nuance of course.  Cannabis may even take a major bite out our nation's deadly and devastating opioid epidemic as well, according to some studies.  There's really no good reason to keep it illegal.  Zip. Zilch. Nada.

One thing is for sure.  Raising the drinking age to 21 in the 1980s, and increasing enforcement from the 1990s onward, appears to have done NOTHING to stem this tide, at least not for this most recent increase in alcohol-related problems, particularly among women.  Yet you can bet that the powers that be will predictably double down on this very ageist abomination and greatest alcohol policy failure since Prohibition.  Because reasons.  Or something.

Update on Guam

Eight years ago this month, we at Twenty-One Debunked were chagrined when Guam unfortunately raised the drinking age from 18 to 21.  We have enough data to give some sort of an update on Guam since the drinking age was raised, and we see that the results were at best a mixed bag overall.

At least one Guam news website since then has trumpeted the July 2010 law change as a success.  For example, they note (correctly) that according to the 2011 Youth Risk Behavior Survey (YRBS), 13.6% of Guam's high school students engaged in "binge" drinking, compared to 19.2% in 2007, the last available year in the survey before the law change.  This drop by nearly a third sounds impressive until you consider the following facts:

1. The decline in high school "binge" drinking actually began in 2001, from a high of 24.9%.  The drop from 2001 to 2007 was almost as large as the drop from 2007 to 2011.
2. The figures also declined in the nation as a whole, from 29.9% in 2001 to 26.0% in 2011 to 21.9% in 2011.
3. Due to the fact that the surveys were not done every year, we have no idea when the decline in Guam began to accelerate.
4. For grades 9 and 10, the differences in "binge" drinking rates between the years 2007 and 2011 were not statstically significant, despite the fact that the differences were significant for the nation as a whole. 
5. In fact, 9th and 10th graders in Guam actually saw increases in self-reported riding with a drinking driver, while the mainland saw decreases.  So much for the trickle-down theory.
6. Guam's teen drinking and "binge" drinking rates have been consistently below the national average, even when their drinking age was 18.
7. Compared with 2007, high school students in Guam saw increases in boozy sex as well as unprotected sex in 2011.
8. While the overall decline in teen drinking did continue in recent years in Guam, we must keep in mind that Puerto Rico (drinking age 18 unchanged) and Northern Mariana Islands (drinking age 21 unchanged) also saw similar declines as well.

As for whether there were any effects on drunk driving arrests or crashes, at first it was too soon to tell since 2011 and 2012 data were not yet available right away.  Even the 2010 data were problematic since the drinking age changed in midyear and there were not enough age-specific data yet for alcohol-related crashes and deaths.   But several years later, we now have enough data to conclude that raising the drinking age in Guam did NOT save lives, since the number of DUI deaths (in total and among people under 21) did not decrease, and in fact even increased a bit since the law change.

We had previously noted the Uniform Crime Report for 2010.  In it we see that total DUI arrests dropped significantly from 2009 but nonetheless remain higher than 2008.  DUI arrests for 18-19 year olds were 42 in 2008, 52 in 2009, and 35 in 2010, which was a slight decrease from 2008.  (Data for 20 year olds in 2010 was lumped in with 21-24 year olds, so it could not be used.)  Juvenile crime (i.e. under 18) saw zero progress overall in 2010, and in fact nearly doubled from 2009.  Specific crimes that rose in 2010 among juveniles included not just DUI but also murder, rape, assault, robbery, vandalism, liquor law, and drug abuse violations among others.

One must also remember that in 2010 Guam had a major crackdown on drunk driving with tougher new penalties (after many years of a very lax policy), and also increased education and awareness about the alcohol problems on the island.  Also, the new drinking age of 21 appears to be more heavily enforced that the previous drinking age of 18, which was poorly enforced.  That's a lot of variables to consider.

The most recent Uniform Crime Report for Guam was for 2016, and the data show that there were 17 DUI arrests for 18-19 in 2015, about half the number there were in 2010. Apparently, data were rather spotty for the years in between.  That said, the number of DUI deaths nonetheless went up from 2010-2013 before dropping again through 2015, so it would be facile and fatuous to link this longer term trend to the drinking age hike.  More likely it was due to increasing crackdowns on DUI in general.

Finally, we should note that if Miron and Tetelbaum's groundbreaking study of the 21 drinking age is any guide, any apparent benefits of Guam raising the drinking age to 21 should disappear beyond the first year or two of adoption.  And while tourism actually went up in 2011 (except for Japanese tourists after the tsunami) contrary to our predictions, and reached a record high in 2017, one could argue that Guam was simply lucky due to a confluence of other factors.  For example, the US military buildup on the island generated increased economic growth that could have potentially masked (or delayed) any declines in tourism that would have otherwise occurred.  The Fijian experience is instructive in that it took fully three years for Fiji to see that tourism was suffering due to the 2006 drinking age hike to 21, and then it was lowered back to 18 in 2009.  And now that Guam has raised the smoking age to 21 as well in 2018, they are really pushing their luck in that regard now.

A Simple, Yet Overlooked Solution to College (Town) Drinking Problems

With all of the perennial hand-wringing about binge drinking and related problems on college campuses and in college towns, one would think that actual solutions would have been implemented long ago.  But it appears that not only are the chattering classes NOT naming and defining the actual problem correctly (spoiler alert:  it is NOT peculiar to college students or limited to a specific age group), but they do NOT seem to be interested in solutions that really work.  They just keep on repeating the same tired, old nostrums that are either feel-good pseudo-solutions or worse, neoprohibitionist measures (usually involving propping up the ageist abomination that is the 21 drinking age) that tend to do more harm than good overall.  Or they jump on the anti-student bandwagon and vilify college students as a group that is somehow unworthy of full adult rights and/or somehow parasitic to the surrounding community.

But there is in fact a very simple solution to reduce such alcohol-related problems, improve town and gown relations, correct for Pigouvian externalities, and raise revenue at the same time:  raise alcohol taxes locally in college towns.  The town of State College, PA, home to my own alma mater, Penn State University, is the latest to float the idea of levying their own local alcohol taxes (though the state would have to grant them permission to do so).  We have known for decades that alcohol taxes work well in general to significantly reduce alcohol-related harms without actually violating anyone's rights, discriminating against students or young people in general, or forcing non-drinkers to foot the bill for the externalities of excessive drinking.  And the state of Pennsylvania (and any other state, for that matter), would do well to grant local governments the right to levy their own alcohol taxes as they see fit, for both on- and off-premise sales.

If the price of alcohol were to go up significantly, even if only modestly, excessive drinking and related consequences (such as traffic casualties, violence, vandalism, overdoses, and public nuisances) would go down, all else being equal.  Moderate drinkers would barely even notice the price difference.  And the revenue it would raise could be used to further reduce (or at least deal with) whatever problems that remain in the community.  A win-win-win situation for everyone but the alcohol industry, basically.

So what are we waiting for?

Have We Got the "Teen Brain" All Wrong? (Part Deux)

One thing that is commonly accepted as a truism in the USA is that crime, especially violent crime, is a young person's (and especially a young man's) vice.  It typically rises rapidly in the mid-teens and peaks around the late teens and very early twenties before rapidly and then gradually declining from then on, and it is often said that "the best cure for crime is a 30th birthday."  The statistics do indeed bear this out, but it is often accepted without question that the causes of this phenomenon are biological (particularly neurological and/or hormonal) as opposed to socioeconomic or cultural ones.

Well, a new study by researchers at Penn State seems to put the lie to the biological determinist theory.   While previous studies tended to look only at Western cultures (which all show a similar age pattern for crime), this one compared the USA to Taiwan instead.  If brain development (or lack thereof) is the cause, then the age pattern for crime should be pretty much the same worldwide, but it turns out that this was not the case for Taiwan.  Over there, crime peaked in the late twenties and early thirties, roughly a decade later than in the USA.  Thus, the researchers concluded that cultural factors, not biological/neurological ones, are primarly responsible for the crime patterns by age.   Notably, this is true even though the drinking age in Taiwan is 18, compared to 21 in the USA.

These findings also dovetail rather nicely with a 2015 study by renowned sociologist and youth-rights activist Mike Males.  Using crime data from California, he found that while the typical Western age-crime pattern for homicide (peaking at age 19) held true at first without controlling for poverty, once poverty was controlled for, that pattern basically vanished for all but the poorest communities, a group in which young people just so happen to be grossly overrepresented (and not just in California either).  And while some other studies have disagreed with such findings, those previous studies have generally failed to disentangle age, period, and cohort effects, greatly confounding the results.  Thus, especially in light of the Taiwan study, we can conclude that the traditional Western age-crime pattern is largely (if not entirely) a function of poverty, not age.  Which is actually good news, given that poverty is a much easier problem to solve (at least for a wealthy and Monetarily Sovereign nation like the USA) than any neurological issues or deeply-ingrained cultural factors could ever be.

It is very rare that a single study (or two) can overturn such an apparent mountain of evidence. Unless, of course, that "mountain" turned out to be a molehill all along--and a rather shaky one at that.

Why Age-Based Curfew Laws Are Still a Bad Idea

While the primary focus and goal of Twenty-One Debunked is getting the drinking age (and now the smoking and toking ages as well) lowered (back) to 18 and not a day higher, yesterday, we have always been adamantly against age-based curfew laws of any kind, period.   It should clearly go without saying that anyone who claims to support youth rights in general should oppose such an ageist abomination.  After all, freedom of movement is a fundamental civil and human right, and youth rights is about ALL young people, NOT just 18-20 or 18-24 year old young adults.  When we ignore that fact, we do so at our own peril, given the tendency for adultism to snowball, creep up the age scale, and ultimately backfire on adults.

And aside from the injustice aspect of curfew laws (the very archetype of so-called "status offenses"), both ageist and also intersectional with classism and racism, there are also utilitarian reasons to oppose these unjust laws.  It turns out that they most likely do NOT work as intended as far as reducing crime, in fact, they may actually increase crime by reducing the number of "eyes on the street" (and thus potential witnesses) at night.  For example, a recent study of Washington, DC's youth curfew law found strong evidence of increased gunshots occurring during the marginal hour of 11pm to midnight when the timing of the curfew varied seasonally.  Also, San Francisco saw a larger percentage drop in crime, particularly juvenile crime, than the nation as a whole the from 1990-2000 when they stopped enforcing their curfew law in 1992 and repealed it in 1995.  And NYC, who also saw more crime reduction than the national average, never had a youth curfew at all.  Thus, the evidence for any benefits of such laws is mixed at best, and the overwhelming weight of the evidence points to no benefit or more harm than good.

Thus, repealing these ageist abominations should really be a no-brainer.  As for the specious argument that curfew laws are a somehow necessary counterweight to peer pressure and social pressure for parents to be more lenient than they would otherwise be, that argument is also not valid in a free society.  What authoritarians and paternalistic types call a "race to the bottom", youth-rights activists, and in fact all genuine libertarians, call "freedom".  And since the neoliberal idea that "if you can, you must" is literally nothing more than the flip side of authoritarianism, the solution to that is LESS authoritarianism, not more.  You don't stop coercion by coercing, after all.  The "tyranny of the weaker brother" is still tyranny, the pompous self-righteousness of its advocates notwithstanding.

And finally, if curfew laws are so great, and our streets are really so dangerous these days (both dubious claims at that), why are their advocates not applying them to all ages then?  After all, most crime is committed by people over 18, not under.  And perhaps if in effect very temporarily (say, 90 days or less) in areas with very high crime, there may very well be a benefit to an all-ages curfew that would not be seen so much with an age-based curfew.  But again, if done willy-nilly and/or left on the books for too long, it may still have the same sort of racist and classist effects that loitering laws and other victimless crime laws have.  After all, if someone is arrested or cited for curfew violation and/or loitering, what it really means is that the cop couldn't get them for trespassing, obstructing traffic, theft, vandalism, violence, disorderly conduct, disturbing the peace, littering, or anything else, but still chose to arrest or ticket them anyway, because reasons.  Or something.

Discriminatory curfew laws of any type have no place in a free society.  It should be "liberty and justice for all", not "liberty for just us, not all".

The Latest Moral Panic: Juuling in the Classroom

Those who are old enough to remember the 1973 song "Smokin' in the Boys' Room" by Brownsville Station (and/or it's 1985 Motley Crue cover version) would certainly remember that there was a whole lot of actual smoking going on in school or at least on school grounds back then.  Since then, in part because of the declining popularity of tobacco in general and in part due to today's stricter rules and laws governing smoking in and around schools, such conduct has declined considerably.

But now, there seems to be a new moral panic du jour taking hold lately:  Juuling.  What's that, you ask?  Well, JUUL is a fairly new brand of e-cigarette (vaping device) that was first launched in 2015 and really took off in 2017 in terms of popularity.  As for why it is so popular, it probably has something to do with the appealing fruity flavors and the fact that it is very easy to conceal since it literally looks just like a USB flash drive and doesn't smell like tobacco.  High school (and younger) students apparently even sometimes sneak using it in class, thus if one were to ever do an updated cover version of the aforementioned song for 2018, it might as well be called "Juuling in the Classroom".

So what should we make of all this?  First, don't panic, lest we continue to fuel a deviancy amplification spiral rather than let this fad burn out on its own.  The good news is that combustible tobacco consumption is now at a record low among young people, and still falling.  Vaping is actually rarely used by teens who have never also tried combustible cigarettes.  If anything, vaping in general (including, but not limited to, Juuling) is displacing combustible cigarettes on balance, and is significantly safer as well--perhaps even 95% safer by some estimates.  The bad news?  Vaping is, of course, not completely safe, as most vape juices (including all JUUL brand ones, even if its users don't realize it) do contain nicotine, which is highly addictive and is even a known neurotoxin, particularly for the developing early adolescent brain.  Other concerns include the relative lack of regulation as to how these things are made and what sort of contaminants may be lurking inside, but again, it still pales in comparison to the dangers of combustible tobacco cigarettes, which contain literally thousands of other nasty chemicals as well as nicotine, including many known carcinogens, mutagens, and teratogens.  So insofar as vaping displaces smoking, it is a net win for public health.

Secondly, we should note that this apparent fad exists even in states and localities where the age limit is 21 for both smoking and vaping (or at least for buying these things), including New Jersey.  Thus, raising the age limit is unlikely to solve anything in that regard compared with keeping it 18 and enforcing it on vendors the same as with combustible tobacco products.  Keep in mind that until fairly recently there was no age limit at all for vaping devices and liquids/pods in many states and localities.

And finally, there are practical ways of reducing any potential harm from all of this:

• Regulate vaping devices and juices/pods the same as combustible cigarettes (but no stricter), and require strong quality control standards and testing
• Warning labels alerting users about the fact that they contain the addictive drug nicotine
• Tax nicotine-containing vape juices/pods by weight or volume adjusted for nicotine content (but much lower than combustible cigarettes)
• Increase the number of nicotine-free vape juices, particularly for Juul brand ones which currently lacks such options 
• Consider banning or phasing out any vape juices/pods that have fruity, floral, or any other non-neutral or non-tobacco-style flavors unless they are completely nicotine-free ones
• Educate the public, especially young people, on the truth about vaping, particularly with an eye towards preventing accidental addiction to something they may not even realize contains nicotine at all
• Social norms marketing to help defuse any deviancy amplification spiral

Most importantly, we need to see the forest for the trees, and stop tilting at windmills already. 

What Really Happened After Raising the Smoking Age to 21? (Updated)

In 2014, New York City became the first major city in the USA to raise the tobacco purchase age to 21.  Prior to that, it was 18, much like the rest of the country.   The law was passed by Mayor Bloomberg at the end of 2013, and it went into effect in May 2014.

Since then, five states (California and Hawaii in 2016, New Jersey in 2017, and Maine and Oregon in 2018) and Guam (2018) have also raised it to 21 and numerous counties and towns/cities did so as well from 2013-2018, though a few localities had also done so earlier as well.  When Needham, MA did so in 2005-2008, there was much praise from the pro-21 crowd when surveys showed that teen smoking rates had dropped much faster in Needham than in its surrounding communities (which were 18) from 2006-2010.  So it is very curious indeed that no one seems to be talking about what happened anywhere else since they raised their own smoking ages to 21.

We think we know why.  At first glance, it does appear to have had some effect.  According to the CDC's Youth Risk Behavior Survey (YRBS), teen smoking rates did in fact drop from 2013 to 2015 in NYC:

2005   11.2%
2007   8.5%
2009   8.4%
2011   8.5%
2013   8.2%
2015   5.8%
2017   5.0%

Those are the percentages of combined 9-12 grade students who reported any current cigarette smoking in the past 30 days.  Looks impressive at first:  a relative 29% drop from 2013 to 2015.  But take a look at the same data for the nation as a whole, for comparison:

2005   23.0%
2007   20.0%
2009   19.5%
2011   18.1%
2013   15.7%
2015   10.8%
2017     8.8%

As you can see, the nation as a whole also saw a similar (if even faster) drop in teen smoking at the same time, with a relative 31% decrease from 2013 to 2015, despite no change in the smoking age in most places.  And the teen smoking rate in NYC was already much lower before the law change, having dropped more dramatically than the rest of the USA prior to 2007 and then remaining at a low level since.

How about San Francisco, another major city that raised its age limit to 21?

2005   10.9%
2007   8.0%
2009   10.4%
2011   10.7%
2013   7.5%
2015   5.4%
2017   4.7%

They also saw a similar size drop from 2013-2015, to the tune of 28% (vs. 29% in NYC and 31% in the USA overall).  Just one problem though.  San Francisco did not raise their smoking age until 2016, so these data show that the drop in the smoking rate happened while it was still 18, before the age limit was raised.  Thus, it would actually be part of the no-change control group, not the experimental group.  And if you include the decrease since 2011, San Francisco in fact saw more progress than NYC.  In fact, when we look at the 2017 data, we see that while the smoking rate continued to drop after San Francisco's age hike to 21 (and California's a month later), it seems to have dropped at a slower rate afterwards.

What about state-level data?  California's data from 2015 and 2017 show the following (the YRBSS has no state-level data for California before 2015 for this question):

2015  7.7%
2017  5.4%

That is a 29.9% drop, compared with an 18.6% drop for the nation as a whole for that two-year period.  But keep in mind that California also raised their cigarette tax by a whopping $2 per pack, effective April 1, 2017.  The YRBSS was taken after that, since the survey was done in the fall semester.  And cigarette taxes are well-known to reduce smoking, especially among young people, who are more price-sensitive.  Thus, California's smoking rate would have likely dropped just as fast without the age hike.

New Jersey has no post age-hike data yet.  But what about Hawaii, who raised their smoking age to 21 in early 2016 (but with no tax hike at all since 2011)?

2005   16.4%
2007   12.8%
2009   15.2%
2011   10.1%
2013   10.4%
2015   9.7%
2017   8.1%

Here we see a drop of 16.5% from 2015 to 2017, slower than the 18.6% drop for the nation as a whole.  Not very impressive.

And what about Pennsylvania, with no change in the age limit (18) but a $1 per pack cigarette tax hike in 2016, now just slightly below California's tax rate?

2009   18.4%
2015   12.9%
2017     8.7%

Here we see a drop of 32.6% (nearly a third) from 2015 to 2017, faster than the national drop of 18.6%, despite no change in the age limit and a tax hike only half the size of California's a year later.  In Philadelphia particularly it dropped by more than half, from 7.2% to 3.5% in those two years.  And the statewide drop from 2009 was likely at least partly a result of the federal cigarette tax hike that year as well.

Game. Set. Match.

Thus, we can conclude that the decrease in teen smoking in NYC and elsewhere following the hike in the purchase age was most likely NOT causally linked to it, and would most likely have occurred regardless given the above counterfactual data.  Kinda like we at Twenty-One Debunked initially predicted back in 2013 after first learning of the law change being proposed.  So if that wasn't the cause, what was?  Well, we know that nationwide, as well as in NYC, the secular trend for the past four decades (except a brief increase from 1992-1997) has been downward for both teen and adult smoking.  This was due to a general combination of education/awareness, taxation, regulation, and advertising restrictions, and the resulting cultural changes.  And in very recent years, electronic cigarettes have gained popularity as an alternative to combustible cigarettes, and in fact overtaking the latter and becoming at least twice as popular among high-schoolers by 2015.  Note that this was also true in NYC despite the 21 age limit applying to e-cigarettes as well.  And according to another CDC survey, the National Youth Tobacco Survey, the massive increase in vaping from 2011-2016 was in fact slightly outweighed by the decrease in combustible cigarette and cigar smoking, indicating a net displacement and substitution effect.

Interestingly, while the YRBSS did not ask about vaping until 2015, the data for 2015-2017 are quite instructive.  While the nation as a whole saw a modest but significant decrease in vaping from 2015 to 2017, California saw a smaller decrease than average and NYC saw a slight increase, as did Hawaii.  Likewise, Pennsylvania saw a larger than average decrease, which is not surprising given that they also significantly hiked their vape tax as well in 2016.  Though there are only two years of data, for 2017 these data are more reliable than the Monitoring the Future (MTF) survey since unlike MTF, there was no change in the question for the YRBSS.

Bottom line:  it looks like the supposed benefits of raising the smoking/vaping age to 21 were, shall we say, all smoke and mirrors.  The supposed success of Needham, MA 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.

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.

Why the STATES Act Doesn't Go Far Enough

As far as the prospect of cannabis legalization at the federal level in the USA is concerned, there seems to be both good news and bad news.

The good news is that there is a bill in Congress with strong bipartisan support, known as the STATES Act, that would effectively make it so the federal Controlled Substances Act would no longer apply to cannabis when used, possessed, produced, transported, distributed, or sold in compliance with state laws.  This will be a real game-changer and would essentially put an end to the legal limbo that state-level legalization has been in with respect to federal law (as cannabis has heretofore remained illegal at the federal level as a Schedule I controlled substance).   Cannabusinesses would no longer be in danger of the feds, and would be able to use the banking system just like any other legitimate business. And Trump has said that he is likely to sign it into law. (Even a stopped clock is right twice a day.)

The bad news is that the STATES Act does not go far enough.  First of all, it does not actually remove cannabis from the Controlled Substances Act, or even remove it from the most restrictive category of Schedule I.  Also, the bill leaves some federal restrictions of the CSA intact, most notably the section prohibiting selling or distributing cannabis to people under 21, even if it did comply with state law (except for medical use, which the bill interestingly does not actually define).  While no legalization state currently has an age limit below 21 for recreational use, if any state did lower it below 21 for recreational use, any vendor who sells to people under 21 would thus still technically be breaking federal law.  Ditto for anyone who hires anyone under 18 to work with cannabis in any capacity, sells at truck stops or rest areas, and a few other things as well. 

There are indeed better bills that have been introduced in Congress that do not have these flaws, most notably the Marijuana Justice Act.   That bill removes cannabis from the Controlled Substances Act entirely, expunges federal cannabis convictions, sets up a community reinvestment fund, and would also help to tackle racial and class disparities in state-level cannabis arrests.  Another bill by Senator Chuck Schumer would simply remove cannabis from the list of controlled substances and otherwise leave it up to the states.   Twenty-One Debunked would clearly much rather those kinds of bills get passed, especially the first one.  But in the interim, we will grudgingly support the STATES Act until we can get the Marijuana Justice Act or a similar bill passed, as federal legalization is LONG overdue.

O Cannabis! Canada Moves to Legalize It

On June 7, 2018, the Canadian Senate voted 56-30 to approve Bill C-45, which will legalize recreational cannabis at the federal level.  The House of Commons had already passed it, and while the House must now decide whether to approve or reject the several amendments added on by the Senate, it is basically a done deal at this point, and will soon be heading to Prime Minister Justin Trudeau's desk.  And he will almosy certainly sign it into law, as after all the basic tenets of this bill were largely his very own brainchild.  Thus, it is now virtually certain at this point that Canada will become the world's first highly developed nation (and second nation overall after Uruguay in 2014) to fully legalize cannabis for all uses at the national level.

Put that in your pipe and smoke it.

And Canada's model for legalization would in fact be superior to those of several US States in several ways:

• The age limit at the federal level will be 18, and at the provincial level will be 18 or 19, depending on the province, just like the drinking age. (In contrast, all US States that have legalized it set the age limit at 21.)
• Penalties for underage possession would likely be just a modest civil citation/ticket (though that will be up to the provinces).  (Unfortunately, in some US States it is still a criminal offense if "underage")
• Penalties for sharing small amounts (such as passing a joint) with someone below the age limit but close in age would also likely be a modest civil citation/ticket rather than a criminal offense.  (Unlike the USA)
• Taxes would start out quite low, to avoid perversely incentivizing the black market to linger around after legalization. (The opposite is true in many US States.)
• The threat of excessively strict "local option" resulting in vast swaths of territory where cannabis cannot be bought and sold legally at all would essentially not exist in Canada.  (Unlike some US States)
• And they added an amendment that would provide better safeguards against organized crime as well.

That said, their model is not completely flawless.  For example, the federal limit for home growing is a mere four plants per dwelling at any given time, with a height restriction, and provinces would have the right to ban home growing entirely if they so choose.  We think a limit of six plants per person and twelve plants per dwelling would be better, and that only densely populated areas with dispensaries fairly close by should be allowed to ban home growing if they so choose (though hopefully no such bans).  Also, First Nations (Indigenous) reserves, though currently allowed to locally ban or heavily restrict alcohol, appear to have no such latitude when it comes to cannabis (though we feel they should on their own land), and the issue of tax-sharing with the tribes needs to be ironed out as well--though the First Nations lobby ultimately dropped the initial opposition to the bill.  But these flaws, along with some more trivial ones, can be resolved later.  Otherwise, this is a good bill overall, and one major step closer to Reefer Sanity for a change.

We here in the USA can certainly learn a lot from our friendly neighbor to the north.  And that is true for both alcohol and cannabis.  They certainly don't seem to be too keen on repeating our mistakes.

UPDATE:  As of June 20, 2018, just in time for Canada Day (July 1), the bill has officially passed in its final form.  The official start date for legalization, though, will be October 17, 2018, to give the provinces more time to prepare.  Better late than never.