Israel's (and Europe's) Non-Ageist, Cool-Headed Response to Vaping

Unlike in the USA, it seems like cooler heads are prevailing in Israel and in the EU when it comes to vaping.  Rather than respond from a position of moral panic over teen use, which only fuels the deviancy amplification spiral, they instead took a much more measured public health response.  Israel recently banned JUUL due to its unusually high nicotine content, and almost immediately afterwards, JUUL began selling the same reduced-nicotine version there that they have already been selling in the UK and Europe to comply with EU regulations.  And interestingly, Israel doesn't even have an age limit for vaping.  (It varies in Europe, and is 18 in the UK.)

The kernel of truth to the concern about youth vaping in the USA has to do with the nicotine, which is hardly a benign substance.  It is a highly addictive drug as well as a known neurotoxin, especially for the early adolescent brain, and yet some teens apparently don't realize that vape juices and pods even contain nicotine at all.  And with JUUL's high nicotine content, by the time some young experimenters realize that it has nicotine, they may already be hooked.  That said, vaping is still safer than smoking, and it seems to be making a dent in reducing youth and adult smoking rates, which are currently at a record low, as well as increasing successful quit rates among adults.  That means that vaping is literally saving people's lives.

The best balancing act would probably be to stop panicking and to cap and reduce the maximum allowable nicotine levels for vape juices/pods to European and Israeli levels.  The FDA already has the authority to do this.  Alternatively, or in in addition, taxing vape juices/pods based on nicotine content would also be a good idea as well.

And stop panicking already!  Seriously, this moral panic is the best free advertising that JUUL and other vape companies could ever possibly dream of.

Oh, and by the way, there is zero evidence that raising the age limit to 21, as was done in several states and localities recently, has had any measurable impact on teen vaping OR smoking rates compared to states and localities that kept it at 18.  And since the apparent success of Needham, MA still has yet to be replicated anywhere, it would be most parsimonious to consider them an outlier, with factors other than raising the age limit being the real underlying causes of success.

Tempest in a Vape Pod: Let's Be Adult About This

Just a few months ago, we at Twenty-One Debunked posted an article about the latest moral panic to sweep the nation: teen vaping, particularly Juuling.  Well, that particular moral panic is now at (or approaching) its ultimate crescendo as we speak, with the FDA not only cracking down on retailers who sell to people under 18, but going so far as to give vendors an ultimatum of sorts:  either they come up with a plan within 60 days to tackle youth use of their vape products, or such products will be pulled from the market.  Such fighting words, aimed primarily at JUUL, have been prompted by largely unpublished data showing an alleged "epidemic" of teen vaping.

Wait, what? Oh, they must mean the "epidemic" where a whopping 2.4% of high school students in 2017 (2.0% in 2015) nationally reported daily vaping.  (And that is the total--keep in mind that among never-smokers, such figures are even lower still, at 0.3%)  Or maybe they mean the "epidemic" in which e-cigarettes have become more popular than combustible cigarettes in terms of experimentation and casual use, and regular vaping is making a dent in displacing regular smoking, but regular vaping among never-smokers still remains vanishingly low, and the use of combustible cigarettes has fallen to a record low.

Yes, you read that right.  A record low. Smoking cigarettes is decidedly "uncool" these days.  And by some measures, vaping has already crested and it too has also declined a bit as well since its 2015 peak.

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, we must repeat, is that combustible tobacco consumption is now at a record low among young people, and still falling.  And again, 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.

For currently addicted smokers of any age trying to quit, vaping can literally save their lives upon switching, and we must remember that no matter how much of a fever pitch the ridiculous moral panic over teen vaping ultimately reaches.  Seriously.

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 highly 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 lack 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
• Consider capping/reducing the maximum nicotine content in vape juice/pods, as is already the case in the EU and now in Israel as well.
• Educate the public, especially young people, on the truth about vaping, particularly with an eye towards preventing accidental addiction to something that 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.

And most ironically of all, this moral panic driven by irresponsible yellow journalism is literally the very best (not to mention free) advertising that JUUL and other vape companies could ever dream of.  Despite being founded in 2015, it is unlikely that very many young people (or anyone else for that matter) had ever even heard of JUUL until it became at the center of the scare stories that started in 2017 and especially 2018.  And if the alleged unpublished increase in teen vaping in 2018 relative to 2017 does turn out to be real, well, we really know who to thank for that!

The Other Drinking Age? Why We Oppose Any Age Limits for Energy Drinks

Given the endless hand-wringing moral panic about energy drinks and young people, it was only matter of time before an age limit for energy drinks would be proposed (in the USA and UK, for example) or in few cases even enacted (in Iceland, for example).  While it should go without saying that energy drinks aren't exactly health food, to put it mildly, and can indeed be abused, they are hardly the demon drink they are made out to be when used in moderation by adults and older teens.  And while prepubescent children should probably not be messing around with such concoctions, it does not follow that there should be an age limit at all, let alone one as high as 18.

We at Twenty-One Debunked believe that while a drinking age of 18 for alcohol would be rather progressive (compared to the current 21 in the USA, and 20 in Iceland), a drinking age of 18 for non-alcoholic energy drinks (compared to no age limit currently in the USA) would be utterly regressive, and thus we oppose any such attempts to enact one.  The alternatives we would support, though are not necessarily wedded to, include the following:

• Better public education about the very real hazards of excessive energy drink consumption at any age, and any special or increased risks that children and early teens (i.e. those under 15) may face.
• Tax energy drinks themselves, as well as tax sugary drinks in general and/or even tax the sugar itself at the source.
• Consider setting a reasonable limit on caffeine content, and banning any drinks over that limit (i.e. Red Bull would be fine, but Redline would be banned).  Ditto for any other ingredients that may be harmful and/or of questionable benefit.
• Restrict advertising and marketing that targets children and teens.
• Better labeling of caffeine content as well as any other ingredients, and better quality control of energy drinks as well.
• And last but not least, make the school day start later and ease up a bit on the homework, so children and teens don't feel the need to be quite so caffeinated (and sleep-deprived) all the time.

And thus, no need to have any new age limits enacted in an ageist society that already has far too many (and often far too high) age limits as it is.  Removing individual rights, from young people or in general, should NOT be the go-to solution to any real or imagined social problem.  Seriously, knock it off.

OK, Ageists, Here's a Modest Proposal Just for You

We at Twenty-One Debunked have absolutely HAD it with ageists of all stripes, especially (but not only) the pro-21 crowd.  And this goes way beyond the 21 drinking age, by the way.  There is an increasing tendency to treat 18-24 year olds as second-class citizens, and people under 18 as not even citizens in what is supposed to be the land of the free.

Ageism/adultism just keeps on creeping up the age scale, it seems.  So many ageist jerks insist that even 18-24 year olds are somehow "not real adults" or at least not as mature as previous generations were at that age, because reasons, and thus somehow not deserving of full adult rights, also because reasons.  Or something.  They often appeal to junk cargo-cult neuroscience to back up their specious arguments that are quite heavy on feelings but light on facts.

So here is a modest proposal for you ageist bigots.  If you insist on treating 18-24 year olds as second-class citizens, and people under 18 as not even citizens, you need to be consistent since you really can't have it both ways.  Go ahead, in every way.  Raise the age of majority, the age to join the military, and the age to be tried and punished as an adult to 25, full stop.  You read that right, especially that last bit.  (Rampage time!)  But wait, there's more.  If 18-24 year olds are somehow not really adults in your view, then you should also raise the age of consent for sex to 25 as well.  Yes, really.  After all, adults should really not be having sex with those whom they consider to be non-adults, because we all know what that is called, and it isn't anything good.  So go ahead and raise it then--what's stopping you? "Under 25 gets you 25 to life."  But truly nothing says adulto-patriarchal dominance like a little droit du seigneur, right ageists?

The fact that the age of consent for sex (16 in most states, 17 or 18 in a few) is lower than age of majority (18), let alone the drinking age (21) and car rental age (25), really speaks volumes as to the rank hypocrisy of the ageists who wrote these laws.  Meanwhile, many states don't even have close-in-age exemptions, so many of the young people such laws are supposed to protect get caught in the dragnet and go to prison or at least have to register as sex offenders for life for having otherwise consensual sex with each other (i.e. an 18 year old and a 16 year old, or even a 16 year old and a 15 year old in some states).  And under federal law, even sending nudes of oneself can land a young person under 18 in adult prison for "child pornography"--of oneself.  But a 30 or 40 year old can legally have sex with someone who is not allowed to drink alcohol, vote, get a credit card, enter contracts, be out after curfew, or even see an R-rated movie in some states.  Let that sink in for a moment.

Or we could, you know, just accept and treat 18-24 year olds as the full adults that they are.  In every way, full stop.  And while there is currently a snowball's chance in hell of lowering the general age of majority below 18 in the near term, we should at least lower the voting age to 16, abolish curfews, refrain from raising any other age limits (such as the driving age) to 18, and also make the emancipation process much easier for people under 18 as well.

For the record, Twenty-One Debunked does not take a firm position on what the exact age of consent for sex should be, as the issue is far too fraught, nuanced, and beyond the scope of our organization.  But we do not think it should be abolished or drastically lowered from current levels (in the 16-18 range) as that would do far more harm than good overall.  Nor do we really think it should be raised any higher than 18.  But we do think there needs to be a close-in-age exemption (when one OR both partners is below the age limit) of four or even five years, and there is really no problem with reasonable age of consent laws that cannot be solved by such exemptions to these laws.

One good article about age of consent issues can be found here, written by the ever-insightful Thomas Macaulay Miller of Yes Means Yes.  As he notes, it really should not be seen as a particularly radical position that a 40 year old should not be having sex with a 13 year old, period, no matter how much the younger person appears to "invite" such conduct.  Sometimes we really need a hard, bright line even if it seems a bit arbitrary.  At the same time, not having a close-in-age exemption ends up hurting the very same young people that such laws are supposed to protect.

Food for thought.

The Most (Cost-)Effective Ways to Reduce Alcohol-Related Harms

It has been three decades since the last state, Wyoming, raised their legal drinking age to 21 in 1988 under federal duress.  And since then, has it really led our culture to a healthier relationship with alcohol?  Hardly.  As Twenty-One Debunked has been noting for years now, the tragic truth is that Americans are drowning at the bottom of the bottle, and paying a heavy price for it.  It is the "pink elephant in the room" that no one wants to talk about, particularly for Americans over 21.  This despite the fact that alcohol continues to literally kill more people than the opioid epidemic, and yet the former has not been declared anywhere near a public health emergency the way the latter has been.  Gee, I wonder why?

And while teen drinking is currently at a record low (though not unique to the USA, so don't be so quick to give credit to the 21 drinking age), adult drinking is anything but.  What is most striking is how ageist (and cowardly) our culture's response has been to this epidemic of excessive drinking, essentially blaming young people for adult drinking problems.

As for what the most effective responses to America's drinking problem, the one that stands out as the lowest-hanging fruit of all in terms of both effectiveness and cost-effectiveness at reducing harm is raising alcohol taxes.  In fact a recent international study of 16 countries by researchers at the World Health Orgainzation (WHO) confirmed what we have basically known all along but for some reason have yet to implement fully despite reams and reams of research evidence supporting it.  Other close contenders in terms of the most "bang for the buck" include restrictions on alcohol advertising/marketing and hours of sale, but higher alcohol taxes/prices emerge as the most cost-effective measure of them all. Somewhat less cost-effective is tougher enforcement of BAC limits for DUI, but it is still highly effective as well.  And the least cost-effective, but still effective (and worth doing) albeit more expensive, measure is screening and brief intervention for alcohol problems by primary-care physicians.

And guess what was not mentioned at all?  You guessed it:  drinking age laws.   And for good reason:  the supposed "mountain" of evidence in favor of the 21 drinking age basically turned out to be a molehill all along, and a very shaky one at that.  But as an avid reader of Twenty-One Debunked, you already knew that, right?  One day we will all look at the pro-21 crowd the same way we do for flat-earthers and such.

So yes, we do need to implement these aformentioned measures, especially raising alcohol taxes.  Currently, in real dollars, alcohol is cheaper than ever in the USA.  Raising and equalizing all federal alcohol taxes to $24 per proof-gallon (i.e. the inflation-adjusted 1991 level for distilled spirits) would be a good idea, though even raising them to $16 per proof-gallon would still yield very large societal benefits as well.  That would not be much of a price hike to a moderate drinker, but to a heavy drinker it certainly would be.

And lowering the drinking age to 18 while implementing better and more honest alcohol education would most likely, at least over time, lead to a culturally healthier relationship with alcohol as well since it would no longer be a fetishized "forbidden fruit" that fosters a "go big or go home" attitude to drinking.  The status quo certainly hasn't helped America's drinking culture one bit.

Let America be America Again, and lower the drinking age to 18.  If you're old enough to go to war, you're old enough to go ot the bar.  'Nuff said.

A Generation of Sociopaths?

Are Baby Boomers (i.e. the generation born between 1946-1964) really a generation of sociopaths and/or narcissists?  That is in fact the conclusion of a controversial new book by Bruce Gibney, titled A Generation of Sociopaths.  And while we at Twenty-One Debunked are really not fond of condescending broad generalizations about any generation, there does seem to be at least a kernel of truth to his thesis, and it is nonetheless a breath of fresh air to have a book that at least doesn't glibly vilify Millennials and/or Gen Z like so many do nowadays.

According to Gibney, himself a member of Gen X, traits associated with antisocial personality disorder and narcissism do seem to be more prevalent in Boomers compared to any generation before or since.  And the hard data pertaining to behaviors associated with such traits, especially crime rates and substance abuse, do indeed seem to bear this thesis out rather nicely, as do the voting records of that generation.  Reagan, both Bushes, Bill Clinton, and especially Trump could never have been elected without the Boomers voting for them in large numbers.  These candidates all basically promised Boomers (especially white, middle class ones) the moon while asking essentially nothing of them in return, and no price was too high as long as someone else (i.e. future generations) paid for it.  And all of these candidates, to one degree or another, did serious damage to our country--economically, socially, and ecologically.

Granted, "not ALL Boomers" are like that.  But enough of them are to be a problem, and more so than any other generation.  Sound familiar?  It really should.

The real question here is WHY this generation who had so many advantages in terms of wealth and power turned out the way that they are.  Gibney, predictably, blames "permissive parenting" and the fact that they were the first generation raised with television.  True, as the Dr. Spock generation they (mainly white, middle-class Boomers) were raised more permissively than previous generations, and likely more so than subsequent generations in at least some ways.  The mid to late 1970s could indeed be considered a time of "peak permissiveness" in terms of both parenting practices and public policy, and such trends towards permissiveness indeed began from about 1945 onward.   No doubt about that.

But stating such time-series correlations does NOT actually establish causation.  Another factor, overlooked by Gibney, explains Boomer (and early Gen X) traits, behaviors, and statistics far more than anything else:  preschool lead poisoning from leaded gasoline and paint.   Leaded gasoline begain being used in the 1930s, and after WWII, gasoline consumption (and thus lead pollution) increased dramatically until the 1973-1974 oil crisis and the phaseout of leaded gasoline beginning in 1976.  Lead paint, which was banned completely in 1978, had already been phased down in decades prior, but lingers in older housing stock.  Thus, the first permissively-raised generation and the first televison-raised generation and the wealthiest generation in history and the most heavily lead-poisoned generation in history are all in fact one and the same.

And unlike the specious correlations with parental permissiveness and screen time, the correlation with early lead poisoning (a known nasty neurotoxin) and various traits and behaviors that can be described as sociopathic (or at least poor impulse control) is undeniable and meets all of the Bradford-Hills criteria of causation.  As researcher Rick Nevin notes, relationship between preschool lead exposure and such adverse later outcomes as major and minor crime, juvenile delinquency, unwed/early pregnancy, and stuff like that remains highly robust across studies numerous time periods, nations, cultures, and functional forms.  And while white, suburban and rural, middle-class Boomers were arguably much less affected by such lead poisoning than their poorer, urban, black, and/or Latino counterparts in terms of lead poisoning, that doesn't mean that they were completely unaffected by it, since there was still plenty of lead to go around everywhere.  The difference was really one of degree, not kind.

Fortunately, thanks to the phaseout of leaded gasoline and paint, newer housing stocks, and reduction of lead emissions from incinerators, lead poisoning in children today is now at the lowest level in at least a century.   But there is still much work to be done.  There is plenty of old housing stock with deteriorating lead paint, and there is still too much lead in the drinking water of many communities across the country.  According to Nevin, replacing old windows in old housing with new, double-glazed, energy-saving windows, along with stablilizing currently deteriorating old lead paint on walls, would be "low-hanging fruit" in terms of lead abatement that would more than pay for itself in the long run.  As for drinking water, replacing the older service lines would be expensive and time consuming (though still worth doing nonetheless), but in the meantime we could stop adding fluoride yesterday (which is not only neurotoxic in its own right, but potentiates the neurotoxicity of lead and increases lead corrosion and leaching from pipes) and perhaps use ozone instead of chlorine (which also leaches lead) for disinfection of the drinking water supply.

And while many of the Boomer-induced problems left for future generations are indeed real, we should also note that Gibney's fretting about the national debt and Social Security's supposedly impending insolvency is misplaced since these things are really non-problems for a Monetarily Sovereign government like our own federal government.  It is in fact a Big Lie that federal taxes actually pay for federal spending and that the federal government can somehow run short on dollars.  And that big, scary number that is our so-called "national debt" is not debt in the usual sense of the term but rather more like a national savings account.  Author Rodger Malcolm Mitchell, himself a member of the Silent Generation, would have some choice words for authors like Gibney in that regard.  But that is a topic for another discussion.

So perhaps what is really needed here, instead of vilification of an entire generation, is that crucial trait that sociopaths and narcissists lack:  empathy.

Finally, a Mainstream Social Science Article that Doesn't Trash Young People

A new article by Jeffrey Jensen Arnett is one of the very few mainstream articles that truly tell it like it is in regards to young people today.  Looking at trends in various risk behavior (e.g. alcohol, tobacco, and other drug use, crime and violence, traffic fatalities, teen pregnancy, unprotected sex, etc.) the author found what renowned sociologist and youth-rights activist Mike Males has been saying all along:  young people aged 13-18 today are actually better behaved overall that previous generations were at that age, at least going back to 1990.  But don't expect the ageist mainstream media to let mere facts get in the way of a good moral-panic story, of course.

Most interestingly, the authors attempts to delve into the causes of such positive trends since 1990.  Two such general explanations--public policy changes and changes in parenting practices/styles--were examined but were found quite lacking, in part due to data unavailability and in part due to no significant or even perceptible time-series correlation (sometimes even in the wrong direction).  The third explanation--the massive increase in smartphone and other media use among young people--is in fact the one that seems to carry the most weight.  Counterintuitive as it may be, such media use, for all of its faults, is quite a time sink that perhaps keeps young people too occupied to get into trouble as much as they otherwise would.

These trends have occurred despite the deteriorating behavior of the adults around them, and also seem to be more pronounced in the USA compared to other industrialized countries.  No explanation explains all of it, and some of it may simply be reversion to the mean or societal evolution.  But one should note that since 1990 there has been no further change in the drinking age since all states were already 21 by then, so there is no evidence that any trends since then were the result of that particular ageist abomination.

In fact, we actually have a very good yardstick (or perhaps meterstick) for what would have happened had the USA not raised the drinking age to 21 in the 1980s.  It's called Canada.  Again, there is no evidence that the 21 drinking age is responsible for such trends.  Zip.  Zilch.  Nada.  Sorry, try again, ageists.

So what else could it be?  Well, one likely candidate could be the retreat of an old villain--preschool lead poisoning from paint and gasoline--after its phaseout.  While the article does not mention it, the fact remains that young people today (except perhaps in Flint, Michigan) were exposed to far less lead (a known nasty neurotoxin) than previous generations were, especially the Baby Boomers.  And the phaseout of leaded gasoline began in 1976, so those born in and after that year reached adolescence in 1990 or later.  And the phaseout began and finished earlier in the USA and Canada than it did in most of Europe, the UK, and Australia, let alone the rest of the world.  In fact, only Japan phased it out significantly sooner than we did.  At the same time, the USA was also much slower in phasing out lead-based paint (1978, much later than the League of Nations did in 1922), and had significantly higher gasoline consumption per capita than the rest of the world, so the "double dose" of lead from gasoline and paint together in the mid-20th century was higher than most other countries, hence the reversion to the mean after 1990 or so.  So that explains at least largely why the trends since 1990 are more pronounced, or at least earlier, in the USA than most other industrialized countries.

Food for thought indeed.

The Public Health Crisis That Wasn't

One of our favorite journalists, Annie Lowrey, recently wrote an article titled, "America's Invisible Pot Addicts".  While she is clearly no friend of cannabis prohibition and in fact has repeatedly gone on the record supporting legalization, in this article the author addresses head-on the issue that many (but not all) legalization advocates have heretofore been loath to discuss at all:  cannabis addiction and its apparently growing trend in this country.

As she quotes various self-styled experts on the matter, we seem to get several different answers on the size of the problem and especially how to handle it.  But some facts are undeniable regardless of who says them:

• Some people can indeed become dependent on cannabis, to one degree or another.  And while cannabis is significantly less addictive than alcohol, tobacco, hard drugs, prescription painkillers and sedatives, and even caffeine, it can still become quite habit-forming when used too frequently and heavily.
• While cannabis addiction is usually not as severe as most other addictions, it can be for some people.  Cannabis may be relatively harmless for most of its users, but that does not make it completely safe for everyone.  Some may find that it can have quite a dark side when seriously abused.
• Since the early to mid-1990s and especially since the early 2000s, rates of "cannabis use disorder" (abuse, dependence, or both) as defined by DSM-IV criteria have increased markedly, as have the percentage of daily or near-daily (DND) users of cannabis (about half of whom are dependent).
• While some of those who technically meet DSM-IV criteria for abuse or dependence are pseudoaddicts or an artifact of social stigma and prohibition, others are indeed genuine addicts, and the exact proportion is not entirely clear.
• Likewise, many DND users are truly medical or quasi-medical users, but many are clearly not.
• These trends in heavy and/or dependent use began long before recreational legalization and even before medical legalization in most states, and there is no unambiguously prospective link between legalization and such trends.
• These trends have occurred primarily among adults rather than teenagers.
• Regardless, none of the above facts constitute a real public health crisis at this time, and all of this truly pales in comparison to the opioid epidemic as well as the "pink elephant in the room" that is America's alcohol problem.

So yes, Virginia, there really is a "there", there, but contrary to what some commentators may fear, it is unlikely that legalization is really anything to fear in terms of making it worse.  After all, prohibition clearly couldn't stop it from rising over the past quarter-century.  And us legalization advocates would do wise to stop the denials and face the problem head-on, without fear that it would weaken our movement one bit.  Do not fall into the trap of ceding the moral high ground to the anti- side.  At the same time, we must also tackle head-on the "tyranny of the weaker brother" that really has no place in a free society.

The message really needs to be that spending the majority of one's waking hours under the influence of any psychoactive substance is probably not a wise idea, unless of course one truly needs it for medical reasons.   Saying that cannabis is the safer choice is NOT the same as saying that it is absolutely safe for everyone.  Besides, when you are stoned all the time, it basically loses its fun eventually, and isn't the whole point of recreational use by definition to have fun in the first place?  As Dr. Andrew Weil notes, if it stops being fun or effective, the worst thing one can do is smoke even more weed or seek out stronger strains.  And if you're at the point where you can't even enjoy video games without being stoned, that is definitely a warning sign that you need to at least take a break or cut back significantly, if not quit completely.

It is utterly important to first name and define the problem before discussing it further, to avoid inadvertently reinforcing the lies and half-truths on either side of the debate. We are talking about problematic, chronic, heavy, very heavy, and ultra-heavy use of cannabis here, at ANY age.  We are NOT talking about casual use, use per se by people below some arbitrarily high age limit, or about the roundly debunked "gateway theory" either.   Toking up, say,  once a week (or less) is really NOT the problem here, it's more like toking up every day or nearly so, especially multiple times a day, and/or in very large quantities, that is the real problem.  And while slopes may be slipperier than they appear as one approaches heavier and heavier use, the vast majority of cannabis users still do NOT become chronic heavy users.  And among those who do, it doesn't usually last very long, though for some it unfortunately does.

Likewise, while there currently is no hard scientific evidence (and not for lack of trying to find it) that using cannabis at 18 is really any worse in practice than using it at 21, 25, or even 30 for that matter, there is nevertheless some evidence that using before 18 and especially before 15 may indeed be riskier overall, both in terms of potential harm as well as addiction potential.  It is quite nuanced and the studies still need to be fleshed out, for sure.  But we should note that the aforementioned chronic, heavy users that represent the real problem typically started toking before 15 and/or transitioned to heavy use before 18 as a rule.  And many, if not most, of those users have also used alcohol and/or tobacco at an early age as well, again especially before 15.

As for public policy within the framework of legalization, Lowrey notes that probably one of the best--if not the best--measures that policymakers can take is to raise the taxes on cannabis.  That would, by definition, hit the heaviest users the hardest, while casual users would barely even notice the resulting price hike.  Of course, it would be best to keep the taxes very low at first in order to destroy the black market, and then gradually but sharply raise them beginning a year or two after legal recreational sales begin in a given state.  Lowrey also notes other ideas as well, such as capping THC levels in products, dispensing public health information, and restricting advertising, which are likely good ideas.  But excise taxes, especially if they are proportional to THC content (and perhaps inversely proportional to CBD content as well), would probably have the largest effect size of all in terms of reducing cannabis-related problems.  As for the fear that higher cannabis taxes would drive users back to alcohol, well, we all know by now how to prevent that hypothetical from happening:  simply raise the taxes on alcohol as well.

In other words, freedom has nothing to fear from the truth.  That, and don't fear the reefer--but DO treat it with the respect it deserves nonetheless.

Why Are Traffic Deaths on the Rise? (Part Deux)

After decades of a massive secular decline in traffic deaths, reaching an all-time record low in 2014 per VMT as well as per capita, such deaths have been creeping up again since then.  2015 and 2016 both saw national increases in fatalities, and while 2017 saw a slight decrease from 2016, the number of deaths still remains stubbornly higher than it was before the increase.  In fact, 2015-2016 is the largest two-year jump in deaths in half a century.  So why has progress stalled and begun to reverse in recent years?

The list of most likely factors includes the following:

• Lower gas prices
• An improving economy since the Great Recession
• An increase in distracted driving (and walking), primarly from smartphones
• Higher speed limits than in the past 
• Infrastructure in disrepair from decades of gross neglect
• Slacking on traffic safety improvements in general since the early 1990s

All of these things are true, and all of them are known to be correlated with traffic casualties.  Other factors are involved as well, to be sure, but these are the big ones.  The first three are the proximal causes, while the last three are the more distal ones.

Of course, drunk driving and not wearing seatbelts remain rather persistent contributors to the number of these deaths, but such behaviors remain far lower than they were decades ago.  Nevertheless, they remain at dangerous levels, and it is apparently a bit too early to feel safe in that regard.  And with real alcohol prices at record lows today and alcohol consumption on the rise for the past two decades, there is definitely a cause for concern in that regard.

What about drugged driving, then?  Is it really on the rise, like some have claimed?  Perhaps, but it may simply be that we are getting better at detecting it rather than an actual increase.  Or perhaps it is a bit of both.  The opioid epidemic certainly doesn't make the roads any safer, with such doped-up drivers nodding off behind the wheel.  And contrary to the anti-legalization folks, there does not seem to be any firm link between cannabis legalization and traffic fatalities.  In fact, some studies have found decreases in highway deaths following cannabis liberalization, due to an apparent substitution with alcohol (and perhaps opioids as well).  As for the specious claim of preliminary evidence linking the increase in pedestrian deaths in some legalization states in the first half of 2017 with legalization, that does not really pass the smell test because 1) not all legalization states even saw any increase during that time, 2) small numbers tend to fluctuate wildly, and 3) why would cannabis legalization only affect pedestrian deaths and not other traffic deaths during that time as well?

One thing is for sure.  Whether this spike in traffic casualties is a short-term blip or the start of a longer-term trend (which will only be known in hindsight), it should be a major wake-up call that we clearly cannot afford to be complacent about it any longer.  The USA has seriously lagged behind other industrialized countries for decades in terms of progress on traffic safety (all of which have lower drinking ages than we do, interestingly enough), and we need to catch up, yesterday.  That includes the safety of pedestrians and cyclists as well, who have borne the brunt of the recent increase in traffic deaths.  And even when vehicle miles (or kilometers) traveled are taken into account, the USA still has either higher fatality rates and/or has seen less progress since the 1980s compared with nearly all other industrialized (and even semi-industrialized) nations.

A short list of things we can do include:

• Crack down on drunk driving, drug-impaired driving, reckless driving, and distracted driving--yesterday.
• Stiffen the penalties for hit-and-run crashes--yesterday.
• Reduce speed limits, especially on side streets, arterials, and smaller highways--yesterday.
• Install speed cameras and red-light cameras in more places (but be sure to also lengthen the yellow lights and double-reds to prevent it from backfiring with more rear-enders).
• Raise the gas tax by a penny per week until it is at least 50 cents/gal higher than now ("A Penny for Progress") and/or implement a carbon tax-and-dividend scheme.
• Raise the alcohol taxes significantly as well (note how those taxes have been lagging behind inflation for decades in most states).
• Design roads/streets to be more pedestrian-friendly and bike-friendly as well.
• Invest more in public transportation, as well as "safe-rider" programs as well. 
• Rebuild America's neglected and crumbling infrastructure, generating millions of new jobs in the process.
• And last but not least, make the road test harder like it is in many other countries, and make driver's licenses easier to lose for serious and/or repeated traffic violations.

After all, if it saves even ONE life, it's worth it, right?  Thought so.  So what are we waiting for?

Which Ancillary Laws Actually Work to Reduce Teen Drinking? (Spoiler Alert: Almost None)

The legal drinking age (at least in terms of purchase and public possession) has been 21 in all 50 states and DC since 1988 (notwithstanding the Louisiana Loophole through 1995), but states and localities have differed since then on the "ancillary" laws that are used to prop up the 21 drinking age.  These laws include, among others:

• Laws against private possession and/or consumption 
• Internal possession laws
• Laws against furnishing alcohol to people under 21
• Dram shop liability laws
• Social host liability laws (civil or criminal)
• Keg registration 
• Use alcohol and lose your license ("use and lose" laws)
• Zero-tolerance laws for DUI
• Fake ID laws and ID scanner laws
• Age limits for serving alcohol

Most if not all of these laws have been studied to some extent, with mixed results and even some serious plot twists.  Most of these studies have been conducted by MADD-affiliated researchers such as James C. Fell, Robert Voas, and Ralph Hingson, so they should probably be taken with at least a grain of salt, if not a whole pound.  But even with this potentially significant bias, most of these laws were found to have either no effect, inconsistent effects, very small effects, or even perverse effects in terms of "alcohol-related" traffic fatalities among young people.

If these laws (and by extension, the 21 drinking age itself) did work as intended, one would expect the effectiveness of these laws to show up not only in traffic fatality statistics (which are the tip of a very large iceberg), but also in surveys of teen drinking as well, especially when recent data are studied.  A 2014 study done by Vanessa H. Sacks et al. of Child Trends examined the relationship between 14 different ancillary laws (and alcohol taxes) and both current drinking (any in the past 30 days) and "binge" drinking (5+ drinks "within a couple of hours") among high school students from 2005-2011 as reported on the Youth Risk Behavior Survey (YRBS) of those years.  The 14 laws studied were the following:

• Laws against consumption of alcohol by people under 21
• Exceptions to possession laws
• Exceptions to furnishing laws
• Social host liability laws 
• BAC limits for people under 21 (i.e. zero-tolerance laws)
• Use-and-lose laws (strength measured in three different ways)
• ID scanners in retail locations
• Keg registration
• Age limits for serving alcohol 
• Beer excise taxes in 2005
• Distilled spirits excise taxes in 2005

And the results?  All but three such laws had no significant or even perceptible effect individually on either current drinking or "binge" drinking rates.  The only three that did have any statistically significant correlation were:

• Beer taxes were significantly and negatively associated with both current drinking and "binge" drinking rates.  No surprise there, as this dovetails nicely with the reams of evidence that have found similar results.  (Distilled spirits taxes showed no correlation either way, but that apparently null result is likely due to multicollinearity since beer and liquor taxes are highly correlated with each other).
• Keg registration laws were significantly and negatively correlated with current drinking, but not "binge" drinking, in one of two models.  This result should probably be interpreted with caution though, given how multiple other studies have found a positive correlation between keg registration and "alcohol-related" youth traffic fatalities.
• Use-and-lose laws (i.e. driver's license penalties for mere possession or consumption of alcohol) showed a positive correlation with current drinking, that is, such laws seemed to perversely increase teen drinking.
• And the real kicker: after controlling for drinking rates in previous years and the number of ancillary laws in previous years, states with a greater total number of such policies perversely had higher rates of both current and "binge" drinking.  But drinking rates in previous years did not predict the number of policies in place in later years, thus ruling out the possibility of reverse causation.

Thus, while the researchers caution that these results alone are not definitive enough to establish causation, it is quite clear that such results certainly cast serious doubt on the effectiveness of such laws, and by extension the 21 drinking age itself, in reducing teen drinking and related problems.  With the notable exception of alcohol taxes, the effects of such laws are most likely negligible or even perverse overall.  That, of course, dovetails rather nicely with Miron and Tetelbaum (2009), who found that raising the drinking age to 21 seems to have had "only a minor impact on teen drinking".  And we couldn't agree more.