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.

Has the Tobacco 21 Movement Already Crested?

The ignoble experiment to raise the legal drinking age to 21 in the 1980s has generated much controversy despite the political and media pseudo-consensus favoring it, and we at Twenty-One Debunked have, well, debunked it time and again.  Of course, the data from the 1970s and 1980s on which nearly all drinking age studies are based are now quite outdated, as the USA is almost a completely different country now.  So what if there was a way to re-run this same natural experiment today?

Well, it turns out that there is, albeit with a different psychoactive substance:  Tobacco 21 laws have proliferated since 2012 and especially since 2015, mostly at the local level but increasingly at the state level as well (with Massachusetts being the most recent one to do so).  And what were the results?  A big nothing in terms of teen smoking rates, basically.  There has been essentially no hard evidence that there was any sort of correlation between a state's or locality's tobacco age limit vs. their teen smoking (or vaping) rate, period, regardless of whether it was 18 or 21 (or, less commonly, 19).  Thus, raising the age limit from 18 to 21 has been an unnecessarily ageist endeavor, and one can thus easily extrapolate these results to alcohol and cannabis going forward as well.

True, from 2013 to 2017, there was a massive drop in teen and young adult smoking.  But that was more likely due to the explosion of vaping during that time than any other factor, and happened in states in localities that kept their age limits at 18 all along as well as those who raised them.  Which, by the way, also debunks the laughable idea that vaping is somehow a "gateway" to combustible cigarettes--if anything, raising the age limit for e-cigarettes/vapes may even steer young people back towards combustible cigarettes according to some studies.

As for Chicago's supposed success story in terms of reduced smoking rates in the first year after hiking their age limit to 21 in 2016, note that Chicago also recently hiked their cigarette tax as well, to make their cigarettes some of the most expensive in the nation.  Pennsylvania also hiked their own cigarette tax while leaving their age limit at 18, and if anything Philadelphia has seen more progress in reducing teen smoking than Chicago from 2013-2017 according to the YRBSS.  Thus, no causal link has been proven.

And while the Tobacco 21 movement luurrrves to gloat about their very first victory in the Boston suburb of Needham, MA, they conveniently ignore another Boston suburb, Cohasset, where teen tobacco use actually increased in the year following enactment of their own local Tobacco 21 law.

Some may dismiss the relevance of tobacco age limits to alcohol (or cannabis), of course, but keep in mind that just a few years ago, Tobacco 21 advocates actually predicted that raising the age limit for tobacco to 21 would be more effective that raising the drinking age to 21 was in the 1980s.  Tobacco is far more addictive, which in economic terms means that while the short-run elasticity is lower than for alcohol (or cannabis), the long-run elasticity is higher than for these other substances.  And easy access to a daily or almost daily source is thought to be far more important for tobacco as well.  Thus, the failure of Tobacco 21 laws to have any meaningful impact on teen and young adult smoking rates would also apply a fortiori to alcohol and cannabis as well.

The Tobacco 21 movement now seems to be running out of steam, as their initial euphoria pinned on irrational exuberance is fading fast.  This year, only one state raised their smoking age to 21, compared with three states last year and two states in 2016, and fewer localities have changed their laws this year as well.  The momentum is almost completely gone now.

And the fact that Big Tobacco has now recently jumped on the Tobacco 21 bandwagon (yes, really), after at least feigning opposition at first, shows that the movement has jumped the proverbial shark, and is now tainted as well.  Strike three, yer out!

2018 is almost over, and the current 2010s decade is also almost over as well.  Let this be the time now to flush the idea of the 21 age limit (for any age-resticted product) down the toilet for good with all of the other dumb things from this despicable decade.

Americans Still Drinking Themselves To Death

With all the news about tobacco, vaping, opioids, and cannabis lately, Twenty-One Debunked had almost forgotten about the very substance that led us to our founding in the first place: alcohol.  And the news about alcohol these days is hardly anything rosy:  Americans are still drinking themselves to death, at an alarming and increasing rate.  And yet, such very bad news (among adults) is strangely banal and often seen as not particularly newsworthy.  As we like to say, it is our country's "pink elephant in the room".

Teen drinking specifically may be at or close to a record low now, as it is in many other countries as well, but the tragic truth is that Americans in general are currently drowning in the bottom of the bottle and paying a heavy price for it.

According to a recent article, there are indeed several proven strategies that can be implemented at federal, state, and local levels to help stem the tide and get a handle on America's drinking problem.  We KNOW how to do it, and have known for decades now.  And while they may not necessarily get at all of the deepest root causes, they are still known to work quite well in the meantime regardless:

• Raising alcohol taxes
• Restricting the number/density of alcohol outlets and/or the hours/days of sale
• Improving access to treatment
• Bolstering coping skills

And while the first two get the most "bang for the buck" in terms of cost-effectiveness, they are unfortunately a relatively tough sell in some places.  Nevertheless, all four of these strategies should be implemented yesterday--if only our "leaders" would have the intestinal fortitude to do so.

Notice also that there was no mention of the 21 drinking age in the article.  And that is probably because after maintaining such ridiculous and ageist laws in all 50 states and DC for at least three decades now, the supposed benefits of such laws are ringing more hollow than ever.  And if anything, it is becoming increasingly crystal clear now that the 21 drinking age is doing more harm than good by merely forcing young adult drinking underground and kicking the proverbial can down the road.

We Know Who To Thank For The "Epidemic" In Teen Vaping (Fearmongers, We're Looking At YOU!)

The FDA found that, according to new 2018 survey data, vaping is up nearly 80% (78%) from 2017 among high school students and up nearly 50% (48%) among middle school students.  Previously, teen vaping had increased 900% from 2011-2015 (while also displacing combustible cigarette smoking which is now at a record low, mind you), dropped slightly in 2016, and held steady in 2017 before this much more recent increase in 2018 that is believed to be driven by flavored vapes, particularly the JUUL brand which didn't really catch on until late 2017.

The recently announced FDA restrictions, in which flavored vapes (other than mint, menthol, and tobacco) will no longer be sold in stores unless those stores prohibit the entrance of people under 18, are largely a reaction to such data.   But let's look at the sequence of events here:  despite JUUL being founded in 2015, it is unlikely that many people had ever even heard of JUUL until the fearmongering mainstream  media's moral panic began in 2017, providing the very best (and free!) advertising that JUUL could ever possibly dream of.  Thus, we all know who to thank for that--fearmongers, we're looking at YOU!

If they really want to reverse this media-induced deviancy amplification spiral, the best thing for the media and the FDA is to simply STFU now that the new regulations are a foregone conclusion.  Also, reducing the maximum nicotine content of vape products (JUUL is apparently unusually high) down to European and Israeli levels would also make it less likely that young experimenters would get hooked.  But of course, that would make too much sense.

FDA and New York Take Aim at Flavored Vapes

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

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

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

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

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

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

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

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

Smoking Tobacco May Actually Be Eradicated By 2030

Well, in the UK at least, particularly in England, according to a new report.  The British currently have the second lowest smoking rate in Europe after Sweden, and only slightly higher than the USA, and rapidly falling for the past several years.  And if current trends of the past five years continue, smoking rates will drop below 5% of the adult population (what researchers define as a "smoke-free" country) by 2030.  Given that nearly half of British adults smoked in the early 1970s, this is no small feat.

And the real kicker?  This is all happening without raising the smoking age to 21, as it is currently 18 (just like their drinking age) with no plans to hike it any further.  The Tobacco 21 fever currently sweeping the USA by storm simply hasn't caught on over on the other side of the Atlantic.  And unlike in the USA, there is no moral panic over vaping either.  If anything, Public Health England encourages current smokers to switch to vaping to help them quit.  These kinds of ageist American-style moral panics, with very few exceptions, are really quite foreign to them.

And come to think of it, after an initial boom in e-cigarettes for a few years, even vaping is now on the decline as well.   It appears that's what happens when you don't turn something like that into a media circus / moral panic / deviancy amplification spiral.

It is things like this that almost make us wish that Britain, our mother country, would just revoke America's hard-won (but subsequently squandered) independence.  (Tongue firmly in cheek, of course.)

Guess Who Now Openly Supports Tobacco 21 Laws? Go On, Guess...

Tobacco 21 laws, or laws that raise the age limit to buy tobacco products to 21, are unfortunately gaining popularity as a sort of "feel good" measure despite the relative dearth of evidence backing them up.  Well, now we can add a new name to the list of supporters:  Philip Morris Altria Group.  That's right, a company whose former name is literally synonymous with Big Tobacco now supports, whether grudgingly or otherwise, a smoking age of 21 (even at the federal level) despite at least feigning opposition just a few years ago followed by awkward silence on the topic.

So why the sudden turnaround?  Probably a cynical combination of public relations as well as the realization that raising the smoking age to 21 (compared to 18) in several states and localities did NOT really end up hurting their bottom lines after all.  And even more cynically, they can perhaps now leverage the arguably enhanced forbidden fruit effect to their own benefit, all while patting themselves on the back for their "corporate social responsibility".

(RALPH!)

You know, kinda like they did all along (to one degree or another) when the age limit was 18, and like the alcohol industry has done with the 21 drinking age.  Put up a public fight at first, take a dive, stay quiet for a few years, then publicly support the new laws while leveraging them (and simultaneously fighting against higher taxes or any new regulations).  Quislings.

Thus, it is safe to say that our cynicism is now fully maxed out.  And that really says something indeed.

Traffic Deaths Down So Far In 2018

There is good news on the highways lately, namely that preliminary data for the first half of 2018 show a 3.1% decrease in traffic deaths, and 2017 saw a 1.8% decrease as well following two straight years of significant increases.  This is true despite the fact that the economy is still improving and there is thus more driving going on now than a few years ago.

So what happened in 2017-2018?  Well, gas prices began rising again, after plummenting in 2014-2015 and reaching a low in the spring of 2016.  And we know that there is an inverse correlation between gas prices and traffic fatalities.  gas prices still remain well below their 2011-2014 average levels, even as some states raised their gas taxes.  So that only explains part of the picture.  And alcohol taxes, already historically low, have actually dropped since the Republican tax bill.  So what else could it be?

The general secular trend in traffic deaths per vehicle miles traveled has been downward for decades, so this recent decrease could simply be reversion to the mean following the 2015-2016 spike in fatalities, at least in part.  But the fact that so many states recently legalized cannabis from 2016-2018, and the proverbial dust has settled in the few states that had done so earlier, at the very least casts serious doubt that the previous spike in fatalities was caused by legalization, and supports the idea that legalization may have even reduced such deaths by displacing alcohol use and thus drunk driving as well.

Thus, as we have noted time and again, cannabis legalization was not a disaster after all, and seems to have been a net benefit to public health and safety overall.  Next step is to legalize it at the federal level and in all 50 states and all territories as well, and also to lower the age limit to 18 like Canada now has.

So what are we waiting for?

If You Can't Beat 'Em, Join 'Em

That is what at least some segments of the alcohol industry increasingly feel about cannabis as it becomes more and more mainstream.  For decades, much of the industry has generally opposed cannabis, and legalization at first seemed to be taking a bite out of the demand for booze.  But now, they are catching on and want a piece of the action now, knowing what an unstoppable juggernaut that legalized cannabis has become.  And this is just the beginning.

Among Millennials, alcohol is retreating while cannabis is advancing, a trend that shows no signs of stopping anytime soon.   Thus, some alcohol companies, particularly the craft brewer Lagunitas (itself owned by the Dutch multinational beer company Heineken) are now starting to market cannabis-infused beverages in California and other states where recreational cannabis is legal.  Meanwhile, the more conservative segments of the alcohol industry, who are loath to associate themselves with something as controversial as cannabis, are likely going to be left behind as a result.

UPDATE:  As of October 2018, it also appears that after sitting on the sidelines for years now, Big Tobacco giant Altria Group (formerly known as Philip Morris) is considering a stake in Aphria, a Canadian cannabis company.  We strongly urge the cannabis industry to refrain from making such a Faustian bargain.

Latest Teen Brain and Cannabis Study More Smoke than Fire

The scary-sounding headline from a few weeks ago in USA Today reads, "Marijuana caused more damage to teens' brains than alcohol, study finds".  Yes, there was a study that claimed to find such results, but there is less here than meets the eye.

In other words, there's more smoke than fire.

The actual study itself is predictably behind a paywall, and we will not dignify such questionable research by paying for it, so we couldn't find the actual numbers and thus could not quantify any effect sizes or how long the reported effects lasted, but the abstract and several news articles summarize qualitatively the main findings.  The study, which involved nearly 4000 students from 7th through 10th grades in the greater Montreal area, longitudinally following them for those four years, asking questions about both alcohol and cannanis use and giving tests on memory and response inhibition.  Statistically significant correlations were noted between increased cannabis use and reduced performance on such tests, while interestingly for alcohol such correlations failed to reach statistical significance.

Again, no information about the size of such reported effects, and guess what?  SIZE MATTERS.  And so does duration.  Also, it say nothing about any such correlations beyond 10th grade, nor clearly distinguish between lighter and heavier use.  (The article did note that there were many more daily users of cannabis than alcohol, despite the fact that there were many more drinkers than tokers overall the sample.)  And it is very curious that the typically pro-21 mainstream scientific community are so willing to practically exonerate alcohol in such a study of teens--or perhaps they are simply alcohol supremacists.  And while the sample size and longitudinal nature of this study puts it head and shoulders about most other studies on the matter, given the aforementioned concerns it should still be viewed with caution in terms of causation.

Additionally, the study seems to be silent on the real "dark horse of drugs"--tobacco/nicotine.  Nicotine is a known neurotoxin, particularly during early adolescence, and is far more correlated with cannabis than alcohol use.  Thus, at least some of the reported effects in the study could in fact be due to tobacco, and/or perhaps other substances as well.

Keep in mind that the infamous 2012 study that reportedly found persistently reduced IQs among adults who used cannabis before age 18, was debunked by 2014 study that found no correlation between adolescent cannabis use and IQ or exam performance (though heavy use beginning before age 15 was associated with slightly poorer exam results at age 16).  This latter study did control for tobacco, alcohol, and a host of other factors.  So it is very likely that soon another study will come a long and refute the first study discussed in this article, or perhaps find that any such effects are limited to the heaviest users, particularly those who began before age 15 or 16.  In fact, a 2018 systematic review of 69 studies of adolescent and young adult cannabis use and cognitive functioning found that reported adverse effects were much smaller in size than the prohibitionists like to claim, and generally tend to be temporary rather than permanent, even for frequent and/or heavy use.  And interestingly, no correlation with age of onset, though the mean age of study participants in these 69 studies was significantly higher than in the aforementioned Montreal study.

Other studies as well cast serious doubt on the scary claims of cannabis neurotoxicity as well, and most studies find weed safer than alcohol.

So what is the best takeaway from such studies?  It would seem that while occasional or moderate cannabis use is basically a non-problem, heavy and/or daily/near-daily use (unless medically necessary) should probably be avoided at any age, but particularly for people under 18 and especially under 15.  And while delaying the onset of use, or at least regular use, for as long as possible is probably wise for people under 18 and especially under 15, there is no hard scientific evidence that cannabis is any more harmful at 18 than it is as 21, 25, or even 30 for that matter.  Thus, there is no good reason to keep it illegal or set the age limit any higher than 18.  And even for people well under 18, the criminal law is still far too harsh a tool to apply to something like this that more likely than not turns out to be a non-problem.