Thursday, February 20, 2020

And You Thought They Would Stop At 21

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

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

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

RIP Hawaii, paradise well and truly lost.

Saturday, February 1, 2020

Does Social Norms Marketing Work In The Long Run? The Latest Study Says Yes

The latest study on social norms marketing for Michigan State University students over a 14 year period is highly encouraging.  From 2000 to 2014, high-risk drinking dropped significantly faster at MSU than it did for national trends:
  • The percentage of MSU students who said they consumed eight or more drinks in one sitting dropped from nearly 28% to 16.5%, a 41% relative decrease.
  • The percentage of MSU students who said they drove after drinking fell by 58% as well.
  • Additionally, another forthcoming study found that the percentage of MSU students who said they drank on 10 or more days in the past month dropped from 24.1% to 13.4% by 2016, while it remained largely flat at the national level.
That is quite impressive.  Considering how MSU went from being consistently in The Princeton Review's list of top 20 "party schools" to no longer being on that list anymore, that really says something.

How does social norms marketing work?  Young people often falsely believe that their peers are drinking, smoking, vaping, toking, or using other substances much more than is actually the case, and they feel pressure to conform to such inaccurate norms.  This is called "pluralistic ignorance".  By simply setting the record straight about the actual numbers, it tends to reduce the use of such substances overall when the "reign of error" is corrected.  In contrast, moral panics exaggerate the levels of use, which tends to increase the use of such substances, in what is known as a "deviancy amplification spiral".

Most other studies agree on the effectiveness of the social norms approach.  The effects are quite robust and seem to occur fairly quickly in most studies.  So what about the handful of studies that seem to disagree?  It is true that poorly designed programs, unsurprisingly, do not work very well.  And for colleges and demographics in which heavy drinking is most entrenched, it stands to reason that it can take longer to show any effects, longer than the short time periods of most studies on the matter.  Attitudes generally have to change first before behavior does, as a rule.  But as we see, Michigan State is clearly an example of a formerly entrenched heavy drinking "party school" that did show massive declines in both high-risk drinking practices as well as drunk driving and the frequency of drinking.  And those declines were in fact quite long-term, continuing at least a decade and a half with still no signs of stalling.

(Looks like William DeJong was right the first time after all, even if the alcohol outlet density in college towns may moderate or confound the results in his later research on the subject.)

Social norms marketing is clearly a highly effective yet inexpensive way to reduce harmful alcohol and other substance use/abuse, and best of all, it does not violate anyone's civil rights or liberties at all.  In contrast, legalistic crackdowns and so-called "environmental management" programs like "A Matter of Degree" are expensive, authoritarian, intrusive, ageist, and can be quite difficult to implement in practice.  So what are we waiting for?

Wednesday, January 29, 2020

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

Finally, an honest article about the teen vaping "epidemic", written by New York University (NYU).  Rather than fan the flames of moral panic, and increase teen vaping even further, they simply tell it like it is.  Based on the 2018 National Youth Tobacco Survey of middle and high school students:
  • Over 80% of students, or more than 4 out of 5, did not use any tobacco or nicotine product at all in the past 30 days.
  • Over 86%, or more than 6 out of 7, of students did not vape in the past 30 days.
  • Only 3.6% of students, or fewer than one in 25, vaped regularly (i.e. on 20+ days per month), while
  • A mere 0.4%, or one in 250, of tobacco-naive students vaped with that sort of frequency.
  • All while combustible tobacco use is at a record low.
And that was in 2018, which was the year when the moral panic over teen vaping really began in earnest.  While the 2019 data for that survey showed a further increase in vaping since 2018, the full data had not been made public yet, so a detailed analysis could not be done as it was for 2018.

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

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

Friday, January 24, 2020

How To Solve The Vaping Crisis In Five Easy Steps

First of all, the "vaping crisis" is actually two different problems that just happen to share the same delivery system.  The first is the explosion of nicotine vaping (particularly the JUUL brand, with very high nicotine levels) among teens from late 2017 onwards.  The second is the "mystery" vaping lung illness, now known as EVALI, that has finally been linked to the cause that we suspected for months now:  Mostly black-market and gray-market THC (and probably CBD) vape cartridges containing the additive Vitamin E Acetate, which is apparently VERY bad for the lungs.  Instead of conflating the two, we must realize that they are two different issues with different solutions, while also noting that pushing them into the black market will only pour gasoline on the fire.

Thus, Twenty-One Debunked recommends the following:
  1. Legalize cannabis, vaping and otherwise, for everyone 18 and older, period. 
  2. For cannabis vape products, ban Vitamin E Acetate and all other additives that are not on a narrow list of approved additives.  Implement strict quality control to test for questionable substances and issue product recalls as needed.  (Also require quality control of nicotine vape products while we're at it.)
  3. Cap the nicotine content of nicotine vape products at similar levels as found in the UK, Europe, and Israel, and also subject such products to the same advertising restrictions as combustible cigarettes.
  4. Tax nicotine vape products, but keep the tax lower than the tax on combustible cigarettes (or alternatively, raise the cigarette tax even higher).
  5. Strictly enforce existing purchase age limits on vendors via compliance checks, but avoid knee-jerk reactionary policy measures such as broad flavor bans or raising the smoking/vaping age to 21, which will drive vapers to the black market.
Do these things and tone down the moral panic, and both of these problems will soon wither on the vine.  But that would make too much sense, of course.

Thursday, January 23, 2020

What If We Can't Lower The Drinking Age Anytime Soon? (Re-Post)

Perish the thought, but it looks like the utterly vile and ageist abomination that is the 21 drinking age will not be lowered to 18 (or even lowered at all) anytime soon.  It's plain to see that the movement to lower it has completely run out of momentum by now, and the movement to raise the smoking/vaping age to 21 has unfortunately only gained momentum in recent years, and with no signs of stopping.  In fact, the federal government recently raised the federal tobacco/vaping purchase age to 21.  And while the cannabis legalization movement still has enough momentum, unfortunately all US states (though not Canada) that have chosen to legalize it so far have chosen 21 as their legal toking age.

Does that mean our movement is dead, never to rise again?  Of course not, but our movement is in a sort of "dark night of the soul", apparently, and a very long one too.  Depressing as it sounds, we must realize that it is always darkest before the dawn, and we must redouble our efforts to tackle the 21 drinking age while the country is hopelessly distracted by tobacco and especially vaping these days.

One bright spot among recent trends is the increasing tendency towards criminal justice reform.  We may be able to use that to our advantage, in fact.  If we can't lower the drinking age right away, we can at least reduce the harm by decriminalizing underage drinking (and smoking and toking), reducing it to a mere infraction (ticket) offense (if there are to even be any penalties at all) without any arrests, criminal penalties, or criminal record, bypassing the criminal justice system entirely.  Some states, such as New York and DC, already have that in place for alcohol, while many other states are still quite draconian by comparison.  We should also seize upon the trend towards reducing or eliminating driver's license sanctions for non-driving related offenses, and apply that to underage drinking (and smoking and toking) as well.  We should re-prioritize law enforcement resources towards retail sellers rather than young buyers and users, and make "underage" drinking (and smoking and toking) by 18-20 year olds the lowest law enforcement priority.  And of course, in our zeal to lower the drinking age to 18, we must not throw people under 18 under the bus in the name of cowardly political expendiency in that regard either.

And of course, we need to prioritize cracking down on drunk driving, drunk violence, drunk vandalism, rape and sexual assault, and other serious stuff like that at ANY age, not the mere victimless "crime" of responsible drinking by 18-20 year old young adults.

So what are we waiting for?

Sketchy Vape Vendors, Stop Spamming And Advertising On This Site!

To anyone who has been spamming and advertising questionable things in the comments section of our blog posts, we at Twenty-One Debunked are asking you to stop doing so.  Yesterday.  Just because of the subject matter of our blog posts or the fact that they contain certain key words, it does NOT mean that you should take that as an invitation to hawk your sketchy wares here.  Needless to say, I have deleted all of your posts.  Don't let the door hit you on the way out.

This applies particularly to people persistently trying to advertise black-market cannabis vaping products (which of course are most likely adulterated with questionable and harmful additives) in the comments section of our posts.  That is practically the definition of chutzpah, given the fact that the "mystery" vaping illness (EVALI) has in fact been traced to adulterants such products.  Twenty-One Debunked does NOT endorse or support the sale, use, or promotion of ANY illicit or black-market products, period.  So cease and desist NOW.  You have been warned.

And for any readers who seek to buy such black-market vape products, please keep in mind that you are essentially playing Russian Roulette when you buy such sketchy stuff, since there is ZERO quality control and a massive profit motive to adulterate their products to inflate their profit margins.  Nearly 60 people have been KILLED by such products, and over 2600 have been seriously injured and sickened.

So buyer beware!

Sunday, January 5, 2020

The Cannabis Black Market Has A Kill Switch, And We Know What It Is

We keep hearing over and over again that the black market for cannabis comtinues to persists despite legalization for several years in several states.  And we also are learning that this black market is selling notoriously tainted counterfeit THC vape products which are the primary cause of the "mystery" vaping lung illness now known as EVALI.  National legalization should really be a no-brainer at this point.

But why does the black market persist so tenaciously even in states like Colorado and Washington that have had legal recreational sales for over five years now?  The answer is overtaxation and overregulation, particularly in terms of retail licensing fees and quotas.  And the kill switch for the black market is thus really quite simple:

So what to do?  Cut the taxes on cannabis, yesterday, for at least a year or two before raising them again.  Consider a complete tax holiday for a few months, like Oregon did when legalization began there.  Ease up a bit on licensing regulations (and fees) for both producers and retailers.  Allow at least all liquor stores to sell weed alongside their booze, and further consider allowing any store that sells cigarettes to also sell weed as well, including grocery and convenience stores.  Lower the age limit to 18, yesterday.  Encourage current black market dealers to "go legit", by giving amnesty to unlicensed sellers and allowing them to obtain retail licenses.  And once these things are done, then crack down hard on what remains of the black market, particularly the illegal commercial growers and higher-ups in the illegal businesses and organized crime syndicates.

Problem solved.

And of course, fully legalize cannabis at the federal level as well.  Period.

Of course, once the black market is dead and gone, then by all means, tax away.  But now is NOT the time for overtaxation or overregulation.

So what should the tax on cannabis be?  To start with, we at Twenty-One Debunked believe it should be no higher that $10/ounce for bud and $2.50/ounce for trim at the production/cultivation level, with no other taxes aside from regular sales tax.  Consider a three-month tax holiday as well, like Oregon did in 2015.  Then, after the first year or two, the tax should be no higher than $50/ounce for bud and $15/ounce for trim, much like it is in Alaska today.  As for concentrates and edibles, those are best to tax based on THC content, e.g. 1 cent/milligram of THC.

Indeed, recent studies in both the USA and Canada do bear this out.  Allowing a legal alternative to the black market will out-compete with the latter, but only if the price of legal cannabis flower remains below about $14/gram.  Above that threshold, adult customers will readily switch back to the black market if it is the cheaper option, at least in the first few years post-legalization.

As for the price elasticity of demand for cannabis, that has been a controversial topic, but recent studies find that it is relatively inelastic at low prices, but becomes quite elastic at high enough prices, implying an "elastic zone" above some threshold (in one study, $15/joint, or about $30/gram based on the study's half-gram definition of a joint) for high-quality weed.

Interestingly, some other studies find cross-elasticity between alcohol, tobacco and cannabis among young people, such that raising the cigarette tax and even the beer tax can lead to reduced cannabis consumption.  Thus, any fears that falling cannabis prices will lead to more teen use can be addressed by simply raising the taxes on the other two substances in the meantime, before the cannabis black market is eradicated.  (Which will also decrease the use of alcohol and tobacco as well, by the way.)

Remember, there is really no good reason why cannabis needs to be regulated any more stringently than alcohol or tobacco.  After all, while it is not completely harmless for everyone, the fact remains that by just about any objective, rational, scientific measure, cannabis is safer than alcohol, tobacco, most prescription drugs, aspirin, and even Tylenol, while it is less addictive than coffee.  Thus our laws and regulations need to align accurately with reality, since facts > feelings, even in a "post-truth" society.

Thursday, January 2, 2020

One Weird Trick Reduces Binge Drinking on College Campuses By Nearly 10%

Clickbait-y title aside, a recent study confirms what we at Twenty-One Debunked have always known.  When examining substance use trends among college students from 2008-2018, it was observed that recreational cannabis legalization was associated with nearly 10% LESS "binge" drinking by students over the age of 21.  That is of course not surprising, given that alcohol and cannabis tend to be substitutes, and the legal age limit for both substances is 21 in all such legalization states so far.  No such effect was observed for students under 21, and no other effects were observed on trends for any other substance use (including nicotine use, illicit drug use, and prescription stimulant, sedative, or opioid misuse) among students under or over 21, except for a modest increase in the (mis)use of sedatives among students under 21 (but not over 21) for whatever reason. (So much for the long-debunked "gateway" theory).

We at Twenty-One Debunked believe that if the age limit was lowered to 18 for both alcohol and cannabis, the benefits of the aforementioned reduction in "binge" drinking would extend to students under 21 as well.   In any case, cannabis legalization looks like a net public health win on balance.

So what are we waiting for?

Monday, December 30, 2019

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

As we had noted a little over a week ago, Congress raised the federal age limit for the sale of tobacco and vape products from 18 to 21 as part of a must-pass budget bill to avoid yet another government shutdown, and on December 20, 2019, Trump signed it into law, and even had the GALL to brag-tweet about it.  And while Republican Senate Majority Leader Mitch "Awkward Turtle" McConnell, a big supporter of the age limit hike, was no doubt very pleased with himself for his "victory", we need to remember that both parties overwhelmingly supported it.  Tyranny is apparently as bipartisan as it is whimisical--and very cowardly as well.  And of course, Big Tobacco and Big Vape overwhelmingly supported it like the cowardly quislings that they are.

If that wasn't bad enough, it looks like the FDA isn't wasting any time in implementing the raising of the tobacco and vape product sale age to 21.  As of December 27, 2019, they officially noted on their website that it is now illegal to sell tobacco or vape products to anyone under 21.  They could have waited up to 180 days to formulate new regulations plus an additional 90 days before enforcing them, according to the new law, but apparently even that very small mercy is somehow beneath them.  And of course there is no grandfather clause either in this disgusting new law, nor will there be in the FDA regulations.  In other words, 18-20 year old young adults in a whopping 31 non-21 states (and several territories) who were legal to buy cigarettes and vapes just a week ago are suddenly banned from buying them now.  Talk about adding insult to injury!

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

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

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

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

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

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

Sunday, December 29, 2019

The Vaping Lung Illness Mystery Has Been Solved

Looks like the "mystery" vaping lung illness (now called EVALI) has been largely solved.  And the primary culprit is indeed the same one that Twenty-One Debunked and many others had long suspected several months agoVitamin E Acetate, a common additive found almost exclusively in black-market and counterfeit THC (and probably some gray-market CBD) vape cartridges.  Though harmless when ingested orally or applied topically, when inhaled it is apparently a different story:  this "thick and greasy" oil, and perhaps also its byproducts upon heating it to high temperatures, can indeed cause serious lung damage, and quickly.  It certainly does NOT belong in the lungs at all!  And both samples of vape cartridges as well as (more recently) samples of lung fluids taken from EVALI patients now confirm such suspicions, as noted recently by the Centers for Disease Control (CDC).  But we could have told you that a while ago.

The illness was apparently quite rare before June 2019, when the epidemic apparently exploded, peaked in September, and sharply declined thereafter.  In other words, this was not a trend, this was an event.  Something had clearly changed about vaping between 2018 and the first half of 2019.

Prior to 2019, Vitamin E Acetate was not widely used in THC vape products, whether legal or illegal, and according to cannabis industry insiders it first emerged as a cutting agent for products made in late 2018 at the earliest.  It may very well have been used before that, but if it was it was too rare to be of any concern or on anyone's radar.  But then, the black-market and counterfeit THC vape product purveyors discovered that this cheap additive can be used to dilute (or "cut") the expensive THC distillate oil while (unlike with other, thinner cutting agents) still maintaining a thick enough consistency to fool unsuspecting buyers into thinking it is purer than it really is, and thus greatly increasing the profit margins.  Yes, you read that right--for filthy lucre.  And they now have a ton of karma to answer for.

And while there apparently have also been some bad actors in the legitimate cannabis market that used this additive here and there, the fact remains that it has been quite rare overall.  And there is still no evidence that Vitamin E Acetate was ever used in any nicotine-containing vapes, whether legitimate or counterfeit.  (Note that those EVALI patients who reported "only nicotine" vaping and not THC may not have been entirely honest.)  In other words, it is fundamentally a black-market and counterfeiting problem that is best solved with legalization and sensible regulation, not blanket prohibition or overregulation.

There may very well have been other additives to blame as well, along with heavy and hard metals leaching from the heating coils of janky devices.  And perhaps some statistical flukes thrown in for good measure.  But these other minor culprits are basically sideshows compared with Vitamin E Acetate, and again the best solution is legalization and regulation of such products and devices, not prohibition.

Of course, that would make too much sense.  But truth is always the first casualty in any moral panic.

And really, SHAME on anyone (politicians, pundits, regulators, and activists) who cynically and disingenuously used the horrendous and hellish suffering of the over 2500 EVALI victims (and over 50 deaths) as a ploy to push their hateful and regressive prohibitionist agendas, while essentially hiding or denying the real cause of the illness for several months, before finally admitting it well after the epidemic had peaked.  You had a chance to save so many lives and prevent so much suffering, but you chose to sit on it, because reasons.  You now have just as much blood on your hands as the aforementioned bad actors that chose to adulterate their products with questionable additives for filthy lucre.  What you did was unforgivable in our view, but you now have a chance to make amends (albeit belatedly) to keep your karma from getting any worse.  So what are you waiting for?  Legalize and regulate yesterday!

JANUARY 2020 UPDATE:  The latest CDC report confirms yet again that the vast, vast majority of EVALI patients, among those for whom data is available, reported obtaining THC vapes from "informal" sources.  And while the anti-legalization lobby seized upon the finding that 16% of those reporting THC vaping reported obtaining their products from "commerical" sources, keep mind that that figure also includes unlicensed pop-up shops that may appear legitimate but are not, and there is always the possibility of recall bias when more than one product is used or shared.  Again, the real solution is to legalize, regulate, and root out the bad actors, not to categorically ban cannabis or vaping.

Though relatively rare, Vitamin E Acetate  has recently been found in some legal THC vape cartridges on the shelves of licensed dispensaries, including medical dispensaries upon testing, at least in Michigan.  A product recall was rightly issued.  Another state that bothered to test for it, such as Massachusetts had found none of that additive in their legal products, but had temporarily quarantined their products in November so they could be tested before reaching consumers.  This is how the system of quality control is supposed to work, and far better than the black market, which has ZERO quality control.

(For those who are interested, the hypothesized underlying chemistry of how exactly Vitamin E Acetate can cause EVALI can be found here and here.  Once thought to be lipoid pneumonia based on a handful of case reports, it turned out to be more like chemical burns in the vast majority of cases.)