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.