What's Up With Iceland?

Iceland, a country that Americans don't hear much about in the news is now the talk of the town, apparently.   At least among those who are interested in reducing youth substance abuse.  Since 1997, the consumption of alcohol, tobacco, cannabis, and other substances among 15-16 year olds has plummeted there, more so than any other nation, according to surveys.  And in fact, by 2016, Iceland was able to boast having the cleanest-living teens in the industrialized world, in contrast from being home to Europe's heaviest-drinking teens twenty years ago.  So how did they do it?

For starters, laws were changed.  The general age of majority was raised from 16 to 18, the smoking age was raised to 18, and the drinking age was raised to 20.  While possession and consumption are not illegal below that age over there, selling or furnishing alcohol or tobacco to people below that age is prohibited.  Advertising for both substances was banned, and the prices for both substances are very high due to taxation (e.g. alcohol in Iceland costs about double what it does in the USA on average). Also, a 10 pm curfew was implemented for 13-16 year olds, albeit relaxed to midnight in the summer.  (Of course, it should go without saying that we at Twenty-One Debunked would NOT support a drinking age any higher than 18, period, and from a youth-rights perspective we would NOT support age-based curfew laws either).

More importantly, though, were the other components of the Youth in Iceland strategy.  From the Mosaic article:

"Links between parents and school were strengthened through parental organisations which by law had to be established in every school, along with school councils with parent representatives. Parents were encouraged to attend talks on the importance of spending a quantity of time with their children rather than occasional “quality time”, on talking to their kids about their lives, on knowing who their kids were friends with, and on keeping their children home in the evenings."

Home and School, the national umbrella body for parental organisations, introduced agreements for parents to sign. The content varies depending on the age group, and individual organisations can decide what they want to include. For kids aged 13 and up, parents can pledge to follow all the recommendations, and also, for example, not to allow their kids to have unsupervised parties, not to buy alcohol for minors, and to keep an eye on the wellbeing of other children.

These agreements educate parents but also help to strengthen their authority in the home, argues Hrefna Sigurjónsdóttir, director of Home and School. “Then it becomes harder to use the oldest excuse in the book: ‘But everybody else can!’”

State funding was increased for organised sport, music, art, dance and other clubs, to give kids alternative ways to feel part of a group, and to feel good, rather than through using alcohol and drugs, and kids from low-income families received help to take part. In Reykjavik, for instance, where more than a third of the country’s population lives, a Leisure Card gives families 35,000 krona (£250) per year per child to pay for recreational activities."

So they seem to have an overall mixed bag from a youth-rights perspective, perhaps.  But that last bit about increasing state funding for recreational activities is what really seems to be the clincher for Iceland's success story.  Twenty-One Debunked certainly supports that aspect of the Youth in Iceland strategy.  And indeed that is precisely what one would predict from the famous yet underrated "Rat Park" studies.  To wit, boredom, stress, and especially lack of connection are the root causes of substance abuse and addiction.  Whether rats or people, give them fun stuff to do and opportunities to interact socially with one another, and they are less likely to want to numb themselves with alcohol or other drugs.  And that is true for all ages.

Note as well that Iceland, like all Nordic countries, has a very robust and generous social welfare state and social safety net. That clearly contributes to their relatively low level of poverty and desperation compared to the USA.  And they are generally one of the most progressive countries in the world in that regard.   And more so now than they were before the 2008 financial crisis.  So that might also have something to do with it as well.

Another gem from the same article, about when the less-controverisal aspects of the Icelandic model have been tried in some other places with a drinking age of 18 and no curfew laws, as Kaunas, Lithuania:

"Across Europe, rates of teen alcohol and drug use have generally improved over the past 20 years, though nowhere as dramatically as in Iceland, and the reasons for improvements are not necessarily linked to strategies that foster teen wellbeing. In the UK, for example, the fact that teens are now spending more time at home interacting online rather than in person could be one of the major reasons for the drop in alcohol consumption.

But Kaunas, in Lithuania, is one example of what can happen through active intervention. Since 2006, the city has administered the questionnaires five times, and schools, parents, healthcare organisations, churches, the police and social services have come together to try to improve kids’ wellbeing and curb substance use. For instance, parents get eight or nine free parenting sessions each year, and a new programme provides extra funding for public institutions and NGOs working in mental health promotion and stress management. In 2015, the city started offering free sports activities on Mondays, Wednesdays and Fridays, and there are plans to introduce a free ride service for low-income families, to help kids who don’t live close to the facilities to attend.

Between 2006 and 2014, the number of 15- and 16-year-olds in Kaunas who reported getting drunk in the past 30 days fell by about a quarter, and daily smoking fell by more than 30 per cent."

Thus, when viewed through a more nuanced lens than the mainstream media does, it becomes clear that Iceland's apparently miracle can indeed be achieved without raising the drinking age (or smoking age) any higher than 18, and without implementing youth curfew laws either.  Or any other forms of "social cleansing" for that matter, something the USA has a rather dark history of doing.

 It's time for the USA to stop "chasing the dragon" of failed drug and alcohol policies, pun intended, because try as we may, we all know that we're never gonna catch it.

What Happened in NYC After Raising the Smoking Age to 21?

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

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

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

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

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

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

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

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

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

They also saw a similar size drop from 2013-2015, to the tune of 28% (vs. 29% in NYC and 31% in the USA overall).  Just one problem though.  San Francisco did not raise their smoking age until 2016, so these data show that the drop in the smoking rate happened while it was still 18, before the age limit was raised.  Thus, it would actually be part of the no-change control group, not the experimental group.  And if you include the decrease since 2011, San Francisco in fact saw more progress than NYC.

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

Bottom line:  it looks like the supposed benefits of raising the smoking age to 21 were, shall we say, all smoke and mirrors.  The supposed success of Needham, MA was likely a statistical fluke and/or a result of endogeneity, much like the "early adopter" effects of the first few states to raise the drinking age to 21 creating that particular mirage in the 1980s.  Or perhaps increased enforcement in general relative to neighboring towns did the trick regardless of the age limit, like it did in Woodridge, IL and several other communities the 1990s.  And even if such benefits of the 21 age limit were real, we at Twenty-One Debunked would still not support an age limit any higher than 18, on principle alone.  Old enough to fight and vote = old enough to drink and smoke.  'Nuff said.