Where are the Crusades to Ban Alcohol, Marijuana & Caffeine – For the Children?

 

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) just introduced a program to discourage underage drinking, aimed specifically at middle schoolers (here). It’s called “Too Soon = Too Dangerous.”  The chart at left, based on data from the government’s Monitoring the Future Survey (MTFS), shows that attention to early substance abuse is timely.

There’s long been a broad crusade to prohibit all tobacco and nicotine products. Local and state governments are banning vaping and e-cigarette flavors (examples here, here and here), and the FDA has rejected thousands of flavored products that were already on the market (resulting in a todal wave of illicit products).

In contrast, 6% of eighth graders say they consume alcohol.  Of course, all alcoholic drinks are flavored. 

Where is the crusade against alcohol, which is inarguably much more dangerous than nicotine?  According to the CDC, “Underage drinking is a significant public health problem in the U.S.  Excessive drinking is responsible for more than 3,900 deaths and 225,000 years of potential life lost among people under age 21 each year.”  The same potential danger exists with marijuana, which is also consumed by eighth graders. 

Like alcohol and marijuana, nicotine is addictive, but no teenagers have died from using it.  Nicotine is more like caffeine, which is also represented in the chart by the 14% of eighth graders who currently consume energy drinks or shots.  Some health professionals (here, here, here, here and here) and federal agencies (here) have expressed concern, and there is at least one study claiming, “Teens who drink high-caffeine energy beverages such as Red Bull or Monster may be more likely to use alcohol, drugs and cigarettes.”  There is even a report of “a 16-year-old [who] tragically lost his life after consuming an energy drink, a soda and a latte — drinks routinely consumed by and often intensively marketed to youths — all within a few hours.”

Where is the crusade to ban energy drinks and shots?  Tobacco harm reduction advocates will be interested to know that Senators Richard Durbin (D-IL), Richard Blumenthal (D-CT) and Edward Markey (D-MA) have agitated about the marketing and advertising of these products, but no one is talking about banning them.

Let me remind you about the stakes here.  While nearly half-a-million American smokers needlessly die each year because they are unable or unwilling to quit nicotine and tobacco, there is a crusade, mostly in the name of protecting children, to ban effective and vastly safer tobacco substitutes.  In contrast, there is no organized movement to ban far more dangerous alcohol and marijuana, nor addictive caffeine, all of which are frequently consumed by American adolescents.    

 

2023 High School Seniors Preferred Alcohol and Marijuana, But Almost Abandoned Cigarettes

 

My readers know that I have followed the results of the annual Monitoring the Future Survey (MTF) for many years, focusing on alcohol, marijuana and tobacco use among high school seniors.  The 2023 MTF results, released in December (here), indicate that past 30-day (i.e., current) use of all products declined from the previous year (as seen in chart at left).    

Despite its illegality, drinking alcohol retained its decades-long top-substance status among seniors at 23%, down significantly from 28% in 2022.  Marijuana was second at 18%, one point higher than the 17% of seniors vaping nicotine in the past 30 days, which was a significant 4 percentage point decline from the year before.  Happily, current smoking remained at the bottom of the chart, at a new low of 2.9%.    

Another fascinating MTF finding (not on my chart) is that 18% of seniors currently consumed flavored alcohol, one point higher than those who vaped nicotine.  Protecting teens from flavors has driven the FDA’s attempts to ban vape flavoring and these products are being prohibited outright in jurisdictions across the country.  Flavored alcohol is far more dangerous for teens, but those products are apparently beyond the FDA’s reach, and no one has yet established a Campaign for Alcohol Free Kids. 

 

Is Industry to Blame for Teen Substance Use?

 

I’m a member of a tobacco policy discussion group that has focused many times on the so-called epidemic of teen vaping.  One recent exchange centered on how e-cigarette and vape manufacturers and retailers might demonstrate to government regulators and policymakers that they are serious about not marketing their products to children.  Frankly, I take issue with the underlying assumption that the industry is actually responsible for teen behaviors.

First, let’s define the so-called epidemic.  The first chart at left represents “current” – that is, past-30-day – nicotine vaping prevalence rates among U.S. high school seniors, according to the federal Monitoring the Future (MTF) survey.  In 2017, the first year the MTF collected this information, 11% of seniors vaped.  Over the next five years, the percentage spiked to over 25%, then settled at around 20%.  A similar pattern is seen in National Youth Tobacco Surveys covering 2013 to 2022 (here). 

Now, ask yourself: Do vape companies play any role in this teen vaping “epidemic”? 

If you answer NO, I agree with you, but if you answered YES, please examine the next chart.

 

Here we see the same vaping numbers, but with the addition of current alcohol use rates for the past 32 years.  Although the trend is going in a welcome direction, 28% of high school seniors in 2022 were current drinkers, putting them at far greater risk than the smaller percentage who were vaping.  Note that all of these teens were under the legal age to purchase alcohol or vape products.

Does the alcohol industry play a role in teen drinking?

Oddly, in contrast to the obsession with vaping, little is said about teen drinking, despite widespread alcohol advertisements and the more immediate and greater dangers posed to underage drinkers.  Parents Against Vaping E-cigarettes (PAVE) and the Campaign for Tobacco-Free Kids (CTFK) portray nicotine vaping as the ruination of an entire generation.  Where are the pressure groups for teen drinking and binge drinking?

If you still blame corporate America for teen alcohol use, consider the next chart. It includes marijuana use, the rate of which has remained above 20% for high school seniors since 1995.

 

 

What industry is responsible for teen marijuana use?  

Until recent years, marijuana, which is still federally illegal, was prohibited in all 50 states, so there were no corporations producing or marketing it.  Industry would appear to be blameless for any underage consumption.

Conclusion

The explanation for teen substance use is that adolescents are strongly attracted to adult behaviors and adult products.  Blaming the vape industry while giving the alcohol industry a pass is illogical.  Teen marijuana use underscores the fact that young people will adopt adult behaviors regardless of industry marketing.