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Giommoni L. The impact of precursor regulations on illicit drug markets: An analysis of Cunningham et al.'s studies. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024:104498. [PMID: 38890057 DOI: 10.1016/j.drugpo.2024.104498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/04/2024] [Indexed: 06/20/2024]
Abstract
This review examines a series of twelve studies led by James K. Cunningham and his team, focusing on the effects of precursor regulation on illicit drug markets. Their research shows that the regulation of chemicals essential for the production of drugs such as heroin, cocaine, and methamphetamine is associated with several positive outcomes. These include a decrease in drug purity, a reduction in seizures, lower demand for treatment and hospitalization, and an increase in drug prices. According to the research, this decrease in harmful outcomes results from a combination of diminished overall consumption and a reduction in harm per dose. However, this review identifies some inconsistencies within their studies. These inconsistencies include premature assumptions about the timing of intervention impacts, uneven influences of similar interventions, variations in the implementation of these interventions, and the disregard of alternate explanations for sudden shifts in drug markets. Cunningham's work can be considered one of the most substantial contributions in this field. However, to secure the full confidence of the drug policy community in the authenticity of their findings, they must effectively address the issues identified in this review.
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Affiliation(s)
- Luca Giommoni
- School of Social Sciences, Cardiff University, Glamorgan Building, King Edward VII Avenue, Cardiff CF10 3WT, United Kingdom
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Rossheim ME, LoParco CR, Walker A, Livingston MD, Trangenstein PJ, Olsson S, McDonald KK, Yockey RA, Luningham JM, Kong AY, Henry D, Walters ST, Thombs DL, Jernigan DH. Delta-8 THC Retail Availability, Price, and Minimum Purchase Age. Cannabis Cannabinoid Res 2024; 9:363-370. [PMID: 36342930 PMCID: PMC11071109 DOI: 10.1089/can.2022.0079] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: Retail sales of Delta-8 tetrahydrocannabinol (THC) products have increased in the U.S. market since the passing of the 2018 Farm Bill, and there is currently little regulation of marketing/sales and limited related safety standards in many states. After thousands of calls to poison control centers (40% for individuals under 18 years old and 70% requiring health care facility evaluation), the Food and Drug Administration issued warnings on Delta-8 THC products, stating their psychoactive effects and that some manufacturers may synthesize Delta-8 using unsafe household chemicals. The current study describes the Delta-8 THC retail sales environment in Fort Worth, Texas. Given its relatively inexpensive manufacturing and that low prices are a major determinant of cannabis use, the price of Delta-8 THC products was examined. This study also examined whether retail outlets in areas with greater socioeconomic deprivation had higher odds of selling Delta-8 THC products. This is important because if Delta-8 THC retailers are disproportionately located in more socioeconomically deprived communities, residents of these communities can more easily access these products and may have higher risk of adverse consequences. Methods: Potential Delta-8 THC retailers were selected by identifying lists of current retail locations with alcohol, cannabidiol, and/or tobacco licenses in Fort Worth. Trained research assistants called outlets in September and October 2021 to query about sales of products containing Delta-8 THC. The response rate was 69% (n=1,223). Outlets' 9-digit zip codes were merged with Area Deprivation Index scores. Products and purported minimum age were described. Chi-squared and Student's t-tests were used. Results: Eleven percent of outlets (n=133) reported selling Delta-8 THC. Ninety-six percent sold vapes and/or "flower" (i.e., hemp leaves coated with Delta-8 THC distillate) and 76% sold edibles. Among the least expensive products available, edibles cost, on average, $8.58 less than flower/vapes (p<0.001). Outlets that sold Delta-8 THC were located in areas with greater deprivation (p=0.02). Most reported a minimum purchase age of 21; however, 4% reported 18 years or no minimum age. Conclusions: Delta-8 THC retail outlets were disproportionately located in areas with more socioeconomic deprivation. Legal intervention such as zoning, minimum age, and tax laws may help reduce Delta-8 THC-related disparities.
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Affiliation(s)
- Matthew E. Rossheim
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Cassidy R. LoParco
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Andrew Walker
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melvin D. Livingston
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Sofia Olsson
- School of Medicine, Texas Christian University, Fort Worth, Texas, USA
| | - Kayla K. McDonald
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Robert A. Yockey
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Justin M. Luningham
- Department of Biostatistics and Epidemiology, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Amanda Y. Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Doug Henry
- Department of Anthropology, University of North Texas, Denton, Texas, USA
| | - Scott T. Walters
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Dennis L. Thombs
- Department of Health Behavior and Health Systems, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - David H. Jernigan
- Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, Massachusetts, USA
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Dasgupta N, Figgatt MC. Invited Commentary: Drug Checking for Novel Insights Into the Unregulated Drug Supply. Am J Epidemiol 2022; 191:248-252. [PMID: 34528056 PMCID: PMC8824693 DOI: 10.1093/aje/kwab233] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/12/2021] [Accepted: 08/17/2021] [Indexed: 12/21/2022] Open
Abstract
Tobias et al. (Am J Epidemiol. 2022;191 (2):241-247) present a novel analysis of time trends in fentanyl concentrations in the unregulated drug supply in British Columbia, Canada. The preexisting knowledge about unregulated drugs had come from law-enforcement seizures and postmortem toxicology. As both of these data sources are subject to selection bias, large-scale drug-checking programs are poised to be a crucial component of the public health response to the unrelenting increase in overdose in North America. As programs expand, we offer 2 guiding principles. First, the primary purpose of these programs is to deliver timely results to people who use drugs to mitigate health risks. Second, innovation is needed to go beyond criminal justice paradigms in laboratory analysis for a more nuanced understanding of health concerns. We provide examples of the role adulterants play in our understanding of drug harms. We also describe the applications and limitations of common laboratory assays, with implications for epidemiologic surveillance. While the research and direct service teams in British Columbia have taken groundbreaking steps, there is still a need to establish best practices for communicating results to sample donors in an approachable yet nonalarmist tone.
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Affiliation(s)
- Nabarun Dasgupta
- Correspondence to Dr. Nabarun Dasgupta, University of North Carolina Injury Prevention Research Center, 725 Martin Luther King Jr. Boulevard, Chapel Hill, NC 27514 (e-mail: )
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Caulkins JP. Radical technological breakthroughs in drugs and drug markets: The cases of cannabis and fentanyl. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103162. [DOI: 10.1016/j.drugpo.2021.103162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 11/24/2020] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
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Bretteville-Jensen AL, Williams J, Gjersing L. How may alternative drug policy settings influence criminal charges? A longitudinal study of cannabis patients and a general population sample. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2020; 84:102863. [DOI: 10.1016/j.drugpo.2020.102863] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/12/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
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The impacts of potency, warning messages, and price on preferences for Cannabis flower products. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 74:1-10. [PMID: 31382201 DOI: 10.1016/j.drugpo.2019.07.037] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/24/2019] [Accepted: 07/26/2019] [Indexed: 12/27/2022]
Abstract
BACKGROUND Recreational cannabis has been legalized in 11 states and Washington DC in the US. However, little is known about individual preferences for legal cannabis products. This study estimated the impacts of tetrahydrocannabinol (THC), cannabidiol (CBD), warning messages, and price on preferences for cannabis flowers. METHODS A cross-sectional online survey with discrete choice experiments was implemented in October 2017. A sample of 2400 adults aged 21 years or older were recruited from 6 US states with recreational cannabis legalization, consisting of 1200 past-year nonusers and 1200 past-year users. Each respondent was randomly assigned to 12 discrete choice scenarios, each asking them to choose from an opt-out option and 3 cannabis flower products with varying levels in THC, CBD, warning messages, and price. The impacts of product attributes on individual choices were analyzed with nested logit regressions. RESULTS Both cannabis nonusers and users preferred higher CBD and lower price. Users also preferred higher THC. The results on warning messages were mixed: graphic warning on drugged driving and text warning message had positive impacts on nonusers' and users' preferences for cannabis flowers, respectively, whereas FDA disapproval disclaimer had negative impacts on nonusers' preferences. Heterogeneities in preferences were revealed among nonusers by former use status and among users by reason of use. Particularly, medical cannabis users were not as responsive to THC as recreational cannabis users or dual users were. Regarding relative importance of the attributes, all respondents but medical cannabis users perceived price as the most important attribute (relative importance 51-64%), whereas medical cannabis users perceived CBD as the most important attribute (relative importance 47%). CONCLUSION The findings indicated that product characteristics may have influences on US adults' choices of legal cannabis flower products and may deserve consideration for cannabis regulatory framework.
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Athamneh LN, Stein JS, Amlung M, Bickel WK. Validation of a brief behavioral economic assessment of demand among cigarette smokers. Exp Clin Psychopharmacol 2019; 27:96-102. [PMID: 30265063 PMCID: PMC6355365 DOI: 10.1037/pha0000228] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Basic and clinical addiction research use demand measures and analysis extensively to characterize drug use motivations. Hence, obtaining an accurate and brief measurement of demand that can be easily utilized in different settings is highly valued. In the current study, 2 versions of a breakpoint measure, designed to capture cigarette demand, were investigated in 119 smokers who were recruited from an online crowdsourcing platform. The first version determines the maximum price a smoker is willing to pay for one cigarette received right now when paid out of pocket, and the second determines the maximum price when paid using a hypothetical $100 gift card received for free. The breakpoint measures were administered along with the Cigarette Purchase Task (CPT), Fagerström Test for Cigarette Dependence (FTCD), and The Questionnaire of Smoking Urges (QSU-brief). Both single-item breakpoint versions were significantly correlated with CPT-derived demand measures loaded on the persistence factor (i.e., elasticity of demand, breakpoint, Pmax, and Omax), but not with those loaded on the amplitude factor (i.e., intensity of demand). In addition, both single-item measures were associated with metrics of tobacco dependence (e.g., FTCD, QSU) with effect sizes that are similar to the ones found between CPT-derived breakpoint and those same metrics. These findings suggest that the single-item breakpoint measure is a viable method for measuring demand that may provide a useful and efficient tool to capture crucial and distinct aspects of smoking. In addition, the breakpoint measures may help increase the utility of behavioral demand measures in novel research and clinical settings. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Liqa N. Athamneh
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, Virginia, USA
| | - Jeffrey S. Stein
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA; Center for Transformative Research on Health Behaviors, Virginia Tech Carilion Research Institute, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, Virginia, USA
| | - Michael Amlung
- Peter Boris Centre for Addictions Research, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Warren K. Bickel
- Addiction Recovery Research Center, Virginia Tech Carilion Research Institute, Roanoke, VA, USA; Center for Transformative Research on Health Behaviors, Virginia Tech Carilion Research Institute, Roanoke, VA, USA; Graduate Program in Translational Biology, Medicine, and Health, Virginia Tech, Blacksburg, VA, USA; Department of Psychology, Virginia Tech, Blacksburg, VA, USA; Department of Neuroscience, Virginia Tech, Blacksburg, VA, USA; Faculty of Health Sciences, Virginia Tech, Blacksburg, VA, USA; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
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Martin CC. High Socioeconomic Status Predicts Substance Use and Alcohol Consumption in U.S. Undergraduates. Subst Use Misuse 2019; 54:1035-1043. [PMID: 30767586 DOI: 10.1080/10826084.2018.1559193] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND In health sociology, the prevailing consensus is that socioeconomic status (SES) lowers illness risk. This model neglects the fact that unhealthful consumption patterns may covary with affluence. The current study examines consumption of drugs and alcohol among affluent U.S. college students. OBJECTIVES The article tests the hypothesis that undergraduate students from high-SES households have higher rates and levels of drug and alcohol consumption than their peers. METHODS The study used self-report data from 18,611 18- to 24-year-old undergraduates across 23 public and private U.S. institutions from the Healthy Minds 2016 dataset. RESULTS I found that high-SES undergraduates were more likely than peers to use marijuana, choose varied drugs, consume alcohol frequently, and use alcohol and substances to cope with stress. The first three results were robust after controlling for gender, race, residence type, and relationship status. Marital status and race were stronger predictors than SES. Asians and married students were the least likely to use alcohol and drugs. Conclusions/Importance: Findings supported the main hypotheses, and the effects were robust to controls. Consumption of illicit drugs and alcohol may be one hitherto neglected reason for downward mobility among economically privileged college students.
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Affiliation(s)
- Chris C Martin
- a Department of Sociology , Emory University , Atlanta , Georgia , USA
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Shi Y, Cummins SE, Zhu SH. Medical Marijuana Availability, Price, and Product Variety, and Adolescents' Marijuana Use. J Adolesc Health 2018; 63:88-93. [PMID: 30060862 PMCID: PMC6070346 DOI: 10.1016/j.jadohealth.2018.01.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to examine the availability of medical marijuana dispensaries, price of medical marijuana products, and variety of medical marijuana products in school neighborhoods and their associations with adolescents' use of marijuana and susceptibility to use marijuana in the future. METHODS A representative sample of 8th, 10th, and 12th graders (N = 46,646) from 117 randomly selected schools in California participated in the cross-sectional 2015-2016 California Student Tobacco Survey (CSTS). Characteristics of medical marijuana dispensaries in California were collected and combined with school locations to compute availability, price, and product variety of medical marijuana in school neighborhoods. Multilevel logistic regressions with random intercepts at school level were conducted to test the associations, accounting for individual and school socioeconomic characteristics. RESULTS The distance from school to the nearest medical marijuana dispensary (within 0- to 1-mi and 1- to 3-mi bands) was not associated with adolescents' use of marijuana in the past month or susceptibility to use marijuana in the future, nor was the weighted count of medical marijuana dispensaries within the 3-mi band of school. Neither the product price nor the product variety in the dispensary nearest to school was associated with marijuana use or susceptibility to use. The results were robust to different specifications of medical marijuana measures. CONCLUSIONS There was no evidence supporting the associations of medical marijuana availability, price, or product variety around school with adolescents' marijuana use and susceptibility to use.
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Affiliation(s)
- Yuyan Shi
- Department of Family Medicine and Public Health, University of California, San Diego, California.
| | - Sharon E Cummins
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Shu-Hong Zhu
- Department of Family Medicine and Public Health, University of California, San Diego, California
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Caulkins JP, Bao Y, Davenport S, Fahli I, Guo Y, Kinnard K, Najewicz M, Renaud L, Kilmer B. Big data on a big new market: Insights from Washington State's legal cannabis market. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 57:86-94. [PMID: 29709847 DOI: 10.1016/j.drugpo.2018.03.031] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/14/2018] [Accepted: 03/31/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Voters in eight U.S. states have passed initiatives to legalize large-scale commercial production of cannabis for non-medical use. All plan or require some form of "seed-to-sale" tracking systems, which provide a view of cannabis market activity at a heretofore unimagined level of detail. Legal markets also create a range of new matters for policy makers to address. DATA Publicly available data were obtained on approximately 45 million individually priced items purchased in the 35 million retail transactions that took place during the first two and a half years of Washington State's legal cannabis market. Records include product type (flower, extract, lotion, liquid edible, etc.), product name, price, and potency with respect to multiple cannabinoids, notably THC and CBD. Items sold can be traced back up the supply chain through the store to the processor and producer, to the level of identifying the specific production batch and mother plant, the firm that tested the product, and test results. METHOD Data visualization methods are employed to describe spatial-temporal patterns of multiple correlated attributes (e.g., price and potency) broken down by product. Text-analytic methods are used to subdivide the broad category of "extracts for inhalation" into more homogeneous sub-categories. To understand the competitiveness of the legal cannabis market in Washington we calculate the Herfindahl-Hirschman index (HHI) for processors and retailers. RESULTS Cannabis prices fell steadily and proportionally at the processor and retailer levels. Retail and wholesale price maintained a roughly 3:1 ratio for multiple product types after some initial fluctuations. Although a wide range of edibles are sold, they account for a modest share of consumer spending; extracts for inhalation are a larger and heterogeneous market segment. The HHI indicates the cannabis market is highly competitive at the processor level, but less so for retail markets at the county level. CONCLUSIONS Washington's state-legal cannabis market is diverse and rapidly evolving in terms of pricing, products, and organization. Post-legalization, researchers and policy makers may need to think in terms of a family of cannabis products, akin to how we think of new psychoactive substances and amphetamine-type stimulants, not a single drug "cannabis."
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Affiliation(s)
- Jonathan P Caulkins
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA.
| | - Yilun Bao
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Steve Davenport
- RAND Drug Policy Research Center, 1776 Main St., Santa Monica, CA 90401, USA
| | - Imane Fahli
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Yutian Guo
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Krista Kinnard
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Mary Najewicz
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Lauren Renaud
- Carnegie Mellon University Heinz College, 5000 Forbes Ave., Pittsburgh PA 15213, USA
| | - Beau Kilmer
- RAND Drug Policy Research Center, 1776 Main St., Santa Monica, CA 90401, USA
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Prohibition, regulation or laissez faire: The policy trade-offs of cannabis policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 56:153-161. [PMID: 29636224 DOI: 10.1016/j.drugpo.2018.03.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/09/2018] [Accepted: 03/20/2018] [Indexed: 11/22/2022]
Abstract
Trade-offs are central to the cannabis policy debate. Prohibition and strict regulation may help reduce the physical, mental and social harms of cannabis consumption, but at the cost of increasing the harms from illegal markets and reducing consumption benefits. An economic model clarifies how these costs and benefits relate to policy and connects them to observable prices and tax-levels given the assumptions of the analysis. These model- based arguments are related to the ongoing academic policy debate. While some arguments from this literature modify the interpretation of the model (e.g., due to dependence, cognitive biases and market structure), the literature often fails to appropriately account for the magnitude of the policy costs and benefits identified. Taking various caveats into account, the framework indicates that a strict regulation would likely be preferable to prohibition given current estimates of excess harms (externalities and internalities) from cannabis use. While cannabis prohibition appears difficult to justify within an economic regulatory framework, risks from industry influence, policy ratchet effects, and human "decision-making flaws" speak to the need for caution and strong regulation when implementing legal regimes.
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Kilmer B, MacCoun RJ. How Medical Marijuana Smoothed the Transition to Marijuana Legalization in the United States. ANNUAL REVIEW OF LAW AND SOCIAL SCIENCE 2017; 13:181-202. [PMID: 34045931 PMCID: PMC8152576 DOI: 10.1146/annurev-lawsocsci-110615-084851] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Public support for legalizing marijuana use increased from 25% in 1995 to 60% in 2016, rising in lockstep with support for same-sex marriage. Between November 2012 and November 2016, voters in eight states passed ballot initiatives to legalize marijuana sales for nonmedical purposes-covering one-fifth of the US population. These changes are unprecedented but are not independent of the changes in medical marijuana laws that have occurred over the past 20 years. This article suggests five ways in which the passage and implementation of medical marijuana laws smoothed the transition to nonmedical legalization in the United States: (a) They demonstrated the efficacy of using voter initiatives to change marijuana supply laws, (b) enabled the psychological changes needed to destabilize the "war on drugs" policy stasis, (c) generated an evidence base that could be used to downplay concerns about nonmedical legalization, (d) created a visible and active marijuana industry, and (e) revealed that the federal government would allow state and local jurisdictions to generate tax revenue from marijuana.
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Affiliation(s)
- Beau Kilmer
- RAND Drug Policy Research Center, Santa Monica, California 90407-2138
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Kilmer B, Pacula RL. Understanding and learning from the diversification of cannabis supply laws. Addiction 2017; 112:1128-1135. [PMID: 27891693 PMCID: PMC5446799 DOI: 10.1111/add.13623] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 06/30/2016] [Accepted: 08/18/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS Prohibitions on producing, distributing and selling cannabis are loosening in various jurisdictions around the world. This paper describes the diversification of cannabis supply laws and discusses the challenges to and opportunities for learning from these changes. METHODS We document changes in cannabis supply laws that de jure legalized cannabis production for medical and/or non-medical purposes (excluding industrial hemp) in Australasia, Europe, North America and South America. We also highlight challenges to evaluating these legal changes based on our experiences studying cannabis laws and policies in the United States. FINDINGS As of August 2016, two countries have passed laws to legalize large-scale cannabis production for non-medical purposes at the national (Uruguay) or subnational level (four US states). At least nine other countries legally allow (or will soon allow) cannabis to be supplied for medicinal purposes. Most of the changes in cannabis supply laws have occurred since 2010. The data available in most countries are inadequate for rigorously evaluating the changes in cannabis supply laws. CONCLUSION The evidence base for assessing changes in cannabis supply laws remains weak. Efforts should focus upon collecting information about quantities consumed and market transactions as well as validating self-report surveys.
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Affiliation(s)
- Beau Kilmer
- Drug Policy Research Center; RAND; Santa Monica CA USA
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Bickel WK, Pope DA, Moody LN, Snider SE, Athamneh LN, Stein JS, Mellis AM. Decision-Based Disorders. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/2372732216686085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dysfunctional health behavior is a contemporary challenge, exemplified by the increasingly significant portion of health problems stemming from people’s own behavior and decision making. The challenge not only includes the direct consequences of unhealthy behavioral patterns but also their origins and the creation of policies that effectively decrease their frequency. A framework rooted in behavioral economics identifies the processes and mechanisms underlying poor health. Two behavioral economic processes, economic demand and delay discounting, are discussed in detail. Through continued development, this behavioral economic framework can guide improved outcomes in treatment and policies related to dysfunctional health behavior. Approaches are evolving to alter demand and discounting. Current and prospective policies aimed at decreasing unhealthy behavior may profit from such research.
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Affiliation(s)
| | - Derek A. Pope
- Virginia Tech Carilion Research Institute, Roanoke, USA
| | - Lara N. Moody
- Virginia Tech Carilion Research Institute, Roanoke, USA
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Krebs E, Wang L, Olding M, DeBeck K, Hayashi K, Milloy MJ, Wood E, Nosyk B, Richardson L. Increased drug use and the timing of social assistance receipt among people who use illicit drugs. Soc Sci Med 2016; 171:94-102. [PMID: 27842998 PMCID: PMC5127399 DOI: 10.1016/j.socscimed.2016.11.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND The monthly disbursement of social assistance (SA) payments to people who use illicit drugs (PWUD) has been temporally associated with increases in drug-related harm. Yet, whether SA receipt changes drug use intensity compared to levels of use at other times in the month has not been established. We therefore examined this relationship among PWUD in Vancouver, Canada (2005-2013). METHODS Data were derived from prospective cohorts of HIV-positive and HIV-negative PWUD. Every six months, participants were asked about their illicit drug use during the last 180 days and the past week. We determined whether SA receipt occurred within the assessment's one-week recall period. We employed generalized estimating equations controlling for confounders to examine the relationship between SA receipt and the change in drug use intensity, defined as a 100% increase in the average times per day a given drug was used in the last week compared to the previous 6 months. We tested the robustness of this relationship by stratifying analyses by whether individuals primarily used stimulants, illicit opioids or engaged in polydrug use and examining the timing of SA receipt relative to date of assessment. RESULTS Our study included 2661 individuals (median age 36, 32% female) with 1415 (53.2%) reporting SA receipt occurring within the one-week recall period of the assessment at least once. SA receipt was independently associated with intensified drug use (Adjusted Odds Ratio [AOR]: 1.79; 95% Confidence Interval [CI]: 1.53, 2.09), and remained significant when stratified by primary use of stimulants (AOR: 1.87; 95% CI: 1.54, 2.26), opioids (AOR: 1.96; 95% CI: 1.23, 3.13) and polydrug use (AOR: 1.53; 95% CI: 1.11, 2.10). CONCLUSION We found a temporal association between SA receipt and drug use intensification. While the health and social benefits of SA are significant, these findings suggest that alternative disbursement strategies, such as staggered or smaller and more frequent SA payments may be able to mitigate drug-related harm. Alternatives should be tested rigorously.
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Affiliation(s)
- Emanuel Krebs
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Linwei Wang
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Michelle Olding
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kora DeBeck
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; School of Public Policy, Simon Fraser University, Suite 3271, 515 West Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Kanna Hayashi
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Medicine, Division of AIDS, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - M-J Milloy
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Medicine, Division of AIDS, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Evan Wood
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Medicine, Division of AIDS, University of British Columbia, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Bohdan Nosyk
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada.
| | - Lindsey Richardson
- BC Centre for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada; Department of Sociology, University of British Columbia, 6303 NW Marine Drive, Vancouver, BC, V6T 1Z1, Canada
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Caulkins JP, Kilmer B. Considering marijuana legalization carefully: insights for other jurisdictions from analysis for Vermont. Addiction 2016; 111:2082-2089. [PMID: 28075542 DOI: 10.1111/add.13289] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/19/2015] [Accepted: 12/22/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS In 2014 the legislature of Vermont, USA passed a law requiring the Secretary of Administration to report on the consequences of legalizing marijuana. The RAND Corporation was commissioned to write that report. This paper summarizes insights from that analysis that are germane to other jurisdictions. METHOD Translation of key findings from the RAND Corporation report to the broader policy debate. RESULTS Marijuana legalization encompasses a wide range of possible regimes, distinguished along at least four dimensions: which organizations are allowed to produce and supply the drug, the regulations under which they operate, the nature of the products that can be distributed and taxes and prices. Vermont's decriminalization had already cut its costs of enforcing marijuana prohibition against adults to about $1 per resident per year. That is probably less than the cost of regulating a legal market. Revenues from taxing residents' purchases after legalization could be many times that amount, so the main fiscal cost of prohibition after decriminalization relative to outright legalization may be foregone tax revenues, not enforcement costs. Approximately 40 times as many users live within 200 miles of Vermont's borders as live within the state; drug tourism and associated tax revenues will be important considerations, as will be the response of other states. Indeed, if another state legalized with lower taxes, that could undermine the ability to collect taxes on even Vermont residents' purchases. CONCLUSIONS Analysis of possible outcomes if Vermont, USA, legalized marijuana reveal that choices about how, and not just whether, to legalize a drug can have profound consequences for the effects on health and social wellbeing, and the choices of one jurisdiction can affect the options and incentives available to other jurisdictions.
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Affiliation(s)
- Jonathan P Caulkins
- Heinz College, Carnegie Mellon University, Pittsburgh, PA, USA.,RAND Drug Policy Research Center, Santa Monica, CA, USA
| | - Beau Kilmer
- RAND Drug Policy Research Center, Santa Monica, CA, USA
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Caulkins J. Commentary on Cunningham et al. (2016): Supply control without incarceration? Addiction 2016; 111:2010-2011. [PMID: 27723204 DOI: 10.1111/add.13497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 06/22/2016] [Indexed: 12/01/2022]
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Davenport SS, Caulkins JP. Evolution of the United States Marijuana Market in the Decade of Liberalization Before Full Legalization. JOURNAL OF DRUG ISSUES 2016. [DOI: 10.1177/0022042616659759] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The past decade has seen a remarkable liberalization of marijuana policies in many parts of the United States. We analyze data from the National Survey on Drug Use and Health (NSDUH) for coinciding changes in the marijuana market from 2002 to 2013, including market size, number and demographics of customers, and varying means of acquiring the drug. Results suggests that (a) the national market has grown, especially in terms of the number of daily users; (b) marijuana users remained economically “downscale” over this period, and in many ways resemble cigarette users; (c) distribution networks appear to be professionalizing in a sense, as fewer users obtain marijuana socially; (d) the typical purchase has gotten smaller by weight but not price paid, suggestive of a trend toward higher potencies; (e) marijuana expenditures vary by user group; and (f) respondents with medical marijuana recommendations differ from other users in systematic ways.
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Lahaie E, Janssen E, Cadet-Taïrou A. Determinants of heroin retail prices in metropolitan France: Discounts, purity and local markets. Drug Alcohol Rev 2015; 35:597-604. [PMID: 26660876 DOI: 10.1111/dar.12355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 09/01/2015] [Accepted: 09/22/2015] [Indexed: 11/27/2022]
Abstract
INTRODUCTION AND AIMS Field studies have indicated a recent increase in heroin availability and use in France, and yet very little is known about the mechanisms underlying heroin retail prices. This paper offers a first attempt at identifying the determinants of heroin pricing, to measure quantity discounts and assess the influence of purity on street prices, while controlling for a geographical effect. DESIGN AND METHODS Data on heroin samples were collected during 2011 in seven urban areas of metropolitan France. Ordinary least squares regression was used to model the associations between price, quantity, purity and other independent variables. RESULTS Quantity remains the most influential variable on heroin pricing. We estimate that a 10% increase in the size of a transaction leads to a 2.3% decrease in the unit price. Assessed purity proved to be significant, although in modest proportion. Sociodemographic characteristics, such as gender, users' experience and relationships with dealers, proved to be insignificant. Heroin retail prices vary according to a geographical gradient related to the routes of entry and distribution. DISCUSSION AND CONCLUSIONS As a credence good, heroin retail prices in France are affected by more than simply the traditional supply and demand relationship. The results of this study also underline the limitations of a quantitative framework and should be complemented by further ethnographic research to obtain an in-depth understanding of local markets. Policies should be designed to better take local disparities into account.[Lahaie E, Janssen E, Cadet-Taïrou A. Determinants of heroin retail prices in metropolitan France:Discounts, purity and local markets. Drug Alcohol Rev 2016;35:597-604].
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Affiliation(s)
- Emmanuel Lahaie
- French Monitoring Centre for Drugs and Drug Addictions, La Plaine Saint Denis, France
| | - Eric Janssen
- French Monitoring Centre for Drugs and Drug Addictions, La Plaine Saint Denis, France.
| | - Agnès Cadet-Taïrou
- French Monitoring Centre for Drugs and Drug Addictions, La Plaine Saint Denis, France
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Chandra S, Chandra M. Do consumers substitute opium for hashish? An economic analysis of simultaneous cannabinoid and opiate consumption in a legal regime. Drug Alcohol Depend 2015; 156:170-175. [PMID: 26455552 PMCID: PMC4655592 DOI: 10.1016/j.drugalcdep.2015.09.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 09/06/2015] [Accepted: 09/08/2015] [Indexed: 10/23/2022]
Abstract
AIM To analyze interrelationships in the consumption of opiates and cannabinoids in a legal regime and, specifically, whether consumers of opiates and cannabinoids treat them as substitutes for each other. METHOD Econometric dynamic panel data models for opium consumption are estimated using the generalized method of moments (GMM). A unique dataset containing information about opiate (opium) consumption from the Punjab province of British India for the years 1907-1918 is analyzed (n=252) as a function of its own price, the prices of two forms of cannabis (the leaf (bhang), and the resin (charas, or hashish)), and wage income. Cross-price elasticities are examined to reveal substitution or complementarity between opium and cannabis. RESULTS Opium is a substitute for charas (or hashish), with a cross price elasticity (βˆ3) of 0.14 (p<0.05), but not for bhang (cannabis leaves; cross price elasticity=0.00, p>0.10). Opium consumption (βˆ1=0.47 to 0.49, p<0.01) shows properties of habit persistence consistent with addiction. The consumption of opium is slightly responsive (inelastic) to changes in its own price (βˆ2=-0.34 to -0.35, p<0.05 to 0.01) and consumer wages (βˆ1=0.15, p<0.05). CONCLUSION Opium and hashish, a form of cannabis, are substitutes. In addition, opium consumption displays properties of habit persistence and slight price and wage income responsiveness (inelasticity) consistent with an addictive substance.
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Affiliation(s)
- Siddharth Chandra
- Asian Studies Center, James Madison College, Department of Epidemiology and Biostatistics, Michigan State University, 427 North Shaw Lane, Suite 301, East Lansing, MI 48824-1035, United States.
| | - Madhur Chandra
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Road, Room B601, West Fee Hall, East Lansing, MI 48824, United States.
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Wan WY, Weatherburn D, Wardlaw G, Sarafidis V, Sara G. Do drug seizures predict drug-related emergency department presentations or arrests for drug use and possession? THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 27:74-81. [PMID: 26547299 DOI: 10.1016/j.drugpo.2015.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Direct evidence of the effect of drug seizures on drug use and drug-related harm is fairly sparse. The aim of this study was to see whether seizures of heroin, cocaine and ATS predict the number of people arrested for use and possession of these drugs and the number overdosing on them. METHOD We examined the effect of seizure frequency and seizure weight on arrests for drug use and possession and on the frequency of drug overdose with autoregressive distributed lag (ARDL) models. Granger causality tests were used to test for simultaneity. RESULTS Over the short term (i.e. up to 4 months), increases in the intensity of high-level drug law enforcement (as measured by seizure weight and frequency) directed at ATS, cocaine and heroin did not appear to have any suppression effect on emergency department (ED) presentations relating to ATS, cocaine and heroin, or on arrests for use and/or possession of these drugs. A significant negative contemporaneous relationship was found between the heroin seizure weight and arrests for use and/or possession of heroin. However no evidence emerged of a contemporaneous or lagged relationship between heroin seizures and heroin ED presentations. CONCLUSION The balance of evidence suggests that, in the Australian context, increases in the monthly seizure frequency and quantity of ATS, cocaine and heroin are signals of increased rather than reduced supply.
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Affiliation(s)
- Wai-Yin Wan
- NSW Bureau of Crime Statistics and Research, Sydney, Australia
| | - Don Weatherburn
- NSW Bureau of Crime Statistics and Research, Sydney, Australia.
| | - Grant Wardlaw
- National Security College, Australian National University, Canberra, Australia
| | - Vasilis Sarafidis
- Department of Econometrics and Business Statistics, Monash University, Caulfield, Australia
| | - Grant Sara
- NSW Ministry of Health, Sydney, Australia; Discipline of Psychiatry, Sydney Medical School University of Sydney, Australia
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Blakely T, Cobiac LJ, Cleghorn CL, Pearson AL, van der Deen FS, Kvizhinadze G, Nghiem N, McLeod M, Wilson N. Health, Health Inequality, and Cost Impacts of Annual Increases in Tobacco Tax: Multistate Life Table Modeling in New Zealand. PLoS Med 2015; 12:e1001856. [PMID: 26218517 PMCID: PMC4517929 DOI: 10.1371/journal.pmed.1001856] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/16/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Countries are increasingly considering how to reduce or even end tobacco consumption, and raising tobacco taxes is a potential strategy to achieve these goals. We estimated the impacts on health, health inequalities, and health system costs of ongoing tobacco tax increases (10% annually from 2011 to 2031, compared to no tax increases from 2011 ["business as usual," BAU]), in a country (New Zealand) with large ethnic inequalities in smoking-related and noncommunicable disease (NCD) burden. METHODS AND FINDINGS We modeled 16 tobacco-related diseases in parallel, using rich national data by sex, age, and ethnicity, to estimate undiscounted quality-adjusted life-years (QALYs) gained and net health system costs over the remaining life of the 2011 population (n = 4.4 million). A total of 260,000 (95% uncertainty interval [UI]: 155,000-419,000) QALYs were gained among the 2011 cohort exposed to annual tobacco tax increases, compared to BAU, and cost savings were US$2,550 million (95% UI: US$1,480 to US$4,000). QALY gains and cost savings took 50 y to peak, owing to such factors as the price sensitivity of youth and young adult smokers. The QALY gains per capita were 3.7 times greater for Māori (indigenous population) compared to non-Māori because of higher background smoking prevalence and price sensitivity in Māori. Health inequalities measured by differences in 45+ y-old standardized mortality rates between Māori and non-Māori were projected to be 2.31% (95% UI: 1.49% to 3.41%) less in 2041 with ongoing tax rises, compared to BAU. Percentage reductions in inequalities in 2041 were maximal for 45-64-y-old women (3.01%). As with all such modeling, there were limitations pertaining to the model structure and input parameters. CONCLUSIONS Ongoing tobacco tax increases deliver sizeable health gains and health sector cost savings and are likely to reduce health inequalities. However, if policy makers are to achieve more rapid reductions in the NCD burden and health inequalities, they will also need to complement tobacco tax increases with additional tobacco control interventions focused on cessation.
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Affiliation(s)
- Tony Blakely
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Linda J. Cobiac
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
- British Heart Foundation Centre on Population Approaches to NCD Prevention, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Christine L. Cleghorn
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Amber L. Pearson
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
- Department of Geography, Michigan State University, East Lansing, Michigan, United States of America
| | - Frederieke S. van der Deen
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Giorgi Kvizhinadze
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Melissa McLeod
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Burden of Disease Epidemiology, Equity and Cost Effectiveness Programme, Department of Public Health, University of Otago, Wellington, New Zealand
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DeCicca P, Kenkel D. Synthesizing Econometric Evidence: The Case of Demand Elasticity Estimates. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2015; 35:1073-1085. [PMID: 25809022 DOI: 10.1111/risa.12363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Econometric estimates of the responsiveness of health-related consumer demand to higher prices are often key ingredients for risk policy analysis. We review the potential advantages and challenges of synthesizing econometric evidence on the price-responsiveness of consumer demand. We draw on examples of research on consumer demand for health-related goods, especially cigarettes. We argue that the overarching goal of research synthesis in this context is to provide policy-relevant evidence for broad-brush conclusions. We propose three main criteria to select among research synthesis methods. We discuss how in principle and in current practice synthesis of research on the price-elasticity of smoking meets our proposed criteria. Our analysis of current practice also contributes to academic research on the specific policy question of the effectiveness of higher cigarette prices to reduce smoking. Although we point out challenges and limitations, we believe more work on research synthesis in this area will be productive and important.
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Affiliation(s)
- Philip DeCicca
- Department of Economics, McMaster University, McMaster, ON, Canada
| | - Don Kenkel
- Department of Policy Analysis and Management, Department of Economics, Cornell University, Ithaca, NY, USA
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Olmstead TA, Alessi SM, Kline B, Pacula RL, Petry NM. The price elasticity of demand for heroin: Matched longitudinal and experimental evidence. JOURNAL OF HEALTH ECONOMICS 2015; 41:59-71. [PMID: 25702687 PMCID: PMC4417427 DOI: 10.1016/j.jhealeco.2015.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 12/05/2014] [Accepted: 01/30/2015] [Indexed: 06/04/2023]
Abstract
This paper reports estimates of the price elasticity of demand for heroin based on a newly constructed dataset. The dataset has two matched components concerning the same sample of regular heroin users: longitudinal information about real-world heroin demand (actual price and actual quantity at daily intervals for each heroin user in the sample) and experimental information about laboratory heroin demand (elicited by presenting the same heroin users with scenarios in a laboratory setting). Two empirical strategies are used to estimate the price elasticity of demand for heroin. The first strategy exploits the idiosyncratic variation in the price experienced by a heroin user over time that occurs in markets for illegal drugs. The second strategy exploits the experimentally induced variation in price experienced by a heroin user across experimental scenarios. Both empirical strategies result in the estimate that the conditional price elasticity of demand for heroin is approximately -0.80.
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Affiliation(s)
- Todd A Olmstead
- Lyndon B. Johnson School of Public Affairs, The University of Texas at Austin, 2300 Red River Street, Austin, TX 78713, United States; Seton/UT Southwestern Clinical Research Institute of Austin, 1400 North IH 35, Austin, TX 78701, United States.
| | - Sheila M Alessi
- University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, United States.
| | - Brendan Kline
- Department of Economics, The University of Texas at Austin, 2225 Speedway, Austin, TX 78712, United States.
| | | | - Nancy M Petry
- University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030, United States.
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Weatherburn D. We know too little about demand: comments on 'cocaine's fall'. Addiction 2015; 110:738-9. [PMID: 25868538 DOI: 10.1111/add.12749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 12/03/2014] [Accepted: 01/28/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Don Weatherburn
- NSW Bureau of Crime Statistics and Research, Sydney, 2000, New South Wales, Australia.
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Pearson AL, van der Deen FS, Wilson N, Cobiac L, Blakely T. Theoretical impacts of a range of major tobacco retail outlet reduction interventions: modelling results in a country with a smoke-free nation goal. Tob Control 2015; 24:e32-8. [PMID: 25037156 DOI: 10.1136/tobaccocontrol-2013-051362] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To inform endgame strategies in tobacco control, this study aimed to estimate the impact of interventions that markedly reduced availability of tobacco retail outlets. The setting was New Zealand, a developed nation where the government has a smoke-free nation goal in 2025. METHODS Various legally mandated reductions in outlets that were phased in over 10 years were modelled. Geographic analyses using the road network were used to estimate the distance and time travelled from centres of small areas to the reduced number of tobacco outlets, and from there to calculate increased travel costs for each intervention. Age-specific price elasticities of demand were used to estimate future smoking prevalence. RESULTS With a law that required a 95% reduction in outlets, the cost of a pack of 20 cigarettes (including travel costs) increased by 20% in rural areas and 10% elsewhere and yielded a smoking prevalence of 9.6% by 2025 (compared with 9.9% with no intervention). The intervention that permitted tobacco sales at only 50% of liquor stores resulted in the largest cost increase (∼$60/pack in rural areas) and the lowest prevalence (9.1%) by 2025. Elimination of outlets within 2 km of schools produced a smoking prevalence of 9.3%. CONCLUSIONS This modelling merges geographic, economic and epidemiological methodologies in a novel way, but the results should be interpreted cautiously and further research is desirable. Nevertheless, the results still suggest that tobacco outlet reduction interventions could modestly contribute to an endgame goal.
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Affiliation(s)
- Amber L Pearson
- Department of Public Health, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE), University of Otago, Wellington, New Zealand
| | - Frederieke S van der Deen
- Department of Public Health, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE), University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE), University of Otago, Wellington, New Zealand
| | - Linda Cobiac
- School of Population Health, University of Queensland, Herston, Queensland, Australia
| | - Tony Blakely
- Department of Public Health, Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE), University of Otago, Wellington, New Zealand
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Cobiac LJ, Ikeda T, Nghiem N, Blakely T, Wilson N. Modelling the implications of regular increases in tobacco taxation in the tobacco endgame. Tob Control 2014; 24:e154-60. [PMID: 25145342 DOI: 10.1136/tobaccocontrol-2014-051543] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 07/29/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVE We examine the potential role for taxation in the tobacco endgame in New Zealand, where the goal is to become 'smokefree' (less than 5% smoking prevalence) by 2025. DESIGN Modelling study using a dynamic population model. SETTING AND PARTICIPANTS New Zealand, Māori and non-Māori men and women. INTERVENTIONS Annual increases in tobacco excise tax of 5%, 10%, 15% and 20% (with 10% reflecting the annual increase recently legislated by the New Zealand Government to 2016). RESULTS With a continued commitment to annual 10% increases in tobacco excise tax, in addition to on-going Quitline and cessation support, New Zealand's smoking prevalence is projected to fall from 15.1% in 2013 to 8.7% (95% uncertainty interval 8.6% to 8.9%) by 2025. This is compared to 9.9% without any further tax rises. With annual tax increases of 20%, the prevalence is projected to fall to 7.6% (7.5% to 7.7%) by 2025. The potential reductions in smoking prevalence are substantial for both Māori and non-Māori populations, although annual tax increases as high as 20% will still only see Māori smoking prevalence in 2025 approaching the non-Māori smoking levels for 2013. Scenario analyses did not suggest that growth of the illicit tobacco market would substantively undermine the impact of tobacco tax rises. Nevertheless, unknown factors such as the gradual denormalisation of smoking and changes to the 'nicotine market' may influence sensitivity to changes in tobacco prices in the future. CONCLUSIONS Regular increases in tobacco taxation could play an important role in helping to achieve tobacco endgames. However, this modelling in New Zealand suggests that a wider range of tobacco endgame strategies will be needed to achieve a smoke-free goal of less than 5% prevalence for all social groups--a conclusion that could also apply in other countries.
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Affiliation(s)
- Linda J Cobiac
- School of Population Health, University of Queensland, Brisbane, Australia Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tak Ikeda
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tony Blakely
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
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Quinlan KJ, Valenti M, Barovier L, Rots G, Harding W. Community-based environmental strategies to prevent the non-medical use of marijuana: A review of the literature. DRUGS: EDUCATION, PREVENTION AND POLICY 2014. [DOI: 10.3109/09687637.2014.920766] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Maria Valenti
- Education Development Center, Inc., Waltham, MA, USA
| | | | - Gisela Rots
- Education Development Center, Inc., Waltham, MA, USA
| | - Wayne Harding
- Education Development Center, Inc., Waltham, MA, USA
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Kilmer B. Policy designs for cannabis legalization: starting with the eight Ps. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2014; 40:259-61. [DOI: 10.3109/00952990.2014.894047] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Beau Kilmer
- Drug Policy Research Center, RAND
Santa Monica, CAUSA
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Why Changes in Price Matter When Thinking About Marijuana Policy: A Review of the Literature on the Elasticity of Demand. Public Health Rev 2013; 35:1-18. [PMID: 25642015 DOI: 10.1007/bf03391701] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Recent debates regarding liberalization of marijuana policies often rest on assumptions regarding the extent to which such policy changes would lead to a change in marijuana consumption and by whom. This paper reviews the economics literature assessing the responsiveness of consumption to changes in price and enforcement risk and explicitly considers how this responsiveness varies by different user groups. In doing so, it demonstrates how most of the research has examined responsiveness to prevalence of use, which is a composite of different user groups, rather than level of consumption among regular or heavy users, which represent the largest share of total quantities consumed. Thus, it is not possible to generate reliable estimates of the impact of liberalizing policies on either tax revenues or harms, as these outcomes are most directly influenced by the amounts consumed by regular or heavy users, not prevalence rates.
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