Marijuana Legalization and the Nanny State: A Reason Debate

Drug Policy Alliance's Ethan Nadelmann and Drug Policy Institute's Kevin Sabet take on pot and public health.


This week, Drug Policy Institute's Kevin Sabet and Drug Policy Alliance's Ethan Nadelmann debate marijuana politics.

Today's question concerns the push for more lenient treatment of marijuana in the context of a broader push for smoking bans, fatty food and drink restrictions, and other regulations ostensibly aimed at promoting public health.

Previously, Sabet and Nadelmann debated state marijuana initiatives

At the same time many states are pursuing more liberal cannabis policies, many are also becoming more strict on other health issues, including tobacco. Does this make sense?

Ethan Nadelmann

Ethan Nadelmann:

The increasing convergence of tobacco and marijuana policy makes a lot of sense in terms of both public health and public safety.  On the one hand, reasonable measures to discourage tobacco consumption among the general population and especially among youth can prevent and reduce addiction to nicotine, a drug that heroin addicts routinely describe as tougher to quit than heroin.  

Raising taxes on cigarettes—while trying to avoid the illicit smuggling that results from significant differences in tax rates among neighboring jurisdictions—is an effective means to do that.  On the other hand, we can anticipate a public safety disaster if ever Americans decide to prohibit tobacco production, sale and consumption as we do now with marijuana and once did with alcohol. With regulation comes quality control, and restrictions on sales to minors, advertising directed at minors and locations where marijuana could be distributed. This would take it out of parks and neighborhoods and into licensed stores.

Ethan Nadelmann is Executive Director of the Drug Policy Alliance.

Kevin Sabet

Kevin Sabet:

Cannabis and tobacco are both harmful to the human body and their use causes billions of dollars in social costs every year. So it makes as much sense to get strict on tobacco and lax on cannabis as it does to institute seat belt laws but give little regard to highway speed limit laws. Attention to both is required to ensure safe driving. Similarly, we should prevent both cannabis and tobacco use—especially among youth—to promote public health.

Cannabis and tobacco are, of course, harmful in different ways. For example, according to the British Medical Journal, which conducted the most exhaustive review of the literature to date, driving while high on cannabis doubles the risk of a car crashes. Tobacco use does not affect driving. On the other hand, few doubt that tobacco directly causes lung cancer; the link between cannabis and lung cancer is still controversial. We also know that cannabis is linked to mental illness—like psychosis and schizophrenia—in ways that tobacco is not.  

Finally, science has shown that tobacco addicts more people than any other drug (including heroin). One in three people who ever start using tobacco will become addicted. The number for cannabis is similar to that for alcohol—about one in 10 (though that number rises to one in six if one starts using cannabis in adolescence). Although their risk profiles are certainly different, there are some similarities too: cannabis and tobacco both contain many of the same ingredients including carbon monoxide, tar, and carcinogens (like "benzanthracenes" and "benzpyrenes").

A great incongruence of our time is that as science has gradually revealed new and disturbing conclusions about the role of today's high-grade cannabis (it contains much more of its psychoactive ingredient today than ever before), support for lax policies has also risen. But with tobacco, learning about its dangers has led to stricter policies. If tobacco teaches us anything about cannabis, it is this: Legalization results in more availability, use, and addiction than we would otherwise have. And importantly, any taxes we collect on tobacco pale in comparison to that drug's social costs. Indeed, for every $1 in tax revenue that states and the federal government take in, $10 are lost on the social costs of tobacco use.

When tobacco established itself in the United States, an entire legal industry erupted and downplayed any negative effects of the drug. Big Tobacco continually deceived the American public by targeting to kids, too. Subsequent court cases against the industry revealed that tobacco companies have said these things:

The Liggett Group: "If you are really and truly not going to sell [cigarettes] to children, you are going to be out of business in 30 years."

R. J. Reynolds: "Realistically, if our company is to survive and prosper, over the long term we must get our share of the youth market."

Lorillard: "The base of our business is the high school student."

Phillip Morris: "Today's teenager is tomorrow's potential regular customer… Because of our high share of the market among the youngest smokers, Philip Morris will suffer more than the other companies from the decline in the number of teenage smokers."

American-style commercialization will undoubtedly accompany cannabis legalization. Commercial speech is free speech in the United States. We would do well to learn from our experience with tobacco and focus our efforts on preventing both tobacco and cannabis use.

Kevin A. Sabet, PhD, is Director of the Drug Policy Institute at the University of Florida. He served as a senior advisor in the Obama Administration from 2009 to 2011.

Ethan Nadelmann responds: 

There is no scientific basis for suggesting that the dangers of cannabis compare to those of tobaccoor, for that matter, alcohol – and no basis for implying that the costs of cannabis use would approximate those of tobacco or alcohol if cannabis were legalized.

Yes, cannabis is a "drug" (like alcohol and tobacco) to which some people become addicted and which can harm the health of those who use it recklessly or in abundance.  It is, however, dramatically less addictive and deadly than tobacco.  It lacks alcohol's association with violent and other reckless behavior.  And addiction to marijuana is far less dangerous to self and others than addiction to alcohol, which experts consistently rank as the most dangerous substance, legal or illegal.  For the vast majority of people who consume marijuana today, the greatest harms associated with their consumption are the criminal and civil sanctions that can prohibit them from gaining employment, housing or an education in the future.

Youth use of alcohol and tobacco has declined over the past few decades, largely due to better education and regulation – not because of prohibition. Marijuana use rates, by contrast, have increased or have remained stable in recent years– in spite of arresting over 750,000 people each year for marijuana possession.
What is needed in the case of all three is responsible regulation of legal markets with the objective of minimizing the harms of both drug misuse and government policies.

Kevin Sabet responds:

As I said before, the harms of cannabis, alcohol and tobacco are different. All three are harmful. Two are legal, and therefore used, abused, and advertised with abandon. Using alcohol and tobacco as our examples of what legal marijuana would look like is hardly responsible. Why can't we make our current policies better before rolling the dice with marijuana legalization?

It's important to be honest about the mixed policy effects both in the Netherlands and here in the United States. Ethan gives us only half of the story on the U.S. decriminalization and Dutch de facto legalization experience. Indeed, the literature on early U.S. decriminalization effects on use is conflicting, according to a more updated review in 2009 done by the same researcher Ethan cites from 2001. Some studies found no increase in use in the so-called decriminalization states, whereas others found a positive relationship between greater use and formal changes in the law. In effect, in the U.S., we have de facto marijuana decriminalization in most of the U.S. today (New York City is a glaring exception). As the RAND Corporation pointed out in an exhaustive report about marijuana legalization, in no Western country is a cannabis user at "much risk of being criminally penalized. Analyses by Beau Kilmer and Robin Room found that the arrest rates for cannabis users who had used the drug in the past year are roughly 3 percent, and that none of those convicted of possession is incarcerated or receives an administrative fine of more than $1,000. Other independent research has shown that the risk of arrest for each "joint," or cannabis cigarette, smoked is about 1 arrest for every 12,000 joints. Mark Kleiman, Jon Caulkins, and others have also previously concluded that "…almost all people imprisoned for drug-law violations were involved in drug distribution; they say so themselves in surveys. The roles may have been small, but they are not in prison just for using."

The Netherlands experience is also interesting, nuanced, and the subject of active debate. First, it's important to remember that the Dutch—indeed most of Europe—have always had lower levels of use than the United States. But it is instructive to look inside the Netherlands to see what the result of their policy change has been. In 1976, the Dutch approved a formal policy to allow the possession and sale of up to about 90 cannabis cigarettes (30 grams). The government allowed "coffee-shops" selling cannabis to appear around the country and approved in 1980 guidelines allowing more local control discretion of commercial cannabis practices. As the Dutch got used to the idea of legal cannabis, coffee shops increased in prevalence and the number of them grew eleven-fold in eight years (nine in 1980 and 102 by 1988). In 2001, a lower-end estimate numbers coffee shops at about 1,200. MacCoun and Reuter point out that between 1976 and 1984, cannabis use remained about the same for adults and youth. Thus the early effect of this policy change seemed to have been minimal. From the mid-1980s to the mid-1990s, though, they observe that "surveys reveal that the lifetime prevalence of cannabis in Holland increased consistently and sharply." They report 15 percent of 18-20 year olds used cannabis in their lifetime in 1984 turned into 44 percent by 1996—a 300 percent increase. Indeed, they also find cite past-month prevalence of 8.5 percent in 1984 to 18.5 percent in 1996. MacCoun and Reuter point to "commercialization" as the reason for this spike in drug use. That is, they contend that during this period between 1984 and 1996, the greater glamorization and more visible promotion of cannabis led to an increase in use. I've also suggested that the increase could also be due in part to a greater normalization of use, as anti-drug attitudes eroded among youth and use became more gradually accepted.

There has been a recent significant shift in policy in the Netherlands. The government is undertaking a massive policy turnaround. It continues to reduce the number of coffee shops, and though current cannabis use in the Netherlands is similar to other European countries, treatment admissions for cannabis are higher in that country than other European neighbors. Severe restrictions by the Dutch government continue to be implemented, including forbidding non-Dutch citizens from buying marijuana and continuing to zone areas forbidding coffee shops altogether.

The more recent discussion about state-level legalization may provide more insights into today's discussions of legalization. Two RAND Corporation reports provide a useful analysis of such a policy. The studies concluded that legalization would result in lower cannabis prices, and thus increases in use (though by how much is highly uncertain), and that "legalizing cannabis in California would not dramatically reduce the drug revenues collected by Mexican drug trafficking organizations from sales to the United States."

Tomorrow, Sabet and Nadelmann will consider the Obama administration's drug enforcement policies. 

NEXT: Lowered Expectations: Joe Biden Polling at 39 Percent Headed into the Debate

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  1. Sure it makes sense.

    They aren’t interested in liberty. They simply hope that people who are stoned won’t notice that they’re being treated like prisoners.

  2. At the same time many states are pursuing more liberal cannabis policies, many are also becoming more strict on other health issues, including tobacco. Does this make sense?

    None whatsoever. And I can think of a few commenters who have been pointing this out… for a while.

    The only hope marijuana advocates have in this current environment is that it continues to not make sense. And in my estimation, it’s possible, especially when you look at abortion.

    Yes, abortion. Consider the Democrats’ view on “choice” in the larger context. They’re mostly against it. But yet abortion remains the centerpiece of what they call a pro-choice agenda.

    To them, abortion is the only choice women are allowed to make. Everything after that is up for negotiation.

    The same thing could happen with marijuana. Marijuana itself, like abortion, could become the political hotbutton, allowing it to remain unrestricted and legal, while everything else around it goes down in the flames of “public health”.

    The fear I have is that policmakers will at some point connect the dots, and when they do, there are essentially no barriers to stop public health advocates to severely limit marijuana smoking on a public health externality argument.

    1. To them, abortion is the only choice women are allowed to make. Everything after that is up for negotiation regulation.

      1. Or outright prohibition, at the whims of the nannies.

        1. I wonder how long it will be before Progressives feel safe enough to trot out their “mothers of the race” argument, albeit sanitized and modernized, for why women should just stay home and breed.

          1. Or vice versa, and make abortions mandatory, which I think slightly more likely. They’re mostly not really so much pro-choice as pro-abortion. Or maybe they’ll come up with rationales to make it mandatory in some cases and forbidden in others.

    2. None whatsoever.

      Marijuana is being widely recognized as medicine while tobacco causes all kinds of health problems.

      1. Marijuana is being widely recognized as medicine

        Good luck entering that wild-west, unregulated, open frontier of a free market completely devoid of any government intervention.

        1. Those days are long gone, never to be seen again.

    3. Yeah, I suppose it is too much to expect that when they connect the dots, they will realize that all other drugs should be legalized too.

    4. There’s a reason not to allow Public use but allow use in a private setting. We do it with alcohol and tobacco, so the model is in place. What we have now is pointless. Marijuana has hardly any negative health effects on adult users so there is np reason to make criminals out of adult users.

      1. “Marijuana has hardly any negative health effects on adult users”

        So what if it did? Should chosing to harm yourself always (or ever for that matter) be criminal?

        1. Double this.

          Sorry, smoke of any kind can cause cancer by the mere mechanical irritation of the lung tissue. It may have a negligible effect compared to tobacco use, but I guarantee that sucking smoke into your lungs cannot have a net positive effect.

          Which is why if Marijuana’s only reason for being legalized is its medicinal properties and not because we as free people have a right to consume it, then grind up the THC, put it in a pill and demand a prescription for it, which can only be filled by a licensed Pharmacist. No more ‘storefronts’ where some dude is growing something in his basement. My neighbor can’t fill my Oxycontin prescription, why should marijuana smokers get a prescription filled by a guy named Chad working out of his basement?

          1. “sucking smoke into your lungs cannot have a net positive effect”

            Well depends on how much more you value getting high than your lung health, I guess.

            But whatever you think about that, it is indeed important to remember that the real reason for legalization is because it is a personal freedom issue, not because pot is good for you, or not too bad or whatever.

          2. Marijuana does not need to be smoked. But, presently, if a store is selling vaporizers, there is always the off chance some overzealous civil servant will conjure up some Drug Paraphernalia charges. It can also be used in cooking.
            One of the problems with pills is that they’re awfully hard to keep down when you’re retching from Chemo or Radiation therapy. BTW, Tens of thousands of Americans are pushing up Daisies from items bought at Pharmacies. As one cannot overdose from marijuana precise dosage is of little consequence.
            No one’s ever died from ingesting Chad’s products.

        2. I just pointed out it was relatively harmless for adults. That’s one less thing for Prohibitionists to lie about.

      2. There’s a reason not to allow Public use but allow use in a private setting. We do it with alcohol and tobacco, so the model is in place

        I can have a Vodka Gimlet in a bar, but I can’t smoke a cigarette there, so your analogy just fell flat on its face.

        1. And I don’t see any reason to ban drinking (or smoking: outdoor smoking bans really rub me the wrong way) on the streets. Maybe obnoxious public drunkenness, but simply walking around with an open beer is no more inherently criminal than walking around with a bottle of water.

          1. It’s the eyes-of-children argument. If children see you drink, they think that drinking is acceptable (it’s not, but the government tolerates it) yadda yadda.

        2. That’s part of the model. Most of NY will not allow Tobacco Smoking, and some towns in MA won’t allow smoking tobacco OUTSIDE. What’s your definition of public? Take that drink out into the street and New Rules apply.
          Nice try though.

          1. That’s part of the model.

            What? Is it legal inside or outside? Why should private places be considered public just because they allow people to wander inside? If I allow people to walk on my property all the time, does that mean my house is now public? Public accommodation laws are bullshit.

            Take that drink out into the street and New Rules apply.

            Why? There’s nothing wrong with walking in public with a drink in your hand. If it’s a public space, then you can’t just prohibit people from normal behaviors just because you want to.
            Nice try though.

  3. I totally believe that if tobacco was illegal today that we’d be trying to end its prohibition AND reduce its use at the same time.

    As we saw with alcohol and cannabis, a tobacco prohibition would NOT prevent people from accessing it but would totally eliminate our government’s oversight of its quality and would provide an enormous economic opportunity for drug dealers to sell it on the street to both children and adults alike. Having tobacco sold to adults in stores is infinitely preferable to having drug dealers sell it to children on the street!

    1. I totally believe that if tobacco was illegal today that we’d be trying to end its prohibition AND reduce its use at the same time.

      And we’d also be recognizing its medicinal properties.

      1. That’s one of the things that bothers me most about the modern nanny climate. The only way to justify not banning or severely restricting something is if it has some kind of health benefits. Alcohol prevents heart disease! Coffee fights alzheimers! Chocolate reduces cholesterol! Video games prevent the spread of STDs!

        Why can’t we all just acknowledge that you can enjoy something even if it’s bad for you?

        1. That’s one of the things that bothers me most about the modern nanny climate. The only way to justify not banning or severely restricting something is if it has some kind of health benefits

          If you were in my office, I’d give you a high-five!

          Make it legal, only because it’s medicine! I can’t really blame people for recognizing the political reality: That public health now drives all government permission slips. Or, shorter: Don’t hate the player, hate the game.

          And I do so hate the game.

          1. I believe we’ve both made the point previously that once government becomes the primary buyer of healthcare services, there is no ban or regulation so onerous that it cannot be justified in terms of “cost-saving.”

        2. Why can’t we all just acknowledge that you can enjoy something even if it’s bad for you?

          Because this country still has a hangover from the Puritanical Days when pleasure was a sin.

          So if pleasure is the only benefit something has, it must be banned.

          1. this.

            Legalize Marijuana!

          2. And yet they legalized prizefighting, albeit with state commissions regulating it, and AFAIK amateur boxing was never illegal.

      2. I guess we’d be recognizing its medicinal properties *if it had any*. But if it didn’t we wouldn’t.

        What are you trying to imply? That everybody’s lying about marijuana except you?

  4. A referendum is put on the ballot in your state to regulate marijuana like alcohol, including home-growing marijuana like you can home-brew beer.

    Do you vote for or against?

    1. For. You should vote for anything that increases liberty.

    2. For. Next question.

    3. For.

      Medical Marijuana advocates are leaning against.…..s-are-oppo

      1. Baptists and bootleggers. This is the biggest problem I have with medical marijuana; it creates rent seekers.

    4. My father, an old hippie in Colorado, said he plans to vote against legalizing the bud because he doesn’t want the feds to go busting people who are following state law.

      I may have convinced him otherwise by explaining that the feds will go after large scale producers and retailers, the people with assets to be stolen, and leave smokers and home growers alone.

      To me it’s a no-brainer.

    5. 100% FOR!

      But once it passes I wouldn’t buy or grow it just as I don’t buy or make alcohol today. It’s just not my thing.

    6. Of course you vote for it. That being said, it is truly astonishing that this issue is still being debated. I understand that there are plenty of people who have a stake (whether emotional or financial) in banning marijuana but it will never cease to amaze me that this is even an issue that needs to be discussed.

  5. Prohibition doesn’t work. I’m really not sure what it’s going to take for people to recognize that. Was it this hard to get people to recognize that bloodletting didn’t work? How obvious does something have to be?

    1. Prohibition doesn’t work.

      Prohibition works just fine, depending on your point of view.

      It gives the cops the power to treat everyone as guilty until they prove their innocence by submitting to a search.

      It provides income to police through asset forfeiture, otherwise known as stealing.

      It keeps the wheels of “justice” turning, providing reliable income to prosecutors, judges, attorneys, prison personnel, probation officers, substance abuse counselors, piss testers, and the like.

      It demonizes an entire class of citizens, giving those with power free reign to stomp all over their rights and treat them like animals.

      It provides an excuse to militarize police forces and treat citizens like enemy combatants.

      There are too many people benefit from prohibition for it to ever go away.

    2. And you will actually hear some drug warriors argue that it does work. And it does in some sense. During alcohol prohibition, fewer people drank. And there is probably some portion of the population who doesn’t smoke pot because it is illegal, but would otherwise (I don’t think there are too many, but such creatures do exist). So if your metric is fewer people using the prohibited substance, then it does work. But if you think prohibition reduces harm to users or to society in general, you’ve got your head up your ass.

    3. Prohibition does work, that’s the problem. They make it harder and dangerous to get weed. That sucks, as weed is really good.

  6. I hate authoritarian fuckwads. “Social costs?” People don’t owe society anything (yeah, yeah, I know Obama begs to differ). I just finished high school a couple years ago, and marijuana was way easier to get than alcohol (though I never smoked)

    1. I never smoked

      Look, everybody! He’s a FAAAAAAAAAAAAAAG!

      1. You bastard!

        *Runs away sobbing*

    2. Yup. “Society” doesn’t own your potential productivity.

  7. Can someone tap out the DPA guy? He’s apparently phoning this in for the second day in a row, and it’s starting to get embarrassing. That’s twice now he’s let the bullshit, completely unjustified argument about marijuana addiction just slide through (the only way the drug warriors can compile those “numbers” is by counting the people admitted to rehab for marijuana, which are usually teenagers who’ve come in contact with the law and are forced to attend some sort of rehab program). I mean, if you’re supposed to “debate” someone, at least pick off the low hanging fruit, like the alleged link between marijuana and mental illness (there isn’t one, the only research that’s been done indicates that people with predispositions or already present schizophrenia might react poorly to THC).

    The drug warrior is crushing. That makes me a sad panda.

  8. “Why can’t we make our current policies better before rolling the dice with marijuana legalization?”

    Hey asshole, trying to make “current policies better” is what you’ve done for 40 goddamn years. It’s an even bigger failure today than it was when it started. Time to try it our way now.

  9. Kevin Sabet; Yet, another Red erring. In any event all of your “worst case scenario” prognostications couldn’t compare to the Harm the carrying out of YOUR Drug War is doing, NOW. BTW, Chocolate can be harmful if abused.

  10. “. . .cannabis and tobacco both contain many of the same ingredients including carbon monoxide, tar, and carcinogens (like “benzanthracenes” and “benzpyrenes”).”

    Really? I wasn’t aware that either tobacco or cannabis contain carbon monoxide. It is a byproduct produced by burning . . . anything. Well guess what, stupid, you can eat ganja and it’s spectacularly healthy for you!

  11. Courageous of him to take this position now that he is out of office.

  12. Wow. How did Kevin Sabet get a PhD? In the future, I’d advise finding someone who is familiar with actual facts regarding the subject matter. He’s totally detached from reality.

  13. “Cannabis and tobacco are both harmful to the human body and their use causes billions of dollars in social costs every year.” – Kevin Sabet.

    You identified the real problem in your first sentence, Kevin (was gonna say “idiot” but that wouldn’t be diplomatic would it, Moron?): Socializing the costs and consequences of individual choices. Socialism is the problem.

  14. “Doctor” Sabet is “prescribing” incarceration for what is at worst an addiction issue.

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