Underage drinking and underage marijuana use linked

Underage drinking and illicit drug use, especially marijuana use, are closely linked according to data from the 2011 National Survey on Drug Use and Health.  Twenty percent of underage drinkers reported using at least one illicit drug within two hours of last using alcohol, compared to 4.9% of those aged 21 or older. Marijuana was by far the most commonly used substance at 19.2% for drinkers under 21 and 4.4% for older drinkers.

The authors of the analysis suggest the need to follow any changes in Washington and Colorado where recreational marijuana is legalized.  Since there seem to differences in how teens use marijuana and how adults use marijuana, it will be important to study the impact of legalization on teens separately from the impact on adults.  

Public consumption of marijuana discussed during City Council committee meeting

Public consumption of marijuana, including smoking, was discussed during last week's City Council Housing, Human Services, Health and Culture Committee meeting. 

During the public comment time, a few citizens testified in favor of the proposed ordinances.  One University District resident complained about neighbors being exposed to marijuana smoke emanating from other people's homes and about the ease of illegally buying marijuana.  With his testimony he submitted marijuana that he had purchased while waiting for the bus to get to the meeting.

A Metro bus driver complained about feeling light-headed after some riders blew marijuana smoke in his face.  This impairment requires that he pull the bus to the curb and call for a replacement. 

A Metro bus rider stated that she suffers from asthma and has had to get off buses when other riders either smoke marijuana on the bus or enter the bus reeking of marijuana smoke.

Two drafted ordinances are being considered.  One would address the part of I-502 that prohibits marijuana use in view of the public and the other would update the ordinance prohibiting public tobacco smoking to include marijuana smoking. 

When asked about enforcing the no public use law, Seattle Police Sergeant Sean Whitcomb said that Police Chief Pugel's number one goal is education.  He added that, if needed, having a ticket is a good enforcement tool. 

When Councilmember Sally Bagshaw asked about marijuana use in bus shelters, the City Attorney said that there is a jurisdictional issue (King County has jurisdiction over buses while the County and SPD share jurisdiction over shelters) and he will continue to work with Sheriff John Urquhart on the issue.

Marijuana affects the teen brain differently than the adult brain

From the University of Maryland School of Medicine:

Regular marijuana use in adolescence, but not adulthood, may permanently impair brain function and cognition, and may increase the risk of developing serious psychiatric disorders such as schizophrenia, according to a recent preclinical study.  Researchers hope that the study, published in Neuropsychopharmacology — a publication of the journal Nature – will help to shed light on the potential long-term effects of marijuana use among adolescents.

The video below provides a summary of the study findings.

Seattle Councilmembers talk about marijuana

Earlier this week, marijuana policy was one of the topics discussed during the Seattle Channel's City Inside/Out: Council Edition.

When asked about the possible proliferation of marijuana in our City, Councilmember Burgess said that it is a priority to "protect young people" as a new marijuana marketplace is established.  He pointed out that the City Council is focusing on marijuana land use issues.  He also stated that there should not be three systems in place -- recreational, medical, and illicit.  It is expected that that the State legislature will reconcile the recreational and medical systems during the next session.

When Councilmember Bagshaw was asked about City Attorney Holmes' letter to the Liquor Control Board that communicated the intention of making Seattle a magnet for marijuana tourism, she did not address the issue.

When asked about the possibility of "green light districts" in the City, where marijuana shops might be concentrated, Councilmember Godden said that they want to make sure that marijuana farming does not interfere with the Port of Seattle.  She said marijuana shops should not be established near places frequented by children, such as schools and playgrounds.

The questions about marijuana start at around 17:40.

Parents want a ban on marijuana advertising

In a national survey, 64% of Washington parents agreed that "marijuana sellers should not be allowed to advertise  . . . " on the Internet, in newspapers, in the yellow pages, in magazines, over social media, through smartphone apps, over the radio, on tv, and through most other common ways of promoting products.  In fact, a vast majority of parents think that marijuana advertising should be banned.

The Washington State Liquor Control Board's proposed rules for our state's new legal marijuana marketplace do not include a ban on marijuana advertising.  The rules place some restrictions on advertising, similar to restrictions on alcohol advertising.  However, they do not specifically address mass media advertising or marketing through smartphone apps, the Internet, and social media platforms.  They do not address celebrity endorsements and the sponsorship of events.  Yet to be publicly discussed is how advertising restrictions will be monitored and enforced.

Why limit hours of marijuana sales?

The Washington State Liquor Control Board's proposed rules for the new legal marijuana marketplace in our state say that marijuana shops may be open from 8:00 a.m. to midnight.  The initial draft rules would have allowed shops to be open from 6:00 a.m. to 2:00 a.m..  Substance abuse prevention advocates asked that the hours be similar to liquor store hours prior to the approval of Initiative 1183: 9:00 a.m to 10:00 p.m.

Why ask the Liquor Control Board to limit marijuana sales to 13 hours per day?

The Centers for Disease Control & Prevention's (CDC) Guide to Community Preventive Services recommends limiting the days and hours of sale of alcoholic beverages to prevent excessive consumption and related harms.  "The reports show that increasing the number of hours and days when alcohol can be sold in bars, restaurants, and liquor stores leads to greater alcohol use and related harms, especially motor vehicle crashes."  Since a legal marijuana marketplace has never been established anywhere before, the best we can do right now is to look to lessons learned from alcohol and tobacco.

Some have publicly wondered why marijuana sales should be shorter than current alcohol sales.  Substance abuse prevention advocates maintain that instead of increasing marijuana sale hours, the Liquor Control Board may want to consider shortening liquor sale hours.  After all, it is a best practice for reducing public health and safety harms related to alcohol consumption.

Some have also suggested that limiting hours of marijuana sales would be bad for Seattle nightlife.  Considering that marijuana cannot be consumed in shops or in public, it is difficult to see how people who go to bars and other nightlife venues would be negatively impacted by limited hours of sale.  It would just take some planning on their part to make sure that they buy their pot before midnight so that they may consume it in private after the bars close.

Marijuana legalization projected to increase heavy use among teens

During Wednesday's "What Works!" symposium about evidence-based marijuana prevention programs, researchers said they expect that most marijuana will be used by Washingtonians who already consume it and that they will increase their use.  Like the alcohol and tobacco industries, it is expected that 80% of the marijuana industry's profits will come from 20% of users -- heavy users.

The July 1 CESAR Fax suggests the same will happen among youth.

When high school students were asked if they would be more likely to use marijuana if it were legal, 16% of those who never used said it would be more likely that they would start using.

While a possible16% increase in teen "lifetime" marijuana use is to be taken seriously and addressed by coalitions such as Prevention WINS, a possible increase in heavy use among current users also needs to be monitored and addressed by organizations who work with youth who use drugs.  According to the authors of the study, "One possible scenario suggested by these data is that even if legalization does not drive up overall prevalence of teen marijuana use, it may lead to increased use among those already using, including teens who are already smoking marijuana almost daily."

In NE Seattle, 25% of high school sophomores reported using marijuana in the last thirty days (2012 Healthy Youth Survey).  Marijuana shops are slated to open in the spring of 2014.  By the time the 2014 Healthy Youth Survey results are in, we may start to see how a fully implemented legal marijuana marketplace affects teen marijuana use.

City Council briefed on marijuana legislation

State marijuana legislation was on today's Seattle City Council Briefing agenda and a presentation was shared by the inter-departmental team working on marijuana issues.

Councilmember Rasmussen asked questions about public health affects of marijuana and if anyone is going to study health-related concerns.  City Attorney Pete Holmes stated that some revenue from marijuana sales will go to fund research on the short and long term affects of marijuana.

Mr. Holmes noted that he thinks that the recreational marijuana system will be able to supply medical marijuana needs.

Concerns about enforcement were expressed by a few councilmembers and City staff.  Councilmember Bagshaw expressed concerns about public consumption of marijuana on city streets and in parks.  Mr. Holmes expressed concern that the City does not have adequate funds to enforce all provisions of the law and hopes that some of the revenue from marijuana sales will be allocated to municipalities to cover the costs.  He also noted that Seattle Police Chief Pugel has his support to hand out tickets to people consuming marijuana in public.  Educating the public about the "no public consumption" law is a first step.

Councilmember Licata stated that there is no underground market for hard liquor.  (I beg to differ.  With  hard liquor being the alcohol of choice among Seattle high school students who drink, there seems to be a robust underground underage market for hard liquor.)  He also stated that when considering the negative health affects of marijuana, the beneficial medical affects need to be considered, as well.

Both the City Attorney and Councilmember Harrell discussed marijuana price concerns especially considering the potential of the medical marijuana market to to undercut recreational marijuana prices.  Price is especially important in preventing youth access and use.

Marijuana rules do not address edibles that are kid-friendly

Earlier today, the Liquor Control Board released their proposed rules that, if ultimately enacted, will help govern our state's commercial marijuana system.  While the rules do incorporate some suggestions made by Prevention WINS and other youth substance abuse prevention advocates, they do not address marijuana-infused foods and beverages that are attractive to youth.

In addition to marijuana-infused breakfast cereals and sodas, here are a few examples of marijuana-infused foods that are currently available:

 Marijuana baked goods that look like Twinkies and Hostess CupCakes

Marijuana sno-cones

Marijuana lollipops

In a letter to the Liquor Control Board, the Prevention WINS coalition asked that marijuana-infused products that appeal to youth be prohibited:

Recently, a report published in the Journal of the American Medical Association – Pediatrics discussed the increase in unintentional ingestion of marijuana among children in Colorado. 

As the Board knows from experience, many flavored malt beverages are fruit flavored and particularly attractive to minors.   In one survey about underage drinking, when asked what one type of alcohol drink they would most prefer, 30% of teens said “alcopops” (the term used to describe these flavored alcoholic beverages – a combination of “alcohol” and “pop”). 

In the past, the Board has banned the sale of certain alcohol products because of the high likelihood that the products are attractive to minors.  A similar ban should be placed on marijuana-infused products that are attractive to minors and resemble products primarily consumed by children.  Examples of such products, many of which currently may be sold in medical marijuana access points, include but are not limited to:

Snow-cones,

• Hard candy, lollipops, and cookies shaped like animals, people, cartoon and other characters, Christmas trees, snowmen, stars, etc.,
• Soda-pop,
• Juice,
• Candy bars,
• Pop-Tarts,
• “Gummy” candies shaped like worms, bears, etc. 

Some flavored tobacco and alcohol products are also banned because of their potential to attract young people.  The Board should ban marijuana products containing flavorings such as fruit, candy, and vanilla.

What recent research tells us about parenting, young adult DUI, and early initiation of alcohol use

White young adults “were 50% more likely to self-report DUI than blacks, Hispanics, or Asians,” according to Driving After Drinking Among Young Adults of Different Race/Ethnicities in the United States: Unique Risk Factors in Early Adolescence? appearing in the May 2013 edition of the Journal of Adolescent Health.  “Black adolescents appear the least likely to DUI as young adults.”

The articles goes on to say, “In additions, perception of easy home access to alcohol had a strong association with DUI for whites, Hispanics, and Asians . . . In 2010, among current drinkers aged 12 to 20 years old, 21.6% reported that they obtained their last use of alcohol in the past month from a parent, guardian, or other family member.  Therefore, the household environments, such as parental alcohol use, play a key independent role in shaping adolescent drinking behaviors.  In a previous study, adolescents with parents who drink or whose parents DUI are also more likely to DUI.  Our study suggests that perceived home access to alcohol is a strong predictor of DUI for all races/ethnicities, except for blacks.”

  

Childhood risk factors for early-onset drinking, published in the September 2011 Journal of Studies on Alcohol and Drugs, describes a study that examined potential risk factors for the initiation of alcohol use at age 14 or younger.  The researchers found that “the variables most-predictive of early-onset drinking were having a single parent, sipping-or tasting alcohol by age 10, having parents who also started drinking at-an early age, and parental drinking frequency.”

Why ban marijuana advertising?

Companies that sell alcohol and tobacco have similar marketing strategies according to Dr. Ken Flegel, Senior Associate Editor for the Canadian Medical Association Journal.   In a recent editorial in the Journal, Dr. Flegel makes the argument that like tobacco companies, the alcoholic beverage industry has recognized that a good way to increase profits is to target young female consumers – and this has left adolescent girls, who also see the ads, particularly vulnerable.  Dr. Flegel offers some insight into responsibility and potential strategies. Here is a link to the article: http://www.theglobeandmail.com/report-on-usiness/industry-news/marketing/is-alcohol-advertising-harming-girls/article12461259/.

Dr. Flegel’s editorial provides another example of the importance of limiting, if not banning, marijuana advertising.  For years, the Center for Alcohol Marketing and Youth has tracked alcohol advertising and how youth continue to be targeted, despite alcohol industry promises not to.  Based on experiences with alcohol and tobacco advertising, Prevention WINS made suggestions to the Liquor Control Board about marijuana advertising:  

While we are pleased that some limits on advertising are proposed, we recommend a full ban on marijuana advertising. 

Myriad research shows that there is a connection between alcohol and tobacco advertising and youth consumption of alcohol and tobacco.  When looking at the link between advertising and underage drinking, the Center for Alcohol Marketing and Youth reports that exposure to alcohol advertising shapes attitudes and perceptions about alcohol use among adolescents.  These attitudes and perceptions predict their positive expectancies and intentions to drink.  A complete ban on alcohol advertising would be the most effective alcohol policy for reducing underage drinking. 

Despite the finding that a ban on alcohol advertising would likely be a best practice for reducing underage drinking, the reality is that alcohol advertising is not banned and regulations are weak.  Therefore, if the Board decides not to ban marijuana advertising we urge you to refer to tobacco advertising restrictions to guide marijuana advertising regulations.

The State of Washington is part of the Tobacco Master Settlement Agreement (MSA) that imposes significant prohibitions or restrictions on advertising, marketing and promotional programs or activities.  In addition to a general ban on direct and indirect targeting of minors in advertising and marketing of tobacco products, the MSA specifically:

• Bans cartoons and any drawing or other depiction of an object, person, animal creature or any similar caricature that comically exaggerates features, attributes human characteristics to animals, plants or other objects, or uses similar anthropomorphic technique or attributes unnatural or extra human abilities.
• Prohibits billboards and other outdoor advertising except for limited advertising where tobacco is sold.
• Bans payments for product placement of branded tobacco products in entertainment media.
• Bans distribution of brand name merchandise except in limited circumstances.
• Prohibits allowing third parties to use tobacco brand names.
• Bans lobbying against certain kinds of tobacco control legislation.
• Bans agreements between tobacco companies to suppress health-related research and product development.
• Bans material misrepresentations of fact regarding the health consequences of using tobacco products.  

Marijuana business websites should be prohibited from including advertising and marketing tools that are attractive to minors.  This includes advertising and marketing tools on Facebook, Google+, Twitter, blogs, Instagram, Pinterest, and other social media platforms.  Widgets, videos, e-cards, and other electronic forms of advertising and marketing, especially those that may easily be cut-and-pasted or embedded in personal Internet and social media sites should also be prohibited.     

Though not included with the comments, below is a screenshot of a game included in a free iPhone app from a rum company.  Similar methods for marketing marijuana products should be banned.  

Additional comments about marijuana advertising are included in the letter to the Liquor Control Board.