Pubdate: Sun, 07 Dec 2014
Source: Washington Post (DC)
Copyright: 2014 The Washington Post Company
Contact: http://mapinc.org/url/mUgeOPdZ
Website: http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Samuel T. Wilkinson
Note: The writer is a resident physician in psychiatry at the Yale 
School of Medicine.
Page: A23

BIG POT?

The Marijuana Industry Is Following Big Tobacco's Lead - With Dire Consequences

Last month, people voted to legalize recreational use of marijuana in 
Oregon, Alaska and the District. As the movement toward marijuana 
legalization continues, lawmakers and policy experts are looking to 
the experiments in Colorado and Washington for guidance.

We should not overlook, however, valuable lessons from our experience 
with another legal drug: tobacco.

In the late 19th century, the landscape of tobacco consumption was 
very different than it is today.

Tobacco use was much less prevalent, and cigarettes accounted for a 
tiny portion of consumption. Yet by the mid-20th century almost half 
of U.S. adults smoked, with major consequences for public health.

Despite important health policy achievements since, cigarette smoking 
remains a major contributor to the top causes of death in the United 
States, including cardiovascular and lung diseases, as well as cancer.

This drastic rise in the prevalence of smoking can be attributed to a 
number of successful business strategies. Hand-rolling of cigarettes, 
a technique that limited production potential, was supplanted by 
machine manufacturing. Changes in the chemical composition and curing 
process of cigarettes made them more flavorful as well as more 
addictive. Aggressive marketing techniques sought to build a larger 
consumer base. Advertisements often featured doctors in an effort to 
quell public fear over smoking-related health concerns; other 
campaigns targeted children or adolescents, who represented potential 
lifetime customers.

Finally, the industry created powerful lobbying groups to protect 
their profits from regulations aimed at curbing consumption.

Alarmingly, marijuana businesses are now mimicking many of Big 
Tobacco's successful strategies. New methods of consuming marijuana 
(such as vaporization) are said to represent a healthier way to get 
high-though little research supports this claim - encouraging 
individuals to consume more marijuana in one sitting.

The percentage of tetrahydrocannabinol (the euphoria-inducing 
compound associated with many adverse health effects) in marijuana is 
much higher than it was a few decades ago. Just as tobacco companies 
featured doctors in advertisement campaigns, marijuana advocates have 
appealed to medical authority by successfully lobbying in many places 
for the approval of "medical marijuana" for a plethora of conditions, 
even when little or no scientific evidence supports its use. While it 
is laudable that Colorado has placed restrictions on marijuana 
advertising, it is also disturbing that the marijuana industry 
quickly mounted powerful legal efforts to challenge these 
restrictions in court.

The formula for success in profiting from a legal drug is simple and 
has been clearly outlined by Big Tobacco: Identify a product with 
addictive potential, aggressively market it to as large an audience 
as possible, develop technical innovations to allow for and promote 
increased consumption, and deny or minimize potential costs to human 
health. The marijuana industry is poised to copy this formula, with 
dire consequences.

Important lessons can also be drawn from the Netherlands, where 
marijuana has been decriminalized since 1976. Following 
decriminalization, the Dutch government strictly enforced guidelines 
prohibiting advertising and transactions above a certain quantity (to 
discourage mass production and distribution). For about a decade, 
marijuana consumption rates remained stable.

However, in the mid-1980s, waning enforcement of these guidelines 
coincided with a drastic increase in both the commercialization of 
marijuana and rates of consumption. The overriding lesson from the 
Netherlands is that it was commercialization, not decriminalization 
itself, that led to sharp increases in use.

If we are intent on legalizing marijuana for recreational use, 
lessons from the tobacco industry and the Dutch marijuana experiment 
suggest that we do so in a way that does not pit corporate incentives 
against the interests of public health.

Similar to efforts in Uruguay, production and distribution should be 
done solely by the government so as to ensure that there is no 
corporate incentive to entice more people to consume marijuana in 
larger quantities. Advertisements in all media venues should be 
banned, or as stringently regulated as allowed by law.

While the health effects of marijuana are generally not as severe as 
those of cigarette smoking, the consequences - including addiction, 
psychosis and impaired cognitive abilities - are nonetheless real. 
Notably, these effects are most pronounced in children and 
adolescents. Claims that marijuana legalization will make it easier 
to prevent use by minors are not backed by scientific or historical 
evidence. The most prevalent drugs consumed by teenagers are those 
that are legal: alcohol and tobacco.

This should give us pause to consider the optimal way to legalize 
marijuana - and indeed whether other states should consider legalization at all.
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MAP posted-by: Jay Bergstrom