The Drug War Without Cops

Michael Bloomberg, the Washington Post once claimed, “may be Big Tobacco’s biggest enemy.” By the time that claim was made, the former mayor was fighting smoking through his philanthropic ventures. But during his decade in Gracie Mansion, reducing smoking was among Bloomberg’s top priorities. He banned smoking in bars, restaurants and parks; raised the smoking age to 21; hiked cigarette taxes; and banned flavored cigarettes.

It’s hard to argue that Bloomberg’s war on smoking didn’t work. Adult smoking in New York City declined 28% between 2002 and 2012, a 10-year retrospective on the program noted, while youth smoking fell by more than half in approximately the same period. The average number of cigarettes smoked per day fell too. Today, under 10% of city residents smoke, down from 14.8% a decade ago — a steeper drop than in the rest of America. By the end of his term, 82% of New Yorkers supported the restaurant ban, making it more popular than other Bloomberg policies like the city’s new public plazas or the Citi Bike program.

Bloomberg’s war on smoking probably saved thousands of lives. Almost as importantly, it showed that it is possible for a society to have a meaningful impact on the level of consumption of a harmful, addictive substance — in this case, cigarettes — through tools other than policing and incarceration.

Much of the debate around vice — illegal drugs, but also alcohol, tobacco, gambling and pornography — focuses on the role of law enforcement in its control. Relaxation of drug enforcement is often taken to require, as a logical consequence, more wholesale destigmatization and commercialization. Reduce enforcement against marijuana or gambling, and a commercial market is considered a logical next step, alongside a regime of legal tolerance and even embrace.

But in controlling vices and their harms, policymakers have many options between incarceration and commercialization. More specifically, nonenforcement tools for vice suppression, like the ones Bloomberg used to such effect, deserve more attention. Approaches like low-enforcement prohibition, prevention programming, public health campaigns and public disapproval of substance use have a lot of power — if we accept that they have a place in the drug-control arsenal.

Start with prohibition itself, which is a powerful tool even without enforcement. Prohibiting producing or trafficking a good imposes all sorts of costs on doing so: It makes it harder to obtain raw materials, access capital and distribute your product. At the same time, it scares away legitimate business owners — who are, in general, more competent than criminals. The limitations imposed by prohibition are why, for example, cocaine costs so much more than coffee, even though they have similar costs at the farm gate. Drug dealers may be villains, but they are much worse at operating businesses than Walmart; prohibition keeps the latter out of the drug trade. 

The obvious example of prohibition with minimal enforcement is sports gambling. For almost 30 years, sports gambling was illegal in all but the four states exempted from the 1992 federal ban. In spite of the formal ban, enforcement was exceedingly rare. Police departments reported just 2,800 gambling arrests in 2018, including just 272 for bookmaking. Rather, prohibition worked primarily by making it costly for anyone but small bookmakers to get involved in the industry. 

Then, in 2018, the Supreme Court struck down the federal ban as incompatible with the 10th Amendment. Sports gambling, now legal in 30 states, is a $13-billion-and-growing industry. This industry gets most of its revenue from a small number of high-intensity problem gamblers. In New Jersey, for example, 5% of bettors make 70% of bets. Data on the effects of enabling gambling addiction in America are still limited, but we can see the effects in the United Kingdom, which legalized gambling in 2005. There, the government estimates some 8% of suicides are attributable to gambling addiction.

In other words, sports gambling was a straightforward example of how prohibition with only minimal enforcement can still avert the major harms of commercialization. Perhaps that genie cannot be put back in that bottle, but the harmful effects are still a warning for the commercialization of other vice goods.

If prohibition — no matter how toothless — is off the table, there are still the array of policy interventions which fall under the umbrella of “prevention.” These aim, through education and public awareness-raising, to discourage use of technically legal substances. Prevention has something of a bad rap: Everyone remembers the “just say no” campaigns of the 1980s with derision. Perhaps because of this, it’s a relatively minor focus of drug policy, receiving for example just 6% of federal drug control funding.

But prevention has come a long way since the ’80s (though it has a long way to go still). We now have evidence of successful public information campaigns. The national Truth Initiative, designed to deter smoking initiation, has been estimated to have prevented nearly half a million teens from smoking. Notable, although less persuasive, is suggestive evidence of the Office of National Drug Control Policy’s “Above the Influence” campaign reducing marijuana use. Part of what differentiates successful prevention campaigns seems to be an emphasis on facts, rather than scare tactics: In a large survey, students were likely to rate as effective anti-drug ads when they considered them realistic and educational.

In-person prevention programming can also help. Here, too, people tend to think of outdated approaches like the D.A.R.E. programs of the 1980s. More evidence-informed programs look like the Communities That Care program or Big Brothers Big Sisters mentoring, both of which have some evidence supporting their effects on drug consumption. Successful programs tend to focus not just on discouraging kids from using drugs, but developing the personal skills and social connections necessary to choose to “say no.”

These approaches aren’t necessarily for everybody; universal interventions for mental health can be ineffective or even backfire. But being honest with kids about the real health and interpersonal harms that can come from drug use — especially when illegal drugs are killing more people than at any point in American history — should be the default practice, regardless of the legal status of the harmful substance in question.

Effective prevention is not only about program specifics; it is also about culture. Glamorizing portrayals of substance use, in media or advertising, help normalize dangerous and harmful behavior. Analogously, how governments choose to speak about vicious substances matters. In New York City, Health Department ad campaigns have told the public, “Don’t be ashamed you are using [drugs], be empowered that you are using safely.” It’s fine to encourage people to use safely — to the extent such a thing is meaningful — but public messaging should be unambiguous that drug use is harmful. 

The same logic applies to legal drugs. Just because pot is permitted by law doesn’t mean cities ought to encourage it. At the least, policymakers should clearly communicate the risks of marijuana use: intoxication and associated dangers, acute psychosis and hyperemesis from consuming too much THC, addiction and attendant dysfunction and heightened risk for schizophrenia. Similar messaging is appropriate for alcohol, gambling and prescription drugs: Don’t lead people to think only tobacco can hurt you.

At the same time, policymakers might take a page from Bloomberg’s book, recognizing that support for order and health mobilizes public support more than fear of drugs themselves. Many legalization cities — especially New York — have big problems with public marijuana consumption (and the attendant smell). Many types of public smoking are already illegal, and a little enforcement might go a long way toward curbing this problem.

The late drug policy scholar Mark Kleiman was known for his idea of “grudging toleration,” a middle ground between prohibition and legalization where vicious substances were neither brutally suppressed nor commercially embraced. Such an approach entails soft-touch law enforcement combined with a vigorous public health agenda. Unfortunately, amid a great cultural rejection of the war on drugs, we have become far too tolerant of many addictive goods — alcohol, marijuana and gambling, just to name a few. The public has little stomach for another law-and-order crackdown. But a little more begrudging in our toleration would do everyone a lot of good.