Gambling addiction

 When gambling opportunities were rare and often illegal in the U.S., gambling addiction was a less visible problem than it is becoming today.

Here's a story from the NYT, about a sports news broadcaster who went to prison after pursuing fraudulent schemes to raise money to pay his gambling debts:

Saturday Mornings With the ‘Voice of Problem Gambling’  Craig Carton, the bombastic sports broadcaster, shows a different side on a weekly show that focuses on the stories of gambling addicts like himself.  By Zach Schonbrun

“There’s a preconceived notion of the kind of guy or gal that is a gambling addict,” Mr. Carton said. “And now you’re listening to schoolteachers and doctors and lawyers and first responders and librarians — normal people who went down a road never having any expectation of having a problem.”

...

"The show’s arrival coincided with an explosion in gambling as 38 states legalized sports betting. The National Council on Problem Gambling estimates that 1 percent of U.S. adults meet the criteria for a gambling disorder, and that an additional 2 to 3 percent are “experiencing problems” due to “moderate” gambling behavior.

"That suggests that most Americans are capable of gambling responsibly, and Mr. Carton believed he could, too. He had gambled his whole life.

...

"The incident that he says “accelerated” his descent into problematic gambling didn’t come until 2014, when Mr. Carton, in his typical bombastic fashion, proclaimed on the air with Mr. Esiason that he could take $10,000 and turn it into $25,000 overnight playing blackjack. To his surprise, Mr. Esiason handed him $10,000 in cash a few weeks later during a special taping at the Borgata, a casino hotel in Atlantic City. Mr. Carton backed up his boast, winning $80,000 playing blackjack.

"But the seeds of compulsion were planted. Almost immediately, Mr. Carton began receiving calls from listeners eager to test his magic touch. Soon he was being handed duffel bags of cash and ushered into private parlors at casinos.

“That just gave me access to more money,” Mr. Carton said. “And when you’re already going down a road where you want to gamble all the time anyway, if you’re betting $100 a hand, and now you’re betting $1,000 a hand, you can’t go back to $100. It just became progressive.”

He won a lot, but at the rate he was going, the odds weren’t in his favor. Debts snowballed; then the federal agents arrived. The judge at his sentencing, Colleen McMahon, introduced herself to him as “Colleen from New York — first time, long time,” echoing a common phrase used by callers into WFAN’s shows. She then told Mr. Carton, “You have indeed descended into a hell of your own making.”

"Mr. Carton’s public disgrace resonated with Dan Trolaro, a former investment adviser for Prudential who spent four and a half years in state prison in New Jersey for stealing $1.9 million in client money. He had committed the thefts to feed an online gambling addiction.

"Mr. Trolaro went on to work for the nonprofit Council on Compulsive Gambling of New Jersey, which is the home of the 1-800-GAMBLER addiction hotline.

...

"On a recent Monday evening, Mr. Carton stood with a microphone in a lecture hall at the LaPenta School of Business at Iona University in New Rochelle, N.Y. For an hour, he implored the 40 or so students in attendance not to follow in his footsteps.

“I’m not here to tell you not to gamble,” he said. “But I am here to tell you that, if you allow it, gambling can ruin your life.”

"The event was presented by FanDuel, the largest online sports book in the country. Mr. Carton is on his second contract as the company’s paid ambassador for “responsible gaming,” a relationship that, he admits, carries the appearance of conflict with his efforts to combat addiction. He insists the arrangement allows him to carry his message to a wider audience."

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See also Gamblers Anonymous  https://www.gamblersanonymous.org/ga/

Menthol cigarettes get a reprieve

 The WSJ has the story:

Biden Administration Shelves Plan to Ban Menthol Cigarettes. White House had been weighing health benefit of ban against angering some Black voters   By Jennifer Maloney, Liz Essley Whyte, and Andrew Restuccia

"The Biden administration is reversing course on its plan to ban menthol cigarettes, after the White House weighed the potential public-health benefits of banning minty smokes against the political risk of angering some Black voters in an election year. 

...

Menthols account for more than a third of all cigarettes sold in the U.S. each year and are predominantly used by Black and Hispanic smokers. Some 81% of Black smokers used menthols in 2020, compared with 30% of white smokers and 51% of Hispanic smokers, according to a Wall Street Journal analysis of data from the National Survey on Drug Use and Health.

Some Black community leaders had fought the measure, saying a ban would expand the illicit market for cigarettes and lead police to racially profile Black smokers. The American Civil Liberties Union and some members of the Congressional Black Caucus expressed similar concerns.

...

"By contrast, Rep. Robin Kelly (D., Ill.), chair of the Congressional Black Caucus Health Braintrust, said she was “deeply disappointed that the FDA has chosen to abandon its established plan to ban menthol cigarettes… This is a common-sense plan which could have saved hundreds of thousands of lives.”

"Political considerations have swayed the Biden administration’s thinking on this public-health issue, said Mitch Zeller, who served as director of the FDA’s Center for Tobacco Products until 2022. “The science is clear that there will be a massive health benefit from removing menthol cigarettes,” he said."

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All my posts on menthol here.

Proposed age-adjusted smoking ban in the U.K.

 The BBC has the story, about a proposal to ban smoking for everyone currently under the age of 18. (What could go wrong?)

What is the UK smoking ban, how will it work and when will it start? By Aurelia Foster, BBC News

"Prime Minister Rishi Sunak effectively wants to ban smoking in the UK.

MPs have voted to back the government's plans to create a "smoke-free generation", and reduce the number of smoking-related deaths.

What is the smoking ban?

The restrictions will apply to the sale of cigarettes in the UK rather than the act of smoking itself.

Under the new law, each year the legal age for cigarette sales - currently 18 - will increase by one year.

It means that people born in or after 2009 will never be able to legally buy cigarettes, leading to an effective ban.

The law will not affect those who are allowed to buy cigarettes now.

To crack down on under-age sales, the government says it will introduce £100 on-the-spot fines for shops in England and Wales which sell tobacco and vapes to under-age people.

Local authorities will retain the proceeds to reinvest into enforcement of the law.

This would be on top of £2,500 fines that courts can already impose.

The government says it will spend £30m on enforcement, which will include tackling the availability of cigarettes on the black market.

The new rules will apply in all duty free shops in the UK, but anyone buying cigarettes abroad would be able to bring them back to the UK as long as they were legally acquired elsewhere.

The government aims to have the new system in force by 2027.

Mr Sunak wants to work with the governments of Wales, Scotland and Northern Ireland to introduce the legislation across the UK."

HT: Oğuzhan Çelebi

#######

Earlier: 

Thursday, March 14, 2024

New Zealand repeals anti-smoking law that would have prevented tobacco sales to anyone born after 2008

Text of the new EU regulations on Substances of Human Origin

 Kim Krawiec points me to this newly published document, with the 'final' regulations intended to prevent compensation of donors of Substances of Human Origin (SoHO), such as blood plasma.  How this will effect the five EU member states that compensate plasma donors remains to be seen, as these regulations are now scheduled to go into effect only in 2027.

REGULATION (EU) 2024/… OF THE EUROPEAN PARLIAMENT AND OF THE COUNCIL … on standards of quality and safety for substances of human origin intended for human application 

After a quick read, I think these are the sections of the new regulations that are most relevant to their elements of market design, and compensation to donors.

(4)… safety standards are to be based on the fundamental principle that the human body or its parts as such are not to be a source of financial gain.

…

(26) Solid organs are excluded from the definition of SoHO for the purposes of this Regulation and, thus, from the scope of this Regulation. Their donation and transplantation are significantly different, determined, inter alia, by the effect of ischemia in the organs, and are regulated in a dedicated legal framework, set out in Directive 2010/53/EU of the European Parliament and of the Council

…

(57) Article 3 of the Charter prohibits making the human body and its parts as such a source of financial gain. The use of financial incentives for SoHO donations can have an impact on the quality and safety of SoHO, posing risks to the health of both SoHO donors and recipients and therefore to the protection of human health. Without affecting the responsibilities of the Member States for the definition of their health policy, and for the organisation and delivery of health services and medical care, SoHO donation should be voluntary and unpaid, and be founded on the principles of altruism of the SoHO donor and solidarity between donor and recipient. Such solidarity should be built from the local and regional levels up to the national and Union levels, aiming for self-sufficiency of critical SoHO, and spreading the responsibility for donation evenly across the Union population to the extent possible. Voluntary and unpaid SoHO donation contributes to the respect for human dignity and to protecting the most vulnerable persons in society. It also contributes to high safety standards for SoHO and therefore to the protection of human health, increasing public trust in donation systems. AM\P9_AMA(2023)0250(244-244)_EN.docx 49/306 PE748.903v01-00 EN United in diversity EN 

(58) It is recognised, including by the Council of Europe Committee on Bioethics in its ‘Guide for the implementation of the principle of prohibition of financial gain with respect to the human body and its parts from living or deceased donors’ from March 2018, that while financial gain should be avoided, compensation should be able to be acceptable to prevent SoHO donors being financially disadvantaged by their donation. Therefore, compensation to remove any such risk is deemed appropriate as long as it endeavours to guarantee financial neutrality and does not result in a financial gain for the SoHO donor or constitute an incentive that would cause a SoHO donor to not disclose relevant aspects of their medical or behavioural history or to donate in any way that could pose risks to their own health and to that of prospective recipients, in particular by donating more frequently than is allowed. It should be possible for compensation to consist of the reimbursement of expenses incurred in connection with SoHO donation or of making good of any losses, preferably based on quantifiable criteria, associated with the donation of SoHO.

Whatever the form of compensation, including through financial and nonfinancial means, compensation schemes should not result in competition between SoHO entities for SoHO donors, including cross-border competition and in particular between SoHO entities collecting SoHO for different purposes, such as the manufacture of medicinal products versus human application as a SoHO preparation. The setting of an upper limit for compensation at national level and the application of compensation that is financially neutral for the SoHO donor have the effect of removing any incentive for SoHO donors to donate to one SoHO entity rather than another, significantly mitigating the risk that compensation differences might result in competition between SoHO entities, in particular between public and private sectors. It should be possible for Member States to delegate the setting of such conditions to independent bodies, in accordance with national law. Prospective SoHO donors should be able to receive information regarding the possibility of having their expenses reimbursed or of receiving compensation for other losses, through information tools, such as website 'Question and Answer' pages, information email addresses, telephone lines or other such neutral channels of factual information dissemination. However, because of the risk of undermining the voluntary and unpaid character of SoHO donation, references to compensation schemes should not be included in advertising, promotion and publicity activities that form part of SoHO donor recruitment campaigns, for example using advertising billboards or posters, on television, newspaper, magazine or social media advertisements or similar.

(59) SoHO entities should not offer financial incentives or inducements to potential SoHO donors or to those giving consent on their behalf as such an action would be contrary to the principle of voluntary and unpaid donation. Refreshments and small gifts, such as pens or badges, should not be considered as inducements and the practice of offering them to SoHO donors is acceptable as a recognition of their efforts. On the other hand, rewards or benefits, such as payment of funeral expenses, or payment of health insurance unrelated to the SoHO collection, should be considered as inducements, and as such contrary to the principle of voluntary and unpaid donation and should not be permitted.

(60) This Regulation is not meant to cover research using SoHO when that research does not involve human application, for example in vitro research or research in animals. However, SoHO used in research involving studies where they are applied to the human body should comply with this Regulation. In order to avoid undermining the effectiveness of this Regulation, and in particular in view of the need to ensure a consistently high level of protection for SoHO donors, and sufficient availability of SoHO for recipients, the donation of SoHO that will be exclusively for use in research without any human application should also comply with the standards concerning voluntary and unpaid donation set out in this Regulation.

…

(68) In cases where the availability of critical SoHO or products manufactured from critical SoHO depends on potential commercial interests, such as those related to the production and distribution of plasma-derived products, there is a risk of not having the interests of patients and research at the forefront, and thus to jeopardise the quality and safety of SoHO, SoHO donors and recipients. There could even be situations in which some products with low profitability are no longer produced, thereby hampering their accessibility for patients. Therefore, by considering all reasonable efforts for an appropriate and continuous supply of critical SoHO, Member States contribute to limiting the risk of shortages of products manufactured from critical SoHO.

(69) The exchange of SoHO between Member States is necessary for ensuring optimal patient access and sufficiency of supply, particularly in the case of local crises or shortages. For certain SoHO that need to be matched between the SoHO donor and the SoHO recipient, such exchanges are essential to allow SoHO recipients to receive the treatment they need in the optimal timeframe. This is for instance the case of hematopoietic stem cell transplants, for which the level of compatibility between the SoHO donor and the SoHO recipient has to be high, which requires coordination at a global level, so that each SoHO recipient has as many options as possible to identify a compatible SoHO donor.

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“Next steps (from the European Commission): 

The Council will now formally adopt the new European Health Data Space regulation which is expected to be published in the Official Journal in autumn. It will then become applicable in different stages according to use case and data type.

The Council will also formally adopt the new revised legislation to increase the safety and quality of substances of human origin, which will become applicable in 2027.

#####

Earlier:

Monday, April 22, 2024

Plasma donation in the EU: compensated and uncompensated

Main causes of death around the world, 1990-2021

 Here's a recent article from the Lancet that traces leading causes of death around the world, in more than a thousand countries and subnational locations.  Kidney disease went from #18 in 1990 to #9 in 2019, to #11 in 2021 (when Covid entered the list at #2)  So it looks like the rest of the world is catching up to the developed world in chronic disease as compared to infectious disease.

Naghavi, Mohsen, Kanyin Liane Ong, Amirali Aali, Hazim S. Ababneh, Yohannes Habtegiorgis Abate, Cristiana Abbafati, Rouzbeh Abbasgholizadeh et al. "Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021." The Lancet (2024).

Most diseases are causing less premature death, but Diabetes and Chronic Kidney Disease (CKD) are among the few that are causing more premature death, along with Malaria, AIDS, Covid and Other Pandemic Related Mortality (OPRM). (War is not included in the study.)

No Prices No Games! Four Economic Models by Michael Richter and Ariel Rubinstein

 Here's a new book on economic theory by Richter and Rubinstein.

No Prices No Games!  Four Economic Models  by Michael Richter and Ariel Rubinstein  

At the link you can download a pdf or read it online for free, or purchase a printed edition.

"While current economic theory focuses on prices and games, this book models economic settings where harmony is established through one of the following societal conventions:

• A power relation according to which stronger agents are able to force weaker ones to do things against their will.

• A norm that categorizes actions as permissible or forbidden.

• A status relation over alternatives which limits each agent's choices.

• Systematic biases in agents' preferences.

"These four conventions are analysed using simple and mathematically straightforward models, without any pretensions regarding direct applied usefulness. While we do not advocate for the adoption of any of these conventions specifically – we do advocate that when modelling an economic situation, alternative equilibrium notions should be considered, rather than automatically reaching for the familiar approaches of prices or games."

By email, Ariel tells me that he designed the cover.

Contents

0. Introduction

(pp. 1–12)

• Michael Richter
• Ariel Rubinstein

1. Equilibrium in the Jungle

(pp. 13–36)

• Michael Richter
• Ariel Rubinstein

2. The Permissible and the Forbidden

(pp. 37–64)

• Michael Richter
• Ariel Rubinstein

3. Status and Indoctrination

(pp. 65–90)

• Michael Richter
• Ariel Rubinstein

4. Biased Preferences Equilibrium

(pp. 91–110)

• Michael Richter
• Ariel Rubinstein

5. A Comparison to Game Theory

(pp. 111–133)

• Michael Richter
• Ariel Rubinstein
• • 
    
  • • 
      
    • • 
        
      • • 
          

"In the final chapter, we compare this book's modeling approaches with each other and to those of standard Game Theory on two ``battlegrounds''.

The first is the matching economy. An even-sized population of agents must match into exclusive pairs (pairings). Each agent possesses a preference relation over potential mates.

The standard cooperative game theory solution concept for matching economies is ``pairwise stability''. Following Richter and Rubinstein (2024), we compare this concept with the jungle equilibrium, the Y-equilibrium and the status and initial status equilibrium concepts.

The second battleground is a ``political economy'' situation. A group of agents hold views on a political issue. Each agent chooses a position and has preferences only regarding the position he himself chooses (and not the choices of others). However, there is a need that a majority of agents choose the same position.

Traditionally, such a situation is modeled as a non-cooperative game and its Nash equilibria are calculated. Extending Richter and Rubinstein (2021), we compare this approach with the convex Y-equilibrium and the biased preferences equilibria.

On both battlegrounds, the new approaches lead to very different outcomes than the traditional ones."

Kurt Sweat defends his dissertation

Kurt Sweat defended his dissertation this week. As you can see in the picture below, we celebrated with the traditional toast, but instead of champagne we're drinking  In-N-Out milk shakes.

 

He and I are flanked by the other members of his committee: Itai Ashlagi, Paolo Somaini, Frank Wolak and Han Hong.  He was also advised by Dr. Chris Almond.

  His job market paper, and the other papers in his dissertation, all concern heart transplants.

Endogenous Priority in Centralized Matching Markets: The Design of the Heart Transplant Waitlist (Job Market Paper) 

[Link to current draft]

"Centralized matching markets that prioritize specific participants to achieve certain policy goals are common in practice, but priority is often assigned using endogenous characteristics of participants. In the heart transplant waitlist in the United States, the treatment that a patient receives is used to assign waitlist priority. Policymakers recently changed the prioritization in an attempt to reduce waitlist mortality by assigning higher priority to patients receiving specific treatments previously associated with high waitlist mortality. First, I document a significant response to waitlist incentives in treatments given and transplants that take place. Then, I develop and estimate a structural model of treatment and transplant choices to evaluate the effect of the policy change on patients' outcomes and doctors' decisions. I find three main results from my model. First, there is little change in aggregate survival, and the effect of the change has been mainly redistributive. Second, the change has effectively targeted patients with lower untransplanted survival, with these patients receiving higher expected survival under the current design. Third, the effect on survival is largely driven by changes in the decision to accept/decline offers for transplants rather than directly due to a change in treatment decisions. The policy implications suggest that future designs of the waitlist should disincentivize declining offers for transplants."

Welcome to the club, Kurt.