Question for a final exam in a very tough course on Public Health and Social Policy

Explain how frequency reduction and risk reduction approaches trade off, and the political tensions surrounding those two approaches, using as illustrations the following policy proposals:

1. Needle exchange for heroin users

2. Allowing makers of smokeless tobacco products, and of reduced-carcinogen cigarettes, to make scientifically valid claims of reduced risk compared to smoking normal cigarettes

3. Publicizing the possible neuroprotective effect of fluoxetine (Prozac) and other SSRI’s if taken four hours after MDMA (ecstasy)

4. Condom distribution

5. Adding B vitamins to whisky to reduce Korsakov’s psychosis among alcoholics.

6. Firearms instruction for children.

Extra credit for explaining why expressing doubt about (1) or (4), or endorsing (2) or (6), will get you lynched at a public health convention.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com