Three essays on the evaluation of public policies in the field of addictions

This dissertation, composed of three essays, aims at providing an evaluation of selected public policies in the field of addictions, focusing on drugs and gambling. Evaluation is increasingly recognised as essential for effective policymaking, helping to empirically verify that policies and programmes have the desired effect, provide value for money and do not have negative unintended consequences. In the case of socially undesirable behaviours, policy evaluation is frequently challenged by the limited data available. To tackle this challenge, the analyses proposed in the present work make use of novel datasets which combine epidemiological, financial, political and administrative data. On the one hand, addictive behaviours constitute an enormous source of revenue for organized crime and for national governments, in the case of legal substances or behaviours such as gambling. On the other hand, they represent a cost for public authorities, e.g., for public health and law enforcement reasons. For these reasons, over the years several policy approaches have been implemented to contrast the externalities produced by the spread of addictive behaviours, however very limited work has been performed to evaluate their effects. The present dissertation aims at contributing to the literature seeking to provide evidence on the possible intended and unintended effects of public policies on addictions, focusing on selected policies aimed at regulating cannabis consumption and gambling. The first chapter is aimed at analysing the effects that the drug policy reforms implemented in Europe in the last 15 years had on youth cannabis consumption behaviours. In fact, cannabis is the most used illicit drug and accounts for the largest share of the European illicit drug market. To tackle this longstanding problem, a broad set of reforms to national cannabis control policies have been implemented, but their effectiveness in achieving the desired results is still unclear. This essay analyses the association between selected categories of cannabis policy reforms and changes in cannabis availability and useamong adolescents. Data from 20 European countries across 15 years were drawn from a novel database of the European school Survey Project on Alcohol and other Drugs. The influence of policy changes on reported access to cannabis and different frequencies of use was estimated through an identification strategy based on a Differences-in-Differences model, which application is allowed by the fact that only thirteen out of the twenty countries included in the analysis implemented relevant reforms. The findings suggest that selected categories of reforms influence the availability and prevalence of cannabis among adolescents. In particular, some forms of restrictive interventions reduce the general prevalence of use and more liberal reforms seem to cause an increase in the share of students approaching cannabis. However, none of the analysed reforms seems to have been able to influence the consumption habits of frequent users. The second chapter deepens the analysis of the effects of drug policy changes by focusing of the reform that in the period 2006-2014 criminalised the possession of cannabis for personal use in Italy. The chapter addresses a key question in the ongoing policy debate over cannabis’ legal status as to whether removing or increasing penalties attached to cannabis use and possession leads not only to changes in the proportion of cannabis users, but also to changes in the dynamics of cannabis use. Empirically investigating this aspect is a growing field of study. This paper aims at extending previous research by studying the effect of increasing penalties on initiation into cannabis use. This is done in the Italian context where, despite the relevant drug policy reforms implemented over the last 30 years, very little econometric studies have been performed to evaluate their effects. In order to identify the effect of criminalisation on the transition into cannabis use, the paper exploits the policy change that in the period from 2006 to 2014 increased the penalties attached to cannabis possession in Italy. For this, a unique dataset pooling seven waves (2001-2017) of the Italian Population Survey on Alcohol and other Drugs (IPSAD) is used. The empirical investigation is based on a Complementary Log-Log regression model to analyse the starting rate, that is, the transition rate from non-use to use. The results suggest that the introduction of higher punishments for cannabis possession has a significant, although limited, effect in reducing the uptake of cannabis. However the research highlights that this relative achievement need to be evaluated against the backdrop of the social consequences of criminalisation. The third chapter is aimed at assessing the market effects of limiting the supply of gambling products. This is done by exploiting the effects of the local policies that imposed restrictions on the supply of offline entertainment machines implemented in the years 2017-2018 by some municipalities in one of the Northern regions of Italy. The market effects of reducing the allowed functioning time of offline entertainment machines are assessed both on the level of the gross gambling turnover and on its composition in terms of possible shifts towards online gambling products. Although the policy should have applied to the entire regional territory, some municipalities did not approve the necessary implementing acts, whilst others imposed functioning time restrictions with varying level of intensity. This variation is exploited using a regression-based Differences-in-Differences (DiD) design with continuous treatment with a unique dataset recording yearly gambling turnover by type of game in the years 2016, 2017, and 2018 matched with data on municipal acts collected for the study and socio-demographic variables. The results suggest that the implemented policies actually reduced the gambling consumption through offline entertainment machines. However, no significant reduction of the total gambling consumption was observed. In fact, focusing on the composition of gambling turnover there is evidence of a shift toward online gambling products. These results support the argument that limiting the physical availability of entertainment machines is an effective policy for reducing the amount of resources invested by consumers in this type of game. At the same time attention should be paid to the possible unintended effects on the shift towards other gambling products, which by definition cannot be subject to similar restrictions.