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National Health Organizations Oppose Florida HB1299

March 25, 2019

The undersigned strenuously oppose HB1299, a measure that would preempt locally-elected Florida office holders from raising the minimum legal tobacco sales age or enacting local licensure for tobacco and nicotine products.  This unwelcome, top-down proposal would remove the ability of local governments to protect the health and safety of their constituents, especially children.

HB1299 is especially egregious in light of the Juul e-cigarette addiction epidemic that has swept through Florida’s adolescent population – with estimates that a quarter of underage teens use these slick devices.  A single Juul pod delivers highly-addictive nicotine equivalent to a pack of cigarettes.

Many public health policy interventions such as Tobacco 21 begin at the local level. As of today, over 450 localities in 25 states, including Florida, have enacted these common-sense regulations.  Alachua County recently demonstrated its health leadership by passing the first Tobacco 21 policy in the state.  The effectiveness of the policy is dependent on local enforcement and a local license.  As a result of Alachua’s leadership, several other Florida municipalities are considering the measure.

Both state and local elected officials have the responsibility to act on urgent matters of public health and safety like that of the adolescent e-cigarette epidemic. Good health policy must be evidence-based, have public support and, above all, not be set by tobacco industry lobbyists in backrooms of the statehouse.

We urge that HB1299 be rejected.

Sincerely,

The Preventing Tobacco Addiction Foundation/Tobacco 21.org

The American Heart Association/The American Stroke Association

The American Lung Association

Campaign for Tobacco-Free Kids

Tobacco-Free Alachua

Cancer advocates say tobacco bill is flawed, encourage lawmakers to vote no

SALT LAKE CITY — A bill to incrementally raise the age for tobacco products, including electronic cigarettes, to 21 passed through the Utah Legislature Wednesday with a 15-12 vote in the Senate and a 55-16 concurrence vote in the House.

HB324, sponsored by Rep. Steve Eliason, R-Sandy, changes the age from 19 to 20 on July 1, 2020, and to 21 one year later. The bill raises the age for “obtaining, possessing, using, providing, or furnishing of tobacco products, paraphernalia, and under certain circumstances, electronic cigarettes.”

Arguments around this bill has centered on the debate of preemption, with cancer advocates speaking against an early version of the bill. The bill that passed made only one amendment to preemption language in current code, adding the minimum age of sale to what cannot be modified by cities and counties.

Sen. Curt Bramble, R-Provo, the Senate sponsor of the bill, said this compromise would allow cities that have already raised the age for sale of tobacco, including Lehi and Cedar Hills, to keep the age at 21 instead of following the incremental age increase in the state.

She said addiction should not be shamed or criminalized, especially for youth. If youth get in trouble while they are building who they are as a person, they could define themselves as thugs or criminals.

“This is not about smokers, this is about protecting youth from having access to these addictive materials that the tobacco industry is pushing,” Tischler said.

According to Tischler, 800 youth in Utah each year become daily smokers, and vaping is especially a problem for youth because they have more access to it and it’s easier to hide from parents.

Jordan Osborne was part of an anti-tobacco youth group in Utah County and helped change laws to make parks tobacco free. But when he was 18, a friend a few years older bought him a vape pen and he became a smoker. He still vapes and occasionally smokes cigarettes. He said he doesn’t feel like he is addicted, but he gets aggravated when he hasn’t smoked.

“If they had the smoking age at 21 back then it would have made it even harder for me to even get (tobacco),” Osborne said.

He said if he had never started using tobacco he would be a lot healthier and wouldn’t have to have something to help him relax.

Cedar Hills and Lehi both passed ordinances in the last few weeks raising the age to buy tobacco to 21. But opponents to HB324 say language in the bill could stop other cities from making changes to local tobacco laws.

Vaping isn’t working at cessation; it is working at hooking our teens

PUBLISHED:  | UPDATED: 
When electronic cigarettes first came on the market, we hoped they might help reduce the tremendous harm caused by tobacco cigarettes. If smokers inhaled a vapor containing nicotine, flavorings and other additives rather than the multitude of cancer-causing chemicals in tobacco smoke, there might be some benefit.

While some adults have used e-cigarettes to wean themselves from tobacco, research indicates that e-cigarettes are really just another nicotine delivery device with its own unique hazards that addict users to nicotine. This is especially concerning for teens and young adults who are using e-cigarettes with alarming frequency.

One recent study did suggest that e-cigarettes helped adults stop smoking. However, those who quit tobacco continued to consume e-cigarettes and nicotine a year later. More common appears to be the experience of smokers studied by Dr. Russell Bowler, a professor of medicine at National Jewish Health. He found that most of the tobacco smokers who started using e-cigarettes in hopes of quitting tobacco continued to smoke tobacco at similar or higher levels five years later. Former smokers who began using e-cigarettes were more than 16 times as likely to resume tobacco smoking.

Additional research at National Jewish Health has shown that, while less harmful than tobacco smoke, e-cigarette vapor itself is harmful. It injures cells lining the airways and blood vessels in the lungs, and increases susceptibility to respiratory viruses.

E-cigarette use, or vaping, by teens and young adults is especially worrisome. After decades of decline, the consumption of tobacco products has taken a U-turn and begun a precipitous climb. Vaping among middle and high school students increased 900 percent from 2011 to 2015 and nearly doubled in just the last year.

Today, one in 20 middle schoolers and one in five high school students use e-cigarettes. College students and young adults vape at similar or even greater rates.

Research has shown that youth who try an e-cigarette are more likely to begin smoking tobacco. The Surgeon General and the Food and Drug Administration have both called e-cigarette use by teens and young adults a serious public health threat.

Nicotine in e-cigarettes poses unique threats to young users’ health. Adolescence is an important period of brain development when learning capacity, decision making, working memory, reward processing and emotional regulation all grow and mature. Nicotine use during adolescence profoundly alters this process, priming the brain for future addictions and increasing the risk of mood disorders, intellectual problems and impulsiveness.

E-cigarettes have become immensely popular, fueled by flavors and marketing targeted at young people. Peer pressure to vape is bearing down on those who don’t. Many don’t even realize they are vaping nicotine and mistakenly believe they are inhaling simple water vapor. Teenage brains are especially susceptible to nicotine’s addictive and rewarding effects, yet many fail to recognize the threat e-cigarettes pose to long-term mental and physical health.

After decades of fighting to reduce harm from tobacco, it is astounding that a new generation faces a renewed threat from tobacco. We must help young people avoid nicotine and quit e-cigarettes. Teens can call the Colorado QuitLine (1-800-QUIT-NOW), which recently lowered the age of eligibility for services to 12.

As the operator of the Colorado and many other state quitlines for 17 years, National Jewish Health has extensive experience treating nicotine addiction with personalized plans to avoid nicotine, navigate peer pressure and manage nicotine withdrawal. At the same time, the FDA must tighten regulation of e-cigarettes and follow through on promises to close down manufacturers who don’t meaningfully limit youth access to e-cigarettes.

JUUL, the dominant company in the market, must follow through on its action plan to cease marketing to youth and limit their access to its products.

We urge Colorado legislators to pass the recently introduced bill to raise the age for legal purchase of e-cigarettes.

Together, we can protect our youth from the dangers of e-cigarettes and vaping.

Dr. Michael Salem is president and CEO of National Jewish Health. Thomas Ylioja, PhD, is an assistant professor of medicine and clinical director of health initiatives at National Jewish Health.

Brian Donohue column: Tobacco 21: Addressing the right problem the wrong way

Nearly 95 percent of adults who smoke started before age 21, so we applaud our state legislators for wanting to reduce the use of tobacco, including e-cigarettes, for those younger than 21. However, the proposed bill as it is drafted will not provide the public policy results legislators are looking for and will not have support from the American Cancer Society Cancer Action Network (ACS CAN).

It is important to closely evaluate each proposed Tobacco 21 bill as the tobacco industry has a history of using age of sale laws to weaken restrictions on sales to youth, penalize youth, create carve-outs for certain products, and to interfere with other effective tobacco control policies.

ACS CAN has been working to advance effective Tobacco 21 legislation across the nation for several years. What we have learned from these debates is that the legislative focus needs to be on the sale — not the purchase — of tobacco and e-cigarette products. We have also seen that penalizing and fining youth who purchase tobacco and e-cigarettes has proven not to be an effective way to reduce consumption. Therefore, as this bill is drafted, it will not have support from ACS CAN.

The Tobacco 21 legislation needs to address three critical areas of concern in order to have the greatest impact: focus on the sale of tobacco and e-cigarettes rather than the purchase, require licensing for all retailers that sell tobacco and e-cigarette products, and fund prevention and cessation programs to help reduce youth tobacco use.

This bill retains penalties for youth who purchase, use, and possess tobacco and e-cigarette products. We have learned from working Tobacco 21 bills across the states that laws that focus on the purchaser rather than the seller fail to reduce youth consumption. Virginia’s current law unfairly penalizes youth, many of whom became addicted at an early age due to tobacco industry marketing campaigns. This takes the spotlight off Big Tobacco and retailers and shifts it onto the victims — our youth.

Not licensing retailers makes enforcement and holding retailers accountable next to impossible. For Tobacco 21 laws to be effective, there must be strict enforcement to ensure a high rate of compliance. We recommend the proposed bill be amended to require retailers to be licensed, designate an enforcement agency, identify a dedicated funding source for enforcement, require annual unannounced compliance checks, increase fines and penalties including license suspension and revocation for retailers found out of compliance, provide for citizen complaints of violations, require appropriate signage at retail stores, and, lastly, provide retailer education.

Our final concern is that many young people who smoke are already addicted. Some research suggests that penalizing youth could deter them from seeking support for cessation. Promoting and increasing funding for tobacco prevention and cessation resources for teens interested in quitting would be a more beneficial alternative to fines and punishment.

Without the amendments outlined above, this bill will prove to be ineffective, feel-good legislation that allows the tobacco and e-cigarette industries to support this measure while presenting themselves as good corporate citizens who are doing the right thing.

We urge lawmakers to oppose this bill as drafted and work to seize this opportunity to pass meaningful legislation that has proven to effectively reduce youth consumption of all tobacco and e-cigarette products. ACS CAN stands ready to work with legislators on amendments needed to make this bill an effective vehicle for protecting our young people from a lifelong addiction to tobacco and e-cigarette products.

E-cigarettes use among youth at epidemic levels

“The latest Florida Youth Tobacco Survey, which tracks indicators of tobacco use and exposure to secondhand smoke among middle and high school students, shows that one in four high school students currently use electronic vaping.  Florida is significantly above the national average.

People do not become addicted to tobacco or to cigarettes. They become addicted to nicotine, which is in tobacco and in electronic cigarettes. Nicotine is an insecticide, and is highly addictive.

Today there are significantly more children inhaling nicotine than 20 years ago. Nicotine adversely affects the brains of children, which are not fully developed. Nicotine addiction leads to a costly, slow and painful death. It kills 480,000 Americans each year.

Any assumption that vaping is safer than smoking has been dispelled by many studies including one at the University of Miami School of Medicine. Vaping is not safe, and there is no safe level of exposure to secondhand smoke.

. . .

The Surgeon General recently declared “e-cigarette use among youth an epidemic.”

. . .

Legislators in Florida (state and local) have done nothing to stop the vaping epidemic, but they can do many things. For example, the state legislature can define electronic nicotine delivery systems (ENDS), which includes electronic cigarettes, as tobacco.

Currently, vape shops in Florida are unregulated and do not require a license to sell ENDS. Requiring vape shops to have licenses to operate and taxing ENDS as cigarettes are taxed will be more popular than raising property taxes.

Since 2016 six states have raised the legal age to purchase tobacco to 21, and so have 370 cities and counties across America. None are in Florida.

The Florida Legislature and local governments must raise the legal age to purchase tobacco to 21. Nearly all tobacco product use, and addiction, begins during youth and young adulthood. Tobacco use among teenagers has been cut in half in communities where the legal age is now 21.

Raising the access age to 21 would be beneficial to elected officials as it is an extremely popular measure. In a statewide poll of likely voters, 69 percent favored raising the legal age to 21 if it were a ballot initiative. This overwhelming popular support is consistent with numerous other polls conducted across America.

Opponents may argue the state will lose tobacco tax revenue. This argument lacks vision because Florida pays out more than twice the money it collects in tobacco tax to pay for Medicaid claims due to tobacco-related illnesses and does not account for the immeasurable human suffering caused by drug addiction.

Healthy laws need to be enacted to protect young people from this deadly epidemic. If the state legislature will not act, then cities and counties must act to end the ENDS epidemic.”