BILL ANALYSIS Ó ----------------------------------------------------------------- |SENATE RULES COMMITTEE | ABX2 9| |Office of Senate Floor Analyses | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ----------------------------------------------------------------- THIRD READING Bill No: ABX2 9 Author: Thurmond (D) and Nazarian (D), et al. Amended: 3/3/16 in Assembly Vote: 21 SENATE PUBLIC HEALTH & DEV. SERVICES COMMITTEE: 9-3, 3/7/16 AYES: Hernandez, Beall, Hall, Leno, McGuire, Mitchell, Monning, Pan, Wolk NOES: Anderson, Moorlach, Nielsen NO VOTE RECORDED: Morrell SENATE APPROPRIATIONS COMMITTEE: 5-1, 3/8/16 AYES: Lara, Beall, De León, Hill, Mendoza NOES: Nielsen NO VOTE RECORDED: Bates ASSEMBLY FLOOR: 59-6, 3/3/16 - See last page for vote SUBJECT: Tobacco use programs SOURCE: Author DIGEST: This bill extends current tobacco use prevention funding eligibility and requirements for county offices of education and school districts to include charter schools. Broadens the definition of products containing tobacco and nicotine, as specified, and prohibits their use in specified areas of schools and school districts, regardless of funding. Requires specified signs to be prominently displayed at all entrances to school property. ANALYSIS: ABX2 9 Page 2 Existing law: 1)Establishes the Tobacco Education and Research Oversight Committee to provide advice to the Departments of Education (CDE) and Public Health (DPH) regarding policy development, integration, and evaluation of tobacco education programs. 2)Requires CDE to allocate funds to county offices of education (COEs) for tobacco use prevention, intervention, and cessation activities. 3)Requires all school districts and COEs that receive Tobacco Use Prevention and Education (TUPE) program funding to adopt and enforce tobacco-free policies, no later than July 1 of each fiscal year, prohibiting the use of tobacco products, any time, in district-owned or leased buildings, on district property, and in district vehicles; prominently display signs stating "Tobacco use is prohibited" at all entrances to school property; and provide information about smoking cessation support programs to students and staff. This bill: 1)Expands eligibility for TUPE funding to include charter schools. 2)Extends to charter schools, as a condition of receiving TUPE funding, all current requirements, including adopting and enforcing a tobacco-free campus policy prohibiting the use of products containing tobacco and nicotine, as defined; prominently displaying "Tobacco use is prohibited" signs at all entrances to school property; and providing information about smoking cessation support programs to students and staff. 3)Broadens the definition of products containing tobacco and nicotine to include, but not limited to, smokeless tobacco, snuff, chew, clove cigarettes, and electronic cigarettes (e-cigs) that can deliver nicotine and nonnicotine vaporized solutions, at any time, in charter school or school district-owned or leased buildings, on school or district ABX2 9 Page 3 property, and in school or district vehicles. 4)Exempts the use and possession of prescription products, nicotine patches, or nicotine gum. 5)Prohibits the use of tobacco and nicotine products, regardless of funding, at any time in COE, charter school, or school district-owned or leased buildings, on school or district property, and in school or district vehicles. 6)Requires school districts, charter schools, and COEs to prominently display signs at all entrances to school property stating "Tobacco use is prohibited." Comments 1)Author's statement. According to the author, many Local Education Agencies (LEAs) receive grants and are required to be tobacco-free. However, not all LEAs are tobacco-free. Research shows that schools that consistently enforce tobacco-free policies have shown decreased rates of smoking among their students. By requiring all LEAs to become 100% tobacco-free, and by including smokeless tobacco and e-cigarettes to the law, ABX2 9 will help ensure that schools protect the health of students and personnel while reducing tobacco use among our youth. 2)Background. Proposition 99, approved by the California voters in the November 1988 general election, increased the tax on each pack of cigarettes sold in the state by 25 cents. The annual Budget Act appropriates funds from the Tobacco Surtax Fund for several purposes, including the TUPE program in schools. According to CDE, the TUPE program provides funding for programs in grades six through 12 through a competitive application process for tobacco-specific student instruction, reinforcement activities, special events, and intervention and cessation programs for students. All LEAs (currently school districts and COEs) that are certified as having a fully implemented tobacco-free school district board policy are eligible to apply for funding. Programs are locally developed, but they are expected to align with the federal Principles of Effectiveness, the recommended California guidelines for ABX2 9 Page 4 tobacco prevention in Getting Results and the Health Framework for California Public Schools. Each COE is eligible to receive funding through the County Technical Assistance and Leadership Funds application to assist school districts within their county in program development, to provide staff development for school and district personnel, and to provide technical assistance as needed. CDE states that the purpose of the TUPE program is to reduce youth tobacco use by helping young people make healthful tobacco-related decisions through tobacco-specific, research-validated educational instruction and activities that build knowledge, as well as social skills and youth development assets. According to CDE's Web page, a tobacco-free school prohibits all tobacco use anytime, anywhere, and by anyone on all school property, and at all school-sponsored events. School property includes buildings, grounds, and vehicles owned or leased by the school. School-sponsored events include sporting events, school dances, and other events held on and off school property. The goal of CDE's tobacco-free school district certification process is to protect children's health by encouraging all school districts and COEs to adopt a model 100% tobacco-free policy. CDE staff works closely with DPH's California Tobacco Control Program to promote smoke-free environments and tobacco-free lifestyles throughout the state, particularly among youth. 3)Smoking prevalence. According to the 2012 Surgeon General's Report, nearly 90% of smokers in the U.S. started smoking by the age of 18, and 99% started by age 26. In California, 64% of smokers start by the age of 18, and 96% start by age 26. According to DPH, in 2010, 36.8% of high school students had smoked a whole cigarette by age 13 or 14, and in 2012, illegal tobacco sales to minors rose to 8.7% from 5.6% in 2011. According to DPH, in 2010, 11.9% of the state's adults smoked, down from 13.1% in 2009, making California one of only two states to reach the federal Healthy People 2020 target of reducing the adult smoking prevalence rate to 12%. However, research highlights that the burdens of smoking do not fall evenly across the state. According to the American Lung Association (ALA), African-American men and women have the highest smoking usage rate at 21.3% and 17.1% respectively, ABX2 9 Page 5 followed by white men at 17.2% and Latino men at 16%. The ALA reports that Korean men have an unusually high tobacco usage rate at 27.9%, as do Lesbian, Gay, Bisexual, and Transgender women who smoke at almost triple the rate of women in general. 4)Tobacco-related diseases. Every year, an estimated 443,000 people in the U.S. die from tobacco and smoking-related illnesses or exposure to secondhand smoke, according to the federal Centers for Disease Control and Prevention (CDC). The CDC also reports that another 8.6 million people suffer from serious smoking-related illnesses. According to DPH, smoking causes ischemic heart disease, cancer, stroke, and chronic lower respiratory diseases, which are the leading causes of death and disability among adults in California. Smoking-attributed diseases are an economic burden due not only to health care expenses but also productivity losses related to disability or early death. DPH asserts that since the passage of Proposition 99 adult smoking rates declined by more than 40%, from 22.7% to 13.3% in 2008. As smoking rates declined, mortality and morbidity rates for diseases related to smoking also declined. This parallel trend, according to DPH, supports causal association between these conditions and smoking. 5)E-cigs. According to a 2014 report by the World Health Organization (WHO), e-cigs are battery heated devices that deliver nicotine by heating solution that users inhale. E-cig cartridges (e-liquids) contain liquid nicotine, and chemicals introduced into a liquid vehicle produce aromas and various flavors such as tobacco, chocolate mint, cotton candy, gummy bear, and grape. The concentration of nicotine varies both across different manufacturers and sometimes within the same brand. The report states that although some e-cigs are shaped to look like conventional cigarettes, they also take the form of everyday items like pens and USB flash drives. 6)Health risks and increase in use of e-cigs. DPH's State Health Officer released a report in January 2015, "A Community Health Threat," about e-cigs that cites, among other things, the concern about the health risks of e-cigs and the growing number of e-cig users. E-cig poisonings increased from seven in 2012 to 154 in 2014. By the end of 2014, e-cig poisonings ABX2 9 Page 6 to young children tripled in one year, making up more than 60% of all e-cig poisoning calls, according to the report. The State Health Officer also noted that in California, use of e-cigs among those between the ages of 18 and 29 tripled in one year, from 2.3% to 7.6%. Nearly 20% of these young adult e-cig users had never smoked traditional cigarettes. The State Health Officer concludes that there is a high need to educate the public about e-cig safety concerns and that existing laws currently in place to protect minors and the general public from traditional tobacco products should be extended to cover e-cigs. 7)Marketing of e-cigs as cessation devices. The DPH report also cites the unrestricted marketing tactics for e-cigs. E-cig marketing continues to claim they are a safer alternative to traditional cigarettes. To date, the effectiveness of e-cigs as cessation aids has not been proven by e-cig companies or approved by the FDA as such. The report states that a number of studies actually show that e-cig users are no more likely to quit than smokers of traditional cigarettes, and in one study, 89% of e-cig users were still using them one year later. Dual use of e-cigs and traditional cigarettes continues to rise, which, according to the report, may be attributed to the unrestricted marketing of e-cigs. E-cig companies are using tactics previously used by tobacco companies that have since been banned. These include running unrestricted ads and promotions on TV, radio, and social media, and in magazines, newspapers, and retail stores, as well as sponsoring sport and music events and giving out free samples, according to the report. FISCAL EFFECT: Appropriation: No Fiscal Com.:YesLocal: Yes According to the Senate Appropriations Committee: Potential state reimbursable mandate costs up to $120,000 due to the requirement that schools post signs notifying the public that tobacco use is prohibited (General Fund). Under current law, school districts that apply for certain grant funds must adopt anti-tobacco use policies, including a requirement to post signs at school sites. About 80% of school ABX2 9 Page 7 districts have adopted such policies in order to qualify for grant funds. This bill prohibits tobacco use at all school sites and requires all schools to post signs. By requiring all schools to comply with this requirement, this bill imposes a state mandate. Whether the state would be obligated to reimburse school districts for this cost will depend on whether the Commission on State Mandates determines that this requirement imposes an additional duty on school districts. Unknown cost pressure on existing grant funds (Proposition 99 funds). This bill specifically authorizes charter schools to access an existing grant program. There are indications that charter school participation in the current grant program is low. To the extent that this bill results in additional charter schools applying for grant funds, that would put cost pressure on the existing grant program. SUPPORT: (Verified 3/8/16) American Heart Association/American Stroke Association American Lung Association in California Association of Northern California Oncologists California Black Health Network California Chronic Care Coalition California Dental Association California Medical Association California Pan-Ethnic Health Network California Primary Care Association California Society of Addiction Medicine First 5 Association of California Medical Oncology Association of Southern California Planned Parenthood Affiliates of California OPPOSITION: (Verified 3/8/16) None received ARGUMENTS IN SUPPORT: Supporters of this bill argue that, under ABX2 9 Page 8 current law, only school districts that receive TUPE funding are required to implement 100% tobacco-free policies, which currently equates to only 46% of school districts, leaving more school districts with no obligation to ban tobacco and other nicotine and non-nicotine products on their campuses. Supporters argue that smoking increases the risk of heart disease and stroke by two to four times, and is linked to vision loss and reduced school attendance, physical fitness, and learning abilities for youth. Supporters state that schools that consistently enforce tobacco-free policies have shown decreased rates of smoking among their students. ASSEMBLY FLOOR: 59-6, 3/3/16 AYES: Achadjian, Alejo, Travis Allen, Baker, Bloom, Bonilla, Bonta, Brown, Burke, Calderon, Campos, Chang, Chau, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Hadley, Roger Hernández, Irwin, Jones-Sawyer, Kim, Levine, Lopez, Low, Maienschein, McCarty, Medina, Mullin, Nazarian, Obernolte, O'Donnell, Quirk, Rendon, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Weber, Williams, Wood, Atkins NOES: Brough, Beth Gaines, Harper, Jones, Lackey, Wagner NO VOTE RECORDED: Bigelow, Chávez, Frazier, Gallagher, Grove, Holden, Linder, Mathis, Mayes, Melendez, Olsen, Patterson, Waldron, Wilk Prepared by:Reyes Diaz / P.H. & D.S. / 3/9/16 14:52:20 **** END ****