BILL ANALYSIS                                                                                                                                                                                                    Ó

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                                   THIRD READING 

          Bill No:  ABX2 9
          Author:   Thurmond (D) and Nazarian (D), et al.
          Amended:  3/3/16 in Assembly
          Vote:     21  

           AYES:  Hernandez, Beall, Hall, Leno, McGuire, Mitchell,  
            Monning, Pan, Wolk
           NOES:  Anderson, Moorlach, Nielsen
           NO VOTE RECORDED:  Morrell

           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.



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          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  

          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  

          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  

          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  


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            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."
          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  


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            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,  


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            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  
          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  


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            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  
          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  

          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  


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            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  


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          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

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