BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SBX2 7|
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THIRD READING
Bill No: SBX2 7
Author: Hernandez (D), et al.
Introduced:7/16/15
Vote: 21
SENATE PUBLIC HEALTH AND DEVELOP. SVCS. COMM.: 9-3, 8/19/15
AYES: Hernandez, Beall, Hall, Leno, McGuire, Mitchell,
Monning, Pan, Wolk
NOES: Morrell, Moorlach, Nielsen
NO VOTE RECORDED: Anderson
SENATE APPROPRIATIONS COMMITTEE: 5-2, 8/24/15
AYES: Lara, Beall, Hill, Leyva, Mendoza
NOES: Bates, Nielsen
SUBJECT: Tobacco products: minimum legal age
SOURCE: American Cancer Society Cancer Action Network
American Lung Association in California
DIGEST: This bill increases the minimum legal age to purchase
or consume tobacco from 18 to 21 and makes additional conforming
changes to restrictions and enforcement mechanisms in existing
law.
ANALYSIS:
Existing law:
1)Prohibits any person, firm, or corporation from selling,
giving, or in any way, furnishing tobacco products to any
person under the age of 18, including in person and through
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mail or telephone.
2)Requires all persons engaging in retail sale of cigarettes and
tobacco products to check the identification of tobacco
purchasers to establish age if the person appears to be under
the age of 18.
3)Establishes that California fully complies with federal
regulations, including the "Synar Amendment," that prohibits
the sale or distribution of tobacco products to individuals
under 18, requires strict enforcement, and conditions federal
Substance Abuse Prevention and Treatment Block Grant funding
upon compliance.
4)Requires the Department of Public Health (DPH) to establish
programs to reduce the availability of tobacco products,
establish requirements for retailers of tobacco products to
post conspicuously a notice that selling to minors is illegal,
and enforce the laws set forth in the Stop Tobacco Access to
Kids Enforcement Act (STAKE Act).
5)Creates the STAKE Act to reduce the availability of tobacco
products to minors through specified sales restrictions and
enforcement activities, including using 15 and 16 year olds
for onsite random sting inspections.
6)Authorizes DPH to assess civil penalties ranging from $400 to
$6,000 against any person, firm, or corporation that sells,
gives, or in any way furnishes tobacco products to another
person who is under the age of 18 depending on the number of
infractions.
7)Establishes a fine of $75 or 30 hours of community service
work for those persons under age 18 who purchase, receive, or
possess any tobacco product, unless participating in STAKE Act
activities.
This bill:
1)Raises the minimum legal age (MLA) to purchase and consume
tobacco products to 21 and makes all conforming changes in
existing law.
2)Extends the applicability of the 21 years of age restriction
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to provisions of the STAKE Act.
Comments
1)Author's statement. According to the author, an estimated 90
% of tobacco users start prior to age 21, and 80 % of lifetime
users start before the age of 18. By increasing the MLA to 21,
this bill intends to prevent or severely restrict youth access
to these highly addictive and deadly products. The consumption
of tobacco products leads to a lifetime of adverse health
effects and remains the leading cause of preventable death in
the nation and California. This bill aims to achieve better
health outcomes for Californians, while lowering the immense
cost on the health care system of tobacco-related disease. UC
San Francisco (UCSF) reported tobacco use cost a staggering
$18.1 billion in California alone, with $9.8 billion in direct
health care expenditures. In 2013, to address the burden of
tobacco, the federal Food and Drug Administration (FDA)
commissioned the Institute of Medicine (IOM) to study the
effectiveness of raising the MLA. The IOM concluded that
raising the MLA to 21 would cause the smoking prevalence to
decline by 12 % more than existing control policies.
California already has a 21 year age restriction for other
dangerous activities; it is time for tobacco to be added to
that list. This bill will help California be a leader in
tobacco control and take steps towards eliminating the
addictive, costly, and deadly habit of tobacco use.
2)Toll of tobacco. The Surgeon General issued a report in 1964
that linked smoking and poor health outcomes, including lung
cancer and heart disease. Over the ensuing 50 years since that
report, research solidified the link between tobacco and poor
health outcomes, both directly and indirectly caused.
According to the Center for Disease Control and Prevention
(CDC), tobacco use causes cancer, heart disease, stroke, lung
diseases, and diabetes and remains the leading cause of
preventable death in the United States, resulting in over
480,000 deaths annually. A study conducted by UCSF estimated
that, in 2009, 34,000 deaths in California were attributable
to smoking. In addition to tobacco-related diseases, like
cancer, heart disease, and lung disease, there are a number of
physiological effects. Low infant birth weight is associated
with mothers who smoke or are exposed to secondhand smoke, and
increased hospitalization and inability to heal wounds are
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both linked to tobacco users. There is also a financial toll
as a result of these impacts. Tobacco use costs the nation
billions in direct health care expenditures and lost
productivity annually. The Campaign for Tobacco-Free Kids
estimates that tobacco use in California results in $3.5
billion in costs to Medi-Cal.
3)Youth and tobacco. The CDC states that nearly all tobacco
users begin during their youth, with 3,200 adolescents trying
their first cigarette each day. DPH estimates that 64 % of
smokers in California start before age 18. According to DPH,
California has one of the lowest teenage smoking rates in the
nation. But the prevalence of smokeless tobacco use among
youth has greatly increased, and there has been a slowing
decline in rates of cigarette smoking among youth. Through
implementation of the STAKE Act, California also has seen a
steady decline in illegal sales to minors, although there has
been a slight increase in recent years. Research shows that
nicotine exposure has a dynamic impact on developing brains in
smaller doses and leads to increased vulnerability to
addiction, impulsivity, and mood disorders. Tobacco use for
youth is also associated with reduced lung function, reduced
lung growth, and early cardiovascular damage.
4)IOM report. The FDA is granted broad authority over tobacco
products by the Family Smoking and Tobacco Control Act of 2009
(Act), but is prohibited from increasing the minimum age above
18 at a federal level. The Act required the FDA to convene a
panel to examine the ramifications of increasing the minimum
tobacco purchase age. The FDA tasked the IOM with
investigating this issue. The IOM recently released a report,
Public Health Implications of Raising the Minimum Age of Legal
Access to Tobacco Products, which examined the impacts of
increasing the age to 19, 21, and 25. The IOM determined that
relative to status quo projected decreases, raising the age to
19 would result in a three % additional decrease; raising the
age to 21, a 12 % additional decrease; and raising the age to
25, a 15 % additional decrease. The IOM concluded that the age
group most impacted by raising the MLA would be 15 to 17 year
olds for any of the three ages studied. The IOM argued that
increasing the age for tobacco purchase will result in delayed
use of such products, which in turn will decrease the
prevalence of users. From a health perspective, the impacts of
decreased prevalence would be short- and long-term. Reductions
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in tobacco-related diseases will take decades to realize, but
there would be immediate reduction in adverse physiological
effects and poor infant health outcomes. The IOM report stated
that raising the age to 21 would result in 200,000 fewer
premature deaths and potentially millions of years of life
gained for those born between 2000 and 2019.
5)Alternative tobacco products. According to DPH, prevalence of
smokeless and other tobacco products have increased among high
school students, which often do not have the same regulations
placed upon them as cigarettes. In recent years, sales of
smokeless tobacco and nicotine products, like snus, have risen
dramatically. Hookah, popular with teens and young adults, has
been shown to contain the same cancer-causing chemicals as
secondhand smoke. Smokeless tobacco has been linked to oral
cancer, pancreatic cancer, and gum disease. DPH recently
released a report on electronic cigarettes, which stated that
teen use of electronic cigarettes has surpassed the use of
traditional cigarettes and marketing of these products has
increased 1,200% in the last three years. Electronic
cigarettes deliver nicotine to the user, which, research from
the IOM shows, can be harmful to brain development in
adolescents. The DPH report asserts that the aerosol emitted
from electronic cigarettes is toxic and contains at least 10
chemicals known to cause cancer, birth defects, and other poor
health outcomes.
6)Age restrictions. Federal and state laws have set various
standards for age restrictions. For example, at age 16, an
individual can obtain a driver's license. At age 18, an
individual gains the right to vote, can join the military,
enter into binding contracts, and be tried as an adult in the
criminal courts. At age 21, an individual can purchase and
consume alcohol, purchase certain firearms, and gamble.
Minimum age restrictions can be established at a federal
level, and states may opt to make restrictions more stringent.
7)Other states. A number of other states have attempted to enact
legislation or have measures pending that would increase the
purchasing age for tobacco to 21, but Hawaii has been the only
state thus far to adopt the increase into law. Alabama,
Alaska, New Jersey, and Utah currently have an age restriction
of 19 for tobacco, which is higher than the national standard
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of 18. In the absence of federal and state action, tobacco
control has been undertaken at a local level. New York City, a
number of municipalities in Massachusetts, and Healdsburg, CA,
have increased their tobacco purchase age to 21.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
According to the Senate Appropriations Committee, likely ongoing
costs in the tens of thousands to low hundreds of thousands per
year for additional survey activities at retail stores that sell
tobacco products.
Likely ongoing costs in the hundreds of thousands per year for
enforcement actions relating to illegal sales of tobacco
products to individuals between 18 and 21 years of age.
Reduced total excise tax and sales tax revenues on tobacco
products of $68 million per year in the near term. The Board of
Equalization (BOE) projects reduced tobacco excise tax revenues
of about $43 million per year (about $4 million of which would
come from the General Fund and the remainder from special funds
that support a variety of public health programs). The BOE
estimates reduced sales tax revenues of about $25 million per
year (about $13 million coming from the General Fund and the
remainder coming from local government sales tax revenues).
Additional long-run reductions in tobacco excise and sales tax,
likely over $100 million per year.
Unknown, but significant health care cost savings to public
payers. According to the CDC, estimates of annual direct health
care costs related to smoking are between $130 billion and $180
billion per year, nationally. This bill is likely to reduce
health care costs, by reducing tobacco use rates. If the
long-term reduction in the expenditure of health care costs
relating to smoking is proportional to the reduction in the use
rate, total direct health care costs in the state would be
reduced by as much as $2 billion per year in the long-run. A
significant portion of those savings would likely accrue to
public payers such as the Medi-Cal program and CalPERS.
SUPPORT: (Verified8/24/15)
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American Cancer Society Cancer Action Network (co-source)
American Lung Association in California (co-source)
American Academy of Pediatrics, California
American College of Emergency Physicians, California Chapter
American Heart Association/American Stroke Association
Association of California Healthcare Districts
Association of Northern California Oncologists
California Academy of Family Physicians
California Academy of Preventive Medicine
California Black Health Network
California Chronic Care Coalition
California Dental Association
California Medical Association
California Optometric Association
California Pan Ethnic Health Network
California Primary Care Association
California Society of Addiction Medicine
California State Association of Counties
Community Action Fund of Planned Parenthood Orange and San
Bernardino Counties
First 5 Association of California
Health Access California
Kaiser Permanente
March of Dimes, California Chapter
Medical Oncology Association of Southern California, Inc.
Planned Parenthood Advocacy Project Los Angeles
Planned Parenthood Affiliates of California
Planned Parenthood Mar Monte
Planned Parenthood Northern California Action Fund
Planned Parenthood of the Pacific Southwest
San Dieguito Alliance for Drug Free Youth
Santa Clara County Board of Supervisors
Service Employees International Union California
Solano Beach City Council
Solano County Board of Supervisors
OPPOSITION: (Verified8/24/15)
American Legion-Department of California
AMVETS - Department of California
Association of the United States Army
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California Distributors Association
California Retailers Association
California State NAACP
Fleet Reserve Association
Jewish War Veterans, Department of California
Military Officers Association of America, California Council of
Chapters
Military Order of the Purple Heart, Department of California
Vietnam Veterans of America - California State Council
ARGUMENTS IN SUPPORT: The American Lung Association in
California (ALA) argues that delaying the age when youth first
use tobacco can reduce their likelihood of transitioning to
regular tobacco users. ALA states that California has a rich
history of tobacco control that has helped to reduce smoking
rates, but tobacco companies continue to find replacement
smokers. The American Cancer Society Cancer Action Network
writes that this bill is an important component in a
comprehensive strategy to reduce youth consumption of tobacco.
ARGUMENTS IN OPPOSITION: Various veterans groups write in
opposition that this would be unfair to men and women in the
armed forces because if they can serve in our military they
should be allowed to buy a legal product and there is nothing to
justify raising the age to 21. They argue further that this is
not about smoking being right or wrong, but about protecting
liberty and personal freedom.
Prepared by:Alex Norring / P.H. & D.S. /
8/26/15 15:13:51
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