BILL ANALYSIS                                                                                                                                                                                                    Ó






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                                   THIRD READING 


          Bill No:  SBX2 8
          Author:   Liu (D)
          Amended:  8/25/15  
          Vote:     21  

           SENATE PUBLIC HEALTH & 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:  5-0, 8/24/15
           AYES:  Lara, Beall, Hill, Leyva, Mendoza
           NO VOTE RECORDED:  Bates, Nielsen

           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. This  
          bill 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.  
          This bill requires specified signs to be prominently displayed  
          at all entrances to school property.


          ANALYSIS:   









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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  
            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), which can deliver nicotine and non-nicotine  
            vaporized solutions, at any time, in charter school or school  
            district-owned or leased buildings, on school or district  
            property, and in school or district vehicles.








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          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."


          Background

          1)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 local educational  
            agencies (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 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. 








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            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.

          2)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,  
            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.

          3)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  







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            only to health care expenses but also productivity losses  
            related to disability or early death. DPH asserts, 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.  
            
          4)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.

          5)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  
            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.
             
          6)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  







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            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.


          Comments


          Author's statement.  According to the author, "SBX2 8 will ban  
          smoking and tobacco products from all California schools.  
          California voters 27 years ago approved Proposition 99, which  
          increased taxes on cigarettes. The annual state budget act  
          appropriates funds from this source for several purposes,  
          including the TUPE program. School districts that receive  
          competitive grants must ban tobacco and post "Tobacco use is  
          prohibited" signs. About 75% of public school districts  
          participate and are certified as tobacco-free school districts,  
          but less than 10% of state-certified charter schools are  
          certified as tobacco-free schools. We need to go farther. This  
          bill requires all public school districts, COEs, and charter  
          schools to be tobacco-free and post the same tobacco prohibition  
          signs. This bill also requires schools to ban electronic  
          cigarettes, snuff, chew, and other tobacco products. This bill  
          will help to keep tobacco out of the hands of our youth while  
          also increasing the overall health and wellness of  
          Californians."
          
          Related Legislation


          SBX2 5 (Leno)/ABX2 6 (Cooper) recast and broaden the definition  
          of "tobacco product" in current law to include electronic  
          cigarettes as specified; extend current restrictions and  
          prohibitions against the use of tobacco products to electronic  







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          cigarettes; extend current licensing requirements for  
          manufacturers, importers, distributors, wholesalers, and  
          retailers of tobacco products to electronic cigarettes; and  
          require electronic cigarette cartridges to be child-resistant.  
          SBX2 5 was heard on August 24, 2015, in the Senate  
          Appropriations Committee, and passed on a vote of 5-2. 

          SBX2 6 (Monning)/ABX2 7 (Stone) prohibit smoking in  
          owner-operated businesses and remove specified exemptions in  
          existing law that allow tobacco smoking in certain workplaces.  
          SBX2 6 is currently on Third Reading on the Senate Floor. 

          SBX2 7 (Hernandez)/ABX2 8 (Wood) increase the minimum legal age  
          to purchase or consume tobacco from 18 to 21. SBX2 7 was heard  
          on August 24, 2015, in the Senate Appropriations Committee, and  
          passed on a vote of 5-2. 

          ABX2 9 (Thurmond and Nazarian) extends current tobacco use  
          prevention funding eligibility and requirements to 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;  
          and requires specified signs to be prominently displayed at all  
          entrances to school property. 

          SBX2 9 (McGuire)/ABX2 10 (Bloom) allow counties to impose a tax  
          on the privilege of distributing cigarettes and tobacco  
          products. SBX2 9 is currently on Third Reading on the Senate  
          Floor. 

          SBX2 10 (Beall)/ABX2 11 (Nazarian) revise the Cigarette and  
          Tobacco Products Licensing Act of 2003 to change the retailer  
          license fee from a $100 one-time fee to a $265 annual fee, and  
          increase the distributor and wholesaler license fee from $1,000  
          to $1,200. SBX2 10 was heard on August 24, 2015, in the Senate  
          Appropriations Committee, and passed on a vote of 5-2. 

          FISCAL EFFECT:   Appropriation:    No          Fiscal  
          Com.:YesLocal:   Yes

          According to the Senate Appropriations Committee:

          1)Potential state reimbursable mandate costs up to $120,000 due  
            to the requirement that schools post signs notifying the  







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            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  
            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.

          2)Unknown cost pressure on existing grant funds (Proposition 99  
            funds). The 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:   (Verified8/25/15)


          State Superintendent of Public Instruction Tom Torlakson
          American Heart Association/American Stroke Association
          American Lung Association in California
          Association of Northern California Oncologists
          California Academy of Family Physicians
          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
          Community Action Fund of Planned Parenthood Orange and San  
            Bernardino Counties
          County Health Executives Association of California
          First 5 Association of California
          Health Access California
          March of Dimes, California Chapter







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          Medical Oncology Association of Southern California 
          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


          OPPOSITION:   (Verified8/25/15)


          None received


          ARGUMENTS IN SUPPORT:      Supporters of this bill argue that,  
          under 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 on their  
          campuses. Supporters argue that smoking increases the risk of  
          heart disease and stroke by two to four times, and is linked to  
          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.

          Prepared by:Reyes Diaz / HEALTH / 
          8/26/15 13:40:44


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