BILL ANALYSIS Ó
SB 140
Page 1
Date of Hearing: July 8, 2015
ASSEMBLY COMMITTEE ON GOVERNMENTAL ORGANIZATION
Adam Gray, Chair
SB
140 (Leno) - As Amended June 1, 2015
SENATE VOTE: 25-12
SUBJECT: Electronic cigarettes.
SUMMARY: This bill makes substantive changes to the regulation
of electronic cigarettes (e-cigarettes). Specifically, this
bill:
1) Recasts and broadens the definition of "tobacco
product" to include a product made or derived from tobacco
or nicotine that is intended for human consumption, whether
smoked, heated, chewed, absorbed, dissolved, inhaled,
snorted, sniffed, or ingested by any other means, and
includes electronic devices that deliver nicotine or other
substances to the person inhaling from the device,
including, but not limited to, an electronic cigarette,
cigar, pipe, or hookah; and any component, part, or
accessory of a tobacco product, whether or not sold
separately.
2) Prohibit the use of e-cigarettes in various places,
including, but not limited to, school campuses, public
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buildings, places of employment, apartment buildings, day
care facilities, retail food facilities, health facilities,
and vehicles when minors are present, and makes a violation
of some of the prohibitions punishable as an infraction.
3) Requires retailers of e-cigarettes, which are not
subject to a tobacco tax, to apply for a license and pay a
license fee, in an amount to be determined by BOE,
beginning October 1, 2016.
EXISTING LAW:
1) Authorizes the California Department of Public Health
(DPH), under the Stop Tobacco Access to Kids Enforcement
(STAKE) Act, to assess civil penalties ranging from $400 to
$6,000, depending on the number of infractions, against any
person, firm, or corporation that sells, gives, or in any
way furnishes tobacco products to a person who is under the
age of 18.
2) Establishes "smoke-free laws," which prohibit the
smoking of tobacco products in various places, including,
but not limited to, school campuses, public buildings,
places of employment, apartment buildings, day care
facilities, retail food facilities, health facilities, and
vehicles when minors are present, and makes a violation of
some of the prohibitions punishable as an infraction.
3) Defines "tobacco product" as any product containing
tobacco leaf, including, but not limited to, cigarettes,
cigars, pipe tobacco, snuff, chewing tobacco, dipping
tobacco, bidis, or any other preparation of tobacco.
4) Defines "electronic cigarette" as a device that can
provide an inhalable dose of nicotine by delivering a
vaporized solution. Prohibits a person from selling or
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otherwise furnishing an electronic cigarette to a person
under the age of 18.
5) Requires the Board of Equalization (BOE), under the
Cigarette and Tobacco Products Licensing Act, to administer
a statewide program to license cigarette and tobacco
products manufacturers, importers, distributors,
wholesalers, and retailers. Prohibits selling tobacco
products without a valid license, and makes violations
punishable as a misdemeanor.
6) Requires a retailer, for purposes of collecting a
tobacco tax, to obtain a separate license for each retail
location that sells cigarettes and tobacco products and pay
a one-time fee of $100. Requires BOE to suspend or revoke a
retailer's license upon notification by DPH of certain
STAKE Act violations.
7) Prohibits, under the Stop Tobacco Access to Kids
Enforcement Act (STAKE Act), any person from distributing
or selling tobacco products via the United States Postal
Service (USPS), or any other public or private postal or
package delivery service, to any purchaser who is a minor.
8) Bans, under the Prevent All Cigarette Trafficking Act
(PACT Act), the shipment of tobacco products through the
USPS.
FISCAL EFFECT: Unknown
COMMENTS:
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Purpose of the bill : According to the author, California has
invested 25 years and $2.5 billion in public health measures
aimed at reducing tobacco use. However, that investment is now
threatened by a new tobacco product: electronic cigarettes.
According to a DPH report, electronic cigarette aerosol contains
at least 10 chemicals that are on California's Proposition 65
list of chemicals known to cause cancer, birth defects, or other
reproductive harm. Despite industry claims that electronic
cigarettes do not present secondhand smoke concerns, studies
have found formaldehyde, benzene and tobaccospecific
nitrosamines (a carcinogen) coming from the secondhand emissions
of ecigarettes.
Despite these potentially serious risks to public health,
electronic cigarette use is growing nationwide. The Centers for
Disease Control and Prevention (CDC) found that more than a
quarter of a million youth who had never smoked a cigarette used
electronic cigarettes in 2013. Electronic cigarettes come in
enticing flavors such as gummy bear and mango. While California
currently bans the sale of electronic cigarettes to minors under
the age of 18, many youth are still able to access the product.
DPH states, "existing laws that currently protect minors and the
general public from traditional tobacco products should be
extended to cover electronic cigarettes." SB 140 will do
exactly this by including electronic cigarettes within the Smoke
Free Act and the STAKE Act.
What are E-Cigarettes? : Electronic cigarettes are
battery-operated inhalers that consist of a rechargeable
battery-operated heating element, a replaceable cartridge that
may contain nicotine or other chemicals, and an atomizer that,
when heated, converts the contents of the cartridge into a
vapor, which the user can then inhale. Electronic cigarettes
are often made to look like cigarettes, cigars, pipes and
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sometimes like everyday items such as pens and USB memory
sticks.
According to the World Health Organization (WHO), electronic
nicotine delivery systems (ENDS), of which electronic cigarettes
are the most common prototype, are devices that do not burn or
use tobacco leaves but instead vaporize. The main components of
the solution, in addition to nicotine-when nicotine is
present-are propylene glycol, with or without glycerol and
flavoring agents. ENDS solutions and emissions contain other
chemicals, some of them considered to be toxicants. There are
more than 450 brands and more than 7,500 flavors on the market,
according to the policy report. There has been an average of 10
new brands entering the market every month for the last two
years, a recent Internet survey found.
Electronic cigarettes have been sold in the USA since 2007. The
biggest markets are Europe and North America. Sales are banned
in 13 of the 59 countries that regulate the devices, the WHO
reported, but most of those 13 countries say they are still
available because of illicit trade and cross-border Internet
sales.
According to the Food and Drug Administration (FDA),
e-cigarettes have not been fully studied, so consumers currently
do not know: 1) the potential risks of e-cigarettes when used as
intended, 2) how much nicotine or other potentially harmful
chemicals are being inhaled during use, or 3) whether there are
any benefits associated with using these products. However,
they do suggest they are safer than some traditional tobacco
products. Mitch Zeller, Director of the Center for Tobacco
Products, FDA, in an NPR interview on January 20, 2014, stated:
"If a current smoker completely substituted all of the
combusting cigarettes that they smoked with an electronic
cigarette, that person would probably be significantly reducing
their risk."
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Electronic cigarette safety : There continues to be many studies
being done on the efficacy and safety of e-cigarettes, some of
which are conflicting:
The California State Health Officer released a report in January
2015, "A Community Health Threat," about e-cigarettes that
cites, among other things, the concern about the health risks of
the product, the growing number of users, and the unrestricted
marketing tactics for e-cigarettes. E-cigarette poisonings
increased from seven in 2012 to 154 in 2014. By the end of
2014, electronic cigarette poisonings to young children tripled
in one year, making up more than 60 percent of all electronic
cigarette-poisoning calls, according to the report.
Furthermore, the state health officer also noted that in
California, use of electronic cigarettes among those between the
ages of 18 and 29 tripled in one year, from 2.3 percent to 7.6
percent. Nearly 20 percent of these young adult electronic
cigarette users had never smoked traditional cigarettes.
However, it must be note, as reported by the Department of
Public Health (DPH); California has one of the lowest teenage
smoking rates in the nation. Through implementation of the STAKE
Act, California also has seen a steady decline in illegal sales
to minors.
A July 2014 report by the WHO, "Electronic nicotine delivery
systems (ENDS)," stated that existing evidence shows electronic
cigarettes do not produce merely a water vapor but an aerosol
that poses serious threats to adolescents and fetuses. The
aerosol inhaled by smokers contains ultra-fine particulate
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matter that gets trapped in the small airways of the lungs.
According to a 2013 study by The National Center for
Biotechnology Information (NCBI) entitled "Does electronic
cigarette consumption cause passive vaping?," aerosol exhaled by
electronic cigarettes smokers contains nicotine, formaldehyde,
and other chemicals, although at much lower levels than
emissions from conventional cigarettes, and nicotine metabolites
were found in nonsmokers exposed to the exhaled aerosol.
According to research paper published in "Tobacco Control" (an
international peer review journal covering the nature and
consequences of tobacco use worldwide) on March 2013, titled:
"Levels of selected carcinogens and toxicants in vapour from
electronic cigarettes," e-cigarette toxicant levels were 9-450
times lower than in cigarette smoke and were, in many cases,
comparable with trace amounts found in the reference product.
The paper goes on to conclude: "that substituting tobacco
cigarettes with e-cigarettes may substantially reduce exposure
to selected tobacco-specific toxicants. E-cigarettes as a harm
reduction strategy among smokers unwilling to quit, warrants
further study".
Based on the lack of consensus on research comparing
e-cigarettes to traditional tobacco products, the committee may
wish to consider whether it is premature to define e-cigarettes
as such.
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Cessation Product : The FDA has approved a variety of smoking
cessation products. These include prescription medicines as
well as over-the-counter products such as skin patches,
lozenges, and gum. Smoking cessation products are regulated
through FDA's Center for Drug Evaluation and Research, which
ensures that the products are effective and that their benefits
outweigh any known associated risks. The FDA, citing the lack
of concrete research, has not approved, or denied, e-cigarettes
as a cessation product. Additionally, much like studies done on
the safety of e-cigarettes, there are conflicting views on the
viability of e-cigarettes as cessation product.
According to an article published in the Journal of the American
Medical Association (JAMA), titled: "A Longitudinal Analysis of
Electronic Cigarette Use and Smoking Cessation," e-cigarettes
are aggressively promoted as smoking cessation aids, however,
studies of their effectiveness for cessation have been
unconvincing. One randomized trial comparing e-cigarettes with
and without nicotine found no differences in 6-month quit rates.
Population-based, longitudinal studies have also not shown
associations between e-cigarette use and quitting. One study
found, although 85% of smokers who used e-cigarettes reported
using them to quit, they did not quit more frequently than
nonusers. Among those surveyed, e-cigarette users were less
likely to have quit at 7 months than nonusers.
According to a survey by the University College London (UCL) and
published in Addiction Journal, people attempting to quit
smoking without professional help are approximately 60% more
likely to report succeeding if they use e-cigarettes than if
they use willpower alone or over-the-counter nicotine
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replacement therapies such as patches or gum. The results were
adjusted for a wide range of factors that might influence
success at quitting, including age, nicotine dependence,
previous quit attempts, and whether quitting was gradual or
abrupt. The study surveyed 5,863 smokers between 2009 and 2014
who had attempted to quit smoking without the aid of
prescription medication or professional support. 20% of people
trying to quit with the aid of e-cigarettes reported having
stopped smoking conventional cigarettes at the time of the
survey. The research, chiefly funded by Cancer Research UK,
suggests that e-cigarettes could play a positive role in
reducing smoking rates: "E-cigarettes could substantially
improve public health because of their widespread appeal and the
huge health gains associated with stopping smoking," says
Professor Robert West of UCL's Department of Epidemiology &
Public Health, senior author of the study.
Based on the lack of consensus on research regarding the
viability of e-cigarettes as a cessation product, the committee
may wish to consider whether it is premature to define
e-cigarettes as a "tobacco product".
Federal Action : Federal law, the Family Smoking Prevention and
Tobacco Control Act of 2009 (Tobacco Control Act), provides the
FDA authority to regulate cigarettes, cigarette tobacco,
roll-your-own tobacco, smokeless tobacco, and any other tobacco
products that the FDA by regulation deems to be subject to the
law. To date, the FDA has not officially acted on the subject
of e-cigarette regulation. However, according to the Federal
Register in print Friday, April 25, 2014, the FDA is considering
proposed rules regarding, in part, deeming e-cigarettes as a
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"tobacco product." Once a product is deemed a "tobacco
product", the FDA may put in place restrictions on the sale and
distribution of said product, including age-related access
restrictions and advertising and promotion restrictions, if FDA
determines the restrictions are appropriate for the protection
of the public health.
The proposed rules have two purposes: (1) To deem products that
meet the definition of ''tobacco product'' under the law except
accessories of a proposed deemed tobacco product and subject
them to the tobacco control authorities in the Tobacco Control
Act; and (2) to apply specific provisions that are appropriate
for the protection of the public health to deemed tobacco
products. These provisions include: (1) Enforcement action
against products determined to be adulterated and misbranded;
(2) required submission of ingredient listing and reporting of
harmful and potentially harmful constituents (HPHCs) for all
tobacco products; (3) required registration and product listing
for all tobacco products; (4) prohibition against use of
modified risk descriptors (e.g., ''light,'' ''low,'' and
''mild'' descriptors) and claims unless FDA issues an order
permitting their use; (5) prohibition on the distribution of
free samples (same as for cigarettes); and (6) premarket review
requirements. The FDA has closed public comment and is
reviewing evidence prior to finalizing the proposed rules,
specifically on the health risks and the viability of
e-cigarettes as a cessation product.
The committee may wish to consider whether it is premature to
define e-cigarettes as a "tobacco product" prior to the
finalization of FDA's regulations.
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Local Action : According to the American Lung Association, 131
cities and counties in California prohibit the use of
e-cigarettes in some outdoor areas (dining areas, entryways,
public events, recreation areas, service areas, sidewalks, and
worksites), some indoor areas (hallways, city owned/ operated
facility, hotels/motels, multi-unit housing, public transit,
places of employment, restaurants, and theaters/ convention
centers), or both. These 131 municipalities represent a diverse
population of local governments-ranging from San Francisco to
San Bernardino-that have taken action on where e-cigarettes may
be used. The ordinances differ in each city/county. For example,
the City of San Francisco prohibits the use of e-cigarettes in
public events, recreation areas, service areas, multi-unit
housing, public transit, places of employment, restaurants, and
theaters/convention centers, while San Bernardino County
prohibits service areas, city owned/ operated facility,
hotels/motels, public transit, and places of employment.
In addition to the prohibitions on usage, 94 cities and counties
now require a retailer to obtain a license to sell e-cigarettes.
Majority of the cities and counties have done this through
special language in the definition of tobacco product in their
local tobacco retailer licensing ordinance.
Mail Delivery : Prevent All Cigarette Trafficking Act (PACT Act)
is a federal law, amongst other things, that prohibits the
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delivery of cigarettes and smokeless tobacco through the United
States Postal Service (USPS). This prohibition does not apply
to other forms of shipment, such as FedEx and UPS.
Some concerns have been raised by the opposition that SB 140, by
defining e-cigarettes as a "tobacco product," will place
e-cigarettes under the provisions of the PACT Act, specifically
the USPS prohibition. Opposition cites this as potentially
damaging to the industry, since a large portion of their sells
are done online and delivered to the consumer.
According to an informal opinion by Legislative Counsel, SB 140
would not be subject to the provision in question under the PACT
Act. The provision states: "All cigarettes and smokeless
tobacco are non-mailable and shall not be deposited in or
carried through the mails. The United States Postal Service
shall not accept for delivery or transmit through the mails any
package that it knows or has reasonable cause to believe
contains any cigarettes or smokeless tobacco made non-mailable
by this paragraph." The language clearly states that only
"cigarettes and smokeless tobacco" are prohibited from being
delivered by USPS. The PACT Act would have to be amended at the
federal level to include e-cigarettes for this provision to
apply.
California law, under the STAKE Act, requires a specified
distributor or seller to verify that a purchaser of tobacco
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products is 18 years of age or older, and to telephone the
purchaser after 5 p.m. to confirm the order prior to shipping
the tobacco products. This provision in state law currently does
not apply to e-cigarettes.
A study by the Journal of the American Medical Association found
that more than 96% of minors aged 15 to 16 were able to find an
Internet cigarette vendor and place an order in less than 25
minutes, with most completing the order in seven minutes. As of
2012, more than 23% of all high school students had used some
kind of tobacco product in the past month and the use of
e-cigarettes has more than doubled among high school students.
The committee and author may wish to amend the bill to require
age verification upon mail delivery of e-cigarettes.
Vending Machines : The STAKE Act prohibits a cigarette or tobacco
product from being sold, offered for sale, or distributed from a
vending machine or appliance, or any other coin or token
operated mechanical device designed or used for vending
purposes, unless the machine or appliance is located at least 15
feet away from the entrance of a premise that has been issued an
on-sale public premises license to sell alcoholic beverages, as
specified.
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According to the National Youth Tobacco Survey, in 2012, 1.78
million middle and high school students nationwide had tried
e-cigarettes. Although it is unknown how many students get
e-cigarettes from vending machines, it is reasonable to assume
that restricting e-cigarette access through this type point of
sale could significantly lower the amount of minors who use
e-cigarettes.
The committee and author may wish to amend the bill to prohibit
e-cigarettes from being sold, offered for sale, or distributed
from a vending machine.
Child Safe Packaging : As stated above, the State Health Officer
has reported an increase in e-cigarette poisonings. While this
is mainly attributable to the increase in overall use of
e-cigarettes, it is reasonable to assume that some poisonings
occur when a child ingests the liquid solution in the cartridge.
SB 438 (Hill), currently set for hearing in Assembly G.O.
Committee, would require all cartridges for electronic
cigarettes and solutions for filling and refilling an electronic
cigarette to be in child-resistant packaging.
The committee and author may wish to amend the bill to require
all cartridges for electronic cigarettes and solutions for
filling and refilling an electronic cigarette to be in
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child-resistant packaging.
Not a Tax : If enacted, SB 140 would NOT add e-cigarettes into
the current tobacco tax framework, nor would it create a new
tax. Currently, e-cigarettes do not have a specific tax other
than the standard state and local sales taxes collected at the
point of sale. As stated above, the FDA is in the process of
finalizing regulations to treat e-cigarettes as tobacco
products, in which time a federal tobacco tax, ostensibly, could
be applied. As for the State, a tax could be implemented
through the legislature, or ballot initiative. Currently, there
are two pending ballot initiatives with the Secretary of State,
one of which would place an excise tax on e-cigarettes.
NJOY vs. FDA : In March of 2009, FDA directed the U.S. Customs
and Border Protection to reject the entry of e-cigarettes into
the United States. Shortly after, Smoking Everywhere, Inc. (SE)
filed a lawsuit against FDA, to "stop FDA from improperly
exceeding its delegated authority by attempting to regulate
electronic cigarettes" to the extent that FDA declared such
products to be a new drug and/or new drug device combination.
Additionally, SE claimed that Electronic Cigarettes are a
"tobacco product", therefore were not currently under regulatory
authority of the FDA. The proponents of SB 140 have pointed to
this argument as an admission by the industry that e-cigarettes
are "tobacco products." Soon to follow, NJOY, Inc. filed a
motion to intervene in the case which was granted.
On January 14, 2010, nearly 10 months after this litigation was
first filed, the Honorable Judge Leon issued a ruling, granting
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SE and NJOY a Preliminary Injunction against the FDA to stop the
embargo against SE and NJOY's products coming into the United
States. The FDA immediately appealed the decision. In December
2010, the U.S. Court of Appeals in Washington ruled that the FDA
can only regulate e-cigarettes as a tobacco product, unless
therapeutic claims are made.
Support : According to the co-sponsor, Cancer Action Network
(CAN), E-cigarette use is exploding amongst youth. According to
the Centers for Disease Control, use among youth has tripled
nationally in the last two years. There were roughly 600,000
high school students nationwide who used e-cigarettes in 2013.
That number climbed to around two million in 2014. In
California, the Department of Public Health says that among
18-29 year olds, use has tripled in the last year. In 2014,
teen use of e-cigarettes surpassed the use of traditional
cigarettes for the first time. More than twice as many 8th and
10th graders reported using e-cigarettes than traditional
cigarettes.
Defining e-cigarettes as a tobacco product in the STAKE Act
tackles the issue of minors accessing e-cigarettes by ensuring
those products are held to the same standards as traditional
cigarettes. Among the ways, that the STAKE Act prevents youth
from purchasing tobacco products is to implement an enforcement
program to reduce the illegal sale of tobacco products to minors
and to conduct sting operations using 15 and 16 year old minors
granted immunity. The STAKE Act also ensures that clerks check
the identification of youthful-appearing persons prior to a
sale. Applying this standard to e-cigarettes will be critical
in preventing youth access.
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Opposition : According to the Smoke-Free Alternatives Trade
Association (SFATA), they support a prohibition on selling to
minors and are willing to engage in discussions regarding
reasonable licensure requirements. They state, however, SB 140
does not provide a reasonable framework for engaging in
conversations on these points, because the bill equates vapor
products to tobacco. Classification of vapor products as
tobacco is grossly inappropriate given that the products clearly
do not contain tobacco. SFATA must strongly oppose any
legislation that seeks to define e-cigs and vapor products as
tobacco, in light of the fact that such a definition is simply
scientifically inaccurate, appears to be part of a broader and
misleading campaign to equate vapor products with tobacco, and
has potentially unfair and unwarranted tobacco tax-related
implications.
Policy Considerations : While the FDA finalizes its proposed
rules regarding e-cigarettes, the committee may wish to further
the core intent of the bill, which is to provide more consumer
protection, public health and prevent under age use of
e-cigarettes.
1. Strike definition of e-cigarettes as a "tobacco product"
from the bill. Add existing definition of e-cigarettes in
Health and Safety Code (Section 119405(b)) for the purposes
of licensure and smoke free laws.
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2. Require age verification upon mail delivery of
e-cigarettes.
3. Prohibit e-cigarettes from being sold, offered for sale,
or distributed from a vending machine.
4. Require child resistant packaging for e-cigarettes.
Provision is also in SB 438 (Hill) which is set for hearing
in Assembly G.O. Committee.
Related legislation : SB 151 (Hernández) of 2015. 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 current law. (Pending in Assembly
G.O. Committee)
AB 216 (Garcia) of 2015. Prohibits the sale of any device
intended to deliver a non-nicotine product in a vapor state, to
be directly inhaled by the user, to a person under 18 years of
age. (Pending in Senate Appropriations)
SB 24 (Hill) of 2015. Extends STAKE Act requirements to the
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sale of electronic cigarettes (e-cigs), distinct from the
definition of tobacco products, and requires enforcement, as
specified, to begin July 1, 2016; extends current smoke-free
laws and penalties to e-cigs; requires e-cig cartridges to be in
childproof packaging, as defined; broadens the current
definition of e-cigs, as specified; and requires all retailers
of e-cigs to apply for licensure to sell e-cigs, as specified.
(Failed passage on the Senate Floor and is pending
reconsideration)
SB 438 (Hill) of 2015. Requires all cartridges for electronic
cigarettes and solutions for filling and refilling an electronic
cigarette to be in child-resistant packaging. (Pending in
Assembly G.O. Committee)
SB 591 (Pan) of 2015. Imposes an additional excise tax of $2.00
per package of 20 cigarettes. This bill also (1) imposes an
equivalent one-time "floor stock tax" on the cigarettes held or
stored by dealers and wholesalers, and (2) indirectly increases
the tobacco products tax. (Ordered to inactive file on Senate
Floor)
Prior legislation : AB 1500 (Dickinson) of 2014. Would have
prohibited a delivery seller, as defined, from selling or
delivering an electronic cigarette to a person under 18 years of
age. (Failed passage in the Assembly Appropriations Committee)
SB 648 (Corbett) of 2013. Would have restricted electronic
cigarettes from being sold in vending machines. (Failed passage
in the Assembly Appropriations Committee)
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SB 568 (Steinberg) Chapter 336, Statues of 2013. Prohibits an
operator of an Internet Web site, online service, online
application, or mobile application, as specified, from marketing
or advertising electronic cigarettes to a minor.
SB 882 (Corbett), Chapter 312, Statutes of 2010. Made it
unlawful, to the extent not preempted by federal law, for a
person to sell or otherwise furnish an electronic cigarette to a
person less than 18 years of age.
SJR8 (Corbett) of 2009. Would have requested that the US Food
and Drug Administration prohibit sale of electronic cigarettes
until they are deemed safe. (Failed passage in the Assembly)
REGISTERED SUPPORT / OPPOSITION:
Support
Alameda County Board of Supervisors
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Alameda County Tobacco Control Coalition
American Academy of Pediatrics, California
American Cancer Society-Cancer Action Network (co-sponsor)
American Heart Association/American Stroke Association
(co-sponsor)
American Lung Association in California (co-sponsor)
Association of Northern California Oncologists (ANCO)
Breathe California
California Academy of Family Physicians
California Academy of Preventive Medicine
California Alliance for Retired Americans
California Chapter of the American College of Cardiology
California Chapter of the American College of Emergency
Physicians
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California Chronic Care Coalition
California College and University Police Chiefs Association
California League of Cities
California Medical Association
California Narcotic Officers Association
California Peace Officers' Association (CPOA)
California Pharmacists Association
California Police Chiefs Association
California Public Health Association - North
California School Employees Association (CSEA)
California Society of Addiction Medicine (CSAM) (co-sponsor)
California State Association of Counties
California State PTA
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California Teachers Association
Campaign for Tobacco-Free Kids
City and County of San Francisco
City of Camarillo
City of Los Angeles
City of Oakland
City of Oceanside
City of Palo Alto
City of San Francisco
City of San Marcos
City of Walnut Creek
Coalition Engaged in A Smoke-free Effort (CEASE)
Coalition for a Tobacco-Free Sonoma County
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Common Sense Kids Action
Community Action Partnership of Madera County (CAPMC)
Community Health Involvement Partners (CHIP)
County Health Executives Association of California (CHEAC)
County of Alameda
County of San Diego
County of San Francisco
First 5 Association of California
Fresno County Tobacco-Free Coalition
Health Access California
Health Officers Association of California (HOAC)
Kaiser Permanente
League of California Cities
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Los Angeles City Attorney Mike Feuer
Los Medanos Community Healthcare District Board of Directors
Medical Oncology Association of Southern California (MOASC)
Monterey County Collaborates
Oceanside city Council
Orange County Tobacco Education Coalition
San Benito County Board of Supervisors
San Francisco Medical Society
San Luis Obispo County Tobacco Control Coalition
San Mateo County Tobacco Education Coalition
Santa Clara County Board of Supervisors
Service Employees International Union
Service Employees International Union - United Health Workers
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Solano County Tobacco Education Coalition
State Board of Equalization
Tobacco Education and Research Oversight Committee
Tobacco Education Network
Tobacco Free Coalition of Santa Clara County
Yolo County Tobacco Prevention Coalition
Yuba County Tobacco Coalition
Opposition
Cal NORML
California Association for Alcohol/Drug Educators
NJOY
Smoke-Free Alternatives Trade Association (SFATA)
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Analysis Prepared by:Kenton Stanhope / G.O. / (916)
319-2531