BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 151|
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THIRD READING
Bill No: SB 151
Author: Hernandez (D)
Introduced:1/29/15
Vote: 21
SENATE HEALTH COMMITTEE: 9-0, 4/8/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE APPROPRIATIONS COMMITTEE: 5-2, 5/28/15
AYES: Lara, Beall, Hill, Leyva, Mendoza
NOES: Bates, Nielsen
SUBJECT: Tobacco products: minimum legal age
SOURCE: Author
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 current
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
mail or telephone.
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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
current law.
2)Establishes minimum state restrictions regarding tobacco
purchase and possession and does not preempt local ordinances
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that impose a more restrictive legal age.
3)Extends the applicability of the 21 years of age restriction
to provisions of the STAKE Act.
Background
Author's statement. According to the author, an estimated 90
percent of tobacco users start prior to age 21, and 80 percent
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 percent 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.
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
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birth weight is associated with mothers who smoke or are exposed
to secondhand smoke, and increased hospitalization and inability
to heal wounds are 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.
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 percent 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.
IOM report. The Food and Drug Administration (FDA) is granted
broad authority over tobacco products by the Family Smoking and
Tobacco Control Act of 2009 (Act), but is prohibited from
raising the minimum age above 18 at a federal level. The Act
required the FDA to convene a panel to examine the ramifications
of raising 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
raising 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 percent additional decrease; raising
the age to 21, a 12 percent additional decrease; and raising the
age to 25, a 15 percent 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.
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 1200 percent 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 ten
chemicals known to cause cancer, birth defects, and other poor
health outcomes.
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.
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 none have yet been signed
into law. Alabama, Alaska, New Jersey, and Utah currently have
an age restriction of 19 for tobacco, which is higher than the
national standard of 18. In the absence of federal and state
action, tobacco control has been undertaken at a local level.
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New York City, a number of municipalities in Massachusetts, and
Healdsburg, CA, have raised their tobacco purchase age to 21.
Related Legislation
SB 140 (Leno) changes the definition of a tobacco product to
include electronic devices that deliver nicotine or other
substances, make providing such a product to minors a
misdemeanor, and update the restrictions of using tobacco
products to reflect the inclusion of electronic devices.
SB 591 (Pan), among other provisions, imposes an additional tax
of $2.00 on each pack of cigarettes sold and requires the funds
generated to be deposited in the California Tobacco Tax Act of
2015 Fund to be expended for specific outlined purposes.
AB 1162 (Holden), establishes tobacco cessation services as
covered benefits under Medi-Cal, and requires the services to
include unlimited quit attempts comprised of counseling and
treatment programs.
AB 1278 (Gray), allows the use of a United States Armed Forces
identification card for age verification, as long as it contains
date of birth and photo, to purchase tobacco products.
Prior Legislation
AB 221 (Koretz, 2003), was substantially similar to this bill. AB
221 failed passage in the Assembly Governmental Organizations
Committee.
SB 1821 (Dunn, 2003), was substantially similar to this bill. SB
1821 was held on the Senate Appropriations Committee suspense
file.
AB 1453 (Koretz, 2002), was substantially similar to this bill.
AB 1453 was subsequently amended to a different subject.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: Yes
According to the Senate Appropriations Committee analysis,
likely ongoing costs in the tens of thousands to low hundreds of
thousands per year for additional survey activities at retail
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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 Centers for Disease Control and
Prevention, 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: (Verified5/28/15)
American Academy of Pediatrics
American Cancer Society Cancer Action Network
American Federation of State, County and Municipal Employees,
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AFL-CIO American Heart Association/American Stroke Association
American Lung Association in California
Association of California Healthcare Districts
Association of Northern California Oncologists
Breathe California
California Academy of Family Physicians
California Academy of Preventive Medicine
California Black Health Network
California Center for Public Health Advocacy
California Chapter of the American College of Cardiology
California Chapter of the American College of Emergency
Physicians
California Dental Association
California Medical Association
California Pharmacists Association
California Police Chiefs Association
California Primary Care Association
California Society of Addiction Medicine
Campaign for Tobacco-Free Kids
El Monte/South El Monte Chamber of Commerce
First 5 Association of California
Kaiser Permanente
March of Dimes California Chapter
Medical Oncology Association of Southern California, Inc.
San Marcos Prevention Coalition
Santa Clara County Board of Supervisors
Solano County Board of Supervisors
Tobacco Education and Research Oversight Committee
OPPOSITION: (Verified5/28/15)
California Retailers Association
Cigar Association of America
Legal Services for Prisoners with Children
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
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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.
Kaiser Permanente states that the serious and negative health
effects of smoking are well known and a costly burden to
society; anything that can be done to restrict access to young
people to prevent addiction is worth doing. The American Academy
of Pediatrics states this is an evidence-based, reasonable and
important step to protect and promote the public health of our
communities.
ARGUMENTS IN OPPOSITION: The Cigar Association of America
(CAA) writes that no state has made a similar move to restrict
the age to purchase tobacco to 21. CAA argues that an individual
can be eligible to vote, serve in the military, and enter into
contracts at the age of 18 and therefore should be able to make
decisions about purchasing tobacco products. Further, CAA states
this bill will result in a decrease in tax revenues to the
state, which could jeopardize ongoing fiscal obligations. Legal
Services for Prisoners with Children writes that addressing
public health concerns through criminal law is counterproductive
and should be resolved with treatment and education, not
criminal sanctions.
Prepared by:Alex Norring / HEALTH /
5/31/15 13:00:39
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