Senate BillNo. 203


Introduced by Senator Monning

(Coauthors: Senators Leno, Mitchell, Pan, and Pavley)

(Coauthors: Assembly Members Chiu, Williams, and Wood)

February 11, 2015


An act to add Article 15 (commencing with Section 111224) to Chapter 5 of Part 5 of Division 104 of the Health and Safety Code, relating to public health.

LEGISLATIVE COUNSEL’S DIGEST

SB 203, as introduced, Monning. Sugar-sweetened beverages: safety warnings.

(1) Existing federal law, the federal Food, Drug, and Cosmetic Act, regulates, among other things, the quality and packaging of foods introduced or delivered for introduction into interstate commerce and generally prohibits the misbranding of food. Existing federal law, the Nutrition Labeling and Education Act of 1990, governs state and local labeling requirements, including those that characterize the relationship of any nutrient specified in the labeling of food to a disease or health-related condition. Existing state law, the Sherman Food, Drug, and Cosmetic Law, generally regulates misbranded food and provides that any food is misbranded if its labeling does not conform with the requirements for nutrient content or health claims as set forth in the federal Food, Drug, and Cosmetic Act and the regulations adopted pursuant to that federal act. Existing law requires that a food facility, as defined, make prescribed disclosures and warnings to consumers, as specified. A violation of these provisions is a crime.

Existing state law, the Pupil Nutrition, Health, and Achievement Act of 2001, also requires the sale of only certain beverages to pupils at schools. The beverages that may be sold include fruit-based and vegetable-based drinks, drinking water with no added sweetener, milk, and in middle and high schools, an electrolyte replacement beverage if those beverages meet certain nutritional requirements.

This bill would establish the Sugar-Sweetened Beverages Safety Warning Act, which would prohibit a person from distributing, selling, or offering for sale a sugar-sweetened beverage in a sealed beverage container, or a multipack of sugar-sweetened beverages, in this state unless the beverage container or multipack bears a safety warning, as prescribed. The bill also would require every person who owns, leases, or otherwise legally controls the premises where a vending machine or beverage dispensing machine is located, or where a sugar-sweetened beverage is sold in an unsealed container to place a specified safety warning in certain locations, including on the exterior of any vending machine that includes a sugar-sweetened beverage for sale.

(2) Under existing law, the State Department of Public Health, upon the request of a health officer, as defined, may authorize the local health department of a city, county, city and county, or local health district to enforce the provisions of the Sherman Food, Drug, and Cosmetic Law. Existing law authorizes the State Department of Public Health to assess a civil penalty against any person in an amount not to exceed $1,000 per day, except as specified. Existing law authorizes the Attorney General or any district attorney, on behalf of the State Department of Public Health, to bring an action in a superior court to grant a temporary or permanent injunction restraining a person from violating any provision of the Sherman Food, Drug, and Cosmetic Law.

This bill, commencing July 1, 2016, would provide that any violation of the provisions described in (1) above, or regulations adopted pursuant to those provisions, is punishable by a civil penalty of not less than $50, but no greater than $500.

This bill would also create the Sugar-Sweetened Beverages Safety Warning Fund for the receipt of all moneys collected for violations of those provisions. The bill would allocate moneys in this fund, upon appropriation by the Legislature, to the department for the purpose of enforcing those provisions.

The bill would make legislative findings and declarations relating to the consumption of sugar-sweetened beverages, obesity, and dental disease.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

The Legislature finds and declares all of the
2following:

3(a) Over the past 30 years, adult diabetes rates have nearly
4tripled in the United States. Currently, one in 9 adults in the United
5States has diabetes and more than one-third have prediabetes. In
6California, 14 percent of adults have diabetes. Over the past 10
7years, the percentage of teens nationwide that have diabetes or
8prediabetes has increased from 9 percent to 23 percent. One in
9three children born today, including one-half of African American
10and Latino children, is expected to develop diabetes in their
11lifetime. Complications of diabetes include heart disease, nerve
12damage, gum infections, kidney disease, hearing impairment,
13blindness, amputation of toes, feet, or legs, and increased risk of
14Alzheimer’s disease.

15(b) Diabetes costs the state at least $24.5 billion each year in
16total health care expenses and lost productivity. Average medical
17expenditures for people with diabetes are 2.3 times higher than for
18those without diabetes. One in three California hospital stays is
19for people with diabetes. Hospital stays for patients with diabetes,
20regardless of the primary diagnosis, cost $2,200 more than other
21patients, which adds an extra $1.6 billion each year to California’s
22hospitalization costs, including $254 million in Medi-Cal costs
23alone.

24(c) The prevalence of obesity in the United States has increased
25dramatically over the past 30 years. In California, 60 percent of
26adults are overweight or obese and adult obesity rates have nearly
27tripled increasing from 8.9 percent in 1984 to 25.0 percent in 2012,
28and if current trends continue, the rate is expected to increase to
2946.6 percent in 2030. Nearly 40 percent of California children are
30currently overweight or obese and obesity rates have tripled for
31adolescents and quadrupled for 6 to 11 year olds. Although no
32group has escaped the epidemic, low income and communities of
33color are disproportionately affected.

34(d) The obesity epidemic is of particular concern because obesity
35increases the risk of diabetes, heart disease, arthritis, asthma, and
36certain types of cancer. Depending on their level of obesity, from
3760 percent to over 80 percent of obese adults currently suffer from
P4    1type 2 diabetes, high blood cholesterol, high blood pressure, or
2other related conditions.

3(e) The medical costs for people who are obese are dramatically
4higher than those of normal weight. Overweight and obesity
5account for $147 billion in health care costs nationally, or 9 percent
6of all medical spending, with one-half of these costs paid publicly
7through the Medicare and Medicaid programs.

8(f) There is overwhelming evidence of the link between obesity
9and the consumption of sweetened beverages, such as soft drinks,
10energy drinks, sweet teas, and sports drinks. The 2010 Dietary
11Guidelines for Americans recommend that everyone reduce their
12intake of sugar-sweetened beverages. California adults who drink
13one soda or more per day are 27 percent more likely to be
14overweight or obese, regardless of income or ethnicity.

15(g) According to nutrition experts, sweetened beverages, such
16as soft drinks, energy drinks, sweet teas, and sports drinks, offer
17little or no nutritional value, but massive quantities of added sugars.
18A 20-ounce bottle of soda contains the equivalent of approximately
1917 teaspoons of sugar. Yet, the American Heart Association
20recommends that Americans consume no more than five to nine
21teaspoons of sugar per day.

22(h) Sugar-sweetened beverages are the single largest source of
23added sugars in the American diet, with the average American
24drinking nearly 42 gallons of sweetened beverages a year, the
25equivalent of 39 pounds of extra sugar every year. Over 50 percent
26of the United States population drinks one or more sugar-sweetened
27beverages per day.

28(i) In California, 19 percent of two to five year olds drink a
29sugar-sweetened beverage each day. That number climbs to 32
30percent among 6 to 11 year olds, and 65 percent among 12 to 17
31year olds. Additionally, major disparities now exist between races
32and ethnicities. Seventy-four percent of African American
33adolescents drink at least one sugar-sweetened beverage each day,
34compared to 73 percent of Latinos, 63 percent of Asians, and 56
35percent of whites.

36(j) Sugar-sweetened beverages are a unique contributor to excess
37caloric consumption. Research shows that calories from
38sugar-sweetened beverages do not satisfy hunger the way calories
39from solid food or fat or protein-containing beverages, such as
40those containing milk and plant-based proteins, do. As a result,
P5    1sugar-sweetened beverages tend to add to the calories people
2consume rather than replace them. Drinking one or two sodas a
3day increases the risk of developing type 2 diabetes by 26 percent.
4Drinking just one soda a day increases an adult’s likelihood of
5being overweight by 27 percent, and for children the likelihood
6doubles to 55 percent.

7(k) Consistent evidence shows a positive relationship between
8sugar intake and dental caries (cavities) in adults and fewer caries
9when sugar intake is restricted. Children who frequently consume
10beverages high in sugar are at an increased risk for dental caries.
11Untreated dental caries can lead to pain, infection, tooth loss, and
12in severe cases, death.

13(l) Evidence suggests that health warnings can increase
14knowledge and reduce consumption of harmful products. Studies
15show that prominent health warnings on the face of cigarette
16packages can increase health knowledge, perceptions of risk, and
17can promote smoking cessation of both youth and adults.

18

SEC. 2.  

Article 15 (commencing with Section 111224) is added
19to Chapter 5 of Part 5 of Division 104 of the Health and Safety
20Code
, to read:

21 

22Article 15.  Sugar-Sweetened Beverages Safety Warning Act
23

 

24

111224.  

This article shall be known and may be cited as the
25Sugar-Sweetened Beverages Safety Warning Act.

26

111224.05.  

It is the intent of the Legislature, by enacting this
27article, to protect consumers and to promote informed purchasing
28decisions by requiring a warning about the harmful health effects
29that result from the consumption of drinks with added sugars.

30

111224.10.  

For purposes of this article, unless the context
31clearly requires otherwise, the following definitions shall apply:

32(a) “Animal milk” means natural liquid milk, which is secreted
33by an animal and consumed by humans. For purposes of this
34definition, “animal milk” includes natural milk concentrate and
35dehydrated natural milk, whether or not reconstituted.

36(b) “Beverage container” means any sealed or unsealed container
37regardless of size or shape, including, without limitation, those
38made of glass, metal, paper, plastic, or any other material or
39combination of materials that is used or intended to be used to hold
40a sugar-sweetened beverage for individual sale to a consumer.

P6    1(c) “Beverage dispensing machine” means any device that mixes
2concentrate with any one or more other ingredients and dispenses
3the resulting mixture into an unsealed container as a ready-to-drink
4beverage.

5(d) “Caloric sweetener” means any substance containing
6calories, suitable for human consumption, that humans perceive
7as sweet and includes, without limitation, sucrose, fructose,
8glucose, and other sugars and fruit juice concentrates. “Caloric”
9means a substance that adds calories to the diet of a person who
10consumes that substance.

11(e) “Concentrate” means a syrup or powder that is used or
12intended to be used for mixing, compounding, or making a
13sugar-sweetened beverage.

14(f) “Consumer” means a person who purchases a
15sugar-sweetened beverage for a purpose other than resale in the
16ordinary course of business.

17(g) “Department” means the State Department of Public Health,
18and any agency or person lawfully designated by the department
19to enforce or implement this article pursuant to Section 111020.

20(h) “Distribute” means to sell or otherwise provide a product
21to any person for resale in the ordinary course of business to a
22consumer within this state.

23(i) “Milk substitute” means a plant-based beverage in which the
24principal ingredients by weight are (1) water and (2) grains, nuts,
25legumes, or seeds. For purposes of this definition, “milk substitute”
26includes, without limitation, almond milk, coconut milk, flax milk,
27hazelnut milk, oat milk, rice milk, and soy milk.

28(j) “Natural fruit juice” means the original liquid resulting from
29the pressing of fruit, the liquid resulting from the reconstitution of
30natural fruit juice concentrate, or the liquid resulting from the
31restoration of water to dehydrated natural fruit juice.

32(k) “Natural vegetable juice” means the original liquid resulting
33from the pressing of vegetables, the liquid resulting from the
34reconstitution of natural vegetable juice concentrate, or the liquid
35resulting from the restoration of water to dehydrated natural
36vegetable juice.

37(l) “Person” means any natural person, partnership, cooperative
38association, limited liability company, corporation, personal
39representative, receiver, trustee, assignee, any other legal entity,
40any city, county, city and county, district, commission, the state,
P7    1or any department, agency, or political subdivision thereof, any
2interstate body, and, to the extent permitted by federal law, the
3United States and its agencies and instrumentalities.

4(m) “Powder” means a solid mixture with added caloric
5sweetener used in making, mixing, or compounding a
6sugar-sweetened beverage by mixing the powder with any one or
7more other ingredients, including, without limitation, water, ice,
8syrup, simple syrup, fruits, vegetables, fruit juice, or carbonation
9or other gas.

10(n) “Sale” or “sell” means any distribution or transfer for a
11business purpose, whether or not consideration is received.

12(o) “Sealed beverage container” means a beverage container
13holding a beverage that is closed or sealed before being offered
14for sale to a consumer.

15(p) (1) “Sugar-sweetened beverage” means any sweetened
16nonalcoholic beverage, carbonated or noncarbonated, sold for
17human consumption that has added caloric sweeteners and contains
1875 calories or more per 12 fluid ounces. “Nonalcoholic beverage”
19means any beverage that contains less than one-half of 1 percent
20alcohol per volume.

21(2) “Sugar-sweetened beverage” does not include any of the
22following:

23(A) Any beverage containing 100 percent natural fruit juice or
24natural vegetable juice with no added caloric sweeteners.

25(B) Any liquid product manufactured for any of the following
26uses and commonly referred to as a “dietary aid”:

27(i) An oral nutritional therapy for persons who cannot absorb
28or metabolize dietary nutrients from food or beverages.

29(ii) A source of necessary nutrition used as a result of a medical
30condition.

31(iii) An oral electrolyte solution for infants and children
32formulated to prevent dehydration due to illness.

33(C) Any product for consumption by infants and that is
34commonly referred to as “infant formula.”

35(D) Any beverage whose principal ingredient by weight is
36animal milk or a milk substitute.

37(q) “Syrup” means a liquid mixture with added caloric sweetener
38used in making, mixing, or compounding a sugar-sweetened
39beverage by mixing the syrup with any one or more other
40ingredients, including, without limitation, water, ice, powder,
P8    1simple syrup, fruits, vegetables, fruit juice, vegetable juice, or
2carbonation or other gas.

3(r) “Unsealed beverage container” means a beverage container
4into which a beverage is dispensed or poured at the business
5premises where the beverage is purchased, including, without
6limitation, a container for fountain drinks.

7

111224.15.  

(a) A person shall not distribute, sell, or offer for
8sale a sugar-sweetened beverage in a sealed beverage container in
9this state unless the container bears the following safety warning
10and otherwise meets all of the requirements under this section:

11“STATE OF CALIFORNIA SAFETY WARNING: Drinking
12beverages with added sugar(s) contributes to obesity, diabetes, and
13tooth decay.”

14(b) (1) The safety warning required by subdivision (a) shall be
15prominently displayed and readily legible under ordinary conditions
16on the front of the sealed beverage container, separate and apart
17from all other information, and shall be on a contrasting
18background. The first five words of the safety warning required
19under subdivision (a), “STATE OF CALIFORNIA SAFETY
20WARNING” shall appear in capital letters. The entire safety
21warning shall appear in bold type.

22(2) The safety warning required under subdivision (a) shall
23appear in a font size and in a maximum number of characters (i.e.,
24letters, numbers, and marks) per inch, as follows:

25(A) For beverage containers of 8 fluid ounces or less, the safety
26warning shall be in script, type, or printing not smaller than 1
27millimeter, and there shall be no more than 40 characters per linear
28inch.

29(B) For beverage containers of more than 8 fluid ounces and
30less than 1 liter, the safety warning shall be in script, type, or
31printing not smaller than 2 millimeters, and there shall be no more
32than 25 characters per linear inch.

33(C) For beverage containers of 1 liter or more, the safety warning
34shall be in script, type, or printing not smaller than 3 millimeters,
35and there shall be no more than 12 characters per linear inch.

36(c) If the safety warning required under subdivision (a) is not
37printed directly on the beverage container, the safety warning shall
38be affixed to the beverage container in such a manner that it cannot
39be removed without thorough application of water or other solvents.

P9    1(d) A person shall not distribute, sell, or offer for sale a
2multipack of sugar-sweetened beverages in sealed beverage
3containers in this state unless the multipack of beverages bears the
4safety warning required under subdivision (a). The safety warning
5shall be posted conspicuously on at least two sides of the multipack,
6in addition to being posted on each individual sealed beverage
7container.

8(e) A person shall not distribute, sell, or offer for sale a
9concentrate in this state unless the packaging of the concentrate,
10which is intended for retail sale, bears the safety warning required
11under subdivision (a). The safety warning shall be posted
12conspicuously on the front of the packaging of the concentrate.

13

111224.20.  

(a) Every person who owns, leases, or otherwise
14legally controls the premises where a vending machine or beverage
15dispensing machine is located, or where a sugar-sweetened
16beverage is sold in an unsealed beverage container, shall place, or
17cause to be placed, a safety warning in each of the following
18locations:

19(1) On the exterior of any vending machine that includes a
20sugar-sweetened beverage for sale.

21(2) On the exterior of any beverage dispensing machine used
22by a consumer to dispense a sugar-sweetened beverage through
23self-service.

24(3) At the point-of-purchase where any consumer purchases a
25sugar-sweetened beverage in an unsealed beverage container, when
26the unsealed beverage container is filled by an employee of a food
27establishment rather than the consumer.

28(b) The safety warning required by subdivision (a) shall contain
29the following language:

30“STATE OF CALIFORNIA SAFETY WARNING: Drinking
31beverages with added sugar(s) contributes to obesity, diabetes, and
32tooth decay.”

33(c) The safety warning required by subdivision (a) shall be
34prominently displayed and readily legible under ordinary
35conditions, separate and apart from all other information, and shall
36be on a contrasting background. The first five words of the safety
37warning in subdivision (b), “STATE OF CALIFORNIA SAFETY
38WARNING” shall appear in capital letters. The entire safety
39warning shall appear in bold type.

P10   1

111224.30.  

(a) Notwithstanding Section 111825, subdivision
2(b) of Section 111855, or any other law, commencing July 1, 2016,
3any violation of this article, or a regulation adopted pursuant to
4this article, is punishable by a civil penalty of not less than fifty
5dollars ($50), but no greater than five hundred dollars ($500). The
6department may assess the civil penalty according to the procedures
7set forth in Section 111855. A person shall not be found to violate
8this article more than once during any one inspection visit.

9(b) There is hereby created in the State Treasury the
10Sugar-Sweetened Beverages Safety Warning Fund. The fund shall
11consist of moneys collected for the violation of this article. The
12department shall remit to the Treasurer any civil penalties collected
13pursuant to subdivision (a) on a biannual basis, no later than March
1415 and September 15 of each year. Notwithstanding any other law,
15moneys in the fund, upon appropriation by the Legislature, shall
16be allocated to the department for the purpose of enforcing this
17article.

18

111224.35.  

Notwithstanding Section 111224.15 or 111224.20,
19if, after appropriate investigation and consultation with the state
20health officer, the department finds that available scientific
21information would justify a change in the language of the safety
22warnings set forth in Sections 111224.15 and 111224.20, the
23department may adopt regulations to develop new language for
24the safety warning and may require that the alternative language
25be adopted in lieu of the language set forth in Sections 111224.15
26and 111224.20.

27

111224.40.  

It is the intent of the Legislature that nothing in
28this article shall be construed to preempt or prohibit the adoption
29and implementation of local ordinances related to sugar-sweetened
30beverages, except any local ordinance that is inconsistent with this
31article. An ordinance is not deemed inconsistent with this article
32if it affords greater protection than the requirements set forth in
33this article.

34

SEC. 3.  

The provisions of this act are severable. If any
35provision of this act or its application is held invalid, that invalidity
36shall not affect other provisions or applications that can be given
37effect without the invalid provision or application.



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