BILL ANALYSIS Ó
SENATE COMMITTEE ON HEALTH
Senator Ed Hernandez, O.D., Chair
BILL NO: SB 203
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|AUTHOR: |Monning |
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|VERSION: |April 6, 2015 |
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|HEARING DATE: |April 22, 2015 | | |
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|CONSULTANT: |Reyes Diaz |
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SUBJECT : Sugar-sweetened beverages: safety warnings.
SUMMARY : Establishes the Sugar-Sweetened Beverages Safety Warning Act,
to be administered by the Department of Public Health, and
requires a safety warning on all sealed sugar-sweetened beverage
containers, as specified. Requires the warning label to be
posted in a place that is easily visible at the
point-of-purchase of an establishment where a beverage container
is not filled by the consumer.
Existing law:
1.Establishes the Department of Public Health (DPH) to protect
and improve the health of communities through education,
promotion of healthy lifestyles, and research for disease and
injury prevention.
2.Establishes the Sherman Food, Drug, and Cosmetic Law (Sherman
Act), which is administered by DPH, to regulate the contents,
packaging, labeling, and advertising of food, drugs, and
cosmetics in California.
3.Allows DPH, upon the request of a health officer, to authorize
the local health department of a city, county, city and
county, or local health district to enforce the provisions of
the Sherman Act and its regulations that pertain to retail
food establishments, as defined, if DPH determines that the
local health department has sufficient personnel with adequate
training to do so, and requires that the enforcement be
limited to the area under the jurisdiction of the local health
department.
This bill:
1.Establishes the Sugar-Sweetened Beverages Safety Warning Act
SB 203 (Monning) Page 2 of ?
(SSBSWA) whereby a person, as defined, is prohibited from
distributing, selling, or offering for sale in the state
sugar-sweetened beverages (SSBs) in a sealed beverage
container; in a multipack of sealed beverage containers; in
concentrate form, as defined; on the premises where a vending
machine or beverage dispensing machine, as defined, is
located; and where SSBs are sold in unsealed beverage
containers unless the container bears a safety warning, as
specified, or the safety warning is posted on the premises,
as specified, and otherwise meets all the requirements of this
bill.
2.Defines "sugar-sweetened beverage" as any sweetened
non-alcoholic beverage, carbonated or non-carbonated, sold for
human consumption that has added caloric sweeteners and
contains 75 calories or more per 12 fluid ounces. Specifies
that SSBs do not include any beverage containing 100 percent
natural fruit juice or natural vegetable juice with no added
caloric sweeteners; any liquid product commonly referred to as
a dietary aid; any product for consumption by infants and that
is commonly referred to as infant formula; or any beverage
whose principal ingredient by weight is animal milk or a milk
substitute. Defines "animal milk" as natural liquid milk
secreted by an animal and consumed by humans, including
natural milk concentrate and dehydrated natural milk, whether
or not reconstituted. Defines "milk substitute" as a
plant-based beverage in which principal ingredients by weight
are (1) water and (2) grains, nuts, legumes, or seeds,
including, without limitation, almond, coconut, flax,
hazelnut, oat, rice, and soy milks.
3.Defines "non-alcoholic beverage" as any beverage that contains
less than one-half of one percent alcohol per volume. Defines
"caloric sweetener" as any substance containing calories
suitable for human consumption that humans perceive as sweet
and includes, without limitation, sucrose, fructose, glucose,
and other sugars and fruit juice concentrates. Defines
"caloric" as a substance that adds calories to the diet of a
person who consumes that substance.
4.Requires the safety warning to read "STATE OF CALIFORIA SAFETY
WARNING: Drinking beverages with added sugar(s) contributes to
obesity, diabetes, and tooth decay" on the front of SSB sealed
beverage containers, separate and apart from all other
information, on a contrasting background, and entirely in bold
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type; to be affixed to an SSB beverage container in a manner
that it cannot be removed without thorough application of
water or other solvents if the warning is not printed directly
on a sealed container; to be printed on at least two sides of
an SSB multipack and on each individual sealed container
inside the multipack; and to be printed on the front of the
packaging of a concentrate, as defined.
5.Requires every person who owns, leases, or otherwise legally
controls the premises where a vending machine or beverage
dispensing machine is located, or where SSBs are sold in an
unsealed container, to place, or cause to be placed, a safety
warning a) on the exterior of any vending machine that
includes SSBs, b) on the exterior of any self-serve beverage
dispensing machine, and, c) at the point-of-purchase where
any consumer purchases an SSB in an unsealed beverage
container, when the container is filled by an employee of a
food establishment rather than by the consumer.
6.Allows DPH to assess a civil penalty of not less than $50 but
no greater than $500 for any violation of the SSBSWA or any
regulation by DPH. Specifies that a person is not to be found
in violation of the SSBSWA more than once during any one
inspection visit.
7.Creates in the State Treasury the Sugar-Sweetened Beverages
Safety Warning Fund consisting of moneys collected for the
violation of the SSBSWA, which is to be appropriated by the
Legislature for allocation to DPH for the purpose of enforcing
the SSBSWA.
8.Requires DPH to adopt regulations to implement the SSBSWA.
Allows the department to adopt regulations to develop new
language for the safety warning, after appropriate
investigation and consultation with the State Health Officer.
9.Makes findings and declarations about obesity and type 2
diabetes rates and resulting health costs in the state, as
well as the link among obesity, diabetes, and dental caries
and SSB consumption.
10.Specifies that the provisions of the SSBSWA are severable and
that any provision or its application that is held invalid
cannot affect other provisions or applications that can be
given effect without the invalid provision or application.
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FISCAL
EFFECT : This bill has not been analyzed by a fiscal committee.
COMMENTS :
1.Author's statement. According to the author, California is in
the midst of an obesity and diabetes epidemic that is wreaking
havoc on the public's health. SSBs are a major contributor to
the problem. SB 203 would provide information to consumers to
make informed choices by requiring warning labels-similar to
those on tobacco and alcohol-that explain the proven health
risks associated with drinking SSBs. The science is clear and
conclusive. Overwhelming research has unequivocally shown that
SSBs are major contributors to obesity, diabetes, and tooth
decay, which cost California billions of dollars in health
care and lost productivity annually.
Nearly 40 percent of California children are currently
overweight or obese. Liquid sugar has a unique role in driving
today's skyrocketing cases of preventable diabetes.
Individuals who drink one or two sugary drinks per day have a
26 percent higher risk for developing type 2 diabetes. If
current trends are not reversed, it is predicted that one in
three children-and nearly half of Latino and African-American
children-born in the year 2000 will develop type 2 diabetes in
their lifetime. SSBs are the biggest contributor of added
calories in the American diet and are unique in not providing
any nutritional value.
2.SSB consumption. According to the U.S. Department of
Agriculture, in 2009, Americans consumed 13.8 billion gallons
of SSBs, which equates to nearly 45 gallons per capita
annually of SSBs with added caloric sweeteners. According to
the UCLA Center for Health Policy Research, in California, 41
percent of children ages 2-11 and 62 percent of adolescents
ages 12-17 drink at least one SSB every day. In addition, 24
percent of adults drink at least one SSB on average per day.
Adults who drink SSBs occasionally (not every day) are 15
percent more likely to be overweight or obese, and adults who
drink one or more SSBs per day are 27 percent more likely to
be overweight or obese than adults who do not. According to a
report produced by the Robert Wood Johnson Scholar's Program,
SSBs were the single largest contributor to energy intake
during the last decade, and SSB consumption has increased by
almost 500 percent during the past 50 years.
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3.Obesity and other chronic diseases. DPH issued a study, The
Burden of Chronic Disease and Injury, in 2013 that highlights
some of the leading causes of death, such as heart disease,
cancer, stroke, and respiratory disease, all of which have a
strong connection to obesity. Diabetes is another serious
chronic disease stemming from obesity that adversely affects
quality of life and results in serious medical costs. The last
decade has witnessed a 32 percent rise in diabetes prevalence,
affecting some 3.9 million people and costing upwards of $24
billion per year. According to the Centers for Disease Control
and Prevention, more than one-third of U.S. adults are obese,
and approximately 12.5 million children and adolescents ages 2
to 19 years are obese. Research indicates a tripling in the
youth obesity rate over the past three decades. While this
increase has stabilized between the years 2005 and 2010, in
2010, 38 percent of public school children were overweight and
obese. Overweight youth face increased risks for many serious
detrimental health conditions that do not commonly occur
during childhood, including high cholesterol and type 2
diabetes. Additionally, more than 80 percent of obese
adolescents remain obese as adults.
4.Consumer view of SSBs. In February 2014, the Field Research
Corporation released a poll of 1,002 registered voters in
California on behalf of The California Endowment. The poll
found that, statewide, 74 percent of voters support a
requirement that beverage companies post health warning labels
on SSBs to alert consumers that their daily consumption
contributes to diabetes, obesity, and tooth decay. The
requirement also carries strong bipartisan support. The poll
also found that nearly two in three voters continue to support
taxing the sale of SSBs and to use the proceeds for school
nutrition and physical activity programs for kids and
distributing the revenues to schools, public health
departments, and local community programs across the state
based on each community's diabetes and obesity rates, so
places with higher rates would get more. Further, the poll
found that seven in 10 Californians support changing the rules
governing the food assistance program so that recipients
cannot use the food assistance benefit to buy SSBs.
The Rudd Center for Food Policy & Obesity at the University of
Connecticut released a study in which 982 parents with at
least one child aged two to 17, from an ethnically diverse
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population sample, were asked about SSBs. The survey found
that one-third or more of parents relied on packing claims,
such as "low-calorie," "real/natural," and "vitamin C," to
influence SSB purchasing decisions. Many parents believe that
SSBs with such marketing claims, which may imply they provide
essential nutrition, are a healthy option for their children,
particularly flavored waters and fruit and sports drinks.
5.Nutrition Facts label update. In February 2014, the FDA
announced an update to the Nutrition Facts label on food
packages to reflect new public health and scientific
information, including evidence on nutrition, obesity, and
chronic diseases. According to the FDA Web site, the update
will reflect amounts of food people are actually eating and
drinking now as opposed to 20 years ago when the Nutrition
Facts label was first introduced. The FDA further states that
serving sizes must be based on amounts of food and drink that
people customarily consume, not on what people should be
eating. People are generally eating more today than 20 years
ago. The FDA set current reference values in 1994, based
primarily on Nationwide Food Consumption Surveys conducted in
1977-78 and 1987-88, according to the FDA's Web site. The FDA
states that the pending changes reflect new dietary
recommendations, consensus reports, and national survey data
and also reflect input obtained through four advance notices
of proposed rulemaking and numerous citizens' petitions.
According to the FDA, Americans on average eat 16 percent of
their total calories from added sugars, the major sources
being soda, energy and sports drinks, grain-based desserts,
sugar-sweetened fruit drinks, dairy-based desserts, and candy.
The proposed requirement to declare "added sugars" in addition
to the total sugar requirement on the Nutrition Facts label
was decided after taking into account new data and
information, including U.S. consensus reports and
recommendations, a citizen's petition, and public comments,
according to the FDA.
In an April 2015 email from Nutrition Programs staff in the
Office of Nutrition, Labeling, and Dietary Supplements, FDA
Center for Food Safety and Applied Nutrition, the FDA states
that it is working on drafting a final rule for the Nutrition
Facts label regulation. Final rules become effective 60 days
after the final rule's publication in the Federal Register
with a compliance date two years after the effective date,
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according to the FDA.
6.Providing understandable caloric information to consumers. A
study published in December 2014 in the American Journal of
Public Health, "Reducing [SSB] Consumption by Providing
Caloric Information: How Black Adolescents Alter their
Purchases and Whether the Effects Persist," concluded that one
promising environmental program to reduce consumption of SSBs
is to provide consumers with easily interpretable caloric
information. In an area with six corner stores close to middle
and high schools in Maryland, consumers were presented with
information about caloric intake on signs posted on the
stores' beverages cases that included the time necessary to
burn off those calories in the form of a physical activity,
such as running or walking. When provided with easily
understandable caloric information, consumers purchased
smaller servings of SSBs, switched from an SSB to a beverage
with no calories, or opted not to purchase a beverage at all.
The study found that providing the easily understandable
caloric information had a persistent effect on reducing SSB
purchases for approximately six weeks after the signs with the
caloric information were removed.
7.Related legislation. AB 1357 (Bloom), establishes the Children
and Family Health Promotion Program within DPH and consists of
a competitive grant process in which grants are awarded to
counties, cities, nonprofit organizations, community-based
organizations, and licensed clinics that seek to invest in
childhood obesity and diabetes prevention activities and oral
health programs. This bill makes legislative findings and
declarations relating to the consumption of SSBs, childhood
obesity, and dental disease. AB 1357 is set for hearing in the
Assembly Health Committee on April 21, 2015.
SCR 34 (Monning), proclaims the month of September 2015, and
each year thereafter, as Childhood Obesity Awareness Month,
and expresses the Legislature's support of various programs
that work to reduce obesity among children, including those
that increase access to affordable healthful foods and
beverages and provide less access to high-calorie foods and
SSBs. SCR 34 has been ordered to third reading in the Senate.
8.Prior legislation. SB 1000 (Monning), of 2014, was identical
to this bill. SB 1000 failed passage in the Assembly Health
Committee.
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SB 622 (Monning), of 2013, would have enacted the Sweetened
Beverage Tax Law, which imposed a one-cent per fluid ounce tax
on any beverage that adds caloric sweeteners, such as sodas,
energy drinks, sweet teas, and sports drinks. SB 622 would
have required funds generated by the Sweetened Beverage Tax to
be directed to the newly created Children's Health Promotion
Fund and allocated to statewide childhood obesity prevention
activities and programs. SB 622 was held under submission in
the Senate Appropriations Committee.
AB 1746 (Williams), of 2012, would have, commencing July 1,
2013, restricted the sale of electrolyte replacement beverages
in middle schools and high schools to specified times before
and after school. AB 1746 was held under submission in the
Assembly Appropriations Committee.
AB 669 (Monning), of 2011, was SB 622's predecessor. AB 669
was held in the Assembly Revenue and Taxation Committee.
AB 2100 (Coto), of 2010, would have imposed a one cent tax per
teaspoon of added sweetener in a bottled sweetened beverage or
in a sweetened concentrate. AB 2100 was held in the Assembly
Revenue and Taxation Committee.
SB 1210 (Florez), of 2010, was a measure similar to SB 622.
SB 1210 was placed on the former Senate Revenue and Taxation
Committee's suspense file.
9.Support. Supporters of the bill argue that consumption of
SSBs has been linked to the development of obesity, diabetes,
and tooth decay, as well as other health-related issues. They
state that the prevalence of overweight children has more than
quadrupled and that research indicates taste preference and
lifelong habits are formed in early childhood. Supporters
further argue that health-relates illnesses linked to SSB
consumption are having a disastrous effect on public health
and health care costs, citing that the average cost for a
hospitalization of a patient with diabetes is about $2,200
more than for patients without diabetes.
10.Opposition. Opponents argue that this bill exposes
manufacturers and retailers of SSBs to significant liability
and litigation just because a consumer chose to consume an
SSB. They also claim that this bill would have a negative
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impact on jobs in the state and say that education, rather
than regulation, should be the goal in providing consumers
with information about SSBs. The California/Nevada Beverage
Association cites a recent RAND Corp. study on the fast-food
ban in South Los Angeles that concluded there is no simple
resolution to a complex public health challenge like obesity
and diabetes.
SUPPORT AND OPPOSITION :
Support: California Black Health Network (cosponsor)
California Center for Public Health Advocacy
(cosponsor)
Health Officers Association of California (cosponsor)
Latino Health Access (cosponsor)
Action Network
Alameda County Board of Supervisors
AltaMed Health Services Corporation
American Cancer Society Cancer Action Network
American Diabetes Association
American Federation of State, County and Municipal
Employees, AFL-CIO
American Heart Association/American Stroke Association
Asian Law Alliance
Asian and Pacific Islander American Health Forum
Asian and Pacific Islander Obesity Prevention Alliance
Berkeley Media Studies Group
Blue Shield of California
California Academy of Family Physicians
California Academy of Physician Assistants
California Association for Health, Physical Education,
Recreation and Dance
California Chapter of the American Association of
Clinical Endocrinologists
California Chapter of the American College of
Cardiology
California Children's Hospital Association
California Chiropractic Association
California Dental Association
California Dental Hygienists' Association
California Dietetic Association
California Food Policy Advocates
California Immigrant Policy Center
California Medical Association
California Naturopathic Doctors Association
California Nurses Association/National Nurses United
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California Pan-Ethnic Health Network
California Park & Recreation Society
California Pharmacists Association
California Physical Therapy Association
California Primary Care Association
California Project LEAN (Leaders Encouraging Activity
and Nutrition)
California Public Health Association - North
California Rural Legal Assistance Foundation
California School-Based Health Alliance
California School Nurses Organization
California State Alliance of YMCAs
California WIC Association
Center for Collaborative Solutions
Center for Communications, Health & the Environment
Center for Ecoliteracy
Center for Science in the Public Interest
Central California Alliance for Health
ChangeLab Solutions
Charles R. Drew University of Medicine and Science
Children Now
Children's Hospital Oakland
City of Richmond
City of South El Monte
Community Bridges
Contra Costa County
Councilmember Laurie Capitelli, City of Berkeley
Cultiva La Salud
Day One
Diabetes Coalition of California
Dignity Health
First 5 Association of California
First 5 Monterey County
47 Games, Inc.
Having Our Say Coalition
Health Access California
Health Improvement Partnership of Santa Cruz County
Healthy & Active Before 5
Hunger Action Los Angeles
Junior League of Monterey County
Khmer Girls in Action
Latino Coalition for a Healthy California
Latino Health Access
Lucille Packard Children's Hospital Stanford
Maternal and Child Health Access
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Napa County Board of Supervisors
National Coalition for 100 Black Women Sacramento
Network of Ethnic Physician Organizations
Pacoima Beautiful
Physicians for Social Responsibility
Prevention Institute
Public Health Institute
Roots of Change
San Diego Hunger Coalition
San Francisco Medical Society
San Francisco Unified School District
Santa Clara County Board of Supervisors
Santa Monica Family YMCA
SEIU California
Shape Up San Francisco Coalition
South Asian Network
Southern California Public Health Association
Strategic Alliance for Healthy Food and Activity
Environments
Sunnyvale School District Board of Education
UCLA Housing & Hospitality Services
Department
Venice Family Clinic
Vice Mayor Linda Maio, City of Berkeley
YMCA of Burbank California
YMCA of the Central Coast
YMCA of the Channel Islands
YMCA of Greater Long Beach
YMCA of Greater Whittier
YMCA of Metropolitan Los Angeles
YWCA of Watsonville
Zion Hill Baptist Church
One individual
Oppose: CalAsian Chamber of Commerce
California Automatic Vendors Council
California Chamber of Commerce
California Grocers Association
California Hotel and Lodging Association
California Hispanic Chambers of Commerce
California Independent Oil Marketers Association
California League of Food Processors
California Manufacturers and Technology Association
California/Nevada Beverage Association
California Retailers Association
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California Restaurant Association
California Service Station and Auto Repair Association
California Teamsters Public Affairs Council
California Travel Association
Can Manufacturers Association
Civil Justice Association of California
Grocery Manufacturers Association
International Franchise Association
Juice Products Association
Los Angeles Area Chamber of Commerce
Los Angeles County Business Federation
National Automatic Merchandising Association
National Federation of Independent Business
SPI: The Plastic Industry Trade Association
Valley Industry and Commerce Association
7-Eleven
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