April 2018 Newsletter

FDA Issues Three Proposed Rules for Tobacco Product Standards
Retail Tobacco Marketing is a Continuing Problem in New York State
Tobacco Use Patterns Set in Youth Persist into Young Adulthood
Tackling Disparate Exposure to Secondhand Smoke in New York City
U.S. Adult Cigarette Smoking is Down, But Use Disparities Persist
E-Cigarette Market Predicted to Value $5.5 Billion in 2018
Research Spotlight: Youth Smoking Associated with Residential Tobacco Retail Density

FDA Issues Three Proposed Rules for Tobacco Product Standards

The agency is seeking public comment on potential actions to reduce nicotine levels in cigarettes, regulate characterizing flavors across tobacco product categories, and regulate premium cigars

On March 15, 2018 the Food and Drug Administration (FDA) issued an Advance Notice issued an Advance Notice of Proposed Rulemaking (ANPRM) requesting public comments on the agency’s potential actions to reduce nicotine in cigarettes to minimally addictive or non-addictive levels. Specifically, the agency is seeking public comment regarding a potential maximum level of nicotine in cigarettes, whether a nicotine product standard should also cover additional combustible tobacco products, and whether unintended consequences such as illicit trade might occur as a result of a potential product standard. Comments are due June 14, 2018.

On March 21, 2018, FDA published a second ANPRM requesting public comments on the role of flavors in tobacco products. Specifically, FDA is seeking public comments that address patterns of use, particularly among youth and young adults, the role of flavors in promoting migration to less harmful products, consumer perceptions of health risks and addictiveness of flavored tobacco products, whether flavors present specific adverse health effects, and the impact of state and local efforts to restrict the sales and marketing of flavored tobacco products, among other issues. Comments are due June 19, 2018.

On March 26, 2018, FDA published a third ANPRM requesting public comments on the agency’s potential regulation of premium cigars under the Federal Food, Drug, and Cosmetic Act. Specifically, FDA is seeking information regarding use patterns, health effects, and consumer perceptions of premium cigars that may help inform potential regulatory actions. Comments are due June 25, 2018.

Proposed rules are published for the purpose of collecting public input. Effective comments offer evidence-based (including experiential and observational evidence) support for or opposition to a proposed rule. Comments may address the rule as a whole or specific aspects of the proposal, and may directly respond to the agency-posed questions.

Community educators’ firsthand experience of the impact of tobacco controls (or lack thereof) is valuable input as the agency develops final rules. See our Ways & Means publication, “Participatory Rulemaking: A Guide to Locating and Commenting on Proposed Federal Regulations” to understand the federal rulemaking process and learn how to submit comments to a federal docket.

Remember, federal action is not a substitute for local government regulation of tobacco products sales. Federal rulemaking can be a lengthy process and litigation may hold up or invalidate implementation of the final rule.  Meanwhile, local tobacco controls benefit public health and reduce the burden of tobacco-related morbidity and mortality.

Retail Tobacco Marketing is a Continuing Problem in New York State

Store surveys reveal pervasive marketing for tobacco products in New York

U.S. tobacco companies spend billions of dollars marketing their deadly products in community stores. In fact, cigarette and smokeless tobacco manufacturers spent nearly 95 percent of their $9.5 billion marketing budget on retail marketing in 2016, according to updated data from the Federal Trade Commission. Through contracts with community retailers, the tobacco industry exerts control of the retail environment.

New York State’s stores are no exception. Recent data from the New York State Department of Health show that half of N.Y. stores display exterior advertisements for tobacco products, and the vast majority advertise tobacco products inside the store. Half of the surveyed stores dedicated more than half the space behind the register to marketing tobacco products. Further, nearly a quarter placed tobacco products or advertising at children’s eye level or near items appealing to youth such as gum, candy, or toys.

Exposure to tobacco marketing is a significant factor in youth initiation of tobacco use, and also factors in failed attempts to quit among current tobacco users, increasing and prolonging use. Point of sale policies that address exposure to tobacco marketing by reducing outlet density and restricting redemption of certain price promotions may address this problem at the local level. Contact the Policy Center to learn more about how to address tobacco sales and marketing in your community!

Tobacco Use Patterns Set in Youth Persist into Young Adulthood

Low rates of high school youth smoking persist into young adulthood, but likewise, rapidly growing e-cigarette use continues into young adulthood

Current smoking among New York young adults (18-24) declined from 21.6 percent in 2011 to 11.7 percent in 2016. In other words, the proportion of young adult smokers declined by 46 percent in just five years. This rate of decrease is significantly steeper than the decline among adults ages 25 and older.

According to the New York State Department of Health, the more rapid decline of smoking among young adults is likely due to swift declines in smoking among high school students. It seems that as these students age into young adulthood, they continue to abstain from cigarette smoking. Indeed, the rate of cigarette smoking among high school students in New York reached a record low of 4.3 percent in 2016. However, use of other tobacco products, such as pipes, hookah, and cigars, remained higher, at 10.6 percent in 2016. Further, use of electronic nicotine delivery systems among New York high school students nearly doubled from 10.5 percent in 2014 to 20.6 percent in 2016.

New York’s comprehensive tobacco control program is working to prevent initiation of tobacco use among youth, and the health benefits of the program reach into adulthood. Yet as new and novel tobacco products attract new youth users, tobacco control advocates’ work remains critical. Evidence suggests that nicotine addiction continues as young adults become more regular users of tobacco products, and that e-cigarette use among youth and young adults increases the likelihood of combustible tobacco product use.

Tackling Disparate Exposure to Secondhand Smoke in New York City

New data from NYC shows Latinos, Blacks and residents in high-poverty areas especially at risk of SHS exposure

A N.Y.C. Health Department report released February 5, 2018 on secondhand smoke exposure and smoke-free housing policies in New York City underscores continued and alarming disparities in exposure to both indoor and outdoor secondhand smoke. The data show that Latinos, Blacks, and residents living in high-poverty areas are far more likely to be exposed to secondhand smoke. Specifically, Latino adults were more likely to report outdoor secondhand smoke exposure than non-Latinos, and Black adults were more likely than any other group to be involuntarily exposed to secondhand smoke in their homes. Residents living in high-poverty areas reported increased risk for exposure as compared to residents living in low-poverty neighborhoods. Just 40 percent of City residents living in multi-unit housing report that their building had a smoke-free policy, highlighting an area for immediate remedy.

Secondhand smoke is a serious public health concern and the third-leading preventable cause of death in the United States. Children exposed to secondhand smoke are more likely to develop asthma, bronchitis, or sudden infant death syndrome (SIDS). Nonsmokers exposed to secondhand smoke for even a short period of time suffer immediate damage to their cardiovascular systems. The most effective means of eliminating exposure to secondhand smoke in homes and workplaces is to establish strong smoke-free policies.

The new data from NYC underline the need to develop equitable smoke-free policies to address exposure disparities. While New York State’s Clean Indoor Air Act prohibits indoor smoking and vaping within “places of employment” and common areas of larger residential buildings, the Act does not restrict product use 1) in outdoor workspaces such as building construction and farm work sites or 2) within residential units of multiunit housing— exposing these populations to increased risk of secondhand smoke exposure. Instituting comprehensive residential and workplace smoke-free policies would help to alleviate these gaps in enforcement as well as limit disparate exposure to secondhand smoke.

For more information on New York’s smoke-free housing laws and guidance on how to work with neighbors and property owners to reduce or eliminate secondhand smoke, please see the Center’s New York Tenants’ Guide to Smoke Free Housing.

U.S. Adult Cigarette Smoking is Down, But Use Disparities Persist 

Vulnerable populations more at risk

The Centers for Disease Control and Prevention (CDC)’s recent article analyzed data from the 2016 National Health Interview Survey (HNHIS) and found that, although overall smoking rates have been on the decline in the United States, cigarette smoking remains high among certain groups. Risk of smoking was higher among: men, adults 25-64, persons with disabilities, those suffering from serious psychological distress, American Indians, Alaska Natives and Multiracial individuals, and LGBT persons. Cigarette smoking was highest among those with serious psychological distress (35.8%) and the uninsured (28.4%). In addition, despite declining smoking rates, nearly 38 million adults continue to smoke in the United States.

In New York State, adults with poor mental health, lower income, and less education use tobacco at far higher rates than the general state population. By no coincidence, tobacco companies disproportionally market to low-socioeconomic status consumers. The CDC concludes that population-based and equity-promoting interventions (such as tobacco price increases, comprehensive smoke-free laws, anti-tobacco mass media campaigns, and barrier-free access to tobacco cessation counseling and medications) are effective in addressing persistent use disparities. For more information on the tobacco industry’s disproportionate marketing to disadvantaged populations, please see the Center’s fact sheet Tobacco Disparities: Evidence Supports Policy Change.

E-Cigarette Market Predicted to Value $5.5 Billion in 2018

E-cigarette sales on the rise across all product types and anticipated to continue increasing

In 2017 and early 2018, e-cigarette sales continued to grow rapidly, according to Bonnie Herzog, an equities and industry analyst with Wells Fargo Securities, LLC. Sales of “open system” e-cigarettes—referring to rechargeable, modifiable devices separately sold from their liquid refills—rose from 73 percent of the market over the last year to 76 percent of the market in the last month. Sales growth of the e-cigarette channel in general—whether open or closed system—was led by Juul, a brand experiencing growing popularity among youth. Juul’s performance is especially notable, as the brand captured nearly 50 percent of the market dollars in the past month, reaching more than $450 million in sales in the past year. Across channels, e-cigarette sales rose by 95.9 percent in the last month.

Herzog forecasts 2018 sales of closed system e-cigarettes through convenience stores and food, drug, and mass retail channels may reach $1.1 billion, with a further $500 million in online sales, and $400 million by tobacco-only outlets and other e-cig retail locations. Meanwhile, the growing vapor market for open-system modifiable devices and liquids may result in these sales exceeding sales of closed systems, and reach $3.5 billion this year. That figure includes a projected $2.0 billion in sales by vape shops, $850 million online and by tobacco-only outlets and other e-cig retailers, and $650 million by convenience stores and food, drug, and mass retail channels.

Research Spotlight: Youth Smoking Associated with Residential Tobacco Retail Density

Meta-analysis shows weak relationship between tobacco retailers near schools and youth smoking

The Journal of Tobacco Control recently published a meta-analysis of 11 studies to examine the effects of tobacco retail density near adolescents’ homes and schools. The researchers found that tobacco outlets near teenagers’ homes (but not near their schools) was associated with likelihood of youth smoking in the past 30 days. Specifically, researchers found that a single additional tobacco outlet near adolescents’ homes was associated with an 8 percent increase in the odds of teen smoking.

The conclusion of this meta-analysis contrasts previous studies’ findings of a significant effect of tobacco retail density near schools on youth tobacco use. One conclusion from this study is that tobacco retail density is an important factor in youth smoking, however, outlets near schools may not have an independent effect above and beyond youths’ existing exposure to tobacco sales and marketing. Communities seeking to reduce the youth exposure to tobacco marketing may benefit from placing an overall limit on the number of outlets, regardless of a store’s location. Reducing the number of tobacco outlets throughout the community will likely reduce youth tobacco use initiation over time as compared to communities without retail density limits.