June 2015 Newsletter

New York Smoking Rates Lowest in Recorded State History
Youth Use of ENDS and Hookah on the Rise
Ulster County Adopts Tobacco Retail Licensing Law
Albany and Ulster Counties Join Growing Number of Communities Regulating ENDS as Tobacco Products
Institute of Medicine Study Supports Raising Minimum Legal Tobacco Access Age to 21
Center for Public Health & Tobacco Policy Now Available for Contractor Support
FDA Center for Tobacco Policy Hosts Public Workshops on ENDS

New York Smoking Rates Lowest in Recorded State History

Due to the incredible efforts of New York’s Tobacco Control Program, smoking rates among both adults and youth are the lowest in the state’s recorded history. Data show that over the last four years the smoking rate among high school students has dropped 42% and now remains at 7.3%. The adult smoking rate has dropped 14.5% and remains below the national average of 17.8%.

The Program is continuing its work to reduce tobacco use with new initiatives. Through a grant from the Centers for Disease Control and Prevention, the department is working to educate communities and local leaders about tobacco use and potential policy solutions, improve health system delivery of cessation services (particularly to vulnerable populations) and develop paid media to change social norms and motivate smokers to quit.

Youth Use of ENDS and Hookah on the Rise

According to the 2014 National Youth Tobacco Surveys (NYTS), 4.6 million students use tobacco products: one in four high school students, and one in 13 middle school students. Moreover, 2.2 million of those students use two or more tobacco products. E-cigarettes (also known as electronic nicotine delivery systems or ENDS) were the most common tobacco product used in both populations (2.4 million students), immediately followed by hookahs, cigarettes, cigars, and smokeless tobacco.

The survey revealed a disturbing trend: youth use of novel tobacco products, such as e-cigarettes and hookah, has significantly increased over recent years. While use of traditional tobacco products (cigarettes and cigars) continues to decline, increased use of novel products results in flattened rates of overall tobacco use. Of note, e-cigarette use among middle and high school students tripled from 2013-2014. This is the first time since the survey started collecting data on e-cigarette use in 2011 that current e-cigarette use has surpassed use of all other tobacco products. This trend is alarming since nicotine exposure during critical brain development in adolescence can have lasting adverse consequences. Further, adolescents are at higher risk of addiction, which could lead to sustained tobacco use and, subsequently, tobacco-related disease.

If contractors have questions about incorporating ENDS into their priority education initiatives, please contact the Center.

Ulster County Adopts Tobacco Retail Licensing Law

On May 14, 2015 the Ulster County Executive signed into law the Local Law Establishing a Tobacco Retail License and Reducing Youth Exposure to Tobacco throughout Ulster County. The law was overwhelmingly approved by the County Legislature in April. It requires all retailers of tobacco products (including e-cigarette cartridges) to obtain a license as of January 1, 2016. Further, after the first year of implementation, new tobacco retailers will be prohibited from locating within 1,000 feet of any school.

A 2008 study found that smoking prevalence among high school students is higher when there are more walkable tobacco retail outlets. Under the new law, Ulster County will over time reduce the number of businesses selling tobacco close to schools and, consequently, decrease County youths’ exposure to environmental cues that encourage youth smoking initiation, such as tobacco marketing and access to tobacco products.

For more information about how tobacco retail licensing can be used in your community, see our report on the topic or contact the Center directly.

Albany and Ulster Counties Join Growing Number of Communities Regulating ENDS as Tobacco Products

On June 8,, 2015 the Albany County Legislature approved a new law that prohibits the use of electronic cigarettes (also known as electronic nicotine delivery devices or ENDS) anywhere smoking is prohibited, including restaurants and workplaces. The move follows closely behind that of Ulster County, which recently prohibited the use of ENDS on county-owned or leased property. These counties are just the most recent of a growing number of communities that have adopted measures designed to address the recent reemergence of commonplace public tobacco use and protect residents from secondhand ENDS emissions.

While the FDA continues to evaluate how to best regulate ENDS, there are rising concerns over ENDS constituents, emissions, and the dramatic increase in youth use rates. Thus many communities are taking the initiative to roll ENDS into their existing tobacco product regulations, including restrictions on use in public spaces.

Other counties that have adopted restrictions on ENDS use are Cattaraugus, Erie, Greene, Oneida, Putnam, Suffolk, and Tomkins Counties. Like Albany County, the Westchester County Legislature has also adopted use restrictions and each proposal awaits approval by the respective County Executive.

If contractors have questions about incorporating ENDS into new or existing tobacco control policies, please contact the Center.

Institute of Medicine Study Supports Raising Minimum Legal Tobacco Access Age to 21

In March, a committee of the Institute of Medicine (IOM) published the findings of a consensus study concluding that raising the “minimum age of legal access to tobacco products” (MLA) could significantly improve public health. Specifically, the committee concluded in Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products that raising the MLA from 18 to 21 or 25 would lower tobacco initiation rates, thus reducing overall prevalence of tobacco use in the U.S.

The Family Smoking Prevention and Tobacco Control Act (Tobacco Control Act) establishes 18 years as the nationwide MLA and prohibits the Food and Drug Administration (FDA) from increasing that age. However, the law directed the FDA to study the public health effects of raising the MLA. At the request of the FDA, the IOM convened a committee in 2013 to carry out the study.

The committee reviewed existing literature on tobacco use initiation, developmental biology and psychology, and tobacco policy and used mathematical modeling to predict public health outcomes of raising the MLA to 19, 21 and 25 years. Notable results include:

  • Among adults who become daily smokers, approximately 90 percent initiated smoking before 19 years of age. Nearly 100 percent initiated before age 26.
  • Increasing the MLA will likely prevent or delay initiation of tobacco use by adolescents and young adults. Raising the MLA to 21 will have substantially higher impact than raising it to 19.
  • The age group most impacted by an increase in MLA will be those age 15-17 years. This is important because the developing brains of this age group are uniquely vulnerable to the effects of nicotine. Moreover, the majority of underage tobacco users rely on social sources of cigarettes; and persons age 21 or older are less likely to be in the same social circles as 15-17 year olds.
  • If the MLA were increased to 21 today, by the time today’s teens reach adulthood, there would be a 12 percent decrease in tobacco use prevalence.
  • Tobacco-related disease would be reduced with a decrease in tobacco use prevalence. While a decline in those conditions which take decades to develop would be achieved over time, an improvement in the health of adolescents and young adults would be more immediate, including a decrease in inflammation and impaired immune function caused by smoking.

While the IOM committee was not tasked with making any recommendations as to whether the MLA should be raised, the conclusions significantly support those progressive state and local governments considering raising the MLA for tobacco products to 21 within their jurisdictions.

Public Health and Tobacco Policy Center Now Available for Contractor Support

The staff at the Public Health and Tobacco Policy Center is thrilled to announce it is the recipient of a 5-year contract by the New York State Department of Public Health to support the Bureau of Tobacco Control (BTC)! The contract will run through February of 2020.

The Center provides policy support services to BTC staff, contractors and community leaders. These services include research, policy development and legal technical assistance. Examples of the types of assistance we have provided in the past include developing model policies for New York communities; assisting municipal and county elected officials develop policies to address specific community needs; teaming with Contractors to educate community leaders about policy options; strategizing one on one with Contractors on their community education efforts; and conducting trainings for contractors on tobacco control policy options. To further support these efforts, we host a website through which our written resources may be found, including technical reports, fact sheets, newsletters, social media feeds and more.

In 2015 the Center moved to the campus of Northeastern University School of Law and where we’ve partnered with the Public Health Advocacy Institute, a fellow organization committed to supporting public health through law and policy. Center staff is very much looking forward to working with New York’s tobacco control partners! Please visit us at www.tobaccopolicycenter.org.

Please note that our new contact information:

Public Health and Tobacco Policy Center
Public Health Advocacy Institute
at Northeastern University School of Law
360 Huntington Ave, #117CU
Boston, MA 02115
tobacco@tobaccopolicycenter.org
(617) 373-8494

FDA Center for Tobacco Policy Hosts Public Workshops on ENDS

In early June, FDA Center for Tobacco Policy (CTP) held its third and final workshop intended to inform the FDA’s rulemaking related to deeming e-cigarettes (also known as electronic nicotine delivery systems or ENDS) as tobacco products within the agency’s regulatory authority. The June workshop focused on the impact of e-cigarettes on population health and requested presentations related to: (1) prevalence and patterns of use; (2) impacts on the use of  current tobacco products; (3) uptake of e-cigarette use by non-users of tobacco products; (4) health effects of e-cigarettes in non-users: and (5) knowledge, attitudes, beliefs, and perceptions about e-cigarette products.

During the two day workshop experts and stakeholders presented evidence from studies examining, for example, characteristics of the population experimenting with and continuing use of ENDS, including a comparison to users of other substances; reasons for initiation and sustained ENDS use; product characteristics and appeal, including flavored products; and ENDS marketing, including through retail websites. There was also discussion regarding the weight the FDA should give to cross-sectional versus longitudinal studies reporting these use behaviors. Day two focused on ENDS constituents and the possibility of secondhand exposure to them.