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Public Health Advocacy Institute

at Northeastern University School of Law

360 Huntington Avenue, 117CU

Boston, MA 02115


You are here: Home > About Us > Newsletters > January 2019 Newsletter

January 2019 Newsletter

New Studies: High Tobacco Retail Density is Harmful; Strong Local Retail Licensing is Beneficial
NY Governor Announces Legislative Priorities for Reducing Tobacco Use
Tobacco-Free Pharmacy Laws Newly In Effect
Surgeon General Issues Advisory on “Epidemic” of E-Cigarette Use Among Youth
Menthol in Massachusetts: Somerville and Needham Close Local Loopholes
Among Youth Tobacco Users, Use of Flavors is on the Rebound
Welcome to the Policy Center, Luis!

New Studies: High Tobacco Retail Density is Harmful; Strong Local Retail Licensing is Beneficial

Differences in tobacco retail density drive tobacco-attributable health disparities

New evidence reaffirms the uneven distribution of tobacco use, and its positive association with tobacco retail density. A recently published study in the Journal of the American Medical Association assessing census-tract data in the 500 largest US cities revealed that tobacco retailers are more numerous in communities with higher smoking prevalence, lower median household income, and fewer White residents, all else being equal. By no coincidence, certain communities bear the brunt of tobacco-related health harms—and these data should serve as a wake-up call for the tobacco control community.

Fortunately, we know what works to reduce tobacco use and promote health equity. Evidence supports local controls that limit the availability and accessibility of commercial tobacco products as a strategy to reduce use disparities. While there is robust evidence of the correlation between stronger tobacco controls and lower use rates, a recent prospective cohort study in the journal Pediatrics (in which researchers follow up with young people to see if they began smoking after baseline assessment) offers new evidence of a causal link. The study showed that where strong local tobacco retail licensing requirements were in place, youth were less likely to initiate tobacco use.

These studies further strengthen the rationale for retail policies we already know are effective—i.e. reducing exposure to retail tobacco marketing prevents youth initiation and progression to regular use. Such policies are all the more urgent in the face of widening disparities in retail density, and researchers have begun to document the protective benefits of such policies in reducing odds of youth tobacco initiation. Contact the Policy Center to learn more about policy options that reduce exposure to retail tobacco marketing, or visit our Tobacco Retail Licensing technical report and model policies.

NY Governor Announces Legislative Priorities for Reducing Tobacco Use

Package of tobacco control proposals would reduce exposure to harmful tobacco marketing
State-level action to drive down tobacco use rates is on the horizon, as NY Governor Cuomo unveiled his legislative priorities related to tobacco control. According to this week’s news release, the Governor’s priorities (proposed via the 2019 Executive Budget) include:
• Ending the sale of all tobacco products (including e-cigarettes) in pharmacies
• Clarifying that the NYS Department of Health is authorized to prohibit the sale of flavored e-cigarette liquids
• Requiring that e-cigarettes be sold only through retailers registered with the Department of Taxation and Finance
• Restricting the use of discounts provided by tobacco and electronic cigarette manufacturers and retailers
• Raising the Minimum Legal Sales Age for all tobacco products (including e-cigarettes) from 18 to 21
• Restricting the display of all tobacco products (including e-cigarettes) at the point of sale in stores that are accessible to people of all ages

These legislative priorities build on local governments’ success in implementing evidence-based tobacco controls throughout New York, and their success will be dependent upon continued community engagement. The package of proposals includes initiatives directly addressing the tobacco industry’s practices at the point of sale. By reducing consumers’ exposure to harmful tobacco marketing, interventions within the retail environment protect young people and help to narrow health inequities.

By enacting these policies, New York could reclaim its status as a leader in tobacco control. “We have made great strides to stamp out teen smoking, but new products threaten to undo this progress to the detriment of millions of Americans,” said Governor Cuomo. “In New York, we refuse to stand idly by while unscrupulous businesses target our young people and put their very futures at risk.” Keep an eye out for opportunities to weigh in on the Governor’s tobacco control priorities for 2019.

Tobacco-Free Pharmacy Laws Newly In Effect

Building on local momentum, Governor Cuomo proposes to expand the initiative statewide

Tobacco-free pharmacies are trending in the Northeast. In New York State, Erie County became the fourth locality to implement a tobacco-free pharmacy law, following in the footsteps of Rockland County, New York City, and Albany County. The effective date of New York City’s 2017 law was January 1 of this year, and advocates celebrated as more than 500 pharmacies cleared their stores of all tobacco products. Most recently, Governor Cuomo proposed expanding tobacco-free pharmacies statewide, via the legislative priorities outlined in his Executive Budget—an endeavor that would mandate approximately 780 additional stores to go tobacco-free if it were to pass.

In Massachusetts, Governor Charlie Baker signed a law last year building on the momentum of local municipalities eliminating tobacco sales at all healthcare facilities, including pharmacies. The Massachusetts law also became effective January 1, 2019 in municipalities that did not already have a local law in place (more than 130 cities and towns had already adopted the policy).

Tobacco-free pharmacy laws are a common-sense, effective public health policy intervention that removes incongruent health messaging. To learn more about the potential impacts of this policy intervention, visit our Tobacco Retail Licensing technical report.

Surgeon General Issues Advisory on “Epidemic” of E-Cigarette Use Among Youth

Advisory notes the role of flavors in driving youth interest in vaping

Following statements by FDA Commissioner Scott Gottlieb and HHS Secretary Alex Azar, U.S. Surgeon General Jerome Adams acknowledged an alarming increase in youth use of e-cigarettes in 2018. Up from 11 percent in 2017, an estimated 21 percent of 12th graders in 2018 were current users of e-cigarettes (which means using at least once in the past 30 days), and 37 percent reported any vaping in the past 12 months, according to the national Institute on Drug Abuse’s Monitoring the Future survey.

The Surgeon General noted the role of kid-friendly flavors in driving youth use of e-cigarettes, in parallel with FDA’s statements of intention to regulate flavors across tobacco products. “We have evidence-based strategies to prevent tobacco use that can be applied to e-cigarettes,” said Adams. “We must take action now to protect the health of our nation’s young people.”

Notably, the Surgeon General’s call to action includes a recommendation to regulate sales of all types of flavored tobacco products, rather than limiting the recommendation to regulate sales of flavored e-cigarettes. State and local governments may act within the authority of their police powers to regulate sales of flavored tobacco products and answer the Surgeon General’s call to action.

Menthol in Massachusetts: Somerville and Needham Close Local Loopholes

Massachusetts municipalities restrict the sale of mentholated products to adult-only retail tobacco stores

More than 130 municipalities in Massachusetts have restricted the sale of flavored tobacco products to adult-only stores that don’t allow kids to enter. Yet these localities have carved out an exemption for menthol flavors, in order to parallel a 2009 federal law that exempted menthol cigarettes from the nationwide flavor ban. There is no real public health reason for doing so, and in fact, menthol products have been shown to be much more harmful for public health, since they are more addictive and easier to start with.

Even worse, menthol products are marketed to African-Americans, teenagers, and other disadvantaged groups, which by no coincidence use these products at higher rates. In recognition of these well-documented health harms, and evidence of widening disparities in tobacco use, Somerville, MA took action to close the exemption for menthol products and restrict their sale to adult-only stores.

“This is an opportunity for the community to take a significant, bold step to take on this epidemic,” said Somerville Mayor Joseph Curtatone. The policy change will apply to all types of tobacco products, including e-cigarettes, and will take effect April 1, 2019.

Following Somerville’s lead, Needham, MA became the second municipality to close the menthol loophole. Needham does not currently have any adult-only retailers in operation. Needham’s policy will take effect July 1, 2019.

Among Youth Tobacco Users, Use of Flavors is on the Rebound

Uptick is driven largely by increases in youth use of flavored e-cigarettes

Every year, researchers ask a nationally representative sample of middle and high school students whether they have recently used tobacco products—asking separate questions for each type of product. Among those who answer “yes” on any question, investigators ask if they have used a version of that product flavored to taste like something other than tobacco.

Combining these data across four years, researchers recently found that among youth tobacco users, overall use of flavored tobacco products rose to 63.6 percent in 2017, after having declined from 2014-2016. While the use of flavored cigarettes, flavored cigars, flavored hookah, and flavored smokeless tobacco all decreased among users of those products, flavored e-cigarette use rose from 51.4 percent in 2016 to 58.7 percent in 2017, driving the overall rise in flavored tobacco use among current youth tobacco users.

“Flavoring has become one of the leading reasons for current tobacco use among youth,” said Dr. Hongying (Daisy) Dai, lead author of the study. While flavored e-cigarettes have been grabbing much of the media attention, flavors are a problem across product categories and the youth rate of flavored tobacco use has stubbornly persisted despite overall declines in youth tobacco use.

Local governments in New York are authorized to address this problem by regulating sales of flavored tobacco products. Contact the Policy Center to learn more!

Welcome to the Policy Center, Luis!

Luis Melero joined the Policy Center as our newest staff attorney. Luis earned his J.D. at the John Marshall Law School in Chicago, and his B.A. at the University of Michigan at Ann Arbor. Luis has extensive experience in governmental processes and policy development and implementation, having worked as a staffer for an Illinois State Representative, as Manager at a public transportation agency, as Senior Advisor at the White House Office of National Drug Control Policy, and most recently, as Policy Manager at the Brady Campaign to Prevent Gun Violence in Washington, D.C. During his time in the Obama Administration, Luis worked to expand the availability of naloxone and access to treatment in the wake of the opioid epidemic, while also working to reduce disparities among disproportionately impacted communities, including justice-involved individuals. Luis has also worked on electoral campaigns and clerked at the Office of the Cook County Public Defender. He is a big fan of Jim Harbaugh and loves fostering rescue pit bulls.

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