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HomeMy WebLinkAboutAgenda - 06-16-2015 - 6h 1 ORANGE COUNTY BOARD OF COMMISSIONERS ACTION AGENDA ITEM ABSTRACT Meeting Date: June 16, 2015 Action Agenda Item No. 6-h SUBJECT: Resolution on Rescinding Preemption of Local Tobacco Control DEPARTMENT: Health PUBLIC HEARING: (Y/N) No ATTACHMENT(S): INFORMATION CONTACT: 1) Youth Access Law (North Carolina General Statute 14-313) Colleen Bridger, 919-245-2412 2) Centers for Disease Control Letter Coby Jansen Austin, 919-245-2424 Regarding Preemption 3) Orange County Board of Health Resolution to Rescind Preemption 4) Proposed Board of Commissioners Resolution UNDER SEPARATE COVER 5) 2014 Point-of-Sale Strategies Report — Only available electronically at http.//cphs s.wust1.edu/Products/Oo currents/CPHSS TCLC 2014 Point ofSa12Strate ies1.j2df PURPOSE: To adopt a resolution (Attachment 4), which is similar to an Orange County Board of Health resolution, that calls on the North Carolina General Assembly to restore local control over tobacco policies by rescinding preemption. BACKGROUND: Research shows that the strongest, most innovative, and most effective tobacco control policies have most often originated at the local level. However, preemptive legislation at the state level prevents local communities in North Carolina from implementing most tobacco control policies related to the retail environment (e.g., price, promotion, minimum sale age, taxation, licensing). Preemption became effective almost two decades ago when the Youth Access Law (Attachment 1) was adopted. That law was recently modified to extend preemption to a-cigs as well. To re-institute local control, the North Carolina General Assembly would need to revise this statute. In March 2015, an Institute of Medicine report showed that increasing the minimum legal sale age for tobacco to 21 years would reduce youth initiation and save lives. More than 58 communities in 12 states have increased the minimum sale age, and Hawaii is poised to be the first state to do so. Multiple opinion polls show popular support for raising the tobacco sales age to 21. Orange County and other localities in NC are preempted from changing the minimum legal sales age. 2 If preemption were lifted, localities would have the ability to increase the minimum legal sales age, as well as to institute local tax strategies to increase the cost of tobacco (a proven approach for reducing tobacco use and preventing youth from initiating use), to adopt retailer licensing laws (which would enable restrictions on density and placement of retailers, helping to prevent tobacco swamps and reducing proximity to schools), to pass restrictions on advertising/promotion and many other possible regulations such as those outlined in 2014 Point- of-Sale Strategies Report (Attachment 5 — only available electronically at http-//cphss.wusti.edu/Products/Documents/CPHSS TCLC 2014 PointofSaleStratepies1.pdf). Attachment 2 is a letter from the Centers for Disease Control highlighting the many public health reasons why preemption should be lifted. When the Orange County Board of Health approved its resolution (see Attachment 3) in March, it was the first in NC to do so. Health Department staff recently shared the resolution with peers, and three other county boards of health have already adopted similar resolutions (Durham, Chatham, and Cumberland). The resolution will also be considered in June by another county board of health (Pitt), and is under consideration by several others. FINANCIAL IMPACT: There is no financial impact associated with adoption of the resolution. If preemption were to be rescinded by the General Assembly, as outlined in the proposed resolution, local governments such as Orange County would have the option of taxing tobacco products, which would generate revenue and - most importantly - reduce use of those products. RECOMMENDATION(S): The Manager recommends that the Board adopt and authorize the Chair to sign the resolution (Attachment 4), which is similar to the resolution previously adopted by the Orange County Board of Health (Attachment 3). 3 Attachment 1 Article 39. Protection of Minors. § 14-313. Youth access to tobacco products, tobacco-derived products, vapor products, and cigarette wrapping papers. (a) Definitions. - The following definitions apply in this section: (1) Distribute. - To sell, furnish, give, or provide tobacco products, including tobacco product samples or cigarette wrapping papers, to the ultimate consumer. (2) Proof of age. - A drivers license or other photographic identification that includes the bearer's date of birth that purports to establish that the person is 18 years of age or older. (3) Sample. - A tobacco product distributed to members of the general public at no cost for the purpose of promoting the product. (3a) Tobacco-derived product. - Any noncombustible product derived from tobacco that contains nicotine and is intended for human consumption, whether chewed, absorbed, dissolved, ingested, or by other means. This term does not include a vapor product or any product regulated by the United States Food and Drug Administration under Chapter V of the federal Food, Drug, and Cosmetic Act. (4) Tobacco product. - Any product that contains tobacco and is intended for human consumption. For purposes of this section, the term includes a tobacco-derived product, vapor product, or components of a vapor product. (5) Vapor product. - Any noncombustible product that employs a mechanical heating element, battery, or electronic circuit regardless of shape or size and that can be used to heat a liquid nicotine solution contained in a vapor cartridge. The term includes an electronic cigarette, electronic cigar, electronic cigarillo, and electronic pipe. The term does not include any product regulated by the United States Food and Drug Administration under Chapter V of the federal Food, Drug, and Cosmetic Act. (b) Sale or distribution to persons under the age of 18 years. - If any person shall distribute, or aid, assist, or abet any other person in distributing tobacco products or cigarette wrapping papers to any person under the age of 18 years, or if any person shall purchase tobacco products or cigarette wrapping papers on behalf of a person under the age of 18 years, the person shall be guilty of a Class 2 misdemeanor; provided, however, that it shall not be unlawful to distribute tobacco products or cigarette wrapping papers to an employee when required in the performance of the employee's duties. Retail distributors of tobacco products shall prominently display near the point of sale a sign in letters at least five-eighths of an inch high which states the following: N.C. LAW STRICTLY PROHIBITS THE PURCHASE OF TOBACCO PRODUCTS, TOBACCO-DERIVED PRODUCTS, VAPOR PRODUCTS, AND CIGARETTE WRAPPING PAPERS BY PERSONS UNDER THE AGE OF 18. PROOF OF AGE REQUIRED. Failure to post the required sign shall be an infraction punishable by a fine of twenty-five dollars ($25.00) for the first offense and seventy-five dollars ($75.00) for each succeeding offense. A person engaged in the sale of tobacco products or cigarette wrapping papers shall demand proof of age from a prospective purchaser if the person has reasonable grounds to believe that the prospective purchaser is under 18 years of age. Failure to demand proof of age as required by this subsection is a Class 2 misdemeanor if in fact the prospective purchaser is under 18 4 years of age. Retail distributors of tobacco products or cigarette wrapping papers shall train their sales employees in the requirements of this law. Proof of any of the following shall be a defense to any action brought under this subsection: (1) The defendant demanded, was shown, and reasonably relied upon proof of age in the case of a retailer, or any other documentary or written evidence of age in the case of a nonretailer. (2) The defendant relied on the electronic system established and operated by the Division of Motor Vehicles pursuant to G.S. 20-37.02. (3) The defendant relied on a biometric identification system that demonstrated (i) the purchaser's age to be at least the required age for the purchase and (ii) the purchaser had previously registered with the seller or seller's agent a drivers license, a special identification card issued under G.S. 20-377.7, a military identification card, or a passport showing the purchaser's date of birth and bearing a physical description of the person named on the card. (b1) Distribution of tobacco products. - Tobacco products shall not be distributed in vending machines; provided, however, vending machines distributing tobacco products are permitted (i) in any establishment which is open only to persons 18 years of age and older; or (ii) in any establishment if the vending machine is under the continuous control of the owner or licensee of the premises or an employee thereof and can be operated only upon activation by the owner, licensee, or employee prior to each purchase and the vending machine is not accessible to the public when the establishment is closed. The owner, licensee, or employee shall demand proof of age from a prospective purchaser if the person has reasonable grounds to believe that the prospective purchaser is under 18 years of age. Failure to demand proof of age as required by this subsection is a Class 2 misdemeanor if in fact the prospective purchaser is under 18 years of age. Proof that the defendant demanded, was shown, and reasonably relied upon proof of age shall be a defense to any action brought under this subsection. Vending machines distributing tobacco products in establishments not meeting the above conditions shall be removed prior to December 1, 1997. Vending machines distributing tobacco-derived products, vapor products, or components of vapor products in establishments not meeting the above conditions shall be removed prior to August 1, 2013. Any person distributing tobacco products through vending machines in violation of this subsection shall be guilty of a Class 2 misdemeanor. (b2) Internet distribution of tobacco products. - A person engaged in the distribution of tobacco products through the Internet or other remote sales methods shall perform an age verification through an independent, third-party age verification service that compares information available from public records to the personal information entered by the individual during the ordering process to establish that the individual ordering the tobacco products is 18 years of age or older. (c) Purchase by persons under the age of 18 years. - If any person under the age of 18 years purchases or accepts receipt, or attempts to purchase or accept receipt, of tobacco products or cigarette wrapping papers, or presents or offers to any person any purported proof of age which is false, fraudulent, or not actually his or her own, for the purpose of purchasing or receiving any tobacco product or cigarette wrapping papers, the person shall be guilty of a Class 2 misdemeanor; provided, however, that it shall not be unlawful for an employee to purchase or accept receipt of tobacco products or cigarette wrapping papers when required in the performance of the employee's duties. (d) Sending or assisting a person [less than] 18 years to purchase or receive tobacco products or cigarette wrapping papers. - If any person shall send a person less than 18 years of age to purchase, acquire, receive, or attempt to purchase, acquire, or receive tobacco products or cigarette wrapping papers, or if any person shall aid or abet a person who is less than 18 years of age in purchasing, acquiring, or receiving or attempting to purchase, acquire, or 5 receive tobacco products or cigarette wrapping papers, the person shall be guilty of a Class 2 misdemeanor; provided, however, persons under the age of 18 may be enlisted by police or local sheriffs' departments to test compliance if the testing is under the direct supervision of that law enforcement department and written parental consent is provided; provided further, that the Department of Health and Human Services shall have the authority, pursuant to a written plan prepared by the Secretary of Health and Human Services, to use persons under 18 years of age in annual, random, unannounced inspections, provided that prior written parental consent is given for the involvement of these persons and that the inspections are conducted for the sole purpose of preparing a scientifically and methodologically valid statistical study of the extent of success the State has achieved in reducing the availability of tobacco products to persons under the age of 18, and preparing any report to the extent required by section 1926 of the federal Public Health Service Act (42 USC § 300x-26). (e) Statewide uniformity. - It is the intent of the General Assembly to prescribe this uniform system for the regulation of tobacco products and cigarette wrapping papers to ensure the eligibility for and receipt of any federal funds or grants that the State now receives or may receive relating to the provisions of G.S. 14-313. To ensure uniformity, no political subdivisions, boards, or agencies of the State nor any county, city, municipality, municipal corporation, town, township, village, nor any department or agency thereof, may enact ordinances, rules or regulations concerning the sale, distribution, display or promotion of (i) tobacco products or cigarette wrapping papers on or after September 1, 1995, or (ii) tobacco- derived products or vapor products on or after August 1, 2013. This subsection does not apply to the regulation of vending machines, nor does it prohibit the Secretary of Revenue from adopting rules with respect to the administration of the tobacco products taxes levied under Article 2A of Chapter 105 of the General Statutes. (f) Deferred Prosecution or Conditional Discharge. - Notwithstanding G.S. 15A- 1341(al) or G.S. 15A-1341(a4), any person charged with a misdemeanor under this section shall be qualified for deferred prosecution or a conditional discharge pursuant to Article 82 of Chapter 15A of the General Statutes provided the defendant has not previously been placed on probation for a violation of this section and so states under oath. (1891, c. 276; Rev., s. 3804; C.S., s. 4438; 1969, c. 1224, s. 3; 1991, c. 628, s. l; 1993, c. 539, s. 216; 1994, Ex. Sess., c. 24, s. 14(c); 1995, c. 241, s. l; 1997-434, ss. 1-6; 1997-443, s. 11A.118(a); 2001-461, s. 5; 2002- 159, s. 5; 2005-350, s. 6(b); 2013-165, s. l; 2014-119, s. 2(c).) lAttachment 2 6 r oi::::' I CIE.i..Aii ri i & I IUMAN SI:..:..]RVIQII:..:..S Public Health Seirvice . ..................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................... Ceinteirs foir E.' isease Control aind Pireveinfloin (C[)C) Aflainta GA 30341 3724 April 5, 2013 Re: State Preemption of Local Authority to Engage in Evidence-Based Tobacco Control Policies Tobacco use is the leading preventable cause of death and disease in the United States [1]. Cigarette smoking and exposure to secondhand smoke are responsible for approximately 443,000 deaths each year in this country [I]. In addition, for every person who dies of a smoking-related disease, another 20 persons are living with a serious chronic disease caused by smoking [1]. Smoking also imposes a major economic burden on society, costing the nation $96 billion each year in medical expenses and another $97 billion annually in lost productivity [I]. In North Carolina, an average of over 12,200 adults died from smoking-related diseases each year from 2000-2004[1]. North Carolina ranks 38th among states in its smoking-related death rate [I]. In North Carolina, smoking is responsible for almost $2.7 billion in personal health care expenditures and over $3.5 billion in lost productivity [2]. About 17 percent of North Carolina adults and about 18 percent of North Carolina high school students are current smokers [2]. The scientific evidence, based on numerous studies and evaluations of tobacco control programs and initiatives in the United States and other countries, shows that the most effective way to reduce tobacco use and secondhand smoke exposure is through a comprehensive approach that combines educational, clinical, regulatory, economic, and social strategies [3,4]. The objectives of such an approach include promoting changes in social norms that discourage smoking and encourage quitting, motivating tobacco users to try to quit and helping them do so successfully, preventing initiation of tobacco use by youth and young adults, eliminating secondhand smoke exposure, and eliminating tobacco-related population disparities [3,4]. Research has shown that policy interventions play a central role in this process [3,4,5]. These policies include laws eliminating smoking in workplaces and public places [3,4,5]. Secondhand smoke causes premature death and disease in children and nonsmoking adults [6]. Specifically, secondhand smoke exposure causes heart disease and lung cancer in nonsmoking adults and a number of serious health conditions in children, including sudden infant death syndrome, acute respiratory infections, ear infections, and more severe asthma [6]. The Surgeon General has concluded that there is no risk-free level of exposure to secondhand smoke [6]. Only eliminating smoking in indoor spaces fully protects nonsmokers from secondhand smoke [6]. Despite recent progress in reducing secondhand smoke exposure in this country, two in five U.S. nonsmokers, including more than half of children, continue to be exposed [7]. Comprehensive smoke-free policies that completely eliminate smoking in indoor workplaces and public places, including restaurants and bars, have been found to reduce secondhand smoke exposure among nonsmokers, to prevent heart attack hospitalizations, to help smokers quit, and to reduce respiratory and sensory symptoms and improve lung function among restaurant and bar workers [6,8,9]. 7 The strongest, most innovative, and most effective tobacco control policies have most often originated at the local level [3,6,10,11]. This is especially true in the area of smoke-free policy [3,6,10,11]. Smoke-free policies have often been adopted at the state level only after being implemented in a critical mass of communities within a state [6]. In other words, communities have played the role of innovators, adopting and implementing important public health policies and demonstrating that they are feasible and effective [3,6,11]. In addition, local smoke-free policies are especially effective in changing public attitudes towards tobacco use in ways that discourage youth from initiating use and encourage adult tobacco users to quit [3,4,6,11]. This is true because these policies change environmental and social cues in the everyday community settings where people live, work, and play [3,4,6,11]. Preemptive legislation at the state level prevents this from happening [3,6,10,12,13,14,15]. State preemption prohibits communities from enacting laws that are more stringent than or that vary from state law [12,13,14,15]. Instead of setting the floor for community public health protections, preemptive state laws impose a ceiling on these protections [12,13,14,15]. This prevents communities that wish to provide their residents with a higher level of public health protection from doing so [12,13,14,15]. Preemption also prevents communities from tailoring policies to fit local conditions and needs [12,13,14,15]. In addition,preemption prevents communities from going through the process of debating proposed local tobacco control policies, a process which itself educates residents about tobacco issues and changes public attitudes, independent of the policies themselves [12,13,14,15]. Besides depriving communities of the opportunity to experience the benefits of local tobacco control policies,preemption prevents communities from documenting these benefits —a step which often leads to the adoption of similar policies in other communities and, ultimately, at the state level. A number of authoritative scientific reports have highlighted the negative impact of preemptive state laws on local public health protections. For example, the Guide to Community Preventive Services concluded that"In many states, preemption is a major barrier to the implementation of effective tobacco prevention policies and programs. It is a direct obstacle to the adoption of local clean indoor air ordinances and to local efforts to restrict youth access to tobacco products from commercial sources" [10]. Similarly, the 2000 Surgeon General's Report on Reducing Tobacco Use found that "A local strategy can usually impose more stringent smoking restrictions than statewide legislation does" [3]. In recognition of the damaging effects of preemption and the importance of community tobacco control policies, both the Healthy People 2010 and the Healthy People 2020 objectives, which are developed by the Department of Health and Human Services to set the national public health agenda for each decade, include an objective calling for the elimination of all state laws that preempt local tobacco control policies [16]. 8 Internal tobacco industry documents show that starting in the early 1990s the tobacco industry recognized the important role played by local tobacco control policymaking and sought to block it by promoting enactment of state legislation preempting local action in some or all tobacco control policy areas [6,12,15]. For example, an internal industry document states that a Tobacco Institute priority for 1993 was to "encourage and support statewide legislation preempting local laws, including smoking, advertising, sales, and vending restrictions" [12]. A total of 31 states incorporated preemptive provisions in their tobacco control laws from 1982 through September 1998 [12]. During the past decade, as the public health community became aware of the damaging impact of state preemption laws, the number of new laws of this type fell sharply [14]. Eight states have rescinded provisions preempting local ordinances restricting smoking in workplaces and public places through legislative action, ballot measures, or state court rulings [14]. As a result, the number of states that preempt local smoking restrictions decreased from 18 at the end of 2000 to 12 at the end of 2010 [2,14]. However, 18 states still preempt local advertising restrictions and 22 states still preempt local youth access restrictions [2]. A total of 27 states preempt local restrictions in any of these three policy areas —local restrictions on smoking, advertising, and youth access [2]. North Carolina is one of only seven states that preempt local action in all three of these policy areas [2]. North Carolina also preempts local smoke-free air policies in private worksites, though not in restaurants, government worksites, or bars [2]. An example of the public health effect of rescinding preemption is provided by Illinois. In 2005, the Illinois Legislature passed legislation repealing a provision in state law preempting local smoking restrictions, effective January 1, 2006 [17]. During the next year, 36 Illinois communities adopted smoking restrictions [17]. Building on this local progress, in 2007 the Illinois Legislature enacted a comprehensive statewide law making workplaces and public places, including restaurants and bars, smoke-free, effective January 1, 2008 [17]. In summary, local restrictions on smoking in workplaces and public places, on advertising, and on youth access have played an important role in changing community social norms, reducing tobacco use and exposure to secondhand smoke, advancing our understanding of effective tobacco control interventions, and laying the groundwork for adoption of important tobacco control policies at the state level. State laws preempting local policy action prevent communities, states, and their residents from realizing these benefits and retard progress toward full adoption of comprehensive, evidence- based tobacco control interventions. This is especially true when these laws preclude local action in all three major local policy areas. Thank you for your interest in this important public health issue. Please let us know if you would like CDC to provide additional information regarding the evidence base for effective tobacco control interventions. Since y, Ti McAM.P.H. Director, Oking and Health National Conic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention 4770 Buford Hwy, MS K-50 Atlanta, Georgia 30341 9 References 1. CDC. Tobacco control state highlights, 2012. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. 2. Centers for Disease Control and Prevention. State Tobacco Activities Tracking and Evaluation System. Available at http://www.cdc.�zov/tobacco/statesystem 3. U.S. Department of Health and Human Services. Reducing tobacco use: a report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000. 4. Centers for Disease Control and Prevention. Best practices for comprehensive tobacco control programs---2007. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2007. 5. World Health Organization. WHO report on the global tobacco epidemic, 2008--the MPOWER package. Geneva, Switzerland: World Health Organization; 2008. 6. U.S. Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke:A report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006. 7. CDC. Vital signs: nonsmokers' exposure to secondhand smoke-United States, 1999-2008. MMWR 2010;59:1141-46. 8. International Agency for Research on Cancer. IARC Handbooks of Cancer Prevention, Tobacco Control, Vol. 13: Evaluating the effectiveness of smoke free policies. Lyon, France. World Health Organization Press, 2009. 9. Institute of Medicine. Secondhand smoke exposure and cardiovascular effects: making sense of the evidence. Washington, DC: The National Academies Press, 2010. 10. The Task Force on Community Preventive Services. The guide to community preventive services: what works to promote health? New York, New York: Oxford University Press, 2005. 11. National Cancer Institute. State and local legislative action to reduce tobacco use. Smoking and Tobacco Control Monograph No. 11. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute, 2000. htlp://dccps.nci.nih.gov/TCRB/monogrqphs/11/monogrqph 11.pdf 12. Centers for Disease Control and Prevention. Preemptive state tobacco-control laws--United States, 1982-1998. MMWR 1999;47:1112-1114. 13. Centers for Disease Control and Prevention. State laws on tobacco control---United States, 1998. MMWR 1999b;48(SS03):21-62. 14. Centers for Disease Control and Prevention. State preemption of local smoke-free laws in government work sites,private work sites, and restaurantsU.S., 2005-2009. MMWR 2010;59:105-108. 15. Hobart R (2003). Preemption: Taking the local out of tobacco control-- Updated Edition. Chicago, Illinois: American Medical Association, Smokeless States National Policy Initiative. 16. See http://www.healthypeople.gov/ 17. Callaway C, Champagne B, Jo C, Sebrie E. Preemption of smokefree policies. i Attachment 10 trim ., `. Improving health. Inspiring change. I RESOLUTION REQUESTING THAT THE NORTH CAROLINA GENERAL ASSEMBLY RESCIND PREEMPTION OF TOBACCO REGULATION, INCLUDING ELECTRONIC CIGARETTES, AND THEREFORE RESTORE LOCAL CONTROL OVER TOBACCO POLICIES WHEREAS, the health consequences of smoking are staggering, and there is irrefutable evidence that tobacco use causes cancer, respiratory and cardiac diseases, infertility, negative birth outcomes, irritations to the eyes, nose and throat (U.S. Department of Health and Human Services, 2014); and WHEREAS, the economic losses in health care expenditures are equally important and the use of tobacco products cost the U.S. as much as $170 billion in health care expenditures each year (Xu, Bishop, Kennedy, Simpson, & Pechacek, 2014); and WHEREAS, nearly 90% of all smokers begin smoking before the age of eighteen (Centers for Disease Control and Prevention , 2014); and I WHEREAS, in North Carolina, 1 in every 10 middle school students is a current tobacco user and 3 in every 10 high school students is a current tobacco user; and i WHEREAS, in North Carolina, 8,676 middle school students currently smoke cigarettes; and 55,688 high school students currently smoke cigarettes; (North Carolina Tobacco Prevention and Control Branch ); and WHEREAS, there is supportive evidence that increasing the minimum legal age of purchase to 21 will save more lives, reduce initiation among adolescents and young adults, and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children (Institute of Medicine, 2015); and WHEREAS, we believe in the need to educate and empower youth about the harmful effects of tobacco use and prohibit these incidences of purchase until the conscious age of 21 years; and WHEREAS, penalties included in G.S 14-313 Youth access to tobacco products, tobacco-derived products, vapor products, and cigarette wrapping papers would remain the same; and i WHEREAS, in recognition of the damaging effects of preemption and the importance of community tobacco control policies, both the Healthy People 2010 and the Healthy People 2020 objectives, which are developed by the Department of Health and Human Services to set the national public health agenda for each decade, include an objective calling for the elimination of all state laws that preempt local tobacco control policies (U.S. Department of Health and Human Services, 2013). THEREFORE BE IT RESOLVED, the Orange County Board of Health requests that the North Carolina General Assembly restore local control over tobacco policies by rescinding preemption; therefore, granting Orange County the legal authority to protect residents from known public health threats by enacting innovative, evidence-based policies such as an increase in the minimum sale age of tobacco products from 18 to 21. The lifting of preemption reinstates local capacity to develop public policy and revitalizes community debate, education and empowerment. 919 245 2400 0. 300 West Tryon Street A� Hillsborough, NC 27278 > orangecountync.gov I i 11 i FURTHER BE IT RESOLVED, that we also call on other Boards of Health to request the restoration of local control over tobacco policies so as to better help prevent youth initiation. o Susan Elmore, Chair Colleen Bridger, MPH, PhD Orange County Board of Health Orange County Health Director i References C Centers for Disease Control and Prevention. (2014, February 14). Smoking and Tobacco Use . Retrieved January 8, 2015, from Youth and Tobacco Use http://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco use/ Institute of Medicine. (2015). Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington, DC: The National Academies Press. North Carolina Tobacco Prevention and Control Branch. (n.d.). North Carolina Youth Tobacco Survey: Middle and High School Fact Sheet. U.S. Department of Health and Human Services. (2013, April 5). State Preemption of Local Authority to Engage in Evidence-Based Tobacco Control Policies. Retrieved March 17, 2015, from NC Alliance for Health: http://www.ncallianceforhealth.org/Media/Tobacco/North%20Carolina%20preemptio n%20LOE%204%2015%202013.pdf U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking-- 50 years of Progress:A Report by the Surgeon General. Rockville: U.S. Department of Health and Human Services. Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2014). Annual Healthcare Spending Attributable to Cigarette Smoking. American Journal of Preventative Medicine, 48(3):326-33. i I 919 245 2400 ;0 300 West Tryon Street )O� Hillsborough, NC 27278 >, orangecountync.gov RES-2015-036 Attachment 4 12 ORANGE COUNTY BOARD OF COMMISSIONERS RESOLUTION REQUESTING THAT THE NORTH CAROLINA GENERAL ASSEMBLY RESCIND PREEMPTION OF TOBACCO REGULATION, INCLUDING ELECTRONIC CIGARETTES, AND THEREFORE RESTORE LOCAL CONTROL OVER TOBACCO POLICIES WHEREAS, the health consequences of smoking are staggering, and there is irrefutable evidence that tobacco use causes cancer, respiratory and cardiac diseases, infertility, negative birth outcomes, irritations to the eyes, nose and throat (U.S. Department of Health and Human Services, 2014); and WHEREAS, the economic losses in health care expenditures are equally important and the use of tobacco products cost the U.S. as much as $170 billion in health care expenditures each year (Xu, Bishop, Kennedy, Simpson, & Pechacek, 2014); and WHEREAS, nearly 90% of all smokers begin smoking before the age of eighteen (Centers for Disease Control and Prevention , 2014); and WHEREAS, in North Carolina, 1 in every 10 middle school students is a current tobacco user and 3 in every 10 high school students is a current tobacco user; and WHEREAS, in North Carolina, 8,676 middle school students currently smoke cigarettes; and 55,688 high school students currently smoke cigarettes; (North Carolina Tobacco Prevention and Control Branch ); and WHEREAS, there is supportive evidence that increasing the minimum legal age of purchase to 21 will save more lives, reduce initiation among adolescents and young adults, and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children (Institute of Medicine, 2015); and WHEREAS, we believe in the need to educate and empower youth about the harmful effects of tobacco use and prohibit these incidences of purchase until the conscious age of 21 years; and WHEREAS, penalties included in G.S 14-313 Youth access to tobacco products, tobacco-derived products, vapor products, and cigarette wrapping papers would remain the same; and WHEREAS, in recognition of the damaging effects of preemption and the importance of community tobacco control policies, both the Healthy People 2010 and the Healthy People 2020 objectives, which are developed by the Department of Health and Human Services to set the national public health agenda for each decade, include an objective calling for the elimination of all state laws that preempt local tobacco control policies (U.S. Department of Health and Human Services, 2013). NOW THEREFORE BE IT RESOLVED THAT the Orange County Board of Commissioners joins with the Orange County Board of Health to request that the North Carolina General Assembly restore local control over tobacco policies by rescinding preemption; therefore, granting Orange County the legal authority to protect residents from known public health threats by enacting innovative, evidence-based policies such as an increase in the minimum sale age of tobacco products from 18 to 21. The lifting of preemption reinstates local capacity to develop public policy and revitalizes community debate, education and empowerment. BE IT FURTHER RESOLVED that we also call on other Boards of Commissioners to request the restoration of local control over tobacco policies so as to better help prevent youth initiation. This the 16th Day of June 2015. Earl McKee, Chair Orange County Board of Commissioners 13 References Centers for Disease Control and Prevention. (2014, February 14). Smoking and Tobacco Use . Retrieved January 8, 2015, from Youth and Tobacco Use : http://www.cdc.gov/tobacco/data—statistics/fact—sheets/youth—data/tobacco—use/ Institute of Medicine. (2015). Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington, DC: The National Academies Press. North Carolina Tobacco Prevention and Control Branch. (n.d.). North Carolina Youth Tobacco Survey: Middle and High School Fact Sheet. U.S. Department of Health and Human Services. (2013, April 5). State Preemption of Local Authority to Engage in Evidence-Based Tobacco Control Policies. Retrieved March 17, 2015, from NC Alliance for Health: http://www.ncalIianceforhealth.org/Media/Tobacco/North%20Carolina%20preemptio n%20 LO E%204%2015%202013.pdf U.S. Department of Health and Human Services. (2014). The Health Consequences of Smoking-- 50 years of Progress:A Report by the Surgeon General. Rockville: U.S. Department of Health and Human Services. Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2014). Annual Healthcare Spending Attributable to Cigarette Smoking. American Journal of Preventative Medicine, 48(3):326-33.