We dedicate this report to our HEROES survivors, patients, and caregivers whose lives have been touched by lung disease

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2 We dedicate this report to our HEROES survivors, patients, and caregivers whose lives have been touched by lung disease LUNG-USA

3 TABLE OF CONTENTS EXECUTIVE SUMMARY... 4 GRADES FOR TOP TEN CITIES IN CALIFORNIA... 7 TOP OF THE CLASS... 8 CITIES AND COUNTIES ON THE RISE CALIFORNIA TOBACCO CONTROL BY THE NUMBERS EMERGING PRODUCT: ELECTRONIC CIGARETTES RAISE YOUR GRADE LOCAL GRADING METHODOLOGY APPENDIX A: LIST OF MUNICIPALITIES THAT REGULATE ELECTRONIC CIGARETTES Grades ALAMEDA COUNTY ALPINE COUNTY AMADOR COUNTY BUTTE COUNTY CALAVERAS COUNTY COLUSA COUNTY CONTRA COSTA COUNTY DEL NORTE COUNTY EL DORADO COUNTY FRESNO COUNTY GLENN COUNTY HUMBOLDT COUNTY IMPERIAL COUNTY INYO COUNTY KERN COUNTY KINGS COUNTY LAKE COUNTY LASSEN COUNTY LOS ANGELES COUNTY MADERA COUNTY MARIN COUNTY MARIPOSA COUNTY MENDOCINO COUNTY MERCED COUNTY MODOC COUNTY MONO COUNTY MONTEREY COUNTY NAPA COUNTY NEVADA COUNTY ORANGE COUNTY PLACER COUNTY PLUMAS COUNTY RIVERSIDE COUNTY SACRAMENTO COUNTY SAN BENITO COUNTY SAN BERNARDINO COUNTY SAN DIEGO COUNTY SAN FRANCISCO COUNTY SAN JOAQUIN COUNTY SAN LUIS OBISPO COUNTY SAN MATEO COUNTY SANTA BARBARA COUNTY SANTA CLARA COUNTY SANTA CRUZ COUNTY SHASTA COUNTY SIERRA COUNTY SISKIYOU COUNTY SOLANO COUNTY SONOMA COUNTY STANISLAUS COUNTY SUTTER COUNTY TEHAMA COUNTY TRINITY COUNTY TULARE COUNTY TUOLUMNE COUNTY VENTURA COUNTY YOLO COUNTY YUBA COUNTY American Lung Association in California 3

4 EXECUTIVE SUMMARY The American Lung Association State of Tobacco Control 2015 report tracks progress on key tobacco control policies at the state and federal levels. The report assigns grades to every state in four key areas: Tobacco Prevention and Control Program Funding, Smokefree Air, Tobacco Taxes and Access to Cessation Services. This year, state grades were calculated using a revised national methodology that captures policy improvements made in these core areas. The grades are based on tobacco control laws and regulations in effect as of January 2, Once a proactive leader of tobacco control efforts, California is at a crossroads regarding tobacco policies in the state. With an increasingly difficult climate at the State Capitol, advances in California-wide tobacco policies have stagnated, while other states have taken considerably more actionable steps toward reducing tobacco use. Previously a leader in the area of Smokefree Air, California is now surpassed by 23 other states and the District of Columbia. In fact, the new national methodology more precisely addresses California s failure to close its loopholes in the smokefree workplace laws. This leaves approximately 1.5 million California workers at risk of exposure to secondhand smoke in their place of employment. California also saw its Tobacco Tax grade drop to an F, which, at $0.87, ranks 33rd in the nation. Combined with its F grade in the area of Tobacco Prevention and Control Program Funding, it s clear that state policies need attention if California is to regain its footing as a national leader in tobacco control. As a pediatric asthma physician, I see the daily impact that tobacco has on the health of children as well as residents in my community. The dangerous effects of tobacco use, including the risk of asthma and lung cancer, have been well documented by the U.S. Surgeon General. I am excited and proud to see the steps that multiple communities around California have taken to fight tobacco and its devastating impact. We must continue to encourage communities to adopt these proven policies to address the number one preventable cause of death, tobacco. Sonal Patel, MD, Pediatric asthma physician, Los Angeles In contrast, local cities and counties in California have enacted strong policies in tobacco control over this same period. In coordination with the national report, the American Lung Association in California releases its State of Tobacco Control 2015 California Local Grades report to track how well California municipalities protect their citizens from the burden of tobacco. The report is based on a review of county and municipal codes in four key areas for all 58 counties (which cover the unincorporated areas of the county) and 482 incorporated cities and towns in the state. Since the first statewide report, the number of communities with an overall A or B grade has increased dramatically. While poor state grades reflect important issues that California should address, there is much that can be done locally. Millions of people in California are still affected by tobacco, tens of thousands of youth in California become smokers each year and untold numbers of Californians are impacted by secondhand smoke. Leadership on key issues and solutions to these difficult problems can come from every level of government. Local elected officials can, and should, take steps to protect residents of their communities from tobacco and secondhand smoke by passing policies to restrict smoking in parks and other outdoor areas, require multi-unit housing to be smokefree and prevent illegal sales of tobacco products to youth. The purpose of the State of Tobacco Control 2015 California Local Grades report is to increase public knowledge about local laws that protect residents from the deadly toll of tobacco and to encourage local leadership to take action where improvement is needed. Grades are not intended to reflect the efforts of local tobacco control coalitions, the broader public health community or organizations working to advance local tobacco control policies. Instead, responsibility for enacting these life- and revenue-saving policies falls to elected officials in each community LUNG-USA

5 METHODOLOGY UPDATE Since this report was first released six years ago, the same methodology has been used for grading local cities and counties. This year, the features a new, updated grading methodology. The updated grading methodology reflects best practices as communities adopt stronger, more health-protective policies that will improve the wellbeing of California residents. In this report, grades are awarded in three categories: Smokefree Outdoor Air; Smokefree Housing; and Reducing Sales of Tobacco Products. Bonus points are provided in a new fourth category: Emerging Issues. These three grades, plus the new bonus point category, are used to calculate one Overall Tobacco Control grade. (See page 21 for more details.) The most significant change to the grading methodology is in the Smokefree Housing section, an issue area that was just emerging six years ago. The intervening years have seen a fair amount of policymaking and learning in this area, and the section is now more accurately based on the strong policies being passed throughout the state that are effectively improving the public health of those living in multi-unit housing. The new methodology differentiates between new and existing units, as well as apartments and condominiums, and there is a 75% threshold to be awarded points in this area. The Reducing Sales of Tobacco Products grade is now solely based on Tobacco Retailer Licensing because this is the most effective way to reduce youth access to these products. Prior methodology was similar, however, there were bonus points which have now moved into Emerging Issues to capture new and expanded policy areas being addressed. The new section, Emerging Issues, reflects issues and policies that are difficult to pass such as emerging products definitions and a ban on flavored tobacco products. A jurisdiction must have four points in this section in order to add one bonus point to their Overall Tobacco Control Grade. Our city was concerned about not having any secondhand smoke protections for our residents. The State of Tobacco Control report allowed us to identify where we could add protections and create safer environments for our community members. As a result, we added comprehensive secondhand smoke restrictions in outdoor spaces, apartment buildings and condominiums, protecting many of our El Cerrito residents. Our grades went from F s to A s and I know that other cities and counties can do the same. Mark Friedman, El Cerrito Mayor American Lung Association in California 5

6 HIGHLIGHTS OF THE REPORT 40 CITIES AND COUNTIES RAISED THEIR POINTS IN 2014 In 2014, 40 municipalities adopted local ordinances in at least one of the three graded categories included in the report. Elected officials in these cities and counties demonstrated great leadership in adopting policies to protect their residents and improving the health of their communities. Policies passed in 2014 include 13 ordinances to prohibit smoking in multi-unit housing, 31 ordinances to restrict smoking in outdoor areas and six ordinances that require tobacco retailers to obtain a license to sell tobacco products. See the Cities and Counties on the Rise section of the report (page 11) for the full list of municipalities that passed policies in CITIES IMPROVED THEIR GRADE FROM AN F TO AN A IN AT LEAST ONE POLICY CATEGORY Culver City, Foster City, Gilroy, Goleta, Healdsburg, Monterey, Morgan Hill, Oakley, Piedmont and Rancho Cordova improved their grade from an F to an A in at least one category in These cities have displayed strong leadership by passing robust tobacco control ordinances in at least one category. One additional city, El Cerrito, improved from an F to an A in two categories Smokefree Outdoor Air and Smokefree Housing resulting in an overall B grade. SMOKEFREE RECREATION AREAS POLICIES NOW PROTECT 80% OF CALIFORNIANS Cities and counties have been very active in passing policies that protect their residents from secondhand smoke in outdoor settings. Specifically, in 2014, 20 communities passed policies restricting smoking at parks, beaches, trails and other similar recreation areas, joining the other 328 cities and counties that represent 80 percent of California s total population. Furthermore, policies in service areas have tripled in comparison to two years ago, as communities restricted smoking in outdoor locations where people stand or wait in-line for services. Also, cities and counties continued their consistent growth by restricting smoking in outdoor dining areas at restaurants and bars, now covering about 40 percent of the total population in California. In September 2012 after a lung biopsy, I was told that I had an incurable lung disease called bronchiolitis obliterans. While this disease has physically slowed me down and my ability to do some of the everyday things I once enjoyed, like swimming, walking, going to the beach, or even climbing the bleachers at my daughter s soccer and cheer events, I do not want it to define who I am and how I live my life. I will continue to live life to the fullest and enjoy every moment, and I am aided in this when cities and counties pass strong policies that protect my right to breathe clean air. Jill Arteaga, LUNG FORCE Hero LOCAL REGULATION OF ELECTRONIC CIGARETTES IS EXPANDING Cities and counties across California are taking steps to protect children from new and emerging tobacco products. One such product that has seen an increase in use and advertising is electronic cigarettes, or e-cigarettes. In 2014, the number of cities and counties that have implemented secondhand smoke and tobacco retailer licensing policies which incorporate e-cigarettes has climbed from 94 cities and counties to 169 municipalities today. This equates to over 40 percent of the total state population being covered by e-cigarette policies (See page 15). PROHIBITING TOBACCO SALES IN PHARMACIES INCREASED After holding steady in this area over the past two years, 2014 saw several municipalities take action to restrict pharmacies from selling tobacco products in their communities. Berkeley, Healdsburg and Marin all exhibited strong leadership in passing these policies, recognizing that pharmacies are wellness and health resources, and shouldn t encourage smoking in consumers and patients who may be most at-risk from using these products. NEARLY TWO-THIRDS OF ALL MUNICIPALITIES STILL RECEIVE AN F GRADE Despite the fact that many cities and counties adopted strong tobacco control policies this past year, a majority of cities and counties in California still fail to protect their residents from the dangers of tobacco use. In total, 323 municipalities (60 percent of all municipalities) receive an F for their Overall Tobacco Control grade LUNG-USA

7 GRADES FOR TOP TEN CITIES IN CALIFORNIA The ten most populous cites in California account for 25 percent of the state s population. Strong tobacco control laws in these cities can make a big difference in protecting more than a quarter of California s residents from secondhand smoke and other dangers of tobacco. In 2014, Los Angeles improved its Smokefree Outdoor Air grade by restricting smoking in entryways that are within a certain distance of doors, windows and other openings. Anaheim also regulated electronic cigarettes in its secondhand smoke laws, although their grade or points did not increase. It should be noted, however, that the majority of the most populous cities have yet to take much action in the area of Smokefree Housing a concern given the population density and need for multi-unit housing in these areas. Below is a table showing the grades for the ten most populous cities in California. Top Ten Cities in California by Population Overall Tobacco Control Smokefree Outdoor Air Smokefree Housing Reducing Sales of Tobacco Products 1. Los Angeles (Population: 3,904,657) C C F A 2. San Diego (Population: 1,345,895) D D F B 3. San Jose (Population: 1,000,536) B B C B 4. San Francisco (Population: 836,620) B B D A 5. Fresno (Population: 515,609) F D F F 6. Sacramento (Population: 475,122) C D F A 7. Long Beach (Population: 470,292) C C D A 8. Oakland (Population: 404,355) B B C A 9. Bakersfield (Population: 367,315) F F F F 10. Anaheim (Population: 348,305) F F F F * Population numbers from State of California, Department of Finance, E-1 Population Estimates for Cities and Counties. Sacramento, CA, January 1, 2013 and Once again this year, local communities have risen to the challenge to enact strong policies that protect children and their families from secondhand smoke and tobacco products. These are important, lifesaving policies, and we encourage more elected officials to follow these examples and bring us one step closer to eliminating lung cancer and other tobacco-related diseases. Olivia J. Gertz, President & CEO of the American Lung Association in California American Lung Association in California 7

8 TOP OF THE CLASS This year, there are 13 cities or counties that received an Overall Tobacco Control Grade of A. These communities across California are a diverse mix in many aspects, demonstrating that support for tobacco control exists in all types of communities. These jurisdictions are of every size and are spread geographically throughout the state. They have populations as low as 53,462 (Dublin) and as high as 195,799 (Glendale). Six jurisdictions are located in the south (Baldwin Park, Compton, Glendale, Huntington Park, Pasadena, and Santa Monica) and seven are located in the north (Berkeley, Dublin, Richmond, Marin, Santa Clara, San Rafael, and Union City). In addition, these cities and counties have varying levels of income and ethnic diversity. The cities and counties range from predominantly white, to predominately Latino. The graphs below show a comparison of all 13 municipalities in the areas of Ethnicity, Latino Origin, Median Income, and Population. ETHNICITY: The graph below shows the ethnic breakdown of each of the 13 jurisdictions. Each municipality varies in its ethnic breakdown, from Union City, with a reported 50.9% Asian population, to Compton, with a 32.9% African American population (for information on Latino Origin, see Latino Origin below). Diverse communities across the state support tobacco control policies. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Baldwin Park Berkeley Compton Dublin Glendale Huntington Park Marin Pasadena Richmond San Rafael Santa Clara Santa Monica Union City Caucasian African American American Indian and Alaska Native Asian American Native Hawaiian and Pacific Islander The local policy in Berkeley has been a miracle in our building. The apartment corridors used to be full of secondhand smoke and since the adoption of the new smokefree housing law, this has become a rare experience today. Some of our residents have decreased the amount they smoke and several have quit smoking entirely. The impact of the policy plus the No Smoking signage around the building has been effective in changing behavior and greatly reducing the secondhand smoke exposure for everyone. Carol Denney, Berkeley Resident LUNG-USA

9 LATINO ORIGIN: Because of the way in which the census is conducted, information on Latino Origin is collected separately from other racial demographics. The graph below depicts the percent of residents who are Latino in the cities and counties with an A grade. These municipalities range from predominantly Latino communities, such as Huntington Park with a population of 97.1% of Latino Origin, to communities with very low numbers of residents with Latino Origin, such as Berkeley (10.8%). Latino Origin, much like ethnicity, varies among the highest graded cities, demonstrating support from a diverse group of constituents. 100% Latino Origin 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Baldwin Park Berkeley Compton Dublin Glendale Huntington Park Marin Pasadena Richmond San Rafael Santa Clara Santa Monica Union City American Lung Association in California 9

10 MEDIAN INCOME: The graph below shows the median income for the 13 municipalities with overall A grades. These jurisdictions fall at all levels of the income scale, from wealthier communities such as Dublin ($113,936) to less affluent communities such as Compton ($40,876) and Huntington Park ($34,395). There is no correlation between a community s median income and its ability to pass and implement tobacco control policies. $ Median Income $ $ $80000 $60000 $40000 $20000 $0 Baldwin Park Berkeley Compton Dublin Glendale Huntington Park Marin Pasadena Richmond San Rafael Santa Clara Santa Monica Union City POPULATION: The graph below compares the population size of the 13 cities and counties that receive overall A grades. It is clear from the graph that jurisdictions with populations of all sizes have implemented tobacco control policies. Glendale, with a population of 195,799, has the largest population of this group, while the city of Dublin, with a population of 53,462, has the smallest. The difference in population has not affected the ability to implement strong tobacco control policies Population Baldwin Park Berkeley Compton Dublin Glendale Huntington Park Marin Pasadena Richmond San Rafael Santa Clara Santa Monica Union City *The demographic information is collected from the 2010 census, and details median income, race (White, Black, American Indian and Alaska Native, Asian, and Native Hawaiian and Pacific Islander) as well as Hispanic Origin (which could include any of the previously mentioned races). Income projections are taken from the American Community Survey year estimates. Population numbers from State of California, Department of Finance, E-1 Population Estimates for Cities and Counties. Sacramento, CA, January 1, LUNG-USA

11 CITIES AND COUNTIES ON THE RISE Cities and counties that have taken any policy action during 2014 toward raising their grades deserve special recognition. These 40 Cities and Counties on the Rise passed ordinances in at least one of the three main policy categories this past year. In most cases, their actions improved their grade, but in some, the ordinance(s) only contributed to increasing the points in the particular grade category. Either way, these policies are noteworthy and deserve acknowledgement. Below are the 2015 Cities and Counties on the Rise, which are listed along with the grade categories in which they passed a policy. The full list of cities and counties that have passed ordinances which regulate the sale and use of electronic cigarettes may be located in the Appendix on page 29. For further details about each municipality s grades and points, including their Overall Tobacco Control grade, see the county report cards that begin on page 35. Ensuring that children are not exposed to the harmful effects of secondhand smoke is a priority in Buena Park. That is why we joined the 347 other communities in California and passed a policy that would prohibit smoking in the city s recreation areas. This is an important step to preserving the health of our children and our community. Art Brown, Mayor of Buena Park Municipality Grade Category For 2014 Policy (Points Improvement) American Canyon Smokefree Outdoor Air (F to D) Apple Valley Smokefree Outdoor Air (F to D) Arvin Smokefree Outdoor Air (F to D) Berkeley Smokefree Outdoor Air (increased points, grade remains A) Beverly Hills Smokefree Outdoor Air (C to B) Biggs Smokefree Outdoor Air (increased points, grade remains F) Buena Park Smokefree Outdoor Air (F to D) Burlingame Smokefree Outdoor Air (D to C) Corte Madera Smokefree Outdoor Air (D to B), Smokefree Housing (F to B) Culver City Smokefree Housing (F to A) Cupertino Smokefree Outdoor Air (D to C) El Cerrito Smokefree Outdoor Air (F to A), Smokefree Housing (F to A) Folsom Smokefree Outdoor Air (F to C), Smokefree Housing (D to C) Foster City Smokefree Outdoor Air (F to A), Smokefree Housing (D to A) Gilroy Reducing Sales of Tobacco Products (F to A) American Lung Association in California 11

12 Municipality Grade Category For 2014 Policy (Points Improvement) Goleta Smokefree Outdoor Air (F to C), Smokefree Housing (F to D), Reducing Sales of Tobacco Products (F to A) Hawaiian Gardens Smokefree Outdoor Air (F to D) Hayward Reducing Sales of Tobacco Products (D to A) Healdsburg Reducing Sales of Tobacco Products (F to A) La Canada Flintridge Smokefree Outdoor Air (F to C) Lafayette Smokefree Housing (C to B) Laguna Niguel Smokefree Outdoor Air (F to D) Lawndale Smokefree Outdoor Air (F to D) Lompoc Smokefree Outdoor Air (F to D) Los Angeles Smokefree Outdoor Air (D to C) Mammoth Lakes Smokefree Housing (D to C) Manhattan Beach Smokefree Outdoor Air (D to A) Monterey Reducing Sales of Tobacco Products (F to A) Morgan Hill Reducing Sales of Tobacco Products (F to A) Norwalk Smokefree Outdoor Air (F to D) Oakley Smokefree Outdoor Air (F to A), Smokefree Housing (F to C) Pasadena Smokefree Outdoor Air (increased points, grade remains A) Piedmont Smokefree Outdoor Air (F to A), Smokefree Housing (F to C) Pittsburg Smokefree Outdoor Air (increased points, grade remains F) Rancho Cordova Smokefree Outdoor Air (F to A), Smokefree Housing (F to D) Rocklin Smokefree Outdoor Air (increased points, grade remains F) Rohnert Park Smokefree Outdoor Air (B to A) Salinas Smokefree Outdoor Air (F to D) San Anselmo Smokefree Outdoor Air (C to A), Smokefree Housing (D to A) San Mateo Smokefree Housing (D to A) Williams Smokefree Outdoor Air (F to D) LUNG-USA

13 CALIFORNIA TOBACCO CONTROL BY THE NUMBERS By grading every city and county in California, the report paints a comprehensive picture of how well local elected officials across the state protect the residents of California. Below is a breakdown of all the tobacco control policies in California, followed by the Overall Tobacco Control grade for every municipality, and a list of the cities and counties with the top grades in each category. BREAKDOWN OF ALL TOBACCO CONTROL POLICIES IN CALIFORNIA SMOKEFREE OUTDOOR AIR 129 cities/counties restrict smoking at outdoor dining areas, covering 40% of the total population in California 117 cities/counties restrict smoking within entryways of buildings, covering 30% of the total population in California 118 cities/counties restrict smoking at public events, covering 33% of the total population in California 348 cities/counties restrict smoking in recreation areas, covering 80% of the total population in California 121 cities/counties restrict smoking at service areas, covering 33% of the total population in California 48 cities/counties restrict smoking on sidewalks in commercial areas, covering 8% of the total population in California 45 cities/counties restrict smoking at outdoor worksites, covering 5% of the total population in California Percent of Total California Population Covered by Policy Dining 40% Smokefree Outdoor Air Entryways Public Events 30% 33% Recreation Areas 80% Service Areas 33% Sidewalks 8% Worksites 5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% American Lung Association in California 13

14 SMOKEFREE HOUSING 39 cities/counties require the creation of nonsmoking units in multi-unit apartment buildings, covering 7% of the total population in California 35 cities/counties require the creation of nonsmoking units in multi-unit condominium buildings, covering 6% of the total population in California 117 cities/counties restrict smoking in indoor and/or outdoor common areas of multi-unit housing, covering 25% of the population in California 40 cities/counties require the creation of nonsmoking units in Housing Authority housing REDUCING SALES OF TOBACCO PRODUCTS 148 cities/counties require tobacco retailers to obtain a local license to sell tobacco products, covering 50% of the total population in California Percent of Total California Population Covered by Policy Smokefree Housing and Reducing Sales of Tobacco Products Apartments 7% Condominiums 6% Common Areas 25% Tobacco Retailer License 50% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% LUNG-USA

15 EMERGING ISSUES 122 cities/counties have a strong definition of smoke, smoking, or tobacco product that includes electronic cigarettes or other new and emerging tobacco products in a jurisdiction s secondhand smoke laws, covering 38% of the total population in California 91 cities/counties have a strong definition of smoke, smoking or tobacco product that would include electronic cigarettes or other new and emerging tobacco products in a jurisdiction s tobacco retailer licensing ordinance, covering 10% of the total population in California 38 cities/counties restrict the sale of tobacco products within a certain distance of schools/parks, covering 8% of the total population in California 46 cities/counties restrict the sampling of tobacco products, covering 12% of the total population in California 6 cities/counties restrict the sale of tobacco products at pharmacies, covering 3% of the total population in California 2 cities/counties prohibit the sale of flavored tobacco products, including cigar, little cigars, pipe tobacco and electronic cigarettes is prohibited, covering approximately 1% of the total population in California 2 cities/counties prohibit the sale of cigars in individual or small packages, covering approximately 1% of the total population in California Percent of Total California Population Covered by Policy Emerging Issues Electronic Cigarettes SHS 38% Electronic Cigarettes TRL TRL Location Restrictions Sampling 8% 10% 12% Pharmacies Flavored Tobacco Products Minimum Pack Size 3% 1% 1% 0% 10% 20% 30% 40% 50% 60% 70% 80% American Lung Association in California 15

16 BREAKDOWN OF OVERALL TOBACCO CONTROL GRADE A grade for Overall Tobacco Control 13 cities/counties received an A grade (Baldwin Park, Berkeley, Compton, Dublin, Glendale, Huntington Park, Marin, Pasadena, Richmond, San Rafael, Santa Clara, Santa Monica, Union City) B grade for Overall Tobacco Control 38 cities/counties received a B grade (Alameda, Albany, Belmont, Burbank, Calexico, Calabasas, Campbell, Carpinteria, Carson, Contra Costa, Culver City, Daly City, Davis, El Cajon, El Cerrito, Foster City, Hayward, Healdsburg, Mill Valley, Murrieta, Oakland, Petaluma, Rancho Cordova, San Anselmo, San Fernando, San Francisco, San Jose, San Luis Obispo, Santa Barbara, Santa Cruz, Sebastopol, Solana Beach, Sonoma, South Pasadena, Temecula, Temple City, Walnut Creek, Watsonville) C grade for Overall Tobacco Control 80 cities/counties received a C grade 3% 7% D grade for Overall Tobacco Control 83 cities/counties received a D grade F grade for Overall Tobacco Control 323 cities/counties received an F grade N/A grade for Overall Tobacco Control 2 cities received an n/a grade as these cities had n/a for two of the grade categories A B C D F 60% 15% 15% LIST OF TOP GRADES IN EACH CATEGORY Overall Tobacco Control Grade Breakdown Across California Smokefree Outdoor Air A grade for Smokefree Outdoor Air 70 cities/counties received an A grade (Alameda, Albany, Arcata, Baldwin Park, Belmont, Berkeley, Blue Lake, Calabasas, Camarillo, Campbell, Capitola, Carpinteria, Carson, Compton, Contra Costa, Coronado, Corte Madera, Daly City, Davis, Del Mar, Dublin, El Cajon, El Cerrito, Eureka, Foster City, Fremont, Glendale, Hillsborough, Huntington Park, Lafayette, Laguna Hills, Laguna Woods, Larkspur, Loma Linda, Mammoth Lakes, Manhattan Beach, Marin, Martinez, Menlo Park, Mill Valley, Moorpark, Morro Bay, Novato, Oakley, Palm Desert, Pasadena, Petaluma, Piedmont, Pinole, Rancho Cordova, Richmond, Rohnert Park, Ross, San Anselmo, San Fernando, San Leandro, San Luis Obispo, San Rafael, San Ramon, Santa Clara, Santa Monica, Santa Rosa, Sausalito, Sebastopol, Solana Beach, Sonoma, Temecula, Temple City, Union City, Walnut Creek) The number of strong Smokefree Outdoor Air Policies has increased from 37 in 2010 to 70 today B grade for Smokefree Outdoor Air 24 cities/counties received a B grade (Alameda, Beverly Hills, Burbank, Calexico, Crescent City, Emeryville, Fairfax, Hayward, Healdsburg, Hermosa Beach, Morgan Hill, Murrieta, Oakland, Orland, Pleasant Hill, San Francisco, San Jose, Santa Barbara, Santa Cruz, South Pasadena, Thousand Oaks, Tiburon, Watsonville, Windsor) LUNG-USA

17 Smokefree Housing A grade for Smokefree Housing 19 cities/counties received an A grade (Alameda, Baldwin Park, Belmont, Berkeley, Compton, Culver City, El Cerrito, Foster City, Pasadena, Petaluma, Richmond, San Anselmo, San Mateo, San Rafael, Santa Clara, Sebastopol, Sonoma, Tiburon, Walnut Creek) B grade for Smokefree Housing 13 cities/counties received a B grade (Corte Madera, Daly City, Dublin, Fairfax, Larkspur, Glendale, Huntington Park, Lafayette, Marin, Santa Monica, South Pasadena, Sausalito, Union City) A B Smokefree Outdoor Air Smokefree Housing Reducing Sales of Tobacco Products Reducing Sales of Tobacco Products A grade for Reducing Sales of Tobacco Products 117 cities/counties received an A grade (Albany, Arroyo Grande, Baldwin Park, Banning, Beaumont, Berkeley, Beverly Hills, Burbank, Calabasas, Calexico, California City, Calimesa, Campbell, Canyon Lake, Carmel-by-the-Sea, Carson, Carpinteria, Cerritos, Coachella, Compton, Concord, Contra Costa, Corona, Culver City, Davis, Delano, Desert Hot Springs, Duarte, Eastvale, El Cajon, El Monte, El Segundo, Elk Grove, Firebaugh, Fort Bragg, Gardena, Glendale, Goleta, Grass Valley, Grover Beach, Hawaiian Gardens, Hawthorne, Hayward, Healdsburg, Hemet, Hollister, Huntington Park, Inglewood, Jurupa Valley, Kern, La Canada Flintridge, Lake Elsinore, Lancaster, Lawndale, Lomita, Long Beach, Los Angeles, Los Angeles, Lynwood, Malibu, Marin, McFarland, Mendocino, Menifee, Mill Valley, Montebello, Monterey, Monterey, Monterey Park, Moreno Valley, Morgan Hill, Murrieta, Nevada City, Norco, Oakland, Oroville, Oxnard, Pacifica, Palmdale, Parlier, Pasadena, Perris, Rancho Cordova, Richmond, Riverbank, Riverside, Riverside, Sacramento, Sacramento, San Fernando, San Francisco, San Gabriel, San Jacinto, San Luis Obispo, San Luis Obispo, San Pablo, San Rafael, Santa Ana, Santa Barbara, Santa Clara, Santa Cruz, Santa Cruz, Santa Monica, Sierra Madre, Solana Beach, South Pasadena, Tehachapi, Temecula, Temple City, Ukiah, Union City, Vista, Wasco, Watsonville, Wildomar, Willits, Yolo ) The number of A s for Reducing Sales of Tobacco Products has increased from 95 in 2010 to 117 today B grade for Reducing Sales of Tobacco Products 5 cities received a B grade (Artesia, Dublin, San Diego, San Jose, West Sacramento) American Lung Association in California 17

18 EMERGING PRODUCT: ELECTRONIC CIGARETTES Over the last decade, the tobacco industry has developed novel products targeting a new generation of tobacco users. One such product that has increased in use and advertising is electronic cigarettes, or e-cigarettes. According to the US Food and Drug Administration (FDA), an e-cigarette is a battery powered device that allows users to inhale an emission containing nicotine or other substances. The safety of these devices is still unknown, and initial studies have found carcinogens and toxic chemicals in the emissions produced by these products, including ingredients used to make antifreeze. The FDA has not found e-cigarettes to be safe and effective in helping smokers quit and has proposed regulations that will extend basic regulatory authority found in the Tobacco Control Act to e-cigarettes. In fact, new evidence indicates that kids may be at-risk users of electronic cigarettes. E cigarettes are often available in flavors that may appeal to children and teens, including cotton candy, bubble gum, chocolate, strawberry and mint. There are almost 470 different brands of e cigarettes on the market today, and e cigarettes come in 7,700 different flavors. Demonstrating that this has become an appealing product for kids, youth usage rates for electronic cigarettes have tripled, 1 with a recent study reporting that more teens use electronic cigarettes than traditional, tobacco cigarettes or any other tobacco product. 2 California cities and counties have taken note of these concerns and proactively moved to regulate e-cigarettes, passing ordinances to capture these products in secondhand smoke and tobacco retailer licensing laws. In 2014, 75 cities and counties recognized the harmful effects of these unregulated products in their communities, and implemented local policies to protect their residents. 3 This is a sharp increase from previous years. The cities and counties who have taken action on e-cigarettes in 2014 and in prior years receive a bonus point in the Emerging Issues section in the revised methodology. Cities can earn one point for including e-cigarettes in their secondhand smoke laws and one point for regulating the sale of e-cigarettes million Electronic Cigarette Policies Implemented by Cities and Counties Californians are covered by e-cigarette policies = over 40% of the general population in California is covered by an e-cigarette policy Arrazola, Rene A. et al., Tobacco use among middle and high school students United States, MMWR Morb Mortal Wkly Rep 2014;63: University of Michigan. Monitoring the Future Study. E-Cigarettes surpass tobacco cigarettes among teens. December 16, 2014 News Release. 3. See Appendix A for the list of all the cities and counties who have enacted e-cigarette policies LUNG-USA

19 RAISE YOUR GRADE As is evidenced by the 13 cities and counties that have overall A grades, strong tobacco control policies can work in any community. So how can your community improve its health and raise its grade? Below is a worksheet that can be used to determine what types of policies could improve the health of your city or county and help raise its grade. Just fill in the points for the policies your community already has in the right-hand column, and see how many more points you will need to increase your grade. These policies will improve the health of your communities and ensure that tobacco is kept out of the hands of children. SMOKEFREE OUTDOOR AIR Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites 1 Point 2 Points 3 Points 4 Points Total Points Allows designated smoking areas or includes exceptions Less than 15 feet of all entryways or within an unspecified distance Some types of public events but not all Some parks, beaches and trails Some types of service areas but not all Some or all sidewalks or other pedestrian walkways Some or all outdoor worksites Within feet of all entryways Allows designated smoking areas Allows designated smoking areas 100% smokefree 20 or more feet from all entryways 100% smokefree 100% smokefree All service areas TOTAL: 18+ points = A points = B 8-12 points = C 3-7 points = D 0-2 points = F SMOKEFREE HOUSING Nonsmoking Units in Apartments Nonsmoking Units in Condominiums Nonsmoking Common Areas Prohibits smoking within 75% of units under control of Housing Authority 1 Point 2 Points 3 Points 4 Points Total Points Prohibits smoking in 75% or more of new apartment units Prohibits smoking in 75% or more of new condos units Prohibits smoking within 75% of units for multiunit housing complexes under control of Housing Authority If jurisdiction has Housing Authority: 11+ Points A 2-4 Points D 8-10 Points B 0-1 Points F 5-7 Points C 75% of new and existing apartment units 75% of new and existing condos units Indoor common areas 100% of units for both new and existing apartments 100% of units for both new and existing condos Indoor and outdoor common areas If jurisdiction does not have Housing Authority: 10+ Points A 1-3 Points D 7-9 Points B 0 Points F 4-6 Points C TOTAL: American Lung Association in California 19

20 REDUCING SALES OF TOBACCO PRODUCTS Policy Provisions: (1) Require tobacco retailers to pay an annual fee that sufficiently covers administration and enforcement efforts, including compliance checks; (2) Requirement that all retailers obtain a license to sell tobacco and renew it annually; (3) Provision that any violation of a local, state or federal tobacco law is considered a violation of the license; and (4) Financial deterrent through fines and penalties for violations that includes suspension and revocation of the license. Tobacco Retailer Licensing 1 Point 2 Points 3 Points 4 Points Total Points A sufficient annual fee and 0 of the other 3 provisions outlined above or licensing ordinance with insufficient annual fee and any of the other 3 provisions outlined above A sufficient annual fee and 1 of the other 3 provisions outlined above A sufficient annual fee and 2 of the other 3 provisions outlined above A sufficient annual fee and the other 3 provisions outlined above TOTAL: 4+ points A 3 points B 2 points C 1 point D 0 points F EMERGING ISSUES BONUS POINTS Secondhand Smoke (Bonus Point) Tobacco Retailer License (Bonus Point) Tobacco Retailer Location Restrictions (Bonus Point) Sampling of Tobacco Products (Bonus Point) Sales in Pharmacies (Bonus Point) Flavored Tobacco Products (Bonus Point) Minimum Pack Size of Cigars (Bonus Point) Bonus Points There is a strong definition of smoke, smoking or tobacco product that would include electronic cigarettes or other new and emerging tobacco products in a jurisdiction s secondhand smoke laws. There is a strong definition of smoke, smoking or tobacco product that would include electronic cigarettes or other new and emerging tobacco products in a jurisdiction s tobacco retailer licensing ordinance. Restricts businesses that sell tobacco from being located within certain distance of schools and/or parks. Or the policy prohibits a tobacco retailer from being located within a certain distance of other retailers. Or there is a limit to the number of tobacco retailer licenses that can be issued. Prohibits sampling or nominal cost distribution of all or some tobacco products or in all locations. Prohibits sales at all or some pharmacies The sale of flavored tobacco products, including cigars, little cigars, pipe tobacco and electronic cigarettes is prohibited. Prohibits the sale of cigars in individual or small packages, which increases the price and makes them less attractive to youth. Total Points TOTAL: Each of the seven Emerging Issues can receive 1 bonus point. Receiving a total of 4 or more of these bonus points adds one point to the Overall Tobacco Control points LUNG-USA

21 LOCAL GRADING METHODOLOGY The American Lung Association in California established local tobacco control grades in three categories that reflects where local action is needed and where the greatest public health benefit can be derived. The bar is set high because tobacco remains the number one preventable cause of death in California and because experience shows that local action has been the cornerstone of the tobacco control movement and public health improvement. The three tobacco control policy grades that are assigned to each city and county are: (1) Smokefree Outdoor Air (2) Smokefree Housing (3) Reducing Sales of Tobacco Products These three grades plus are then used to calculate an Overall Tobacco Control grade for each municipality. An n/a or not applicable score is given to municipalities in which it is not possible to adopt a specific type of policy due to a complete lack of the entity that is being graded. For example, if a city or county doesn t have any stores that sell tobacco products, then the city is awarded an n/a as opposed to 0 points in the Reducing Sales of Tobacco Products category, and the grading scales are adjusted accordingly. Below is a description of each of the grading categories, a summary of the relevant state laws and an explanation of the grade criteria. OVERALL TOBACCO CONTROL GRADE Description The Overall Tobacco Control grade is a letter grade awarded to the municipality based on its grades in the three categories, plus. Grade Criteria To determine the Overall Tobacco Control grade, the city or county is given a point value for each of its grades in the three categories (Smokefree Outdoor Air, Smokefree Housing, Reducing Sales of Tobacco Products) as follows: A=4; B=3; C=2; D=1; and F=0. These three point values are then added together, along with the section (4 or more bonus points = 1 additional point), for a total point value for the Overall Tobacco Control grade. The total points are turned into grades based on a scale of: A (11-12); B (8-10); C (5-7); D (2-4); and F (0-1). SMOKEFREE OUTDOOR AIR Description Secondhand smoke exposure is proven to be harmful at any level. This recognition that secondhand smoke is extremely toxic has bolstered efforts by local elected officials across the state to protect the health of their residents by adopting local ordinances that restrict smoking in a variety of outdoor areas ranging from parks to sidewalks. State Law California used to have some of the strongest laws in the nation to protect people from harmful secondhand smoke exposure. However, these state laws mostly focus on workplaces and other indoor areas and only a few laws restricting smoking in outdoor areas, such as those detailed below. Cities and counties have the explicit authority to go beyond state law and enact secondhand smoke restrictions in outdoor areas. Grade Criteria The Smokefree Outdoor Air grade is based on the smoking restrictions adopted by local communities in seven outdoor areas (1) Dining Areas; (2) Entryways; (3) Public Events; (4) Recreation Areas; (5) Service Areas; (6) Sidewalks in Commercial Areas; and (7) Worksites. In the five outdoor areas, the city or county is given a point value between 0 and 4 based on the strength of their local ordinance. In two of the outdoor areas (Sidewalks in Commercial Areas and Worksites), the city or county is given a point value of 0 or 1 based on their local ordinance. These point values for the seven areas are then added together to calculate the overall Smokefree Outdoor Air grade using a scale of: A (18+); B (13-17); C (8-12); D (3-7); and F (0-2). American Lung Association in California 21

22 Dining Areas Description Restrictions on smoking in outdoor seating areas at restaurants and bars. State Law Smoking is prohibited in indoor dining areas but there are no state law restrictions on smoking in outdoor dining areas. Criteria 4 All outdoor dining areas at bars and restaurants are 100% smokefree 2 Smoking restricted in outdoor dining areas but designated smoking areas allowed or exceptions made for certain types of bars and/or restaurants 0 No smoking restrictions in outdoor dining areas Entryways Description Restrictions on smoking in places within a certain distance of doors, windows, and other openings into all enclosed areas where smoking is prohibited. State Law Smoking is prohibited within 20 feet of entrances, exits, or operable windows of a public building, which includes state, county and city buildings. Criteria 4 Smoking prohibited within 20 or more feet of entryways 3 Smoking prohibited within feet of entryways 2 Smoking prohibited within some distance less than 15 feet of entryways or within an unspecified distance of entryways 0 No smoking restrictions for entryways Public Events Description Smoking restrictions at events open to the public such as fairs, farmer s markets, parades, concerts and other similar events that take place on public property. State Law There are no statewide restrictions on smoking in outdoor public events. Criteria 4 All public events are 100% smokefree 3 Smoking restricted at all public events, but designated smoking areas are permitted 2 Smoking restricted at specific types of public events (such as in all farmer s markets), but not all public events 0 No restrictions on smoking at public events Recreation Areas Description Smoking restrictions at parks, beaches, trails and other similar recreation areas. State Law Smoking is prohibited within 25 feet of tot lots and playgrounds. Criteria 4 All recreation areas are 100% smokefree 3 Smoking restricted in all recreation areas, but designated smoking areas are permitted 2 Smoking prohibited in some parks, beaches and trails but not all recreation areas 0 No smoking restrictions in recreation areas LUNG-USA

23 Service Areas Description Smoking restrictions in outdoor locations where people stand or wait for services including ATM lines, public transit stops, taxi stands and ticket lines. State Law There are no statewide restrictions on smoking in service areas. Criteria 4 Smoking restricted at all service areas 2 Smoking restricted at some types of service areas (such as at bus stops) but not all service areas 0 No restrictions on smoking in service areas Smokefree Outdoor Air - Sidewalks in Commercial Areas Description Smoking restrictions on sidewalks and other pedestrian walkways in commercial areas, such as downtown areas and outdoor shopping centers. State Law There are no statewide restrictions on smoking on sidewalks in commercial areas. Criteria 1 Smoking restricted on sidewalks or other pedestrian walkways within all commercial areas or within a specified commercial or downtown area Smokefree Outdoor Air - Worksites Description Smoking restrictions in outdoor places of employment, such as construction sites. State Law There are no statewide restrictions on smoking in outdoor worksites. Criteria 1 Smoking restricted for some or all outdoor worksites SMOKEFREE HOUSING Description While California has been a leader on protections from secondhand smoke, one area where people continue to be unprotected is in multi-unit housing. Secondhand smoke exposure in multi-unit housing is a serious health threat because secondhand smoke drifts into housing units from other units, balconies, patios and common areas. State Law The only statewide smoking restriction in multi-unit housing is a workplace restriction prohibiting smoking in indoor common areas (described below) and is not intended to protect the health of tenants. A new state law that went into effect on January 1, 2012 authorizes landlords to prohibit smoking in the units they manage. While it was legal for landlords to prohibit smoking in the apartments they own and manage prior to this law, that authority is now specifically articulated in state law. Cities and counties are allowed to go beyond state law in enacting secondhand smoke restrictions for multi-unit housing and the new state law does not preempt these local ordinances. Grade Criteria Cities and counties have taken a variety of approaches in passing local ordinances to try to address the problem of secondhand smoke in multi-unit housing. The overall Smokefree Housing grade is based on the grades for four types of smokefree housing policies (1) Nonsmoking Units in Apartments; (2) Nonsmoking Units in Condominiums; (3) Nonsmoking Common Areas; and (4) Nonsmoking Units in Housing Authorities. For three of the policy areas, the city or county is given a point value between 0 and 4 based on the strength of their local ordinance. For the Nonsmoking Units in Housing Authorities policy area, the city or county is given a point value of 0 or 1 based on the strength of their local ordinance. The point values for the four areas are then added together to calculate the overall Smokefree Housing Grade. If the jurisdiction has a Housing Authority, the point values are added and given a grade using a scale of: A (11+); B (8-10); C (5-7); D (2-4); and F (0-1). If the jurisdiction does not have a Housing Authority, the point values are added and given a grade using a scale of: A (10+); B (7-9); C (4-6); D (1-3); and F (0). American Lung Association in California 23

24 Nonsmoking Units Description Prohibiting smoking within the units of multi-unit apartment buildings. State Law There are no statewide restrictions on smoking in units of multi-unit housing. Criteria 4 Prohibits smoking in 100% of units for both new and existing apartments 2 Prohibits smoking in 75% or more of new and existing apartments units 1 Prohibits smoking in 75% or more of new apartment units 0 No requirements for declaring multi-unit housing units nonsmoking Nonsmoking Units in Condominiums Description Prohibiting smoking within the units of multi-unit condominium buildings. State Law There are no statewide restrictions on smoking in units of multi-unit housing. Criteria 4 Prohibits smoking in 100% of units for both new and existing condos 2 Prohibits smoking in 75% of new and existing condos units 1 Prohibits smoking in 75% or more of new condos units 0 No requirements for declaring multi-unit housing units nonsmoking Nonsmoking Common Areas Description Smoking restrictions in both indoor common areas, which include hallways, stairwells, laundry rooms and recreation rooms, and outdoor common areas, which include swimming pools, play areas, outdoor eating areas and courtyards of multi-unit housing. State Law Smoking is prohibited in indoor common areas of apartments and condominiums if the areas are places of employment. These areas are places of employment if there is an employee who works on the property, such as an on-site property manager, security guard or maintenance worker. Criteria 4 Smoking restricted in all indoor and outdoor common areas, including ordinances that allow for designated smoking areas in outdoor common areas 2 Smoking restricted in all indoor common areas, but not outdoor common areas 0 No restrictions on smoking in common areas Nonsmoking Units in Housing Authorities Description Prohibiting smoking within the actual units, patios and balconies of multi-unit housing units that are under the control of the city or county Housing Authority, such as low-income, senior or migrant housing. These policies generally need to be approved by the City Council/Board of Supervisors. It is important to note that not all cities or counties have housing authorities, these cities will not receive a bonus point. State Law There are no statewide restrictions requiring nonsmoking for housing authorities. Criteria 1 Smoking is prohibited within 75% of units for the multi-unit housing complexes under the control of the housing authority LUNG-USA

25 REDUCING SALES OF TOBACCO PRODUCTS Description An important aspect of reducing the smoking prevalence rates in California is to reduce the availability and sales of tobacco products. This most efficient way to do this is through the tobacco retail environment. State Law California has several statewide laws related to access to and sales of tobacco products that are described in the policy areas below. The state allows municipalities to go beyond state law in enacting restrictions in these policy areas. Grade Criteria The Reducing Sales of Tobacco Products grade is determined by the ordinances adopted by cities/counties in one area, Local Tobacco Retailer Licensing Ordinance. For this policy area, the city or county is given a point value between 0 and 4 based on the strength of their ordinance. The point value regarding the Tobacco Retailer Licensing Ordinance is then used to calculate the overall Reducing Sales of Tobacco Products grade using a scale of: A (4); B (3); C (2); D (1); and F (0). Local Tobacco Retailer Licensing Ordinance Description Youth under the age of 18 are often able to purchase tobacco products at all types of retailers, ranging from convenience stores and gas stations to large chain grocery stores and pharmacies, even though it is illegal to sell tobacco products to minors. To combat this problem many cities and counties in California are passing ordinances that require tobacco retailers to obtain a license to sell tobacco products, which allows the municipalities to keep track of tobacco retailers, conduct enforcement activities to ensure compliance with state and local laws and penalize retailers who sell to minors. State Law It is illegal in the state to sell or give tobacco products to anyone under the age of 18. There are laws in California to punish the business owner or the clerk when an illegal sale is made. Tobacco retailers are also required to obtain a state tobacco retailer license, which has generally been used to combat black market sales and tax evasion. Criteria In order for a local licensing ordinance to effectively reduce illegal sales to minors, it must contain four provisions: (1) requiring tobacco retailers to pay an annual fee that sufficiently covers administration and enforcement efforts, including compliance checks; (2) requirement that all retailers obtain a license to sell tobacco and renew it annually; (3) provision that any violation of a local, state or federal tobacco law is considered a violation of the license; and (4) financial deterrent through fines and penalties for violations that includes suspension and revocation of the license. Of these four provisions, it is essential that the licensing ordinance requires a sufficient fee that will cover the administration and enforcement of the license to ensure that these activities occur. A city/county can get credit for meeting the annual fee requirement if it uses other sustainable funding sources (such as funds from the Master Settlement Agreement) that are dedicated for administration and enforcement of the retailer license. The grade for Local Tobacco Retailer Licensing Ordinance is based on the provisions of the ordinance that a city or county has adopted with the following scale: 4 Licensing ordinance with sufficient annual fee and the other 3 provisions outlined above 3 Licensing ordinance with sufficient annual fee and 2 of the other 3 provisions outlined above 2 Licensing ordinance with sufficient annual fee and 1 of the other 3 provisions outlined above 1 Licensing ordinance with sufficient annual fee and 0 of the other 3 provisions outlined above or licensing ordinance with insufficient annual fee and any of the other 3 provisions outlined above 0 No licensing ordinance or a licensing ordinance none of the provisions outlined above American Lung Association in California 25

26 EMERGING ISSUES BONUS POINTS Description To combat ways the tobacco industry promotes the use of tobacco, cities and counties are adopting policies in new and challenging areas to reduce the prevalence of smoking in California. Grade Criteria The Emerging Issues section includes 7 possible bonus points and factors them into the Overall Tobacco Control Grade. Bonus points are available in the following issue areas (1) Emerging Products Definition in Secondhand Smoke; (2) Emerging Products Definition in Tobacco Retailer Licensing Ordinances (3) Tobacco Retailer Location Restrictions; (4) Sales of Tobacco Products in Pharmacies; (5) Sampling of Tobacco Products; (6) Flavored Tobacco Product; and (7) Minimum Packaging of Cigars. Receiving a total of 4 or more of these bonus points adds one point to the Overall Tobacco Control points. Emerging Products Definition Secondhand Smoke Description The tobacco industry is constantly creating and marketing new tobacco products. These products are often targeted to kids and can continue to attract new users to tobacco products. One such product is electronic cigarettes. State Law There are no statewide restrictions on the use of electronic cigarettes. Criteria 1 bonus point There is a strong definition of smoke, smoking or tobacco product that would include electronic cigarettes or other new and emerging tobacco products in a jurisdiction s secondhand smoke laws. Emerging Products Definition Tobacco Retailer License Description The tobacco industry is constantly creating and marketing new tobacco products. These products are often targeted to kids and can continue to attract new users to tobacco products. One such product is electronic cigarettes. State Law It is illegal to sell electronic cigarettes to anyone under the age of 18. Criteria 1 bonus point There is a strong definition of smoke, smoking or tobacco product that would include electronic cigarettes or other new and emerging tobacco products in a jurisdiction s tobacco retailer licensing ordinance. Reducing Sales of Tobacco Products - Tobacco Retailer Location Restrictions Description Cities and counties can restrict where tobacco retailers are located and can prohibit them from being located within a certain distance, such as within 1,000 feet, of schools and parks. This type of policy can be enacted in several ways including through conditional use permits, other zoning restrictions and local tobacco retailer licensing ordinances. By reducing the presence of tobacco retailers in locations where youth congregate, this type of policy can reduce sales of tobacco products to youth and assist with efforts to reduce youth smoking. Furthermore, the number of tobacco stores in a neighborhood can have an effect on youth smoking behaviors in that neighborhood and in some disadvantaged neighborhoods, the numbers of tobacco retailers is far greater than in less disadvantaged neighborhoods. State Law There are no statewide laws restricting tobacco retailers from being within a certain distance of schools and parks based on proximity to other retailers or populations. Criteria 1 bonus point The city/county restricts businesses that sell tobacco from being located within a certain distance of schools and/or parks through a conditional use permit, other zoning restrictions or a local tobacco retailer licensing ordinance. Or the city/county prohibits a tobacco retailer from being located within a certain distance of other retailers to avoid a high concentration in certain areas. Or there is a limit to the number of tobacco retailer licenses that can be issued LUNG-USA

27 Reducing Sales of Tobacco Products - Sampling of Tobacco Products Description Giving away free tobacco products or providing these products at a greatly reduced cost is a tool that tobacco companies use to gain new customers and keep current customers addicted to new types of products. Restricting this sampling can make it harder for tobacco companies to addict new users and can help to reduce prevalence rates for using tobacco products. State Law The sampling of tobacco products is restricted by federal law, state law and the Master Settlement Agreement. The strongest restrictions are in the federal law, which prohibits free samples of cigarettes and smokeless tobacco (this does not apply to cigars, little cigars or pipe tobacco). Federal law bans free samples of smokeless tobacco products in most places, but allows sampling in qualified adult-only facilities. State law bans the nominal-cost distribution of cigarettes or smokeless tobacco products on public grounds or private grounds open to the public, but allows exemptions for adult only facilities. This law includes coupons, coupon offers, rebate offers, gift certificates/cards and other similar offers in this prohibition. Criteria 1 bonus point The city/county has adopted an ordinance that goes beyond the state and federal restrictions on sampling. This includes banning the sampling of all tobacco products, including cigars, little cigars, and pipe tobacco or restricting the nominal-cost distribution of cigarettes and tobacco products. It also includes eliminating sampling all together, including in adult only facilities. Reducing Sales of Tobacco Products - Sale of Tobacco Products in Pharmacies Description Cities and counties can restrict sales of tobacco products at pharmacies. Pharmacies are traditionally places where people go to purchase products to get healthy or improve their health. The availability of tobacco products at pharmacies associates them with other healthy products and with the general health focus of these stores. Selling tobacco at pharmacies is contrary to a pharmacy s purpose and sends a mixed message to consumers and youth. State Law There is no statewide law that restricts pharmacies from selling tobacco products. Pharmacies that elect to sell tobacco products, like all other types of tobacco retailers, must obtain a statewide tobacco retailer license. Criteria 1 bonus point Tobacco products are prohibited from being sold at all pharmacies or at certain types of pharmacies in the city/county Reducing Sales of Tobacco Products - Flavored Tobacco Products Description Another tool used by tobacco companies to target youth and gain new customers is to produce tobacco products in a myriad of flavors. Restricting the flavors of tobacco helps to reduce the appeal to youth. State Law There are no statewide laws restricting the sale of flavored tobacco products. Criteria 1 bonus point The sale of flavored tobacco products, including cigars, little cigars, pipe tobacco and electronic cigarettes is prohibited. American Lung Association in California 27

28 Reducing Sales of Tobacco Products - Minimum Pack Size of Cigars Description Tobacco products are often sold individually to make them less expensive, and more enticing to youth. Establishing policies to ensure minimum packaging, or a minimum unit in which cigars can be sold in, will increase the purchase price and help protect youth from the health dangers of smoking little cigars and cigarillos. State Law There is no statewide law that restrict the sale of cigars in individual or small packages. Criteria 1 bonus point Prohibits the sale of cigars in individual or small packages, which increases the price and makes them less attractive to youth. GRADE SCALE Below is a quick reference for the point scale for the four letter grades received by each city and county. Overall Tobacco Control Grade A: points B: 8-10 points C: 5-7 points D: 2-4 points F: 0-1 points Smokefree Outdoor Air Grade A: 18+ points B: points C: 8-12 points D: 3-7 points F: 0-2 points Smokefree Housing Grade A: 11+ points B: 8-10 points C: 5-7 points D: 2-4 points F: 0-1 points Reducing Sales of Tobacco Products Grade A: 4+ points B: 3 points C: 2 points D: 1 point F: 0 points 4+ points adds one point to the Overall Grade LUNG-USA

29 APPENDIX A: LIST OF MUNICIPALITIES THAT REGULATE ELECTRONIC CIGARETTES SHS = Secondhand smoke electronic cigarettes are regulated through SHS laws TRL = Tobacco Retailer License electronic cigarettes are regulated through TRL laws Municipality SHS TRL Albany Alameda X Berkeley Alameda X Dublin Alameda X X Emeryville Alameda X Fremont Alameda X Hayward Alameda X X Oakland Alameda X Piedmont Alameda X Pleasanton Alameda X San Leandro Alameda X Union City Alameda X X Alpine Alpine X Oroville Butte X X Concord Contra Costa X X Contra Costa Contra Costa X X El Cerrito Contra Costa X Martinez Contra Costa X Oakley Contra Costa X Pittsburg Contra Costa X X Richmond Contra Costa X X Walnut Creek Contra Costa X Crescent City Del Norte X Firebaugh Fresno X Selma Fresno X Orland Glenn X Arcata Humboldt X Eureka Humboldt X Arvin Kern X California City Kern X Delano Kern X Kern Kern X Wasco Kern X Susanville Lassen X Alhambra Los Angeles X Arcadia Los Angeles X Baldwin Park Los Angeles X X Bellflower Los Angeles X Beverly Hills Los Angeles X X Burbank Los Angeles X Calabasas Los Angeles X X Cerritos Los Angeles X Compton Los Angeles X X Municipality SHS TRL Culver City Los Angeles X X Duarte Los Angeles X El Monte Los Angeles X X Gardena Los Angeles X X Glendale Los Angeles X X Hawaiian Gardens Los Angeles X X Hawthorne Los Angeles X Huntington Park Los Angeles X X Inglewood Los Angeles X X Lakewood Los Angeles X Lancaster Los Angeles X Lomita Los Angeles X X Long Beach Los Angeles X X Los Angeles Los Angeles X X Lynwood Los Angeles X Malibu Los Angeles X Manhattan Beach Los Angeles X Montebello Los Angeles X Monterey Park Los Angeles X X Norwalk Los Angeles X Palmdale Los Angeles X X Pico Rivera Los Angeles X San Fernando Los Angeles X Santa Monica Los Angeles X X South Pasadena Los Angeles X X Corte Madera Marin X Fairfax Marin X Larkspur Marin X Marin Marin X Mill Valley Marin X X Novato Marin X San Anselmo Marin X Sausalito Marin X Tiburon Marin X Carmel-By-The-Sea Monterey X Gonzales Monterey X Greenfield Monterey X Monterey Monterey X Monterey Monterey X American Canyon Napa X Grass Valley Nevada X Nevada City Nevada X American Lung Association in California 29

30 Municipality SHS TRL Anaheim Orange X Buena Park Orange X Garden Grove Orange X Laguna Hills Orange X Laguna Niguel Orange X Santa Ana Orange X Seal Beach Orange X Westminster Orange X Banning Riverside X Beaumont Riverside X Coachella Riverside X Corona Riverside X Desert Hot Springs Riverside X Eastvale Riverside X Hemet Riverside X Lake Elsinore Riverside X Menifee Riverside X Moreno Valley Riverside X Murrieta Riverside X X Norco Riverside X Perris Riverside X Riverside Riverside X San Jacinto Riverside X Temecula Riverside X X Wildomar Riverside X Folsom Sacramento X Rancho Cordova Sacramento X X Hollister San Benito X Apple Valley San Bernardino X San Bernardino San Bernardino X Carlsbad San Diego X Del Mar San Diego X El Cajon San Diego X X Encinitas San Diego X La Mesa San Diego X Oceanside San Diego X Poway San Diego X San Diego San Diego X X San Diego San Diego X San Marcos San Diego X Solana Beach San Diego X X Vista San Diego X X San Francisco San Francisco X X Arroyo Grande San Luis Obispo X Grover Beach San Luis Obispo X Municipality SHS TRL San Luis Obispo San Luis Obispo X Belmont San Mateo X Daly City San Mateo X Foster City San Mateo X Menlo Park San Mateo X Pacifica San Mateo X San Mateo San Mateo X X South San Francisco San Mateo X Buellton Santa Barbara X Carpinteria Santa Barbara X Goleta Santa Barbara X X Lompoc Santa Barbara X Santa Barbara Santa Barbara X Santa Barbara Santa Barbara X Santa Maria Santa Barbara X Cupertino Santa Clara X Gilroy Santa Clara X Los Altos Santa Clara X Milpitas Santa Clara X Morgan Hill Santa Clara X X Mountain View Santa Clara X Santa Clara Santa Clara X X Saratoga Santa Clara X X Sunnyvale Santa Clara X Campbell Santa Clara X Santa Cruz Santa Cruz X X Scotts Valley Santa Cruz X X Watsonville Santa Cruz X X Shasta Shasta X Benicia Solano X Healdsburg Sonoma X X Petaluma Sonoma X Santa Rosa Sonoma X Sebastopol Sonoma X Sonoma Sonoma X Windsor Sonoma x Oxnard Ventura X Davis Yolo X X Woodland Yolo X Yolo Yolo X LUNG-USA

31 ALAMEDA COUNTY Overall Tobacco Control Grade B B A A C C B D D B C D C A D Total Points Smokefree Outdoor Air A A A A B A B D C B A C A A B Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing A C A B C C F D D C C D D B D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority 1 n/a 0 0 n/a n/a n/a 0 n/a 0 n/a 1 n/a n/a 0 Total Points Reducing Sales of Tobacco Products F A A B F F A F F A F F F A F Tobacco Retailer Licensing Total Points Alameda Albany Berkeley Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Dublin Emeryville Fremont Hayward Livermore Newark Oakland Piedmont Pleasanton San Leandro Union City American Lung Association in California 31

32 Overall Tobacco Control Grade Total Points 2 Smokefree Outdoor Air C Dining 0 Entryways 4 Public Events 2 Recreation Areas 2 Service Areas 0 Sidewalks D n/a Worksites 0 Total Points 8 Smokefree Housing Nonsmoking Apartments 0 Nonsmoking Condominiums 0 Nonsmoking Common Areas 0 Nonsmoking Housing Authority n/a Total Points 0 Reducing Sales of Tobacco Products Tobacco Retailer Licensing 0 Total Points 0 Emerging Products Definition - Secondhand Smoke 1 Emerging Products Definition - Licensing 0 Retailer Location Restrictions 0 Sampling of Tobacco Products 0 Sale of Tobacco Products in Pharmacies 0 Flavored Tobacco Products 0 Minimum Pack Size of Cigars 0 Total Points 1 F F ALPINE COUNTY LUNG-USA

33 Amador Overall Tobacco Control Grade F F F F F F Total Points Smokefree Outdoor Air F F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F Tobacco Retailer Licensing Total Points F F F F F F Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Ione Jackson Plymouth AMADOR COUNTY Sutter Creek American Lung Association in California 33

34 Overall Tobacco Control Grade F D F C F F Total Points Smokefree Outdoor Air F C F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F D F D D D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F A F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Biggs Chico Gridley Oroville BUTTE COUNTY Paradise LUNG-USA

35 Overall Tobacco Control Grade F F Total Points 0 0 Smokefree Outdoor Air F F Dining 0 0 Entryways 0 0 Public Events 0 0 Recreation Areas 0 0 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 0 0 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 0 Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Angels City CALAVERAS COUNTY American Lung Association in California 35

36 Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air D D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Colusa Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Williams COLUSA COUNTY LUNG-USA

37 CONTRA COSTA COUNTY Overall Tobacco Control Grade F F D C D B F C C F C F C F C A D C B B Total Points Smokefree Outdoor Air F F D C D A F A A F A F A D B A F A A A Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F A F B C F C F C F C A F C A C Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 0 n/a 1 n/a n/a n/a 0 Total Points Reducing Sales of Tobacco Products F F D A D F F F F F F F D F F A A D F A Tobacco Retailer Licensing Total Points Antioch Brentwood Clayton Concord Danville Emerging Products Def - Secondhand Smoke Emerging Products Def - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points El Cerrito Hercules Lafayette Martinez Moraga Oakley Orinda Pinole Pittsburg Pleasant Hill Richmond San Pablo San Ramon Walnut Creek American Lung Association in California 37

38 Overall Tobacco Control Grade D F Total Points 3 1 Smokefree Outdoor Air B D Dining n/a 0 Entryways 4 4 Public Events 4 0 Recreation Areas 4 0 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 12 4 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 n/a Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 1 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 1 0 Crescent City DEL NORTE COUNTY LUNG-USA

39 Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air D D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Placerville Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points South Lake Tahoe EL DORADO COUNTY American Lung Association in California 39

40 FRESNO COUNTY Overall Tobacco Control Grade F F C F F F F F F F D F F F F F Total Points Smokefree Outdoor Air D F C F D F F F D D F D F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F A D F F F F F F A F F F F F Tobacco Retailer Licensing Total Points Clovis Coalinga Firebaugh Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Fowler Fresno Huron Kerman Kingsburg Mendota Orange Cove Parlier Reedley Sanger San Joaquin Selma LUNG-USA

41 Overall Tobacco Control Grade D F F Total Points Smokefree Outdoor Air B F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Orland Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Willows GLENN COUNTY American Lung Association in California 41

42 Overall Tobacco Control Grade C C C F F F F F Total Points Smokefree Outdoor Air A A A F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D D C F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Arcata Blue Lake Eureka Ferndale Fortuna HUMBOLDT COUNTY Rio Dell Trinidad LUNG-USA

43 Overall Tobacco Control Grade F B F D F F F F Total Points Smokefree Outdoor Air F B F D F D F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F D F D F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F A F F F F F F Tobacco Retailer Licensing Total Points Brawley Calexico Calipatria El Centro Holtville Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points IMPERIAL COUNTY Imperial Westmorland American Lung Association in California 43

44 Overall Tobacco Control Grade F F Total Points 0 0 Smokefree Outdoor Air F F Dining 0 0 Entryways 0 0 Public Events 0 0 Recreation Areas 2 2 Service Areas n/a n/a Sidewalks 0 0 Worksites 0 0 Total Points 2 2 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas n/a 0 Nonsmoking Housing Authority n/a n/a Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Bishop INYO COUNTY LUNG-USA

45 KERN COUNTY Overall Tobacco Control Grade F F D D F D F F F C D D Total Points Smokefree Outdoor Air D F F F F F F F F D F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority 1 1 n/a n/a 1 n/a n/a 1 1 Total Points Reducing Sales of Tobacco Products F F A A F A F F F A A A Tobacco Retailer Licensing Total Points Arvin Bakersfield California City Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Delano Maricopa McFarland Ridgecrest Shafter Taft Tehachapi Wasco American Lung Association in California 45

46 Overall Tobacco Control Grade F F F F F Total Points Smokefree Outdoor Air F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F Tobacco Retailer Licensing Total Points Avenal Corcoran Hanford Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Lemoore KINGS COUNTY LUNG-USA

47 Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air D D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Clearlake Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Lakeport LAKE COUNTY American Lung Association in California 47

48 Overall Tobacco Control Grade F F Total Points 1 0 Smokefree Outdoor Air D F Dining 0 0 Entryways 0 0 Public Events 2 0 Recreation Areas 4 0 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 6 0 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 0 Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 1 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 1 0 Susanville LASSEN COUNTY LUNG-USA

49 LOS ANGELES COUNTY Overall Tobacco Control Grade F F D D F F A F F F C F B B B C F F A F F B F Total Points Smokefree Outdoor Air F D C F D F A F F F B F B A A D D D A D F C F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F A F F F F F D C D F F F A F F A F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units Total Points Reducing Sales of Tobacco Products F F F B F F A F F F A F A A A A F F A F F A F Tobacco Retailer Licensing Total Points Agoura Hills Alhambra Arcadia Artesia Avalon Azusa Baldwin Park Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Bell Bellflower Bell Gardens Beverly Hills Bradbury Burbank Calabasas Carson Cerritos Claremont Commerce Compton Covina Cudahy Culver City Diamond Bar American Lung Association in California 49

50 LOS ANGELES COUNTY Overall Tobacco Control Grade F C C D C A F C C D F A F C F C D F F F F D C Total Points Smokefree Outdoor Air D D D F D A D D C B F A F C F C C F F D F F D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F B F F F F F B F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units Total Points Reducing Sales of Tobacco Products F A A A A A F A A F F A F A F A F F F F F A A Tobacco Retailer Licensing Total Points Downey Duarte El Monte El Segundo Gardena Glendale Glendora Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Hawthorne Hawaiian Gardens Hidden Hills Hermosa Beach Huntington Park Industry Inglewood Irwindale La Canada Flintridge La Mirada La Habra Heights La Puente La Verne Lakewood Lancaster Lawndale LUNG-USA

51 LOS ANGELES COUNTY Overall Tobacco Control Grade C C C D C D F F D C F C F F A F F F F F F F F Total Points Smokefree Outdoor Air D C C F C A F F F C D D F F A F F D D F F D D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F D F F F F F F F D F D F F A F F F F n/a F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A A A A A F D F A A F A F F A F F F F n/a F F F Tobacco Retailer Licensing Total Points Lomita Long Beach Los Angeles Lynwood Malibu Manhattan Beach Maywood Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Monrovia Montebello Monterey Park Norwalk Palmdale Paramount Palos Verdes Estates Pasadena Pico Rivera Pomona Rancho Palos Verdes Rolling Hills Redondo Beach Rolling Hills Estates Rosemead San Dimas American Lung Association in California 51

52 LOS ANGELES COUNTY Overall Tobacco Control Grade B C F F F A C F F F B B F F F F F F F C Total Points Smokefree Outdoor Air A D F D D A D F D D B A D F D F D F D D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F B F F F F B D F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A A F F F A A F F F A A F F F D F F F A Tobacco Retailer Licensing Total Points San Fernando San Gabriel San Marino Santa Clarita Santa Monica Santa Fe Springs Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Sierra Madre Signal Hill South Gate South El Monte South Pasadena Temple City Torrance Vernon Walnut West Covina West Hollywood Westlake Village Whittier LUNG-USA

53 Chowchilla Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Madera MADERA COUNTY American Lung Association in California 53

54 MARIN COUNTY Overall Tobacco Control Grade F C C C B C C B A C C A Total Points Smokefree Outdoor Air F A B A A A A A A A B A Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D B B B F C D A A B A B Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority n/a n/a 0 n/a n/a 0 n/a Total Points Reducing Sales of Tobacco Products n/a F F F A F n/a F A F F A Tobacco Retailer Licensing Total Points Belvedere Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Fairfax Corte Madera Larkspur Mill Valley Novato Ross San Anselmo San Rafael Sausalito Tiburon LUNG-USA

55 MARIPOSA COUNTY Overall Tobacco Control Grade Total Points 0 Smokefree Outdoor Air F Dining 0 Entryways 0 Public Events 0 Recreation Areas 2 Service Areas 0 Sidewalks 0 Worksites 0 Total Points 2 Smokefree Housing Nonsmoking Apartments 0 Nonsmoking Condominiums 0 Nonsmoking Common Areas 0 Nonsmoking Housing Authority 0 Total Points 0 Reducing Sales of Tobacco Products Tobacco Retailer Licensing 0 Total Points 0 Emerging Products Definition - Secondhand Smoke 0 Emerging Products Definition - Licensing 0 Retailer Location Restrictions 0 Sampling of Tobacco Products 0 Sale of Tobacco Products in Pharmacies 0 Flavored Tobacco Products 0 Minimum Pack Size of Cigars 0 Total Points 0 F F F F American Lung Association in California 55

56 Overall Tobacco Control Grade C F C D C Total Points Smokefree Outdoor Air D F C F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D F F F D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A F A A A Tobacco Retailer Licensing Total Points Fort Bragg Point Arena Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Ukiah MENDOCINO COUNTY Willits LUNG-USA

57 Overall Tobacco Control Grade F F F F F F F Total Points Smokefree Outdoor Air F F F F F F F Dining 0 n/a n/a n/a Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F Tobacco Retailer Licensing Total Points Atwater Dos Palos Gustine Livingston Los Banos Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points MERCED COUNTY Merced American Lung Association in California 57

58 Overall Tobacco Control Grade F F Total Points 0 0 Smokefree Outdoor Air F F Dining 0 0 Entryways 0 0 Public Events 0 0 Recreation Areas 0 0 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 0 0 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 0 Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Alturas MODOC COUNTY LUNG-USA

59 Overall Tobacco Control Grade C F Total Points 6 0 Smokefree Outdoor Air A F Dining 4 0 Entryways 4 0 Public Events 4 0 Recreation Areas 4 2 Service Areas 4 0 Sidewalks 0 0 Worksites 1 0 Total Points 21 2 Smokefree Housing C F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 4 0 Nonsmoking Housing Authority 1 0 Total Points 5 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 1 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 1 0 Mammoth Lakes MONO COUNTY American Lung Association in California 59

60 MONTEREY COUNTY Overall Tobacco Control Grade C F F F F F C F D F F F C Total Points Smokefree Outdoor Air D F D F F F D D D D F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F D F F F D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A F F F F F A F F F F F A Tobacco Retailer Licensing Total Points Carmel-by-the-Sea Del Rey Oaks Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Gonzales Greenfield King City Marina Monterey Pacific Grove Salinas Sand City Seaside Soledad LUNG-USA

61 Overall Tobacco Control Grade F F F F F D Total Points Smokefree Outdoor Air D F D D F D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F Tobacco Retailer Licensing Total Points American Canyon Calistoga Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Napa St. Helena NAPA COUNTY Yountville American Lung Association in California 61

62 Overall Tobacco Control Grade C C F F Total Points Smokefree Outdoor Air D D F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A A F F Tobacco Retailer Licensing Total Points Grass Valley Nevada City Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Truckee NEVADA COUNTY LUNG-USA

63 ORANGE COUNTY Overall Tobacco Control Grade F F F F F F F F F F F F F C F C F F F F F F F Total Points Smokefree Outdoor Air F F F D D F D D F F F D D A D A F F F F F D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F F D F C F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units n/a 0 n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Total Points Reducing Sales of Tobacco Products F F F F F F F F F F F F F F F F F F F F F F F Tobacco Retailer Licensing Total Points Aliso Viejo Anaheim Brea Buena Park Costa Mesa Cypress Dana Point Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Fullerton Fountain Valley Garden Grove Huntington Beach Irvine Laguna Beach Laguna Hills Laguna Niguel Laguna Woods La Habra Lake Forest La Palma Los Alamitos Mission Viejo Newport Beach Orange American Lung Association in California 63

64 ORANGE COUNTY Overall Tobacco Control Grade F F F F C F F F F F F F Total Points Smokefree Outdoor Air F F D F D D F F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Total Points Reducing Sales of Tobacco Products F F F F A F F F F F F F Tobacco Retailer Licensing Total Points Placentia Rancho Santa Margarita San Clemente San Juan Capistrano Santa Ana Seal Beach Stanton Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Tustin Villa Park Westminster Yorba Linda LUNG-USA

65 Overall Tobacco Control Grade F F F F F F F Total Points Smokefree Outdoor Air F F F F F D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F Tobacco Retailer Licensing Total Points Auburn Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Colfax Lincoln Loomis Rocklin PLACER COUNTY Roseville American Lung Association in California 65

66 Overall Tobacco Control Grade F F Total Points 0 0 Smokefree Outdoor Air F F Dining 0 0 Entryways 0 0 Public Events 0 0 Recreation Areas 0 2 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 0 2 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 1 Total Points 0 1 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Portola PLUMAS COUNTY LUNG-USA

67 RIVERSIDE COUNTY Overall Tobacco Control Grade C C F D D F D C D C D F F C D Total Points Smokefree Outdoor Air D D F F F F F D F D F F F D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units Total Points Reducing Sales of Tobacco Products A A F A A F A A A A A D F A A Tobacco Retailer Licensing Total Points Banning Beaumont Blythe Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Calimesa Canyon Lake Cathedral City Coachella Corona Hemet Desert Hot Springs Eastvale Indio Indian Wells Jurupa Valley Lake Elsinore American Lung Association in California 67

68 RIVERSIDE COUNTY Overall Tobacco Control Grade F D C B D C F D F C D B C D Total Points Smokefree Outdoor Air F F D B F A D F F D F A D D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F D F D F F F F F D F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F A A A A D F A D A A A A A Tobacco Retailer Licensing Total Points La Quinta Menifee Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Murrieta Moreno Valley Norco Palm Desert Palm Springs Perris Riverside Rancho Mirage San Jacinto Temecula Wildomar LUNG-USA

69 Overall Tobacco Control Grade F C D F F B C C Total Points Smokefree Outdoor Air F D C F F A D D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F C F F D F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F A F F F A A A Tobacco Retailer Licensing Total Points Citrus Heights Elk Grove Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Folsom Galt SACRAMENTO COUNTY Isleton Rancho Cordova Sacramento American Lung Association in California 69

70 Overall Tobacco Control Grade D F F Total Points Smokefree Outdoor Air F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A F F Tobacco Retailer Licensing Total Points Hollister Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points San Juan Bautista SAN BENITO COUNTY LUNG-USA

71 SAN BERNARDINO COUNTY Overall Tobacco Control Grade F D F F F F F F F F F C F Total Points Smokefree Outdoor Air D D F F F F D F F F F A F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F C F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units Total Points Reducing Sales of Tobacco Products F D F F F F F F F F F F F Tobacco Retailer Licensing Total Points Adelanto Apple Valley Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Barstow Big Bear Lake Chino Chino Hills Colton Fontana Hesperia Grand Terrace Highland Loma Linda Montclair American Lung Association in California 71

72 SAN BERNARDINO COUNTY Overall Tobacco Control Grade F F D F F F F F F F F F Total Points Smokefree Outdoor Air F F C D F F F F F D F D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Housing Authority Units Total Points Reducing Sales of Tobacco Products F F F F F F F F F F F F Tobacco Retailer Licensing Total Points Needles Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Ontario Rancho Cucamonga Redlands Rialto San Bernardino Twentynine Palms Upland Victorville Yucaipa Yucca Valley LUNG-USA

73 SAN DIEGO COUNTY Overall Tobacco Control Grade D D D D B D D F F F D F F D F F B C F Total Points Smokefree Outdoor Air C C A A A C C D D D C D D D D F A D D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokfree Housing F F F F C F F F F F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority 0 n/a n/a n/a n/a 0 n/a n/a n/a n/a 0 0 n/a 1 n/a n/a n/a n/a 1 Total Points Reducing Sales of Tobacco Products F F F F A F F F F F F F F B F F A A F Tobacco Retailer Licensing Total Points Carlsbad Chula Vista Coronado Del Mar El Cajon Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Encinitas Escondido Imperial Beach La Mesa Lemon Grove National City Oceanside Poway San Diego San Marcos Santee Solana Beach Vista American Lung Association in California 73

74 SAN FRANCISCO COUNTY Overall Tobacco Control Grade Total Points 9 Smokefree Outdoor Air B Dining 2 Entryways 3 Public Events 4 Recreation Areas 4 Service Areas 4 Sidewalks 0 Worksites 0 Total Points 17 Smokefree Housing Nonsmoking Apartments 0 Nonsmoking Condominiums 0 Nonsmoking Common Areas 2 Nonsmoking Housing Authority 1 Total Points 3 Reducing Sales of Tobacco Products Tobacco Retailer Licensing 4 Total Points 4 Emerging Products Definition - Secondhand Smoke 1 Emerging Products Definition - Licensing 1 Retailer Location Restrictions 0 Sampling of Tobacco Products 1 Sale of Tobacco Products in Pharmacies 1 Flavored Tobacco Products 0 Minimum Pack Size of Cigars 0 Total Points 4 B D A San Francisco LUNG-USA

75 Overall Tobacco Control Grade F F F F F F F F Total Points Smokefree Outdoor Air F F F F F D F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F D F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Escalon Lathrop Lodi Manteca SAN JOAQUIN COUNTY Ripon Stockton Tracy American Lung Association in California 75

76 Overall Tobacco Control Grade C F C D F F B C Total Points Smokefree Outdoor Air D D D A F D A D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F C F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A F A F F F A A Tobacco Retailer Licensing Total Points Arroyo Grande Atascadero Grover Beach Morro Bay Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points SAN LUIS OBISPO COUNTY Paso Robles Pismo Beach San Luis Obispo LUNG-USA

77 SAN MATEO COUNTY Overall Tobacco Control Grade F B F D F B F B F n/a C F C F D F D D D F C Total Points Smokefree Outdoor Air F A F C F A F A F A A F D F D F D D D F D Dining n/a Entryways n/a Public Events Recreation Areas Service Areas n/a Sidewalks n/a Worksites Total Points Smokefree Housing F A F D F B F A F n/a D F F F F F D F D F A Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F D F D D D F F n/a D D A D D D D D D F D Tobacco Retailer Licensing Total Points Atherton Belmont Brisbane Burlingame Colma Daly City Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points East Palo Alto Foster City Half Moon Bay Hillsborough Menlo Park Millbrae Pacifica Portola Valley Redwood City San Bruno San Carlos San Mateo South San Francisco Woodside American Lung Association in California 77

78 SANTA BARBARA COUNTY Overall Tobacco Control Grade D B C F F D F F B Total Points Smokefree Outdoor Air C A C F D D F F B Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F C D F F D F F D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority 0 n/a Total Points Reducing Sales of Tobacco Products F A A F F D F F A Tobacco Retailer Licensing Total Points Buellton Carpinteria Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Goleta Guadalupe Lompoc Santa Barbara Santa Maria Solvang LUNG-USA

79 SANTA CLARA COUNTY Overall Tobacco Control Grade B D C F F D F n/a C D D B F F D A Total Points Smokefree Outdoor Air A C D D F C D n/a B C C B F D C A Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F F F C D F F A Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 1 Total Points Reducing Sales of Tobacco Products A F A F n/a F F n/a A F F B F F F A Tobacco Retailer Licensing Total Points Campbell Cupertino Gilroy Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Los Altos Los Altos Hills Los Gatos Milpitas Monte Sereno Morgan Hill Mountain View Palo Alto San Jose Santa Clara Saratoga Sunnyvale American Lung Association in California 79

80 Overall Tobacco Control Grade C B D B C Total Points Smokefree Outdoor Air A B C B D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D D D D D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F A F A A Tobacco Retailer Licensing Total Points Capitola Santa Cruz Scotts Valley Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points SANTA CRUZ COUNTY Watsonville LUNG-USA

81 Overall Tobacco Control Grade D D F D Total Points Smokefree Outdoor Air C D F D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D D D D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F Tobacco Retailer Licensing Total Points Anderson Redding Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Shasta Lake SHASTA COUNTY American Lung Association in California 81

82 Overall Tobacco Control Grade F F Total Points 0 0 Smokefree Outdoor Air F F Dining 0 0 Entryways 0 0 Public Events 0 0 Recreation Areas 0 2 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 0 2 Smokefree Housing F F Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 0 Nonsmoking Housing Authority 0 n/a Total Points 0 0 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 n/a Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Loyalton SIERRA COUNTY LUNG-USA

83 SISKIYOU COUNTY Overall Tobacco Control Grade F F F F F F F F F F Total Points Smokefree Outdoor Air F F F F F F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Pointst Smokefree Housing F F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Dorris Dunsmuir Etna Fort Jones Montague Mount Shasta Tulelake Weed Yreka American Lung Association in California 83

84 Overall Tobacco Control Grade F F F F F F D F Total Points Smokefree Outdoor Air F F D F F D D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F D F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Benicia Dixon Fairfield Rio Vista Suisun City SOLANO COUNTY Vacaville Vallejo LUNG-USA

85 SONOMA COUNTY Overall Tobacco Control Grade F F B B C D B F D B Total Points Smokefree Outdoor Air F F B A A A A F B A Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F D D A C F A D F A Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a Total Points Reducing Sales of Tobacco Products F F A F F F F F F F Tobacco Retailer Licensing Total Points Cloverdale Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Cotati Healdsburg Petaluma Rohnert Park Santa Rosa Sebastopol Sonoma Windsor American Lung Association in California 85

86 STANISLAUS COUNTY Overall Tobacco Control Grade F F F F F F D F F F Total Points Smokefree Outdoor Air F F F F F F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D D D F F D F D F D Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F A F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Ceres Hughson Modesto Newman Oakdale Patterson Riverbank Turlock Waterford LUNG-USA

87 Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air D D F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Live Oak Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Yuba City SUTTER COUNTY American Lung Association in California 87

88 Overall Tobacco Control Grade F F F F Total Points Smokefree Outdoor Air F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F Tobacco Retailer Licensing Total Points Corning Red Bluff Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Tehama TEHAMA COUNTY LUNG-USA

89 Overall Tobacco Control Grade Total Points 0 Smokefree Outdoor Air F Dining 0 Entryways 0 Public Events 0 Recreation Areas 2 Service Areas 0 Sidewalks 0 Worksites 0 Total Points 2 Smokefree Housing Nonsmoking Apartments 0 Nonsmoking Condominiums 0 Nonsmoking Common Areas 0 Nonsmoking Housing Authority 0 Total Points 0 Reducing Sales of Tobacco Products Tobacco Retailer Licensing 0 Total Points 0 Emerging Products Definition - Secondhand Smoke 0 Emerging Products Definition - Licensing 0 Retailer Location Restrictions 0 Sampling of Tobacco Products 0 Sale of Tobacco Products in Pharmacies 0 Flavored Tobacco Products 0 Minimum Pack Size of Cigars 0 Total Points 0 F F F TRINITY COUNTY American Lung Association in California 89

90 TULARE COUNTY Overall Tobacco Control Grade F F F F F F F F F Total Points Smokefree Outdoor Air F D F F F F F F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F F F F F F Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Dinuba Exeter Farmersville Lindsay Porterville Tulare Visalia Woodlake LUNG-USA

91 Overall Tobacco Control Grade F D Total Points 0 2 Smokefree Outdoor Air F D Dining 0 2 Entryways 0 0 Public Events 0 2 Recreation Areas 0 0 Service Areas 0 0 Sidewalks 0 0 Worksites 0 0 Total Points 0 4 Smokefree Housing F D Nonsmoking Apartments 0 0 Nonsmoking Condominiums 0 0 Nonsmoking Common Areas 0 2 Nonsmoking Housing Authority 0 0 Total Points 0 2 Reducing Sales of Tobacco Products F F Tobacco Retailer Licensing 0 0 Total Points 0 0 Emerging Products Definition - Secondhand Smoke 0 0 Emerging Products Definition - Licensing 0 0 Retailer Location Restrictions 0 0 Sampling of Tobacco Products 0 0 Sale of Tobacco Products in Pharmacies 0 0 Flavored Tobacco Products 0 0 Minimum Pack Size of Cigars 0 0 Total Points 0 0 Sonora TUOLUMNE COUNTY American Lung Association in California 91

92 VENTURA COUNTY Overall Tobacco Control Grade C F D D D F F F D F F Total Points Smokefree Outdoor Air A F A D F F F F B F F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D F F D F F F F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F F A F F F F F F Tobacco Retailer Licensing Total Points Camarillo Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Fillmore Moorpark Ojai Oxnard Port Hueneme Santa Paula Simi Valley Thousand Oaks Ventura LUNG-USA

93 Overall Tobacco Control Grade B D F D D Total Points Smokefree Outdoor Air A F D C F Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing D F F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products A B F F A Tobacco Retailer Licensing Total Points Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Davis Winters West Sacramento Woodland YOLO COUNTY American Lung Association in California 93

94 Overall Tobacco Control Grade F F F Total Points Smokefree Outdoor Air F F D Dining Entryways Public Events Recreation Areas Service Areas Sidewalks Worksites Total Points Smokefree Housing F F F Nonsmoking Apartments Nonsmoking Condominiums Nonsmoking Common Areas Nonsmoking Housing Authority Total Points Reducing Sales of Tobacco Products F F F Tobacco Retailer Licensing Total Points Marysville Emerging Products Definition - Secondhand Smoke Emerging Products Definition - Licensing Retailer Location Restrictions Sampling of Tobacco Products Sale of Tobacco Products in Pharmacies Flavored Tobacco Products Minimum Pack Size of Cigars Total Points Wheatland YUBA COUNTY LUNG-USA