Tobacco 21 in Oregon 7,000. Leading Causes of Preventable Death in Oregon. Most addiction to tobacco starts in adolescence.

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Tobacco 21 in Oregon Luci Longoria, MPH Health Promotion Manager Health Promotion and Chronic Disease Prevention Oregon Health Authority www.nwcphp.org/hot-topics Leading Causes of Preventable Death in Oregon Other ~24,000 7,000 Tobacco use Obesity, poor diet, and physical inactivity Alcohol use Most addiction to tobacco starts in adolescence. Among adults who become daily smokers, approximately 90% first smoked cigarettes before 18 years of age, and almost 100% report first use before age 26. 1

Most addiction to tobacco starts in adolescence. If a man has never smoked by age 18, the odds are threeto-one he never will. R.J. Reynolds company report Most addiction to tobacco starts in adolescence. 2013 2015 Youth cigarette smoking decreased from 1996 to 2015. Smoking among 11 th graders declined by 68 percent. Most addiction to tobacco starts in adolescence. Youth smokers choose flavored 2013 products over 2015 cigarettes because they taste better and are perceived to be safer than nonflavored tobacco products. 2

Most addiction to tobacco starts in adolescence. Flavored tobacco products are more popular among youth and young adults compared to older adults. Flavors appear to be a key component for youth who start using tobacco. E-cigarette use is on the rise. A survey released by CDC found that youth who had tried e-cigarettes were nearly twice as likely to say they would try a conventional cigarette. E-cigarette use is on the rise. Use of electronic cigarettes among 11th-graders increased by more than 750 percent from 2011 to 2015 2013 2015 3

Polling Question #1 My state/local jurisdiction has had serious conversations about youth access to alternative tobacco products (e.g. e-cigarettes, Juul) in the retail environment. Yes No Unsure During adolescence, youthful experimentation often accelerates into daily use. Exposure during this period results in permanent neurological receptor changes that can lead to a lifetime nicotine addiction. The tobacco industry is outspending prevention efforts in Oregon. 4

91% of expenditures on cigarette promotion and advertising are at the point of sale. Tobacco products are heavily promoted in locations accessible to youth. Nearly 93% of stores in Oregon that sell tobacco sell flavored tobacco products. More than half of Oregon 8thgraders and 11th-graders shop in a convenience store at least once a week Tobacco products are often marketed to appeal to kids. Among stores that sell tobacco in Oregon: More than one-quarter display toys, candy or gum within 12 inches of tobacco products Nearly one-quarter place advertisements for tobacco products within three feet of the floor Nearly nine in 10 stores that sell little cigars and cigarillos sell them as singles, which makes them cheap and accessible to young people 5

80% of marketing expenditures at the point of sale are for price reductions. Underage youth often obtain cigarettes from social sources. Three in four smokers ages 15 to 17 obtain tobacco from social sources That amounts to nearly 7,000 students getting tobacco from their friends and family Tobacco 21 Teen smoking is not powered by illegal sales nearly as much as by legal sales to older youth. Raising the age to 21 puts legal purchasers outside the social circle of most high school students. -MetroWest Health Foundation surveys in Needham, MA, high schools 6

Polling Question #2 The biggest challenge to support for stronger tobacco retail laws in my area (state/local) is: 1) concerns about equitable enforcement of law 2) concerns about economic effects 3) competing priorities for state/local policymakers 4) Other (type in chat box) Local Efforts in Oregon Multnomah County Lane County Support and Engagement 7

Support and Engagement Support and Engagement [Governor Kate] Brown specifically pushed for a bill currently in the state Legislature that would make Oregon the third state to raise its tobacco purchase age to 21 from 18. It would cover all tobacco products, from cigarettes to electronic devices such as vaping pens. - The Register-Guard (Eugene, OR), Governor praises anti-tobacco efforts in county Highlights Signed into law by Governor Brown on August 9, 2017. Raised the minimum legal sales age of tobacco products and inhalant delivery systems from 18 to 21 years old. Amended the definition of tobacco products to include devices that can deliver tobacco to the person using the device. Created a tiered violation schedule for sales to those under the age of 21. 8

Challenges Communications Implementation 9

Evaluation Polling Question #3 My state/local jurisdiction is ready to move forward with Tobacco 21, or other tobacco retail policy, and I d like to connect with OHA to discuss further. Yes No Luci Longoria, MPH Health Promotion Manager Health Promotion and Chronic Disease Prevention Luci.longoria@state.or.us 971-673-0984 10

Questions? 11