NYS Conference of Environmental Health Directors Meeting October 28, 2014 Bureau of Community Environmental Health and Food Protection Director: Brian M. Miner
Discussion Topic: Smoking Restrictions ATUPA and Synar CIAA and Electronic Nicotine Delivery Systems (ENDS)
ATUPA Statewide Program Highlights Year 15 (April 1, 2013 March 31, 2014) 21,906 registered retailers Over 31,404 compliance investigations 1,221 sales to minors Retailer non-compliance rate 4.96% $2,730,038 fines assessed 127 DTF Suspensions 41 Lottery license suspension
Adolescent Tobacco Use Prevention Performance Measures Outcome Measure: Decrease the percentage of NYS tobacco retailers non compliant with the Public Health Law requirement prohibiting the sale of tobacco products to minors to 5% or below, and maintain below 5% annually.
Non-Compliance Rate New York State Tobacco Retailer Non-Compliance Rate ATUPA Program Years 1-16 20.0% 18.0% 16.0% 14.0% 12.0% 10.0% 19.0% 17.0% 13.0% 13.0% 11.0% 11.0% 11.0% 10.4% 10.0% 8.0% 7.6% 8.3% 7.0% 6.0% 5.9% 4.99% 5.3% 4.96% 4.0% 2.0% 0.0% Year The retailer non-compliance rate for FFY 1998 & 1999 is based on the number of enforcement actions for illegal sales to minors; the 2000-2013 rate is based on the actual number of sales to minors. * The FFY 2011 contract period covers the 18 months from October 1, 2010 to March 31, 2012. ** The tobacco enforcement program year now follows the State Fiscal Year (SFY).
Adolescent Tobacco Use Prevention Performance Measures Process Measure: Conduct unannounced compliance inspections with minors at all tobacco retailers (approximately 21,000) each program year to assess compliance with the Public Health Law.
30000 New York State Department of Taxation and Finance (DTF) Registered Tobacco Retailers Receiving at least one Annual Youth Access Compliance Check ATUPA Program Years 8-15 25982 25917 25000 20000 23705 24440 24198 22931 23380 20451 19880 20232 20834 18305 18266 19077 21906 19788 15000 10000 5000 0 2006 2007 2008 2009 2010 2011 2012 2013 DTF Registered Facilities Facilities receiving a Youth Compliance Check
Synar Survey Comparison of NYS and National Non-Compliance Rates for Sales to Minors 45.0% 40.0% 35.0% 33.0% 30.0% 27.0% 25.0% 20.0% 19.0% 15.0% 16.0% 17.0% 13.0% 13.0% 10.0% 5.0% 11.0% 10.4% 11.3% 11.2% 9.9% 7.6% 8.3% 7.0% 5.9% 5.0% 5.3% 4.96% 0.0% National Synar Survey Non-Compliance Rate P:Sections/Tobacco/Synar/NationvsNYSNew.xls New York State Synar Survey Non-Compliance Rate New York State Non-Compliance Rate for all Retailers
CIAA CIAA amendments of 2003 have been highly successful, resulting in: Reduced exposure to secondhand smoke among the general public with direct measurable health impacts The Clean Indoor Air Act was estimated to prevent nearly 4,000 hospital admissions for heart attacks in the first year following the law, saving New Yorkers direct health care costs of at least $56 million. Social norm change Such policies send the message that tobacco use in public places is unacceptable, unhealthy behavior.
E-cigarettes or Electronic Nicotine Delivery Systems (ENDS) Environmental Heath Perspectives September 2014 Volume 122 http://ehp.niehs.nih.gov/122-a244/
Maciej Goniewicz, a toxicologist at the Roswell Park Cancer Institute in Buffalo, New York, says, This is vapor, but only a small proportion of it is water. Mostly, he says, it s made up of propylene glycol and/or glycerin, the main ingredients in the e-liquid (or e-juice ) that is vaporized inside e- cigarettes. When heated, these solvents produce an aerosol resembling cigarette smoke. Most e- liquids also contain flavorings and preservatives. Most of what we know about e-cigarettes is from lab studies, Goniewicz says. We don t know about the real health effects on the users of this product, especially on long-term users.
Liquid nicotine solution e-liguid or e-juice
100s of E- liquid varieties Targeting Youth? XTC Blue Menthol Ice Kryp-tonite Captain Jack Grape Fez French Vanilla Cherry Crush Bubble Gum Gummy Bear.
Public Hearing: To consider including electronic cigarettes in the existing Clean Indoor Air Act and regulating liquid nicotine Committee: Senate Standing Committee on Health, Chair: Senator Kemp Hannon Date: May 12, 2014 10:00 am Location: Van Buren Hearing Room A, Legislative Office Building, 2nd Floor, Albany, New York Testimony: New York State Department of Health: Harlan R. Juster, Ph.D. Director, New York State Department of Health Bureau of Tobacco Control
DOH Testimony DOH expressed concern that nicotine delivery devices will result in one or more of the following negative health outcomes: 1. Youth using ENDS will become addicted to nicotine and many will transition to the use of tobacco cigarettes. Tobacco cigarettes deliver nicotine more efficiently than nicotine delivery devices and the transition seems to be a logical extension of ENDS use. 2. Nicotine devices will re-glamorize the act of smoking. This is a battle fought by public health for a long time and continues to be a key strategy to reducing youth initiation. 3. Nicotine devices will be used to maintain and strengthen nicotine addiction in smokers who then continue to also smoke tobacco cigarettes, known as dual use, and 4. Former smokers will return to nicotine use and addiction through the use of these devices and then relapse to tobacco use.
Conclusion New York State has made great progress in reducing the impact of tobacco use and adult and youth tobacco use rates have come down. This progress is directly attributable to strong tobacco control policies and a strong statewide tobacco control program. The unregulated market that is electronic nicotine delivery devices threatens the gains that have been made in New York and must not be allowed to undermine the important progress made in de-normalizing tobacco use, especially among youth and young adults. We must continue to conduct well-designed studies to better understand the impact of these products on public health but the paucity of research cannot be used as an excuse to refrain from action. Harlan Juster, Ph.D.