Testimony on Three Proposals that Address Continuing Epidemic of Tobacco Use

Presented on May 2, 2013 before the New York City Council Health Committee:

Sheelah Testimony

Sheelah Feinberg in center of panel at public hearing

Good afternoon and thank you to Council Member Arroyo and the members of the Health Committee for the opportunity to speak today about three exciting and bold new proposals that address the continuing epidemic of tobacco use head-on: Intro 1020, Intro 1021, and Intro 250.

My name is Sheelah Feinberg, and I am the Executive Director of the NYC Coalition for a Smoke-Free City, a program of Public Health Solutions.  The Coalition is a public health advocacy group that has worked with over one hundred health and youth focused community groups across the five boroughs to raise awareness around tobacco control and prevention.  We support neighborhood efforts for long-term change and believe that all New Yorkers have the right to breathe clean, smoke-free air where they live, work, and play.

A little over a month ago, the Coalition celebrated the ten-year anniversary of the Smoke-Free Air Act.  New York City was considered a public health pioneer when we made our bars and restaurants smoke-free.  Despite negative press coverage, concerns about potential harm to businesses, and big spending by Big Tobacco to defeat the proposal, the City Council and the Administration took bold steps to protect the health of New Yorkers.  Contrary to the assertions of these critics, the restaurant and bar industry flourished, and an estimated 150,000 fewer New Yorkers were exposed to secondhand smoke at work.[1]

Since 2002, the Coalition has continued to educate community members, leaders, and organizations around the public health importance of tobacco control initiatives, such as expanding tobacco-free outdoor areas to hospital entryways and parks, beaches and pedestrian plazas, and decreasing tobacco marketing and product accessibility.  Now, there are more former smokers in New York City who have successfully quit than there are current smokers.[2] With more adult smokers quitting, we must turn to preventing our youth and young adults from ever starting.

In 2011, the Coalition collaborated with the American Lung Association of the Northeast on a series of youth-led events called “Take a Walk in Our Shoes.” These neighborhood walking tours highlighted that 75% of tobacco retailers are within 1,000 feet of a school.[3]  In addition, Asian Americans for Equality (AAFE), a Coalition partner that works with a population disproportionally affected by the negative health effects of tobacco use, recently conducted an observational survey of tobacco sales and displays in pharmacies in New York City’s Asian American neighborhoods.  AAFE found that of the pharmacies they surveyed, 71% not only prominently displayed tobacco products but had them placed close to candy, gum, and other products typically purchased by youth.[4]  New York City’s youth are bombarded with tobacco products and marketing.  The proposals being discussed today will address this critical public health issue directly.
The Coalition and its partners are grateful to have a City Council and Mayor who have demonstrated an unprecedented commitment to improving public health.  Our combined efforts have yielded historic success. Thanks to a comprehensive tobacco control program that includes bold policies, higher cigarette taxes, hard-hitting media campaigns, and cessation services to help smokers quit, the percentage of adults smoking in New York City has dropped to14.8%[5] and the percentage of public high school students has dropped to 8.5%.[6]  This means thousands of lives saved, increased life expectancy, and improved health for all New Yorkers.

While New York City has enjoyed tremendous success reducing both adult and youth smoking rates, our progress has stalled.  This is not surprising since tobacco companies spend $8.5 billion each year in the United States on marketing that works counter to the public’s health and best interests, including $196 million in New York alone.[7] We will continue to work vigilantly to give the community a Big Voice against Big Tobacco’s commitment to recruiting New Yorkers into a lifetime of addiction to their deadly products.

The Health Committee now has before it three proposals: Intro 1020, which restricts the display of tobacco products in our local stores where youth frequently shop, Intro 1021, also known as the Sensible Tobacco Enforcement and Pricing (STEP) initiative, and Intro 250, which will raise the minimum age required to purchase tobacco products in New York City to twenty-one.  All three are complementary, evidence-based strategies that will prevent today’s youth from becoming the next generation of addicted smokers.

Intro 1020 goes to the front line of where we will win or lose our fight against the tobacco epidemic: prominent tobacco displays behind the register in retail chain pharmacies and our neighborhood convenience stores and bodegas.  These displays are designed to attract youth and normalize both the availability and purchase of tobacco products — the leading cause of preventable death in the United States.  Multiple studies show that visibly placing cigarettes behind the register influences youth opinions on the social acceptability of tobacco use and makes them more likely to smoke.[8][9][10] Tobacco displays right behind the register also make it increasingly difficult for adult smokers and those trying to quit from making impulse purchases.

Intro 1021 will level the playing field for retailers who play by the rules and do not sell loose or unstamped tobacco products by increasing the penalties for those that do.  This will strongly discourage retailers from evading tobacco taxes or selling without a license.  Intro 1021 also brings New York City up-to-date with the changing marketplace for tobacco products by requiring cheap cigars ($3 or less) and cigarillos to be sold in packs of no less than four and little cigars to be sold in packs of twenty.  According to the NYC Department of Health and Mental Hygiene, the rate at which our youth are smoking individually wrapped and cheaply sold cigars, little cigars, and cigarillos nearly tripled from 2001 to 2009.[11]

Intro 250 takes the important step of raising the minimum age to purchase tobacco products to twenty-one, targeting both youth access and addiction.  Research shows that 90% of people purchasing cigarettes for minors are eighteen, nineteen, or twenty years old.[12]  Under the new minimum age of twenty-one, New York City high school students could no longer purchase cigarettes, and the number of public high school students under the age of eighteen who smoke, currently 20,000,[13] would decline.  We can stop our young people from becoming addicted: experimental smoking for young adults typically becomes regular smoking around age twenty.[14]

While opponents of tobacco control are often vocal, well-funded, or both, public opinion polls show that 59% of New Yorkers support prohibiting tobacco displays in stores,[15] and 67% support raising the minimum age to purchase tobacco products to twenty-one.[16]

In closing, despite great progress, tobacco use still causes hundreds of thousands of preventable deaths in the United States annually including thousands of lives lost here in New York.  For over twenty years, the NYC Coalition for a Smoke-Free City has been a proud supporter of the leadership and historic tobacco control work of New York City.  We’re ready to make history again.

Thank you.

[1] “The State of Smoke-Free New York City: A One-Year Review.” New York City Economic Development Corporation & the Departments of Finance, Health & Mental Hygiene, Small Business Services, March 2004.

[2] Community Health Survey, 2011. New York City Department of Health and Mental Hygiene.

[3] Henriksen, L. et al. “Is adolescent smoking related to the density and proximity of tobacco outlets and retail cigarette advertising near school?” Preventive Medicine 47, 2008.

[4] Le D, Ryder M, Schmeltz M. “Prescription for a Healthy City.” Asian Americans for Equality, 2012.

[5] Community Health Survey, 2011. New York City Department of Health and Mental Hygiene.

[6] Youth Risk Behavior Survey, 2011.  New York City Department of Health and Mental Hygiene.

[7] Campaign for Tobacco Free Kids. “Estimated tobacco industry marketing in NYS.” December 2012.

[8] Wakefield M, Germain D, Durkin S, Henriksen L. An experimental study of effects on schoolchildren of exposure to point-of-sale cigarette advertising and pack displays. Health Educ Res 2006;21(3):338-47.

[9] MacKintosh AM, Moodie C, Hastings G. The association between point-of-sale displays and youth smoking susceptibility. Nicotine & Tobacco Research. 2012;14(5):616-620

[10] U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, 2012.

[11] Youth Risk Behavior Survey, NYC Department of Health and Mental Hygiene, 2001 & 2009 Data Analysis.

[12]  DiFranza J, Coleman M. Sources of tobacco for youths in communities with strong enforcement of youth access laws. Tob Ctrl 2001;10:323-328.

[13] Youth Risk Behavior Survey, 2011.  New York City Department of Health and Mental Hygiene.

[14] Hammond D. Smoking behavior among young adults: beyond youth prevention. Tob Ctrl 2005;14:181-185.

[15] NYC Department of Health and Mental Hygiene Tobacco Behavior and Public Opinion Survey, 2012.

[16] NYC Department of Health and Mental Hygiene Tobacco Behavior and Public Opinion Survey, 2012.