COMMUNITY HEALTH COMMISSION MEETING AGENDA …€¦ · Meatless Monday letter to City Council 7....

Community Health Commission (CHC)

A Vibrant and Healthy Berkeley for All

1947 Center Street, 2nd Floor, Berkeley, CA 94704 Tel: 510. 981.5300 TDD: 510.981.6903 Fax: 510. 981.5395 E-mail: [email protected] - - http://www.cityofberkeley.info/health/

COMMUNITY HEALTH COMMISSION MEETING AGENDA

Thursday, November 19, 2015 - 6:30 pm – 9:00 pm South Berkeley Senior Center, 2939 Ellis Street

Berkeley, CA 94709

Preliminary Matters 1. Roll Call 2. Introductions of any new members 3. Approval of Minutes from prior meeting (Attachment 1) 4. Confirm note taker – Commissioner Engelman’s transcriber 5. Public Comment (Speakers will have up to 5 minutes each)

Presentation & Discussion Items

1. Presentation: Carol Johnson, City of Berkeley Planning Department – Adeline Corridor Project

2. Presentation: Speaker, African American Resource Center 3. [Health Officer Update]: Introduction of Manager of Family Health & Nursing

Services, Cheryl Ford Health Equity Action Items (from Health Equity subcommittee)

1. Subcommittee report/Discussion: Community Health Action Team (CHAT) outreach and linkage concept to facilitate access to health care

2. Action: Recommend that City Council direct the City Manager to explore implementing a CHAT outreach and linkage program

Break Action Items

1. Action: Determine 2016 Community Health Commission meeting schedule – maximum of 10 meetings per year (Attachment 3)

2. Action: Determine how to proceed with City Council referral on consideration of creation of an ordinance establishing healthy default beverages offered with children’s meals

a. City Council Action: Approved recommendation revised to refer the item to the Community Health Commission only. (Attachment 4)

3. Action: Approved edited version of BTA memo to City Council (Attachment 5) 4. Subcommittee Report: Electronic Controlled Weapon (Stein)

a. Action: Recommend that the Electronic Controlled Weapon subcommittee be retired

5. Subcommittee Report: Public Education and Marketing (Franklin) a. Action: Communicate support for Meatless Mondays to City Council

(Attachment 6) 6. Subcommittee Report: Raising Minimum Age for Purchasing Tobacco Products

(Soichet) a. Action: Recommend that City Council raise the minimum age to purchase of

tobacco products (including e-cigarettes) to 21 (Attachments 7, 7a, 7b)

mailto:[email protected]

Agenda – Community Health Commission 11/19/2015 of 2

Future Agenda Items 1. Presentations on Alta Bates Charity Care 2. Discuss and approve establishment of a City of Berkeley Race & Equity Department

(Namkung) Announcements from Commissioners Information Items

1. City of Berkeley Aging Services Meatless Mondays (Attachment 8) 2. Link to Portrait of Promise: The California Statewide Plan to Promote Health and

Mental Health Equity here – www.cdph.ca.gov/programs/Pages/OHEMain.aspx Adjournment Attachments:

1. Draft minutes of 10/22/15 CHC meeting 2. Approved minutes of 9/24/15 CHC meeting 3. City-observed holiday schedule 4. City Council referral on considering creating an ordinance establishing healthy

default beverages offered with children’s meals 5. Edited memo to City Council regarding BUSD recommendation around Berkeley

Technology Academy (BTA) 6. Meatless Monday letter to City Council 7. Tobacco Minimum Age Recommendation to City Council 8. City of Berkeley Aging Services Meatless Monday Menu 9. Community Health Commission Subcommittee Roster

The next meeting of the Community Health Commission is scheduled for January 2016. The specific date has not yet been selected as the Commission will be voting on 2016 meeting dates on November 19, 2015. Dates are subject to change; please contact the Commission Secretary to confirm.

Please refrain from wearing scented products to this meeting.

COMMUNICATION ACCESS INFORMATION This meeting is being held in a wheelchair accessible location. To request a disability-related accommodation(s) to participate in the meeting, including auxiliary aids or services, please contact the Disability Services specialist at 981-6346 (V) or 981-6345 (TDD) at least three business days before the meeting date. Communications to Berkeley boards, commissions or committees are public record and will become part of the City’s electronic records, which are accessible through the City’s website. Please note: e-mail addresses, names, addresses, and other contact information are not required, but if included in any communication to a City board, commission or committee, will become part of the public record. If you do not want your e-mail address or any other contact information to be made public, you may deliver communications via U.S. Postal Service or in person to the secretary of the relevant board, commission or committee. If you do not want your contact information included in the public record, please do not include that information in your communication. Please contact the commission secretary for further information. Any writings or documents provided to a majority of the Commission regarding any item on this agenda will be made available for public inspection at the North Berkeley Senior Center located at 1901 Hearst Avenue, during regular business hours. The Commission Agenda and Minutes may be viewed on the City of Berkeley website: http://www.cityofberkeley.info/commissions.

http://www.cityofberkeley.info/commissions

Community Health Commission



Draft Minutes Regular Meeting, Thursday October 22, 2015

The meeting convened at 6:35 p.m. with Chair Rosales presiding. ROLL CALL Present: Commissioners Chen, Engelman, Franklin, Kwanele (6:48), Nathan (6:39),

Rosales, Shaw, Smith, Soichet, Speich, Stein, Thornton, and A. Wong Absent: Commissioners Namkung & M. Wong Excused: Commissioner Lee Staff present: Janet Berreman and Tanya Bustamante COMMENTS FROM THE PUBLIC Mara Guccione – Meatless Mondays in November announcement & request for support Sheila Quintana, Berkeley Technology Academy – request for support of funding for school garden PRESENTATIONS

Ghanya Thomas, Transportation Commission – Request for support of recommendation to City Council to adopt and implement “It’s Up to All of Us” pedestrian safety campaign

ACTION ON MINUTES 1. M/S/C (Chen/Stein) Motion to approve the draft September 2015 minutes. Ayes: Commissioners Chen, Engelman, Franklin, Rosales, Shaw, Smith,

Speich, Stein, Thornton and A. Wong Noes: None Abstain: Commissioner Soichet Absent from vote: Commissioners Kwanele, Namkung, Nathan, and M. Wong Excused: Commissioner Lee


Meeting Location: South Berkeley Senior Center 2939 Ellis Street, Berkeley, CA

Attachment 1


Community Health Commission Minutes October 22, 2015 Page 2 of 4

Motion Passed. ACTION ITEM

2. M/S/C (Franklin/Shaw) Motion to support the Transportation Commission’s recommendation that the Berkeley City Council adopt and implement in the City of Berkeley the “It’s Up to All of Us” pedestrian safety campaign established by the California Department of Public Health. As a first step, the Council should direct the City Manager to authorize staff to prepare a budget and action plan in consultation with the Transportation Commission, and determine the most efficient use of funds.

Ayes: Commissioners Chen, Franklin, Kwanele, Nathan, Rosales, Shaw, Smith, Soichet and Stein

Noes: Commissioners Engelman, Speich and A. Wong Abstain: Commissioner Thornton Absent: Commissioners Namkung and M. Wong Excused: Commissioner Lee

Motion passed. ACTION ITEM 3. M/S/C (Speich/Smith) Motion to create a subcommittee on Raising the Minimum Age

for Purchasing Tobacco Products to 21. Membership of subcommittee will include Commissioners Chen, Nathan, Soichet, Speich and A. Wong. Commissioner Soichet will chair the subcommittee.

Ayes: Commissioners Chen, Engelman, Franklin, Kwanele, Nathan,

Rosales, Shaw, Smith, Soichet, Speich, Stein, Thornton and A. Wong

Noes: None Abstain: None Absent: Commissioners Namkung and M. Wong Excused: Commissioner Lee

Motion passed.


ACTION ITEM 4. M/S/C (Franklin/Soichet) Motion to support the recommendation by City

Councilmember Worthington to refer to the Sugar Sweetened Beverage Panel of Experts to consider creating an ordinance that would establish healthy default beverages with children’s meals.


Rosales, Shaw, Smith, Soichet, Speich, Stein, Thornton and A. Wong


Motion passed. ACTION ITEM 5. M/S/C (Chen/Soichet) Motion to approve communication to City Council regarding

recommendation to support Berkeley Technology Academy, with the following edits: replace “increased” with “allocate;” include “prioritize fully staffing vacant Nurse Practitioner position with Berkeley Technology Academy” and “support ongoing efforts of Public Health to fill the vacancy.”

Ayes: Commissioners Chen, Engelman, Franklin, Kwanele, Nathan, Rosales, Shaw, Smith, Soichet, Speich, Stein, Thornton and A. Wong


Motion passed.


ACTION ITEM 6. M/S/C (Speich/Chen) Motion to retire the CEAC Liaison subcommittee.


Rosales, Smith, Soichet, Speich, Stein, Thornton and A. Wong Noes: None Abstain: Commissioner Shaw Absent: Commissioners Namkung and M. Wong Excused: Commissioner Lee

Motion passed. ACTION ITEM 7. M/S/C (A.Wong/Nathan) Motion to add Commissioner Smith to the Health Equity

subcommittee.

Ayes: Commissioners Chen, Engelman, Franklin, Kwanele, Nathan, Rosales, Shaw, Smith, Soichet, Speich, Stein, Thornton and A. Wong


Motion passed. NEXT MEETING The next regular meeting will be on November 19, 2015 at 6:30 p.m. at the South Berkeley Senior Center.

This meeting was adjourned at 9:02 p.m.

Respectfully Submitted, Tanya Bustamante, Secretary.




Approved Minutes Regular Meeting, Thursday September 24, 2015

The meeting convened at 6:35 p.m. with Chair Rosales presiding. ROLL CALL Present: Commissioners Chen, Engelman, Franklin, Lee (6:45), Nathan, Rosales,

Shaw, Smith, Speich, Thornton, A. Wong and M. Wong Absent: Commissioner Soichet Excused: Commissioners Kwanele, Namkung and Stein Staff present: Janet Berreman and Tanya Bustamante COMMENTS FROM THE PUBLIC Mara Guccione – Meatless Mondays PRESENTATIONS

Steve Grolnic-McClurg – Update on Mental Health Division

Katherine Brown & Gin Hansson – Overview of Heart-2-Heart Project with Focus on Community Advocates

Janet Berreman, Health Officer – Update on Public Health Priorities Community Engagement

ACTION ON MINUTES 1. M/S/C (Speich/Chen) Motion to approve the draft July 2015 minutes as amended

(Commissioner Nathan as excused and deletion of Commissioner Franklin as motioning for approval of draft June 2015 minutes).

Ayes: Commissioners Chen, Engelman, Franklin, Nathan, Rosales,

Shaw, Smith, Stein, Thornton and M. Wong Noes: None Abstain: Commissioner A. Wong Absent from vote: Commissioners Lee and Soichet


Meeting Location: South Berkeley Senior Center 2939 Ellis Street, Berkeley, CA

Attachment 2


Community Health Commission Minutes September 24, 2015 Page 2 of 2

Excused: Commissioners Kwanele, Namkung and Stein

Motion Passed. ACTION ITEM

2. M/S/C (Speich/Shaw) Motion to end the services of the GMO Labeling Subcommittee.

Ayes: Commissioners Chen, Engelman, Franklin, Lee, Nathan, Rosales, Shaw, Smith, Stein, Thornton, A. Wong and M. Wong

Noes: None Abstain: None Absent: Commissioner Soichet Excused: Commissioners Kwanele, Namkung and Stein

Motion passed. ACTION ITEM

3. M/S/C (Speich/Smith) Motion to retire the Alta Bates Charity Care and Community Benefits Subcommittee as it stands.

Ayes: Commissioners Chen, Engelman, Franklin, Lee, Nathan, Rosales, Shaw, Smith, Stein, Thornton, A. Wong and M. Wong

Noes: None Abstain: None Absent: Commissioner Soichet Excused: Commissioners Kwanele, Namkung and Stein

Motion passed. NEXT MEETING The next regular meeting will be on October 22, 2015 at 6:30 at the South Berkeley Senior Center.

This meeting was adjourned at 9:05 p.m.

Respectfully Submitted, Tanya Bustamante, Secretary.

Possible Meeting Times for 2016

4th Thursday of each Month

Thursday, January 28, 2016

Thursday, February 25, 2016 Holiday Date Day

Thursday, March 24, 2016 New Year's Day January 1 Friday

Thursday, April 28, 2016 Martin Luther King Jr. Birthday January 18 Monday 3rd Mon

Saturday, May 26, 2018 Lincoln's Birthday February 12 Friday

Saturday, June 23, 2018 Washington's Birthday February 15 Monday 3rd Mon

Thursday, July 28, 2016 Malcolm X Day May 20 Friday

Thursday, August 25, 2016 Memorial Day May 30 Monday 5th Mon

Thursday, September 22, 2016 Independence Day July 4 Monday 1st Mon

Tuesday, October 27, 2015 Labor Day September 5 Monday 1st Mon

Thursday, November 24, 2016 Indigenous People's Day October 10 Monday 2nd Mon

Thursday, December 22, 2016 Veteran's Day November 11 Friday

Thanksgiving Holiday November 24-25Thursday

& Friday4th Thr.

Christmas Day December 25 Sunday

Christmas Day (Observed) December 26 Monday 4th Mon

2016 City-Observed Holidays

Attachment 3

Kriss Worthington Councilmember, City of Berkeley, District 7

2180 Milvia Street, 5th Floor, Berkeley, CA 94704

PHONE 510-981-7170 FAX 510-981-7177 [email protected]

CONSENT CALENDAR

September 15, 2015

To: Honorable Mayor and Members of the City Council

From: Councilmember Kriss Worthington

Subject: Referral to Sugar Sweetened Beverage Panel of Experts: Consider Creating an Ordinance, Establishing Healthy Default Beverages with Children’s Meals

RECOMMENDATION: Refer to the Sugar Sweetened Beverage Panel of Experts to consider creating an ordinance establishing healthy default beverages offered with children’s meals. The main goals are to promote awareness of the increasing rate of obesity-related health problems among children and help to establish healthier eating habits in order to achieve balanced caloric intake and energy expenditure. BACKGROUND: Sugary beverages are a major factor that contributes to today’s obesity epidemic. Recent studies have shown that one of three children in American is diagnosed with obesity-related health problems due to rising consumptions of sugary beverages. Children may consume half of their daily sugar intake from soda and sugar-sweetened beverages, which makes up for most of their source of calories in daily consumption. Communities can enact policies to increase access to healthy beverages for children by adopting standards for beverages provided in parks, recreational facilities, and city-sponsored programs. Restaurants also serve as another important venue within cities where changing local policies on healthy beverages could contribute to the fight against childhood obesity. Cities can promote good health for their youngest residents and support parents in purchasing healthy beverages for their children by adopting a policy that requires restaurants to offer water and low fat milk as a default option for consumers. The City of Davis has led this effort by requiring fast food restaurants to make available as part of any kids' meal water or lowfat milk unless a customer specifically requests an alternative beverage. For more information please see: http://city-

council.cityofdavis.org/Media/Default/Documents/PDF/CityCouncil/CouncilMeetings/Agendas/20150602/04D-Ordinance-Second-Reading-Kids-Meal-Beverages.pdf


http://city-council.cityofdavis.org/Media/Default/Documents/PDF/CityCouncil/CouncilMeetings/Agendas/20150602/04D-Ordinance-Second-Reading-Kids-Meal-Beverages.pdf



rthomsen

Typewritten Text

51

FINANCIAL IMPLICATIONS: Unknown. CONTACT PERSON: Councilmember Kriss Worthington 510-981-7170 Enrique Lopez 510-981-7170

A Vibrant and Healthy Berkeley for All 1947 Center Street, 2nd Floor, Berkeley, CA 94704 Tel: 510. 981.5300 TDD: 510.981.6903 Fax: 510. 981.5395

E-mail: [email protected] - - http://www.cityofberkeley.info/health/

MEMORANDUM

To: City Council From: Ces Rosales, chair

Community Health Commission Date: October 20, 2015 Subject: Request Additional Support for Berkeley Technology Academy

Recommendation: The Community Health Commission recommends that city City

Ccouncil provide increased support for Berkeley Technology Academy (BTA) and that this recommendation also be forwarded this request to the School board. In particular the Community Health Commission supports Berkeley Technology's request for:

1) Access to Mental Health professionals on campus five days a week which which would require two to -three more Mental Health staff days.

2) Provide a replacement primary care practitioner for BTA, a position which which has been vacant since March 2015.

3) Reduce hunger among BTA students by Increase the snack budget for BTA students to $3000/school year to reduce hunger among BTA students, and

3)4) Allocate budget an additional $2000 to BTA’s budget to expand the BTAits garden program.

Background: At the May 28, 2015 meeting of the Community Health Commission,

cCommissioners heard a powerful presentation from Dr. Sheila Quintana, the principal of the Berkeley Technology Academy (BTA). The facts presented by Dr. Quintana have moved the commissioners to write this letter requesting additional funding for Berkeley Technology Academy to increase mental health support, provide a primary care practitioner, increase the snack budget and expand the garden project. Since this meeting, there has been considerable media about BTA; howeverand, the commissioners stand by our rationale for advocating for this support. T and the documentation of the facts and reasoning for this support is as follows: . BTA currently has 66 students with an expectation of receiving at least 60 more, the majority of whom are African American males. One-third of the student population are identified as “homeless,” 86% qualify for free/reduced lunch, and 90% of the students suffer from some form of complex Post-Traumatic Stress Disorder. Ten percent of the students are referred from the Juvenile Justice system and 90% come from Berkeley High. As can be inferred, these students face challenges well beyond what one would hope or wish that a high school student would have to face. A huge potential barrier to their academic success is the emotional and psychological traumas that stress many of

Attachment 5

Formatted: Font: (Default) Arial, Bold


BTA Memorandum October 16, 2015

Page 2

them every day. In her five years as principal, Dr. Quintana has been a Trojan, pulling together resources and programs to support her students. EXPAND MENTAL HEALTH SERVICES:

There is a mMental hHealth professional and a mMental hHealth intern present at BTA two days a week. However, this is not enough. The return on investment for mMental hHealth support and counseling for adolescents and young adults is overwhelmingly documented in terms of improved academic success, decreased violence, improved emotional stability, and an increased willingness to participate or engage with others. REQUESTED SUPPORT: the need is clear that there should be access to Mental Health professionals on campus five days a week, which would require two to -three more staff days.

PROVIDE ON-SITE HEALTH SERVICES AGAIN:

Berkeley High School students have access to a well-regarded student health center with both primary care and mental health services. Until March of this year, BTA had a Nurse Practitioner three half-days per /week. BTA students now have no access or very limited access to such health services. They face a culture that does not welcome them on the BHS campus. Therefore, medical problems that could be cared for simply and quickly often go unreported by the student. REQUESTED SUPPORT: Prioritize fully staffing vacant Nurse Practitioner position with Berkeley Technology Academy” and “support ongoing efforts of Public Health to fill the vacancy. A replacement primary care practitioner is desperately needed on campus.

ALLOCATE A SNACK BUDGET AND EXPAND THE BTA GARDEN PROJECT TO REDUCE HUNGER AMONG STUDENTS:

The last issue may be the most pressing and the most creative. As was stated, 86% of the students qualify for free or reduced lunch, an astonishingly high figure in a city as affluent as Berkeley. Many students would never eat a hot meal if they didn’t get one at school. Those of us who have been parents of adolescents know how much an adolescent boy can consume, but stop any student at BTA at random, and chances are, he will be hungry. The solution proposed by Ms. Quintana is two-fold—both immediate and long-term. REQUESTED SUPPORT: The immediate solution is to allocate a snack budget of $3000 per /school year. This would provide a healthy snack for every student every day.

Expand the BTA garden so teens can supplement purchased food with food they have grown, and so the garden can be ready for a newly funded culinary program:

The long-term solution is where the creativity and the dream emerge. BTA has a thriving garden with room for considerable expansion. The Garden Program could be increased such that in the future, the garden itself would be robust enough to provide food for the meals and snacks and even, in Dr. Quintana’s dreams—take-home meals for students whom she knows do not have healthy food at home. BTA has joined with

BTA Memorandum October 16, 2015

Page 3

BUSD Garden Director, Jezra Thompson, to create a program that uses the garden to deescalate traumatized students and provide a “healthy space” using trauma-informed care techniques. The intervention is called the Response to Intervention II (RTI2) in the BTA Garden. The Health Commission recommends support for this program as well. Dr. Quintana wrote and was just awarded a special grant to obtain funds to build a complete kitchen so a career pathway in culinary arts could be at BTA, so having the kitchen could join together the growing, the cooking, and the healthy eating. REQUESTED SUPPORT: The CHC therefore recommends budgeting an additional $2,000 to expand the BTA garden program, the details of which will be outlined in a specific forthcoming proposal by Dr. Quintana and staff.

It is often said that a measure of a civilized society is not how well the privileged fare, but how those most in need are supported. The students of BTA as a whole are the most in need of all the students in high school in Berkeley and they have tremendous potential which they can realize with basic supports that are within our capacity to provide—basic primary care, mental health counseling, and food to stave off hunger. The Community Health Commission respectfully requests that the responsible governing entities consider these needs carefully and address them in a timely fashion.

Attachment 6

CHC Letter to City Council: Support for Meatless Monday and greater access to healthy food for Berkeley residents. The Community Health Commission (CHC) supports the Feb 24, 2015 council resolution which declared Mondays to be “Meatless Mondays” in the City of Berkeley, since the city is committed to the well-being and good health of its citizens and dedicated to the preservation of the environment and natural resources. In October 2015, Mara Guccione, a Berkeley resident and member of the Animal Care commission as well the Humane Society, came to both Community Health Commission and City Council meetings. She asked community residents, city staff, commission and council members to make the commitment to try out Meatless Mondays. The Community Health Commission agrees that the campaign for Meatless Monday is a good way to raise awareness of the benefits of a plant based diet, which can reduce heart disease, limit cancer risk, fight diabetes and curb obesity. The need is great in Berkeley. Berkeley's 2013 Health Status Report shows that while "Berkeley adults, on average, enjoy excellent health"... "not everyone in Berkeley shares equally in these advantages. There are marked inequities by race/ethnicity and income. African Americans living in Berkeley’s South and West neighborhoods have high rates of chronic diseases and risk factors for chronic disease: often many times higher than other racial/ethnic groups." Furthermore, in the city's "Public Health Priorities: Community Engagement Report" (Sept 29, 2015), it was reported that "residents of all ages and demographics shared the belief that they had received enough information and education about healthy eating and active lifestyles, but didn’t have access to enough affordable healthy food and exercise opportunities." Cost and transportation are important factors in food access. As the city embarks on use of Measure D funds, the CHC recommends that council to direct staff (including those in public health, planning and zoning) to seek information about food security in Berkeley and fund activities and programs to assure greater access to affordable healthy foods, especially for lower income residents. In addition, the Sugar-Sweetened Beverage Product Panel of Experts has voted to recommend that city council allocate $200,000 to the city's Public Health Department to launch a communication and education campaign, which includes mini grants. The CHC also recommends that city council direct staff to incorporate culturally relevant Meatless Monday messages in this campaign and in efforts in programs like Heart to Heart and the WIC Program. Finally, we also want to congratulate the Tri-City Nutrition Program, provider of meals at senior centers in Emeryville, Berkeley and Albany, which took a step toward even healthier, and more environmentally sustainable meals by offering meatless meals every Monday, starting in November. Senior Meals and other nutrition programs help to improve access to healthy foods, and providing meatless options can support and encourage resident's choices.


ACTION CALENDAR

To: Honorable Mayor and Members of the City Council

From: Community Health Commission

Submitted by: Ces Rosales, Chairperson, Community Health Commission

Subject: Tobacco 21 Recommendation

RECOMMENDATION: In response to the City Council’s referral, and upon further investigation, the Community Health Commission recommends that Council amend Berkeley Municipal Code section 9.80.035 to add a subdivision H, stating: “Effective January 1, 2017, no tobacco retailer or person shall sell tobacco-related products, including flavored tobacco products, electronic nicotine delivery systems and e-liquid, to individuals under the age of 21.” This recommendation, in our belief, would advance three main objectives:

1. Decrease the rate of youth smoking in Berkeley, which would ultimately lower the rate of adult-aged regular smokers;

2. Lower the amount of secondhand smoke near schools and places where youth congregate;

3. Decrease long-term medical costs by decreasing smoking rates among the city population.

FISCAL IMPACTS: Increasing the minimum age for tobacco purchases would decrease sales and revenues for local tobacco retailers and, as a result, the amount of tax revenue generated. The impact on tax revenue is unknown. At the same time, if increasing the purchase age to 21 decreases smoking rates among youth and eventually the population overall, this would likely have a long-term effect of reduced healthcare costs borne by the community.

Attachment 7

CURRENT SITUATION AND ITS EFFECTS: Under state law, the current minimum age to purchase tobacco products is 18 years. A bill passed by the State Senate this year, SB-7 (2015), would have raised the minimum age to 21, but failed to advance in the State Assembly. Since 2010, Council has taken multiple actions to protect Berkeley youth from the negative impacts of tobacco by adopting ordinances (1) prohibiting smoking in multi-unit housing; (2) prohibiting the use of electronic nicotine delivery systems (ENDS) in all places where smoking is prohibited; and, most recently, (3) prohibiting the sale of all tobacco products (conventional and electronic) within 600 feet of schools and parks. BACKGROUND: Cigarette smoking is the single most preventable cause of disease and death in the United States. In Berkeley, teen smoking rates are an ongoing issue of concern, in part because it is well-established that teenagers who smoke are more likely to develop a regular habit of smoking as adults than people who start at a later age.1 According to the most recent California Healthy Kids Survey, ten percent of BUSD 11th graders report “currently” smoking cigarettes or using smokeless tobacco.2 This is in addition to an alarming rate of e-cigarette use, notably among younger teenagers. In 2013-2014, for instance, 13 percent of BUSD 9th graders reported current use of e-cigarettes.3 This follows a nationwide trend, in which e-cigarette use among high school students tripled in one year from 4.5 percent in 2013 to 13.4 percent in 2014.4 Not only do e-cigarettes present a health risk on their own, but a recent study has shown that e-cigarettes are a gateway to traditional tobacco use among teenagers5—raising the specter that teen smoking rates may increase once more. In addition to concern over teen smoking, research has further shown that the 18 to 21 age range is a critical period in the formation of long-term smoking habits. This is because, according to the Campaign for Tobacco-Free Kids, “[w]hile less than half (46%) of adult smokers become regular, daily smokers before age 18, four out of five become regular, daily smokers before they turn 21.”6 Older teenagers and young adults are also suppliers of cigarettes to teenagers. According to one survey of underage smokers in California in 2005, 40 percent reported obtaining cigarettes from legal-age smokers, the majority of whom were between 18 and 20 years of

1 CDC, “Smoking & Tobacco Use: 2012 Surgeon General’s Report—Preventing Tobacco Use Among Youth and Young Adults,” 2012. Available: http://www.cdc.gov/tobacco/ data_statistics/sgr/2012/index.htm. 2 Berkeley Unified School District. California Healthy Kids Survey (“Healthy Kids Survey”), 2013-14: Main Report. Page 27. 3 Healthy Kids Survey. Page 29. 4 See Centers for Disease Control and Prevention, “E-cigarette use triples among middle and high school students in just one year,” http://www.cdc.gov/media/releases/2015/p0416-e-cigarette-use.html 5 Primack, Brian A. et al., “Progression to Traditional Cigarette Smoking After Electronic Cigarette Use Among US Adolescents and Young Adults,” JAMA Pediatrics (November 2015), available at http://archpedi.jamanetwork.com/article.aspx?articleid=2436539. 6 Campaign for Tobacco-Free Kids, “Increasing the Minimum Legal Sale Age for Tobacco Products to 21”

(October 12, 2015), page 1, available at https://www.tobaccofreekids.org/research/factsheets/pdf/0376.pdf

Attachment 7

age.7 This comports with national estimates that 90 percent of cigarettes purchased for minors are purchased by 18 to 20 year olds.8 In Berkeley, thirty-nine percent of 11th graders said in 2014 that cigarettes were “very easy to obtain.”9 For these reasons, delaying the availability of tobacco has been one approach taken by local governments to reducing tobacco use. According to the Campaign for Tobacco-Free Kids, 90 cities and counties across the country, as well as the state of Hawaii, have raised the minimum age to purchase tobacco products to 21. While these laws are too new in many localities to assess their impact, some cities have reported success. For instance, in Needham, Massachusetts—an early adopter of the raised age limit in 2005—teenage smoking rates fell by half from 13 percent to 7 percent in the first five years that the law went into effect.10 In addition, a March 2015 report by the Institute of Medicine predicted that raising the minimum purchase age to 21 nationwide would significantly reduce the number of adolescents and young adults who start smoking; and reduce the overall smoking rate by about 12 percent and smoking-related deaths by 10 percent.11 ENVIRONMENTAL SUSTAINABILITY: Any reduction in smoking resulting from this law could reduce secondhand-smoke air pollution in areas where teenagers smoke. It might also general fewer cigarette butts littering, leading to less toxic run-off into local water and soils. RATIONALE: Given the current rates of tobacco and e-cigarette use among Berkeley youth—and the known connection to adult cigarette addition and its long-term consequences—the City must take all reasonable steps to reduce youth smoking. The state legislature has failed to act on the issue of raising the minimum smoking age, leaving cities left to act. When Council acted in September to prohibit the sale of tobacco-related and e-cigarette products within 600 feet of any school or park, it did so by adding certain eligibility requirements for tobacco retail licenses under B.M.C. section 9.80.035. This avenue of regulating cigarette sales is appropriate here, as well. In particular, the Commission recommends the following addition:

“Effective January 1, 2017, no tobacco retailer or person shall sell tobacco-related products, including flavored tobacco products, electronic nicotine delivery systems and e-liquid, to individuals under the age of 21.”

7 White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health

Promotion, 19(5): 355–360, May/June 2005. 8 Steinberg MB, Delnevo CD. Increasing the “smoking age”: the right thing to do. Annals of internal medicine. 2013; 159(8):558-559 9 Healthy Kids Survey. Page 27. 10 “,” Boston Globe, https://www.bostonglobe.com/2015/06/17/smoking-among-needham-high-schoolers-plunged-after-legal-age-rose/k0KDLz110EWI7W7TxCtOXJ/story.html 11 Tobacco-Free Kids, page 1.

Attachment 7

https://www.bostonglobe.com/2015/06/17/smoking-among-needham-high-schoolers-plunged-after-legal-age-rose/k0KDLz110EWI7W7TxCtOXJ/story.html

https://www.bostonglobe.com/2015/06/17/smoking-among-needham-high-schoolers-plunged-after-legal-age-rose/k0KDLz110EWI7W7TxCtOXJ/story.html

This date—January 1, 2017—would match the effective date of the tobacco-free buffer zone enacted by Council earlier this year. ALTERNATIVE ACTIONS CONSIDERED: The Community Health Commission considered the following alternatives:

(1) Raising the minimum purchase age to 21 for tobacco products only, and not e-cigarettes. Given the well-documented increase in teen vaping, the associated health risks, and the direct connection between vaping and future smoking habits, this option would not be a comprehensive solution to reducing smoking in the long term.

(2) Recommending that the City Council request that the City Manager and Attorney draft an ordinance to raise the minimum tobacco age to 21. Given Council referred this issue to the Community Health Commission directly, the most responsive alternative was to propose a change directly.

CONTACT PERSON: [Insert – Subcommittee chair?]

Attachment 7

1400 I Street NW · Suite 1200 · Washington, DC 20005 Phone (202) 296-5469 · Fax (202) 296-5427 · www.tobaccofreekids.org

“Raising the legal minimum age for cigarette purchaser to 21 could gut our key young adult

market (17-20) where we sell about 25 billion cigarettes and enjoy a 70 percent market share.”1

— Philip Morris report, January 21, 1986 Tobacco use remains the leading cause of preventable death in the United States, killing more than 480,000 people each year.

2 It is known to cause cancer, heart disease and respiratory diseases, among

other health disorders, and costs the U.S. as much as $170 billion in health care expenditures each year.3

Each day, 700 kids under the age of 18 become regular, daily smokers; and almost one-third will eventually die from smoking.

4 If current trends continue, 5.6 million of today’s youth will die prematurely

from a smoking-related illness.5

High tobacco taxes, comprehensive smoke-free laws and comprehensive tobacco prevention and cessation programs are proven strategies to reduce tobacco use and save lives. Increasing the minimum legal sale age (MLSA) for tobacco products to 21 complements these approaches to reduce youth tobacco use and to help users quit. On June 19, 2015, Hawaii became the first state to raise the tobacco sale age to 21. At least 90 localities in eight states, including New York City, have also raised the tobacco sale age to 21.

6 Statewide

legislation to do so is being considered in several states, including California. Raising the legal sale age is popular with the public, including smokers. A July 2015 CDC report found that three quarters of adults favor raising the tobacco age to 21, including seven in 10 smokers. The idea has broad-based support across the country, including support among men and women, and Americans of all income, education, race/ethnicity and age groups.”

7

Because it is a relatively new strategy, direct research on the impact of increasing the MLSA to 21 is somewhat limited; but, the data that are available provide strong reason to believe that it will contribute to reductions in youth tobacco use. Central to the MLSA strategy are the facts that many smokers transition to regular, daily use between the ages of 18 and 21; many young adult smokers serve as a social source of tobacco products for youth; and tobacco companies have long viewed young adults ages 18 to 21 as a target market group. The IOM Predicts MLSA 21 Will Reduce Smoking and Save Lives A March 2015 report by the Institute of Medicine (IOM), one of the most prestigious scientific authorities in the United States, strongly concluded that raising the tobacco sale age to 21 will have a substantial positive impact on public health and save lives.

8 Based on a review of the literature and predictive

modelling, it finds that raising the tobacco sale age will significantly reduce the number of adolescents and young adults who start smoking; reduce smoking-caused deaths; and immediately improve the health of adolescents, young adults and young mothers who would be deterred from smoking, as well as their children. Specifically, the report predicts that raising the minimum age for the sale of tobacco products to 21 will, over time, reduce the smoking rate by about 12 percent and smoking-related deaths by 10 percent, which translates into 223,000 fewer premature deaths, 50,000 fewer deaths from lung cancer, and 4.2 million fewer years of life lost. Most Adult Smokers Start Smoking Before Age 21 National data show that 95 percent of adult smokers begin smoking before they turn 21, and a substantial number of smokers start even younger— about 80 percent of adult smokers first try smoking before age 18.

9 While less than half (46%) of adult smokers become regular, daily smokers before age 18, four out of

five become regular, daily smokers before they turn 21.10

This means the 18 to 21 age range is a time when many smokers transition to regular use of cigarettes.

11 According to one national survey, 18-20 year

olds are twice as likely as 16-17 year olds to be current smokers (27.1% vs. 11.4%, respectively).12

INCREASING THE MINIMUM LEGAL SALE AGE FOR TOBACCO PRODUCTS TO 21

Attachment 7a

Increasing MLSA for Tobacco to 21 / 2

Tobacco companies have admitted in their own internal documents that, if they don’t capture new users by their early 20’s, it is very unlikely that they ever will. In 1982, one RJ Reynolds researcher stated:

“If a man has never smoked by age 18, the odds are three-to-one he never will. By age 24, the odds are twenty-to-one.”

13

Delaying the age when young people first experiment or begin using tobacco can reduce the risk that they transition to regular or daily tobacco use and increase their chances of successfully quitting, if they do become regular users.

14 The IOM report notes that the age of initiation is critical and predicts that

“Increasing the minimum age of legal access to tobacco products will likely prevent or delay initiation of tobacco use by adolescents and young adults.”

15

Adolescents are particularly vulnerable to the addictive effects of nicotine. The IOM report found that “The parts of the brain most responsible for decision making, impulse control, sensation seeking, and susceptibility to peer pressure continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine and nicotine addiction.”

16 The U.S. Surgeon

General has stated that “the potential long-term cognitive effects of exposure to nicotine in this age group are of great concern.”

17 Because adolescence and young adulthood are critical periods of growth and

development, exposure to nicotine may have lasting, adverse consequences on brain development. The IOM report’s review of the literature on the developmental context of youth tobacco use emphasizes that the brain continues to develop “until about age 25.”

18 As reported by the U.S. Surgeon General:

“This earlier age of onset of smoking marks the beginning of the exposure to the many

harmful components of smoking. This is during an age range when growth is not complete and susceptibility to the damaging effects of tobacco smoke may be enhanced.

In addition, an earlier age of initiation extends the potential duration of smoking throughout the lifespan. For the major chronic diseases caused by smoking, the

epidemiologic evidence indicates that risk rises progressively with increasing duration of smoking; indeed, for lung cancer, the risk rises more steeply with duration of smoking

than with number of cigarettes smoked per day.”19

Adding to the concern is the fact that young people can often feel dependent earlier than adults.

20 Though

there is considerable variation in the amount of time young people report it takes to become addicted to using tobacco, key symptoms of dependence—withdrawal and tolerance—can be apparent after just minimal exposure to nicotine.

21 According to the 2014 Report of the Surgeon General, “the addiction

caused by the nicotine in tobacco smoke is critical in the transition of smokers from experimentation to sustained smoking and, subsequently, in the maintenance of smoking for the majority of smokers who want to quit.”

22 IOM’s recent review summed up the evidence:

“It is clear that the juxtaposition of numerous risk factors during the adolescent and young adult years is likely to increase the probability that first trials of tobacco use will turn into

persistent use. These factors include the sequence of neurodevelopment in the adolescent years, the unique sensitivity of the adolescent brain to the rewarding properties of nicotine, the early development of symptoms of dependence in an adolescent’s smoking experience (well before reaching the 100-cigarette lifetime

threshold), and the difficulties that adolescents have in stopping smoking.”23

As a result of nicotine addiction, about three out of four teen smokers end up smoking into adulthood, even if they intend to quit after a few years.

24 As noted above, smoking-related health problems are

influenced by both the duration (years) and intensity (amount) of use. Unfortunately, individuals who start smoking at younger ages are more likely to smoke as adults, and they also are among the heaviest users.

25 In addition to longer-term health risks such as cancer and heart disease, young people who

smoke are at risk for more immediate health harms, like increased blood pressure, asthma and reduced lung growth.

26

Nationally, 15.7 percent of high school students and 18.7 percent of young adults ages 18 to 24 currently smoke.

27 According to one national survey, 27.1 percent of 18 to 20 year olds currently smoke.

28

Attachment 7a


Older Adolescents and Young Adults are a Source of Cigarettes for Youth According to the 2014 Monitoring the Future Survey, more than two-thirds (69.0%) of 10

th grade students

and nearly half (47.2%) of 8th grade students say it is easy to get cigarettes.

29 This perception that getting

cigarettes is easy exists despite the fact that fewer retailers are selling tobacco to underage youth than before. In FFY 2013 (the most recent year for which data are available), the national retailer violation rate was 9.6 percent.

30 This suggests that youth are obtaining cigarettes from sources other than direct store

purchases. Research shows that youth smokers identify social sources, such as friends and classmates, as a common source of cigarettes. Although older and more established youth smokers are more likely to attempt to purchase their cigarettes directly than kids who smoke less frequently or are only “experimenting,” they are also major suppliers for kids who do not purchase their own cigarettes but instead rely on getting them from others.

31 And with more 18- and 19-year olds in high school now than in

previous years, younger adolescents have daily contact with students who can legally purchase tobacco for them.

32

A 2005 study based on the California Tobacco Survey found that 82 percent of adolescent ever smokers obtained their cigarettes from others, most of whom were friends. A substantial percentage (40.9%) of the people buying or giving the cigarettes were of legal age (18 years or older) to purchase them, with most (31.3%) being between 18 and 20 years of age. 16- to 17-year-olds were more likely to get their cigarettes from 18- to 20-year olds than were younger adolescents.

33 Another study found that smokers

aged 18 and 19 years were most likely to have been asked to provide tobacco to a minor, followed by smokers aged 20 to 24 years and nonsmokers aged 18 and 19 years, respectively.

34

Data from the National Survey on Drug Use and Health (NSDUH) show that nearly two-thirds (63.3%) of 12- to 17-year olds who had smoked in the last month had given money to others to buy cigarettes for them. One-third (30.5%) had purchased cigarettes from a friend, family member or someone at school. In addition, six out of ten (62%) had “bummed” cigarettes from others.

35

Raising the sale age of tobacco to 21 is likely to make both direct retail purchase and social source acquisition more difficult for underage youth, especially for 15,16, and 17 year olds, “who are most likely to get tobacco from social sources, including from students and co-workers above the [minimum legal age of access] MLA.”

36 With the minimum legal sale age set at 21 instead of 18, legal purchasers would be

less likely to be in the same social networks as high school students and therefore less able to sell or give cigarettes to them. Tobacco Companies Target Young Adults Ages 18 to 21 Tobacco industry advertising and promotional activities cause youth and young adults to start smoking, and nicotine addiction keeps people smoking past those ages.

37 Tobacco companies heavily target young

adults ages 18 to 21 through a variety of marketing activities—such as music and sporting events, bar promotions, college marketing programs, college scholarships and parties—because they know it is a critical time period for solidifying tobacco addiction.

38 It is also a time when the industry tries to deter

cessation and recapture recent quitters.39

Tobacco companies realize that the transition into regular smoking that occurs during young adulthood is accompanied by an increase in consumption, partly because the stresses of life transitions during that time—going to college, leaving home, starting a new job, joining the military, etc.—invite the use of cigarettes for the effects of nicotine.

40 Statements obtained from the tobacco industry’s internal

documents emphasize the importance of increasing consumption within this target market in order to maintain a profitable business:

“…eighteen to twenty-four year olds will be “[c]ritical to long term brand vitality as consumption increases with age.”

41

“…[t]he number one priority for 1990 is to obtain younger adult smoker trial and grow

younger adult smoker share of market.”42

Attachment 7a


“To stabilize RJR’s share of total smokers, it must raise share among 18-20 from 13.8% to 40%...ASAP.”

43

“Our aggressive Plan calls for gains of about 5.5 share points of smokers 18-20 per year,

1990-93 (about 120,000 smokers per year). Achieving this goal would produce an incremental cash contribution of only about $442MM during the Plan period (excluding promotion response in other age groups and other side benefits). However, if we hold

these YAS [young adult smokers] for the market average of 7 years, they would be worth over $2.1 billion in aggregate incremental profit. I certainly agree with you that this

payout should be worth a decent sized investment.” [emphasis in original]44

In 2006, after reviewing the evidence against the tobacco companies in a civil racketeering case brought forth by the U.S. Department of Justice, U.S. District Court Judge Gladys Kessler made this conclusion about the industry’s marketing practices:

“From the 1950s to the Present, Different Defendants, at Different Times and Using Different Methods, Have Intentionally Marketed to Young People Under the Age of

Twenty-one in Order to Recruit ‘Replacement Smokers’ to Ensure the Economic Future of the Tobacco Industry.”

45

And in 2014, the U.S. Surgeon General eliminated all doubt regarding the industry’s role in perpetuating our nation’s tobacco epidemic. He stated:

“…the root cause of the smoking epidemic is also evident: the tobacco industry aggressively markets and promotes lethal and addictive products, and continues to

recruit youth and young adults as new consumers of these products.”46

Increasing the Minimum Drinking Age Law to 21 Reduced Youth Drinking and Fatalities The public health benefits and lessons learned from increasing the minimum drinking age to 21 offer additional support for pursuing a higher MLSA for tobacco products. In the early 1980’s, many states raised the legal drinking age to 21. By 1988, all states had minimum drinking age laws of 21.

47 Data from

the Monitoring the Future Survey show that past month and binge drinking among high school seniors decreased by 22 percent between 1982 and 1998, while youth drinking driver involvement in fatal crashes decreased by 61 percent over this same time period. The decrease in drinking may account for some of the decrease in drinking and driving.

48

Subsequent research suggests that raising the minimum drinking age to 21 is associated with reduced alcohol consumption among youth and young adults and fewer alcohol-related crashes.

49 In fact, the

National Highway Traffic Safety Administration reports that, since 1975, increasing the minimum drinking age has saved more than 21,000 lives.

50 Moreover, research shows that, when the drinking age is 21,

individuals under 21 drink less and continue to drink less through their early twenties.51

With increased enforcement of the law, these impacts could be even greater.

52

The IOM concluded in its review that “raising the minimum legal drinking age for alcohol coupled with rigorous enforcement and penalties for violations has been associated with lowered rates of alcohol consumption among adolescents and adults as well as with reduced rates of alcohol-related adverse events (e. g. traffic crashes and hospitalizations).”

53

Benefits of Raising the MLSA to 21 Comprehensive approaches to addressing public health problems work. Much like increasing the minimum drinking age has not eliminated underage drinking, a higher MLSA is not likely to eliminate underage tobacco use. Rather, it is one more part of a comprehensive tobacco control effort that offers several benefits that could help reduce youth tobacco use and increase the likelihood that youth will grow up to be tobacco-free:

Attachment 7a


• Delaying the age when young people first begin using tobacco would reduce the risk that they will transition to regular or daily tobacco use and increase their chances of quitting, if they become regular users.

54

• Raising the MLSA to 21 would increase the age gap between adolescents initiating tobacco use and those who can legally provide them with tobacco products by helping to keep tobacco out of schools.

55

• Younger adolescents would also have a harder time passing themselves off as 21-year-olds than they would 18-year-olds, which could reduce underage sales.

56

• MLSA of 21 may simplify identification checks for retailers, since many state drivers’ licenses indicate that a driver is under the age of 21 (e.g. license format, color or photo placement).

57

Campaign for Tobacco-Free Kids, October 12, 2015/ Becca Knox

1 Philip Morris, “Discussion Draft Sociopolitical Strategy,” January 21, 1986, Bates Number 2043440040/0049, http://legacy.library.ucsf.edu/tid/aba84e00. 2 U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014. 3 Xu, X., et al., “Annual Healthcare Spending Attributable to Cigarette Smoking: An Update,” Am J Prev Med, 2014. HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General., 2014. 4 Substance Abuse and Mental Health Services Administration (SAMHSA), HHS, Results from the 2013 National Survey on Drug Use and Health, NSDUH: Summary of National Findings, 2014. 5 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. 2014. 6 See: http://www.tobaccofreekids.org/content/what_we_do/state_local_issues/sales_21/states_localities_MLSA_21.pdf; for a case study of

NYC’s adoption of Tobacco 21, see SCTC, Reducing Cheap Tobacco & Youth Access: New York City, June 2015, http://publichealthlawcenter.org/sites/default/files/resources/ASPiRE_2015_NYC_POS_CaseStudy.pdf 7 King, Brian A., Jama, AO, Marynak, KL, and Promoff GR, “Attitudes Toward Raising the Minimum Age of Sale for Tobacco Among U.S.

Adults,” American Journal of Preventive Medicine, 2015, http://www.sciencedirect.com/science/article/pii/S0749379715002524 8 Institute of Medicine, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products, Washington, DC: The

National Academies Press, 2015, http://www.iom.edu/~/media/Files/Report%20Files/2015/tobacco_minimum_age_report_brief.pdf; In addition, a recent study suggests that raising the sale age to 21 is a promising practice, finding that the policy contributed to a greater decline in youth smoking in one community that passed a 21 ordinance compared to comparison communities that did not pass an ordinance restricting tobacco product sales to 21 and older. While the results are promising, the magnitude of the impact is unknown given that there are no baseline measurements and there were confounding issues that were not controlled for. See Kessel Schneider, S. et al, “Community reductions in youth smoking after raising the minimum tobacco sales age to 21,” Tobacco Control, June 12, 2015, http://tobaccocontrol.bmj.com/content/early/2015/06/12/tobaccocontrol-2014-052207.1.abstract 9 Calculated based on data in the National Survey on Drug Use and Health, 2013, http://www.icpsr.umich.edu/icpsrweb/SAMHDA/; see also Institute of Medicine, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products, Washington, DC: The National Academies Press, 2015, http://iom.nationalacademies.org/Reports/2015/TobaccoMinimumAgeReport.aspx 10 Calculated based on data in the National Survey on Drug Use and Health, 2013, http://www.icpsr.umich.edu/icpsrweb/SAMHDA/. 11 Calculated based on data in the National Survey on Drug Use and Health, 2013, http://www.icpsr.umich.edu/icpsrweb/SAMHDA/. See also: Hammond, D, “Smoking behaviour among young adults: beyond youth prevention,” Tobacco Control, 14:181 – 185, 2005. Lantz, PM, “Smoking on the rise among young adults: implications for research and policy,” Tobacco Control, 12(Suppl I):i60 – i70, 2003. 12 Substance Abuse & Mental Health Services Administration, U.S. Dept. of Health & Human Services, 2013 National Survey on Drug Use and Health, Summary of National Findings, 2014, http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf. 13 RJ Reynolds, “Estimated Change in Industry Trend Following Federal Excise Tax Increase,” September 10, 1982, Bates Number 513318387/8390, http://legacy.library.ucsf.edu/tid/tib23d00;jsessionid=211D4CCF0DBD25F9DC2C9BB025239484.tobacco03. 14 See, e.g., Khuder, SA, et al., “Age at Smoking Onset and its Effect on Smoking Cessation,” Addictive Behavior 24(5):673-7, September-October 1999; D’Avanzo ,B, et al., “Age at Starting Smoking and Number of Cigarettes Smoked,” Annals of Epidemiology 4(6):455-59, November 1994; Chen, J & Millar, WJ, “Age of Smoking Initiation: Implications for Quitting,” Health Reports 9(4):39-46, Spring 1998; Everett, SA, et al., “Initiation of Cigarette Smoking and Subsequent Smoking Behavior Among U.S. High School Students,” Preventive Medicine 29(5):327-33, November 1999; Breslau, N & Peterson, EL, “Smoking cessation in young adults: Age at initiation of cigarette smoking and other suspected influences,” American Journal of Public Health 86(2):214-20, February 1996. 15

Institute of Medicine, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products, Washington, DC: The

National Academies Press, 2015, http://www.iom.edu/~/media/Files/Report%20Files/2015/tobacco_minimum_age_report_brief.pdf 16 IOM briefing paper, p. 3, http://iom.nationalacademies.org/~/media/Files/Report%20Files/2015/TobaccoMinAge/tobacco_minimum_age_report_brief.pdf 17 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General, 2014.

Attachment 7a


18


National Academies Press, 2015 , http://www.iom.edu/Reports/2015/TobaccoMinimumAgeReport.aspx 19 U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2012. 20 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. , 2014.HHS,Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, 2012; U.S. Department of Health and Human Services (USDHSS), How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010. 21 HHS. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, 2010. 22 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General, 2014. 23


National Academies Press, 2015 ,http://www.iom.edu/Reports/2015/TobaccoMinimumAgeReport.aspx.. 24 HHS. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General, 2012. 25 USDHSS, Preventing Tobacco Use Among Young People: A Report of the Surgeon General, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994. 26 HSS. Preventing Tobacco Use Among Young People: A Report of the Surgeon General, 1994. See also Campaign for Tobacco-Free Kids fact sheet, “Health Harms from Smoking and Other Tobacco Use,” http://www.tobaccofreekids.org/research/factsheets/pdf/0194.pdf. 27 CDC, “Youth Risk Behavior Surveillance,—United States, 2013,” MMWR 63(No. 4), June 13, 2014; 2011 National Youth Tobacco Survey MMWR 61(No. 31), August 10, 2012. CDC, “Current Cigarette Smoking Among Adults—United States, 2005–2013,” MMWR, 63(47):1108-1112, November 28, 2014, http://www.cdc.gov/mmwr/pdf/wk/mm6347.pdf. 28 Substance Abuse & Mental Health Services Administration, U.S. Dept. of Health & Human Services, 2013 National Survey on Drug Use and Health, Summary of National Findings, 2014, http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf. 29 2014 Monitoring the Future Study, http://www.monitoringthefuture.org/data/data.html. 30 Substance Abuse and Mental Health Services Administration, FFY2013 Annual Synar Reports: Tobacco Sales to Youth, http://beta.samhsa.gov/sites/default/files/synar-annual-report-2013.pdf. 31 Robinson, LA, et al. “Changes in Adolescents’ Sources of Cigarettes,” Journal of Adolescent Health, 39:861 – 867, 2006. White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health Promotion, 19(5): 355 – 360, May/June 2005. DiFranza, JR, et al. “Sources of tobacco for youths in communities with strong enforcement of youth access laws.” Tobacco Control,10:323 – 328, 2001. Substance Abuse & Mental Health Services Administration, U.S. Dept of Health & Human Services, 2003 National Survey on Drug Use and Health, September 9, 2004, http://oas.samhsa.gov/NHSDA/2k3NSDUH/2k3results.htm#ch4. CDC, “Youth Risk Behavior Surveillance – United States, 1999, CDC Surveillance Summaries,” MMWR 49(SS-5), July 9, 2000, http://www2.cdc.gov/mmwr/mmwr_ss.html. 32 National Center for Education Statistics, “Enrollment Trends by Age (Indicator 1-2012),” The Condition of Education, 2012, http://nces.ed.gov/programs/coe/pdf/coe_ope.pdf. U.S. Census Bureau, Current Population Survey, Data on School Enrollment, http://www.census.gov/hhes/school/data/cps/index.html. Ahmad, S, “Closing the youth access gap: The projected health benefits and costs savings of a national policy to raise the legal smoking age to 21 in the United States,” Health Policy, 75:74 – 84, 2005. White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health Promotion, 19(5): 355 – 360, May/June 2005. 33 White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health Promotion, 19(5): 355 – 360, May/June 2005. 34 Ribisl, KM, et al., “Which Adults Do Underaged Youth Ask for Cigarettes?” American Journal of Public Health, 89(10):1561 – 1564, 1999 35 Substance Abuse & Mental Health Services Administration, U.S. Dept of Health & Human Services, 2003 National Survey on Drug Use and Health, September 9, 2004, http://oas.samhsa.gov/NHSDA/2k3NSDUH/2k3results.htm#ch4 http://www.oas.samhsa.gov/nhsda.htm#NHSDAinfo. (Note: While there have been more recent NSDUH surveys, no questions on youth access have been asked since 2003.) 36


National Academies Press, 2015 , http://www.iom.edu/Reports/2015/TobaccoMinimumAgeReport.aspx 37 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General, 2014. 38 Ling, PM, et al., “Why and How the Tobacco Industry Sells Cigarettes to Young Adults: Evidence From Industry Documents,” American Journal of Public Health, 92(6):908 – 916, June 2002. Sepe, ES, et al., “Smooth Moves: Bar and Nightclub Tobacco Promotions That Target Young Adults,” American Journal of Public Health, 92(3):414 – 419, March 2002. Ernster, VL, “Advertising and promotion of smokeless tobacco products,” NCI Monograph, 8:87 – 94, 1989. Griffith, D., “Tobacco pitch to college students: Free samples of smokeless products are offered near campuses,” Sacramento Bee, May 25, 2004, http://www.calstate.edu/pa/clips2004/may/25may/tobacco2.shtml. 39 Ling, PM, et al., “Tobacco Industry Research on Smoking Cessation: Recapturing Young Adults and Other Recent Quitters,” Journal of General Internal Medicine, 19:419 – 426, 2004. 40 Ling, PM, et al., “Why and How the Tobacco Industry Sells Cigarettes to Young Adults: Evidence From Industry Documents,” American Journal of Public Health, 92(6):908 – 916, June 2002. 41 U.S. V. Philip Morris USA, Inc., et al., No. 99-CV-02496GK (U.S. Dist. Ct., D.C.), Final Opinion, p. 978, August 17, 2006, http://www.tobaccofreekids.org/content/what_we_do/industry_watch/doj/FinalOpinion.pdf.

Attachment 7a


42 RJ Reynolds, “1990 Strategic Plan,” 1990, Bates Number 513869196/9303, http://legacy.library.ucsf.edu/tid/vvn13d00. 43 RJ Reynolds, “Strategic Overview of YAS,” February 16, 1989, Bates Number 506788947/8989, http://legacy.library.ucsf.edu/tid/rrg44d00. 44 U.S. V. Philip Morris USA, Inc., et al., No. 99-CV-02496GK (U.S. Dist. Ct., D.C.), Final Opinion, p. 978, August 17, 2006, http://www.tobaccofreekids.org/content/what_we_do/industry_watch/doj/FinalOpinion.pdf. 45 U.S. V. Philip Morris USA, Inc., et al., No. 99-CV-02496GK (U.S. Dist. Ct., D.C.), Final Opinion, p. 972, August 17, 2006, http://www.tobaccofreekids.org/content/what_we_do/industry_watch/doj/FinalOpinion.pdf. 46 HHS. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General, 2014. 47 Wagenaar, AC and Toomey, TL, “Effects of Minimum Drinking Age Laws: Review and Analyses of the Literature from 1960 to 2000,” J Stud Alcohol, Supplement No. 14: 206-225, 2002; Hedlund, JH, Ulmer, RG, and Preusser, DF, “Determine Why There Are Fewer Young Alcohol-Impaired Drivers, DOT HS 809 348, Final Report,” U.S. Department of Transportation, National Highway Traffic Safety Administration (NHTSA), September 2001, http://icsw.nhtsa.gov/people/injury/research/FewerYoungDrivers/. 48 National Highway Traffic Safety Administration, Determine Why There Are Fewer Young Alcohol-Impaired Drivers, Final Report, September 2001, http://www.nhtsa.gov/people/injury/research/FewerYoungDrivers/iii__c.htm; See also, Monitoring the Future, www.monitoringthefuture.org 49 Wagenaar, AC and Toomey, TL, “Effects of Minimum Drinking Age Laws: Review and Analyses of the Literature from 1960 to 2000,” J Stud Alcohol, Supplement No. 14: 206-225, 2002; O’Malley, PM, and Wagenaar, AC, “Effects of Minimum Drinking Age Laws on Alcohol Use, Related Behaviors and Traffic Crash Involvement among American Youth: 1976-1987,” J Stud Alcohol, 52:478-491, 1991; Dejong, W and Blanchette, J, “Case Closed: Research Evidence on the Positive Public Health Impact of the Age 21 Minimum Legal Drinking Age in the United States,” J Stud Alcohol Drugs, Supplement 17:108-115, 2014. 50 Kindelberger, J, Calculating Lives Saved Due to Minimum Drinking Age Laws, National Highway Traffic Safety Administration (NHTSA), March 2005. See also, NHTSA, Lives Saved in 2012 by Restraint Use and Minimum Drinking Age Laws, November 2013. 51 O’Malley, PM, and Wagenaar, AC, “Effects of Minimum Drinking Age Laws on Alcohol Use, Related Behaviors and Traffic Crash Involvement among American Youth: 1976-1987,” J Stud Alcohol, 52:478-491, 1991; Wagenaar, AC and Toomey, TL, “Effects of Minimum Drinking Age Laws: Review and Analyses of the Literature from 1960 to 2000,” J Stud Alcohol, Supplement No. 14: 206-225, 2002. 52 Dejong, W and Blanchette, J, “Case Closed: Research Evidence on the Positive Public Health Impact of the Age 21 Minimum Legal Drinking Age in the United States,” J Stud Alcohol Drugs, Supplement 17:108-115, 2014; Wagenaar, AC and Toomey, TL, “Effects of Minimum Drinking Age Laws: Review and Analyses of the Literature from 1960 to 2000,” J Stud Alcohol, Supplement No. 14: 206-225, 2002. 53


National Academies Press, 2015 http://www.iom.edu/Reports/2015/TobaccoMinimumAgeReport.aspx. 54 See, e.g., Khuder, SA, et al., “Age at Smoking Onset and its Effect on Smoking Cessation,” Addictive Behavior 24(5):673-7, September-October 1999; D’Avanzo ,B, et al., “Age at Starting Smoking and Number of Cigarettes Smoked,” Annals of Epidemiology 4(6):455-59, November 1994; Chen, J & Millar, WJ, “Age of Smoking Initiation: Implications for Quitting,” Health Reports 9(4):39-46, Spring 1998; Everett, SA, et al., “Initiation of Cigarette Smoking and Subsequent Smoking Behavior Among U.S. High School Students,” Preventive Medicine 29(5):327-33, November 1999; Breslau, N & Peterson, EL, “Smoking cessation in young adults: Age at initiation of cigarette smoking and other suspected influences,” American Journal of Public Health 86(2):214-20, February 1996. 55 White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health Promotion, 19(5): 355 – 360, May/June 2005. Ahmad, S, “Closing the youth access gap: The projected health benefits and cost savings of a national policy to raise the legal smoking age to 21 in the United States,” Health Policy, 75:74 – 84, 2005. 56 White, MM, et al. “Facilitating Adolescent Smoking: Who Provides the Cigarettes?” American Journal of Health Promotion, 19(5): 355 – 360, May/June 2005. 57 Tobacco Control Legal Consortium, “Raising the Minimum Legal Sale Age for Tobacco and Related Products,” May 2014, http://publichealthlawcenter.org/sites/default/files/resources/tclc-guide-minimumlegal-saleage-2014.pdf.

Attachment 7a

9.80.035 Limits on eligibility for a tobacco retailer license.

A. No new tobacco retailer license may be issued to a pharmacy.

B. No existing tobacco retailer license may be renewed by a pharmacy.

C. No new tobacco retailer license may be issued to authorize the sale of tobacco products with six hundred (600) feet of anyschool as measured by a straight line from the nearest point of the property line of the parcel on which the school is located to thenearest point of the property line of the parcel on which the business is located.

D. Effective January 1, 2017, no person shall sell, give away, barter, exchange, or otherwise deal in flavored tobacco productswithin six hundred (600) feet of any school as measured by a straight line from the nearest point of the property line of the parcel onwhich the school is located to the nearest point of the property line of the parcel on which the business is located.

E. 1. Effective January 1, 2017, no person shall sell, give away, barter, exchange, or otherwise deal in electronic nicotine deliverysystems or eliquid within six hundred (600) feet of any school as measured by a straight line from the nearest point of the propertyline of the parcel on which the school is located to the nearest point of the property line of the parcel on which the business islocated.

2. Subdivision E.1 shall not prohibit the sale of electronic nicotine delivery systems to persons who demonstrate that they arequalified patients or primary caregivers as defined in Health and Safety Code section 11362.7 or persons with identificationcards issued pursuant to Health and Safety Code section 11362.71, provided that such electronic nicotine delivery systems areunaccompanied by any tobacco product defined in Sections 9.80.020.K.1 or 9.80.020.K.2.

F. A tobacco retailer lawfully operating prior to March 1, 2015, that is engaged primarily in the sale of electronic nicotine deliverysystems or eliquid and is prohibited from selling electronic nicotine delivery systems and eliquid due to the proximity to a school asspecified in subdivision E.1 may obtain an exemption from subdivision E.1 yearly for up to a total of three years, beginning January 1,2017, if it makes a showing, as determined by the City Manager or his or her designee, that application of subdivision E.1 wouldresult in a taking without just compensation under either the California or the United States Constitution. "Engaged primarily" forpurposes of this subsection means that the sale of electronic nicotine delivery systems and eliquids account for more than 50% ofthe tobacco retailer’s calendar year 2014 gross receipts.

G. A map identifying the areas falling within six hundred (600) feet of schools shall be adopted by the City Council by resolution,and may be amended from time to time. (Ord. 7441NS § 5, 2015: Ord. 7377NS § 3, 2014)

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Attachment 7b

http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC&sectionNum=11362.7

http://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=HSC&sectionNum=11362.71

http://codepublishing.com/ca/berkeley/html/Berkeley09/Berkeley0980/Berkeley0980020.html#9.80.020

http://codepublishing.com/ca/berkeley/html/Berkeley09/Berkeley0980/Berkeley0980020.html#9.80.020

http://www.cityofberkeley.info/Home.aspx

http://www.codepublishing.com/

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http://www.cityofberkeley.info/webpolicy

http://www.cityofberkeley.info/SiteMap.aspx

http://www.cityofberkeley.info/contactus

http://www.cityofberkeley.info/clerk


City of Berkeley Aging Services Division Presents

THE NEW FALL/WINTER MENU, FEATURING MEATLESS MONDAYS

The City of Berkeley, through the Tri-City Nutrition Program, provides home-delivered and

congregate meals for residents of Berkeley, Albany and Emeryville. Each day, over 200 meals

are served to seniors at Senior Centers and over 200 meals are delivered to seniors in their

homes.

Beginning in November, the Tri-City Nutrition Program is taking a step toward even healthier,

and more environmentally sustainable, meals by offering meatless meals every Monday.

Working in close partnership with Nutrition Solutions, the Tri-City caterer, we have been

successful in increasing the vegetarian entrées. Positive feedback from senior participants has

encouraged the move to Meatless Mondays. Eight distinct menus are featured, including

favorites like Spinach & Mushroom Lasagna and Cheesy Brown Rice Casserole with Broccoli, as

well as new items like Butternut Squash Lasagna and Indian-Style Vegetable Curry.

WHY MEATLESS MONDAYS? Start your week off on a nutritious note… The Tri-City Nutrition Program is joining an international movement to encourage less meat consumption to improve personal health and the health of the planet.

FOR YOUR HEALTH!

Reduce Heart Disease Beans, peas, nuts and seeds contain little to no saturated fats. Reducing saturated fats can help keep your cholesterol low, and cut risk of cardiovascular disease.

Limit Cancer Risk Hundreds of studies suggest that diets high in fruits and vegetables can reduce cancer risk. Red meat consumption is associated with colon cancer.

Fight Diabetes Research suggests that plant-based diets– particularly those low in processed meat – can reduce your risk of type 2 diabetes.

Curb Obesity People on low-meat or vegetarian diets have significantly lower body weights and body mass indices. A plant-based diet is a great source of fiber (absent in animal products). This makes you feel full with fewer calories, so less overeating.

Live Longer Red and processed meat consumption is associated with increases in total mortality, cancer mortality and cardiovascular disease mortality.

Improve Your Diet Consuming beans or peas results in higher intakes of fiber, protein, folate, zinc, iron and magnesium with lower intakes of saturated fat and total fat.

Attachment 8

FOR YOUR WALLET!

Cut Weekly Budget Food prices continue to rise. Current increases are especially sharp in packaged items and meat, which require extra expenses like feed and transportation. Forgoing meat once a week is a great way to cut the weekly budget.

Curb Healthcare Spending Treatment of chronic preventable diseases accounts for 70% of total U.S. healthcare spending. By reducing our risk for these conditions, we can curtail healthcare spending nationwide.

FOR OUR PLANET!

Reduce Carbon Footprint The UN estimates the meat industry generates nearly one-fifth of the man-made greenhouse gas emissions that accelerate climate change.

Minimize Water Usage The water needs of livestock are huge, far above those of vegetables or grains. An estimated 1,800 to 2,500 gallons of water go into a single pound of beef.

Reduce Fuel Dependence On average, about 40 calories of fossil fuel energy go into every calorie of feed lot beef in the U.S. (compared to 2.2 calories of fossil fuel for plant-based protein).

Meatless Mondays is a non-profit initiative of The Monday Campaigns, in association with the Johns Hopkins

Bloomberg School of Public Health. For more information, go to http://www.meatlessmonday.com. © The

Monday Campaigns, Inc. 4/13

Attachment 8

http://www.meatlessmonday.com/


2015 Subcommittee Roster

Health Equity

Public Education

& Marketing

Electronic

Controlled

Weapon

1 Engelman Alina

1 Lee Charles X

2 Smith Kad

2 Speich Pamela

3 Kwanele Babalwa X

3 Thornton David X

4 Stein Antoinette X

4 Wong Marilyn X X

5 Soichet Emma

5 Vacant

6 Franklin Linda X

6 Vacant

7 Nathan Neal X

7 Wong Andrew X

8 Chen Leona

8 Namkung Poki

M Rosales Ces X X

M Shaw Mia

District Last First

Subcommittees

City of Berkeley Confidential 11/16/2015 Page 1

Attachment 9

COMMUNITY HEALTH COMMISSION MEETING AGENDA …€¦ · Meatless Monday letter to City Council 7....

Documents

Transcript of COMMUNITY HEALTH COMMISSION MEETING AGENDA …€¦ · Meatless Monday letter to City Council 7....