HomeMy WebLinkAbout2017-02-13 Community Health Commission AgendaAgenda
Community Health Commission
City Of Edina, Minnesota
City Hall, Community Room
DRAFT
Monday, February 13, 2017
6:30 PM
I.Call To Order
II.Roll Call
III.Approval Of Meeting Agenda
IV.Approval Of Meeting Minutes
A.January 9, 2017 Draft Minutes
V.Community Comment
During "Community Comment," the Board/Commission will invite residents to share relevant
issues or concerns. Individuals must limit their comments to three minutes. The Chair may limit
the number of speakers on the same issue in the interest of time and topic. Generally speaking,
items that are elsewhere on tonight's agenda may not be addressed during Community Comment.
Individuals should not expect the Chair or Board/Commission Members to respond to their
comments tonight. Instead, the Board/Commission might refer the matter to sta% for
consideration at a future meeting.
VI.Reports/Recommendations
A.Chair and Vice-Chair Election
B.Tobacco Work Plan Item
VII.Correspondence And Petitions
A.Chair Term Limit Feedback
VIII.Chair And Member Comments
IX.Sta2 Comments
X.Adjournment
The City of Edina wants all residents to be comfortable being part of the
public process. If you need assistance in the way of hearing ampli5cation, an
interpreter, large-print documents or something else, please call 952-927-8861
72 hours in advance of the meeting.
MINUTES
Community Health Commission
January 9, 2017 at 6:30 PM
City Hall, Community Room
I.Call To Order
II.Roll Call
Present: Christy Zilka, Caleb Schultz, Steve Sarles, Amanda Herr, Alison Pence,
Nina Sokol.
Absent: Connie Weston, Britta Orr, Kristen Conner, McKenna Knapp.
III.Approval Of Meeting Agenda
Motion by Caleb Schultz to Approve Meeting Agenda. Seconded by Christy
Zilka. Motion Carried.
IV.Approval Of Meeting Minutes
Motion by Steve Sarles to Approve December 12 Meeting Minutes.
Seconded by Amanda Herr. Motion Carried.
A.Approval of December 12, 2016 Meeting Minutes
V.Community Comment
VI.Reports/Recommendations
A.Tobacco Work Plan Item - Kickoff
Discussion of 2017 work plan item relating to tobacco use. Discussed format
for Advisory Communication to City Council and possible presentation.
Staff will send Advisory Communication template to Caleb Schultz for work
on language. Language to be reviewed at February meeting.
B.Comprehensive Plan Discussion
Discussed comprehensive plan participation and timeline. Staff will
coordinate with Planning to clarify how to engage and incorporate health in
all chapters of comprehensive plan.
C.Temporary Family Healthcare Dwellings
Discussion regarding many aspects of Temporary Family Healthcare
Dwelling regulation and possible changes to City ordinance.
VII.Correspondence And Petitions
VIII.Chair And Member Comments
IX.Staff Comments
A.Tri-City Meeting, March 13, 2017 @ 6:00pm
B.Fred Richards Park - Public Meetings
C.Southdale Library Site - Community Meeting
X.Adjournment
Date: February 13, 2017 Agenda Item #: VI.A.
To:Community Health Commission Item Type:
Report and Recommendation
From:Britta Orr, Chair
Item Activity:
Subject:Chair and Vice-Chair Election Action, Discussion
CITY OF EDINA
4801 West 50th Street
Edina, MN 55424
www.edinamn.gov
ACTION REQUESTED:
Motion to elect chair and vice-chair for 2017-18.
INTRODUCTION:
Date: February 13, 2017 Agenda Item #: VI.B.
To:Community Health Commission Item Type:
Report and Recommendation
From:Britta Orr, Chair
Item Activity:
Subject:Tobacco Work Plan Item Action, Discussion
CITY OF EDINA
4801 West 50th Street
Edina, MN 55424
www.edinamn.gov
ACTION REQUESTED:
Review of Advisory Communication language prepared by member Caleb Schultz and motion regarding action for
Advisory Communication to Council.
INTRODUCTION:
ATTACHMENTS:
Description
Draft Advisory Communication
MN Medicine Article - Tobacco
MSFG Fact Sheet
MSFG Talking Points
Date: February 13, 2017
To: City of Edina Mayor and City Council
From: Caleb Schulz, MD, MPH
Edina Community Health Commission
Subject: Community Health Commission Recommendations on the City of Edina Tobacco
Regulations
Attachments: 1. Draft Ordinance Changes to Edina City Code Chapter 12, Article VI
2. Raising the Minimum Legal Sale Age for Tobacco to 21. Raymond
Boyle, PhD, John Kingsbury, PhD, Michael Parks, PhD. Minnesota
Medicine. January/February 2017
3. Minnesotans for a Smoke-Free Generation Tobacco 21 Fact Sheet
Action Requested:
The Edina Community Health Commission requests that the City Council consider revising
Edina City Code Chapter 12, Article VI, to reduce youth tobacco use in the city by raising the
minimum legal age to purchase tobacco to 21.
Situation:
Tobacco use is still the leading cause of preventable death and disease in Minnesota. If used as
intended, cigarettes will kill more than half their users. i ii More than 6,000 Minnesotans die
each year from tobacco use and smoking costs Minnesota more than $3 billion annually in
excess health care costs.iii The U.S. Surgeon General has identified the tobacco industry as the
root cause of the smoking epidemic through its promotion of tobacco products to youth.iv
Raising the tobacco age to 21 will prevent youth tobacco use and save lives. The tobacco
industry heavily targets young adults ages 16-21 in order to recruit new tobacco users and
guarantee profits. Approximately 95 percent of current adult smokers started before they were
21.v Increasing the age gap between young people and those who can legally buy tobacco will
reduce youth access to tobacco. Keeping tobacco out of high schools will reduce the number
of youth under 18 who become addicted to smoking. Many youth get tobacco from other 18-
19-year olds. In fact, 59 percent of 18-19-year-olds have been asked to buy cigarettes for
someone younger.vi High school students are less likely to be around a 21-year-old than they
would be an 18-20-year-old in a setting where they would ask for tobacco.vii
Page 2
Tobacco executives are fully aware of the importance of young smokers
to tobacco company profits. For example, one Phillip Morris executive
said in 1986, "Raising the legal minimum age for cigarette purchaser to 21 could gut our key
young adult market (17-20)..."viii
The industry is constantly looking to replace smokers who die from diseases related to tobacco
use. An RJ Reynolds executive stated in 1982, "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."ix
Ages 18-21 are a critical time when young people move from intermittent smoking to daily
use. Four out of five experimental smokers becomes daily smokers by age 21.x
The tobacco industry markets to youth in a variety of ways. For example, they sell cheap,
colorful and flavored tobacco products. In July and August of 2016, an assessment of all
sixteen tobacco vendors in the city of Edina found flavored cigars and electronic cigarette juice
for sale in flavors such as strawberry, chocolate and fruit punch. These products are cheap and
appealing to youth. For example, flavored cigars can be purchased in Edina for as little as $1.69
for a two-pack, and seven stores sell flavored electronic cigarette liquid.xi
Despite overall tobacco rates declining, tobacco use is a still a problem among Edina youth. In
2013, 12.8 percent of Edina 11th graders reported using tobacco in the last 30 days.
Tobacco Use in the Past 30 Days Among Edina High School Students - 2013 MN Student Survey
11th Grade Male 11th Grade Female
Smoke a cigarette 8% 6%
Smoke cigars, cigarillos or little cigars 13% 3%
Use chewing tobacco, snuff or dip 9% 0%
*Edina 11th graders did not take the Minnesota Student Survey in 2016; therefore 2013 is the most recent data
available for 11th graders.
Background:
Nicotine is particularly harmful to the development of the adolescent brain. The addictive
properties of nicotine can lead adolescents to heavier daily tobacco use and a difficult time
quitting later in life.xii Evidence suggests that nicotine interferes with brain maturation and can
have a long-term effect on cognitive development and mental health.xiii The lasting effect of
nicotine on the adolescent brain is a serious public health concern. xiv
In 2015, the Institute of Medicine (now known as the National Academy of Medicine) published
a report that found increasing the tobacco age to 21 would decrease smoking initiation among
15-17 year olds by 25 percent.xv A survey in the City of Needham, Mass., a city that raised the
Page 3
tobacco age to 21 in 2005, found that within five years, tobacco use
among high school students decreased by nearly half.xvi
A national consensus is growing to protect young people from a lifetime of addiction and
health problems caused by tobacco by raising the tobacco age. A 2014 national survey shows
that 75 percent of adults favor increasing the tobacco age to 21. In addition, 70 percent of
current smokers and 65 percent of young adults ages18-24 support raising the minimum legal
age.xvii
California, Hawaii and a growing list of more than 210 cities in the United States including
Chicago, Kansas City and Cleveland have raised the minimum legal sale age for tobacco
products to 21. With full support from the Community Health Commission, the City of Edina is
well positioned to be the first city in the state of Minnesota to pass this kind of policy.
Assessment:
A recent study published in Minnesota Medicine predicted the long-term impact of raising the
tobacco age to 21. The study found that raising the tobacco age to 21 in Minnesota would
result in 25 percent fewer 15-year-olds starting smoking by the time they turn 18; and 15
percent fewer 18-year-olds starting smoking by the time they turn 21. This translates to 30,000
Minnesota young people not becoming smokers over the next 15 years.xviii
Recommendation:
A revision to the Edina City Code Chapter 12, Article VI, to reduce youth tobacco use in the city
by raising the tobacco age to 21. There is national momentum around this issue and numerous
community health benefits. The Community Health Commission recommends that that a
review of the ordinance and public hearing occur as soon as possible.
i Prabhat Jha, M.D., Chinthanie Ramasundarahettige, M.Sc., Victoria Landsman, Ph.D., et al 21st-Century Hazards of
Smoking and Benefits of Cessation in the United States. N Engl J Med 2013;368:341-50.
ii Banks E, Joshy G, Weber MF, et al. Tobacco smoking and all-cause mortality in a large Australian cohort study:
findings from a mature epidemic with current low smoking prevalence. BMC Medicine. 2015; 13:38.
doi:10.1186/s12916-015-0281-z.
iii Blue Cross and Blue Shield of Minnesota. Health Care Costs and Smoking in Minnesota. January 2017.
iv U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. 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.
2014.
v U.S. Department of Health and Human Services. Results from the 2010 National Survey on Drug Use and Health: Summary
of National Findings. Substance Abuse and Mental Health Services Administration - Center for Behavioral Health Statistics
Page 4
and Quality; September 2014. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-
DetTabs2014.pdf.
vi Ribisl, K. M., Norman, G. J., Howard-Pitney, B., & Howard, K. A. (1999). Which adults do underaged youth ask for
cigarettes? Am J Public Health, 89(10), 1561-1564.
vii Ahmad, S. (2005). 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(1), 74-84.
viii Philip Morris Discussion Draft of Sociopolitical Strategy. http://legacy.library.ucsf.edu/tid/aba84e00/pdf.
ix RJ Reynolds Estimated Change in Industry Trend Following Federal Excise Tax Increase.
https://www.industrydocumentslibrary.ucsf.edu/tobacco/docs/#id=nnnw0084.
x Campaign for Tobacco-Free Kids. Increasing the Sale Age for Tobacco Products to 21.
https://www.tobaccofreekids.org/what_we_do/state_local/sales_21.
xi Survey conducted by Association for Nonsmokers-Minnesota in July and August 2016.
xii Nelson, D. et al. Long-term trends in adolescent and young adult smoking in the United States: metapatterns and
implications. Am J Public Health. 2008.
xiii U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. 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. 2014.
xiv Abreu-Villaca, Y et al. Short-term adolescent nicotine exposure has immediate and persistent effects on cholinergic
systems: critical periods, patterns of exposure, dose thresholds. Neuropsychopharmacology. 2003.
xv National Academy of Medicine (formerly Institute of Medicine). Public Health Implications of Raising the Minimum Age
of Legal Access to Tobacco Products. National Academy Press. 2015.
xvi Kessed Schneider S et al. Community reductions in youth smoking after raising the minimum tobacco sales age to 21. Tob
Control. 2015.
xvii King BA et al. Attitudes Toward Raising the Minimum Age of Sale for Tobacco Among U.S. Adults. Am J Prev Med. 2015
xviii Boyle, R., Kingsbury, J. & Parks, M. Raising the Minimum Legal Sales Age for Tobacco to 21. Minnesota Medicine. 2017.
Clinical AND Health Affairs
JANUARY/FEBRUARY 2017 | MINNESOTA MEDICINE | 35
Raising the Minimum Legal Sale Age
for Tobacco to 21
The Estimated Effect for Minnesota
BY RAYMOND G. BOYLE, PHD, JOHN H. KINGSBURY, PHD, AND MICHAEL J. PARKS, PHD
A campaign to raise the minimum legal sale age for tobacco products from 18 to 21 years known as Tobacco 21
is having a nationwide impact, with at least 200 localities in 14 states having already implemented a Tobacco
21 policy. A 2015 report from the Institute of Medicine (IOM) estimated the effects of such policy on cigarette
use at the national level; however, little is known about the expected effects for individual states. The purpose
of this study was to consider the effect on smoking initiation in Minnesota if the minimum sale age were 21 in
2015. Estimates from the Minnesota Adolescent Community Cohort and Minnesota Adult Tobacco Survey were
used to calculate the uptake of smoking in a hypothetical cohort of Minnesota adolescents 15 to 20 years of age.
Expected reductions in initiation in the IOM report were used to calculate the effects of Tobacco 21 policy on
smoking uptake in this cohort. Results revealed that raising the sale age to 21 in 2015 would prevent 3,355 young
Minnesotans from starting to smoke.
Minnesota addresses tobacco use
through a comprehensive ap-
proach that includes coordinating
smoke-free policies, promoting norma-
tive changes in the social acceptability of
tobacco use, establishing and expanding
the reach of cessation programs, keeping
the price of tobacco high and preventing
young people from initiating tobacco use.
The overall effect of these actions has been
a 35% reduction in cigarette smoking in
Minnesota since 1999;1 however, tobacco
use remains popular among young adults
in Minnesota and nationally.1,2
The persistence of tobacco use among
young adults, coupled with an evolving
marketplace that includes new flavored
products (eg, flavored cigars and cigaril-
los) and new delivery methods (eg, elec-
tronic cigarettes), has led to a desire for
increased regulation of tobacco. In 2009
the U.S. Congress granted authority to the
Food and Drug Administration (FDA)
through the Family Smoking Prevention
and Tobacco Control Act to regulate the
manufacture, distribution and marketing
of tobacco products.3
Although this law prohibited the FDA
from increasing beyond age 18 the na-
tional minimum sale age for tobacco prod-
ucts, state and local governments are able
to raise the minimum sale age for tobacco.
In addition, the law required a study of the
health implications of a higher minimum
age of legal access. The Institute of Medi-
cine (IOM), now the National Academy
of Medicine, conducted the study using
national data to consider the effects of dif-
ferent minimum purchase ages (19, 21 or
25 years) and examine multiple outcomes,
including preventing young people from
starting and encouraging current smokers
to quit smoking, and the health benefits
from reduced smoking because of an in-
creased purchase age. Nationally, increas-
ing the purchase age to 21 would result in
approximately 223,000 fewer premature
deaths and 50,000 fewer deaths from lung
cancer.4
Adolescents younger than age 18 fre-
quently obtain tobacco from social sources
who are older than 18 but younger than
21.5 If tobacco could not be sold to 18- to
20-year-olds, they would be far less likely
to provide tobacco to younger teens. By
age 21, young adults are likely to have
friends older than high-school age and,
therefore, less likely to provide tobacco to
minors.
The IOM’s 2015 report is particularly
important because it provides scientific
guidance for state and local governments
as they seek to protect public health. Al-
though the report provided novel informa-
tion on the expected effects of Tobacco 21
policy on a national level, it provided little
Clinical AND Health Affairs
36 | MINNESOTA MEDICINE | JANUARY/FEBRUARY 2017
in other places. For example, in New York
City, compliance has fallen over time after
Tobacco 21 policy was implemented.10
Calculation: In this analysis, we began
with a cohort of Minnesota 15-year-olds
in 2015–approximately 72,000. We esti-
mated the smoking initiation rate in two
periods: during high school (ages 15 to 17
years) and after high school (ages 18 to
20 years). Next, the reduction in smoking
was calculated for each period if the sale
age for tobacco were raised to 21 in 2015.
We assumed that the smoking uptake in
high school and after high school would
not change in future years. The difference
is reported as the number of young people
15 to 20 years of age who would not have
started smoking.
Results
In 2015, the Minnesota population of
those 15-year-olds was approximately
72,000. Of these, an estimated 7,200 will
start smoking during their high school
years. If the minimum legal sale age in
2015 were 21, an estimated 1,800 would
not start smoking in high school.
tion, the expected reduction in smoking
initiation is thought to vary by age. The ef-
fect is expected to be larger among youth
15 to 17 years of age, with an expected re-
duction in the uptake of smoking of 25%.
Among those 18 to 20 years of age, the
expected reduction is 15%.4
Variation by demographic variables:
Smoking rates vary substantially by popu-
lation groups in Minnesota. For example,
in 2014 the overall adult smoking rate was
about 14%,1 but within the urban Ameri-
can Indian population the smoking rate
was 59%.8 There is a lack of literature on
how smoking initiation would be affected
in population groups with higher smoking
rates if the sale age were increased. Thus,
the estimate here is not adjusted by gender
or other demographic variables (eg, race/
ethnicity, income).
Enforcement: States are required to
enact and enforce laws prohibiting the sale
or distribution of tobacco products to in-
dividuals younger than 18 years of age. A
major assumption of Tobacco 21 policy is
that the same level of current enforcement
and retailer compliance would remain in
effect. Although Minnesota has a high
rate of retailer compliance with current
law,9 retailer cooperation has been lower
information about the expected effects at
a state level.
The purpose of this study was to con-
sider the effects on smoking initiation in
Minnesota if the legal minimum sale age
for tobacco products were 21. The specific
goal was to calculate how many young
people ages 15 to 20 years would not start
smoking if the assumptions from the IOM
report were applied to Minnesota.
Methods and Assumptions
Age groups: The 2015 IOM report exam-
ined effects among specific age groups:
under 15 years, 15- to 17-year-olds and
18- to 20-year-olds. In this analysis, we
limited the consideration to ages 15 and
older.
Initiation rate: Cohort studies that fol-
low participants over time provide the best
estimates of smoking initiation. The Min-
nesota Adolescent Community Cohort
(MACC) study was a population-based
study of Minnesota youth ages 12 to 16
in 2000 who were followed until 2008. In
2003, approximately 19% of the cohort
reported smoking in the previous month.6
Smoking among Minnesota high school
students has fallen to about 10% since
2003. Therefore, in this analysis we used
10% as the estimate of smoking initiation
among youth 15 to 17 years of age.
In a later analysis of the MACC data,
16% of the cohort who did not start
smoking in high school took up smoking
(smoked in the past month) between the
ages of 18 and 21.7 This estimate of smok-
ing uptake is consistent with the preva-
lence of smoking among young adults in
the Minnesota Adult Tobacco Survey. For
this analysis we used 16% as the estimate
of 18- to 20-year-olds who would initiate
smoking.
Estimated effects of Tobacco 21 policy:
An increase in the minimum sale age is
expected to apply to all commercial to-
bacco products; however, for the purpose
of estimating effects similar to those in the
IOM report, the scope of this study was
restricted to cigarette smoking. In addi-
COHORT AGE
(YEARS)
NUMBER WHO
HAVE NOT
SMOKED
PROPORTION
WHO START
SMOKING
NUMBER
SMOKING
NUMBER NOT
SMOKING IF
POLICY WERE
IN EFFECT
15 72,000
16 to 17 64,800 10% 7,200 1,800
18 to 20 54,432 16% 10,368 1,555
FIGURE
Estimated Reduction in Youth Smokers with Implementation
of Tobacco 21 Policy
NUMBER OF YOUTHAges 15 to 17 years
WITHOUT TOBACCO 21 POLICY
WITH TOBACCO 21 POLICY
Ages 18 to 20 years
7,200
17,568
5,400
8,813
14,213
Combined Total
AGE GROUPS AFFECTED BY TOBACCO 21 POLICY
TOTAL: 3,355Note: The cohort size is 1/5 of the census estimate of
Minnesota 15- to 19-year-olds in 2015.
10,368
Clinical AND Health Affairs
JANUARY/FEBRUARY 2017 | MINNESOTA MEDICINE | 37
3. Mitka M. FDA exercises new authority to regulate
tobacco products, but some limits remain. JAMA.
2009;302(19):2078, 2080-1.
4. IOM (Institute of Medicine). Public Health
Implications of Raising the Minimum Age of Legal
Access to Tobacco Products. Washington, DC: The
National Academies Press; 2015.
5. Lenk KM, Toomey TL, Shi Q, Erickson D, Forester
JL. Do sources of cigarettes among adolescents vary
by age over time? J Child and Adolesc Subst Abuse.
2014;23(2):137-143.
6. Centers for Disease Control and Prevention.
Cigarette smoking among adults—United States,
1992, and changes in the definition of current
cigarette smoking. MMWR Morb Mortal Wkly Rep.
1994;43(19):342–6.
7. Bernat DH, Klein EG, Forester JL. Smoking initia-
tion during young adulthood: A longitudinal study
of a population-based cohort. J Adolesc Health.
2012;51(5):497-502.
8. Forster J, Poupart J, Rhodes K, et al. Cigarette
smoking among urban American Indian adults —
Hennepin and Ramsey Counties, Minnesota, 2011.
MMWR Morb Mortal Wkly Rep. 2016;65(21):534–7.
9. Substance Abuse and Mental Health Services
Administration. Tobacco sales to youth. Available
at: http://store.samhsa.gov/shin/content//SYNAR-14/
SYNAR-14.pdf. Accessed September 1, 2016.
10. Silver D, Macinko J, Giorgio M, Bae JY, Jimenez G.
Retailer compliance with tobacco control laws in New
York City before and after raising the minimum legal
purchase age to 21. Tob Control. 2015 Nov 19. pii:
tobaccocontrol-2015-052547. [Epub ahead of print]
11. Increasing the Sale Age for Tobacco Products to
21. Campaign for Tobacco Free Kids. Available at:
www.tobaccofreekids.org/what_we_do/state_local/
sales_21. Accessed October 1, 2016.
12. Farley SM, Coady MH, Mandel-Ricci J, et al. Public
opinions on tax and retail-based tobacco control strat-
egies. Tob Control. 2015 Mar;24(e1):e10-3.
13. Winickoff JP, McMillen R, Tanski S, Wilson K,
Gottlieb M, Crane R. Public support for raising the
age of sale for tobacco to 21 in the United States.
Tob Control. 2016 May;25(3):284-8.
14. King BA, Jama AO, Marynak KL, Promoff GR.
Attitudes toward raising the minimum age of sale
for tobacco among U.S. adults. Am J Prev Med.
2015;49(4):583-8.
15. Vuolo M, Kelly BC, Kadowaki J. Independent and
interactive effects of smoking bans and tobacco taxes
on a cohort of US young adults. Am J Public Health.
2016;106(2):374–80.
16. Gielen AC, Green LW. The impact of policy, envi-
ronmental, and educational interventions: a synthesis
of the evidence from two public health success sto-
ries. Health Educ Behav. 2015;42(1S):20S-34S.
strongly to smoking bans than to other
types of tobacco control15 in part because
a ban is an unambiguous anti-tobacco
message that indirectly influences social
norms, creating a social environment
that discourages health-risk behavior.16
Put differently, the effects of Tobacco 21
policy would extend into the future as new
cohorts of young people do not start using
tobacco.
Our analysis considered only cigarette
smoking; but a Tobacco 21 policy would
apply to all tobacco products. Whether the
effects of raising the purchasing age to 21
would be similar across all demographic
and racial/ethnic groups is not known.
Similar to the IOM, we did not adjust the
Minnesota estimate for any variation by
demographics other than age. This ques-
tion should be examined when there is
sufficient data on communities that have
implemented the policy.
Conclusion
Raising the minimum sale age for tobacco
to 21 would prevent the uptake of smoking
among youth and young adults, subse-
quently reducing smoking prevalence over
time. Applying national estimates from the
2015 IOM report to Minnesota, we found
that implementing a Tobacco 21 policy
could have a marked impact on smok-
ing initiation among Minnesota’s young
people. Tobacco 21 should be considered
an effective strategy for reducing smok-
ing initiation. Preventing smoking among
youth remains a primary focus for reduc-
ing morbidity and mortality as well as pro-
moting health across the lifespan. MM
Raymond Boyle is director of research programs
for ClearWay Minnesota. John Kingsbury and
Michael Parks are research scientists for the
Minnesota Department of Health.
REFERENCES
1. Boyle RG, Amato MS, Rode P, Kinney AM, St.
Claire AW, Taylor K. Tobacco use among Minnesota
adults, 2014. Am J Health Behav. 2015;39(5):674-9.
2. Johnston LD, O’Malley PM, Miech RA, Bachman
JG, Schulenberg JE. Monitoring the Future National
Survey Results on Drug Use, 1975-2015: Overview,
key findings on adolescent drug use. Ann Arbor:
Institute for Social Research, The University of
Michigan. 2016. Available at: www.monitoringthefu-
ture.org/pubs/monographs/mtf-overview2015.pdf.
Accessed September 3, 2016.
Of those who finished high school with-
out initiating smoking, 10,368 will begin
smoking between ages 18 and 21. Under a
Tobacco 21 policy, 1,555 fewer young peo-
ple would start smoking after high school.
Overall, 3,355 fewer young people would
start smoking in this cohort of youth if a
Tobacco 21 policy were in effect (see Fig-
ure). In other words, increasing the sale
age to 21 would increase the proportion
of nonsmokers in a cohort of 15-year-olds
from 76% to 80%.
Discussion
Increasing the sale age to purchase tobacco
products from 18 to 21 would have a posi-
tive effect on Minnesota, where tobacco
use remains popular among young adults.1
Given that almost 95% of smokers start
smoking by age 21, raising the age of sale
to 21 years would prevent the vast majority
of young people from becoming addicted
to the nicotine in tobacco.
At least 200 localities in 14 states have
raised the minimum legal sale age for
tobacco products to 21 years.11 Notably,
Hawaii was the first state (2015) followed
by California (2016), and New York City
(2013) is the largest city to adopt a To-
bacco 21 policy. This policy has broad
support and is viewed positively by both
smokers and nonsmokers. In New York
City, 60% of smokers and 69% of non-
smokers have supported the age increase.12
In a national sample of adults, 70.5% sup-
ported the increase.13 And in an online
survey, 77.5% of never smokers and 70%
of current smokers either strongly favored
or somewhat favored raising the legal pur-
chasing age to 21.14
We acknowledge that some young
people will begin using tobacco at a later
age. The amount is unknown; but even if
5% eventually take up smoking, this would
not diminish the overall effect of Tobacco
21 policy. In addition, while we have
highlighted how Tobacco 21 would inhibit
more than 3,300 youth from initiating
smoking, it is important to note the policy
could have additional and more indirect
benefits. Youth tend to respond more
1-6-17
IncreasE the tobacco age to 21
Raising the
TOBACCO age to
21 will prevent
youth tobacco
use and
save lives.
Almost 95 percent
of addicted adult
smokers started
smoking by age 21.2
• Increasing the age gap between kids and those who can legally buy tobacco will help remove access to tobacco products from the high-school environment.
Minnesotans agree: We can do more to prevent kids from becoming addicted. A national consensus is growing to prevent addictions and future health problems by ensuring that those who sell tobacco products do so to adults who are 21 and older. Minnesotans for a Smoke-Free Generation supports this movement.
Research shows a 25 percent reduction in smoking initiation among 15-to-17-year-olds following such an increase.1
Adults support raising
the tobacco age to 21.
• A national survey shows that 75 percent of adults favor increasing the minimum sale age for tobacco to 21.3
• 70 percent of smokers are in support of raising the minimum legal age.3
Big Tobacco
actively recruits
replacement
smokers to
guarantee
profits.
• The tobacco industry heavily targets 18-to-21-year-olds with menthol and candy flavoring, magazine advertisements, product design and packaging, and event sponsorships and promotions.3,4
1. Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine (formerly Institute of Medicine). Public Health Implications of Raising the
Minimum Age of Legal Access to Tobacco Products. National Academy Press. 2015.
2. U.S. Department of Health and Human Services. Results From the 2010 National Survey on Drug Use and Health: Summary of National Findings. Substance Abuse and Mental
Health Services Administration - Center for Behavioral Health Statistics and Quality. 2014.
3. King BA, et al. Attitudes toward raising the minimum age of sale for tobacco among U.S. adults. Am J Prev Med. 2015.
4. Gemma JL (RJR Tobacco). Memorandum from JL Gemma, Marketing Development Department to Marketing Development Department Committee at RJ Reynolds Tobacco Co. Aug 16. 1985. http://legacy.library.ucsf.edu/tid/xgm15d00/pdf
5. Kessel Schneider S, et al. Community reductions in youth smoking after raising the minimum tobacco sales age to 21. Tob Control. 2015.
6. U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. 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. 2014.
7. Minnesota Department of Health. Health Advisory: Nicotine Risks for Children and Adolescents. 2015.
State and local
governments are taking
action to protect youth.
Nicotine can cause addiction
and disrupt attention
and learning in adolescents.7
• California, Hawaii and more than 200 localities in the United States have raised the sale age of tobacco to 21, including New York City, Boston and Kansas City.
• Needham Massachusetts found that tobacco use among high-school students fell by nearly half after raising the age to 21.5
• Nicotine is addictive, and adolescents are especially vulnerable to the health impacts of tobacco use.6
• The adolescent brain is negatively impacted by nicotine, and its long-term effects are a significant public health concern.7
TOBACCOAGE
21years
Minnesotans for a Smoke-Free Generation is a coalition of Minnesota
organizations that share a common goal of saving Minnesota youth from a
lifetime of addiction to tobacco. The coalition supports policies that reduce youth smoking,
including keeping tobacco prices high, raising the tobacco sale age to 21,
limiting access to candy-, fruit- and menthol-flavored tobacco and funding future
tobacco control programs. Find out more at www.smokefreegenmn.org.
Anne Mason Yoder – amason@clearwaymn.org
Cites available at www.smokefreegen.org/data January 20, 2017
Increase the minimum legal sale age for tobacco products to 21
Minnesotans agree: We can do more to prevent kids from becoming addicted. A national consensus is growing to
prevent addictions and future health problems by ensuring that those who sell tobacco products do so to those who
are 21 and older. Minnesotans for a Smoke-Free Generation supports this movement.
Raising the tobacco age to 21 will prevent youth tobacco use and save lives.
The tobacco industry aggressively markets to youth and young adults to recruit replacement smokers and
guarantee profits.
There is broad support for raising the age and many cities and states around the country have taken action.
Raising the tobacco purchase age to 21 will prevent youth tobacco use and save lives.
Almost 95 percent of addicted adult smokers start before age 21.1
The Institutes of Medicine reports that there would be a 25 percent reduction in smoking initiation among
15-to-17-year-olds if the age to purchase tobacco was raised to 21.2
Raising the minimum age to 21 nationally would result in 223,000 fewer premature deaths and 50,000 fewer
deaths from lung cancer.2
Raising the tobacco purchase age will reduce teens’ ability to buy tobacco products themselves or to access
them through social sources.3
The tobacco industry aggressively markets to youth and young adults to recruit replacement smokers and
guarantee profits.
The U.S. Surgeon General has identified the tobacco industry as the root cause of the smoking epidemic
through its promotion of tobacco products to youth.4
The tobacco industry heavily targets 18-to-21-year olds. The tobacco industry continues to use tactics like
candy flavoring, magazine advertisements and event sponsorships to attract young people to tobacco.5,6
“Raising the legal minimum age for cigarette purchase 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.”7
Innovative new tobacco products like e-cigarettes are highly attractive to youth.8
There is broad support for raising the age and many cities and states around the country have taken action.
75 percent of adult Americans favor increasing the minimum purchase age for tobacco to 21.5
Hawaii and California were the first states to raise the age to purchase tobacco to 21.
More than 200 localities in the United States have raised the age to purchase tobacco to 21, including Kansas
City, Chicago, Cleveland, New York City and Boston.
One locality, Needham, Massachusetts, increased the tobacco age to 21 in 2005. After increasing the age,
Needham found that smoking among high-school students fell by nearly half.9
1 U.S. Department of Health and Human Services. Results from the 2010 National Survey on Drug Use and Health: Summary of National
Findings. Substance Abuse and Mental Health Services Administration - Center for Behavioral Health Statistics and Quality; September
2014 https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.pdf.
2 Institute of Medicine. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. National Academy
Press. 2015.
3 Campaign for Tobacco-Free Kids. Increasing the Minimum Legal Sale Age for Tobacco Products to 21.
https://www.tobaccofreekids.org/research/factsheets/pdf/0376.pdf.
4 U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. 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. 2014.
5 King BA, Jama AO, Marynak KL, Promoff GR. Attitudes Toward Raising the Minimum Age of Sale for Tobacco Among US Adults. Am J Prev
Med. 2015; 49(4): 583-588.
6 Gemma JL (RJR Tobacco). Memorandum from JL Gemma, Marketing Development Department to Marketing Development Department
Committee at RJ Reynolds Tobacco Co. Aug 16. 1985; http://legacy.library.ucsf.edu/tid/xgm15d00/pdf.
7 Philip Morris, “Discussion Draft Sociopolitical Strategy,” January 21, 1986, Bates Number 2043440040/0049,
http://legacy.library.ucsf.edu/tid/aba84e00.
8 Campaign for Tobacco-Free Kids. Electronic Cigarettes and Youth. https://www.tobaccofreekids.org/research/factsheets/pdf/0382.pdf.
9 Kessel Schneider S, Buka SL, Dash K, Winickoff JP, O'Donnell L. Community reductions in youth smoking after raising the minimum
tobacco sales age to 21. Tob Control. 2015.
Date: February 13, 2017 Agenda Item #: VII.A.
To:Community Health Commission Item Type:
From:Jeff Brown, Community Health Administrator
Item Activity:
Subject:Chair Term Limit Feedback Information
CITY OF EDINA
4801 West 50th Street
Edina, MN 55424
www.edinamn.gov
ACTION REQUESTED:
INTRODUCTION:
ATTACHMENTS:
Description
B & C Chair Term Limit Memo
City of Edina • 4801 W. 50th St. • Edina, MN 55424
Administration
Date: January 20, 2017
To: Edina’s Advisory Boards and Commissions
cc: Board and Commission Liaisons
From: MJ Lamon, Project Coordinator
Subject: Board/Commission Chair Term Feedback Requested
City Council has been reviewing Board and Commission practices at both January work sessions.
One topic in discussion has been protocol and City Code around Board and Commission chair term
limits. Currently Board and Commission chairs are limited to 2 one-year consecutive terms. This is
outlined in City Code, Section 2-83 – Organization and Bylaws:
Sec. 2-83. - Organization and bylaws.
(a) Bylaws. Each board or commission will be governed by such bylaws as approved by the city
council.
(b) Chairperson and vice-chairperson. Each board or commission annually shall elect from its
members a chairperson and vice-chairperson to serve a term of one year. No person shall serve
more than two consecutive one-year terms as chairperson of a particular board or commission. A
chairperson elected to fill a vacancy shall be eligible to serve two full terms in addition to the
remainder of the vacated term. There are no term limits for the position of vice-chairperson.
The Council would like Board and Commissions to respond to the questions below. The Liaisons
will record a summary in the minutes which will be shared with Council when they review the
protocol. When providing feedback consider the balance between experience and efficiency of
running a meeting vs leadership change and opening opportunities.
1) Is the term limit of two consecutive years too short?
2) Would a longer term limit better balance chair experience and leadership change?
3) If so, what is the right number (3 years, 4 years, no limit)?
Thank you for your input and service!
MJ Lamon,
Board and Commission Staff Liaison
Page 2
City of Edina • 4801 W. 50th St. • Edina, MN 55424
mlamon@edinamn.gov