ACS CAN Calls on New York City Council To Adopt Comprehensive Tobacco Control Package

Earlier today, Michael Davoli, ACS CAN Director of Government Relations in Metro New York testified in front of the New York City Council Committee on Health in support of the comprehensive tobacco control package of bills announced ealier in the month by Mayor de Blasio.

Read the full testimony below.

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Testimony of American Cancer Society Cancer Action Network to  the New York City Council Committee on Health

April 27, 2017 • New York, NY

Chair Johnson, members of the health committees, thank you for the opportunity to testify today.  My name is Michael Davoli and I am the Director of Government Relations in Metro New York for American Cancer Society Cancer Action Network (ACS CAN), the nonprofit, nonpartisan, advocacy affiliate of the American Cancer Society.  I am pleased to be able to speak on the legislation under consideration today. While my testimony will focus primarily on Intro 1138-A-2016, Intro 1544-2017, and Intro 1547-A-2017, I will also touch on Intro 1471-2017, Intro 1532-2017, Intro 5930-2017, Intro 0484-2014 and Intro 0977-2015.

Let me start by expressing that the American Cancer Society Cancer Action Network examines all policy issues by their direct impact on cancer. Here in New York City on average 78,000 people will be diagnosed with cancer each year and on average 25,000 people will lose their lives to the disease. While smoking, rates are at a historic low, on average more than 5,400 New Yorkers will be diagnosed with tobacco related cancer and more than 3,200 people will lose their lives. This includes lung, bronchus, esophagus, oral and pharynx.

The impact of tobacco use goes beyond the public health toll. The annual health care cost in government expenditures in New York State directly caused by smoking is $10.39 billion. Lower income New Yorkers who smoke suffer disproportionately due to the high cost of tobacco. New York state residents’ tax burden from smoking-related healthcare government expenditure is $1,488 per household annually. Helping a lower income pack-a-day smoker quit would, on average, free up more than $1,494 per year that he or she previously spent on cigarettes. The results of this saving could be life changing for a low-income family, as lower-income smokers spend a larger portion of their income on tobacco products and related costs than higher income smokers. Reductions to other smoking-caused costs would add to this benefit, making lower-income households more secure.

We must not let up our fight against the deadly tobacco epidemic. This includes supporting increasing funding for tobacco control and cessation programming by the NYC DOHMH and examining other possible strategies, like those below, to reduce the impact that tobacco has in New York City.

Retail License Cap

ACS CAN strongly supports Intro 1547-A-2017, expanding the retail dealer license to include retailers of all tobacco products and setting caps on retail dealer licenses.

Last week ACS CAN released a new report documenting the oversaturation of New York City by licensed tobacco retail outlets. The report breaks down the number of retail outlets in each borough as well as the proximity of the retail outlets to schools and other tobacco retail outlets. I have provided copies of the report to all of you.

The results that we have included in this report are disturbing.  As of October 1, 2016, there were: 8,992 licensed tobacco retail outlets citywide, including 2,725 in Brooklyn, 2,196 in Manhattan, 2,117 in Queens 1,542 in the Bronx and 412 on Staten Island.

To put those numbers in perspective, the number of licensed tobacco retail outlets citywide is: 3X more than the total number of the top 10 corporate chain stores combined (2,984), 3 ½ X more than the number of pizzerias (approximately 2,500), 3X more than the number of public, private, charter, and parochial schools (2,619) and 29 times more than the number of Starbucks (307) in New York City.

Citywide, there is a licensed tobacco retailer every five blocks or 1,312 feet; and when you factor in all the open spaces where there is no commercial or residential activity like parks, cemeteries or beaches, the number becomes even lower.

In far too many New York City neighborhoods, a child is more likely to walk past a tobacco retail outlet than a library or playground. In New York City, 6,778, over 2/3 of all licensed tobacco retail outlets are within 1,000 feet of a school. Making matters worse, over 93% or 8,442 licensed tobacco retail outlets are within 1,000 feet of another licensed tobacco retail outlet.

In some of our most vulnerable communities, tobacco is both persistent and pervasive. Significant disparities in the number of retail outlets in relation to the population are found when comparing boroughs and neighborhoods. Midtown and lower Manhattan, parts of the Bronx and most of Brooklyn are home to the highest density of tobacco retail outlets.

The five Community Districts with the highest rate of tobacco retail outlets in the Bronx are in the South Bronx, and the seven Community Districts with the highest rate of tobacco retail outlets in Brooklyn are in North and Central Brooklyn. In both the South Bronx (17 per 10K ppl) and in North (16 per 10K ppl) and Central Brooklyn (16 per 10K ppl) the rate of tobacco retailers found in the corresponding community districts is significantly higher than the borough. (10 per 10K ppl). Meanwhile, smoking rates in each of these neighborhoods rank near the top in the city.

Cigarette smoking disproportionately affects the health of people with lower income, lower levels of educational achievement and those who live at or below the poverty level. Recent studies demonstrate that living near tobacco outlets makes it harder for smokers to quit and that teens who live in areas with higher tobacco outlet density are more likely to have tried smoking, and more likely to think that more adults smoke. In dense urban neighborhoods, tobacco retail outlets often feature signs that promote tobacco products and pricing. Sidewalks are littered with cigarette butts and city residents and visitors’ ability to breathe smoke-free air is compromised.

Widespread availability of tobacco in our communities dangerously normalizes tobacco use. Each year in New York state, 22,500 youth under the age of 18 become regular daily smokers and 31.6 million packs of cigarettes are bought or smoked by New York youth. The cost, accessibility and limits on where tobacco may be used play a significant role in smoking rates. While requirements for minimum prices and restrictions on tobacco use have significantly driven down smoking rates, the continued widespread and unfettered availability of tobacco in New York City is a major factor contributing to the number of youth who become smokers each year. The tobacco industry spends enormous sums of money in New York State to market its products in places where young people shop, like retail stores near schools.

Establishing a cap on the number of tobacco retail outlets will reduce the number of outlets where community members can access or be exposed to deadly tobacco. In addition to improving health of the entire population, establishing a cap protects low income communities and communities of color that have disproportionately high numbers of tobacco retail outlets in their neighborhoods, as well as disproportionately higher smoking rates. Through a process of attrition of stores with licenses that are either revoked through normal processes, or by licenses that are not renewed, a cap will gradually reduce the number of tobacco retail outlets.

Reducing the number of locations where tobacco can be legally purchased will also help drive down illegal tobacco sales. Limiting the legal locations will allow law enforcement to focus their efforts on a smaller number of outlets and ultimately drive down illegal tobacco sales.

Similar approaches have been successfully adopted in various communities including San Francisco, Chicago and Philadelphia. While reducing the number of licensed tobacco retail outlets is not a silver bullet and will not end all tobacco use, by establishing a cap on the number of licensed tobacco retail outlets, New York City can reduce the impact of tobacco retail outlets and end the oversaturation of New York City.

Pharmacy Restriction

ACS CAN strongly supports Intro 1131-A-2016—A Local Law to restrict the sale of tobacco products in pharmacies. Tobacco-free pharmacies reduce access to all tobacco products, which will help prevent kids from forming a lifelong addiction as well as help support those who are coming to the pharmacy for help quitting. Pharmacies are in the business of improving health; however, they represent nearly 5 percent of cigarette sales.

Cigarette sales declined by 17 percent between 2005-2009, but increased in pharmacies by 23 percent during the same timeframe. It is a contradiction for pharmacies to be a facilitator of health and wellness while selling cigarettes and tobacco products. Selling these products side-by-side helps to normalize tobacco use, and serves to further obscure the deadliness of these products. The CVS Pharmacy chain acknowledged this in 2015 when it voluntarily gave up tobacco sales at all its stores nationwide. Research shows that pharmacists and the public support removing tobacco products from pharmacies.

A 2014 survey showed two-thirds of Americans support prohibiting tobacco sales in pharmacies, including nearly half of smokers. As I stated earlier in my testimony, New York City is oversaturated with licensed tobacco retail outlets.  If we are to further drive down smoking rates, we must begin by reducing the number of licensed tobacco retail outlets and their density in New York City.

Prohibiting tobacco sales in pharmacies reduces the density of tobacco retail outlets. Cities in Massachusetts and California that have prohibited the sale of tobacco products in pharmacies saw a three times greater reduction in tobacco retail outlet density than cities that did not. Another study predicted that prohibiting tobacco sales in pharmacies in North Carolina found that it would reduce retail outlets in the state by over 1,000 and reduce density by 13.9 percent. Over 150 municipalities around the country have prohibited tobacco sales in pharmacies.

Minimum Price/Other Tobacco Product Tax

ACS CAN strongly supports Intro 1544-2017, a Local Law to establish price floors and minimum package sizes for tobacco products and shisha, and establish a tax on tobacco products other than cigarettes. Significantly increasing the cost of tobacco reduces tobacco consumption. Regular, significant increases in the retail price of cigarettes reduces the number of people who begin smoking and increases the number of smokers who quit. Studies have shown that for every 10 percent increase in the price of cigarettes, there is a 4 percent reduction in overall cigarette consumption and a 6.5 percent reduction in youth consumption. Low-income adults, youth, and pregnant women are especially likely to quit or reduce their smoking when the price increases. Increasing the minimum per pack price or the tax on tobacco will both accomplish this goal.

When different types of tobacco products cost different rates, lower-cost products become more readily available. Setting minimum prices on all tobacco products, including electronic cigarettes, and establishing a tax on all tobacco products at an equivalent rate will have a significant impact on tobacco use. This tax parity helps reduce tax evasion, generating more new revenue, and ensures that more tobacco users quit instead of switching to a cheaper

product. ACS CAN strongly endorses increasing the minimum price of cigarettes, establishing price floors for other tobacco products and establishing a tax on other tobacco products.

Other Legislation

ACS CAN strongly supports Intro 1471-2017, a Local Law to raise the biennial fee for a Cigarette Retail Dealer License from $110 to $340. Increasing the Cigarette Retail Dealer License fee would bring it on par to similar licenses in New York City while at the same time dissuading store owners from continuing to sell tobacco.

ACS CAN strongly supports Intro 1532-2017, a Local Law to require a license to sell electronic cigarettes. Electronic cigarette use among high school students nationwide increased an astounding 900 percent from 2011 to 2015 per the U.S. Surgeon General. At the same time the electronic cigarette industry has exploded into a $3.5 Billion industry. However, no license is required to sell electronic cigarettes in New York City or State. It is imperative that New York City establish a license for electronic cigarettes and cap the number of licensed available.

ACS CAN strongly supports Intro 1585-2017, a Local Law to require rental apartment buildings, as well as co-op and condo buildings, to create a smoking policy for the building. This measure will encourage landlords to transition more private rental buildings into smoke free properties without requiring it. It is a smart, common sense approach, to encourage the private sector to adopt smoke free policies.

ACS CAN supports Intro 0484-2014, a Local Law to ban smoking in the common areas of all multiple dwellings and Intro 0977-2015, a Local Law to ban smoking in city-financed housing. While ACS CAN generally supports policies that promote smoke free housing, including these proposals, we believe that it is critical that New York City expand the promotion of and access to tobacco cessation resources to help smokers quit.

In conclusion

The American Cancer Society Cancer Action Network looks forward to working with the City Council, the Office of the Mayor, the Department of Health and Mental Hygiene and all stakeholders in New York City on these and other efforts in the fight against the deadly tobacco epidemic.

During today’s hearing, you will undoubtedly hear from tobacco and electronic cigarette industry representatives, tobacco retail outlet owners and electronic cigarette users warning of the dire consequences of New York City adopting the proposed legislation. The same arguments that you will hear were made 50, 30, 10 and even five years ago. Their sky is falling arguments were false then and they are false now.  What is true is the fact that 12,000 people will die from smoking related illness every year in New York City---that is approximately 32 people every day. In a four-year period, approximately 38,000 New Yorkers died from smoking illness. That’s almost two times the capacity of Madison Square Garden.

We must not let up. We must do more if we are to defeat tobacco once and for all.