History and Overview of Tobacco Policy Initiatives in Maine Amy Olfene and Becky Smith Maine Public Health Association July 11, 2011
Disclaimer• This presentation contains policy initiatives and laws successfully passed by the Maine State Legislature between 1897 and 2011. The presentation does not include all tobacco-related initiatives or legislation.• Efforts to expand smoke-free air laws to encompass tribal gambling establishments and private clubs, increase the age to purchase/use tobacco, reclassify little cigars as cigarettes, include additional products to flavored tobacco bans, and provide constitutional protections for the Fund for a Healthy Maine have all been proposed, but failed, before the legislature.• For a complete history of Maine’s tobacco control initiatives and a copy of this presentation please visit www.slideshare.net/hppofme.• This PowerPoint was last updated on July 20, 2011.
INTRODUCTIONMaine‘s first law regarding smoking was enacted over100 years ago. However, most legislation concerningsmoking and public health has been passed since 1981.Since that time, laws have been passed to reduceexposure to secondhand smoke; to reduce youth accessto tobacco; to encourage smokers to quit and to preventyouth from starting by raising the price of cigarettes; andto establish a comprehensive tobacco prevention andcontrol program that includes educating Maine citizensabout the dangers of tobacco use and providing servicesto smokers who want to quit.
Background• Prompted by the failure of the Smoke-free Workplace bill in 1983, tobacco control advocates—led by Ed Miller of the Lung Association and Gordon Smith of the Medical Association—held a meeting in May 1984 to establish a dedicated coalition of tobacco control advocates looking to achieve policy change at the state level. The coalition became known as the Maine Coalition on Smoking or Health (MCSOH).• Over the years, MCSOH partnered with more than 100 state and municipal agencies, including the American Cancer Society, New England Division, the Maine Lung Association, Anthem Blue Cross Blue Shield, the American Heart Association, and the Maine Center for Public Health.• In 2001, Maine received a RWJF Smokeless States Grant, providing funding to hire permanent coalition staff.• In 2007, the coalition changed its name to Health Policy Partners of Maine in response to the coalition’s growing involvement in obesity prevention.• In October 2010, the Health Policy Partners of Maine merged with the Maine Public Health Association in an effort to both sustain and expand advocacy efforts. The Association maintains a policy committee that focuses directly on legislative issues related to tobacco prevention, treatment, and control.
Smoke-Free Spaces• Workplaces• Public places• Restaurants• Bars• Outdoor dining areas• Schools (indoor and out)• Daycare centers• Homes and vehicles occupied by foster children• Cars with children <16 years old• Commercial vehicles (including livery vehicles)• State parks and beaches
Smoke-Free Voluntary Spaces• Commercial property (outdoors)• Residential property (indoor and outdoor); rental and owner occupied• Hospital campuses• Post-secondary educational institution campuses• Municipal and private parks, beaches, and athletic fields• Hotels and motels• Private clubs*
Secondhand Smoke Maine’s first law regulatingsmoking in public places is passed. It prohibits smoking in public Tobacco use is prohibited in proceedings of various types, public school buildings and on unless consent is given by all The Workplace Smoking school grounds while school is members of the board, in session, except in commission, or other public body Act of 1985 is passed. designated smoking areas.that has convened the proceeding. 1981 1983 1985 1987 1988 1989 Smoking is prohibited in jury Restaurants are required to provide Smoking is prohibited from public rooms unless all members a no-smoking area for customers areas of hosptials and enclosed of jury consent and licensed that is reasonably calculated to shopping centers, except in nursing homes except in address the needs of nonsmokers. designated smoking areas. designated areas. Smoking is prohibited in public areas Smoking prohibited from of publicly owned buildings. enclosed areas of ferries.The Workplace Smoking Act of 1985 has been amended, and strengthened, significantly over thepast 26 years. The law concerning workplace smoking and smoking in public places can be found in Title 22, sections 1541-1545 and 1580-A of Maine Statutes.
Secondhand Smoke The public places law prohibiting smoking in the portion of a residence licensed for use as a The City of Portland daycare or babysitting service is The law regulating smoking in hospitals adopts a ban on is amended to omit the requirement to expanded to cover unlicensed smoking in all residences and to prohibit provide designated smoking areas for restaurants that do not smoking in adjacent areas from patients in psychiatric facilities, Smoking on public have separately which smoke could enter the ventilated rooms for substance abuse units, and state mental buses is prohibited. health institutes. areas directly used for care. smokers. 1990 1993 1997 1998 1999 2001 2003 A comprehensive law is passed The restaurant exemption in the The exemption in the public places smoking prohibiting smoking in most enclosed public places smoking law is law for taverns (bars), lounges and pool halls public places.* Enclosed, designated repealed, requiring all restaurants is repealed. The new law also repeals the smoking areas are permitted as long as (with exemptions for hotel lounges, provision permitting public places to installno sales, services or other commercial or off-track betting lounges, and bars) enclosed, designated smoking areas and public activities are conducted. to be smoke-free. grandfathered off-track betting facilities. *Several exemptions are included to the public place smoking law, PL 1993, c. 342, § 1, aff. § 9. They include taverns and lounges, restaurants, places where licensed bingo and beano games are conducted, motel and hotel rooms rented to the public, and smoke shops under 2000 square feet.
Secondhand Smoke The exemption for most The public places smoking law is strengthened bylicensed bingo/beano games in tightening smoking restrictions for daycare the public places smoking law facilities, and closing some loopholes being A bill passes that restricts the is repealed. High-stakes misused by bars and other businesses that are smoking exemption for tobacco bingo/beano conducted by required to be smoke-free. The Workplace Smoking specialty stores, including ‘hookah federally recognized Indian Act is strengthened by eliminating the “opt out” bars’ (an expemption for existing tribes remain exempt. provision for all workplaces except private clubs. establishments is included). 2003 2004 2005 2007 2007 2008 Rules are adopted by DHS to address smoking by An ordinance is enacted by the City Council of Smoking is prohibited in a foster parents. The rule prohibits smoking in a foster Bangor that prohibits smoking in vehicles motor vehicle when a person home when a child is in placement or in respite care, when minors under 18 are present. aged 16 or younger is and if child is away, within 12 hours of when the child A bill passes that expands the ban on tobacco present in the vehicle. will return. It also prohibits smoking in any vehicle of use on school grounds to all persons, not just foster parent within 12 hours of transporting a child students and employees. The ban applies and when a child is present in the vehicle. year round, not just when school is in session. By 2005, Maine’s bars, restaurants, public places, and workplaces had gone smoke-free (thoughsome exemptions remained). In 2006, Maine received all A’s on the American Lung Association’s State of Tobacco Control Report Card.
Smoke-Free Legislation in 2009• A law prohibiting smoking within state parks, beaches, and state historic sites is enacted, and goes into effect, May 13th, 2009.• A law barring smoking in outdoor eating areas is passed.• A law eliminating the separate exemptions for hospitals, nursing homes and jury rooms, and clarifies that smoking is prohibited in private multi-unit developments and in state licensed facilities during the period of time employees are working in those facilities, is passed. It also requires smoking be prohibited within 20 feet of entryways, vents, and windows of workplace establishments.
Other Smoke-Free Initiatives• Breathe Easy Coalition of Maine—advocates, educates, and supports voluntary smoke-free policy adoption in rental housing, hospital and college campuses. – All of Maine’s public housing authorities and 2 tribal housing authorities have adopted smoke-free housing policies. – Nearly 50% of Maine landlords report owning a smoke-free property. – 19 (of 39) hospitals have 100% tobacco-free campus policies. – 2 (of 32) college/post-secondary campuses have 100% smoke-free campus policies.• LD 1067, An Act To Improve Awareness of Smoking Policies in Maine Rental Housing (PL 2011, c. 199) – Requires landlords to disclose, in writing, to tenants and potential tenants the smoking policy of the rental property.• The Good Work! program assists workplaces meet the requirements of the Workplace Smoking Act and adopt voluntary policies to eliminate exposure to secondhand smoke in the workplace.
Retail Sales and Distribution• 1897: The sale and giveaway of cigarettes to anyone under 21 is prohibited. Violation is criminal and is punishable by a fine or imprisonment (60 day max.)• 1983: Sale/distribution of tobacco to anyone under 18 is made unlawful.• 1987: Vending machine sales of cigarettes are limited to generally supervised areas.• 1989: A new law tightens regulation of tobacco vending machines and prohibits the sale of unpackaged cigarettes. Purchase of tobacco products by anyone under 18 is prohibited; retailers are required to post signs regarding the prohibition. Penalties for sale or distribution to minors are broadened and increased. The sale/distribution of tobacco to minors by minors and the sale of unpackaged cigarettes by minors become juvenile crimes.• 1995: A law is passed to improve youth access laws and provide enforcement capacity. – Makes possession and use of tobacco products by anyone under 18 unlawful. – Increases the penalties for sales/distribution to minors and for purchase by minors, and adds a penalty scheme for offering a false ID. – Designates the Office of Substance Abuse for enforcement of Maine’s youth access laws and the Synar Amendment/Program. – Tightens regulation of tobacco sales from vending machines; and sets up a comprehensive scheme for one-time licensing of tobacco retailers (who sell or give away) and for suspending or revoking a license.• 1996: The State hires a Tobacco Enforcement Officer. John Archard has occupied this position since its inception.
Retail Sales and Distribution• 1997: The first random, unannounced inspections of retail establishments are conducted to ensure that tobacco is not being sold to minors.• 1997: The vending machine law is amended to permit machines to be located only in areas where minors must be accompanied by an adult. The packaging law is amended to prohibit packages that contain fewer than 20 cigarettes. For point-of-service retail sales, all sales must be face-to-face so age of buyer can be identified. For retail sales, seller must verify age of anyone under 27 by means of a photo ID.• 1999: Self-service display of tobacco products is prohibited. The law does not apply to multi- unit packaging of 10 units or more (i.e., cartons of cigarettes), or to tobacco shops or other locations where minors are generally prohibited.• 2004: A new law prohibits anyone from selling, furnishing, giving away or offering to sell, furnish or give away water intended for consumption and containing nicotine.• 2005: A bill is passed that requires minors to be accompanied by a parent or guardian in order to enter a tobacco specialty store and sets a minimum age of 17 for retail clerks who sell tobacco. Clerks younger than 21 must be directly supervised by someone 21 or older.• 2005: A resolve directing the Bureau of Health to develop an education and recognition program to encourage tobacco retailers to responsibly manage point-of-sale marketing materials is passed. Examples of programs implemented: NO BUTS! and Star Store• 2007: A bill passes banning distributors from selling cigarettes to a retailer who fails to provide documentation that he holds a current retail tobacco license.
Tobacco Prevention Funding• 1991: In partnership with the American Cancer Society, the State of Maine successfully applies for its first tobacco prevention and control funds through the “American Stop Smoking Intervention Study” (ASSIST) project at the National Cancer Institute. Maine is one of 17 states to receive seven-year federal grants for smoking-related cancer prevention. The focus is on reducing smoking among adults and reducing the initiation of tobacco use by youth.• 1997: The cigarette excise tax is increased from 37 to 74 cents. The statutory language specifies that the increase is a “public health measure.” The Tobacco Tax Relief Fund, a dedicated fund for cigarette excise tax receipts, is established. The Law also establishes the Tobacco Prevention and Control Program, along with the Tobacco Prevention and Control Advisory Council. $3.5 million from the Relief Fund is allocated to tobacco prevention and control for each year in the biennium. These are the first state dollars ever spent on tobacco control.• 1997: Maine files a lawsuit against tobacco companies (on June 17, 1997) in Kennebec County Superior Court.• 1998: Maine’s ASSIST grant ends and the CDC begins providing infrastructure funding under its National Tobacco Control Program.• 1998: Maine signs the Master Settlement Agreement and settles its lawsuit against the tobacco companies.
Tobacco Prevention Funding• 1999: The Fund for a Healthy Maine is established by the Legislature to receive tobacco settlement payments; the FHM Trust Fund is also created. About $18.6 million is allocated to FHM programs, much of it contingent funding because settlement payments are yet to be received. A $3.5 million capital advance is made from the General Fund for tobacco programs to be paid back with settlement money; the first MSA payments are received, totaling $35.7 million.• 2000-Present: The Fund for a Healthy Maine is subjected to regular diversions both proposed and enacted. The Fund loses 17.1% of its Funds to General Fund transfers, with 90% coming from unallocated and reserve funds. In 2011, the Fund was faced with a 33.7% cut, with the Governor proposing to supplant General Fund expenditures to MaineCare (Medicaid) in the FY12/13 biennial budget; 15 programs faced funding elimination. The budget as passed and enacted included a total cut of 1.1% to (non-Dirigo) programs and 7.56% to the Fund for a Healthy Maine as a whole; there were not cuts made to the Tobacco Prevention, Treatment, and Control Program.
MSA Payments and FHM Tobacco Control Program Funding* SFY 2001-2013*Only ~66% of funds allocated to the Tobacco Prevention, Treatment, and Control Program and the Community and School Grantslines of the FHM directly support tobacco control efforts.
‘Fire Safe’ Cigarettes• 2008: A bill passes that requires all cigarettes sold in Maine to be ‘reduced ignition propensity’ (‘fire safe’) cigarettes. This bill requires that cigarettes be manufactured in accordance with standards introduced in New York (and subsequently adopted by Vermont, New Hampshire and Massachusetts). The bill requires cigarettes to be marked as ‘fire safe’; establishes penalties and forfeitures of products sold or offered for sale in violation of the law. – The Fire Marshal may adopt rules to implement the law. – A fund is created to hold monies collected from penalties assessed. – Distributors and retailers may sell existing ‘floor stock’ stamped inventory, under certain conditions.
Delivery Sales• 2003: A new law is passed that further regulates the delivery sales of tobacco products by extending the retail licensing law to anyone who wants to sell to consumers, whether through the Internet, by phone or other electronic method of voice transmission, or through a delivery service. In addition, all sellers must meet strict requirements regarding determination of the purchaser’s age, provide age information to any delivery service used, use only delivery services that meet strict age verification requirements, meet strict package- labeling requirements, and report all sales to the State. The law also provides the AG’s office with additional enforcement tools.• 2008: The U.S. Supreme Court in a unanimous decision affirms the Court of Appeals for the First Circuit, striking down two provisions of Maine’s delivery sales law as pre-empted by federal law (Federal Aviation Administration Authorization Act). The two provisions struck down were: the presumption that a delivery service is ‘deemed to know’ that a package contains tobacco, under certain circumstances, and the requirement that a delivery service observe specified age-verification procedures. (Rowe v. NH Motor Transport Association, Inc.)• 2009: In response to the Supreme Court decision in Rowe v. NH Motor Transport Assoc., Inc., a bill is passed that prohibits the delivery of tobacco products including cigarettes, smokeless tobacco and non-‘premium’ cigars, to anyone other than licensed tobacco retailers or distributors.
Flavored Tobacco Products• 2008: A bill passes prohibiting the sale or distribution of flavored cigarettes or cigars unless they were first on the market prior to 1/1/85. A flavored cigarette or cigar sold after 1/85 may be exempted from the ban if approved by the Attorney General (AG). The exemption requires a determination that the product does not have a ‘characterizing flavor’ and associated packaging, promotion and brand style that directly or indirectly targets youth or encourages the initiation of smoking.• 2008: A bill passes that amends a previous law prohibiting the sale of flavored cigarettes or cigars. A flavored cigarette or cigar on the market after 1/85 may be exempted from the ban if the Attorney General (AG) determines that its characterizing flavor is not one ‘known to appeal or likely to appeal to youth’. The ‘associated packaging promotion or brand style’ language was eliminated. The original law was also amended to require that after an exemption is granted for a product, the manufacturer has an affirmative duty to inform the AG of a material change in characterizing flavor and the AG can revoke an exemption if he determines that a material change has been made.• 2010: A bill is passed which amends existing prohibitions on the sale of flavored tobacco products to make Maine law consistent with the new federal Family Smoking Prevention and Tobacco Control Act, retains the prohibition on selling flavored nonpremium cigars, while exempting cigars previously exempted by the Attorney General.
Tobacco Related Legislation, 2011• LD 216, Resolve, Regarding MaineCare Tobacco Treatment and Smoking Cessation Benefits, (Resolve 2011, c. 24) – Requires the Maine CDC and the MaineCare program to work together to reduce tobacco use among MaineCare members• LD 1067, An Act To Improve Awareness of Smoking Policies in Maine Rental Housing, (PL. 2011, c. 199) – Requires landlords to notify, in writing, all tenants of the smoking policy on the property• LD 1505, An Act To Clarify the Scope of Practice of Licensed Alcohol and Drug Counselors Regarding Tobacco Use (PL. 2011, c. 222) – Authorizes Licensed Drug and Alcohol Counselors (LADCs) to provide tobacco treatment counseling