Other Tobacco Products Equalization Vital for Maine's Youth
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Other Tobacco Products Equalization Vital for Maine's Youth
- 1. Other Tobacco Products Equalization What is it and why is it important to Maine? Tina Pettingill, Maine Public Health Association Becky Smith, American Heart Association Mike Freiberg, Tobacco Control Legal Consortium
- 2. Webinar Agenda Background: Maine’s Tobacco Control Success Background: Tobacco use in Maine Definition of Other Tobacco Products - OTP What Are OTP? National trends Who is Using OTP? How and why OTP are marketed to youth. What is OTP equalization and why/how it would work in ME? Advocacy Opportunities.
- 3. Maine’s Tobacco Control Efforts In 1997 Maine had the dubious distinction of having the highest high school smoking rate in the nation at 39%. Today it is 15%. Partnership for a Tobacco Free Maine Healthy Maine Partnerships Smoke-free workplace laws Periodic cigarette tax increases
- 4. The Tobacco Industry Isn’t Going Anywhere Photo source: http://www.trinketsandtrash.org/
- 5. Video… How Much is a Life Worth? The Truth About Tobacco http://youtu.be/2m7-zIa6-Es
- 6. Replacement Smokers 99% of tobacco users start before they are 26 years old 9 in 10 current smokers started before the age of 18 An estimated 3,800 kids pick up their first cigarette every day Nearly 1 in 4 high school seniors smoke 2 new smokers under age 25 replace every person who dies from tobacco use
- 7. Maine Youth and Smoking 20.3% of Maine high school students report using some form of tobacco product (i.e. cigarettes, smokeless or cigars) at least 1 time in the past month. 15.2% of Maine high school students report smoking in the past month. 7.7% of high school students—primarily male—use smokeless tobacco. 2.9 million packs of cigarettes are sold to Maine’s underage youth each year.
- 8. Big Tobacco has found an opening Changes in High School Tobacco Use Prevalence by Type in Maine, 2001-2011 20% Use of Smokeless 10% Tobacco increases 21% Use of Cigars 0% Increases 7.5% Smokeless Use of -10% Cigarettes Cigars Decreases Cigarettes 38.7% -20% -30% -40%
- 9. Kids Disproportionately Use OTP Comparison of Tobacco Use Prevalence in Maine by Product, 2011 25% 23% Use of lower-price 20% Other Tobacco Products is higher among Maine 15% youth than adults. 15% 13% 10% 8% 5% 4% 3% 0% Cigarettes Cigars, Little Cigars, Cigarillos Smokeless Adult Data: 2011 BRFSS Youth Data: 2011, YRBSS Adult Youth
- 10. Options to Regulate Non-Cigarette Tobacco Products Mike Freiberg, JD Tobacco Control Legal Consortium
- 11. Other Tobacco Products- OTP 1. Dissolvable Tobacco Products Health Risks: Addictive Risk of Tobacco Initiation Risk of Tobacco Continuation (Dual Use) Carcinogenic Risk of Poisoning Especially Children Resemble Candy Potentially Less Harmful Than Cigarettes
- 12. Other Tobacco Products - OTPs 2. Electronic Cigarettes Health Risks: Addictive Risk of Tobacco Initiation Risk of Tobacco Continuation (Dual Use) No Manufacturing Standards Potentially Less Harmful Than Cigarettes
- 13. Other Tobacco Products -OTPs 2. Electronic Cigarettes
- 14. Other Tobacco Products - OTPs 3. Little Cigars Health Risks: Addictive Risk of Tobacco Initiation Risk of Tobacco Continuation (Dual Use) Carcinogenic
- 15. Other Tobacco Products - OTPs 4. Snus Health Risks: Addictive Risk of Initiation Risk of Continuation (Dual Use) Carcinogenic Increased Pre-Term Birth Potentially Less Harmful Than Cigarettes
- 16. Other Tobacco Products - OTPs 5. Water Pipes Health Risks: Addictive Risk of Tobacco Initiation Risk of Tobacco Continuation (Dual Use) Carcinogenic Shared Mouthpieces Pose Risk of Disease Transmission, e.g., Herpe s, Hepatitis, Tuberculosis
- 17. Tax Laws OLD DEFINITION: Subd. 19.Tobacco products. "Tobacco products" means cigars; little cigars; cheroots; stogies; periques; granulated, plug cut, crimp cut, ready rubbed, and other smoking tobacco; snuff; snuff flour; cavendish; plug and twist tobacco; fine-cut and other chewing tobacco; shorts; refuse scraps, clippings, cuttings and sweepings of tobacco, and other kinds and forms of tobacco, prepared in such manner as to be suitable for chewing or smoking in a pipe or otherwise, or both for chewing and smoking; but does not include cigarettes as defined in this section. Minn. Stat. § 297F.01, Subd. 19 (1997)
- 18. Tax Laws OLD DEFINITION: Subd. 19.Tobacco products. "Tobacco products" means cigars; little cigars; cheroots; stogies; periques; granulated, plug cut, crimp cut, ready rubbed, and other smoking tobacco; snuff; snuff flour; cavendish; plug and twist tobacco; fine-cut and other chewing tobacco; shorts; refuse scraps, clippings, cuttings and sweepings of tobacco, and other kinds and forms of tobacco, prepared in such manner as to be suitable for chewing or smoking in a pipe or otherwise, or both for chewing and smoking; but does not include cigarettes as defined in this section. Minn. Stat. § 297F.01, Subd. 19 (1997)
- 19. Other States’ Tax Laws
- 20. Other States’ Youth Access Laws
- 22. Tax Laws NEW DEFINITION: Subd. 19.Tobacco products. "Tobacco products" means any products containing, made, or derived from tobacco that is intended for human consumption, whether chewed, smoked, absorbed, dissolved, inhaled, snorted, sniffed, or ingested by any other means, or any component, part, or accessory of a tobacco product, including, but not limited to, cigars; little cigars; cheroots; stogies; periques; granulated, plug cut, crimp cut, ready rubbed, and other smoking tobacco; snuff; snuff flour; cavendish; plug and twist tobacco; fine-cut and other chewing tobacco; shorts; refuse scraps, clippings, cuttings and sweepings of tobacco, and other kinds and forms of tobacco, prepared in such manner as to be suitable for chewing or smoking in a pipe or otherwise, or both for chewing and smoking; but does not include cigarettes as defined in this section. Tobacco products excludes any tobacco product that has been approved by the United States Food and Drug Administration for sale as a tobacco cessation product, as a tobacco dependence product, or for other medical purposes, and is being marketed and sold solely for such an approved purpose. Minn. Stat. § 297F.01, Subd. 19 (2010)
- 23. Tax Laws NEW DEFINITION: Subd. 19.Tobacco products. "Tobacco products" means any products containing, made, or derived from tobacco that is intended for human consumption, whether chewed, smoked, absorbed, dissolved, inhaled, snorted, sniffed, or ingested by any other means, or any component, part, or accessory of a tobacco product, including, but not limited to, cigars; little cigars; cheroots; stogies; periques; granulated, plug cut, crimp cut, ready rubbed, and other smoking tobacco; snuff; snuff flour; cavendish; plug and twist tobacco; fine-cut and other chewing tobacco; shorts; refuse scraps, clippings, cuttings and sweepings of tobacco, and other kinds and forms of tobacco, prepared in such manner as to be suitable for chewing or smoking in a pipe or otherwise, or both for chewing and smoking; but does not include cigarettes as defined in this section. Tobacco products excludes any tobacco product that has been approved by the United States Food and Drug Administration for sale as a tobacco cessation product, as a tobacco dependence product, or for other medical purposes, and is being marketed and sold solely for such an approved purpose. Minn. Stat. § 297F.01, Subd. 19 (2010)
- 24. Weaknesses in OTP Regulation Price of OTPs Tax laws Free Samples Coupons, discounts and rebates Minimum pack size Flavoring Fruit, candy and alcohol flavors Menthol Youth Access Use restrictions
- 25. Opportunities for Regulation Point of Sale Warnings Marketing restrictions Category prohibitions
- 26. Other Tobacco Products: The Industry and Maine Objectives Becky Smith, American Heart Association
- 28. What is OTP? OTP = Other Tobacco Products • Chewing/Spit Tobacco • Snus • Dissolvables • Cigars/Cigarillos • Roll-your-Own Photo source: http://www.trinketsandtrash.org http://www.winwins.posterous.com
- 29. Chewing/Spit Tobacco Photo source: http://www.flickr.com/photos/clearinghouse
- 30. Pipe tobacco Photos: http://upload.wikimedia.org/wikipedia/commons/f/f4/DunhillEarlyMorningPipeMurrays.jpg http://farm5.static.flickr.com/4094/4873834291_5d955ef421_z.jpg
- 31. Snus Photo source: http://www.trinketsandtrash.org/
- 33. Little Cigars/Cigarillos Photo source: http://www.trinketsandtrash.org/ Photo source: http://www.flickr.com/photos/clearinghouse
- 34. Little Cigar or Cigarette? cigarette little cigars Photo source: http://www.flickr.com/photos/clearinghouse
- 35. Blunt wraps Photo source: http://www.flickr.com/photos/clearinghouse
- 36. Dissolvables Photo source: http://www.flickr.com/photos/clearinghouse http://www.trinketsandtrash.org
- 38. What is the Problem? Appealing Packaging Candy-Flavored Cheap
- 39. THE PROBLEM Photo source: FACT collection
- 41. Photo source: Utah Tobacco Prevention & Control Program
- 42. Photo source: FACT collection
- 44. Photo source: Utah Tobacco Prevention & Control Program
- 45. Let’s Play a Game…. The Price Isn’t Right
- 46. Let’s Play a Game… The Price Isn’t Right $0.89 at Hannaford $1.56 at Hannaford
- 47. The Price Isn’t Right
- 48. The Price Isn’t Right $0.99 at Hannaford $1.03 at Hannaford
- 49. The OTP Tax Loophole • Other Tobacco Products are taxed differently than a pack of Cigarettes 20% of wholesale • OTPs are taxed at a percent of the wholesale price, rather 92% of than a per unit amount. wholesale • Maine’s tax on OTP is the 48% of lowest in New England. wholesale • One Caveat- Maine already 50% of wholesale taxes cans of moist snuff at the equivalent of a pack of 50% of Wholesale cigarettes ($2). 80% of Wholesale
- 50. The OTP Tax Loophole 20 Cigarettes 20 Little Cigars Cigarette Tax Collected: Tobacco Tax $2.00 Collected: $0.30* *amount will vary by product
- 51. What can be done?
- 52. Federal Responsibility FDA should assert its authority over ALL tobacco products Manufacturing, marketing, sales, distribution State and local tobacco control laws should be broad enough to cover emerging tobacco products Funding at federal, state and local levels for prevention programs, cessation, and research is needed for ALL tobacco products Remove flavors from ALL products Tax equivalence Tobacco-free venues
- 53. State Responsibility New products, but not new issues We want tax equivalence Higher prices on any tobacco product reduces consumption, especially for youth Equal to a pack of cigarettes % of price Capture very low weight products Broad definitions of tobacco products in tax laws
- 54. OTP Resources in Maine • Fact Sheets • MPHA Tobacco Policy Committee • Advocacy Networks and • Lobbyists & other staff
- 55. OTP Resources in Maine
- 56. OTP Equalization Efforts in Maine Representative Megan Rochelo has introduced a bill this session to equalize the tax on OTP This bill will: • Generate revenue of between 8-10 million dollars • Reduce youth use rates in Maine • Equalize the tax to cigarettes • Sets aside $140,000 for the Maine Tobacco Helpline
- 57. OTP Advocacy Efforts Talk to your legislators Submit LTE/Op Eds Talk to your co-workers, friends, neighbors Distribute OTP fact sheets Include OTP info in newsletters, on listservs, and on social media Join our Advocacy Networks- ACS, MPHA, AHA, ALA, etc.
- 59. MPHA MEMBER BENEFITS • MPHA has 3 Policy Committees open to all members: • Tobacco • Obesity • Broad Public Health • We also convene the Friends of the Fund for a Healthy Maine. • Together, we achieve more. • Attend Hall of Flags events • Attend Press events • Write/submit Letters to the Editor & Opinion articles • Friend us on FB and share postings • Educate your local legislators • We need you to become a member of MPHA. www.mainepublichealth.org
- 60. Thank You! • To Our Speakers • To Our Sponsor, UNE • To YOU, our participants • Questions? Use your Chat Box. • Tina Pettingill: mainepha@gmail.com • Mike Freiberg: michael.freiberg@wmitchell.edu or (651) 290-7517 • Becky Smith: becky.smith@heart.org •
Editor's Notes
- Since 1997 Maine has taken the lead in reducing smoking rates in both teens and adults. The High School smoking rate has declined nearly 63% since 1997. This eclipses the national decline of about 50% over the same time period.Maine’s Comprehensive tobacco control program has been a huge part of this success. The Partnership for a Tobacco Free Maine has established strong counter marketing campaigns in the mass media, they have supported policy change at the state and local levels, supported efforts to enforce restrictions on sales to minors and helped to support the creation of the Center for Tobacco Independence – which runs Maine’s Tobacco Helpline.The Healthy Maine Partnerships were created to support tobacco-free policies in local communities, schools, businesses and other organizations. Their efforts to change social norms among these groups has supported Maine’s decline in youth smoking.Maine is currently one of 30 states with strong smoke free workplace laws, but when our law was first passed in 1993, it was a trend setter. We continue to push greater protections for non-smokers through smoke free beaches, parks, housing and more. All of these efforts change the social norm around smoking and reinforce that no level of second hand smoke is acceptable.We know that keeping the price of tobacco high is extremely effective in keeping kids from starting to use tobacco and it helps induce adults to quit.Maine’s Cigarette tax currently stands at $2 a pack. This is 11th in the nation, but the second lowest tax rate in New England after New Hampshire. Notice we use the word “periodic” increases on the screen – keeping the price high and hiking enough so that people will notice are key to getting a public health benefit. The cigarette tax has not been raised in Maine since 2005.
- But…The fight is NOT over. Big tobacco isn’t just going to concede a loss and leave Maine. They are still here, trying to make a profit - in a BIG way. Tobacco remains the #1 cause of preventable cause of death and disease in Maine and in the USBig Tobacco is putting their money into creating and marketing smokeless tobacco products. Some new smokeless products are already in Maineand they’re currently testing a number of other new products in a few cities in the US and they will soon be available for purchase all around the country. And they are creating and marketing new and cheap cigar products that appeal to kids.
- After years of progress, declines in the use of tobacco by youth and young adults have slowed for cigarette smoking and stalled for smokeless tobacco use. Ninety-nine percent of all first-time tobacco use occurs by age 26 and many of the long-term diseases associated with smoking, such as lung cancer, are more likely among those who begin to smoke earlier in life.
- Here we see that while use of cigarettes has dropped among high school students in Maine, use of other tobacco products – smokeless and cigars - has increased over the last decade for which we have data. (YRBSS)This is really one consequence of our success in driving down the use of cigarettes and not keeping up with the OTP price comparison.
- In 2011 survey data we see starkly that use of Other Tobacco Products is much higher among youth than it is among adults and that kids do not smoke cigarettes as heavily as adults.Why is this?
- Last year, we had a research project funded to look at gaps in regulation related to non-cigarette tobacco products, often called other tobacco products, or OTPs by public health folks. I’ll use the term OTPs during this presentation, even though it isn’t a perfect term, since some of these products don’t even contain tobacco. I’m going to focus on five of these products, tell you a bit about them, and tell you some of the common gaps in regulation related to them.About me: Staff Attorney with Tobacco Control Legal ConsortiumAbout Consortium: National network of law centers relating to tobacco control. Affiliated with Public Health Law Center. Based out of William Mitchell College of Law in St. Paul, Minnesota.
- It seems like we’ve seen an explosion of new tobacco products in the last ten years, and many tobacco control laws were drafted in the 90s before we knew about these. So many tobacco control laws are written in a way that potentially excludes many of these new products. As part of the research project, we looked closely at five specific types of OTPs, which I’ll talk about in turn. CLICK. First, dissolvable tobacco products, or dissolvables are small pellets, strips, or sticks, of compressed tobacco that dissolve in your mouth. The product doesn’t involve spitting, like moist snuff does. They’re sold in lesser known brands like Stonewall and Ariva, and being test marketed in a few states under the popular Camel and Marlboro brands. CLICK. There are various health risks to these products, including the addictive nature of nicotine, the possibility of cancer, and a poisoning risk for children. There is a debate in the public health community about whether the use of these products should be encouraged because they are presumably less harmful than cigarettes and other types of combustible tobacco. I don’t think these harm reduction claims have been proven, so I’m generally of the mind that the products should be restricted until their health effects can be proven more conclusively. It seems that this is something the FDA would be well suited to do, and until this happens, states should regulate these products pretty strongly. I did want at least to acknowledge this debate, however. I should mention that the FDA announced recently that it would not regulate a new line of Stonewall and Ariva dissolvable tobacco products as tobacco products, because of the way they’re manufactured. This is a bizarre decision that nobody really understands. But, actually, this may be a moot point, since the maker of these products recently announced it was getting out of the tobacco business.
- The second product we looked at is electronic cigarettes, or e-cigarettes. E-cigarettes deliver nicotine or other substances to a user in the form of a vapor. They often physically resemble a cigarette, down to an LED light at the tip to make it look more like a cigarette. They are typically composed of a rechargeable, battery-operated heating element, a replaceable cartridge that may contain nicotine or other chemicals, and an atomizer that, when heated, converts the contents of the cartridge into a vapor. CLICK. Very little is known about these products, but there are a few health risks that we can talk about, including the addictive nature of nicotine. For a couple years, the FDA had claimed e-cigarettes were unapproved drug delivery devices and the agency tried to block the importation of the products. The FDA alleged “violations of good manufacturing practices, making unsubstantiated drug claims, and using the devices as delivery mechanisms for active pharmaceutical ingredients. The agency lost two rounds of litigation, however, and announced that it would regulate e-cigarettes as tobacco products. So this is a developing area, and we’ll see how it works out. But even though the agency lost the litigation, I presume the claims they made about manufacturing practices and so forth are still true.
- I just want to mention that e-cigarettes are becoming much more accessible as well. When they first came out a couple years ago, this is pretty typical of what you’d see. This was an e-cigarette starter kit that I bought in North Dakota for $94. It came in the box in the middle with the e-cigarettes themselves, a charger, a power line, two replacement cartridges, and a user’s manual. Probably not something too many price-sensitive youth are going to buy. CLICK. Fast forward to more recently. You can now buy a single e-cigarette, good for 500 puffs, equivalent to two packs of nicotine – at least that’s what they tell you – and it costs only eight bucks. I’ve seen them as cheap as five dollars since then, which is about the cost of a pack of cigarettes in Minnesota.
- The third product we looked at is little cigars. The term “little cigars” is often a misnomer, exploited by tobacco companies to take advantage of tax laws that are more favorable to cigars than cigarettes. Some of them, like the Remingtons you see here, are basically cigarettes in every way, except their wrappers contain at least some tobacco, rather than a cigarette, which is wrapped solely in paper, so they are often taxed at a lower rate than cigarettes, even though they are virtually indistinguishable from cigarettes.CLICK. The health risks are basically the same as what you might see with cigarettes, and I haven’t heard anybody make harm reduction claims about little cigars.
- The fourth product we looked at is snus. Snus is the Swedish word for snuff, but it’s actually a form of tobacco that comes in a teabag-like pouch which you place between your lip and gum. It also doesn’t involve spitting. In the U.S., it comes in both Marlboro and Camel brands, and is sold pretty much everywhere. CLICK. The health effects that we know of are similar to those seen in dissolvable tobacco products. There have been a few more studies on snus than on dissolvables, because of the Swedish experience, so I found one study showing a relationship between snus use and pre-term birth. In the tobacco context, the harm reduction debate pretty much came into being because of snus.
- The fifth and final product we looked at is water pipes, also called Hookah pipes, or shisha pipes. These were originally used in the Middle East and Mediterranean regions, but are becoming more popular in the U.S., often among college students, but also in immigrant populations. CLICK. The health effects of water pipe smoking are fairly well documented, even though there can be a variety of products smoked in them. The shared mouthpiece brings some additional health risks into the picture, such as herpes and TB.
- Now that we have reviewed some of the newer tobacco products on the market, let’s discuss a problem you’ll find in many state laws that pre-date the tobacco product innovations. Not all of the laws are written in a way that encompasses the new products. I want to start with a law that was passed by the Minnesota legislature in 2010, called the Tobacco Modernization and Compliance Act. I’ll start with the tedious, legalistic stuff. An important thing in any tobacco control law, or any law, is the definition section. In a tobacco control law, there will usually be a definition for cigarettes, which are often defined as a stick of tobacco wrapped in paper. There will also be a definition for cigars, which is a stick of tobacco that is not wrapped in paper, but in tobacco in some form. There will also be many other products you want encompassed as well. Now this is the old definition from the tobacco tax section of Minnesota’s law. As you can see, it lists a lot of random products, many which I’ve never heard of. I looked it up once, but I’ve since forgotten what periques or cavendish are. Anyway, it does list a lot of kinds of products, but this was written 15 years ago, before many new products were on the market. If a product isn’t one of the listed products, it would only get taxed as a tobacco product if it falls within the general language, which is this part: CLICK TO NEXT SLIDE
- As you can see, to get taxed as a tobacco product, a product has to be a tobacco product that is prepared in a manner to be suitable for – CLICK - chewing or smoking. This could potentially exclude some novel products - CLICK - such as dissolvable products like Camel Orbs, Sticks, and Strips, or Ariva and Stonewall, or snus. These products aren’t smoked, and they aren’t exactly chewed, so there was some question about whether most of Minnesota’s tobacco control laws would apply to them at all. Many of Minnesota’s other tobacco control laws, like restrictions on the self-service of tobacco products, also relied on these definitions, which led to some gaps in regulation where other tobacco products were concerned.
- This problem with the definitions of tobacco products isn’t unique to Minnesota. We looked at the tax laws of all fifty states, and the states colored blue have laws that limit the definitions to products that can be smoked or chewed. So the tax laws in these states potentially don’t cover dissolvable tobacco products or snus. This is a couple years old, so it’s possible some of these states (including Maine) have updated their definitions.
- And the same problem exists with the youth access laws in many states. In the red states, at least arguably it’s legal for minors to purchase dissolvable tobacco products because they aren’t chewed or smoked.
- And you wonder if the tobacco companies know about this. This is an ad for Camel Dissolvables that Ann sent me that came out of North Carolina, where the new line of dissolvable products is being test marketed. As you can see – CLICK – they emphasize that the products are not intended to be chewed or swallowed whole. Do they know that the tax and youth access laws in many states, including Indiana, where the products were test marketed for a couple years, limit the definition of tobacco products to products that are chewed or smoked?
- So in 2010, Minnesota changed its law to fix this problem. This is the new definition. First I want to mention how legislative language is written. The text that is neither underlined nor struck through is existing language that was already on the books in Minnesota. This language wasn’t changed at all by the bill. The underlined text is new language, however, that was created by the bill; the struck through text is language that the bill deletes from Minnesota’s laws. This is the way bill language typically looks. The two main changes you see here were: first – CLICK - getting rid of the requirement that the tobacco be suitable “for chewing and smoking,” and second – CLICK TO NEXT SLIDE
- …adding a string of verbs describing how tobacco can enter the body, including the word “dissolved” specifically. There’s also a catch-all phrase that talks about tobacco ingested “by any means.” We have no idea what tobacco companies might come up with in the future, so hopefully this language will encompass future products. What this means is that all tobacco products are now at least taxed as other tobacco products, and products that aren’t chewed and aren’t smoked aren’t excluded from the law. CLICK - There also is now an exemption for bona fide FDA-approved cessation products. They won’t be taxed as tobacco products. The product has to be approved by the FDA as a tobacco cessation product, and it can be marketed and sold only for that purpose.So just by updating the definitions in laws like tax laws and youth access laws, you can make sure these novel products are encompassed in your tobacco control laws.
- There are other areas where the regulation of OTPs lags behind the regulation of cigarettes. I don’t have time to go over all of them, so I thought I’d just point them out to you here. - Tax laws: I talked about the definitions in tax laws, but even if those are okay, the tax *rates* for OTPs may still lag behind cigarettes. - Free samples: Many states and the federal government restrict the distribution of free samples of cigarettes, but have nothing comparable for OTPs. - Coupons: Same problem, although that tends to apply to cigarettes as well. - Minimum pack size: Cigarettes are required by federal law to come in a pack of 20, but many OTPs area available in single serving. - Flavoring: Federal law prohibits cigarettes from being sold in fruit, candy or alcohol flavor, but not OTPs. - Youth access: The federal sales to minor regulation applies only to cigarettes and smokeless tobacco, which excludes cigars, pipes, and e-cigarettes. - Use restrictions: Most states have smoke-free laws, but don’t limit the use of other products in public places.
- State and local units of government should take steps to regulate OTPs more effectively. Measures could include:Price restrictions such as strengthened tax laws; restrictions on free samples and coupon redemption; minimum pack size for OTPs sold in discrete units; a prohibition on the sale of OTPs with characterizing flavors, including menthol; strengthened youth access laws; strengthened use restrictions; a requirement that health warnings be posted at the point of sale; marketing restrictions;outright prohibition on the sale of certain categories of products.
- Other Tobacco Products, called OTP, represent products that contain tobacco but are not cigarettes.There is no safe form of tobacco.28 cancer-causing agentsCertain types of cancer increase with smokeless tobacco:Esophageal cancer, oral cancer (cancer of the mouth, throat, cheek, gums, lips, tongue).Cavities, gum disease, heart disease.
- This is not your Grandpa’s chew. They’re putting candy flavoring in these products to make them more attractive to new users.As you can see on the slide, there are various forms of chew tobacco. These are tobacco leaves that have been cured and sweetened. The user selects the quantity desired, and places it in the mouth. The tobacco is then chewed and sucked until discarded. This may be what most policymakers envision when we say “smokeless tobacco”.Moist snuff is the most commonly used smokeless tobacco product in the US. Copenhagen and Skoal are examples of moist snuff. These leaves are cured, cut, and flavored. The user places a pinch of the tobacco between the teeth and gums. Spitting is recommended with this product. Chew is NOT discreet – users have to spit. Skoal’s Bandits are marketed as discreet and easy to use wherever, whenever.Here are some quotes that have been used in marketing it:"Discreet. Minty. Those are just two words Brothers use to describe Skoal Bandits Mint. Dip'em wherever, whenever. Because a brother shouldn't have to do without a dip.”"Sometimes, dipping with discretion is of great importance to a brother."“The style that started it all in the Bandit that lets you dip without the whole world knowing. It's all about options."
- And to make tobacco even easier to use, Big Tobacco came up with products like Snus – a product that doesn’t require any spitting.Snus is discreetIt comes in small teabag-like pouches that contain tobacco and other flavorings.Because it does not require spitting, it can be easily concealed.Users place the bag between their upper gum and lip. Due to the placement and lower salt and moisture content, users are not required to spit.You leave it in your mouth for about a half-hour without spitting.Controlled product – specific amount in bag.The different flavors of Snus make it attractive to new tobacco users. Cheaper than cigarettesSnus was introduced in Maine within the last few years – and can be found in convenience stores around the stateOne high school senior admitted to using Camel Snus during class, saying, “It’s easy, it’s super-discreet…and none of the teachers will ever know what I’m doing.”
- Because these are new products, the manufacturers include directions on how to use them in their marketing. This teaches the concept of nicotine dosing to inexperienced users.
- Although the new FDA law that was signed in 2009 bans flavored cigarettes, the law doesn’t currently affect flavored cigars. Maine passed a law in 2007 to ban the sale of flavored cigars. However, it appears that manufactures are skirting the Maine ban by not saying they are flavored, but just putting the word “grape” or “peach” on them. And flavors like grape, tangerine and chocolate are obviously being marketed toward teens.Cigars don’t have filters. They contain cut tobacco wrapped in a tobacco leaf.Little cigars are sold individually or in packs, come in flavors, cheaper due to taxes, have filters, wrapped in tobacco leafUnder Maine law a Cigarillo or little cigar must have some amount of tobacco leaf in the wrapper, but otherwise they are functionally a cigarette.
- There also dissolvables on our market:StonewallArivaDissolvables are dried crushed tobacco leaves with bindings and flavorings They are made from finely milled tobacco that is held together with food grade binders. The products melt in the mouth within three to fifteen minutes, with the strips melting the fastest, and the sticks lasting the longest. The amount of nicotine in dissolvable tobacco varies widely by brand and type, but some contain 3xs the nicotine in one cigarette. Melts in the mouth within 3 to 15 minutes, requiring no spitting of tobacco juices.Cigarette = 1 mgDissolvables = 0.6 – 3.1 mg nicotine
- Dissolvables were taken off the test market for a short period of time to be refined.These are the new products and the new packaging that are currently being test marketed.
- Tobacco companies are putting a lot of money into creating and marketing these new products. These products are cheap because they’re not taxed the same way cigarettes are.And that’s a problem because of their packaging, shapes, and flavors.To the un-seasoned eye, they are almost indistinguishable from candy and mints. And who likes candy? Kids.
- Tobacco industry re-emphasizing “reduced harm” with new productsNo scientific evidence of overall health benefitsMay even be worse for public healthFDA will now regulate “modified risk” productsMust be proven safe and lower risk than cigarettesNo evidence to support state diversion of prevention/cessation funds or research dollars
- On the Left, we have a 2 pack of White Cat, White Grape cigarillos. On the Right, we have a “Big Pack of Tic Tacs”.Guess which one cost more?
- The tobacco product is less.Tobacco, packaged like candy, with fruit flavor themes priced less than a box of Tic Tacs.
- Now we have a small bag of peanut M&Ms and one cigar.
- Again, when the tobacco is the same price as the candy, it will be attractive to kids.
- Here we see the OTP tax rates in New England.At 20% Maine is quite low. One note on OTP taxes is that while we have mentioned Moist Snuff as a PH concern, Maine does already tax cans of dip at the equivalent of a pack of cigarettes. So, when we talk about equalization, we are mostly talking about smoked tobacco and dissolvables.When the state is allowing products that appear to any reasonable person to be a cigarette, it makes no sense to allow them to be taxed at different rates.
- Here we see a traditional pack of 20 cigarettes on the left.The Marlboro Reds retailed at a Walgreens in Augusta in January for $6.23 and that included the $2.00 per pack of state cigarette tax.On the right, is a pack of 20 Cheyenne Peach Little Cigars. These retailed at the Maine Smoke Shop in Augusta for $1.65. As we have covered, these are exactly like a cigarette. But because the tax is 20% percent of the wholesale price, we estimate that the state may have only collected thirty cents on this pack of little cigars. The current system is not transparent. We do not know what the wholesale price of a product is, so we can’t say with certainty what the tax paid actually is. But we know it is mere pennies and it is a huge loophole that puts kids at risk.
- We’ve shared the problem – big tobacco marketing their candy-look alike products to teens. However, we don’t have to let them get away with it. We can fight back…. But it’s going to take a community-wide effort.
- As we have pointed out, the tobacco industry continues to exploit loopholes that allow them to sell flavored cigars. They are also exploiting loopholes in the federal tax code that allow them to change products to evade higher federal taxes.These loopholes need to be closed.We also need the federal government to step up to the plate and help states fund tobacco prevention programs. Healthcare costs are the biggest threat to our nation’s finances and tobacco prevention is the single best use of prevention dollars.
- Taxes – Evidence shows that higher prices discourage tobacco use, especially among youth. But these products are often taxed at lower rates, as little as a few cents for a pack of snus, which is very light weight. In many states, the tobacco excise tax laws will include these new products in their definitions of tobacco product so they can be taxed. The problem is, like for smokeless and snus, the taxes often are too low to have any impact on use. Also, dissolvables are very light.We want to avoid having people switch from one product to another simply based on price differential between and among products.
- Gaining bi-partisan support for OTP.
- Grassroots efforts very important as is EDUCATION about OTP- share and SHOW (buy little cigars and dissolvables to show people- believe me, everyone is amazing that we even have these products, especially when they see the price).
- Coalition is gathering signatures
- Monthy e-news to keep you updated on legislative strategies and advocacy opportunities.We have lobbyists and advocates at the statehouse working for you – join today!!ACTion alerts