The Board of Commissioners on Thursday unanimously approved an ordinance banning the sale of flavored tobacco and nicotine products in Multnomah County, marking a decisive step forward after years of wide-ranging work to address a vaping and smoking crisis among young people.
The ordinance will become effective on Jan. 1, 2024.
The final vote came two weeks after the Board unanimously signaled its support during a first reading of the ordinance held Thursday, Dec. 1. As part of their Dec. 1 hearing, the Board voted 4-1 to deny an amendment brought by Commissioner Lori Stegmann that would have exempt Multnomah County’s three existing hookah lounges.
At the final vote, Chair Deborah Kafoury and Commissioner Stegmann both acknowledged the impact the ban will have on the existing hookah lounges even as it achieves long-held public health goals.
“When we make these types of decisions, we know that there are going to be individuals who will be impacted,” said Chair Kafoury, “and this is not taken lightly.”
“I do know that these businesses were going to be out of business and that does give me heartburn. For that, I am sorry,” said Commissioner Stegmann.
The Board also hosted a public listening session last month that drew more than 80 people, including physicians, tobacco retailers, students and other residents who shared their thoughts on a ban.
Vape shop owners and others who opposed the ordinance said a ban would harm local businesses. Physicians, on the other hand, spoke about their personal experiences treating young people using flavored tobacco products. While others spoke about an overall increase in vape products in local high schools.
Brittany Grant with the Campaign for Tobacco-Free Kids said the passing of this ordinance is “vital to protecting the health of our children and saving lives by preventing them from becoming addicted to tobacco.”
Long-term work to reduce preventable tobacco deaths
Over several years, the Board has held a series of public hearings, briefings, and community engagement sessions to address the health risks of nicotine and tobacco, the leading cause of preventable death in Multnomah County.
The Action Communities for Health, Innovation and Environmental Change (ACHIEVE) Coalition and the County’s Racial and Ethnic Approaches to Community Health (REACH) program asked the County to ban flavored tobacco products back in 2015, identifying them as a major contributor to health disparities, specifically affecting the Black and African American communities. Health experts say flavored tobacco and nicotine products also disproportionately attract young people.
The final vote to stop sales of the products came four months after the Chair Kafoury directed the Health Department’s Public Health Division to return with a draft language for a ban. Her request followed an August briefing by the Health Department on the impacts of flavored tobacco and nicotine products.
During the briefing, Multnomah County Health Officer Dr. Jennifer Vines said young people tend to use flavored nicotine and tobacco products in the form of e-cigarettes or vapes, calling them gateways to nicotine addiction.
In 2017, the Oregon Health Authority reported, 57% of Oregon eighth graders using tobacco or vaping sought out flavored products, with that share climbing to 65% among 11th graders who used tobacco or vaped.
Dr. Vines noted, during the August briefing, that the African American community, along with the LGBTQ+ community, have traditionally been targets of tobacco industry marketing. Saturated advertising has led to more youth and adults in those communities using those products. According to Tobacco Control, Black smokers use menthol at a higher rate – 85% – than smokers of any other race.
LGBTQ+ youth also use cigars, e-cigarettes or vaping products at higher rates than other youth. Dr. Vines said that among high school students who report smoking e-cigarettes, 30% identify as bisexual, 27% as lesbian/gay, and 23% as heterosexual.
The Health Department returned to the Board on Oct. 20, 2022, with a recommendation and draft language for a ban on the sale of flavored tobacco and nicotine products. The County’s REACH program participants had identified flavored tobacco as a major contributor to health disparities.
Public Health Director Jessica Guernsey thanked the REACH staff in particular and community leaders, “who have really held us accountable to what we mean when we say addressing racism and a public health crisis.
Moving forward
The Board voted after more 1,000 people weighed in online, or in person.
“I want to thank the many people who shared testimony today and in the past about this,” said Commissioner Sharon Meieran.
Commissioner Susheela Jayapal said she didn’t want to create any loopholes when considering the exemption for the hookah lounges, “I am very concerned that as other flavored products come off the market, if this flavored product still exists, that will continue to be marketed towards young people.”
“I come back to the public health rationale, and we do know that young people are using hookah products,” she said.
“I want to appreciate all of the years of advocacy and work that have gone into getting used to this point,” said Commissioner Jessica Vega Pederson. “We know that this isn’t the final point, we’ve got a lot of work in front of us.”
Chair Kafoury also thanked Director Guernsey, Dr. Vines and the Health Department tobacco and other staff who have worked to limit tobacco-related illness and deaths for years.
“This is going to save people’s lives,” said Chair Kafoury. “There will be teenagers today who will not start smoking or vaping and become lifelong addicts.”