Commissioners weigh public health benefits, private industry risks in sales restriction of nicotine flavor

November 13, 2019

Youth and public health advocates pushed the Board of Commissioners Tuesday to restrict the sale of all flavored nicotine products including menthol cigarettes in Multnomah County while vaping industry lobbyists and convenience store owners said comprehensive restricts would put their businesses at risk. 

Arinze McGee, 11, asked Commissioners to restrict sale of flavored products to correct racial health disparities and help kids stay healthy

Vaping industry representatives pointed fingers at traditional tobacco as the true villain, while convenience store owners that sell tobacco argued youth vaping and the risk of lung damage from e-liquids are to blame.

Commissioners held a work session on their options for restricting flavored e-liquids and tobacco. They also took more than an hour of testimony from community members on the impacts of aggressive marketing, concerns for the interests of small businesses and freedom of choice, the rights of youth to grow up healthy and the rights of people of color to grow old. 

The Commissioners’ Conversation

The Board of Commissioners is considering restrictions on flavored nicotine products to minimize initiation of nicotine products among youth, correct health disparities among people of color and reduce the number of preventable deaths; actions that will benefit youth, families and taxpayers. 

“Minimize nicotine addiction in youth and decrease racial disparities related to menthol?” said Commissioner Sharon Meieran. “I could not be in more agreement with those as public health goals.”

Deputy Health Officer Dr. Jennifer Vines, who has worked on tobacco policy in Multnomah County for years, asked commissioners to expand their sights beyond the national outbreak of lung illnesses. Policy recommendations on flavored nicotine products go back years. In the early 2000s, African American community groups asked the County to restrict sales of menthol cigarettes, which were killing its community members at dramatically higher rates. In the early 2010s, public health advocates and teens began asking the Board for flavor restrictions on e-cigarette sales as youth vaping rates took off.

Commissioners had lingering questions about the safety of e-liquids.

Are e-cigarettes really 95 percent safer than cigarettes?  “It’s a low bar to be safer than cigarettes,” said Dr. Vines. She said there have been no long-term studies show the safety of e-cigarettes.

Does the Food and Drug Administration regulate vaping products? Not really.

Is there evidence that restrictions on flavors reduce youth consumption or increase the rate of quitting among menthol smokers of color? Yes. and Yes.

If people vape to quit smoking, will they quit vaping too? Not usually.

“I know lots of people who vape. The reality is, I haven’t seen any of those people quit,” Commissioner Lori Stegmann said. “They wanted to vape to get off nicotine but I see them smoking more.”

Stegmann said she worries local rules would be weakened by access to products in neighboring counties and Washington State.

“A lot of things that should be handled at the federal level are being put upon cities and counties,” she said. “We’re having to make big important decisions... We know there are a lot of things that are illegal that people can get. We’re trying to do the right things for the right reasons, but we have to weigh business owners and employees and people who contribute to our tax base.”

She said she might support a restriction that only allows sales in shops that only serve people 21 and over, because, she said, too many retailers in Multnomah County continue to sell to minors.

“I don’t think retail stores have demonstrated they can abide by current regulations,” she said. “Either government comes in — and I don’t want overreach — but we have a responsibility to our youth. If I have to choose, it’s going to be youth. I’d really like industry to step up.”

Commissioner Susheela Jayapal acknowledged the potential impact on business and suggested the County investigate ways to mitigate the financial impact. But she said there should be no equivalence between the risk to business and the risk to health. 

Commissioners hear from shop owners, health officials before discussing their options to restrict flavored nicotine sales.

“The most important objective is reduction of youth smoking,” she said. “I have heard comments that smoking rates have declined. I’ve heard that the percent of youth use is low. But that percentage translates into actual people.”

Jayapal said she is inclined to support restrictions on flavors, but, “I want to make sure we hear and take seriously these comments and questions.”

Commissioner Jessica Vega Pederson said she’s concerned about limiting what adults can buy.

“You can smoke tobacco, smoke pot and drink alcohol. To limit the choices of adults and what they can and can’t buy, from a personal liberty standpoint is a big decision,” she said. “ We do let adults make decisions and buy products that are not the best for them. Alcohol has detrimental impacts in similar way of nicotine, and yet that’s legal.”

Commissioner Sharon Meieran argued tobacco is inherently different from alcohol. Some studies suggest a small amount of alcohol might actually be good for you, she said. But tobacco, when used as directed, could kill you.

She said keeping teens from starting to smoke will protect adults from chronic illness and death later in life. And while the risks of vaping are still unknown, “shouldn’t we err on the side of caution?”

Meieran said she would support a comprehensive ordinance restricting the sale of flavored products. That the federal and state governments has not sought permanent restrictions on flavored e-liquids and all flavored tobacco, should not stop the County, she said. 

“We do what we can at the local level,” she said, “and hope we’re a model and others will follow suit.”

Retailers, distributors say they oppose limits

As they sat down for the first work session and public hearing on proposed restrictions, the Board heard from more than a dozen supporters and opponents of any bans.

“People vape. You can’t put that genie back in the bottle,” said Art Way, who was representing  tobacco company Reynolds American, which produces Newport cigarettes and the e-cigarette product VUSE. Way warned commissioners Tuesday not to “pick sides between the tobacco industry and public health,” and said that restrictions on flavored tobacco and e-liquid sales would increase internet and illicit sales of products.  He said he would follow up with individual Commissioners in the coming days.

Sean Kenney with the e-liquid distributor Doyles Sheehan, echoed Way’s concerns. “We know there’s a problem with youth vaping. No one wants to see a child vape,” he said. “But with sensible regulations we can make sure this is not happening.” 

Chris Ferrerra with Oregon Vapor Trade Association said his members supported the legal sales age increase to 21 and stiff fines for retailers who sell illegally. But a restriction on flavored e-liquids would cut sales to his members by 90 percent. 

“If a flavor ban passes those jobs will be lost and tax revenue will decrease,” he said.

“This ban will absolutely put me out of business,” Marcus Nettles with Rose City Vapors, told Commissioners. He recommended the County instead charge teens with a criminal violation of minor-in-possession when they’re found with e-cigarettes.

Shaun D'Sylva, owner of Fatboy Vapors, said he doesn’t want to see youth vaping. But adults come to his store to find products that might help them quit smoking. And flavors are an important part of that. “Flavors let smokers disassociate from tobacco flavor,” he said. And in the United Kingdom, public health supports people who shift from tobacco to vaping. “I resent being treated like big tobacco,” he said. 

Rocco Russo, vice president of operations for Maddy’s Lottery Retailer, asked commissioners to exclude menthol cigarettes from a flavor ordinance, and focus instead on vaping. That’s where the youth market is, he said. 

Jay Chun who sits on the board of the Korean American Grocers Association, said youth vaping is certainly a problem.  “It needs to be solved but this ban is extreme. Banning all flavored and menthol will hurt local retailers in the community.”

Jonathan Polonski, president of Plaid Pantry, told Commissioners his company employs more than 700 employees in 105 Oregon stores, where tobacco accounts for a third of sales. Menthol cigarettes are a big seller, he said.  

“Traditional products are not related to the recent outbreak,” he said, asking the Board to exempt tobacco from any flavor restrictions. “A County ban will shift sales and hurt local business. It will not eliminate the use of products, but it will cause businesses to falter and be a windfall for vendors in neighboring counties.” 

Polanski said there are rules in place already. “We urge you to maintain current enforcement,” he said.

Youth and families call for curbs on flavor

Arinze McGee, 11 is asthmatic. So when people smoke outside a Blazers game, where his family holds season tickets, his mom makes him cross the street. But at school, smoke  — and vapor — is harder to escape.

“It’s disturbing how often I observe peers Juuling and smoking,” he told the Board Tuesday. He did some research and discovered that teens who smoke are more likely to become adults who smoke. And these products, especially menthol cigarettes, have been heavily marketed to Black residents like him. 

“The guy next to me said there’s already a ban on underage smoking,” he said. But his peers don’t seem to have trouble getting ahold of flavored products designed to attract people his age.

“I’m very passionate about this cause,” he said. “Children are the future and need to be protected.” 

High school senior Tess Wright asked “How many adults who try to quit use birthday cake flavor? Flavors are a big reason why youth start using.” 

Emma Cady, a senior at Beaverton High School, said students are always “Juuling” in class and they do it because it tastes and smells good.

“No one wants to smoke something that leaves a nasty tar flavor in their mouth,” she said. “But when you smell something sweet it feels inviting, not dangerous.’’ 

Liuba Vega said she worries about her middle-school-aged son vaping and encouraged the Board to restrict the sale of flavored products.

“It doesn’t smell like cigarettes so kids do it and teachers don’t know. At recess, in class,” she said. “It’s not about carding kids or criminals selling it to them at the street. His friends talk about it. They use it as casually as eating candy or chewing gum. They don’t know better.”

The Board may consider restrictions that include both flavored tobacco and flavored vaping liquids. They may also consider carving out an exemption for stores that only allow people 21 and older to enter, an option some jurisdictions have passed to the chagrin of some public health associations and advocates.

Christina Bodamer, government relations director for the Oregon chapter of the American Heart Association, testified in support of a comprehensive flavor ban that includes both tobacco and e-liquids, and without carve-outs for adult-only stores. 

“If e-cigarettes become an FDA-approved cessation product, we would support it. But it's not,” she said. Most smokers who vape to quit smoking, don’t stop vaping.

Public health campaigns have dispelled the myth that smoking is safe, but many youth still see sweet-tasting e-liquids as a low risk. The recent outbreak of lung illnesses has highlighted immediate danger, but long-term risks are just becoming clear. 

Two new studies being released this week will demonstrate how vaping affects cholesterol and glucose the same way as cigarettes and reduce blood flow to the heart  — possibly more chronically than with cigarettes. A third study released this week suggests that even short-term exposure to e-cigarette vapor appears to cause inflammation and damage of cells that line blood vessels in ways that can affect blood flow, leading to lung, heart and brain damage.

Daniel Morris, Ph.D., a public health researcher who sits on the Multnomah County Public Health Advisory Board, urged the Board to support a flavor ban with no exemptions. 

“It might be tempting to give someone a break,” he said, “but every exemption you consider adding will be costly and cause unforeseen problems. I have seen this again and again. Exemptions make for bad public policy.” 

Hanna Atenafu, who also sits on the Multnomah County Public Health Advisory Board, works with families through Early Head Start. She said that while overall smoking rates have declined in recent decades, tobacco is still the leading cause of preventable death, and the outcomes for people of color are much worse than for White residents. 

Vaping is just another industry tactic to attract and maintain a new generation of nicotine addicts, and most youth start because of flavor

“The cycle of nicotine production and consumption needs to stop,” she said. “I support a ban on the sale of all flavored products.”

Robyn Stowers said restricting all flavors, including menthol tobacco is vital to support the health of those 85 percent of Black smokers who use menthol. It’s also imperative to restrict flavors to protect teens from addiction as adults, because more adult smokers started before they turned 18. 

Your mission says you prioritize the needs of the most vulnerable population, not private industry,” she said. “You can put a price on profit loss but you can’t put a price on life.”