The Multnomah County Public Health Division this week recommended that the Board of County Commissioners ban the sale of flavored tobacco and nicotine products in order to reduce young people’s access to flavored tobacco products and adopt a sales restriction within the County’s Tobacco Retail License program.
Public Health leaders presented the recommendation Oct. 20 in response to Chair Deborah Kafoury’s request on Aug.16, 2022 for a pathway by which the County could reduce youth access to flavored tobacco and nicotine products and their impact on death and illnesses in the community, and in particular communities of color.
“This has been a long journey with the fight against tobacco,” said Jessica Guernsey, Multnomah County Public Health Director. Tobacco use is the number one cause of preventable death, locally and nationally. Flavored or starter products for youth create a whole new generation of users, she said.
“And we absolutely know that there have been racist practices in Black, Hispanic, Latinx and the Native community for decades around the marketing, sale and the positioning of products in the community.”
Surveys show that more than one in four 12th graders in Oregon report vaping in the last 30 days. And, there is “massive confusion,” Guernsey said, as to whether vaping products are safer than smoking, or whether they are regulated.
Guernsey also called out the blurring of the cultural use of hookahs and the use by young individuals. Up to 40% of college students identified using a hookah as their preferred use of flavored tobacco.
“What we do know about the use of hookahs is that one cigarette equals about 600 milliliters of smoke while an hour of hookah use equals about 90,000 milliliters of smoke,” Guernsey said.
That kind of use of flavored products is why more than 300 jurisdictions have adopted some kind of restriction.
“We all have this shared concern: disallowing the sale of flavored tobacco will help us fend off the next generation of smokers and help create nicotine-free future generations,” she said.
How the County ban would work:
Once enacted, the ban would end retail sales of flavored tobacco across Multnomah County, while at the same time, the County would increase access to culturally appropriate quitting services.
Kari McFarlan, Tobacco Control & Prevention Program supervisor, told the Board that the County currently licenses 771 licensed tobacco retailers, including 401 convenience stores, 100 bars and restaurants, 32 liquor stores, 20 vape shops and three hookah lounges.
The County’s $683 annual retail license fee covers the staffing and compliance training for the program, as well as communication and educational materials in multiple languages. “Our goal since the start of the program in 2016 is to increase retailer knowledge and compliance of tobacco sale laws and reduce youth access,’’ McFarlan said.
Each retailer is inspected at least once a year during regular business hours. If the business is found to have a flavored tobacco violation, the County would present them with a remediation plan. The retailer is then reinspected and if no flavors were being sold, no penalty would be issued. The enforcement only focuses on store owners and never the people who buy or use the products.
McFarlan clarified that youth cannot buy flavored tobacco online in Oregon – all online sales of tobacco products, including e-cigarettes and vapes, are prohibited under state law. The County also conducts surprise inspections by underage youth inspectors. As of Monday, youth inspectors were able to purchase products illegally one in four times.
The recommended ordinance would be enforced by Public Health, and would only interact with store owners. This would not target the people who buy or use the products.
Community members add their support
Hauoa Dogo is a community member and a member of the ACHIEVE (Action Communities for Health, Innovation and Environmental Change) Coalition, a group of partners who work to end health inequities in chronic diseases for African-Americans and African immigrants and refugees.
“I live in Northeast Portland and I am here because I have witnessed how early menthol use can cause addiction to nicotine products,” she said. “I saw middle and high school friends who had never smoked a cigarette in their life become addicted to menthol products like Backwoods, JUUL, hookah, Swishers… I’ve seen what these products have done to my community.”
Every year, she said, 45,000 Black people die from preventable smoking-related deaths.
Community leader and poet Cheryl Carter, who also serves on the Multnomah County Public Health Advisory Board (MC-PHAB), echoed that concern.
“All I have heard this morning is a reason for us to be doing what we’re doing. The things we are embarking on will give our youth a chance,” she said. “Growing up, I’ve seen a lot of those chances taken away. I will not sit around and have these chances taken away.”
The ordinance defines flavored tobacco as:
- A distinguishable or distinctive natural or artificial taste, flavor, smell, or aroma, other than tobacco, that emanates from or is imparted by a tobacco product, a component of a tobacco product, or a tobacco product's smoke or vapor at any time prior to or during consumption. The term "flavored" includes, but is not limited to, mint, menthol, wintergreen, fruit, candy, honey, cocoa, chocolate, herb, spice, vanilla, liquors, and any and all other distinguishable or distinctive natural or artificial tastes, flavors, smells, or aromas.
- Any product containing, made, or derived from tobacco or nicotine, natural or synthetic, that is intended for human consumption by any means including but not limited to cigarettes, cigar, little cigars, pipe tobacco, shisha, hookah tobacco, snuff, chewing tobacco, dipping tobacco, bidis, or any other preparation of tobacco or nicotine.
Commissioner Susheela Jayapal said she was glad the restriction was moving forward. It made complete sense to pause while the County spent time examining the recent Washington County ruling striking down their ban, establishing that the ruling doesn’t apply in Multnomah County, and moving ahead.
Commissioner Jessica Vega Pederson thanked the tobacco team for doing “a really good job in making the case of why we need to do this and what we’re looking at if we don’t: devastating health impacts for decades for people here in Multnomah County.’’
Commissioner Sharon Meieran said as a physician, she has seen the horrible impacts of tobacco on health “where death is just the tip of the iceberg.” She asked about how the Health Department works with schools. The Health Department has several programs in area schools, McFarlan, the Tobacco Control & Prevention Program supervisor, responded, including a new “Text to Quit’’ program that just launched last spring.
Chair Kafoury said that in listening to the briefing, she was reminded of a comment youth shared during a public hearing on tobacco several years ago.
“All those youth showed up and said, ‘Do us a favor, ban the flavor,’” she recounted. “The youth came up with that and it seems perfect for this.”
The Chair said that she would schedule two public hearings in the coming weeks for members of the public to share their thoughts with the Board. She also invited people to continue commenting through an online survey that has already drawn more than 900 responses.
