HEARING OF THE SENATE COMMITTEE
ON HEALTH- ON THE RISE AND
EIGHTEEN HEALTH IMPACTS
REDUCING USE I WELCOME EVERYONE
HERE- VERY MUCH LOOKING FORWARD
TO THE- TESTIMONY AROUND-
WHAT'S GOING ON IN SHAPING ANDSO I THINK IS A VERY IMPORTANT.
INFORMATIONAL HEARING TO TALK
ABOUT WHAT WE CAN DO TO.
PROTECT THE PEOPLE OF
CALIFORNIA- IS YOU KNOW THE
NATION HAS EXPERIENCED AN
ALARMING HEALTH OUTBREAK
RELATING TO VAPING PRODUCTS I
WHICH IS CALLED THE OF ALI
OUTBREAK E. A. B. A. R. T. V.
A. L. I. OUTBREAK. AND WELL
PERHAPS BEING OVERSHADOWED BY
CORONA VIRUS AND- THE FLUTE AT
THIS TIME OF THE YEAR SHOULD
RECOGNIZE YOUR BEEN ABOUT
TWENTY SEVEN HUNDRED
HOSPITALIZATIONS AND SIXTY
CONFIRMED DEATHS IN THE UNITED
STATES- WITH MORE THAT'S BEING
INVESTIGATED POLLUTION TO THIS
OUTBREAK AND HERE IN CALIFORNIA
WE'VE HAD TWO HUNDRED FIVE
HOSPITALIZATIONS WITH THIRTY
COUNTIES REPORTING CASES AND
FOUR. CONFIRMED DEATHS THE CDC
NOW REPORTS THAT THERE'S BEEN
US THAT THERE IS A STRONG LINK
BETWEEN THE VALLEY OUTBREAK AND
BLACK MARKET CANNABIS BEEPING
PRODUCTS CONTAIN. VITAMIN D.
ACETATE AS AN ADDITIVE- BUT
BOTH THE CCM TO THE PAR PUBLIC
HEALTH CONTINUE TO CAUTION
ABOUT THE USE OF ANY VAPING
PRODUCTS PARTICULARLY AMONG
YOUTH YOUNG ADULTS PREGNANT
WOMEN ADULTS WHO'VE NEVER USE
FADING PRODUCTS. AND WILL
CERTAINLY THE BLACK MARKET-
CANNABIS INDUSTRY CONTINUES TO
BE A CONCERN REYES A HOST OF
OTHER ISSUES THIS HEARING WILL
FOCUS MAINLY ON TOBACCO BASED
DATING PRODUCTS. NOW THE RECENT
NAY USED TO BE SERVE CONDUCT BY
THE SEA. AND FDA THAT THE AMONG
USE CONTINUES TO RISE. AND
REPORTS IN TWENTY NINETEEN MORE
THAN FIVE MILLION USE USE THE
CIGARETTES UP FROM NEARLY THREE
POINT SIX MILLION IN TWENTY
EIGHTEEN SO THINK ABOUT THAT
THREE POINT SIX TO FIVE MILLION
IN THE YEAR. TWENTY SEVEN AND A
HALF PERCENT OF HIGH SCHOOL
STUDENTS REPORTER VAPING UP
FROM EIGHT PERCENT. TEN POINT
5% MIDDLE SCHOOL STUDENTS FACE
UP FROM FOUR POINT 3% AND
TWENTY SIXTEEN CELEBRATE
DRAMATIC RISE. WE ALSO KNOW
THAT THE MARKETING OF FLAVOR
TOBACCO PRODUCTS PLAYED A MAJOR
ROLE IN ATTRACTING USE TO
VAPING AND THOSE NUMBERS
CONCERTS FIRM THAT WE SHOULD
ALL BE VERY CONCERNED. ABOUT
THE FEDERAL GOVERNMENT FOLLOW
CALIFORNIA'S LEAD IN RAISING
THE MINIMUM AGE TO PURCHASE
TOBACCO PRODUCTS TO TWENTY ONE
AND THE FDA ALSO ISSUED A
TEMPORARY BAN ON MOST FLEETING.
FLAVORED BAKING PRODUCTS UNTIL
MANUFACTURES CAN SHOW THE
PRODUCTS ARE SAFE. AND
CERTAINLY THE RISING YOU TO USE
AN ACCESS OF ANY CONCERN FOR
MANY YEARS. AND THE NUMBERS
THAT I. QUOTED PROVIDE PROOF
THAT WE NEED TO CONTINUE TO
TAKE BOLD STEPS BEYOND JUST
WHAT THE FEDERAL GOVERNMENT HAS
DONE. I THINK WE NEED TO
RECOGNIZE THAT WAS CERTAINLY-
UNDERSTAND THAT SOME PEOPLE
HAVE ARGUED THAT VAPING AS X.
GOKUL SAFER ALTERNATIVES THEN.
PERHAPS COMBUSTIBLE CIGARETTES
THAT WE DO SEE THIS RISE IN USE
WHO MANY WAYS IS THE FIRST
INTRODUCTION TO NICOTINE. AND
NICOTINE WHETHER IT'S AN OF A
PRODUCT OR IN A COMBUSTIBLE
CIGARETTE IS AN ADDICTIVE
SUBSTANCE ONE THAT WE SHOULD
NOT BE INTRODUCING ARE USED TO
WE KNOW THAT STUDIES HAVE ALSO
SHOWN THAT- IF YOU GET.
DISPOSED TO NICOTINE- THROUGH
VAPING YOU'RE MORE LIKELY TO
THEN MOVE ON TO COMBUSTIBLE
CIGARETTES- I WOULD ALSO MAKE
NOTE THAT- UNFORTUNATELY- WELL.
THE AP HAS BEEN TOUTED AS AN
ALTERNATIVE TO CIGARETTES AND
MAYBE- BUT NOT AS FAR AS I
KNOW. NO VAPING PRODUCTS HAS
BEEN. FORMALLY SUBMITTED TO THE
FDA FOR USE AS A SMOKING
CESSATION- DEVICE SO- I THINK
THAT'S IT THE FACT THAT THAT
HASN'T HAPPENED YET- I THINK
THOSE RAISE SOME ISSUES ABOUT.
ANY SORT OF CLAIMS THAT THIS IS
A THIS IS AN ALTERNATIVE OR
WAIT SORTS SMOKE CESSATION WELL
CERTAINLY WE DO WANT TO
PROMOTE- WAYS TO GET PEOPLE OFF
TO BACK BOTH TOGETHER AND
PARTICULARLY NEXT. SO I'M
LOOKING THE CONVERSATION TODAY
AM. PLEASED TO WELCOME CENTER
HELLO. WELL NOW NOW THIS CAN
SOMEONE COME INTEREST IN. THIS
ISSUE SO TO JOIN US TODAY THANK
YOU THREE SIR HELL. AND SO WITH
THAT LIKE TO ASK FOR ASK ALSO
CENTER LEAVE IT IS A MEMBER OF
THE COMMITTEE OR DO YOU HAD. IT
FOR DO YOU WOULD LIKE TO MAKE
SOME. REMARKS YEAH OKAY. HILL
THANK YOU CHAIR IN IN IN THANK
YOU FOR HOLDING HEARING IN. YOU
FOR LEADERSHIP YOUR- LEADERS ON
THIS SUBJECT I IT'S INCREDIBLE
AND- FRANKLY WE WERE WINNING
THE WAR. YEAH WE HAVE BEEN
SUCCESSFUL ADULTS SMOKING HAD.
IS DROPPED. AND YOUTH SMOKING
HAS CONTINUOUSLY GOING DOWN
WITH THE STAKE ACTED ALL IN
FORTUNATE EVERYTHING WE'VE
DONE. BUT AS YOU MENTIONED WITH
OVER FIVE MILLION KIDS NOW
USING E. CIGARETTES. YOUTH
TOBACCO CONSUMPTION HAS- ASSUME
UNPRECEDENTED SURGE- IT AND
IT'S TROUBLING IS TROUBLING TO
ME AND I THINK TO MOST OF US
BUT IT'S NOT SURPRISING.
BECAUSE WHAT WE HAVE LEARNED
ALSO IS IT THE VAPING INDUSTRY
IS COPIED THE BIG TOBACCO
PLAYBOOK. LAUREN OUR MOST
VULNERABLE COMMUNITIES WITH
PERVASIVE MARKETING FALSE
PROMISES AND REALLY THIS KID
FRIENDLY FLAVORS SO. THEY SAY
E. CIGARETTES ARE SAFE AND
SMOKE AS A GOOD SMOKING
ALTERNATIVE BUT AS THE CHAIR
MENTIONED- NONE OF THEM HAVE
BEEN APPROVED AS A SMOKING
CESSATION PRODUCT. OR SOMETHING
THAT CAN HAVE EVERYTHING HAS
BEEN DEBUNKED IN EVERY DAY MORE
EVIDENCE EMERGES TO SUGGEST
OTHERWISE SO. THERE'S AN URGENT
NEED. FOR THIS LEGISLATOR TO
LEGISLATURE TO TAKE STRONG AND
MEANING MEANINGFUL ACTION TO
DISRUPT THIS EPIDEMIC THAT WERE
SEEN SO I APPRECIATE THE
OPPORTUNITY TO PARTICIPATE
TODAY. AM EAGER AND REALLY TO
LEARN MORE ABOUT THIS CRISIS SO
THAT WE CAN FIGHT IT HEAD ON SO
THANK YOU MISTER CHAIR AGAIN.
Q. THANK YOU VERY MUCH RIGHT SO
LET'S GO AND HEAD AND BRING UP
FOR- FIRST SPEAKER- PLEASE
INVITE. BY DR MICHAEL ON- FROM
THE- IS PROFESSOR RESIDENTS OF
MEDICINE HEALTH POLICY OVER AT
AND MANAGEMENT AT UCLA- THANK
YOU SO MUCH FOR BEING HERE. AND
LOOKING FOR DURING YOUR
PRESENTATION WELCOME. SENATE
AND I'LL GET SOMEONE ELSE'S.
THANK YOU SENATORS UP FOR
INVITING ME HERE TODAY MY NAME
IS MICHAEL ôNG AND THE
PRACTICING PHYSICIAN AND
PROFESSOR OF MEDICINE AND
PUBLIC HEALTH AT UCLA I ALSO IN
THE CHAIR OF THE STATE OF
CALIFORNIA TO BACK ON EDUCATION
RESEARCH OVERSIGHT COMMITTEE-
ALSO KNOWN AS T. ROCK AND SO
WHILE IM NOT SPEAKING ON
BEHALF OF T. ROCK TODAY I'M
HAPPY TO REITERATE MANY OF THE-
POINTS THAT- T. ROCK HAS
ALREADY ENDORSED THAT RELATE TO
BE PAYING- AND JOB OTHER
FLAVORED PRODUCTS. I THINK THAT
IT'S CRITICAL TO- THINK ABOUT
WHAT KIND OF PRODUCTS ARE YOU
THREE USING AND SO IN TWENTY
EIGHTEEN FROM THE CALIFORNIA
STATE TO SCHOOL TOBACCO SURVEY-
OVER 85% OF CALIFORNIA HIGH
SCHOOL STUDENTS TO USE THE
TOBACCO PRODUCT IN THE PAST
THIRTY DAYS USED A FLAVOR
TOBACCO PRODUCTS AND SOME OF
MEMBERS ARE SPECIFICALLY SEEN
WITH FLAVORED ELECTRONIC
SMOKING DEVICES. FOR THE MOST
PART YOU THEY'RE NOT USING
TRADITIONAL CIGARETTES ANYMORE
THEY'RE USING ELECTRONIC
SMOKING DEVICES OR COMMON KNOWN
AS THE CIGARETTE VAPING DEVICES
AND SO IF THE FROM THAT SURVEY
ALONE AROUND 11% OF- TWELVE SO
IF THAT TWELVE POINT SEVEN
PERCENT- 11% ARE USING
ELECTRONIC SMOKING DEVICES AND
IT'S REALLY ONLY 2% PREVALENCE
FOR TRADITIONAL CIGARETTE. SO
I'M FROM ROCKSTAND. WE DO RIGHT
PROHIBITING FLAVOR TOBACCO. IN
THAT'S WITHOUT EXAM. FORCED
FLAVORS RETAIL LOCATIONS WERE
PRODUCT TYPE- INSULT AS A YOU
HEARD ALREADY FAVOR TOBACCO
PRODUCTS ARE PARTICULARLY
APPEALING FOR YOUTH AND YOUNG
ADULTS TO BEGIN USING TOBACCO.
AND DUE TO THE CURRENT LACK OF
REGULATION AS YOU ALREADY
MENTIONED- VERY FEW THE
FLAVORING CHEMICALS IN
ELECTRONIC SMOKING DEVICES HAVE
UNDERGONE ADEQUATE TOXICITY OR
SEATING TESTING FOR. OUR SAFETY
TESTING FOR ACUTE OR CHRONIC
INHALATION. A PROBLEM THAT HAS
BEEN HIGHLIGHTED BY THE RECENT
E. CIGARETTE AND VAPING
ASSOCIATED LONG INJURY CASES
HERE IN CALIFORNIA. AND ACROSS
THE COUNTRY. SHE WROTE PREGNANT
PROHIBITING ALL FLAVORS
INCLUDING MEANT AND MENTAL.
MENTAL MASKS THE HARSH TASTE OF
TOBACCO AND MAKES THE SMOKE
EASIER TO INHALE AND IT'S AND
THAT'S HOUSING AFFECT MAKE IT
EASIER AND MORE APPEALING TO
USERS PARTICULARLY USED TO
START USING TOBACCO. SPECIFIC
POPULATIONS HAVE ALSO BEEN THE
TARGETS OF TOBACCO INDUSTRY
MARKETING TO INCREASE THEIR USE
OF MENTHOL CIGARETTES AND OTHER
PRODUCTS INCLUDING THE AFRICAN
AMERICAN AND LGBT Q.
COMMUNITIES. MEANT ALONG WITH
WRITTEN MANGO HAVE BEEN THE TOP
FLAVORS FOR YOUNG JEWEL USERS
IT I LAST YEAR WITH NEARLY A
THIRD OF- EIGHTEEN TO TWENTY
ONE YEAR OLD JEWEL USERS USING
MEANT THE LAST TIME THE FATE.
KID ROCK ALSO RECOMMENDS
PROHIBITING THE SALE OF FAVOR
TOBACCO PRODUCTS IN ALL STORES.
IN TWENTY NINETEEN- OVER 30% OF
INSPECTED TALKED ABOUT THE
STORES AND SMOKE SHOPS IN
CALIFORNIA WHICH SHOULD BE
LIMITED TO ADULTS ONLY SOLD
TOBACCO PRODUCTS TO UT CHORUS
WHICH WOULD SUGGEST THAT
DESPITE THE FACT THAT WE DO
HAVE LAWS THAT RESTRICT- SALES
TO. THOSE UNDER TWENTY ONE THAT
WE REALLY NEED TO RESTRICT
THESE PRODUCTS- IN TERMS OF
THEIR AVAILABILITY. IT IS
IMPORTANT FOR CALIFORNIA TO ACT
COMPREHENSIVELY IN ADDITION TO
FEDERAL ACTION WEEK WHICH
EXEMPTED CERTAIN FAVORITE
PRODUCTS AT ADDICTED YOUTH THAT
ARE SO- THAT- YOU THIRD NOW
SWITCHING TOWARD SUCH AS
DISPOSABLE E. CIGARETTES AND
TANK BASED SYSTEMS. THE FOOD
AND DRUG ADMINISTRATION WHILE
THEY DO HAVE THE AUTHORITY TO
REGULATE THESE PRODUCTS THEY
HAVE YET TO START EVALUATING
ANY THESE PRODUCTS ON SAFETY-
THAT SHOULD HAPPEN LATER THIS
YEAR. BUT POTENTIALLY THEY MAY
LOSE THEIR OVERSIGHT OF TOBACCO
PRODUCTS IS. LISTED IN THE
CURRENT- BUDGET- THAT HAS BEEN
PROPOSED- AT THE FEDERAL LEVEL.
SOME CALIFORNIA COMMUNITIES OF
ALSO EXEMPTED TOBACCO PRODUCTS
AND SPECIFICALLY DOWN IN
SOUTHERN CALIFORNIA HOOKAH
PRODUCTS. FROM FLAVOR
REGULATION AND SO I JUST TO
CLARIFY THE HARMS FROM HOOKAH
PRODUCTS. THE WORLD HEALTH
ORGANIZATION HAS DETERMINED
THAT- ONE HOUR OF HOOKAH
SMOKING IS EQUIVALENT TO
SMOKING OVER A HUNDRED
CIGARETTES. CALIFORNIA HAD BEEN
MAKING A LOT OF PROGRESS IN
REDUCING HIGH SCHOOL AGE YOUTH
TOBACCO USE. BRING IT DOWN FROM
TWENTY TWO POINT 1% IN TWO
THOUSAND AND NINETY TWO
THOUSAND AND TEN DOWN TO TWELVE
POINT TWO IN TWO THOUSAND AND
FIFTEEN TO TWO THOUSAND SIXTEEN
WE HAVE MADE A TON OF PROGRESS-
THAT BEING SAID IN TWO THOUSAND
SEVENTEEN TO TWO. TWO THOUSAND
EIGHTEEN THAT RATE WAS AT
TWELVE POINT 7% WE'VE REALLY
TAKEN A STEP BACKWARDS IN TERMS
OF WORKING ON YOUTH TOBACCO USE
RATES AND SO. IT IS REALLY
CRITICAL FOR THE HEALTH OF
CALIFORNIA FOR THE LEGISLATURE
TO TAKE ACTION. THANK YOU.
THANK YOU VERY MUCH QUESTIONS
FROM IN CENTER HILL THANK YOU
MISTER CHAIR OF A GLITCH IN THE-
DO IS IT. OR ARE THE FLAVORS
WHAT IS THE ATTRACTIVE NATURE
OF THE E. CIGARETTE TO THEM OR
IS IT THE- THIS SECTION IS OF
SOME OF THOSE PRODUCTS THE
DISPENSING DEVICES. I THINK
THAT IT IS A COMBINATION OF
BOTH AND I THINK THAT THAT IS
WHAT FUELED THE RISE OF
PRODUCTS LIKE JEWEL WHICH WERE-
LOOKS JUST LIKE A STANDARD USB
DEVICE THAT- MOST A SCHOOL-
TEACHERS- AND OTHER INDIVIDUALS
IN SCHOOLS. HAD NO IDEA WHAT
THESE WERE A SEVERAL YEARS AGO
SO I DO THINK THAT- THE KINDS
OF DEVICES ARE ONE THING BUT IT
IT'S THE FLAVORS AT ALSO REALLY
ATTRACT INDIVIDUALS TO IT
BECAUSE IF IT REALLY TASTED
LIKE TOBACCO I DON'T THINK THAT
PEOPLE WOULD REALLY BE USING
THOSE PRODUCTS AND THAT'S I
THINK THE MAIN REASON WHY YOU
SEE. MOST YOUTH USING FLAVORED
ALEX RATHER THAN SOMETHING
THAT- DISPLAY FOR LIKE TOBACCO.
IN IF I COULD FOLLOW UP WITH
ANOTHER QUESTION FUTURE THE-
THE- HE WOULD TALK ABOUT WE
ASSUME THAT NICOTINE IS. A
PROBLEM IN THE ADDICTION IS A
PROBLEM WE KNOW WHAT THE
EFFECTS KßT LONG TERM CAN BE
WITH TOBACCO SMOKING BUT- WHAT
ARE THE EFFECTS OF. NICOTINE
ADDICTION TO A YOUNG PERSON
WHEN THEY'RE NOT SMOKING A
CIGARETTE AND ADDICTED TO THE
NICOTINE COMING FROM OF A PIN
DEVICE. SO ARMY WE OF OFTEN-
HAD A LOT OF DEBATES- YOU
SINCE- THE- RISE OF ELECTRONIC
CIGARETTES AS TO THE RELATIVE
SAFETY OF THESE PRODUCTS AND
SO- FOR EXAMPLE MANY PEOPLE
LIKE TO TALK ABOUT THE NATIONAL
HEALTH SERVICES ESTIMATE. QUITE
AWHILE AGO THAT SAID THAT-
THESE PRODUCTS ARE 95% SAFER
THAN. TRADITIONAL CIGARETTES. I
THINK THAT THAT'S REALLY
DIFFICULT TO REALLY SAY THAT
WAS BASED ON A LOT OF
CONJECTURE ON DEVICES THAT WERE
PROBABLY THREE OR FOUR
GENERATIONS AGO- IN TERMS OF
LOOKING AT THESE. PRODUCTS NOW-
IN PARTICULARLY SOMETHING LIKE
THE JEWEL WHICH- HAVE VERY
CONCENTRATED FORMS OF NICOTINE
LIKE NICOTINE SALTS- ONE OF
THE- COUPONS IS EQUAL TO. THE
SAME AMOUNT OF NICOTINE THAT
YOU WOULD GET IN A PACK OF
CIGARETTES A TWENTY CIGARETTES.
AND I SEE KIDS OR HEAR ABOUT
KIDS BETTER USING COMPUTER FOR
JEWEL PODS. NOW AS THE INTERNAL
MEDICINE PHYSICIAN- WE ICE I
WORK WITH A LOT OF INDIVIDUALS
WHO HAVE BEEN HEAVY SMOKERS
BEFORE. USUALLY THERE AT ONE OR
TWO PACKS A DAY THAT'S
CONSIDERED HEAVY SMOKING AND SO
THE AMOUNT OF NICOTINE THAT
THESE INDIVIDUALS ARE GETTING
NOW IS TREMENDOUS- NICOTINE
ITSELF- HAS AN LD FIFTY NUMBER
WHICH MEANS THAT IT. IS A
LEGAL- KIND OF COMPOUND WHEN
GIVEN AT HIGH LEVELS AND SO. ON
PARTICULARLY WHEN THESE TYPE OF
PRODUCTS WERE FIRST MADE
AVAILABLE WHEN THE FOR FREE
FORM- WITH LITTLE REGULATION BE
WE WOULD HEAR ABOUT POISON
CONTROL CENTER CALLS GOING UP
WITH THESE TYPE OF PRODUCTS SO.
I THINK THAT WITH NICOTINE
ITSELF COME WHEN IT'S INHALED.
IN A WHILE EVEN WHILE THESE
PRODUCTS MAY NOT NECESSARILY.
BE BURNING MATERIALS THAT WOULD
HAVE CARCINOGENIC COMPOUNDS AS
MUCH AS WE WOULD SEE FROM OTHER
TYPE OF PRODUCTS. NICOTINE
AFFECTS MANY DIFFERENT. ORGANS
IN THE SYSTEM WE KNOW THAT IT
HAS A LOT OF CARDIO VASCULAR
EX. IT'S ALSO GOING TO THE
FACTS ARE THE DEVELOPING BRAIN
AS WELL SO THINK THAT. THEY'RE
NOT. GOING TO CONSIDER IT
WOULD. THAT BE THREE USE THIS
FOR. SENATE THINK STRUCTURE. DR
ON THANK YOU FOR BE HERE WITH.
TODAY SO WE HEAR FOR. JEWEL AND
THESE OTHER. THAT THIS IS A SUS.
TO THE SOMEONE STOPS. AND GO TO
VAPE. IN ORDER TO HELP THEM
STOP SMOKING. I PERSONALLY I'M
NOT A DOCTOR- BUT I DON'T THINK
THAT RINGS TRUE WITH ME WHAT
RINGS TRUE WITH ME IS THAT
TOBACCO. USAGE WAS GOING DOWN
SIGNIFICANTLY. AND THE TOBACCO
INDUSTRY IS LOOKING FOR. A NEW
WAY TO MAKE MONEY. AND THE
FLAVORS ARE MARKETING DEVICE TO
GET MORE CHILDREN HOPPED. SO
THAT'S MY COMMENTARY MY
QUESTION IS. DO YOU THINK
THERE'S ANY VALUE IN VAPING. TO
BE USED AS A CESSATION DEVICE.
I THINK THAT IT IS POSSIBLE
THAT VAPING DEVICES COULD BE
USED FOR CESSATION COMEDY HIT
AT- IF YOU THINK ABOUT THE
KINDS OF PRODUCTS THAT WE HAVE-
THAT OUR FOOD AND DRUG
ADMINISTRATION APPROVED FOR A
TOBACCO CESSATION. WE DO USE
NICOTINE REPLACEMENT THERAPY
AND THERE IS A PRODUCT- HAT IS
A NICOTINE INHALER THAT- AS
DEVELOPED MANY YEARS AGO ON
THAT IT'S NOT THAT DISSIMILAR
TO A BEEPING DEVICE- THAT BEING
SAID- IN TERMS OF ITS USE FOR
CESSATION. HOW IT'S USED- IS
GOING TO BE REALLY CRITICAL IN
TERMS OF- HOW SOMEBODY'S GOING
TO BE ABLE TO SET SUCCESSFULLY
QUIT- AS SOMEBODY WHO DID SOME
OF THE EARLY RESEARCH IN TERMS
OF MAKING THESE TYPE OF
PRODUCTS OVER THE COUNTER WE
ALL THOUGHT AT THAT POINT IN
TIME THAT. MAKING NICOTINE
REPLACEMENT THERAPY OVER THE
COUNTER WOULD LEAD TO A LOT OF
CESSATION AND THAT DIDN'T
HAPPEN- EVEN THOUGH WE MAY LOTS
OF PRODUCTIONS THAT THAT WOULD
BE THE CASE. AND SO I THINK
THAT IN TERMS OF TO HAVING TRUE
CESSATON HAPPEN FOR
INDIVIDUALS WHO NEED A
COORDINATED EFFORT IT CAN'T
JUST BE FROM SOMEBODY BUYING IT
FROM A BAIT SHOP- IMMEDIATE WE
DO HERE MANY STORIES- FROM
INDIVIDUALS WHOSE. SAY THAT
THEY'VE BEEN SUCCESSFULLY ABLE
TO TRANSITION OFFICE CIGARETTES
AND JUST BEEPING ONLY- YOU
OFTEN DON'T CARE ABOUT THE
PEOPLE THAT RELAPSE BECAUSE
THEY'RE NOT THE ONES ARE GOING
TO COME OUT AND TALK ABOUT- AND
SO I THINK THAT IN TERMS OF
USING THESE TYPE OF PRODUCTS.
WELL THERE ARE RANDOMIZED
CONTROL TRIALS ON THAT ARE NOT
THE UNITED. THAT SHE NOT
DEMONSTRATE INDIVIDUAL FOR A TO
STOP USING TRADITIONAL
CIGARETTE. ON THAT PARTICULAR
STUDY THAT WAS RECENTLY
PUBLISHED IN NEW ENGLAND
JOURNAL OF MEDICINE MOST PEOPLE
CONTINUE TO STAY ON USING
NICOTINE ITSELF SO THERE I'M
NOT TRULY QUITTING ALL NICOTINE
PRODUCTS. BUT THEY'RE
CONTINUING TO USE THESE TYPE OF
PRODUCTS WHICH IN CALIFORNIA WE
DEEM AS TOBACCO PRODUCTS. THE
TREATING WANTED. FOR A IT'S THE
ADDICTION IT IS THE NEW. IN
OKAY SO THEY'RE JUST YOU KNOW
CHANGING. PRODUCT FOR ANOTHER.
I'M IN THAT THINGS WE DO A LOT
OF. DO WILL. AS WELL- IN THE
ADULT COMMUNITY AND I THINK
THAT THE OTHER CONCERN THAT WE
DO HAVE IS FOR YOU TO ARE
STARTING OFF USING NICOTINE
PRODUCTS. LIKE VAPING PRODUCTS
THAT THEY WILL EVENTUALLY
TRANSITION TO OTHER TYPES OF
PRODUCTS THAT WILL HAVE MORE
HARM SUCH AS TRADITIONAL
CIGARETTES IN THE RIBBON.
SEVERAL STUDIES. ON THAT BEEN
DONE HERE IN THE US THAT HAVE
LOOKED AT INDIVIDUALS IN TERMS
OF THEIR TRANSITION FOLLOWING
THEM OVER TIME AND SEEN THAT.
THERE TRANSITION RATES ARE
THREE TO FIVE TIMES HIGHER IN
TERMS OF STARTING A TRADITIONAL
CIGARETTE INITIATION AS OPPOSED
TO PEOPLE WHO ARE NOT TAPING.
THANK YOU. QUESTIONS SO WITH
AGAIN THANK YOU SO MUCH FOR
YOUR PRESENTATION- EIGHT. YEAH%
I GUESS I WILL AND HE DID TOUCH
ON MANY OF THE QUESTIONS-
QUESTIONS I HAD ABOUT. NICOTINE
ITSELF BECAUSE I THINK WE NEED
TO REMEMBER THAT- VAPING
PRODUCT IS A NICOTINE PRODUCTS
SO. ONE CAN ARGUE WHETHER IT'S
BETTER OR WORSE THAN.
COMBUSTION BUT THE REAL
QUESTION IS DO PEOPLE ACTUALLY.
FINALLY GET OFF THE NICOTINE
AND SOUNDS LIKE. YOU'RE TELLING
ME THE ANSWER IS NO DATE FOR BY
ME TO MAYBE. DEREK TOTAL
EXAMPLES BUT- IN GENERAL WE'RE
NOT SEEN THAT BASICALLY TO
SWITCHING ONE PRODUCT FOR
ANOTHER CORRECT. THAT IS
CORRECT I THINK THAT WHEN YOU
TALK TO PEOPLE WHO ARE ADDICTED
TO MULTIPLE SUBSTANCES
INCLUDING NICOTINE THEY WILL
INVARIABLY TELL YOU THAT IT IS
NOT THE CALL CAME. IT IS NOT
THE HEROIN. IT IS THE NICOTINE
THAT IS THE HARDEST THING FOR
THEM TO QUIT. SO ME JUST-
PERHAPS SPECULATE A LITTLE BIT
HERE AND TELL ME WHETHER YOU
GOT STRAIGHT SO WHAT SO THE
CHALLENGE HERE IS THAT WHAT THE
VAPING. WE HAVE USE. WHO MAY
NOT HAVE SMOKE BEFORE WHO
ATTRACTED TO A PRODUCTS PERHAPS
THEN AND MADE EASIER TO BE
INTRODUCED BECAUSE OF FLAVORS.
BUT NOW THAT DAVIS TRIED IT AND
I'VE BEEN EXPOSED TO THIS
NICOTINE SOMETIMES IT DOES AS
FAR HIGHER THAN THEY WOULD BE
EXPOSED TO IN COMBUSTIBLE
CIGARETTES. SO THEY WILL
PROBABLY SIXTEEN GIVEN ITS
ADDICTIVE QUALITIES WOULD YOU
SAY IF WE SEE ELIMINATED TAPING
THEY WOULD SIMPLY STOP RD WOULD
THEN SEEK OUT ALTERNATIVE
NICOTINE PRODUCTS LIKE
COMBUSTIBLE CIGARETTES ARE EVEN
BY THE WAY EVEN UNFLAVORED-
VAPING PRODUCTS IF THEY WEREN'T
ABLE TO GET FLAVORED VAPING
PRODUCTS NOW THAT THERE ARE
THEY'VE BEEN EXPOSED TO
NICOTINE AND BRAINS I THINK
THAT THE- WE ARE SEEING THAT
ALREADY- SO IN TERMS OF THE
FEDERAL RESTRICTIONS IN TERMS
OF THE CARTRIDGE BASED PRODUCTS
ON THE REUSABLE WE DO- HERE
ABOUT INDIVIDUALS FOR NOW SEEK
OTHER TYPES OF. BECAUSE THEY
ARE THE AN UNFORTUNATEBE I'M
PARTICULARLY IN THE WE DON'T
HAVE A LOT OF EVIDENCE IN TERMS
OF BEST WAYS TO GET PEOPLE TO
QUIT THESE PRODUCTS A YOU SEE
WHEN WE COME UP WITH-
APPROACHES FOR CESSATION WE
USUALLY WANT TO HAVE A LOT OF
EVIDENCE BEFORE WE THE EYES
THAT WE'RE GOING TO USE A
KILLER PRO I'M WHICHMEANS MY
CONTROL TRYING TO RESEARCH
WHICH IS DONE BY OTHER AT.
MISSION ADULTS AT. LA MY
COLLEAGUES WHO WERE THE OTHER
KERRIER. THEY GET CALL ALL THE
TIME THE INDIVIDUALS WHO ARE
TRYING TO STOP A AND WE DON'T
HAVE A GRAY APPROACH INTO OF
DOING THAT SO I. IT IS TRUE
THAT THE INDIVIDUAL PROBABLY BE
SEEKING OTHER PRODUCTS IN THE
INTERIM I THINK THAT IT'LL BE
REALLY CRITICAL FOR US TO COME
UP WITH WAYS TO HELP THESE
INDIVIDUALS- ON WOMEN'S SELF
OFFER THIS ADDICTION. AND AGAIN
PART OF IT IS A RECOGNITION
THAT THE ERROR ADDICTED TO MUCH
HIGHER LEVELS THAN WE
TRADITIONALLY I'VE EVER SEEN-
FOR OTHER TYPES OF ADULTS. OKAY
AND WOULD YOU. NUMBER I KNOW
I'M FUTURE XIN AND YOU'RE NOT
BUT PERHAPS YOU KNOW- IN TERMS
OF- EXPOSURE AT THE AGES THAT
THEY'RE BEING EXPOSED TO SO WE
SEE PEOPLE STARTING BE PAYING
NOT ONLY LATE. TEENS EARLY
EIGHTEEN THIRTY EIGHT ALASKA
SOMETIMES EVEN BEFORE- IS IT IS
FROM YOUR- POINT OF VIEW-
ARTICLE OR POTENTIALLY. TO
ATTACK THE NICOTINE. TO BE AS
OF THE- RING SPUR A AGE. WHEN
IN DEVELOPING TO STILL ON A
SIGNIFICANT ON GOING ON THAT IS
LIKELY THE CASE AND IT'S NOT SO
CLEAR WHAT SORT OF AFFECTS WE
WILL SEE- AND UNFORTUNATELY-
MUCH LET THE DAM. THAT SUPPORT
OTHER TYPES OF DOCTORS THAT
WERE RIGHT. ON RIGHT IN TOP
BEING A FIRST AS LIKE
CIGARETTES ARE FILTERED. WERE
GONNA THE DAMAGED GET NOW TERMS
OF WHAT PROTECT WE HAVE IS IN
THE BILLS BECAUSE OF THE HIGH.
OF THE RITUAL. TO SO. THIS MAY
UP DURING THE FARMS PUBLIC
HEALTH UP ACTIVITY AND MANY
WHAT WE'RE TO AT THIS POINT
THEN THEN I SAY WE NEVER GIVE
UP ON ANYBODY BUT ESSENTIALLY
YOU. WHEN WE TALK THE ROLE THE
RIVER RAP RISE IN USE FADING.
BY ELIMINATING FLAVORS AS A
POLICY DECISION WHAT WE'RE
TRYING TO DO IS AND FOURTEEN WE
ARE GOING TO HAVE TO DEAL WITH-
AND ALSO MENTIONS INCLUDING-
YOU KNOW THE COST TO OUR
SOCIETY OF THE- TEENS AND YOUNG
ADULTS TO ALREADY STARTED
VAPING. AB BECAUSE THEY WILL
THEY'RE GOING TO WHETHER IT'S
IMPOSSIBLE CIGARETTES ARE
CONTINUE VAPING OR SOMETHING
ARE EVEN BLACK MARKET- WHICH
WILL RECEIVE THE DEATH THE LAW
THAT THAT'S- WHAT WE'RE TRYING
TO DO SAVE OUR NEXT GENERATION
FROM BEING EXPOSED. RIGHT I
MEAN THAT'S WHAT WE'RE TRYING
TO DO WHAT WE'RE IT'S NOT THAT
CERTAINLY WELL WE ELIMINATE THE
FLAVORS AND PEOPLE STOP HATING
AND ALL BE GOOD AGAIN IT'S
ACTUALLY WE'VE CREATED. THE ARE
WE CAN SAY THE VAPING INDUSTRY
HAS CREATED A WHOLE GENERATION-
VERY RAPIDLY. OF USE AND YOUNG
ADULTS WHO WERE GOING TO HAVE
TO FIGURE OUT HOW TO HELP. AND
WHAT WE NEED TO DO IS WE NEED
TO STOP THE BLEEDING NOW THAT
WE DON'T HAVE. THE SUBSEQUENT
GENERATIONS WHO ALSO STRUGGLED%
THE SAME ADDICTION PROBLEM
CORRECT THAT WOULD BE CORRECT I
THINK ONE OF THE- TREMENDOUS-
SUCCESS STORY THINKING- IT'D
NEW WORLDWIDE HAS BEEN WHAT
WE'VE DONE INTO THE CONTROL
HERE IN CALIFORNIA WE ACTUALLY
A SCENE LUNG CANCER RATES
DECLINING IN AGAIN THOSE ARE
THINGS THAT. DECADE TO
DEVELOPING INDIVIDUALS AND SO-
WE'VE MADE SO MUCH PROGRESS
HERE IN CALIFORNIA WE LEAD THE
WORLD IN TERMS OF- YOU DOING
ABOUT THE CONTROL- BUT- IN
TERMS OF VAPING AND WHILE I
THINK THAT WE'VE DONE A GOOD
JOB IN TERMS OF TRYING TO TAKE
DOWN. HAS GONE ON WITH BE
PAYING IN CALIFORNIA HAS BEEN
AN EARLY RECOGNITION PARTICULAR
FROM THE DEPARTMENT OF PUBLIC
HEALTH- THAT BEEPING WAS A
SERIES TO EVEN BACK IN TWENTY
FIFTEEN TWENTY SIXTEEN THINK
THAT. TWO ONE TRY TO BUY THE
THAT WE ARE SEEING AS YOU. FROM
THE RECENT SERVE FROM MONITOR
THE FUTURE THAT TO ABOUT HOW
OVER QUARTER OF. A HIGH. YOU RV
AT THE POINT AND WE THAT IS.
THE NUMBERS THAT WE JUST DON'T
SEE. A IN THE NEXT ANYMORE
TRANSIT ABOUT PRODUCTS. OKAY
ANY OTHER QUESTIONS. OKAY WELL
THE FACT HE SAID WE ALREADY
HAVE A QUARTER OF OUR USE- NOW
EXPOSED TO A HIGHLY ADDICTIVE
SUBSTANCE THAT'S VERY DIFFICULT
THAT EVEN POSITIONS RIGHT NOW
STRUGGLING TO HELP THOSE
PATIENTS WE ENOUGH OF IT IS A
FRIGHTENING THOUGHT AND THE
IDEA THAT THAT WE WOULD ALLOW
THIS CONTINUE CERTAINLY IS PART
THE REASON WE'RE HAVING THIS
HEARING AND I KNOW OUR PUBLIC
ALSO IS GOING TO WORK OUT
LOOKING FORTY HEARING FROM THEM
I WANT THANK YOU SO MUCH FOR
YOUR PRESENTATION. THANK YOU
MUCH THANK YOU THANKS. OKAY
NEXT UP WE HAVE. OUR DIRECTOR
OF THE STATE OR POLICY PUBLIC
HEALTH OFFICER AND DIRECTOR
CALIFORNIA. APARTMENT PUBLIC
HEALTH DOCTOR SONYA ANGEL
WELCOME. I THINK THIS IS YOUR
FIRST HEARING FOR THE HEALTH
COMMITTEE TO ALL RIGHT WELL
THANK YOU WELCOME. THANK YOU
CAN YOU HEAR ME YES. ALRIGHT I
WOULD THE FOR I WAS TAUGHT TO
PUSH THAT BUTTON SO FAR SO GOOD
RIGHT- IT IS ABSOLUTELY A
PLEASURE TO BE HERE- CHAIR AND
MEMBERS AS MENTIONED I DOCTOR
SONYA ANGEL AND THE STATE
PUBLIC HEALTH OFFICER. AND
DIRECTOR OF THE CALIFORNIA
DEPARTMENT OF PUBLIC HEALTH I
REALLY APPRECIATE THIS
OPPORTUNITY TO PRESENT TO THE
COMMITTEE TODAY I'M GOING TO
SHARE WITH YOU WHAT WE KNOW
ABOUT YOUTH VAPING IN OUR STATE
AND PROVIDE INFORMATION ABOUT
THE RECENT OUTBREAK OF A VOLLEY
OTHERWISE KNOWN AS- E.
CIGARETTE VAPING ASSOCIATED
LONG INJURY. THEN I'LL PROVIDE
INFORMATION FOR YOU ON GOVERNOR
NEWSOME'S INITIATIVE TO ADDRESS
YOUTH VAPING IN CALIFORNIA ONE
IN TEN HIGH SCHOOL STUDENTS
REPORT USING E. CIGARETTES OR
VAPING. THAT'S BASED ON TWENTY
EIGHTEEN DATA AND REPRESENTS A
27% INCREASE FROM JUST TWO
YEARS EARLIER RISING FROM EIGHT
POINT SIX TO TEN POINT NINE
PERCENT. IN YOUNG ADULTS AGES
EIGHTEEN TO TWENTY FOUR YEARS
OF AGE OVER ONE IN SEVEN REPORT
E. CIGARETTE USE AND ITS USE IS
INCREASING FASTEST AMONG THIS
DEMOGRAPHIC FIFTEEN POINT 5%
REPORTED USING E. CIGARETTES IN
TWENTY EIGHTEEN A 53% INCREASE
FROM TEN POINT ONE PERCENT. IN
TWENTY SEVENTEEN. DESPITE RAPID
UPTAKE IN YOUTH AND YOUNG
ADULTS ONLY THREE POINT 5% OF
ADULTS AGE THIRTY OR OLDER
REPORTED EASE CIGARETTE USE IN
TWENTY EIGHTEEN. AS THATTHAT A
CHERUB PAN MENTION THIS IS
LARGELY AN EPIDEMIC OF THE
YOUNG. FLAVORED TOBACCO PART OF
PRODUCTS ARE PARTICULARLY
FAVORED AMONGST YOUTH ACCORDING
TO THE TWENTY EIGHTEEN
CALIFORNIA STUDENT TOBACCO
SURVEY. EIGHTY SIX POINT 4% OF
CALIFORNIA HIGH SCHOOL STUDENTS
WHO USE THE CIGARETTES REPORT
USING A FLAVORED PRODUCT.
COMPARED WITH THE COUNTRY AT
LARGE EASE CIGARETTE USE A
MONTH CALIFORNIA HIGH SCHOOL
STUDENTS IS SUBSTANTIALLY LOWER
HOWEVER I THINK WE WOULD ALL
AGREE THAT 10% OF CALIFORNIA'S
YOUTH REPORTING USING E.
CIGARETTES IS ALARMING AND
UNACCEPTABLE. WHEN SPEAKING OF
YOUNG ADULTS AGES EIGHTEEN TO
TWENTY FOUR YEARS OF AGE
CALIFORNIA'S DOING WORSE THE
NATIONAL STATISTICS NATIONALLY
SEVEN POINT 6% REPORTED USING
IN TWENTY EIGHTEEN COMPARED
pWITH OUR RATE OF FIFTEEN POINT
5% OF THESE ADULTS. THE VAPING
EPIDEMIC AMONG TEENS AND YOUNG
ADULTS IS PARTICULARLY
CONCERNING BECAUSE NICOTINE IS
HIGHLY A DEATH ADDICTIVE AND IT
AFFECTS THE DEVELOPING BRAIN A
PROCESS WHICH CONTINUES THROUGH
YOUNG ADULTHOOD. MANY PEOPLE
ARE NOT AWARE THAT NICOTINE IS
A NEUROTOXIN OR A BRAIN POISON
RESEARCH SHOWS THAT NICOTINE
CAN AFFECT BRAIN DEVELOPMENT.
AND CAN WORSEN ANXIETY INCREASE
LEARNING DIFFICULTIES MOOD
SWINGS AND IMPULSIVITY
NICOTINE'S EFFECT ON THE
DEVELOPING BRAIN CAN BE
PERMANENT. INFORMATION ON THE
MORE GENERAL ADVERSE HEALTH
AFFECTS OF THE CIGARETTES AND
VAPING NICOTINE PRODUCTS
CONTINUES TO EMERGE. ONE RECENT
STUDY SHOWED LONG TERM HEALTH
EFFECTS ASSOCIATED WITH VAPING
NICOTINE THAT INCLUDED
INCREASED RISK OF LUNG RELATED
ILLNESSES SUCH AS CHRONIC
OBSTRUCTIVE PULMONARY DISEASE
CHRONIC BRONCHITIS EMPHYSEMA
AND ASTHMA BY A THIRD COMPARED
WITH THOSE WHO NEVER SMOKED
DEBATE. E. CIGARETTE USE IS
ALSO BEEN ASSOCIATED WITH AN
INCREASED RISK FOR HEART
DISEASE GUM DISEASE AND TOOTH
DECAY. NOW TURNING TO A VOLLEY
VITAMIN E. ACETATE HAS BEEN
IDENTIFIED AS THE MOST LIKELY
CULPRIT OR CHEMICAL OF CONCERN
FOR THIS SPECIFIC OUTBREAK BY
THE CDC AND FDA. IT WAS THOUGHT
TO HAVE BEEN INTRODUCED INTO
THE UNREGULATED MARKET PLACE AS
A DILUENT IN THC VAPING
PRODUCTS THAT SAID WE CANNOT
RULE OUT THE POSSIBLE
CONTRIBUTION OF OTHER
CHEMICALS. INCLUDING BECAUSE
SOME OF THOSE AFFECTED REPORT
HAVING ONLY USED NON THC VAPING
PRODUCTS. FIRST LET ME SHARE A
BIT ABOUT THE SCOPE OF THE
OUTBREAK ITSELF IT WAS FIRST
REPORTED IN AUGUST OF TWENTY
NINETEEN AND BY JANUARY TWENTY
TWENTY THE CENTERS FOR DISEASE
CONTROL AND PREVENTION REPORTS
TWO THOUSAND SEVEN HUNDRED
ELEVEN CASES AND SIXTY DEATHS
NATIONWIDE. IN CALIFORNIA AS OF
FEBRUARY ELEVENTH THIS YEAR.
THIRTY ONE CALIFORNIA CAUGHT A
COUNTIES HAVE REPORTED CASES
TOTALING TWO HUNDRED AND EIGHT
CASES WITH FOUR DEATHS IN OUR
STATE. THE MEDIAN AGE OF THOSE
AFFECTED IN CALIFORNIA IS
TWENTY FIVE WITH AN AGE RANGE
FROM FOURTEEN TO SEVENTY YEARS.
62% OF THOSE REPORTED WERE MALE
38% FEMALE ALL IN ALL THE CASES
THAT WERE HOSPITALIZED AND OF
THOSE OF 45% REQUIRED INTENSIVE
CARE. AND 28% REQUIRED
MECHANICAL VENTILATION. A VAST
MAJORITY OF PATIENTS 83%
REPORTED RECENTLY VAPING THC
PRODUCTS MOST OF WHICH WERE
REPORTED TO BE HAVE BEEN
ACQUIRED FROM NON REGULATED
SOURCES. THE DEPARTMENT'S
PUBLIC HEALTH LABORATORY WHICH
IS LOCATED IN RICHMOND HAS BEEN
TESTING LIQUID FROM VAPING
PRODUCTS- THAT HAVE BEEN
VOLUNTARILY RECOVERED FROM
PATIENTS WITH A VOLLEY. FORTY
NINE OF THE EIGHTY SEVEN
PRODUCTS TESTED IN THESE
REPRESENT TWENTY FOUR PATIENTS
CONTAINED T. H. C. FORTY ONE OF
THESE CONTAINS VITAMIN E. OR
VITAMIN THE ACETATE. THE PEAK
OF THE OUTBREAK WAS IN
CALIFORNIA WAS BETWEEN AUGUST
AND OCTOBER AS OF FEBRUARY THE
OVERALL NUMBER OF CASES HAS
SLOWED IT TO THREE TO FIVE
CASES PER WEEK. WHEN NEWS BROKE
UP INITIALLY BROKE OF THIS
NEWLY DESCRIBED CLUSTER OF
CASES ARE DEPARTMENT WAS QUICK
TO RESPOND WE ACTIVATE OUR
DEPARTMENT'S EMERGENCY
RESPONSE. AND LAUNCH THESYSTEM
OF THAT THOUGHT A QUICK
COLLECTING INFORMATION ON
POTENTIAL NEW CASES. ON AUGUST
NINTH AUGUST TWENTY SEVENTH AND
OCTOBER FIRST WE RELEASED
INFORMATION AND GUIDANCE TO
HEALTHCARE PROVIDERS ALERTING
THEM TO THE VAPING RELATED LONG
INJURY OUTBREAK. THE ADVISORIES
ALSO FOCUSED ON THE
IDENTIFICATION REPORTING AND
TREATMENT OF THE VOLLEY. WE
ALSO STARTED COMMUNICATING WITH
THE PUBLIC EARLY IN THE OUT
BREAK THE DEPARTMENT ISSUED AN
INFORMATIONAL HEALTH ADVISORY
ON SEPTEMBER TWENTY FOURTH AND
ESTABLISHED AN EVIL THE
WEBSITE. FOCUSED ON SHARING
INFORMATION ABOUT THE SYMPTOMS
OF THE VALLEY AND ENCOURAGING
EVERYONE TO REFRAIN FROM VAPING
NO MATTER THE SUBSTANCE OR
SOURCE UNTIL THE CURRENT
INVESTIGATION COULD BE
COMPLETED. IN THE NATION WIDE
EFFORT TO DETERMINE TE CAUSE
MANY STATES ARE PROVIDED
RECOVERED VAPING PRODUCTS TO
THE FDA. OUT FOR TESTING OF
RESIDUAL LIQUID WE'VE ALSO
SHARED PRODUCTS AND PATIENT DE
IDENTIFIED CASE DATA WITH THE
FDA TO CONTRIBUTE TO THE
NATIONAL INSPECTING CATION. THE
DEPARTMENT THE VOLLEY TEAM IS
COORDINATED WITH THE CDC AN
ESSENTIAL PARTNER IN
DETERMINING THE CAUSE SINCE
CALIFORNIA'S CASES WERE FIRST
IDENTIFIED EACH WEEK THE
DEPARTMENT SHARES UPDATED CASE
COUNTS AND PATIENT INFORMATION
WITH THE CDC. THE DEPARTMENT
AND IN PARTICULAR THE LAB THE
RICHMOND LABORATORY SCIENCE
TEAM ALSO SERVES A LEADERSHIP
ROLE ON NATIONAL VAPING TASK
FORCES- ONE OF WHICH IS WITH
THE COUNCIL OF STATE AND
TERRITORIAL EPIDEMIOLOGISTS.
THE CITY WILL BE WINDING DOWN
ITS NATIONALLY LED OUTBREAK
INVESTIGATION BY THE END OF
FEBRUARY IN OUR DEPARTMENT IS
MOVING TOWARD STANDARDIZING.
SURVEILLANCE OF THIS NEWLY
DESCRIBES CONDITION ON GOING WE
BELIEVE IT'S ESSENTIAL THAT WE
REMAIN VIGILANT. IN CASE OF
FUTURE OUTBREAKS. THE
CONVERGENCE OF AN EPIDEMIC OF
DATING NICOTINE IN TEAMS AND
THE OF ALI OUTBREAK RECEIVED A
SWIFT RESPONSE FROM GOVERNOR
NEW SOME AS YOU'RE AWARE HE
ISSUED AN EXECUTIVE ORDER ON
SEPTEMBER SIXTEENTH TWENTY
NINETEEN. PURSUANT TO THIS
ORDER ON OCTOBER TWENTY FIRST
TWENTY NINETEEN THE DEPARTMENT
DEVELOPED AND RELEASED A RAPID
RESPONSE ADVERTISING CAMPAIGN.
CALLED OUTBREAK. NOW NATIONALLY
RECOGNIZED THE OUTBREAK
ADVERTISING CAMPAIGN SOUGHT TO
REACH YOUNG ADULTS AGES
EIGHTEEN TO TWENTY NINE AND
PARENTS OF MIDDLE AND HIGH
SCHOOLS TEENS. THE OB THE
OBJECTIVE OF THE YOUNG ADULT
CAMPAIGN WAS TO DISSUADE YOUNG
PEOPLE FROM VAPING AND TO
DECREASE THE INCIDENCE OF LONG
ILLNESS OUTBREAK. ASSOCIATED BY
VAPING. FOR PARENTS OBJECT WAS
TO RAISE THEIR AWARENESS ABOUT
THE HEALTH HARMS OF VAPING AND
FOR THEM TO INITIATE
CONVERSATIONS WITH THEIR
CHILDREN. THE PARENT TARGETED
MEDIA CAMPAIGN AIRED IN SEVEN
LANGUAGES INCLUDING SPANISH
MANDARIN CANTONESE KOREAN.
VIETNAMESE AND TO GARLIC.
LUMINARY VALUATION OF MEDIA
RESULTS HAS SHOWN THAT WAS
EFFECTIVE AT DRIVING VIEWERS TO
THEIR WEBSITES. ANOTHER KEY
APPROACH TO ADDRESSING USE
VAPING IS BY INCREASING THE
PRICE OF THESE PRODUCTS BECAUSE
YOUTH ARE EXQUISITELY SENSITIVE
TO PRICE. GOVERNOR NEWSOME IN
THE TWENTY TWENTY ONE BUDGET
PROPOSES A NEW NICOTINE CONTENT
BASED EASE CIGARETTE TAX TO
BEGIN ON JANUARY FIRST TWENTY
TWENTY ONE. THIS TAX WOULD BE
IN ADDITION TO THE CURRENT TAX
AND IT WOULD BE AT A RATE OF
TWO DOLLARS PER FORTY
MILLIGRAMS OF NICOTINE IN THE
PRODUCT. IN ADDITION TO THE TAX
COVER NEWSOME IS INDICATE
GOVERNOR NEWSOME HAS- INDICATED
SUPPORT FOR A STATEWIDE BAN OF-
THE SALE OF ALL FLAVORED
TOBACCO. WE BELIEVE THAT THESE
ARE KEY STEPS TO COMBAT THE
RISE IN YOUTH VAPING I
APPRECIATE THE OPPORTUNITY TO
PROVIDE THIS INFORMATION TO THE
COMMITTEE I LOOK FORWARD TO
WORKING WITH YOU ON IS
IMPORTANT ISSUES AND I WOULD
URGE THE COMMITTEE TO VIEW OUR
DEPARTMENT AS A RESOURCE AS YOU
CONSIDER POLICY. IN THIS AREA.
THANK YOU SO MUCH DOCTOR ANGEL
A QUESTION FROM COMMITTEE
MEMBERS. A CENTER HELP IT THANK
YOU MISTER THANK YOU DOCTOR FOR
BEING HERE TODAY IT'S MUCH
APPRECIATED OF THE TALK TO
CERTAINLY ABOUT FLAVORS AND THE
EPIDEMIC THAT WE'RE FACING BUT-
IT WHAT ROLE DO YOU SEE
FLAVORED PRODUCTS. CLEAN IN THE
EPIDEMIC AND MORE BROADLY IN
TERMS OF THE YOUTH PART OF THAT
EPIDEMIC AND FLAVORED TOBACCO
YEAH WE KNOW THAT YOUTH UP ARE
PARTICULARLY ATTRACTED TO
FLAVOR PRODUCTS THEY SELF
REPORT VERY HIGH USAGE OF THESE
PRODUCTS OVER UNFLAVORED AND
THEY MAKE THEM EASIER FOR IT
USED TO USE WE THINK THAT THEY
ARE. A KEY AND VERY IMPORTANT
ATTRACTED THIS BEEN USED TO
ENGAGE YOUTH IN INVADING WHEN
IN FACT- THESE PRODUCTS TO NAME
EVEN BE AVAILABLE TO THEM SO WE
THINK IT'S INCREDIBLY IMPORTANT
STEP TO REMOVE A FOR ACCESS TO
AND TO SUPPORT THE REMOVAL OF
THE- LABOR PRODUCTS. HE'S THE
QUESTIONS. MAY HAVE A COUPLE
MYSELF BUT I DO ENJOY FIRST OF
ALL I WANT A- APPRECIATE IN
YOUR PRESENTATION YOU TALKED
ABOUT THE ROLE OF THE BRAIN- IN
NICOTINE BECAUSE OFTENTIMES WE
TALK ABOUT TOBACCO WE TALK
ABOUT LUNGS AND CERTAINLY WE
ONLY TALK ABOUT LUNG CANCER
PREVENTION AND- WE TALK ABOUT
IT WE THE BALI IS A LONG LONG
CONDITION RIGHT- AND SO OFTEN
TIMES THE FOCUSED ON THE LONG
BUT I APPRECIATE AS A-
PHYSICIAN MYSELF. THE REAL
CHALLENGE ACTUALLY THE BRAIN.
IT'S NICOTINE GETTING TO THE
BRAIN THAT THEN COMPELS THE
PERSON TO THEN SEEK OUT WHETHER
COMBUSTIBLE CIGARETTE OR SOME
OTHER TOBACCO ALTERNATIVES-
THAT AND INJURES THE LONG AND
OTHER ORGANS. SO I JUST WANNA
THANK YOU FOR HIGHLIGHTING THAT
BECAUSE I THINK TOO OFTEN WE
TALK ABOUT TOBACCO WE TALK OF
WE DO NOT TALK ABOUT THE BRAIN
ITSELF. AND THE IMPACT IT HAS
ON THE BRAIN. SO YOU KNOW THE
NUMBER OF CASES OF THE OF ALL
THE HAVE DROPPED YOU HAVE
TALKED ABOUT SOME OF THE THINGS
IT MINISTRATION HAS ALREADY
DONE- TO TRY TO- WARNED- USE
AND PARENTS ABOUT THE- THE
HAZARDS OF VAPING BUT CAN YOU
BABY. TALK A LITTLE BIT MORE
ABOUT- GREAT CASES ARE DOWN-
PROBLEM SOLVED THE WE DON'T
NEED TO WORRY ABOUT THIS I MEAN
WHAT'S WHAT'S DRIVING THE CASES
DOWN OF ALL THE I MEAN IS IT-
THE BLACK MARKETS DRIED UP- IS
IT'S JUST PEOPLE OR DOUBTS MORE
SCARED TO. NOT VOTING IT CAN.
IS THERE IS THERE INFORMATION
TO THE PUBLIC HEALTH IS TO.
CERTAINLY VERY HAPPY THAT'S
HAPPENING. BUT CAN YOU MAYBE
SPEAK TO. MISTER DATA ABOUT
WHAT WHY THE NUMBER OF CASES IS
DOWN LIKE WHAT WE DOING RIGHT.
YES WE DON'T HAVE AN EXACT-
ANSWER TO THAT QUESTION BUT
ABSOLUTELY TO YOUR POINT- IT
COULD BE DUE TO BEHAVIOR CHANGE
SO INDIVIDUALS MAY BE
RESPONDING. BEING ARE AT AT
ADVICE THAT THEY STOP EATING
INTO VAPING AND PARTICULARLY
THOSE PRODUCTS THAT THEY GET
FROM THE INFORMAL MARKET IS
CERTAINLY IT BEEN DEMO. THAT BY
YEAH. WE BELIEVE ME THE CALL
HAS BEEN THE IN THE INFORMAL
AND- MARKET AND THEREFORE BY
PEOPLE NOT USING THOSE AND ALSO
POTENTIALLY THAT MOVING OUT OF
THE MARKET- MAKES IT MORE LESS
LIKELY THAT PEOPLE WOULD BE
EXPOSED TO IT- BUT- AS I
MENTIONED WE REMAIN VIGILANT
IT'S NOT CLEAR. THAT THIS IS-
GONE FOR EVER AND THEREFORE ARE
CONTINUING SURVEILLANCE AND
INVESTMENT IN SURVEILLANCE OF
THESE PRODUCTS IS GOING TO BE
IS GOING TO BE KEY GOING
FORWARD. OKAY AND THEN. CAN YOU
JUST SPEAK TO SO WE ONLY KNOW
THAT- FLAVORED TOBACCO PRODUCTS
INCLUDING- VAPING FLAVORS ARE
POPULAR WITH USE- SOMETIMES
SOME PEOPLE ARGUE THAT WELL YOU
KNOW THE OLD LIKE THEM TO AND-
BUT. TERM TO SMOKING SUS. SINCE
THAT'S ONE OF OTHER CLAIM. DO
YOU TRAVESTY TO THE NASA. OUR
LACK OF FLAVOR. AT SOMEONE TO
WAS TO. THE FOR NOW SEEKING TO.
QUIT TODAY TO HOW PHONE ROLL
THIS LEAVING PLAY AND THE
CHOICES THEY MAKE IN THAT CASE.
SO IT A COUPLE OF THE POINTS
YOU MAKE FIRST OF ALL. IN THE
DOTS OVER THIRTY I'D MENTION
THAT IS JUST OER 3% THAT
ACTUALLY RIGHT USE THESE
PRODUCTS SO LET'S BE VERY
CLEAR. THAT THE REALLY WHO IS
USING THESE PRODUCTS ARE USE-
THEIR HIGH SCHOOL STUDENTS AND
YOUNG ADULTS THAT IS THAT IS
WHERE THE PREPONDERANCE OF USED
IS. WHEN IT COMES TO THINKING.
USING YOUTH THEY WEREN'T USING
IT BEFORE THEY'RE NOT USING IT
TO SORT OF WEAN OFF OF ANY
PRODUCTS SO THERE'S NO ARGUMENT
THAT CAN BE MADE FOR USE IN
THAT SENSE- IN ADULTS WE HAVE
AS MENTIONED EARLIER A NUMBER.
OF DEMONSTRATED EVIDENCE BASED
APPROACHES TO SMOKING CESSATION-NICOTINE REPLACEMENT PRODUCTS
THAT EXIST. THEREFORE FIRST AND
FOREMOST FOR THOSE ADULTS THAT
VERY SMALL PERCENT OF ADULTS
OVER THE AGE OF THIRTY WHO
ACTUALLY USING THESE PRODUCTS
FOR SMOKING CESSATION THERE ARE
ALL OTHER ALTERNATIVES. OF
THEIR CERTAINLY ON THE MARKET
PLACE FOR THEM. SO TO JUSTIFY
KEEPING FLAVORED PRODUCTS
SPECIFICALLY. ON THE MARKET FOR
THAT VERY SMALL- PERCENT OF
ADULTS IT'S NOT CLEAR TO ME
THAT THAT THAT EVIDENCE SPACES
BEEN CREATED THAT IT'S
NECESSARY FOR THEM TO STOP
SMOKING. BUT WHAT IS VERY CLEAR
WITH BUT IN SUPPORT ABSOLUTELY
IS THOSE THAT. THOSE PARKS ARE
BEING USED BY AND LARGE BY OUR
YOUTH AND THAT'S WHAT I THINK
WE'RE ALL HERE TALKING ABOUT
TODAY. ANY OTHER QUESTIONS ALL
RIGHT WELL I WANT THANK YOU
VERY MUCH FOR YOUR
PRESENTATION- APPRECIATE- USE
THE THAT THE ANSWERS YOU GAVE
THE SAID THREE ONLY 3% LOAN
ADULTS SO WITH SETS THREE POINT
5% OF ADULTS OVER THE AGE OF
THIRTY RIGHT COMPARED TO THE
PERCENTAGE IN OUR YOUTH OUR
YOUTH WHICH IS ABOUT ONE
INTENDS A LITTLE OVER 10% AND
IN OUR YOUNG ADULTS- FIFTEEN
POINT FIVE PERCENT. SAYS LIFE
HAVING TO KEEP IN MIND AS WE'RE
TALKING ABOUT WHO'S REALLY
WHOSE WHOSE LIVES ARE AT STAKE
FROM FROM THIS EPIDEMIC LOT OF
PEOPLE BEING EXPOSED TO
NICOTINE THAT'S CORRECT BURNED
USE THANK YOU SIR REMEDY THANK
YOU VERY MUCH. THANK YOU. RIGHT
CASE ONLY BE UP FOR NEXT
BECAUSE I KNOW LOW GUY ARE WORK
VERY HARD TO AND THEIR POLICIES
TREES ACCESS TO VAPING PRODUCTS
WE HAVE- DANIEL PRETTY CORD A
DIRECTOR OF PUBLIC HEALTH AND
CONTRA COSTA HEALTH SERVICES
AND- DOCTOR TRYSTS FOR NINETEEN
TEN FERNANDO OKAY HEALTH
OFFICER CONTRA COSTA I SHOULD
MAKE NOTE THAT- DOCTOR GOING
FROM THE SITTING COUNTY OF SAN
FRANCISCO WAS UNABLE TO MAKE IT
TODAY AND I THINK HAD TO DEAL
WITH THE VIRUS ISSUE OR
SOMETHING SO- BUT- AND- I KNOW.
THAT TO YOU WILL OF THE WILL
WILL BE ABLE TO ANSWER ME
QUESTION AND LOW FOR TO. A
WELCOME AND THANKS MUCH FOR
BEING. THANK YOU VERY MUCH A
PAY AND CAN MEMBERS I'M CORE
THE DRUG OF PUBLIC FOR CON
COSTA HOW SERVICES AND AS YOU
KNOW IN JOINT. BY CHRIS
FARRAKHAN OR ARE OFFICE AND
ALSO LIKE DIRECT. TO TOBACCO
STAFF TO MY AND MY LOPEZ WHO
REALLY HELPED US GET READY FOR
OUR PRESENTATION TODAY SO THANK
THE TWO OF YOU. WE VERY MUCH
APPRECIATE THE OPPORTUNITY TO
PROVIDE TESTIMONY TO THE
COMMITTEE AND OFFER SOME
INSIGHTS AS TO HOW WE ARE USING
LOCAL POLICY. TO ADDRESS THE
EPIDEMIC OF YOUTH USE OF
TOBACCO RELATED PRODUCTS
SPECIFICALLY VAPING PRODUCTS.
IN TWO THOUSAND AND SIXTEEN
CONTRA COSTA WORST WITNESS THE
START OF AN ALARMING INCREASE
IN THE PREVALENCE OF YOUTH
VAPING AS THE SLIDE
ILLUSTRATES. THE SLIGHTEST
ILLUSTRATE SYSTEM THREE OF OUR
LOCAL HIGH SCHOOLS. YOU NOTICE
THAT MARTINEZ HIGH SCHOOL
JUMPED FROM 8% OF ELEVENTH
GRADERS WHO SAID THEY HAD Vì
IN THE PAST THIRTY DAYS 230% IN
THE TWO YEARS BETWEEN THE
SURVEY PERIODS ADDITIONALLY IN
THIS IS NOT ON THE SLIDE. IN
THE TWO THOUSAND AND SEVENTEEN
EIGHTEEN SURVEY ACALANES HIGH
SCHOOL WHICH IS IN LAFAYETTE.
WAS NOTED AS HAVING THE HIGHEST
RATE OF YOUTH BEEPING IN THE
ENTIRE BAY AREA 25% AT THE TIME.
IN RESPONSE TO THIS URGENT
PUBLIC HEALTH CONCERN. THE
CONTRA COSTA ADOPTED AN
ORDINANCE TO BAN THE SALE OF
FLAVORED TOBACCO PRODUCTS IN
PROXIMITY TO YOUTH SENSITIVE
AREAS THIS INCLUDED FLAVORED E.
CIGARETTES IN JULY OF TWO
THOUSAND AND SEVENTEEN.
SUBSEQUENTLY WITH THE EMERGENCE
OF THE ACUTE VAPING ASSOCIATED
ILLNESS THE VALLEY. AND
REFLECTING ON THE DATA WE'VE
PRESENTED THE CONTRA COSTA
BOARD OF SUPERVISORS EXTENDED
THEIR BAN ON FLAVOR TOBACCO
PRODUCTS TO THE ENTIRE
UNINCORPORATED COUNTY. IN THE
FALL OF TWO THOUSAND NINETEEN
JUST VERY RECENTLY. AND
ADDITIONALLY WE BANNED THE SALE
OF ALL THE PING PRODUCTS IN THE
UNINCORPORATED COUNTY. THIS
SPECIFIC ACTION WAS TAKEN IN
RECOGNITION THAT NONE OF THESE
PRODUCTS HAVE YET MET THE
REQUIRED FDA PREMARKET REVIEW
AN AUTHORIZATION PROCESS THAT
WENT INTO EFFECT IN AUGUST OF
TWO THOUSAND AND SIXTEEN. YOU
MAY BE AWARE THAT ON SEPTEMBER
TWENTY FIFTH TWO THOUSAND AND
NINETEEN BEFORE THE U. S. HOUSE
SUBCOMMITTEE. ON OVERSIGHT AND
INVESTIGATIONS DR NORMAN
SHARPLESS THE INTERN DIRECTOR
OF THE U. S. FOOD AND DRUG
ADMINISTRATION STATED. NO
ELECTRONIC NICOTINE DELIVERY
SYSTEM PRODUCT IN THE UNITED
STATES IS ON THE MARKET
LEGALLY. ALL E. CIGARETTES
CURRENTLY ON THE MARKET ARE
ILLEGAL BECAUSE THEY HAVE NOT
BEEN ASSESSED BY THE FDA. HENCE
THE IMMEDIATE GOAL OF THE
CONTRA COSTA ORDINANCE WAS TO
CREATE CONDITIONS IN THE RETAIL
ENVIRONMENT THAT ARE PROTECTIVE
TO YOUTH IS WE'VE NOTED IS A
YOUTH EPIDEMIC. IF THE EXPOSURE
TO FINE PARTICULATE MATTER
WHICH IS A BIG DEAL. AND
TOBACCO CONSTITUENTS IS NOT
ENOUGH. WE'VE MENTIONED TODAY
THAT THESE PRODUCTS CONTAIN ONE
OF THE MOST ADDICTIVE
SUBSTANCES EVER PUT IT THE
CONSUMER PRODUCT NICOTINE. AND
MORE IMPORTANTLY THE STANDS TO
DRAMATICALLY REVERSE DECADES
LONG TREND. IN TOBACCO
PREVENTION WE SEEN A COMPLETE
TURNAROUND. IT IS OUR HOPE THAT
THESE ACTIONS WILL HELP CURB
THE SURGE IN YOUTH USE WHICH IN
TURN WILL YIELD LONG TERM
HEALTH IMPROVEMENT AND PREVENT
COUNTLESS NUMBERS OF CASES OF
RESPIRATORY ILLNESS CANCER AND
DEATH NOT TURN IT OVER TO DR
FARZANA. SO IN TOTAL CONTRA
COSTA COUNTY HAS NINETEEN
DIFFERENT CITIES AS WELL AS THE
UNINCORPORATED AREAS THAT WE
HAVE TO WORK WITH TO TRY TO
ALIGN OUR- TOBACCO PREVENTION
POLICIES AND REGULATION AND
THAT AS YOU CAN SEE ON THIS
MAP- THERE ARE FIVE
JURISDICTIONS WHICH ARE
OUTLINED IN IN GREEN INCLUDING
THE UNINCORPORATED AREAS. THAT
HAVE ALREADY ADOPTED A BAN ON
FLAVOR TOBACCO- IN THOSE FIVE-
JURISDICTIONS TWO OF THEM HAVE
ALSO- ADOPTED LIMIT AND- ON THE
SALE OF NON FDA APPROVED
BEEPING PRODUCTS SO ARE ARE
UNINCORPORATED COUNTY AS WELL
AS RICHMOND WHICH IS ONE OF OUR
LARGEST CITIES- AND AGAIN NONE
OF THE- VAPING PRODUCTS SOLD IN
CALIFORNIA. ES DE PENSION HAVE
ON WE ARE LEGAL IN THE NOT BEEN
REVIEWED BY THE FDA FOR EITHER
THEIR SAFETY OR THEIR
EFFECTIVENESS AND THESE ARE
DRUG DELIVERY DEVICES IN THE
FTA. IN A REALLY I SHOULD BE
AND HAS SO FAR NOT EXERCISED
ITS AUTHORITY TO REGULATE THESE
AND KEEP THESE OFF OF THE
MARKET. SO THE GOAL OF OUR
ACCOUNT ORDINANCE ON HAS TO BAN
THESE FLAVOR TOBACCO AND
BEEPING PRODUCTS IN ORDER TO
REDUCE. REDUCE THE USE ACCESS
AND EXPOSURE TO THESE A TOBACCO
PRODUCTS AND PREVENT A NEW
GENERATION OF USE BECOMING
ADDICTED. TO NICOTINE AND WE
KNOW FROM STUDIES WITH
CIGARETTES THAT YOU KNOW IT CAN
TAKE JUST A HUNDRED- CIGARETTES
SMOKED ANY USES ALREADY
ADDICTED AND WE KNOW WITH
PRODUCTS LIKE TOOL. FIVE OF
THOSE LITTLE CARTRIDGES HAVE AS
MUCH NICOTINE IS NOT A HUNDRED
CIGARETTES- IF YOU LOOK AT THEM
THIS NEXT MAP THE LITTLE DOTS
IN RED. ARE THE TOBACCO
RETAILERS THAT- ARE- AFFECTED
BY ORDINANCE AND AS YOU CAN SEE
MANY OF THESE ARE RIGHT ON THE
BORDERLINE BETWEEN
JURISDICTIONS THAT HAVE ADOPTED
FLAVOR RESTRICTIONS. AND THOSE
THAT DON'T HAVE ANY TOBACCO
PREVENTION PROP POLICIES. TO
USE CAN STILL ACCESS WEEPING
PRODUCTS AND FLAVORED TOBACCO
WHEN THEY GO SOMETIMES DOWN THE
STREET SOMETIMES JUST ACROSS
THE STREET OR NEXT DOOR FROM
ONE JURISDICTION. THAT
REGULATES THESE PRODUCTS AND
ANOTHER NEIGHBORING CITY THAT
DOES NOT AND THAT'S WHY IT IS
SO IMPORTANT THAT WE HAVE
STATEWIDE ACTION TO CREATE A
UNIFORM. REGULATORY ENVIRONMENT
AND ELEVEN LEVEL PLAYING FIELD
FOR RETAILERS- AND WHILE
FEDERAL ACTION IS CERTAINLY
WELL THE CURRENT FEDERAL
LOOPHOLE ON RECHARGEABLE
DEVICES IN REFILLABLE AND
DISPOSABLE DEVICES IS A REALLY
BIG CONCERN IN THERE ARE
ANECDOTES THAT YOUTH ALREADY
SWITCHING- TO THESE. DEVICES
THAT AREN'T GOING TO BE COVERED
BY CURRENT FEDERAL REGULATIONS-
SO IT'S REALLY STATE. STATE
ACTION IS SO IMPORTANT. THANK
YOU SIR MUCH QUESTIONS FROM
COMMITTEE MEMBERS CENTER LEYVA.
THANK YOU DOCTOR PAN THANK YOU
BOTH FOR BEING HERE WHEN YOU
TALK ABOUT THE RETAILERS DO YOU
KNOW HOW MANY VIOLATIONS CITY
RETAILER CAN GET BEFORE THEY
LOSE THEIR PERMIT. THERE'S BEEN
A QUESTION FOR RYAN BUT I
BELIEVE IT'S THREE. IS THAT
RIGHT SO WE HAVE A SORT OF A-
SUCCESSION OF PHONE OKAY OF
PENALTY IN AT THE THIRD ONE WE
CAN ACTUALLY REMOVE THEIR-
LOCAL. TOBACCO ILL THAT'S WHAT
HAVE A LOCAL TOBACCO LICENSING-
INITIATIVE IS REALLY IMPORTANT
AND DO WE FIND THE THAT
RETAILERS ARE VIOLATING THE-
VIOLATING THIS AND THAT THEY
ARE HAVING THEIR PERMITS PULLED
THAT'S FAIRLY REALLY WE'VE
FAIRLY RARE THAT THAT'S
HAPPENED IN OUR COUNTY I DON'T
THINK WE HAVE A SINGLE INCIDENT
WE WERE WHERE WE- ACTUALLY HAD
TO PULL LICENSE. IS IT BECAUSE
THEY'RE NOT VIOLATING THE LAW
OR BECAUSE THERE'S NOT SOMEONE
THERE TO POLICE THEM WELL IT
AYE AYE WE BELIEVE THAT IT'S
BECAUSE THERE ARE MORE OR LESS
COMPLIANT WE DO HAVE A FAIRLY-
AGGRESSIVE COMPLIANCE- YOU
SHOULD HAVE IN COOPERATION WITH
OUR LOCAL LAW ENFORCEMENT
AGENCIES. OKAY THANK YOU VERY
MUCH. SIR HILL THANK YOU MISTER
CHAIR AND IT USUALLY REQUIRES A
STING OPERATION IN ORDER TO
CATCH THEM AT THAT AND THAT'S
NOT ALWAYS THE EASIEST. TO PUT
TOGETHER WITH LAW ENFORCEMENT
TO THE TO THE CHALLENGE AND ON
THAT- IT YOU KNOW I APPRECIATE
THE FACT THAT IN IN CONTRA
COSTA WHICH IS REALLY GREAT
THAT THE- FIVE. HAVE FLAVORED
BANDS AND TO HAVE- VAPING
PRETTY MUCH PROHIBITIONS OUT OF
THE NINETEEN CITIES TO WHICH TO
ATTRIBUTE THE- ROAD BLOCKS IF
ANY THAT ARE. PREVENTING THOSE
OTHER JURISDICTIONS. PREVENT
LEAN FORWARD WITH SOME BANNERS
AND WHEN AND HOW CAN WE HELP
THAT THAT'S A GREAT QUESTION
AND- IT'S BEEN MY EXPERIENCE
AND MY OVER TWENTY YEARS AS A-
PUBLIC HEALTH DIRECTOR THAT.
CITIES LIKE TO SEE THEIR COUNTY
GO FIRST- IN JUST HAVING
RECENTLY PASSED THE COUNTY.
BàN ON. DATING PRADA IN I
THINK IT WAS NO FOR. THE LAST
YEAR WERE FOR OFFERED. NEW WITH
THIS THE REASON. OUR TEAM GOING
LITERALLY TO SEE. MAKING
MEETING WITH MAYOR AND OTHER
LIKE OFFICIAL. THE INTRODUCED
WHAT WE'VE DONE WE'RE STARTING
TO GET- A LOT OF CALLS FROM
CITIES OUT OF INTEREST SO.
SORTS ARE OPEN IN A YEAR. FROM
NOW WE WOLD HAVE. THE MORNING
OF OUR CITIES ARE DOT IMILAR
POLICIES. HOPEFULLY WE HELP YOU
WITH THAT THE ON THAT BE WONDER
I THINK IS. FAR MEANT THAT
WOULD BE THE RELIEF IDEAL HAVE
STAY. PAUL ON. THANK YOU VERY
MUCH FOR YOUR GREAT WORK AT THE-
GRASSROOTS ON THE TO HELP IN
SUBTLE AND WITH THANK YOU.
THANK YOU CHAIR. OTHER
QUESTIONS. HEY WHY WITH YOU SO
MUCH FOR YOUR FOR AND I HAVE A
FEW HERE NOW THE CITY OF A
BECAUSE THAT MATTER SO YOU CAN
YOU KNOW. A CAL WIDE MAY ARE
THE CITY ARE SO EACH CITY
SEISMIC ON THE CITY WE THE ON
IN COURT. BAND RIGHT THEN I
BELIEVE THIS OF RICH. HAS ALSO
A COME CITY BAN. ALL RIGHT SO
IT'S STILL KIND OF. AND THAT'S
ON THE PRODUCTS. OKAY WELL THIS
WHO HAVE BANNED FLAVORED
TOBACCO AS WELL OKAY. ALL RIGHT
SO- GIVEN YOUR CURRENT
EXPERIENCE AS SOME OF IT'S
FAIRLY RECENT- SO. AND YOU MAY
OR MAY NOT HAVE A THIS. WHAT DO
YOU SEE IS. HAPPENING TO- THE
PEOPLE WHO BASICALLY YOU WERE
DATING BEFORE ARE WE SEEING A
AND AGAIN RECOGNIZING THAT.
THERE WILL BE A SWISS CHEESE SO
MAYBE THE EASIEST THING FOR
PEOPLE SIMPLY MOVE YOU KNOW GO
BY FROM A JURISDICTION THAT
HASN'T THAT'S CLOSE ENOUGH
RIGHT. AS OF TWO IS A CHALLENGE
BUT- FOR EXAMPLE DO YOU SEE A
RISE AND BLACK MARKETS.
ACTIVITY WERE ARE IS THERE I'M
AND JUST TRYING TO GET A SENSE
OF- WHAT WOULD HAPPEN IF CIEL-
WHAT YOUR EXPERIENCES WHAT
HAPPENED AFTER THE BAND SO WHAT
WHAT HAPPENED TO THE PEOPLE WHO
WERE. INVADING BEFORE- THE
DISEASE THE VIEWS WE TALKED
ABOUT THE FACT THAT NICOTINE SO
ADDICTED RIGHT SO YOU HAVE TO
SO OBVIOUSLY WHAT IMPACT YOU
WANT TO HAVE THIS IS THAT THE
PEOPLE WHO. SMOKE ARE KEEPING
THEY JUST DON'T START RIGHT I
MEAN THAT THAT THAT IS GOAL
NUMBER ONE MUCH OKAY AND THAT
HOPEFULLY IS SOMETHING THAT WE
WILL SEE HAPPEN THAT MAKES IT
BASICALLY THEY WON'T SEEK IT
OUT. SINCE DESERVE IT ALL THE
HAVE THE GOING TO GRAD
SOMETHING. AND ANY OF PEOPLE
WHO BASED. AND ON THE- AND WHAT
DO THEY UP DOING THE- LETTER
PERCENT OF USING THE FIFTEEN
FOR. STAY THAT WE FOR SENATE
WHAT DID HE AND DOING ALSO YOU
SO WITH YOU HAVE A INFORMATION
ON THAT YOU'RE ABLE TO SHARE.
HER I REALIZE IS SOME OF THIS
IS FAIRLY RE. SO CAN YOU SPEAK
TO. I JUST TOLD A LITTLE BIT
AND RYAN. FEEL FREE TO COME UP
AND JOIN A YOU WISH TO THEY
COME THAT WHEN HE SPEAKS TO BE
JUST AND- SOME THAT'S GRAY I DO
THINK THAT INITIALLY THAT ARE
OUR GOAL WAS. CREATE FRANK TO
MAKE IT HARDER AND HARDER GET
THESE PRODUCTS IN OUR COUNTY
THAT THAT WAS NUMBER ONE GOAL
IT'S PROBABLY LITTLE EARLY TO
TELL IF THE BEEPING NUMBERS ARE
DOWN. WILL AND START SEE THAT
THE NEXT SURVEY PER IT'S FOR
BURKE THAT BE VERY LIST OF THE
STUFF FOR OF ACTUALLY BORNE
FRUIT I CAN'T. THE BLACK MARKET
ISSUE I DON'T KNOW IF YOU KNOW
ANYTHING BY THAT. WE ACTUALLY.
INSIDE MAKING SURE THAT THEY
UNDERSTAND THE NEW POLICIES
NOW- OUR- ORDINANCE WE DID GET
ADOPTED IN NOVEMBER AND IT
WASN'T EFFECTIVE THIRTY DAYS
LATER WHICH WAS IN DECEMBER.
AND THEN WE GAVE ABOUT FOUR
MONTHS OF- TO FOR OUR RETAILERS
TO BE IN COMPLIANCE SO- UP
UNTIL FIVE APRIL FIRST IS WHEN
WE'RE GOING TO BE ABLE TO
REALLY. KIND OF UNDERSTAND HOW
MUCH OF IMPACT THAT'S GONNA
AFFECT OUR UNINCORPORATED AREAS
BECAUSE RIGHT NOW WE REALLY
UNDERSTAND THAT TOBACCO
RETAILERS WHEN THEY NEED TO
ADJUST AS WELL WE'VE GIVEN THEM
THAT- YOU KNOW THAT. GRACE
PERIOD ALLOWING THEM TO SELL
OFF THEIR- THE REST OF THE
PRODUCTS AND NOT ALLOWING THEM
TO BUY ANYMORE- BEYOND WIND
DECEMBER ORDINANCE PASSED. BUT
ALSO LIKE TO ADD THAT THERE'S
REALLY NOT A LOT OF- FDA
APPROVED TOBACCO CESSATION-
DEVICES THAT ARE APPROVED FOR
USE CERTAINLY SOME PHYSICIANS
MAY USES OFF LABEL FOR USE BOTH
NICOTINE. REPLACEMENT THERAPY
AND MEDICATIONS LIKE ANTICS AND
APPROPRIATE ON- BUT I THINK THE
MOST IMPORTANT THING IS REALLY
PREVENTING YOU FROM GETTING
ADDICTED IN THE FIRST PLACE
THERE ARE A THING- PLACES LIKE
THE CALIFORNIA SMOKERS HELP
LINE IS DEVELOPING. IN OF
PEEPING FOCUSED- STRATEGIES TO
HELP PEOPLE GET OFF OF NICOTINE
BUT AGAIN THE- GATE KEEPING YOU
FROM GETTING ADDICTED IN THE
FIRST PLACE IS THE MAIN GOAL.
HI AND THEN I GUESS OTHER
QUESTION IS THE THIS IS REALLY
YOUR EXPERIENCE WELL CERTAINLY-
SO I KNOW THAT SOMETIMES WHAT
HAPPENS WHEN WE TALK ABOUT
BAKING LEGISLATION WE DO HAVE
RETAILERS COME UP AND SAY WELL.
YOU KNOW YOU'RE GOING TO KILL
MY BUSINESS NOW I THINK THERE'S
AN ARGUMENT ABOUT. DO YOU
SHOULD KNOW ABOUT SELLING
THINGS THAT ARE HARMFUL TO
PEOPLE BUT WE WERE BUT LET'S
JUST MOVE THAT TO THE SIDE
BRIEFLY HAVE YOU SEEN ANY
RETAILERS- GO OUT OF BUSINESS
BECAUSE OF THE BANDS THAT
YOU'VE PUT IN PLACE WE'VE NOT
AND I'M ASKING LEGAL AND TURN
THIS OVER TO RYAN TO MAKE SOME
COMMENTS BUT I THOUGHT IT WAS
ILLUSTRATIVE ONE RYAN SHARED
WITH ME THAT ONCE WE WENT TO
THE ENTIRE UNINCORPORATED
COUNTY IN BAND- FLAVORS AND
EVEN PRODUCTS RETAILER SAID.
THANK YOU BECAUSE NOW YOU'VE
CREATED A LEVEL PLAYING FIELD
FOR US. YEAH THAT WAS A REALLY
BIG DEAL FOR OUR RETAILERS
WANTED PARITY- THE TWO THOUSAND
SEVENTEEN ORDINANCE ONLY
ALLOWED- THOSE WITHIN WITH UP
OUTSIDE OF THE ONE THOUSAND
FEET BOUNDARY TO SELL AT THE
FLAVOR TO- TOBACCO SO WHEN WE
HAD THAT THROUGHOUT THE WHOLE
AND CORPORATE AREA IT ALLOWED
TO TOBACCO RETAILERS WE HAVE.
YOUR BILL. KNOWN TO THE- OF
TOBACCO. NOW SO FAR HAVE BEEN
YOU KNOW AT A BUSINESS I THINK
A FEW PEOPLE HAVE JUST DECIDED
WHEN. THEIR RENEWAL OVER THEIR
TOBACCO LICENSE- EXPIRED IN
DIDN'T WANNA- RENEW IT- BUT AT
THAT AT THE TIME WHAT WE ARE
GEARING TOWARDS IS REALLY-
HEALTHY NEW. HEALTHY RETAIL
RATE AND SO WE'RE TRYING TO
MAKE SURE THAT IN OUR EDUCATION
WITH OUR RETAILERS WE ALLOW
THEM TO REALLY UNDERSTAND TO BE
ABLE TO. DO MORE HEALTHY RETAIL
TO BE A LEADER IN THE COMMUNITY.
BUT I JUST YES I CERTAINLY.
WANT TO MAKE A COMMENT ABOUT
YOUTH- AND KEEPING THEM FROM
GETTING ADDICTED I REALLY JUST
WANT TO A SHOUT OUT TO SOME OF
THE STUDENTS THAT KERRY HIGH
SCHOOL IN POMONA. THEY ARE
CURRENTLY PARTICIPATING IN
SOMETHING CALLED THE SAMPSON
CHALLENGE WHERE THEY ARE TRYING
TO WIN MONEY SO THAT THE DEVICE
THAT THEY HAVE CREATED. TO
DETECT VAPING ON THEIR CAMPUS
WILL ACTUALLY BE THE BILL TO
PUT IT INTO PRODUCTION SO WE
EVEN HAVE YOUTH THAT ARE
WORRIED ABOUT OTHER YOUTH I
JUST MET WITH THEM ON SATURDAY
VERY IMPRESSIVE GROUP OF HIGH
SCHOOL STUDENTS SO. WE ALL WORK
TOGETHER WE CAN WIN TOGETHER.
CENTER HER TADA. I JUST WANT TO
GO AHEAD AND COMMENT IN AND
FOLLOW THAT. AT SO IN MY HOME
TOWN OUR CURRENT SINGER OUR
HIGH SCHOOL IS IMPLEMENTED
EIGHT EIGHT NEW PROGRAM WHERE
THEY HAVE THE BABY- DETECTION-
MONITORS. AND THE PROVIDE REAL
TIME- AT THAT INFORMATION- TO
THE ADMINISTRATORS I THOUGHT IT
WAS PRETTY INTERESTING SO.
THEY'RE GOING AHEAD AND
BEGINNING WITH THE
IMPLEMENTATION- PROCESS BUT THE
SAID REAL TIME ALERTS FOR QUICK
RESPONSE THEY ALSO AT THE IT
ALSO IDENTIFIES AGGRESSIVE
BULLYING AND- BEHAVIOR- I JUST
THOUGHT IT WAS. SOMETHING VERY
FASCINATING THAT I WANTED TO
SHARE WITH YOU THIS AFTERNOON
IF I'M SURE. THERE'S PROBABLY
SOME INFORMATION ALREADY OUT
THERE BUT- ALONG WITH THAT
THEY'RE ALSO LOOKING AT
INTERVENTION- NOT JUST
PUNISHMENT BUT HOW THEY'RE
GOING TO. CONTINUE TO. PUT A
PROGRAM IN PLACE THAT WILL HELP
THEM MOVE AWAY FROM IT. JUST
COMMENT ON THAT- WE HAVE SEEN
IN THERE AS A COALITION BETWEEN
THE REGIONAL BIT BAY AREA-
TOBACCO PREVENTION PROGRAMS A
LOT OF THE COUNTIES COME
TOGETHER AND WE TALK ABOUT THE
VAPING DEVICES AND WE HAVE-
KIND OF DISCUSS TO THE SUCCESS
OF THE OF THOSE DEVICES. A LOT
OF TIMES THEY DO DETECT THAT
THERE ARE THERE IS BEEPING
HAPPENING WENT ON A SATURDAY
AND NOBODY'S THERE SO- THERE'S
SOME LEVEL OF A- FALSE-
DETECTION SOMETIMES AND SO I
THINK- WORKING WITH THE
DEPARTMENT OF JUSTICE
CALIFORNIA DEPARTURES THIS WE
HAVE A GREAT WITH THE- WELL.
REALLY UNDERSTANDING STIFF I
WORK WHICH DO NOT IS REALLY
HELPFUL AS WELL SO JUST WANTED
TO COMMENT ON THAT. CERTAINLY
HEARING FROM SCHOOL MINUTE.
WHAT A BIG PROBLEM THE IS IT'S
OVER. THAT THE HIGH SCHOOLS AND
MIDDLE SCHOOLS IN THERE IF
THERE'S HAVING SPENT A LOT OF
RESOURCES TO TRY TO ADDRESS.
THIS ISSUE RATHER THAN FOCUS ON
TEACHING THEIR STUDENTS. THIRTY
DOLLARS. THANK YOU SO MUCH FOR-
THIS PANEL VERY ENLIGHTENING I
HAVE A QUESTION I ASKED-
SENATOR HILL I KNOW HE'S
OBVIOUSLY GOT THE BIG BILL AND-
HE'S ADDRESSED ONLINE SALES BUT
IS THERE ANY DATA POINT- IN
YOUR COUNTY ON ONLINE SALES AND
WHAT THAT LOOKS LIKE COMPARED
TO THE RETAIL ESTABLISHMENTS
JUST CURIOUS AS TO. WHAT THAT.
YEAH YEAH OF COURSE- SO WHEN.
THE CALIFORNIA HEALTHY KIDS
SURVEY- JAPAN THOUGH SOME OF
THE DATA THAT DâN ALREADY HAD
SHARED. WITHIN THE CALIFORNIA
HEALTHY KIDS SURVEY WE NOTICED
THAT- WHEN ELEVENTH GRADERS IN
THE ALL THREE SCHOOL DISTRICTS
THAT WE ASKED IT THEY NOTED
THAT. ABOUT 74277% SAID IT WAS
VERY EASY OR FAIRLY EASY. TO
OBTAIN KEEPING PRODUCTS NOW.
KIND OF. DISCUSSING WHERE THOSE
PRODUCTS WERE OBTAINED KINDA
LOOKING AT THE NATIONAL DATA AS
WELL AS THE STATE DATA- FROM
THE- CALIFORNIA STUDENT
TOBACCO- SURVEY WE SAW THAT
ONLY ABOUT LESS THAN NINE
PERCENT- WORD GETTING THEIR
PRODUCTS FROM- ONLINE. SO WHERE
ARE THEY GETTING THESE PRODUCTS
ABOUT 3031% SAID THAT THEY
WOULD BE BUYING THEM. FOR
THEMSELVES AT THE STORE. AND
THEN- THEY ALSO GET IT FROM
SOMEONE ELSE WHICH IS EITHER
THEIR FRIEND OR SOMEONE THEY
KNOW. ABOUT THE 6% SAID THEY
WERE BECAUSE THEY WERE GETTING
THAT FROM THERE UP FROM SOMEONE.
BILL CONLEY SALE WHEN THEY MAKE
THAT ARGUMENT IS IT'S TO SO FAR
WHAT WE KNOW IS THAT'S NOT
WHERE STUDENTS ARE GETTING IT
FROM. IT'S REALLY THE LOCAL
STORE FRONTS. BERRYHILL THANK
YOU MISTER CHAIR AND JUST TO
FOLLOW UP ON ON A SENATOR
GONZALEZ- COMMENTS ON THE ON
LINE WHICH IS SOMETHING THAT IS
REALLY OF CONCERN TO SO MANY OF
US THAT. IN THE LAST YEAR THIS
LEGISLATURE AND THE GOVERNOR
SUPPORTED WHICH TOOK EFFECT
JANUARY FIRST ALL ONLINE
PURCHASES OF. E. CIGARETTE OR
TOBACCO PRODUCTS NOW HAVE THE
SAME HAVE TO GO THROUGH THE
SAME QUALIFICATIONS AND
STANDARDS AS ALCOHOL DOES WORK
HAS TO BE DELIVERED TO SOMEONE
TWENTY ONE YEARS OF AGE SIGN
FOR THAT PRODUCT AS WELL SO. I
THINK WE'VE TRIED TO LOOK AT
THAT ISSUE TO CLEAN IT UP A
LITTLE BIT BECAUSE BY
UNDERSTANDING BEFORE WAS THAT
THEY WERE IN MANY CASES
THROWING IT ON THE DOORSTEP AND
PEOPLE WERE ABLE TO PICK IT UP
FROM THAT. AS WELL AND IN AN
INTERESTING ASIDE AND TALKING
ABOUT THE HIGH SCHOOLS IN THE
DETECTION AND- OF THE PAPER.
THE LIEUTENANT GOVERNOR WHO IS
A SPONSOR OF THE LEGISLATION I
HAVE THIS YEAR ON FLAVOR
TOBACCO- AND- IF AT U.
CIGARETTE BAND. SHE INDICATED
IN COMMON WITH HER SONS GO TO
HIGH SCHOOL IN SAN FRANCISCO
AND THAT. WHEN THERE IS- OF
RECESS OR A- YOU BREAKING
CLASSES THEY ALL FLED TO THE-
RESTROOM AND- BABY AND IT SETS
OFF THE ALARM TO SMOKE ALARMS
BECAUSE OF THE CHEMICAL.
COMBUSTION OUR WORKS WITHIN
THOSE. AND HAVE TO CLEAR THE
SCHOOL IN FIRE HAS TO COME IN
AND- AND- IT AND GO THROUGH
THAT WHOLE PROCEDURE OF MAKING
SURE THAT IT'S SAFE BEFORE THE-
THE HIGH SCHOOL STUDENTS CAN
COME BACK INTO SCHOOL SO IT'S
VERY DISRUPTIVE AS WELL AS A
PROBLEM SO THERE'S DETECTION
DEVICES. COULD BE HELPFUL TO
SOMEONE TO. GET BEFORE IT CAN
GET OUT OF HAND SO. THANK YOU
FOR THIS DISCUSSION TODAY WAS
REALLY WONDERFUL THANK YOU
PICTURE. AN EX UP FOR THE
RECORD AND SURE IF YOU
INTRODUCE YOURSELF THE RECORD
THIS. OF HIS YOUR NAME YOUR
POSITION AND- I APOLOGIZE MANY
WAS RIGHT SCHUMACHER ON THE
TOBACCO PREVENTION- MANAGER AT
CONTRA COSTA COUNTY. OKAY THANK
YOU JUST BECAUSE YOU'RE NOT
ACTUALLY FORMALLY ON THE
AGENDA- I'D SO LET ME ASK
ANOTHER QUESTION- I CAN ACT. I
CAN ASK THIS OF- DIRECTOR ANGEL
BECAUSE I KNOW THAT SHE IS A-
DEPARTMENT DIRECTOR AND- HAS TO
SUPPORT THE GOVERNOR'S BUDGET-
BUT FROM YOUR PERSPECTIVE AS
COUNTY HEALTH LEADERS- SO WHEN.
MAINLY FOCUSED ON THE POLICY
PART AROUND WILL BE A PASSING
LAWS OR SO FORTH- BUT NOW. IS
WE SAID THE OUR FIRST GOAL IS
TO PREVENT. YOUTH FROM STARTING
IN THE FIRST PLACE RIGHT AND WE
HOPE THE POLICIES WILL DO THAT
TO THIS WEEK'S WORK ON THOSE
POLICIES. SHE THE GOVERNOR'S.
LEADERSHIP AND THE PROPOSALS
THAT COME OUT HIS SUPPORT FOR
ELIMINATING- FLAVORS OF TOBACCO
PRODUCTS TO. THE PROPOSAL FOR
FUNDING- THROUGH A- ATTACKS ON
NICOTINE- BUT I ALSO RECOGNIZE
THAT- SAID WE HAVE PEOPLE RAVEN
EXPOSED. TO VAPING AND
EIGHTEEN- WHETHER THROUGH
VAPING WHICH IS WERE SENIOR USE
ARE POSSIBLE CIGARETTES- YOU
KNOW WHAT IS YOUR OF LIMITING
YOUR POLICY WE HAVE TO- WHAT.
OTHER THINGS SHOULD THE STATE
BE FUNDING TO ASIDE FROM DOING
OUR POLITICIAN A STATEWIDE
POLICY CHANGES IN ORDER TO BE
SURE WE- MITIGATE THE IMPACTS
THAT EVERY HAPPENED AS A RESULT
OF BEING IN TOBACCO SO FOR TO
WE EVER EXISTING PROGRAMS ARE
THERE. THINGS THAT WE NEED TO
DO IN TERMS OF EDUCATION OR
OTHER TYPES OF PROGRAMS IN
TERMS OF- YELLS SUBSTANCE VEGAS
NICOTINE TREATMENTS AT CETERA
SO CAN YOU MAYBE SPEAK TO WATER
MAYBE SOME OTHER THINGS THE
STATE SHOULD BE LOOKING AT
BEYOND JUST POLICY CHANGE IN
TERMS OF PROGRAMS THAT- WEEK.
SHOULD BE SUPPORTING- AND THAT-
COUNTIES WOULD BE LIKE YOURS
WOULD LIKE TO IMPLEMENT BEYOND
THE POLICY CHANGES YOU'RE
SAYING OKAY WHAT WELL WE MADE
THE POLICY CHANGE BUT NOW WE'RE
STILL DEALING WITH THESE ISSUES
RESULT IN BECAUSE OF THAT.
THAT'S A GREAT QUESTION AND-
MENTAL TICKET AT LEAST AN
INITIAL STEP BUT THAT BEFORE
CHRIS AND RYAN COMMENT BUT I
THINK AS WE ALL KNOW THE SINGLE%
MOST IMPORTANT TOOL WE ALL
HAVE. SITS ON THE DíAS- IT'S
PUBLIC POLICY RIGHT WE KNOW
THAT THAT MAKES A PROFOUND
DIFFERENCE IN SHAPING THE LIVED
ENVIRONMENT AND REALLY WHAT'S
AVAILABLE TO OUR YOUTH AND
GIVEN THE COMMENTS TODAY THAT
THIS REALLY IS A YOUTH EPIDEMIC
I WOULD- REFLECT THAT WE NEED
TO DO MORE- AROUND THE U.
CESSATION BECAUSE WE HAVE.
ADDICTED A NEW GENERATION OF
YOUNG INDIVIDUALS POTENTIALLY
WILL HAVE A LIFETIME OF NAKED
IN ADDITION MADE LEADS OTHER
FORMS OF ADDICTION THAT IS NOT
A GOOD THING. REPLY ON THE THAT
YOU THE WE HAD FAR LOW
JURISDICTIONS THEY COME BY TO
HE YOU SOME USED WAS AROUND OR
SO PERCENT. AND WE WERE ALL
KIND OF OR ON THE THAT UP
DECADE THAT FOR REALLY IT CEMEX
AND NOW THE IS TURNED AROUND A
NEED ISN'T SHORT YEARS. THAT
WOULD COMMENTS. I WOULD.
CONTINUE UNDER. OF SERVICE
SECOND CAN REALLY PHN
YOUTH EDUCATE YOU AND A CITY
YOU IN QUICKLY I MEAN THIS.
SMOKERS HELP LINE IS START TO
THE- TOOLS THAT ARE DIRECTLY-
FOCUSED ON VAPING USERS-
THERE'S OTHER- PRODUCTS LIKE
THIS TEXT TO CRITICS OF VAPING-
THAT- WORKS WITH- USERS. TO TAX
TO HELP GIVE THEM- ASSISTANCE
IN INCLUDING SO. SO BILLS YOU
KNOW IN MARKETING TO OUR
ADVERTISING PROMOTING-
CESSATION TO USE WAR CONTAINING
THE WARN THEM OF THE DANGERS-
ENCOURAGING THEM TO QUIT. AND
THEN PUT A PROVIDING SOME TOOLS
AND ASSISTANCE TO QUITTING. ON
TOP OF THOSE TWO SUGGESTIONS-
WE KNOW THAT THIS IS A YOUTH
EPIDEMIC. AND WE CANNOT KEEP
DOING THE SAME THINGS THAT
WE'VE DONE FOR ADULTS. AND
YOUTH ARE ONLINE IN THERE ON
SOCIAL MEDIA SO WHAT I WOULD BE
ASKING THEN IS FOR A FULL FOR
MORE FUNDING ARE BEEFING UP THE
FUNDING. ON REALLY BEING ABLE
TO ADDRESS THE BEHAVIOR IS THE
PERCEPTIONS AND ATTITUDES OF
VAPING PRODUCTS WITH THE YOUTH
AND ON THE YOUNG ADULTS. I MEAN
SAYIN THE SAME MESSAGE OVER
AND OVER IS NOT GONNA BE ABLE
TO ATTRACT THE USED TO BE UNDER
TO UNDERSTAND HOW MUCH. THIS IS
AFFECTING THEM BEING ABLE TO
REALLY AT THIS DISCUSS THAT.
THE PLATFORM THAT THEY'RE ALL
IN IN A PLACE AND A AND- DIRECT
WAY OF ADDRESSING THAT THROUGH
MEANS THAT THEY UNDERSTAND IS
THE BEST WAY TO REALLY GET THEM.
TO UNDERSTAND HOW MUCH THIS IS
AFFECTING THEM. OKAY ANY OTHER
QUESTIONS. NO WELL I WANT THANK
YOU VERY MUCH I DO I RECOGNIZE
THAT- YEAH AND THAT- THE
GOVERNOR DID. YOU KNOW- AND THE
ADMINISTRATION DID NOT TALK
ABOUT AN AD CAMPAIGN THAT THEY
DID OUTBREAK AND THE RESULTS OF
THAT BUT I THINK WHAT WE'RE
HEARING S THAT WE NEED TO
CONTINUE TO STAY IN THOSE
EFFORTS- SO. WE CERTAINLY ARE
GOING TO BE WORKING ON POLICY
CHANGE HERE APPRECIATE CENTER
HILLS LEADERSHIP. AND THAT- AND
OTHERS- BUT I THINK WE NEED TO
THINK IN ADDITION TO POLICY
CHANGE WE ALSO NEED TO SURE WE
SUPPORT OUR- STATE AND COUNTY
HEALTH OFFICES TO BE ABLE TO BE
FREE OF THE PROGRAMS- TO BOTH.
OF PREVENT OUR PEOPLE FROM
INITIATING TOBACCO AND ALSO
HELPED PEOPLE WHO UNFORTUNATELY
EVERY BEEN CAUGHT. IN NICOTINE
EXPOSURE AN ADDICTION TO HELP
THEM SO THAT THEY CAN HELP THEM
IN THEIR LIVES SO THANK YOU
VERY MUCH FOR YOUR
PRESENTATIONS. THANK YOU ALL
RIGHT. OKAY WE WILL NOW- OPEN
UP FOR PUBLIC COMMENT- SO AS
THE IF YOU CAN- ITS USE YOUR
SELF WITH YOUR NAME YOUR
ORGANIZATION IF YOU HAVE ONE
AND- ASKED IF YOU CAN TRY TO
KEEP YOUR COMMENT TO A MINUTE
OUR LESSON OF COURSE WE ALWAYS
HAPPY TO TAKE WRITTEN. THAT
TESTIMONY AND MATERIAL YOU CAN
HAVE THOSE TO THE SERGEANTS SO
WELCOME. THANK YOU. GOOD TO SEE
YOU AGAIN CENTER. UP THANK YOU
FOR THIS OPPORTUNITY MY NAME'S
DOCTOR SILVER FROM THE PUBLIC
HEALTH INSTITUTE. I JUST WANTED
TO COMMENT THAT THE DATA SHOWS
THAT THESE ARE TWO INEXTRICABLY
INTERTWINED EPIDEMICS. OF
CANNABIS AND- TOBACCO VAPING.
VAPING C. T. H. C. IS NOW
FOURTEEN POINT 3% OF TWELFTH
GRADERS THREE POINT 5% DAILY.
OUR APPROACH HAS FAILED TO
REGULATE THE CHARACTERISTICS
THAT MIMIC JUL. IN THE CANNABIS
MARKET INCLUDING VASTLY
INCREASED POTENCY. FLAVORED
PRODUCTS PRODUCTS LIKE PACKS
MANGO THAT SOUND LIKE THEY'RE
FLAVORED- AS WELL AS THE ISSUE
OF HARMFUL ADDITIVES. WE NEED
TO DEVELOP BOTH THROUGH THE
LEGISLATURE IN THROUGH THE
STATE. A COMPREHENSIVE
REGULATORY FRAMEWORK THAT IS
COHERENT ACROSS TOBACCO. AND
CANNABIS WE CAN'T SOLVE THIS BY
ADDRESSING. JUST ONE AND WE
HOPE TO COUNT ON THE HEALTH
COMMITTEE TO ALSO PROVIDE ITS
LEADERSHIP THANK YOU. THANK
YOU. WELCOME THANK YOU FOR THIS
OPPORTUNITY KELLY BEAM ON
BEHALF OF THE CALIFORNIA
MEDICAL ASSOCIATION WE- SUPPORT
CURRENT. USE OF TOBACCO
PRODUCTS- ACROSS DIFFERENT
MODES OF- APPROACH SO INCLUDING
THE NEW TOBACCO TAX. ARE THE
VAPING TAX AND THE STATEWIDE
FLAVOR BAND AND THEN ALSO I'M
EDUCATIONAL PROGRAMS AND
ENFORCEMENT- WE- YOU KNOW WE'RE
HOPE. HOPING THE NEW TAX
BECAUSE IT'S BASED ON LEVELS OF
NICOTINE IN THE PRODUCT AND NOT
JUST PER POD. THAT ITWILL HELP
TO REGULATE THE AMOUNT OF
NICOTINE INDUSTRY IS ABLE TO
LOAD THEM WITH AND MAYBE THEY
WILL BE USE AS A CESSATION
DEVICE IF THEY ARE. THEY DO
HAVE LESS NICOTINE- WILL ALSO
HELP CURB THE GROWING USE OF
DISPOSABLE E. CIGARETTES
BECAUSE WE SEE WITH THAT
NATIONAL BAND. KIDS ARE NOT
INTO DISPOSABLE PRODUCTS
BECAUSE IS THAT PAUL THANK YOU
OKAY THE YOU. WELCOME YOU CAN
OPERATE IS THERE BRIDGE TO ME
HAVE THOSE OF CALIFORNIA HOW
CARE DISTRICTS LIKE TO WRECK
THAT MAY OF OUR HEALTH DISTRICT
ENGAGING BEEPING SO OF
CALIFORNIA LOCALLY ESPECIALLY
AMONG YOUTH- THE ASSOCIATION
WOULD BE GRATEFUL TO SUPPORT
AND IS REALLY LOOKING FORWARD
TO STATEWIDE EFFORTS TO MAKE A
POLICY UNIFORM ACROSS
CALIFORNIA THANK YOU THANK YOU
WELCOME GOOD AFTERNOON MICHELLE
GIVENS WITH THE COUNTY HEALTH
EXECUTIVES ASSOCIATION A
CALIFORNIA AND WE'RE WE'RE
REALLY APPRECIATE OF THIS OF
THIS HEARING IN THE DISCUSSION
IT WAS HOT HERE TODAY FIRST AND
FOREMOST LET ME START BY SAYING
SENATOR HOW WE ARE GOING TO BE
IN STRONG SUPPORT OF YOUR BILL
SB SEVEN NINETY THREE. TO BAN
FLAVORS AND WILL CAN WE'VE DONE
THAT IN THE PAST AND WILL
CONTINUE TO DO SO- WE ALSO IN
TERMS OF SOLUTIONS OR WHAT CAN
BE DONE A FEW THINGS TO KEEP IN
MIND THERE ARE SOME BUDGET CUTS
THEY'RE HAPPENING TO TOBACCO
PREVENTION PROGRAMS THAT ARE
SLATED TO HAPPEN IN THIS BUDGET
PROCESS AND SO JUST ENSURING
THAT THOSE CUTTER BOX SOME
WEIGHTS SO THAT WE CAN CONTINUE
THE GOOD WORK THAT WE'RE DOING
ALREADY WOULD BE REALLY HELPFUL
AND TRAINERS BUT- ABLE TO USE
IT BOB BEYOND BEEPING ISSUE
RECEIPT TO YOU THAN A AND SO
FORTH SO JUST GIVING US THAT
FOR BILLY. THE OTHER PIECE THAT
I MENTION AS WE REPORTED THE
NICOTINE TAX THAT- THE
GOVERNOR'S PROPOSED AT ONE OF
THE THINGS THAT I WOULD JUST
NOTICE THE REVENUES IN TERMS OF
BEING PROVIDED TO BET TOBACCO
PREVENTION PROGRAMS ARE EIGHT
THE OTHER PIECE THAT I WOULD
JUST THINK ABOUT THAT WAS
SERVICE AND FROM A BROADER
PUBLIC HEALTH PERSPECTIVE AS
YOU HEARD LOCAL HEALTH
DEPARTMENTS ARE OFTEN IN IN LOT
HELLO F. AND WE WILL FOR ABOUT
HEALTH CARE FOR SURE STAND TO
SPECIAL AS THE- STAFF IN A TO
THE BEFORE SO JUST BUILD UP THE-
PUBLIC AND TRUCK SO THAT WE CAN
WORK. TO THE THAT THE ABOUT
EIGHT OR JUST. AN THE BUT WITH
THE FOURTEEN DOWN THE SAYS HE'S
ECHOING THE PRE OF THOSE HAVE
GONE BEFORE ME FOR THE NEED FOR
THIS HEARING AND THAT IS
HAPPENING TODAY- WE'VE BEEN A
LONG PROPONENT OF MEASURES TO
REDUCE THE NEGATIVE HEALTH
EFFECTS OF TOBACCO ADS
ESTIMATED THAT OVER 90% OF
CANCERS OF THE ORAL CAVITY ARE
DUE TO TOBACCO PRODUCTS. AND IT
IS THE SINGLE GREATEST
PREVENTABLE RISK FACTOR FOR ALL
CANCERS ALONG WITH OTHER DENTAL
AND ORAL DISEASES LIKE THAT
LEAD EVENTUALLY TO CANCERS AND
POTENTIALLY THE LOTS OF TEETH.
AS WELL NOTED TODAY FLAVOR
TOBACCO PRODUCTS ESPECIALLY
ELECTRONIC SMOKING DEVICES HAVE
THE POTENTIAL TO STAGNATE OVER
VERSE A DECADES LONG TREND. IN
THE DECLINE OF TOBACCO USAGE IN
THE STATE. AND OF GREATEST
CONCERN IS THE YOUTH. USE OF
TOBACCO PRODUCTS AND ESPECIALLY
OF FLAVORED TOBACCO. WE
STRONGLY SUPPORT THE EFFORTS OF
THE GOVERNOR AND THE
LEGISLATURE TO ADDRESS THIS
GROWING PUBLIC HEALTH CRISIS
INCLUDING THE BANNING OF
FLAVORED TOBACCO PRODUCTS IN
THE STATE. AND THE ALIGNING OF
THE TAXATION FOR ELECTRONIC
TOBACCO PRODUCTS WITH
TRADITIONAL TOBACCO PRODUCTS
THANK YOU VERY MUCH THANK YOU
AND THANK YOU FOR REMIND US
ABOUT THAT IMPACT ON ORAL
HEALTH AS WELL. WELCOME LIBBY
SANTOS ON BEHALF OF AS HE ARE
YOU CALIFORNIA I WANT TO ASK
YOU A CO EVERYONE'S COMMENTS OF
SUPPRESSING APPRECIATION FOR
HOLDING THIS HEARING I'M GONNA
HAVE SO MUCH GOOD INFORMATION
TO SHARE WITH MY THREE KIDS
TONIGHT SO I APPRECIATE THAT- I
JUST WANT TO. URGE THE
COMMITTEE AND OTHER MEMBERS THE
LEGISLATURE AS WE MOVE THROUGH
THIS PROCESS AND CONSIDER THE
TAX TO CONSIDER ALLOCATING SOME
OF THE FUNDING TOWARDS PUBLIC
HEALTH NURSES WHO ARE OFTEN NOT
ONLY IN UNDER USED RESOURCE BUT
IN A UNIQUE POSITION TO BE ABLE
TO HAVE DIRECT CONTACT WITH THE
MOST VULNERABLE AND
SUSCEPTIBLE. POPULATIONS THAT
ARE MOST AFFECTED BY THIS
FOSTER YOUTH SOCIO ECONOMICALLY
DISENFRANCHISED YOUTH OF TANTRA
THANK YOU. THANK YOU WELCOME.
GOOD AFTERNOON LYNN THE FREIGHT
IS AT THE CAMPAIGN FOR TOBACCO
FREE KIDS I THINK YOU SO MUCH
FOR HAVING THIS IMPORTANT
DISCUSSION TODAY AND FOR. THE
AMOUNT OF LEADERSHIP WE HAVE UP
IN FRONT OF US ON THIS ISSUE
MANY OF YOU HAVE HAD TAKEN A
VERY STRONG STANCE ON THIS. I
JUST WANT TO HIGHLIGHT THAT-
ALTHOUGH WE DO SEE THE EVIL IN
NUMBERS DROPPING ARGUES USE
NUMBERS ARE SKYROCKETING AND WE
PLEASE IT IS AN URGENT ISSUE
THAT WE TO DO SOME ABOUT. AND
SO WE'RE REALLY EXCITED
CONTINUE WORK WITH IF YOU UP
THERE'S- HELL ON FLAVOR TO.
POLICY WE FEEL THAT THE IS A
PRE STRESS TO KEEP. AWAY FROM
TRACK PRODUCTS. IT'S IMPORTANT
TO REMEMBER THAT WE NEED TO
ELIMINATE ALL FLAVORS ALL
FLAVORED TOBACCO PRODUCTS THAT
I AM AS A MUST SO WE DON'T HAVE
PRODUCT MIGRATION THANK YOU.
THANK YOU. WELCOME HELLO GOOD
AFTERNOON MEMBERS ERIC ACOSTA
WITH THE AMERICAN LUNG DISEASE
ASSOCIATION JUST WANT TO
REITERATE- THE COMMENTS THAT
HAVE BEEN SAID BEFORE THANK YOU
SO MUCH FOR THE ROBUST
DISCUSSION TODAY WE REALLY SEE
THIS IS SUCH AN URGENT ISSUE-
AND- THANK YOU SENATOR HEALTH
YOUR LEADERSHIP ON SB SEVEN
NINETY THREE REALLY. THINK THAT
FOR FLAVORS ARE THE ISSUE THAT
ARE HOOKING YOUNG PEOPLE AND
HOOKING ANOTHER GENERATION. AND
IF WE DON'T TAKE. MATTERS INTO
HER OWN HANDS RIGHT NOW WE'RE
GOING TO SEE MORE OF THIS
CONTINUING OVER TIME. AND JUST
REALLY APPRECIATE CONTINUE THE
CONVERSATION THANK YOU. THANK
YOU WELCOME. CHU REMEMBERS
ALTAMONT IN SMITH WITH THE
AMERICAN CANCER SOCIETY CANCER
ACTION NETWORK THANK YOU SO
MUCH AGAIN FOR YOUR LEADERSHIP
ON THIS- WE KNOW THAT THE BEST
WAY TO IN THIS EPIDEMIC IS TO
PROHIBIT THE SALE OF ALL
FLAVORS WITHOUT EXCEPTION AND
WE LOOK FORWARD TO WORKING WITH
YOU- TO MOVE FORWARD ON THAT
AND THANK YOU CENTER HEALTH FOR
YOUR LEADERSHIP ON THIS
ESPECIALLY. THANK YOU. WELCOME
HIGOOD AFTERNOON JAMIE MORGAN
WITH THE AMERICAN HEART
ASSOCIATION. LINE MY COMMENTS
WITH MY COLLEAGUES. I JUST WANT
TO THANK YOU FOR HOLDING THIS
HERE HEARING FOR CLEARLY IN THE
MIDST OF A BEEPING EPIDEMIC-
IT'S CLEAR WE NEED TO TAKE
URGENT ACTION. NOW I DON'T NEED
TO REITERATE ALL OF THE
STATISTICS AND INFORMATION
YOU'VE ALREADY HEARD. BUT IT IS
CLEAR THAT WE NEED TO DO
SOMETHING NOW IN THIS YEAR AND
THE AMERICAN HEART ASSOCIATION
BELIEVES ONE IMPORTANT POLICY.
AND KEEP POLICY IS TO BAN THE
SALE OF ALL FLAVORED TOBACCO
PRODUCTS. SO WE ARE HOPEFUL THE
LEGISLATURE WILL TAKE ACTION I
KNOW MANY OF YOUR SUPPORT AND
THANK YOU SENATOR HELEN WE
THANK THE GOVERNOR FOR.
RECOGNIZING IT IN HIS BUDGET.
THANK YOU. THANK YOU. WELCOME
GOOD AFTERNOON VANESSA QUE
HANNAH ON BEHALF OF THE
CALIFORNIA ACADEMY OF FAMILY
PHYSICIANS WE REALLY APPRECIATE
THE PLATFORM THAT'S BEEN
OFFERED THIS AFTERNOON AND WE
BELIEVE. THAT THE TENANTS
PREVENTION ARE PART THE MOST
IMPORTANT PART OF THIS
CONVERSATION THAT INCLUDES THE
TAX EFFORTS IN THE GOVERNOR'S
BUDGET AND ALSO A- PROHIBITION
ON FLAVORED PRODUCTS SO. WE
APPRECIATE BOTH OF THOSE
EFFORTS AND WE LOOK FORWARD TO
CONTINUING THE CONVERSATION ON
THIS TAX PROCEEDS AND
SUPPORTING THE PRIMARY CARE
WORK FORCE THANK YOU. THANK
YOU. WELCOME THE SEVENTH BREAST
CANCER PREVENTION PARTNERS- WE
AGAIN ALSO WANT TO THANK YOU
FOR HAVING THIS HEARING- ASIDE
FROM ALL OF THE OTHER
RELATIVELY WELL KNOWN HEALTH
IMPACTS. THAT ARE LINKED TO
SMOKING AND NICOTINE WE'RE VERY
CONCERNED ABOUT THE PRESS
CANCELING WE HAVE ONE IN EIGHT
WOMEN NOW WHO HAVE BREAST
CANCER WE HAVE TWENTY NINE
THOUSAND NEW DIAGNOSES EVERY
YEAR. AND WHERE YOU'RE
CONCERNED ABOUT THE SCIENCE
THAT INDICATES A LINK BETWEEN
NICOTINE CHEMICALS AND BREAST
UNKNOWNS WITH THE FLAVOR
CHEMICALS AND THE SOLVENTS
INVOLVED SO THANK YOU VERY MUCH
FOR YOUR WORK WE LOOK FORWARD
TO- SEEING HOW THIS DEVELOPS WE
WILL ALSO BE SUPPORTING SB
SEVEN NINE THREE FROM SEVEN
SENATOR HEALTH THANK YOU. THANK
YOU. WELCOME GOOD AFTERNOON MY
ROBINSON ON BEHALF OF KAISER
CORRENTE JUST ONE THINK THAT
CHAIR- FOR DOING THIS VERY
IMPORTANT HEARING AND YOU KNOW
PROUD TO VOICE HER SUPPORT. FOR
SB SEVEN NINETY THREE AND THE
GOVERNOR'S BUDGET PROPOSAL
THANK YOU. THANK YOU. RIGHT
SEEN NO ONE ELSE THE MICROPHONE
I WANT TO THANK. ALL THE- ALL
YOU FOR BEING HERE AND I THINK
ALL THE PRESENTERS YOU FRIED
SOME VERY IMPORTANT INFORMATION
TO OUR COMMITTEE INTO THE
LEGISLATURE. I THINK THERE'S A
LOT OF WORK AHEAD OF US AND I
THINK CENTER HILL FOR JOINING
US. TODAY ASSISTANT NIELSEN IS
ENOUGH FOR ME ON THE COMMITTEE
ITSELF OKAY THANK YOU SO MUCH
FOR BEING HERE AS WELL- WITH
THAT- THAT COMPLETES THE AGENDA
FOR THIS INFORMATIONAL HEARING-
SO THIS A HEARING OF THE SENATE
CAMINO HEALTH IS NOW ADJOURNED.
THANK YOU.