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CPPW tobacco prevention initiative
Public Health was awarded nearly $10 million over two years from the CPPW tobacco prevention initiative to create changes that will result in decreased tobacco use rates, youth initiation, and exposure to secondhand smoke within King County and particularly within communities and groups that bear disproportionate burden of tobacco use and/or exposure. To accomplish the goals of the grant, Public Health will work with and provide support to our community partners to implement evidence-based, proven strategies that will create these policy, system, and/or environmental changes.

$2.2 million of the tobacco CPPW funds were released to the community through a competitive Request for Proposal (RFP) process. Half of the available funds are dedicated for specific activities that are high priorities for the grant: school-based activities, tobacco-free parks, smoke-free housing, and smoke-free college/university campuses. The remaining $1.1 million will be used to support work on all other policy, system and environment changes that work to increase access to quality cessation support, restrict where tobacco is used and where and/or how it is sold, advertised and promoted.

• Implement a media campaign
• Support small employers in promoting employee health
• Support health clinics in adding tobacco questions to electronic medical records
• Evaluate funded activities
• Provide Quitline services to King County residents
• Support policy changes with technical legal and advocacy assistance
• These activities, coupled with the work of our community partners, make for a comprehensive and robust project that will have lasting impacts on our community.

What the CPPW funds means for you and the community
Simply stated, this grant means big changes are on the horizon. This funding will make it easier to quit using tobacco, harder to start smoking and easier to avoid secondhand smoke exposure. For example, some tangible outcomes of this work may include:

• Fewer retail outlets selling tobacco products
• Less in-store tobacco advertising and promotions
• Decreased visibility and/or attractiveness of tobacco advertisements
• More service providers inquiring with clients/patients about tobacco use and providing cessation support and/or referrals
• Wider variety of culturally and linguistically appropriate cessation support materials and services
• More tobacco-free and smoke-free places, including parks and public places (e.g., beaches, hospitals, farmer markets), multi-unit housing buildings, college campuses, clinics and treatment centers, private businesses and worksites.

These types of population-level strategies have shown to have a dramatic influence on healthy behaviors because they work to change the social, physical and built environment around us. In other words, an individual will make healthier choices, such as quitting tobacco, if we make changes within the community to make quitting tobacco easier and more acceptable than using tobacco.

Ultimately, CPPW works to change communities by building capacity within these communities to create their own change. Research shows us that these changes will have a profound effect - not only will it decrease tobacco use rates, but it will work to create tobacco-free norms. This process will be occurring within many different areas of King County, and these collaborating and coordinating efforts can work to foster a greater sense of community and change for the county and state.

http://www.kingcounty.gov/health/cppw

Historic legislation gives FDA regulation authority on tobacco products
by Fel Pajimula

Larger warning labels, banned flavors, and youth marketing restrictions
In June 2009, President Obama signed the Family Smoking Prevention and Tobacco Control Act, which the Senate and the House of Representatives overwhelmingly approved prior to his signing. The Family Smoking Prevention and Tobacco Control Act grants the U.S. Food and Drug Administration (FDA) the authority to regulate tobacco products. Prior to the new law, tobacco products were one of the least regulated consumer products for sale in the United States, exempt from numerous consumer protections. These protections included disclosure of ingredients, testing of products and marketing to youth. Tobacco products will now be regulated under a new standard which is appropriate for the protection of public health.

Various provisions of the law went into effect immediately after it was signed. One provision was the ban of artificial or natural characterizing flavors (other than tobacco or menthol) from all cigarettes. Candy and fruit flavors were seen as a marketing strategy to lure in new and younger smokers, with a taste they were familiar with. The law also prohibits the use of "light," "low," "mild," and all similar descriptors in advertising, labeling and marketing of any new cigarettes and smokeless tobacco products. This was done in order to prevent inaccurate and misleading claims, and claims of reduced harm. Beginning on June 22, 2010, a year after the law was signed, the use of those descriptors will no longer be allowed in ads and labels of existing cigarettes and smokeless products. This date marks the time that all cigarettes can no longer be referred to as "light" or "mild", or advertised as "low tar." For example: "Camel Light" has been replaced by "Camel Blue." Along with those provisions, June 22, 2010 is the date that a number of other major provisions also go into effect, including:

• Advertising changes - Ads for cigarettes and smokeless tobacco must be in black and white text only and can not be within 1,000 feet of schools, parks or playgrounds.
• Warning labels - Companies are required to include larger warning labels on all packaging and advertising of smokeless tobacco products.
• Product access - No free samples of tobacco products and no vending machines or self-service displays of cigarettes or smokeless tobacco, except in adult-only facilities. Sampling of smokeless tobacco will be allowed in adult-only facilities in certain restricted situations.
• Branded products - Tie-ins / giveaways are restricted from accompanying the purchase of tobacco products (t-shirts, lighters, wallets, etc.).
• Sponsorship - Cigarette and smokeless manufacturers, distributors and retailers are restricted from branded sponsorship of athletic and cultural events.

With these changes in regulation, the FDA will also be establishing the Tobacco Product Scientific Advisory Committee. The committee will then issue reports on public health impact in regards to menthol flavored cigarettes and their prevalence of use among youth, African Americans, Latinos and other racial and ethnic groups. The FDA also has the authority to require changes in tobacco products, including removing or reducing the number of harmful ingredients.

The ban on candy and fruit-flavored cigarettes emphasizes the importance of reducing the number of minors who start smoking. The advertising and sampling restrictions continue this message by limiting when and where youth are exposed to messaging and imagery of tobacco products. Additionally, advertising changes for alcohol have also gone into effect in Washington State. These advertising restrictions limit a licensed facility to four signs (visible from the outside) that advertise alcohol, brand names or alcohol manufacturers. Clearly, these new laws are for the protection of youth, reducing underage exposure to tobacco, as well as increasing overall public health.

http://www.fda.gov/flavoredtobacco

Local groups conduct "Learning Congress" on menthol cigarettes and the FDA
by Paul Zemann

On April 16th, the Asian Pacific Islander Coalition Against Tobacco (APICAT) and the Center for Multicultural Health (CMH) jointly hosted a policy focused "Learning Congress" called Keeping Cool; Menthol Cigarettes & FDA Tobacco Regulation.

Public health experts are questioning why menthol, the most widely used cigarette flavoring and the most popular cigarette choice of Black American smokers, is receiving special protection as Congress gives the FDA the authority to regulate tobacco for the first time. The legislation, which gave the Food and Drug Administration the power to oversee tobacco products, would try to reduce smoking's allure to young people by banning most flavored cigarettes ...most flavored cigarettes that is except for menthol flavored cigarettes. In an interesting twist on the whole review process, the Phillip Morris Corporation, which was part of the legislation development committee, unveiled a new menthol cigarette, #54, the day after President Obama signed the legislation into law.

In an attempt to understand the FDA regulations as well as the history of menthol cigarettes and their strong draw for Black Americans and youth, APICAT and CMH brought in national and local experts to present on the topic. Dr. Phillip Gardiner from the University of California and one of the preeminent experts on tobacco policy, presented on the History and Science of Menthol Cigarettes. Rod Lew from Asian Pacific Partners for Empowerment, Advocacy & Leadership worked with the attendees to develop a community action plan to call attention to the problem and help effect policy change on the issue. Paul Zemann from Public Health - Seattle & King County gave the group an overview of the new FDA tobacco regulation and reviewed the timeline for implementation of the specific portions of the law.

As the temperature increases, so do smoking complaints
by John Bennett

Public Health - Seattle & King County would like to thank all of the business owners, residents, and visitors who have done their part to ensure compliance with the Smoking in Public Places law.

Smoking is prohibited in all work areas and places open to the public. The smoking ban applies to all indoor areas, all areas where alcohol is permitted, any area where employees are present, and within 25 feet of a door, window, or air-intake to an indoor area.

Business owners are responsible for making sure that smoking is prohibited in all protected areas under their control. However, if a person is simply smoking on the sidewalk outside of their establishment and the owner has not provided an ashtray, seating area, or other accommodation, then the owner is not responsible for the violation. The individual smoking can be cited for violating the smoking ban by local law enforcement officers.

If you are visiting an establishment in King County and you notice a smoking violation, please let the owner, manager, or other person on duty know of the violation so that they may correct it. If they do not handle the situation, or if you would prefer not to talk to the business staff, you can report the violation to Public Health by sending an email to smoking.concern@kingcounty.gov or by filling out our online form at:

http://kingcounty.gov/healthservices/health/drugs/tobacco/report.aspx

Public Health will respond to complaints about violations of the law by notifying the establishment of the complaint (without releasing any information identifying the complainant), explaining the requirements of the law, and giving the establishment time to take corrective action. If the establishment receives additional complaints, Public Health will conduct a site inspection and take enforcement action if necessary.

Again, thank you! With your help, King County offers a healthier environment for people to work, eat, and play.