Legislature(2015 - 2016)BUTROVICH 205
04/02/2015 09:00 AM Senate STATE AFFAIRS
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| Audio | Topic |
|---|---|
| Start | |
| SB91 | |
| SB1 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | SB 74 | TELECONFERENCED | |
| + | SB 1 | TELECONFERENCED | |
| + | SB 58 | TELECONFERENCED | |
| *+ | SB 91 | TELECONFERENCED | |
| + | TELECONFERENCED |
SB 1-REGULATION OF SMOKING
10:00:31 AM
CHAIR STOLTZE announced the consideration of SB 1.
10:00:53 AM
SENATOR PETER MICCICHE, Alaska State Legislature, Juneau,
Alaska, Sponsor for SB 1, stated that his hope is that with
everyone's help that some lives can be saved and less spent on
healthcare. He read the following sponsor statement into the
record:
SB 1 seeks to safeguard working Alaskans and their
children from the adverse health effects of secondhand
smoke by providing a statewide smoke-free workplace
law for businesses and public places. This is about
protecting workers, this is not an anti-smoker bill at
all.
As a conservative Alaskan, I actively support a
philosophy that works to limit and reduce the role of
government in our daily lives. I work towards that
every day in this building, but I believe Thomas
Jefferson got it right when he said, "The legitimate
powers of government extend to such acts only as are
injurious to others."
This case, I believe that both the right to breathe
smoke-free air and the significant, documented public
health risks of secondhand smoke exposure compel us to
view the protection of Alaska's labor force and their
families as an appropriate governmental
responsibility. With the new issues with marijuana Mr.
Chairman, I also believe this bill reduces the
potential of folks smoking marijuana at the workplace
as well. Similar comparisons include the government
role in establishing speed limits, seat belt laws,
motor vehicle design safety improvements, electrical
codes, pipeline safety laws, and agency
responsibilities. There are places in our society
where regulation is the right thing to do and it's
largely why we are here in this building. As judicial
philosopher Zechariah Chafee said in the Harvard Law
Review in 1919, "Your right to swing your arm ends
just where the other man's nose begins;" that's kind
of what SB 1 is about, it doesn't preclude Alaskans'
right to smoke, but it protects the rights of working
Alaskans who choose not to smoke.
This law is much like the law that is in half of the
states right now. Over half of the population of
Alaska including those in Bethel, Anchorage, Juneau,
Barrow, Dillingham, Haines, Skagway, Petersburg,
Klawock, Nome, Unalaska, and Palmer are currently
living under a similar law. You also can't smoke in
healthcare facilities, schools, childcare facilities,
and public meeting rooms in government buildings.
These laws are well established and once they have
been on the books there has been some effort to
reverse them and not once have those reversal
processes been successful. Communities, once they have
been successful learn the value of smoke-free
workplaces, they've kept them intact.
10:03:38 AM
This applies a uniform safeguard from secondhand smoke
for workers in Alaska. Why is a conservative willing
to take on this issue? The reality of it is for me,
simply to protect the lives of nonsmokers. We think
about the staggering health costs of secondhand
exposure to tobacco products and I'm not talking about
the over half million Americans that die from lung
cancer that do smoke, we are talking about the folks
that choose not to. It's a critical public health
issue in my view and when you think about it, people
are now talking about expanding Medicaid, people are
talking about us taking on expanded roles of
healthcare in the state, this is just an added expense
and it hits the taxpayer heavily. It kills more than
41,000 adult non-smokers from coronary heart disease
and lung cancer each year. For example, it is four
times the number for DUI fatalities each year. While
our DUI laws are rightfully stringent, our response to
stopping an enormous loss of life due to secondhand
smoke has been comparatively lax.
I often hold up a photo of my dad, who I lost last
year, this bill is not about my father, my father
chose to smoke, that was his right. This is about the
folks that are effected that choose not to but have to
go to work every day. What this bill is about is
essentially asking smokers to take it outside. More
than 860 Alaskan businesses and organizations, and
many more representing all regions of the state have
signed on to support this smoke-free workplace law.
We have some opposition as well, I believe we have a
few hundred opposition letters; virtually 100 percent
of those letters are asking us to exclude vaping or e-
cigs from the bill.
10:05:44 AM
There are very many well-meaning governmental actions
that are simply not good examples of the use of common
sense; one of them is Positive Train Control. For the
billions of dollars it will cost to do Positive Train
Control, it will save about three American lives per
year in the U.S., that's a government added control
trying to spend a lot of money protecting folks that
are not at risk. In this case we have the number, we
have the overwhelming evidence that at no cost to our
government, and we can protect a lot of Alaskans.
I've got to say out of respect for you and your
committee that we are listening. We will be listening
to your comments, we're open to suggestions, we want
this to be the best bill it can be, and we want to
impact Alaska businesses as little as possible, so we
are open to reasonable exemptions.
This bill effects my core belief in the self-evident
truths and the Declaration of Independence and its
desire to conserve life and protect liberty. I think
forcing Alaskan employees to smoke on the secondhand
aspect is challenging those rights. The other thing
that I've got to say is this bill is purposely
designed not to be heavy handed, it doesn't come with
control, it comes with no imposing enforcement
actions, all this bill does is it asks smokers to take
it outside while they are at work, it's just respect
for their neighbor's right to breath clean air.
I'd like to reiterate again, this bill is not about my
father, this is not about folks who choose to smoke,
if they choose to smoke, they have every right to
continue to do that, we just ask for them to not
affect the rights of their friends at work.
10:07:42 AM
CHUCK KOPP, Staff, Senator Micciche, Alaska State Legislature,
Juneau, Alaska, noted that the bill packets contain a copy of
the slide show that is considered the "Take it Outside Act." It
is from the Smoke Free Alaska website.
MR. KOPP read the following statement:
SB 1 is about healthier citizens and spending less on
healthcare, providing a smoke-free work environment
for workers in Alaska and a statewide standard with
regard to secondhand smoke, it puts all businesses and
workplaces in Alaska on a level playing field.
About half of the population in Alaska is covered by
workplace law now. In the members' packets was a 2012
Dittman Research survey that shows 82 percent of
Alaskans support a statewide, smoke-free indoor air
law that includes restaurants and bars. You see the
support we have from across the state from every
members' district, which is consistent with that 82
percent polling. Also in the members' packets is a
documentation from the Institute of Social and
Economic Research (ISER) in 2014, and a Journal of
Cancer article in 2007 which shows that smoke-free air
laws do not have adverse economic consequences for
restaurants and bars subject to them.
What does SB 1 not do? SB 1 does not ban cigarette
smoking and it does not ban e-cigarettes. What does SB
1 do? SB 1 provides a statewide smoking prohibition in
enclosed public spaces, public transportations and
facilities, places of employment, government owned or
operated places, buildings or residences that are used
to provide paid childcare, healthcare facilities, the
Pioneer Homes and the Veterans Homes, and vehicles
that are places of employment with certain exceptions.
Included are school grounds, public parks for
children, outdoor arenas sitting, and areas within
certain distances from entrances, open windows, and
air intake vents where smoking is prohibited. The bill
requires the Commissioner of Health and Social
Services to adopt regulations for filing, processing,
and investigating reports of violations of the smoking
prohibition, which may include filing complaints and
issuing citations.
The Department of Health and Social Services (HSS)
role in implementing this statewide smoking
prohibition is to provide education and respond to
complaints as they come forward. Under the Anchorage
law, which was enacted in 2000 and updated in 2007,
the average number of enforcement actions a year is
between 3 and 6. The bill allows the HSS commissioner
to delegate to other agencies any other
responsibilities to implement the bill's provisions.
The bill also requires a person who is in charge of a
place where smoking is prohibited to post it with
specific signs saying that smoking is not allowed and
it requires the HSS department to furnish signs to
anyone who had requested them. The Division of Public
Health's Tobacco Prevention and Control Program would
be responsible for developing public education
materials regarding the new requirements and for
educating business owners, grantees, and the public on
the specifics of the law.
10:11:01 AM
MR. KOPP addressed "2014 Surgeon General Report" and "Premature
Deaths Caused by Smoking, 1965-2014" as follows:
Over the last 50 years, there have been 31 Surgeon
General's reports that have utilized the best
available evidence to expand our understanding of the
health consequences of smoking and involuntary
exposure to tobacco smoke. We have heard of these
staggering statistics about the repercussions of this
exposure and the recent data indicates it is something
akin to a public health emergency. Just looking at
smoking related incidents all together, including
primary and secondhand exposure for the last 50 years,
we see there's been over 20 million American lives
lost. Looking at just secondhand smoke in two
categories: lung cancer and heart disease, it's almost
3 million Americans. Looking at just the numbers in
comparison just for analysis, there have been 20
million Americans die in that period, 2.5 million were
non-smokers, and more than 100,000 babies were
impacted due to smoking related issues with secondhand
smoke. That's a lot of people, it's 68 times the
combat deaths in WWII and 30 times the number of U.S.
deaths from the 1919 flu pandemic.
10:12:16 AM
He addressed "What We've Learned in 50 Years" as follows:
With respect to secondhand smoke, we know now that
smoking and passive smoking causes disease in nearly
every organ. Exposure to secondhand smoke is causally
linked to cancer, respiratory and cardiovascular
diseases, and adverse effects on the health of infants
and children. 41,000 non-smokers a year die from
secondhand smoke according to the U.S. Surgeon
General's report in 2014, and as Senator Micciche
said, this is 4 times the number of DUI fatalities in
2013, which according to the National Highway
Transportation Safety Association was 10,046. In our
50 year history of progression with our response to
DUI as a country, we started off with no jail and a
0.15 breath alcohol limit, lowered that to a 0.10 and
started bringing on jail time, now we are down to a
0.08 with mandatory 3 days in jail as a national
standard in all 50 states. The point here is the
response to something that kills at 4 times the rate
is we think, more measured than that.
10:13:16 AM
MR. KOPP addressed "Health Consequences Causally Linked to
Secondhand Smoke" as follows:
Stroke is more recently acknowledged by the U.S.
Surgeon General as being causally linked to secondhand
smoke with about a 30 percent increased risk due to
secondhand smoke exposure. The annual number of deaths
attributable to smoking and exposure to secondhand
smoke is now approaching 500,000 people. The exposure
to secondhand smoke we now know is more immediate than
thought, even a decade ago, as far as its impact to
the cardiovascular system, damage to blood vessels,
making blood more likely to clot, and increasing the
risk for heart attack and stroke. The 2006 and the
2010 Surgeon General's report both reported that there
is no safe level of secondhand exposure.
Our national cost in 2006 was $5.6 billion in lost
productivity alone due to exposure to secondhand
smoke. The estimate from the American Cancer Society
for Alaska is 60 deaths and more than $1 million per
year. The evidence is sufficient to infer a causal
relationship between the implementation of a smoke
free law or a policy and a reduction in coronary
events among people under 65 years of age. Doctor
Urata with the Juneau hospital is here to speak to
that.
In conclusion, this is a question of rights, the
choice to smoke versus the need to breathe. A clean
indoor air policy does not prohibit smoking, it only
requires that those who choose to smoke do so in a
manner that does not threaten or harm others.
10:15:06 AM
MR. KOPP addressed "What About E-cigarettes?" as follows:
There's a lot of discussion about e-cigarettes. The
science is still maturing with respect to e-
cigarettes, there are studies that show that because
of the unregulated nature of the market, depending on
the tool that is being used, that you can have a
significant amount of toxins, ultra-fine medical
particles, volatile compounds, and other carcinogens
that become part of the vaping or the aerosolized air.
The biggest problem is that the U.S. Food and Drug
Administration (FDA) has not assumed regulation of
them and there are 470 different brands. According to
Alaska state law, it is illegal to sell or give any
product containing nicotine to anyone under 19 years
old, and because e-cigarettes retailers do not need a
sales license endorsement to sell their products like
tobacco retailers, there is no program of compliance
checks for youth sales in place for these retailers.
10:16:06 AM
He addressed "Why Smoke-Free Workplaces?" as follows:
The implantation of comprehensive clean indoor laws
has been shown to significantly reduce heart attacks.
We talked about separating smokers from non-smokers.
Air clean technologies and ventilation systems, it's
very hard to get those to remove carcinogens from the
air, you can sometimes get down toward the detectable
smoke is not there, but they are not reliable to
protect public health. In addition, eliminating
exposure of secondhand smokers to secondhand smoke
helps reduce tobacco use among smokers. The Surgeon
General's quote is probably the most relevant on the
page, "The right of smokers to smoke ends where their
behavior effects the health and wellbeing of others."
10:16:51 AM
He addressed "Smoke-free Laws in Alaska" as follows:
Half of Alaska's population is protected by a local
law from secondhand smoke at work and the remaining
part, largely in the unorganized boroughs or boroughs
that do not have healthcare laws, are not affected. We
also recently have support from the Kodiak Borough,
and Bristol Bay Native Corporation just signed on with
this bill, not the smoke-free Alaska act, but actually
this bill. 82 percent of Alaskans agree, according to
the Dittman 2012 survey, that Alaska workers should be
protected from secondhand smoke in the workplace.
Support even among smokers is strong for a smoke-free
indoor workplace laws according to Dittman. Alaska's
support for smoke-free indoor workplaces is high
throughout all regions of the state.
CHAIR STOLTZE commented that the bill's concept is simple and
there is no reason to go through a sectional analysis. He said
he believes that the committee understands the politics and the
public opinion. He related that C. Everett Koop was vilified
when he was a nominee for Surgeon General because he was pro-
life and deified when he was anti-tobacco.
10:18:40 AM
DR. JAY BUTLER, MD, Chief Medical Officer/Director, Department
of Health and Social Services, Anchorage, Alaska, stated that he
wants to provide perspective of a physician as well as a bit of
a baseline skeptic and touch briefly on the health effects of
secondhand smoke, but really focus on the health benefits of
avoiding smoking environments. He stated that he would focus on
one outcome which is heart attacks, an outcome that is not junk-
science and not an idea that is based on a single study in the
journal of irreproducible results.
DR. BUTLER detailed the link between heart attacks and cigarette
smoke as follows:
There are three lines of evidence, two of which have
already been touched on. There's multiple
epidemiological studies linking smoke exposure to the
risk of heart attack; we also understand how this
works, the path of physiology if you will, this isn't
magic, the platelets become stickier, the lining of
the vessels in the heart change function within
minutes after tobacco smoke exposure for people who
are non-smokers, increasing the risk of a clot, which
is what causes a heart attack.
Finally, I wanted to really emphasize the fact that
taking cigarette smoke outdoors has been found in
numerous places to reduce the overall hospitalization
rates for heart attacks and in places as diverse as
Helena, Montana; Saskatoon; to the entire nation of
Scotland. I also wanted to stress that in most of
these places, the enforcement is passive, there's not
storm troopers sweeping in with squirt guns to
extinguish the stogies the cigar bars. It is worth
pointing out though that some of the very earliest
evidence of the very short term benefits of smoke-free
laws were observed among barkeepers and tavern owners.
It's also worth noting that in places where these laws
have been in place for a number of years, these
benefits have been sustained and actually increased as
time passes.
10:20:56 AM
DR. BUTLER explained the impact of cigarette smoke on children
as follows:
Secondhand smoke exposure has been associated with the
sudden infant death syndrome, respiratory infections,
middle ear infections, and asthma attacks in kids; in
fact, in Scotland they found that their trends in
asthma or hospitalizations among children which had
been increasing, part of a global trend, actually
began to turn after they passed their smoke-free laws.
It's also worth pointing out that concerns that smoke-
free laws force people to smoking indoors at home has
not been borne out, in fact the data has shown that
using Cotinine in urine as a marker of cigarette
exposure, this marker has actually gone down among
children in areas where these laws have been enacted.
We are all concerned about the high cost of
healthcare. Avoiding secondhand smoke helps avoid the
cost of illness associated with secondhand smoke that
employers, government, and all of the "average Joes,"
with the exception of Joe Camel, have to bear.
10:22:15 AM
SENATOR MCGUIRE asked Dr. Butler to comment about e-cigarettes.
She noted that the bulk of complaints she has received pertains
to the bill defining smoking to include the use of e-cigarettes.
She revealed that there have been some pretty personal e-mails
from folks in her community where individuals at one point were
addicted to smoking nicotine through tobacco use and have found
reprieve smoking e-cigarettes as a perceived health benefit.
DR. BUTLER replied that the role of e-cigarettes as a harm
reduction tool or even as a tobacco cessation tool is an ongoing
debate.
He pointed out his concerns with e-cigarettes as follows:
· Aerosol exhaled from an e-cigarette is not always easy to
detect unless a person is very close.
· E-cigarettes normalize smoking behaviors.
· Using marijuana in an e-cigarette is virtually impossible
to differentiate.
He reiterated that e-cigarettes are not regulated by the FDA and
not approved as tobacco cessation instruments. He noted that
nicotine replacement products already exist. He revealed that he
has received more than a dozen emails that all cite the same
study that addresses contaminants and not what is intentionally
in the liquids. He said he questions the renormalization of
smoking where e-cigarettes target the junior high school age
group with flavors like Candy Crush, Vanilla Dream, Captain
Crunch, and Mountain Dew. He stated that he remains skeptical
and asserted that e-cigarettes should be included in the bill
for ease of enforcement.
10:25:12 AM
JOE DARNELL, Investigator, Tobacco Youth Education & Enforcement
Program, Division of Behavioral Health, Alaska Department of
Health and Social Services, Anchorage, Alaska, stated that he
works on under aged tobacco enforcement and compliance. He said
enforcement of SB 1 will be done statewide through passive
enforcement with the use of a toll-free number and website.
MR. DARNELL specified that an initial complaint will result in a
letter to let a business know that a complaint was received. He
added that educational information about the bill with details
on health effects will be sent as well. He said a second
complaint will result in a more strongly worded letter as well
as a follow up by a local coalition or one of the statewide
grantees. He stated that a third complaint will lead to a follow
up in-person. He opined that he does not anticipate a third
complaint situation. He noted that Anchorage has never had a
third complaint and added that a second letter has rarely been
sent out.
10:26:52 AM
DR. ROBERT URATA, MD, volunteer, American Heart Association,
Juneau, Alaska, revealed that he was born and raised in Wrangle,
Alaska and that he has practiced medicine in Juneau since 1984.
He noted that he has been an American Heart Association
volunteer for the past 15 years. He stated that he supports SB 1
with the inclusion of e-cigarettes.
DR. URATA read the following statement:
Every 34 seconds an American dies of a heart attack,
every 40 seconds an American dies of a stroke. Cancer
and cardiovascular disease are the number one and two
causes of death in Alaska. Secondhand smoke kills over
100,000 Americans every year and it also costs a lot
of money. This state may save up to $5 million if this
law goes through. Smoke-free working places are really
important for the health of this country and this
state. In Pueblo, Colorado, smoke-free ordinance found
a 20 percent gain in their combined bar and restaurant
sales tax and a 27 percent decrease in heart attacks
when they compared a year and a half before the law
and a year and a half after the law; I believe this
was also reproduced in Helena, Montana when they
passed their clean air law. I would also wish to
include e-cigarettes because there are serious
questions to their safety. The FDA has found known
toxins in nicotine, but currently there are over 240
products and they are not all tested, so it is hard to
know what's going on there. The FDA is still studying
this and my feeling is this should be included because
what we do in medicine is first, "do no harm;" I think
this should be included in this bill until we have
more knowledge because harm could be done. Imagine the
many lives saved if cigarettes had been studied
properly before putting it on the market. On behalf of
the American Heart Association I urge you to support
this bill and thank you for your time.
10:29:58 AM
CHAIR STOLTZE announced that SB 1 will be held in committee.