Legislature(1999 - 2000)
04/16/1999 08:55 AM House FIN
| Audio | Topic |
|---|
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE FINANCE COMMITTEE
April 16, 1998
8:55 A.M.
TAPE HFC 99 - 82, Side 1
TAPE HFC 99 - 82, Side 2
CALL TO ORDER
Co-Chair Therriault called the House Finance Committee
meeting to order at 8:55 a.m.
PRESENT
Co-Chair Mulder
Co-Chair Therriault Representative Grussendorf
Vice-Chair Bunde Representative Kohring
Representative Austerman Representative Williams
Representative G. Davis
Representatives Moses, Davies and Foster were absent from
the meeting.
ALSO PRESENT
Representative Norman Rokeberg; Anne Marie Holen, Alaska
Native Health Board, Anchorage; Danny McGoldrick, Campaign
for Tobacco Free Kids, Washington D.C.
TESTIFIED VIA THE TELECONFERENCE NETWORK
Christine McIntire, Executive Director, American Lung
Association, Anchorage; Craig Harpel, Executive Director,
American Heart Association, Anchorage; Angie Aceltine,
Community Outreach, Soldotna; Diana Campbell, Tanana Chiefs
Conference, Fairbanks; Elizabeth Ripley, Director, Community
Health Planning Valley Hospital Association, Matsu; Mykki
Orth, Soldotna.
SUMMARY
HB 37 "An Act relating to smoking education and
cessation programs administered by the Department
of Health and Social Services."
CSHB 37 (FIN) was REPORTED out of Committee with
"no recommendations" and two zero fiscal notes,
one by the House Finance Committee, for Tobacco
Prevention and Control, Department of Health and
Social Services and one by the Department of
Health and Social Services, Community Health
Services.
SUMMARY
HOUSE BILL NO. 37
"An Act relating to smoking education and cessation
programs administered by the Department of Health and
Social Services."
NORMAN ROKEBERG, SPONSOR spoke in support of HB 37. He
observed that there are 110,000 smokers in the state of
Alaska. He maintained that a large percentage of these
persons wish to stop smoking. Nicotine is one of the most
difficult addictions to "kick". Tobacco use is the leading
cause of death in the state of Alaska. He provided members
with a spreadsheet detailing the tobacco settlement's annual
payments to each state (copy on file). He observed that the
state of Alaska is scheduled to receive $668,9 million
dollars or approximately $25 million dollars a year for 25
years. Alaska will receive an additional $8 million dollars
on or before June 30, 2000 as part of the small state
settlement. This is to allow small states to establish
smoking control and cessation programs.
Representative Rokeberg noted that HB 37 does three things.
It prohibits the sale cigarettes in packages of less than
20. It also prohibits the re-importation and mislabeling of
cigarettes produced for foreign markets. He observed that
manufacturers are allowed to produce packages without the
warning label for foreign sales. Some of these cigarettes
are finding their way back into the U.S. market. It also
authorizes the Department of Health and Social Services to
develop and implement a fundamental smoking control and
cessation program based on recommendations of the Center of
Disease Control (CDC) for a comprehensive program. He
observed that the CDC recommends between $8 and $17 million
dollars is needed to develop a workable and effective
program in Alaska. The state of Alaska currently spends $200
thousand dollars for tobacco control. He observed that
smokers are paying over $40 - $50 million dollars a year in
tobacco taxes. Tobacco companies have raised the price of a
package of cigarettes by an additional .45 cents per package
to finance their costs for the tobacco settlement. The
additional tax costs Alaskans approximately $30 million
dollars per year. The state receives back approximately $25
million dollars through the tobacco settlement. He concluded
that Alaskan smokers pay approximately $70 million dollars
annually in taxes on tobacco products.
Representative Grussendorf questioned if $3 million dollars
would be sufficient to begin the program. Representative
Rokeberg emphasized that $3 million dollars would be a
minimal approach to implementation. He pointed out that
smoking cessation programs are expensive. He noted that a
six-week program using a nicotine patch at the state
discount would still cost $105 dollars.
ANNE MARIE HOLEN, ALASKA NATIVE HEALTH BOARD, ANCHORAGE
spoke in support of the legislation. She manages a small-
scale tobacco control program at the Alaska Native Health
Board. She spoke in support of a fully funded comprehensive
tobacco control program that would build on the success of
the tobacco tax and ultimately push smoking rates below the
state goal of 15%. Smoking is currently estimated at 27%. It
is estimated that 4,000 young Alaskans join the ranks of
daily smokers every year. Once addicted, most smokers remain
addicted for years before they quit, if they quit. Those who
die from smoking lose an average of 12 to 15 years of life.
Half of all long-term smokers die from smoking-caused
disease, and half of those deaths occur in middle age.
Persons who start smoking as children typically incur
thousands or tens of thousands of dollars in medical bills
to treat respiratory illness, heart disease, and cancer
caused by smoking.
Ms. Holen observed that smoking has been the leading cause
of death in Alaska for some time. The state of Alaska
appropriated $200 thousand dollars towards tobacco control
in FY99. This was the first state appropriation toward
tobacco control. The state brings in about $48 million
dollars annually in tobacco taxes and will soon be seeing
another $26 million dollars a year from its settlement with
the tobacco industry.
Ms. Holen maintained that the first priority for spending
tobacco settlement dollars should be on programs to prevent
and treat nicotine addiction. In a statewide public opinion
survey of Alaskan voters, 86 percent said that a significant
amount of the settlement money should be spent on tobacco
control programs. She added that 65 percent felt that it
should be a first priority.
Ms. Holen observed that the Center for Disease Control has
issued program and funding guidelines for each state. It
recommended that Alaska spend $8.7 to $17.7 million dollars
annually. That would be one-third to two-thirds of the
tobacco settlement. She emphasized the importance of
investing in a long-term, comprehensive program.
Ms. Holen noted that the Alaska Tobacco Control Alliance has
prepared a document called "The Alaska Tobacco Control
Program: A Plan for the Future" (copy on file). She
acknowledged that the state faces a difficult fiscal
challenge. The Alliance maintains that $8.2 million dollars
is the minimal amount needed for an effective, comprehensive
program.
Ms. Holen emphasized that the Alaska Tobacco Control Program
has three main goals: to reduce initiation among youth, to
help addicted youth and adults quit, and to protect non-
smokers from secondhand smoke. These goals would be
accomplished by the coordinated action of the seven
components. It utilizes a decentralized approach that
transfers most of the resources outside of state government
and into communities and organizations that are fighting
this battle on the front lines. She listed the seven
elements that make up the program. The seven components are:
? Community Programs to Reduce Tobacco Use
? Cessation Programs
? Counter marketing
? School-based Programs
? Tobacco-Free Partnership Projects
? Enforcement
* Program Development, Management, and Evaluation
DANNY MCGOLDRICK, CAMPAIGN FOR TOBACCO FREE KIDS, WASHINGTON
D.C. testified in support of HB 37. He stated that there are
six major components for tobacco free kids: public
Education, community-based programs, school-based programs,
helping smokers quit, enforcement, and evaluation. He
stressed that these elements work together. He discussed
marketing efforts by tobacco companies. The tobacco industry
spends $5 billion dollars a year or about $13 million
dollars a day to market their products. He observed that 75
percent of kids surveyed had seen recent tobacco
advertising. Only 31 percent of the adults surveyed had seen
recent tobacco advertising. He noted that the perception by
children surveyed was that more adults smoke than the actual
number. He asserted that efforts by the tobacco industry to
market their product must be countered. Counter marketing
consists of paid print, radio, and television advertising,
and public relations efforts. The public education campaign
utilizes contracts with marketing experts. He stressed that
public education campaigns work. The California anti-tobacco
media campaign reduced sales by 232 million packs in the
first two years of its campaign. He noted that a combined
smoking and media campaign reduced smoking in Vermont by 35
percent. Community based programs work and are a good way to
reach culturally diverse populations. Community programs
such as the ASSIST Program reduced tobacco consumption by 7
percent within three years of inception. The Minnesota Heart
Health Program reduced smoking by nearly 40 percent by grade
12. He emphasized that most smokers start as kids, 90
percent of smokers start before the age of 19. He emphasized
the importatnce of beginning tobacco education early.
Mr. McGoldrick discussed school-based programs. The Alaska
Coalition has developed a plan to give competitive grants to
school districts. Only districts that demonstrate that they
will implement school-based programs that follow CDC
guidelines are given grants. These guidelines demand that
programs emplemented in schools are evidence based programs
that have been proven to be effective. School based programs
have been demonstrated to reduce prevalence by 20 percent by
grade 12. A recent study showed that a middle school social
influences program reduced teen smoking even in a tobacco-
producing state.
He maintained that most smokers want to quit. He added that
cessation products are promising but not accessible to all.
Many health professionals do not provide counseling. Adults
are important role models. Reducing adult smoking has a
preventative affect on children and reduces second-hand
smoke.
The comprehensive plan would have a quit smoking line
operated by nonprofit organization. Insurance coverage for
cessation would be linked to providers. There would be
statewide training for health providers. He observed that
long-term quit rates with no counseling are less than 5
percent. Those with counseling and medications can obtain
quit rates of up to 30 percent.
Mr. McGoldrick discussed enforcement. Young people are
still able to buy cigarette. He noted that enforcement is a
key. Compliance goes along with enforcement. The plan calls
for funding to enforce existing laws. Enforcement in
California and Massachusetts has dramatically reduced
illegal sales. It is crucial to have evaluation programs.
Evaluation shows the effectiveness in states that have
implemented programs.
He noted that programs in California and Massachusetts have
reduced tobacco consumption by 2 to 4 times the rate of
other areas of the nation. Consumption in California has
declined by 38 percent. Enforcement in California and
Massachusetts has dramatically reduced illegal sales to
minors in those states. Several community studies have shown
that active enforcement of youth access laws increase
merchant compliance. A recent study in Minnesota showed that
increased enforcement also reduced youth smoking.
Mr. McGoldrick observed that since 1992, tobacco consumption
in Massachusetts has declined by 31 percent. Tobacco
consumption in Oregon declined by 11.3%, with almost half
the decline (5%) attributable to a comprehensive tobacco
prevention program, the rest to the excise tax that was
passed to fund the program.
Less than a year after the initiation of Florida's Tobacco
Pilot program, current smoking was reduced by 19% among
middle school students and 10% among high school students.
California and Massachusetts have avoided the dramatic
increases in youth smoking that has occurred in the rest of
the country. Since 1993, smoking among California 8th
graders has remained relatively constant while increasing as
much 36 percent in the rest of the country.
Smoking among Massachusetts 8th graders decrease slightly
between 1993 and 1996. It increased dramatically elsewhere
during this period. In the last couple of years there has
been a decline in smoking of 10th - 12 graders in
Massachusetts while it has increased elsewhere in the
country.
Mr. McGoldrick noted that other early results from the
Florida Tobacco Pilot Program are very encouraging: the
proportion of teens who "strongly agree" that smoking has
nothing to do with whether a person is cool increased.
A 15-year follow-up study in Finland showed that the
reductions in tobacco use produced by a mass media
intervention combined with a school and community-based
education program last over time. Mean lifetime cigarette
consumption was 22 percent lower among program subjects than
among control subjects.
The proportion of California tobacco retailers who failed
compliance checks for selling tobacco products to minors
declined from 52% in 1994 to 22% in 1997.
Mr. McGoldrick observed that the proportion of tobacco
retailers in Massachusetts who sold tobacco illegally to
minors has fallen from 48% to only 8% since the inception of
the program. There have also been declines in adult smoking
California and Massachusetts. In Massachusetts, smoking
declined by 48% from 1990 to 1996. He stressed that a
reduction of smoking during pregnancy reduces medical costs.
Mr. McGoldrick emphasized that there is tremendous public
support for these programs. He stressed that these programs
are available and work. He pointed out that the state has a
funding source that would generate $25 million dollars a
year. He maintained that the settlement would accomplish
little in terms of improving the public health if the money
is not used for tobacco control programs.
Mr. McGoldrick showed the Committee advertising used to
counter marketing by tobacco companies.
Co-Chair Mulder asked how important is price as a
determination of children smoking. Mr. McGoldrick stated
that price is an important deterrent. He stated that studies
have shown that the strongest impacts occur when a price
increase is combined with tobacco control programs. Co-Chair
Mulder noted that Alaska has the highest tobacco tax in the
country. Mr. McGoldrick stated that reductions in sales are
17 percent after the first year of the tobacco tax. Co-Chair
Mulder observed that reductions in sales could be
misleading, since Alaska is influenced by a number of
markets. Mr. McGoldrick emphasized that this is consistent
with other states. Co-Chair Mulder noted that the state of
Alaska has taken the first step in tobacco control by
imposing the highest tax level and suggested that it would
make sense to allow the tax program to work before starting
another. Mr. McGoldrick reiterated that there would be a
better reduction rate with the addition of other programs.
He added that it is essential to counter marketing by the
tobacco industry.
In response to a question by Vice-Chair Bunde, Mr.
McGoldrick noted that there is a 30 percent national
increase of smoking among high school students. He observed
that there are few national smoking prevention programs.
Most states spend little on prevention and many programs are
new. Statistics show that smoking prevention programs are
successful.
Vice-Chair Bunde that there is more product placement of
tobacco products in entertainment. Mr. McGoldrick observed
that our culture promotes smoking and that it needs to be
countered.
(Tape Change, HFC 99 - 82, Side 2)
Vice-Chair Bunde stated that a national news program has
suggested that the tobacco industry encourages shoplifting
of their products. Mr. McGoldrick noted that tobacco
industries pay retailers to place their products in
prominent places. Almost 40 percent of the marketing and
promotion budget of the tobacco industry are spent on
slotting fees.
Representative Austerman asked if there is federal funding
for these programs. Mr. McGoldrick observed that 17 states
receive federal ASSIST funding of less than $1 million
dollars per state. The remaining states receive a nominal
amount through a program called IMPACT. Representative
Austerman questioned if there is a breakdown of what is
spent in states like California for different aspects of the
program. Mr. McGoldrick stated that there are guidelines for
what needs to be spent. He observed that media is a large
part of the expense. He noted that there are fixed costs
that would result in a larger cost per capita in small
population states. He pointed out that arguments made by
small states during the settlement discussions, resulted in
a supplement based on the fact that small states would have
greater per capita costs to implement programs.
CHRISTINE MCINTIRE, EXECUTIVE DIRECTOR, AMERICAN LUNG
ASSOCIATION, ANCHORAGE testified via teleconference in
support of HB 37. She noted that recent data from the state
of Florida demonstrates that results from tobacco control
programs can be quick and effective. She stressed that they
have worked long and hard on a rational strategic plan that
reduces state bureaucracy. She emphasized that money spent
now on these programs can reduce future costs. The state of
Alaska receives a total of $74 million dollars from the
tobacco tax and the tobacco settlement per year. She
maintained that half of this funding should be used to turn
back the tobacco epidemic.
CRAIG HARPEL, EXECUTIVE DIRECTOR, AMERICAN HEART
ASSOCIATION, ANCHORAGE testified via teleconference in
support of HB 37. He noted that although there are other
factors to heart disease, tobacco is the number one risk
factor in cardio-vascular disease. He noted that 28 percent
of Alaskans smoke. He observed that 47 percent of Alaska
Natives smoke. He observed that 36 percent of Alaskan teens
have smoked within the last 30 days.
DIANA CAMPBELL, TANANA CHIEFS CONFERENCE, FAIRBANKS
testified via teleconference in support of HB 37. She
maintained that 100 percent of the tobacco settlement money
should be used for health programs, primarily tobacco
programs. She stated that cancer deaths of Alaska Natives
are the highest in the nation. She stressed that smokers
want to quit. She observed that one child started smoking at
age 6. She stressed that there are not enough programs
available for those that want to quit.
ELIZABETH RIPLEY, DIRECTOR, COMMUNITY HEALTH PLANNING VALLEY
HOSPITAL ASSOCIATION, MATSU testified via teleconference in
support of HB 37. She noted that the Association
commissioned a health status survey in the Matsu area in
1998. She observed that 31 percent of the population smoked.
The rate of emphysema correlated to the rate of smoking in
the communities surveyed. There is no smoking cessation
program in the Matsu Valley. The survey asked what change
respondents would make to change their health in the next
year. The number one change was to quit smoking. She
stressed that she has seen countless patients, in great
suffering, lament that they are dying from something that is
so preventable.
ANGIE ACELTINE, SOLDOTNA testified via teleconference in
support of HB 37. She stressed that the settlement money
should go to medical and education prevention.
MYKKI ORTH, SOLDOTNA testified via teleconference in support
of HB 37. She agreed that settlement money should go to
medical and education prevention.
Representative Williams MOVED to ADOPT Amendment 1 (copy on
file). Representative Rokeberg explained the amendment.
Amendment 1 deletes "does not comply with all of" and
inserts differs in any respect from" on page 1, line 12. It
also inserts "adding" on page 2, line 5 before "masking" and
changes "may" to "shall" on page 2, line 10. He observed
that the wording may differ and the rotating warnings would
not be utilized as required by the FTC. He added that the
amendment would require the commissioner to destroy the
cigarette rather than resale them.
There being NO OBJECTION, Amendment 1 was adopted.
Vice-Chair Bunde suggested that the fiscal note be increased
by $2 million dollars. Representative Grussendorf clarified
that the intent would be that the additional funding come
from the Department of Health and Social Services. He stated
that he supported the amount but not the funding source.
Co-Chair Therriault recommended that the fiscal note be
zero.
Vice-Chair Bunde MOVED to report CSHB 37 (FIN) out of
Committee with the accompanying $3 million dollar fiscal
note by the Department of Health and Social Services, dated
4/15/99. Co-Chair Therriault OBJECTED. He MOVED to DIVIDE
the question. He stated that he would support a zero fiscal
note. He observed that there is no funding in the majority-
spending plan to support the $3 million dollar fiscal note.
Co-Chair Therriault noted that the pending MOTION would be
to move from Committee the $3 million dollar fiscal note by
the Department of Health and Social Services dated 4/15/99.
Co-Chair Mulder MOVED to AMEND the MOTION by reducing the
fiscal note to zero. There being NO OBJECTION, it was so
ordered. Representative Grussendorf suggested that the
legislation be held for further review of the fiscal note.
Co-Chair Therriault observed that their Committee's schedule
was full.
A roll call vote was taken on the motion to adopt a zero
fiscal note for the Department of Health and Social
Services, Tobacco Prevention and Control.
IN FAVOR: Kohring, Austerman, Davis, Therriault, Mulder
OPPOSED: Grussendorf, Williams, Bunde
Representatives Foster, Moses and Davies were absent from
the vote.
Representative Grussendorf and Vice-Chair Bunde stated that
they could not support the legislation without the
accompanying funding.
Co-Chair Therriault observed that funding could be added
anywhere in the process if a funding source were found.
Representative Grussendorf stated that he would support
moving the bill from committee, but that he would try to
find support for funding to implement the program.
Vice-Chair Bunde OBJECTED to moving the bill. He emphasized
that it is a hollow gesture. Representative Rokeberg stated
that he preferred that the legislation move from committee.
A roll call vote was taken on the motion to move CSHB 37
(FIN) from Committee.
IN FAVOR: Kohring, Austerman, Davis, Therriault, Mulder
OPPOSED: Grussendorf, Williams, Bunde
Representatives Foster, Moses and Davies were absent from
the vote.
The MOTION PASSED (5-4).
CSHB 37 (FIN) was REPORTED out of Committee with "no
recommendations" and two zero fiscal notes, one by the House
Finance Committee, for Tobacco Prevention and Control,
Department of Health and Social Services and one by the
Department of Health and Social Services, Community Health
Services.
ADJOURNMENT
The meeting adjourned at 10:10 a.m.
House Finance Committee 11 4/16/99
| Document Name | Date/Time | Subjects |
|---|