SENATE BILL NO. 209 "An Act prohibiting smoking in certain locations; and providing for an effective date." 6:23:33 PM Co-Chair Meyer relayed that the committee would begin with public testimony. DR. BOB URATA, PHYSICIAN AND AMERICAN HEART ASSOCIATION VOLUNTEER, JUNEAU, spoke in support of SB 209. He was in favor of the inclusion of e-cigarettes and hoped that the opt-out provision would be removed. He relayed that every 34 seconds an American died of a heart attack; every 40 seconds an American died of a stroke. He stressed that cancer and cardiovascular disease were the number one and two causes of death in Alaskans respectively. He detailed that secondhand smoke killed approximately 50,000 Americans annually. He cited that the Center for Disease Control (CDC) reported that secondhand smoke exposure cost Americans $5.6 billion annually in lost productivity. He continued that annually tobacco cost the U.S. $133 billion in direct medical care for adults and $156 billion in lost productivity. He believed that smoke-free air workplace laws were an important part in improving the health of Americans. He emphasized that clean air reduced heart attacks, strokes, cancer, and lung disease. He provided an example that in Pueblo, Colorado there had been a decrease in heart attacks due to an implementation of a clean air act. He referenced an Institute of Social and Economic Research (ISER) report documenting Anchorage's positive business experience that occurred when a clean air act was implemented. He opined that e-cigarettes should be included under the legislation due to serious questions related to their safety. He detailed that the Federal Drug Administration had found known toxins in nicotine. He thought the approach should be to do no harm. He asked the committee to imagine how many lives would be saved if cigarettes had been properly studied prior to being placed on the market; he believed the same went for e-cigarettes. He stated that the bill's positive impacts would benefit many individuals in a short period of time. On behalf of the American Heart Association he urged the committee to support the bill. 6:27:51 PM MICHAEL PATTERSON, SELF, JUNEAU, spoke in support in SB 209. He shared that he had been chosen by the CDC to do a nation-wide campaign on chronic obstructive pulmonary disease (COPD) because there was little known about the disease and it was killing Alaska Natives at twice the rate of any other nationality in the U.S. He discussed his personal experience living with COPD, which had changed his life. He shared that in the past he had been a smoker and had objected to others infringing on his rights as a smoker; he no longer felt the same way. He expressed his dedication to traveling throughout Alaska to speak in schools about COPD. He agreed with a Juneau Empire story that stated he faced the anti-smoking campaign with a "fever of an evangelist." He stressed the importance of communicating with students and others about the impacts of smoking. He discussed how difficult it was to avoid secondhand smoke. He emphasized that the CDC had determined that e-cigarettes were an aerosol that contained carcinogens known to cause cancer in addition to ultrafine particles that caused veins to constrict. The e-cigarettes could cause a person with heart problems to have a heart attack; they also caused exacerbation attacks in people with asthma, emphysema, and COPD. 6:31:11 PM Mr. Patterson experienced extreme exacerbation attacks caused by cigarettes and e-cigarettes, which were so intense he had quit smoking. He recalled extensive hospital stays as a result of the attacks. He stressed that e- cigarettes were deadly and although they had no smell, they could cost a person with COPD their life. He asked the committee to help him in his mission to help children understand the cost of smoking. He emphasized that he had not understood what life was until he was faced with his own death. He urged the committee to consider the bill and to set aside thoughts about ramifications to business owners. He thanked the committee for its time and consideration and underscored that the issue was a matter of life and death. 6:35:34 PM Co-Chair Meyer thanked Mr. Patterson for his testimony and agreed that the legislation had many merits. LINCOLN BEAN SR, ALASKA NATIVE HEALTH BOARD, KAKE, JUNEAU, spoke in support of SB 209. He discussed his membership on various boards. He agreed with comments made by the prior testifiers. He pointed to his membership on the National Indian Health Board. He relayed that Alaska had the highest cancer rate in the nation. He believed the issue should get the undivided attention of the state's residents. He recalled that when he had taken over at the Alaska Native Tribal Health Consortium (ANTHC) the organization had needed one oncologist; it currently required four. He stressed that the statistics did not lie. He communicated the Alaska Native Health Board's support for the legislation; the board had implemented a similar policy and had seen a positive impact. He relayed that the cancer rate was highest among Alaska Natives primarily due to tobacco use. He communicated that prevention was the key. He discussed a recent board meeting focusing on prevention. He emphasized that the news was not all grim; less than one in five (18 percent) of Alaska Native youths smoked at present. He compared the number to the 31 percent who had smoked five years earlier. He shared that non-smokers could be sickened by secondhand smoke and pointed to the successes of smoke-free businesses. He appreciated the committee's time and believed that speaking out on the issue could save lives. EMILY NENON, DIRECTOR, ALASKA GOVERNMENT RELATIONS, AMERICAN CANCER SOCIETY CANCER ACTION NETWORK, testified in support of SB 209. She relayed that she had been working on the issue in Alaska for 13 years in local areas. She mentioned barriers to furthering local action and stressed that it was time to protect all workers from secondhand smoke in the workplace. The organization did not support the opt-out provision in the bill, but it did support the continued public discourse and moving the bill forward. She highlighted a study commissioned by the American Cancer Society that looked at how the law would impact states. She shared that over five years a comprehensive smoke-free law would be expected to produce economic benefits including a $3.69 million savings in heart attack and stroke treatments, $1.35 million in lung cancer savings, $520,000 in state Medicaid savings, and $980,000 in smoking related pregnancy treatment savings. She stated that the e- cigarettes information had come forth in the past couple of years due to the product's newness. She relayed that the organization had been working closely with the Department of Health and Social Services on implementation plans; the department would be able to implement the legislation smoothly with the existing community grant program around the state with a focus on public education. She communicated that everyone had the right to breathe smoke- free air. Co-Chair Meyer wondered if there were items in the bill such as the opt-out provision that Ms. Nenon did not like. Ms. Nenon replied that the American Cancer Society Action Network supported protecting all workers from secondhand smoke in the workplace. The organization was confident the legislative process would continue to deal with the issues. 6:43:52 PM Co-Chair Meyer asked how many Alaskan cities and communities had become smoke-free. Ms. Nenon replied that Bethel was the first community to become smoke-free in 1998. Other smoke-free communities included Barrow, Nome, Dillingham, Unalaska, Anchorage, Juneau, Palmer, Haines, Skagway, Petersburg, and Klawok. She noted that the information was included in the sponsor statement. She added that the smoke-free communities accounted for approximately half of the state's population. SB 209 was HEARD and HELD in committee for further consideration. Co-Chair Meyer discussed the schedule for the following day.