Sponsor: Public Health
Title
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Minimum Floor Price on Cigarettes and Smokeless Tobacco in Ramsey County
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Recommendation
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Support a minimum floor price on cigarettes and smokeless tobacco and ban the redemption of coupons and in-store discounts on all tobacco products in Ramsey County.
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Background and Rationale
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Ramsey County is committed to being a vibrant community where all are valued and thrive and seeks to strengthen individual, family and community health, safety and well-being through prevention and early intervention. Tobacco use is the single most preventable cause of disease and death, and Public Health, acting in the health interests of both the residents of the city of Saint Paul and Ramsey County, seeks to reduce tobacco use rates and tobacco-related disease prevalence among adults and youth. Long-term tobacco use is directly related to many illnesses, including lung, oral and pharyngeal cancer, heart disease, and lung diseases such as emphysema and bronchitis. People who receive price discounting coupons and promotions are more likely to start using tobacco and less likely to stop.
Increasing the price of tobacco products is important:
• In 2018, tobacco companies spent $9.1 billion to reduce the price of cigarettes and smokeless tobacco for consumers (Federal Trade Commission, 2019).
• In Minnesota, adult smokers who redeemed cigarette coupons were less likely to quit smoking than those who didn’t use coupons (Choi, et al., 2013; Choi & Forester, 2014; Slater, et al., 2007).
• Price is the most effective tool in reducing smoking in adults and preventing youth from starting.
• Studies have shown that a $10 per pack retail price and regulating discounts could result in (Marynak, et al., 2016):
o 637,270 fewer smokers aged 12-17 years
o 4,186,954 fewer smokers aged 18-25 years
o 7,722,460 fewer smokers aged 26 and older
• When prices are higher, tobacco use decreases, especially among youth and low-income smokers. It prevents youth from starting and helps people quit (U.S. Department of Health and Human Services, 2014; Institute of Medicine, 1998).
Prohibiting the redemption of coupons and promotions on all tobacco products is important:
• Tobacco companies use coupons and retail promotions to lower the price of products, making them much more appealing to youth and young adults.
• About 50 percent of Minnesota smokers have used tobacco coupons or promotions in the past year to save money on cigarettes and one-third of adult smokers use tobacco coupons or discounts every time they see one (Choi, et al., 2013; White, et al., 2006).
• Coupons also undermine smokers’ attempts to quit. Minnesota adult smokers who redeemed cigarette coupons were less likely to quit smoking than those who didn’t use coupons (Choi, et al., 2013; Choi & Forester, 2014; Slater, et al., 2007).
• Doing a complete ban on redemption of coupons and promotions would also apply to electronic cigarettes, which are known to be more commonly used among youth. Because there are so many electronic cigarette products available, banning the redemption of coupons and promotions would help keep the price of these products high.
The impacts to racially and ethnically diverse and other underrepresented communities because of price discounting are important:
• Price discounting is targeted at communities disproportionately impacted by the harms of tobacco: African Americans, lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals, women, youth, and low-income populations.
• Because of the harms caused by tobacco products, these communities experience tobacco-related illnesses at greater rates.
o Lower-income populations have less access to health care, making it more likely that they are diagnosed at later stages of diseases and conditions (CDC, 2019).
o LGBT individuals are less likely to have health insurance than straight individuals, which may negatively affect health as well as access to cessation treatments, including counseling and medication (CDC, 2019).
• Keeping tobacco prices low means people of color and low-income communities will continue to experience health disparities and inequities.
Between October 6 and 27, 2021, the Saint Paul City Council will review and vote on a proposed ordinance to ban tobacco price discounting in Saint Paul. This ordinance proposes that the city of Saint Paul require a minimum floor price on cigarettes and smokeless tobacco and ban the redemption of coupons on all tobacco products. A resolution from the Ramsey County Board of Commissioners would help advise and support this proposed ordinance and future Ramsey County cities and municipalities that wish to pass similar ordinances.
Public Health, in partnership with the Association for Non-Smokers Rights Minnesota, supports a minimum floor price on cigarettes and smokeless tobacco and a ban on the redemption of coupons and in-store discounts on all tobacco products. The Ramsey County Board of Commissioners has previously taken actions to regulate tobacco and smoking to promote public health and community well-being as additional data and information about the harmful effects of smoking have emerged. This includes adoption of the Ramsey County Clean Indoor Air Ordinance in 2015 and the support of municipal restrictions on menthol tobacco products to adult only access in 2017.
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County Goals (Check those advanced by Action)
☒ Well-being ☒ Prosperity ☐ Opportunity ☐ Accountability
Racial Equity Impact
Once approved, this action will help ensure tobacco discounting does not disproportionately affect racially and ethnically diverse communities in Ramsey County. African Americans are more likely to use tobacco coupons or promotions and people using these to discount tobacco products are more likely to start smoking and less likely to quit smoking. According to the Centers for Disease Control and Prevention, tobacco use is a major contributor to the three leading causes of death among African Americans: heart disease, cancer, and stroke (CDC, 2019).
Community Participation Level and Impact
The community was engaged in this action through the long-standing work of the Ramsey Tobacco Coalition. Representatives from Public Health’s Statewide Health Improvement Partnership team regularly participate in Ramsey Tobacco Coalition meetings.
Community research and key informant interviews brought price discounting to the front of conversations. Many community partners were recipients of tobacco coupons and price promotions. Many community members considered these coupons and promotions predatory and wanted to focus efforts to end this targeting. Community members have been involved in outreach, including meetings with decision makers.
ANSR and community partners have led the initiative to engage with Saint Paul District Councils and Commissions to educate them on the problem of price discounting in Saint Paul using data and pictures collected from the city. ANSR has also continued to educate and engage community organizations across Saint Paul to get support for this ordinance over the last year and a half despite a pandemic. The proposed Saint Paul tobacco price discounting ordinance has the support of over 40 local and statewide organizations, the Human Rights and Equal Opportunity Commission, the Youth Commission, and three District Councils (North End, Saint Anthony Park, and Union Park).
☒ Inform ☐ Consult ☐ Involve ☐ Collaborate ☐ Empower
Fiscal Impact
This item has no fiscal impact.
County Manager Comments
No additional comments.
Last Previous Action
On September 12, 2017, the County Board approved a resolution which supported restrictions to the sales of mentholated tobacco products to adults only throughout all Ramsey County jurisdictions (Resolution B2017-211).
Attachments
1. None