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6.a Letters of support tobacco 21 American Heart Association I 2750 Blue Water Road I Suite 250 I Eagan I Minnesota I 55121 October 7, 2019 Dear Mayor Maefsky and Scandia City Council Members: I am writing on behalf of the American Heart Association to express our support for the proposed ordinance that would raise the minimum sales age for tobacco products from 18 to 21 in Scandia. The National Academy of Medicine reports that there would be a 25 percent reduction in smoking initiation among 15-to-17-year-olds if the age to purchase tobacco was raised to 21. Preventing youth from starting to smoke is essential to reducing smoking prevalence, considering that almost 95 percent of addicted adult smokers started before age 21. Increasing the age gap between kids and those who can legally buy tobacco will help remove access to tobacco products from the high-school environment and stop the start. Over 45 communities in Minnesota have also raised the minimum sale age for tobacco from 18 to 21 and many cities statewide are considering adopting this policy. We need to continue to do everything we can to protect the health of our young people. Scandia has the opportunity to help prevent another generation from becoming lifelong tobacco users. Thank you for your consideration. Sincerely, Jess Nolan Community Advocacy Director 952-278-7928 Jess.Nolan@heart.org American Heart Association I 2750 Blue Water Road, Ste. 250 I Eagan I MN I 55121 HealthPartners 8170 33rd Avenue South Bloomington, MN 55425 healthpartners.com Mailing Address: PO Box 1309 Minneapolis, MN 55440-1309 October 7, 2019 Scandia City Hall 14727 209th St. N. Scandia, MN 55073 Dear Mayor Maefsky and Scandia City Council Members: On behalf of the 26,000 employees at HealthPartners, we want to express our strong support for the proposed city ordinance that will raise the age for sales of tobacco products to 21. It is HealthPartners’ mission to improve health and well-being in partnership with our members, patients and the community. Nearly every adult smoker (approximately 95%) started before they were 21. For years tobacco use has been the number one preventable cause of death in our country and our state. Smoking costs the state more than $3 billion annually in excess health care costs and each year more than 6,000 Minnesotans die from tobacco-related diseases. As you may know, teen tobacco use in Minnesota has also risen rapidly, primarily due to a sharp increase in e-cigarette use. The FDA recently called youth e-cigarette use an epidemic, and in a recent editorial, said “We cannot let e-cigarettes become an on-ramp to teenage addiction.” We echo those concerns and implore you to include e-cigarettes in any proposal considered by the city. 18-21 is a critical time when young people move from intermittent smoking to daily use. In addition to the countless long-term negative health effects of tobacco, nicotine itself is known to be particularly harmful to the development of the adolescent brain. Research suggests that nicotine interferes with brain maturation and can have long term effects on development and mental health. A recent report from the Institute of Medicine found that increasing the tobacco sales age to 21 would also mean that smoking initiation among 15-17-year-olds would be reduced by 25 percent. Thank you for you for helping lead our state on these issues, and taking a positive step towards keeping tobacco out of the hands of our children. Sincerely, Dr. Thomas Kottke, M.D. HealthPartners Medical Director, Well-being 1406 Sixth Ave. North St. Cloud, MN 56303 FeelingGoodMN.org October 8, 2019 Scandia City Council 14727 209th St. N. Scandia, MN 55073 Dear Scandia City Council Members: On behalf of Feeling Good MN, a collaborative initiative of CentraCare Health focused on improving health and wellness in Central Minnesota, I write to applaud the Scandia City Council on its efforts to prevent youth tobacco use and express our support for the tobacco ordinance being considered. Raising the tobacco sales age to 21, while restricting flavored tobacco products and the availability of cheap cigars, will go a long way to reducing youth access and addiction. If we can stop youth from starting, then we can save lives and lower healthcare costs. We know kids often turn to older friends and classmates as a source of all tobacco products, and they are more susceptible to the addictive effects of nicotine because their brains are still developing. We also know that nearly all addicted adult smokers, an estimated 95%, started smoking by the age of 21. Raising the minimum legal sale age for tobacco products would delay initiation rates of tobacco use by adolescents and lower prevalence in the overall population. The federal government banned fruit and candy flavors from cigarettes but left it to local government to address the problem with all other flavored tobacco products like e-cigarettes and cheap cigars. Increasing the age gap between young people and those who can legally buy tobacco will reduce youth access to tobacco, remove these products from our high schools and ensure Golden Valley youth don’t suffer from a lifetime of tobacco addiction. Your consideration of a T21 and flavoring policy shows a strong commitment to fostering a healthier future for Minnesota’s youth. We look forward to Scandia City Council joining the stand against Big Tobacco. Your leadership will help pave the way for other communities to act and bring us one step closer to achieving a Minnesota where all people are free from the harms of tobacco. Sincerely, Jodi Gertken Director, Community Wellness Association for Nonsmokers-Minnesota | www.ansrmn.org | 651.646.3005 October 8, 2019 Scandia City Councilmembers City Hall 14727 209th St. N. Scandia, MN 55073 Dear Mayor Maefsky and Councilmembers: The Association for Nonsmokers-Minnesota (ANSR) strongly supports your efforts to increase the tobacco sales age to 21 in Scandia. Our organization has a long history of restricting youth access to tobacco by supporting policies like the one you are currently considering. For decades, the tobacco industry has targeted children and teens. Tobacco executives admitted to these intentions in countless emails and industry documents throughout the late 20th century. Now, the industry is craftier, but their intentions are still clear. E-cigarettes are marketed and sold in ways that are appealing to teens through social media and the internet. In 2017, for the first time in decades, youth tobacco use rose due to the influence of these devices. E-cigarettes are infiltrating high schools, and the FDA has called youth e-cigarette use an epidemic. Increasing the tobacco sales age to 21 in Scandia is an important step towards decreasing access to these harmful products among teens. Tobacco use remains the leading preventable cause of death in Minnesota, and most smokers become addicted before they turn 21. Raising the tobacco sales age to 21 will limit access to tobacco products by 18-20 year olds and help cut off access to these products for younger teens. Scandia will set a positive example for other communities looking to improve the lives of their youth. ANSR supports your efforts. Thank you for prioritizing the wellness of your community above the interests of the tobacco industry. Sincerely, Jeanne Weigum President- Association for Nonsmokers-Minnesota 1406 Sixth Avenue North | St. Cloud, MN 56303-1901 (320) 251-2700 phone | (320) 255-5711 fax www.centracare.com October 10, 2019 To the Scandia City Council: CentraCare is a not-for-profit health care system that provides comprehensive, high -quality care to people throughout Central Minnesota. Our mission is not only to improve the health of our patients, but also the community at large. Our day-to-day work in our health care settings and in the community has given us a deep and intimate understanding of individual and community health. Our experience has shown us time and again the number one disruptor of individual and community health is tobacco. Consider these facts: • Tobacco is the number one killer of Minnesotans. Approximately 6,300 Minnesotans die every year due to smoking. • 102,100 Minnesota youth are projected to die from smoking. • More Minnesotans will die from tobacco use than alcohol, homicides, car accidents, AIDS, illegal drugs, and suicide combined. • 580,000 Minnesotans, 14.4 percent of the state’s population, still smoke. • Smoking causes over $3.2 billion in medical costs annually in Minnesota. As grim as these statistics are, there is hope. Part of that hope lies with the ordinance before you to raise the age to legally purchase tobacco and nicotine products to 21. Increasing the tobacco sales age to 21 makes it more difficult for youth to get tobacco from social sources, their primary source for tob acco and nicotine. Surveys have found 75% of smokers ages 15-17 get tobacco from social sources. High school students are less likely to be around a 21 -year-old than an 18-year-old. The more difficult it is for youth to access tobacco products, the less likely they are to use those products and end up as one of the more than 100,000 who will die from a tobacco-related disease. The tobacco industry is well aware of this fact which is why they oppose this and why as far back as 30 years ago Philip Morris not ed in an internal report that raising the “the legal minimum age for cigarette purchaser to 21 could cut our key young adult market (17-20) where we sell about 25 billion cigarettes and enjoy a 70 percent market share.” While Minnesota has made many positive strides toward reducing tobacco use and exposure, no one should pat themselves on the back. The most recent Minnesota student survey showed that while cigarette use has generally declined among youth, there is a dramatic and deeply troubling increase in the number of students using e-cigarettes with 11th and 9th graders now using e-cigarettes at twice the rate of conventional cigarettes. This product is highly addictive and its significant negative health impacts are just becoming known. It is the tobacc o industry’s new and highly marketed device designed to regain their foothold in the youth tobacco market. Again, the ordinance before you offer hope. Hope for the future of our community’s youth and hope for the health of our community and the individuals who live here. Passing the Tobacco 21 ordinance as it is currently written will go down as one of the most important and significant actions you will take when it comes to protecting community health. Thank you for your time and consideration. If you have questions or if I can ever be of assistance, please don’t hesitate to contact me at any time. Kenneth Holmen, MD President/CEO CentraCare 5901 Lincoln Drive | Edina, MN 55436 | 952.992.5734 | childrensMN.org SENT VIA E-MAIL October 15, 2019 Dear Mayor Christine Maefsky and Scandia City Council Members (Chris Ness, Steve Kronmiller, Patti Ray, Jerry Cusick): On behalf of Children’s Minnesota, I am writing to urge you to adopt the proposed Tobacco 21 ordinance that raises the legal minimum age for sale of all tobacco and nicotine products to age 21. Children’s Minnesota is the state’s largest pediatric provider of health care. Last year, we saw over 135,000 patients; 66 of those patients were from Scandia. Children’s Minnesota is also one of the state’s largest Medicaid providers with approximately forty-four percent of our patient population reported as Medicaid eligible in 2018. The community of patients treated at Children’s is incredibly diverse and we are acutely aware of the health inequities and disparities that exist within our community and between our kids. A recent report from the Centers for Disease Control highlights the racial and ethnic disparities in the use of tobacco products among middle and high school students and notes that, often, specific racial and ethnic groups are targeted by the tobacco industry’s advertising efforts. This makes comprehensive tobacco policies even more necessary as w e work to address these disparities and promote health equity for all youth and teens living in our state. In the United States more than ninety-five percent of smokers start smoking before they turn 21. Research has shown that the developing teenage brain is particularly vulnerable to the addictive effects of nicotine. The rate of high school smoking in Minnesota is higher than the national average with 2,500 children becoming daily smokers each year. Current data estimates that 102,000 children living in our state will die prematurely due to smoking. Tobacco 21 laws work to disrupt the social availability of nicotine products to young people. Currently, more than forty percent of the nation’s population is covered by a Tobacco 21 policy and tobacco use among teens has decreased in locations where the policies have been adopted. If we are serious about creating a healthier future for our children, passing and enforcing policies that prevent teens from engaging in habitual smoking is one incremental step. Children’s Minnesota applauds efforts being made in cities and counties across the state to adopt Tobacco 21 policies. We hope to see the City of Scandia join the others that have chosen to take this step to reduce teen smoking in our communities. Sincerely, Kelly Wolfe Director, Public Affairs and Advocacy Children’s Minnesota October 15, 2019 City of Scandia City Hall 14727 209th St. N. Scandia, MN 55073 Dear Mayor Maefsky and Members of the Scandia City Council: I am pleased to provide this letter of support on behalf of the Minnesota Medical Association (MMA) for efforts by the City of Scandia to raise the minimum legal sale age for tobacco products to 21. The MMA is deeply appreciative of your leadership and efforts to protect the health of the youth in your community. The MMA represents more than 10,000 physicians, medical residents, and medical students throughout Minnesota. In our efforts to help make Minnesotans the healthiest in the nation, preventing death and disease caused by tobacco and secondhand smoke has long been an MMA goal. The MMA proudly and actively supported passage of the Freedom to Breathe Act in 2007, and strongly supports restricting the sale of tobacco products to individuals under the age of 21. As of September 18, 2019, eighteen states (Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Massachusetts, New Jersey, New York, Ohio, Oregon, Texas, Utah, Vermont, Virginia and Washington) and over 500 localities in 25 states, the District of Columbia and the U.S. territory of Guam, have raised the minimum legal sale age for tobacco products to 211. Benton County, Beltrami County, Hennepin County, Isanti County, Olmsted County, Otter Tail County, Pope County, Stevens County, Wilkin County, Wright County, and the cities of Albert Lea, Arden Hills, Austin, Bemidji, Bloomington, Byron, Brooklyn Center, Duluth, Eden Prairie, Edina, Excelsior, Falcon Heights, Forest Lake, Golden Valley, Hermantown, Lauderdale, Lilydale, Little Canada, Mankato, Mendota Heights, Minneapolis, Minnetonka, Mounds View, New Brighton, North Mankato, North Oaks, Plymouth, Richfield, Robbinsdale, Roseville, Shoreview, St. Louis Park, St. Peter, Waseca, and West St. Paul are now counted in the growing list of localities that have taken action to protect our youth from the harms of tobacco, and it is our hope that the City of Scandia and the rest of Minnesota will follow suit. 1 Campaign for Tobacco Free Kids, States and Localities that Have Raised the Minimum Legal Sale Age for Tobacco Products to 21, available at: https://www.tobaccofreekids.org/content/what_we_do/state_local_issues/sales_21/states_localities_MLSA_21.pdf Cigarette smoking remains the leading preventable cause of death in the United States2, and while there are many strategies already in place to reduce the use of tobacco, a strategy is needed to ensure that adolescents and young adults to do not start to smoke. Raising the minimum legal sale age for tobacco products will delay initiation rates of tobacco use by adolescents and lower prevalence in the overall population.3 In addition, the downstream effects of smoking – tobacco-related disease – will also decrease in proportion to the reduction in tobacco use. On behalf of the MMA, I urge you to acknowledge the long-term effects of tobacco use on the adolescent brain and adopt an ordinance to protect this community’s children. Sincerely, Keith Stelter, MD MMA President 2 Centers for Disease Control and Prevention (CDC), Health Effects of Smoking, available at: https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/ 3 National Academy of Medicine, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products, March 2015, available at: http://www.nationalacademies.org/hmd/Reports/2015/TobaccoMinimumAgeReport.aspx