American Lung Association’s report card has some bright spots, but some areas still have room for improvement

Every year the American Lung Association releases a report card of sorts, where counties and communities can see how they are doing in terms of tobacco use abatement, known as the State of Tobacco Control report. In conjunction with a national report, the American Lung Association in California releases its companion report, State of Tobacco Control 2020 – California Local Grades, which issues grades for 482 cities and 58 counties in California on local tobacco control policies.

Report criteria

The report generates letter grades in three categories including smokefree outdoor air, smokefree housing and reducing sales of tobacco products.

For each of these topics a range of points is given in various subcategories. For example under smokefree outdoor air, in the subcategory of dining areas, the points are awarded as follows: all outdoor dining areas at bars and restaurants are 100% smokefree, four points; smoking restricted in outdoor dining areas but designated smoking areas allowed or exceptions made for certain types of bars and/or restaurants, two points; no smoking restrictions in outdoor dining areas, zero points.

In addition, there are so-called emerging issues bonus points, such as emerging products definitions-second hand smoke (to include any emissions from e-cigarettes), emerging products definitions-licensing (to include any retailers of e-cigarettes), retailer location restrictions, sale of tobacco products in pharmacies, flavored tobacco products and the minimum pack size of cigars. Receiving a total of three or more of these bonus points adds one point to the Overall Tobacco Control points.

For the overall grade, municipalities must receive 11 or 12 points to receive a grade of “A.” Under each individual category, the points required to get an “A” grade range from four to 18.

State numbers

California is considered to be in the top five states, receiving grades of “A” for Smokefree Air Policies and Funding for State Tobacco Prevention Programs, and receiving grades of B for Level of State Tobacco Taxes; Coverage and Access to Services to Quit Tobacco; and Minimum Age of Sale for Tobacco Products to 21, the latter being a new law this year.

Statewide, California now has a total of 44 communities with an overall “A” grade, 34 additional communities restricted the sale of flavored tobacco products, doubling the number 63 and over half of the policies passed in 2019 updated definitions of smoking or tobacco products to include e-cigarettes.

Seven new communities received a grade of “A” in 2019, and 29 communities improved their grade to “A” in at least one policy category.

Overall, of the 537 California communities included in the report, 8% (44) have an overall grade of “A,” 10% (56) have an overall grade of “B,” 19% (103) have an overall grade of “C,” 16% (87) have an overall grade of “D,” and 46% (247) have an overall grade of “F.”

Local numbers

Overall, Sonoma County continues to be a leader in tobacco control, though some local areas are doing better than others.

Windsor and Healdsburg both scored an “A” grade, each with an overall score of 12 points.

Healdsburg recently adopted a strong smokefree multi-unit housing policy, which helped lead the way to a top score. They received maximum scores for smokefree housing and reducing the sale of tobacco products. The lack of regulations to create smokefree air in service areas, worksites or on sidewalks prevented a perfect score  in that category, but the city received three emerging issue bonus points for limiting sale of tobacco products in pharmacies and emerging products definitions for second hand smoke and licensing.

Healdsburg was also declared a “Community on the Rise” for improving its overall grade from a “B” to and “A” and its smokefree housing grade from a “D” to an “A.”

Windsor had the same scores and findings, however they ended up with five bonus points, for emerging products definitions-second hand smoke, emerging products definitions-licensing, retailer location restrictions, flavored tobacco products and the minimum pack size of cigars. 

Just as last year, Sebastopol earned an overall grade of “B”, with a total of 8 points. It got dinged for lack of smokefree air in worksites and on sidewalks, though it got full marks for smokefree housing. However, they received an “F” grade (and subsequent zero points) for reducing sales of tobacco products, which hurt their overall score. They also only received one bonus point, for emerging products definitions-second hand smoke.

Cloverdale kept its grade from last year, continuing to lag behind the other local municipalities with seven points for a grade of “C.” Like other areas, Cloverdale lost points for a lack of smokefree air in worksites and on sidewalks, however where it really fell behind was in reducing the sales of tobacco products and smokefree housing because Cloverdale only restricts smoking in common areas.

They did receive five bonus points for emerging products definitions-second hand smoke, emerging products definitions-licensing, sale of tobacco products in pharmacies, flavored tobacco products and the minimum pack size of cigars, however they still only garnered a score of seven points overall.

The unincorporated parts of Sonoma County had the highest scores of all, with a total of 13 for an “A” grade. They received perfect scores for smokefree housing and reducing sales of tobacco products, though they did lose some points for the outdoor air portion, with zero points awarded, like the other areas for worksites and sidewalks, though they only scored three points each for pubic events and recreation areas.

The highest scoring city in Sonoma County was the city of Sonoma, which had an overall score of 13 points.

Vaping continues to trouble

According to the report, tobacco use remains the nation’s leading cause of preventable death and disease, taking an estimated 480,000 lives every year. This year’s report finds that while California received solid grades in many areas, a significant trend is threatening the health of the state’s young people as youth e-cigarette use has taken a deadly turn.

According to the report, youth vaping is rising at an alarming rate with more than one in four high school students reporting they vape. This is a 135% increase in high school e-cigarette use in just the past two years, which translates to nearly three million more kids starting to vape in that time period.

“In California, our adult smoking rate remains at 11.2%. Sadly, with the youth vaping epidemic still rising, we may be squandering an opportunity to make the current generation of kids the first tobacco-free generation,” said Erica Costa, director of advocacy for the American Lung Association in California, in a statement. “Tobacco use is a serious addiction, and as such, California needs to implement measures proven to prevent and reduce tobacco use as outlined in the ‘State of Tobacco Control’ report.”

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