Title
a. Receive a presentation from the Health Department, Public Health Bureau on current tobacco use prevention efforts and implementation of evidence-based and best practices to address youth vaping; and
b. Approve allocation of the JUUL settlement funds in the amount of $1,487,999 to Public Health Bureau to be utilized in FY 2024-25 for $496,000, FY 2025-26 for $496,000, and FY 2026-27 for $495,999; and
c. Direct staff to include Public Health Bureau’s budget augmentation request in the amount of $496,000 funded by the JUUL settlement in the FY 2024-25 recommended budget (4/5 vote required).
Report
RECOMMENDATION:
It is recommended that the County of Monterey Board of Supervisors:
a. Receive a presentation from the Health Department, Public Health Bureau on current tobacco use prevention efforts and implementation of evidence-based and best practices to address youth vaping; and
b. Approve allocation of the JUUL settlement funds in the amount of $1,487,999 to Public Health Bureau to be utilized in FY 2024-25 for $496,000, FY 2025-26 for $496,000, and FY 2026-27 for $495,999; and
c. Direct staff to include Public Health Bureau’s budget augmentation request in the amount of $496,000 funded by the JUUL settlement in the FY 2024-25 recommended budget (4/5 vote required).
SUMMARY DISCUSSION:
Public health prevention efforts are crucial in addressing youth tobacco and vaping. Early exposure to nicotine can lead to a lifelong addiction and may also increase the likelihood of experimenting with other substances. Preventing youth from starting tobacco and vaping product use reduces the likelihood of them developing a lifelong addiction to nicotine, leading to better long-term health outcomes. Tobacco and vaping use can also negatively impact academic performance and overall well-being. Preventing youth from using these products promotes a healthier learning environment and better educational outcomes.
Tobacco and vaping products pose significant health risks, including respiratory problems, cardiovascular diseases, and addiction. Preventing youth from using these products helps mitigate these health risks and harmful behavioral patterns. Youth, especially adolescents, are more susceptible to peer pressure and advertising tactics promoting tobacco and vaping. Prevention measures help protect these vulnerable populations.
In 2018 the Surgeon General issued an advisory statement recognizing youth vaping as an epidemic, and JUUL Labs, Inc. was deemed responsible for promoting their product to youth. JUUL controlled approximately 75 percent of the country’s electronic cigarette market creating new smaller devices with flavored products that appealed to youth and introduced the concept of nicotine salts. Nicotine salts in electronic cigarettes provide capacity for higher levels of nicotine to be ingested, increasing likelihood of nicotine dependance. The Center for Disease Control and Prevention reports that youth vaping began peaking in 2019.
In 2019 various government entities filed lawsuits against JUUL Labs, Inc. seeking accountability for the company’s role in the public health epidemic. While litigation settlements have been reached, youth vaping continues to be a problem and the rate of addiction has increased as nicotine salts found in vaping devices allow high levels of nicotine to be inhaled quickly and with less irritation than free-base nicotine that has traditionally been used in tobacco products. In 2023 National Youth Tobacco Survey (NYTS) reported electronic cigarettes were the most popular product for the 10th year in a row. According to NYTS data, more than 1 in 4 youth use electronic cigarettes daily, and among students who vape, 9 out of 10 use flavored e-cigarettes. Among college students the vaping rate continues to climb. In 2023 National Institutes of Health reported 18 percent of college students between 19 to 22 years old used electronic cigarettes in the last 30 days.
Public Health activities are critical to reach and educate youth on the health risks associated with vaping, potential dangers to the respiratory and cardiovascular systems and risks of addiction to nicotine. There are misconceptions among youth that vaping is harmless or less harmful than smoking cigarettes. Tobacco and vaping-related illnesses impose a considerable economic burden on healthcare systems and society at large. Prevention efforts reduce these costs and improve overall public health. By using JUUL settlement funds to focus on public health prevention strategies, such as education and awareness campaigns and cessation intervention, we can effectively combat the youth tobacco and vaping epidemic and improve the overall health and well-being of county residents.
The Health Department requests JUUL settlement funds be fully allocated to Public Health to implement evidence-based and best practices addressing youth vaping. The goal of JUUL settlement funds is to support local health jurisdictions to address the youth vaping crisis. JUUL settlement funds were designed to be used for prevention and abatement of youth vaping. JUUL settlement funds can be used over the course of the next 3 fiscal years (beginning on July 1, 2024) to adopt community-focused approaches to youth vaping by engaging social media platforms, schools, and community organizations to provide socially, culturally and linguistically tailored prevention and education campaigns.
JUUL settlement funds will be utilized to address current gaps in Public Health programing and support new community-focused activities as well as program evaluation. Public Health currently has dedicated grant funding to implement tobacco retail licensing ordinances, and limited funding to support smokefree housing, cannabis education, drugged driving, and adult centered community coalition building on tobacco related issues. Public Health has no dedicated funding to prevent youth vaping. When JUUL settlement funds have been spent down programming will return to the level of services covered by grants.
The table below provides the nature of the request:
Public Health Allocation Request FY 24/25 FY 25/26 FY 26/27 Total
(7/1/2024 to 6/30/2027)
I. Evaluation………………………………$60,000 $60,000 $60,000 $180,000
II. Implementation of Education……………$160,000 $160,000 $159,999 $479,999
a. Curriculum cost, training,
other educational materials
b. Presentations, workshops,
peer led activities
c. Youth leadership training
d. Prevention Kits
III. Media……………………………………$106,000 $106,000 $106,000 $318,000
a. Campaign, social media,
print, etc.
b. Webpage updates
c. Youth creative arts & media
IV. Engagement & subcontracts w/ CBO…...$120,000 $120,000 $120,000 $360,000
V. Cessation promotion partnership………$50,000 $50,000 $50,000 $150,000
Total Request …………………………….$496,000 $496,000 $495,999 $1,487,999
Allocating the JUUL settlement funds to the Health Department will ensure that Public Health is positioned to meet community needs. This augmentation request supports the direction provided by Judge Orrick who oversaw the litigation and settlement. Judge Orrick has directed the litigation attorneys to provide annual reports regarding the use of the government entity settlement funds. The Health Department will provide updates to the litigation attorneys outlining current baseline youth-focused nicotine/vaping programs as well as programs that are subsequently bolstered, subsidized, or developed with JUUL settlement funds.
The Health Department respectfully requests approval of the allocation of the JUUL settlement funds in the amount of $1,487,999 to Public Health Bureau to be utilized in FY 2024-25 for $496,000, FY 2025-26 for $496,000, and FY 2026-27 for $495,999. The Health Department also requests direction to staff to include Public Health Bureau’s budget augmentation request in the amount of $496,000 funded by the JUUL settlement in the FY 2024-25 recommended budget.
This work supports the County of Monterey Health Department 2018-2024 Strategic Plan Goals:
1. Empower the community to improve health; 2. Enhance public health and safety through prevention; and 3. Ensure access to culturally and linguistically appropriate, customer-friendly, quality health services. It also supports three of the ten essential public health services, specifically: 3. Communicate effectively to inform and educate people about health, factors that influence it, and how to improve it; 4. Strengthen, support, and mobilize communities and partnerships to improve health; and 7. Assure an effective system that enables equitable access to the individual services and care needed to be healthy.
OTHER AGENCY INVOLVEMENT:
This presentation is preceded by the Board of Supervisors’ Fiscal Year 2024-25 Budget Workshop held on April 2, 2024 where the Board directed staff to return with a presentation before the May Budget Hearings.
FINANCING:
There is no financial impact to receiving this presentation. Public Health has requested a budget augmentation for FY 2024-25 in the amount of $496,000 funded by the JUUL settlement.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐ Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☐ Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒ Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐ Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☐ Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Christabelle Oropeza, Public Health Program Manager II, 755-4572, and
Elaine Narciso, Health Program Coordinator/Supervisor, 755-4607
Approved by:
______________________________Date: _________
Elsa Mendoza Jimenez, Director of Health Services, 755-4526
Attachments:
Board Report
Presentation