DPH releases Alaska Tobacco Prevention and Control Annual Report

On Tuesday, the Alaska Department of Health Department of Public Health released highlights from the 2021 Annual Report from Alaska’s Tobacco Prevention and Control Program (TPC). The Annual Report, a yearly report that summarizes what program strategies are working on reducing the number of people starting to use tobacco and nicotine products. The report also covers what areas are working to increase the number of people who quit these products.

So what is working, specifically in Alaska? The report lays out nine programs that have been proven most effective in helping Alaskans quit using tobacco or never use them. The first, tobacco price increases. Alaska has seen an increase in tobacco product prices over the past two decades, most notably in 1997 and 2004, which the report says has led to lower levels of use by youth and adults. One method has been through taxes, an effective strategy for decreasing tobacco use and prevention.

Another effective method, according to TPC has been the passage of the Alaska Smokefree Workplace Law in 2018, which prohibits smoking in enclosed public places and workplaces, including buses and taxis, stores, bars and restaurants. The law also defines what is considered smoking, to include cigarettes, cigars and pipes, e-cigarettes, and other oral smoking devices that contain tobacco or marijuana.

There are two programs geared towards youth that the TPC lists as also being successful in the prevention of tobacco use-availability and age of sale.

In 2019, Alaska added restrictions on selling e-cigarettes and products containing nicotine to youth. Some of those restrictions included removing vending machines and introducing legislation that would make it a criminal offense to negligently sell or give an electronic smoking product or a product containing nicotine to a person under 19 years of age. That bill, HB 2, has stalled in committee.

However, in 2018, Sitka was the first community in Alaska to raise the minimum legal sales age for tobacco products to 21. In December 2019, the legislation was included in the federal year-end legislative package and passed by both houses of Congress. Later that month, President Trump signed the bill into law and it immediately took effect. the federal minimum age for sale of tobacco products was raised to 21, also called “Tobacco 21” or “T21.” Other methods the report says are working include access to quit support, education, restrictions on advertising, and retail licensure.

The TPC reports that these strategies seem to be working as the number of Alaskan adults who smoke appears to have decreased from 28% in 1996 to 19% in 2019, while the youth numbers appear more promising, with a reported 8% of Alaskan youth smoking in 2019, down from 37% in 1995. On the prevention side, the TPC reports that only 28% of Alaskan youth report ever even trying smoking, even just a puff. That number is down from 72% in 1995.

Little is known about the impact of stay-at-home orders resulting from the COVID-19 pandemic on tobacco and nicotine use including among young adults. According to a 2022 report from the National Institute of Health, initial evidence suggests that young adults may have reduced their tobacco and nicotine use during the stay-at-home orders. The study points to a few reasons, including limited access to tobacco products via other people, business closures which decreased access to retailers, an unwillingness to visit in-person stores to purchase products, or due to changes in daily routines associated with tobacco. While others said they rationed e-cigarettes due to challenges obtaining products during the stay-at-home phase; however, others noted increasing use or stockpiling e-cigarettes.

The report also says that some reduction during the pandemic may have come, from some extent, to smoke-free home policies. If people who smoke typically smoke away from home and have smoke-free home restrictions, they might have restricted smoking at home.

The report does state: “However, more work is needed to determine the long-term impact of the COVID-19 pandemic on tobacco use and cessation in this population.

The TPC wrote in their report that “Despite the difficult circumstances many people in Alaska have faced, tobacco prevention and control initiatives continue to advance. The pandemic has made us understand as never before the importance of health in our lives.”

The TPC does point out some emerging trends, most notably secondhand marijuana smoke exposure, which the report says contains many of the same toxic and cancer-causing chemicals found in tobacco smoke. It also contains the compound tetrahydrocannabinol, also known as THC, which can be passed to others, including infants and children, through secondhand smoke. The CDC says that people exposed to secondhand marijuana smoke can experience psychoactive effects, such as feeling high. The CDC also reports that more research is needed to understand how secondhand marijuana exposure may affect children.

For people who work in marijuana retail, Alaska’s Smokefree Workplace Law includes protection from secondhand smoke from marijuana, unless a licensed marijuana retail store holds a valid on-site consumption endorsement which must be approved by the Marijuana Control Board, and on-site consumption is not prohibited by a local option. Some communities, such as Anchorage, Juneau, and Homer have upheld comprehensive smoke free workplace laws and protect against consumption of combustible marijuana products inside licensed marijuana retailers. Juneau passed safe outdoor on-site consumption policies, allowing for employees to breathe clean air while meeting regulations for on-site consumption.

While the tobacco industry is constantly evolving with products in different shapes, forms, and methods of use that deliver tobacco, nicotine, or synthetic nicotine, experts continue to monitor how these new and emerging products may play a role in addiction, particularly in young people.