comprehensive approach to strengthen community and support businesses and promote the over all public health. thank you very much. >> we also have gary way, also in the department of public health. >> all right, good afternoon, supervisors, my name is gary way with the tobacco free

project. >> i created this to show the distribution as well as it is effects of the prevalence on smoking, this shows the distribution of tobacco permits by district. and as you can see the districts are more heavily burdened with tobacco outlets than others, and for instance this has 187 and this one has 37 as you mentioned earlier this next up shows the prevalence of smoking in san francisco by zip code, the darker zip codes indicate a higher prevalence of smoking you can also see that the darker areas are associated with the higher density of tobacco permits this is not

really a coincidence. the darker areas, represent a higher percentage of the residents that don't feel like that they can cover the basic expenses and once again, the darker areas are associated with the heighter density of the tobacco permits. the higher numbers of the ethic population. and so, this first map shows the asian americans in san francisco. the areas such as the exelceir in china town has a high number

of tobacco permits now the areas like the western addition, have a high number of african americans and also has a high number of tobacco permits. this last map is hispanic populations in san francisco and in an area like the mission, right here, also has a high number of latinos and a high number of tobacco permits. areas with low status are purchase denied with the tobacco outlet and also the areas with high density, have a higher prevalence of smoking and finally, the tobacco permits are disproportionately established between the districts. >> thank you. >> mr. chairman, i would like to ask if we could open this up for public comment. >> okay. >> the first public commenter is karin licaboli the co-chair of the tobacco free coalition and i am going to call a number of other names to come forward,

dr. lisa henrickson from stanford, and dr. mcdanaled from ucsf and the senior director of programs from the youth leadership institute and (inaudible) from the leadership institute and noel knowels and (inaudible) it does not have to be in that order and then i will call, the other cards that i have here, and i will ask that you can limit it to two minutes per person. >> all right. >> good afternoon. my name is karin and i am with brief california and i am also the co-chair of the tobacco free coalition and i think that gary made a good case of why it is an issue in san francisco and so i think that have you heard about it and there are 1,000 outlets in san francisco and there are licensed to sell the tobacco in the city. most of these located as you now are very well versed in the low income communities, and communities of color and larger populations of youth that is

one retailer for 110 youth and that is comparative to generally in california, which is about one outlet for every 254 youth. there are no limits to restrict or to reduce the tobacco, the number of tobacco outlet permits and this means that anyone can get a permit or sell tobacco. tobacco use has a huge cost on the city and we know that the money can be spent, better elsewhere. and the normalization of tobacco sales under minds all of our efforts. they have banned the locations near each other, and we have capped the number per population and another aid,

california jurisdictions have also prohited the tobacco outlets or south valley and restaurant and i want to say that we greatly appreciate as well as actively listening to your youth. thank you for your support. >> next speaker? >> i forgot to mention that we have dr. (inaudible) the city's physician from the department of public health. >> i will be very brief, thank you so much for taking this issue on. my name is dr. aragon and i am the health officer of san francisco and at times that i presented here in the past i grew up and born and raised in

the mission district and so i have the opportunity to be the benefit of all of the great public health work that the boards supervisors has done and so this is actually a really important public health issue. and so the microenvironment that the kids grow up influences the decisions they make, the mental model that they have and ultimately impacts their health. and this issue is so important that the health commission, at the san francisco department of public health passed the resolution, on may 15th, 2012, to set limits to the number of tobacco permits and in all the supervisor districts in san francisco and i am sure that have you this and that really documents the science and all of the rationale for why we need to do this. and so i am not going to go over all of the details, because i am sure that you have heard a lot about the science

and there are three big issues and this is good public health and it is going to make a difference and having grown up in the city i am going to tell you that it is going to make a difference. and the second issue is just the economic impact that this is going to have, it is going to have a positive economic impact and the less ber deny of disease that we have, we save money as a city and the healthy people have and the healthy the economy is, the people want to come to a city that promotes and protects health, it is going to save us and the city a lot of money and there is a huge economic impact on the city from tobacco related diseases and the last issue that i want to mention is that this is an equity issue and you have heard of this, and the low social economic and neighborhoods that have more ethnic minorities are more likely to be impacted by this and to the extent that we protect our health it is a health equity for us and it is a geographic, across the district and on every dimension

this is the right thing to do and the san francisco department of public health and the health commission are totally behind you and thank you so much for your public health champion role that you have in protecting people like myself and my kids that live in the city thank you. >> thank you. >> i am a tobacco control researcher from the stanford university, and being here is to confirmed that the research is evidence-based and i want to make three points about what the research tell us. my first point is that you have heard there is an over supply of tobacco retailers and this problem is most acute in areas of economic disadvantage. that is true no matter how it is measured in the literature. so there are more tobacco retailers in areas with lower median income and more familis in poverty and many other

measures of neighborhood depravation, we documented them near the high schools with a proportion of students who received free or reduced meals and a higher of latino students. and at high schools there was a higher proportion of students who were current smokers, and with at schools with five or more retailers in walking distance, going to school or living in a neighborhood with a high concentration of tobacco retailers has serious consequences for health inequity. s and the students are likely to try to purchase the tobacco and in areas with a high concentration of tobacco retailers, illegal sales rates are higher. and they are more likely to report being current smokers and more likely to report frequent smoking. my third point is that clamping down on the youth access is not a solution to this problem. and in one study, adults in houston who tried to quick smoking were more likely to relapse if they lived in a

third of a mile from retailers and here in the bay area, persons with serious mental illness are burdened by the retailers than the people who live the closest and so this effects adults too, thank you for your attention. >> thank you. >> next speaker? >> my name is patricia mcdan ald and i am a researcher at the university of california san francisco and my research explores voluntary decisions by retailers to discontinue tobacco sales, in california and elsewhere, independent pharmacies were among the first to give up tobacco, they were followed by local grocery store chains in the bay area, there are at least four grocery store chains that have stopped selling tobacco in the past ten years. in my research? california, grocery store owners said that they stopped selling tobacco for hel and this business related reasons, including a family history of

tobacco caused death and disease, a declining tobacco sales, tobacco license requirements, or attempts by minors to purchase tobacco, not selling tobacco was a way to avoid the hassles associated with tobacco sales, and a way to avoid selling a deadly product. and there were a few complaints from the customers after the retailers stopped selling tobacco and in fact, some smokers were trafrngful because they thought that it would be easier to quit smoke and non-smokers were pleased because they thought that it sent a positive message to kids. california retailers that i spoke to reported no negative impact on their bottom line from stopping tobacco sales, instead they saw an improved public image because the decision made a statement to their customers that the store owners were concerned about health. retailers and other states, pointed to some other advantages including improved cash flow, the ability to

replace tobacco with higher profit items my research suggests that there is a strong base of support among the customers for tobacco free retailers thank you. >> thank you, professioner. >> i am going to call a few more names and i know that i have called, already, patricia. amanda, and alecia. and fred from the healthy corner store coalition, >> thank you so much, supervisors. i want to say really quickly that i would be remiss if i did not acknowledge the young people that have been working on this ordinance since 2008 that are in the room and i would like to give them a round

of applause. this works with the youth leaders to shape the policies like these, and that work and that create a long term impact and i want to say that the youth leadership has been funded by the department of health that has made the serious investment in public health and really thinking about how youth development and how we tap into the youth development to create social change that is meaningful. the equation, this was something that leaders young people in 2008, developed, the idea around more outlet and people with more access, equals more disease and death and i know that is something that is outlined throughout the presentation and i do want to say quickly, that the outlets that we are talking about have been partners, and have been voices and leaders really in shaping this policy, to insure that their voice was heard, along the way so i want to acknowledge their leadership.

>> you have seen the maps, and we hope that in 15 or 10 years this policy is going to impact these maps and you are going to see it spread out across san francisco. and thank you so much. >> thank you. >> thank you for empowering, and supporting young people's leadership with omi as well, but thank you. >> hello, and thank you. thank you, supervisors for your time. and so, this what these statistics are basically showing is basically what we have all about saying is that neighborhoods with low income and higher number of youth are targeted. >> this has 270 permits in the district and opposed to the inner sunset that only has 37 and you can see that the household income is severely different. the one in soma had 38,000, and the inner sunset has almost 100,000, you can see that they

are being targeted and the other 6 districts are also, highly impacted by these tobacco densities. and the reason that we are doing this is basically because we want to create health equity among the entire city of san francisco this is not just youth it effects everyone, the city financially, health wise, and just going to improve everyone's health in san francisco. and we will insure health equity over the next ten to 15 years through this policy. we did a survey in 2009, and in four different neighborhoods and 83 percent supported the limits of tobacco sell ng san francisco and we have conducted another survey which also showed that 80 percent of people supported our policy and supported the decrease of the tobacco outlets and also they felt that having numerous tobacco outlets, each block was too much. >> and the last one was just, we have over 900 endorsements

of people supporting us and we would like to thank you supervisors for all of your support and hard work. >> and if it is you and you organized really an amazingly effective campaign and just to have that much support is really a testament to the hard work that you have done, but thank you. >> thank you. >> next speaker. >> hi my name is monroe and i am (inaudible) and i support the policy that we are trying to pass right now. so basically i live on treasure island is really a lot of tobacco outlets but when i go to soma or china town or to the mission, the education from, and i also have to see all of these tobacco let's and it makes me want to try it and not just me and my peers want to try it. and there is also like kind of messed up because after the shows and you see from the map that it is targets people of

colored youth and also, lgbtq and also the people who have the teen line and also you can see if you see it in the map that you can see that. and it is targeting it by having it right there so it really makes a problem and not just for me, but for everybody and also i have asthma and it is also part of my family and we have to live in that. and so it really makes us really unhealthy. thank you, and i hope that you support our policy. >> could you say what high school you are from and what grade. >> i am from cono, and i am in the ninth grade. >> thank you. [ applause ] >> next speaker. >> good afternoon, my name is fred tamko. and i would like to introduce

and... and community leader. well, also i am independent of the tobacco industry and the sector and i have smoking since i was 13 years old and about 30 years ago i know how easy for the access to get i seg cigarette in the store and i started to smoke and get addicted to them as i became a chemical dependant. and now i am suffering the heart and lungs continue and several and possibly i have cancer and asthma. and i could become vegetable after getting a stroke and and paralyzed and die quickly, most of my family die this way, my chances are for my life is to create smoking cigarette in support to eliminate the cigarette to the population and it will save a millions of lives because of the quantity and the quality pays for the

process, and the price of smoking should be prohibited and the human, and as we know, we are (inaudible) smoking cigarette and once we start it is very addictive. thank you so much. >> thank you. >> next speaker. >> (inaudible).

>> next speaker. >> thank you. >> good afternoon, my name is

cathy otto... >> could you hold the microphone closer. >> my name is cathy otto and i am a volunteer legislative ambassador for the american cancer society and i live in san francisco and thank you for inviting me here. and i have supervisor mar mentioned, tobacco is the leading cause of preventable death. low income neighborhoods and those with people of color have a greater number of tobacco retailers in san francisco. and these neighborhoods also have a greater number of tobacco related diseases. and the tobacco industry markets heavily to youth and ethnic minorities that lost a lot of the adult and reducing the density of the retailers and prohibiting them to being near the schools will over time reduce the number of tobacco

ads they will be exposed to and will reduce access to tobacco by youth. we all know if you make something inconvenient for people they won't do it. and if you make it really convenient, it is very easy for them to do it. we know that the tobacco industry is well aware that most smokers start before age 18. and nearly 100 percent began before age 26. i know this because, i taught smoking cessation classes for the american cancer society for many years. when i asked the students their age when they started it was 14 to 16, and they never stopped. and they were like 50 or 60 for the first time trying to stop and some of them have lung caner by then, by reducing this access the youth are less likely to start smoking, nationwide, one-third of the illegal sales of tobacco to youth occur within 1,000 feet of a school. communities across the state are recognized the link between tobacco, retailers and schools. we urge you to support the

strongest possible amendment to the existing ordinance, and thank you very much. >> thank you. >> i wanted to just first say that the next three speakers have educated me so much on this issue and they are the tremendous leadership that has created this policy that we hope will become law in san francisco. i want to say besides, secaros, we are going to hear from presscott and (inaudible) and they are really the face of tobacco youth reduction force and the creation of this policy, amanda? [ applause ] >> thank you, my name is amanda prescott and i am a staff member of the youth leadership institute and i am here to express my support for the proposed density policy, all youth receive the same education about the harmful effects of tobacco use, but for some reason the environment they live in shows reality that

it is okay to live in an area saturated with outlets that far exceed that of affluent communities, and all that you learned in school about the harmful effects of tobacco use will only benefit affluent youth who don't have to walk past multiple outlets on the way to school or just walking down the street, this is a public health issue and a social justice issue and an issue that we need to practice what we preach when we are talking to young people about their health. i believe that now more than ever, through the partnership with merchants who care deeply about the youth and the communities of san francisco, we can advocate to make it a healthy place, please support this policy, thank you. >> hello. my name is malina san ders and i am representing the bay view district and the youth, leadership institute and i am the student at a college in san francisco and i have been

working with the turf policy and our team for over three years now. and we conducted a lot of research and some of the research shows a number of permits around all of the districts and mostly in the low income neighborhoods. and they are targeting people of color, and youth. and i think that this turf policy is a positive move towards creating different numbers lower numbers, and it is good for, the residents and also the business owners, in these neighborhoods. and i just wanted to say that small businesses, owners are partners in this and do i want to recognize that they have a big leadership role in the passing of this policy. >> thank you. >> thank you. >> hello, supervisors, and i am really excited to be here and i

could not speak last night because i was overly excited and right now the caffeine is talking but the excitement. but i just want to be, i am so grateful for all of these people showing up and all of my jeans and everything that goes through the association and for partnering with us and i am wearing my old t-shirt from six years ago because we have been working on this for so long and it is something that we are very passionate about because tobacco has been an issue, in our city for so long and it is not fair that we continue to suffer with the effects of tobacco any longer. our communities, deserve better, we should be living in the healthier place where we get healthier options where we can walk around without passing a bunch of smoke and influences such as advertisements to tell us us to buy this and it is just really not fair. and we should, and we should be having more tobacco entering the communities and right now i am working and in the mission, and everywhere i go, tobacco, tobacco, tobacco and it is not

just targeting young people, like patty mentioned earlier it is effecting everyone, the people of color, low income, and the elderly, the young people and everyone and it is effecting everyone and so this is a cause that we should all be working together and i am so glad and i am so happy to see so many support again, here because this is an issue that we are taking matters in our own hands today and we went down and dirty to get our hands dirty for this work and i think that it is time for you guys, to pass this. and it has been too long, 6 years. and i really encourage you all to pass this today and thank you, supervisor mar for supporting us for so long, and also, and supervisor campos for always, speaking out for us as well, and i really appreciate every single one of you and all of the rest of the supervisors that have been helping us, thank you. >> thank you. >> hi, supervisors my name is brenda, and i am from the russian hills, part of the city

and i have been a san francisco resident my whole life and i am a young advocate with the program (inaudible) and it is for the limited density of tobacco and influence around the city and so i have a friend in the tender loin and block by block you can see like at least when i guarantee. the tobacco outlet. and seeing like a problem, or an issue but when you look at it more in depth you can see that the tobacco outlets are the gateway for the tobacco for youth and you know as a tobacco are constantly on display and the youth along with many others are exposed to such a problem and in addition, to this, my friend a family is low income, and (inaudible) tobacco density is greatest in the neighborhoods where the incomes of the families are lower and so trying to pass is to cap the number of outlets in the district and i hope that you guys will support us in getting this policy passed thank you for your time. >> thank you. >> i am going to call a few

more names, we have the director of our office of small business, and nate from the youth leadership and brian davis. salena from horizon, unlimited, and brian stegner. samara whit. and ferad karashi as well, and jose louis from ta sf. next speaker? >> hi, my name is (inaudible) and i live in district eight or the twin peaks district of san francisco i am a youth for turf which is a program (inaudible) and i am standing before you here today to show you my support for this policy and to ask your your support. the neighborhood where i live is the valley and the neighborhood where my school is located which is in the heights, and there is barely me tobacco et