>> good afternoon and welcome to a special meeting of thursday, december 4th, of the board of supervisors. neighborhood services and safety committee, my name is david campos and i am the chair and we are joined by committee vice chair, supervisor eric mar and we want to thank the clerk of the committee, derek evans as well as the following members of sfgtv staff, who are covering this meeting, jennifer low and jessy larson, with that, mr. clerk, do we have any announcements? >> thank you, mr. chair, make sure to silence all cell phones and electronic device and completed speaker cards to be included in the file should be submitted by the clerk, items acted upon today will be on the

december 14th, board of supervisor's agenda unless otherwise stated. >> before we move on to the one item, i know that norman yee is excused from this meeting, could we have a motion to excuse him? so we have a motion without objection. >> mr. clerk, if you could call our one item? >> item isordinance amending the health code by adding density, proximity, and sales establishment limitations on the granting of new tobacco sales permits, and renumbering all sections in article 19h; amending the business and tax regulations code by increasing the annual license and application fees; and making environmental findings. >> great, thank you very much. and this is an item that has been introduced by supervisor mar, and it is co-sponsored by supervisor kim and wean and her we want to thank supervisor mar for his leadership and i know that we have a number of young people and community members who are here and thank you for being here and, welcome to the

board chambers and i really appreciate chair campos for being here and for adjusting the schedule as an example of the youth commission's leadership for just to give a stronger voice and the respect to young people, and for your advocacy and organizing and this is an ex-siding day sxim here with amazing leaders that are about the future of our community's and the healthy communities and the younger people with a stronger voice in city hall, i call this a tobacco license reduction act. and there is other names for it, but that is the easy way for me to remember this. and it is legislation that has come about from you think that karin was discussing this since 2008, but it is really the result and the sweat and the

blood from youth organizing and i am just going to stand right now, and just honor the amazing young people from the tobacco youth reduction force, whether they were working from city college san francisco, state or the high schools that you came from, supported by youth leadership and institute or the vietnamese youth development center but you are a great example of creating policy from the bottom up and educating all of us to make the communities healthy and better and so i am just standing up to give you tremendous props as we introduce this legislation today. >> thank you, chair. [ applause ] >> so this policy, i think, is an example of the tireless focus, leadership, research and commitment to the city's public health by the young people and the tobacco free coalition as well. without their efforts we would not be here today. this initiative and this act

will set san francisco as the city with a strongest comprehensive effort to limit tobacco licenses in our communities and there is about 1,000 right now, according to the research, and this is a reasonable way to limit them over time so that we protect the health of our community and in san francisco, low income areas, especially communities of color and the communities with a large number of young people have a disproportionate concentration of tobacco permits compared to other neighborhoods, for example, in jane kim's district, which includes the tender loin, there is approximately 270 permits, or stores that are selling cigarettes and other types of products and that was in 2011. compared to only, 37 in the inner sunset area of district seven in norman yee's district and or only, 51 in the marina area of san francisco and supervisor farrell's district and this effort will help to

address this disparity, by protecting young people, and preventing the sales of cigarettes and tobacco products around schools but also protecting vulnerable communities by not allowing the number of permit to rise before a certain level and gradually reduce these permits and i also wanted to say that this tobacco reduction act is part of our broader effort and so the coalition from the tobacco free coalition and others it is part of our broader community and public health approach that is creating healthier sf retail and corner stores and really are doing away with and limiting and ending the sales of junk food, cokes, and smokes as well, so i feel like this is a really, positive effort to create healthier option and to limit the harmful ones as well. also, when we looked at the equity and i know that we will

have speakers that will show some of this inequity and why this is a way and protecting the vulnerable communities and youth but we will look at maps of san francisco and where the tobacco licenses are and where the sales are, especially around low income communities and where young people have access as well. our department of public health staff and i want to thank them, and they are amazing and so great to work with. but they are leading the country in many ways, in showing what cities can do, but our department of public health staff, they emphasize that tobacco use is the leading cause of death in in our city and in our country. we spend in san francisco, nearly 400 million dollars a year, on the cost related to tobacco, and tobacco addiction as well. and that is about 625 dollars per san francisco resident, and 625 dollars per person based on

the addictions to smoking and the hooking of young people in some ways to addictions like smoking. the youth leadership institute did a great survey, over the past few years, 2014, survey though of san francisco residents showed that nearly 84 percent of respondents support the policies like this one that reduce the concentration of tobacco retailers and the tobacco sales. and nationally and researchers from stanford and ucsf, they will emphasize in a moment, that the greater the exposure to tobacco outlets or the stores that sell tobacco, the more likely a neighborhood is at risk for tobacco related deaths, and disease, and those cost related to it. specifically low income communities, but i will just emphasize again there is a racial justice and it is largely people of color and immigrants as well and so the researchers will emphasize that

higher exposure to tobacco density or these stores clustered together sometimes in low income neighborhood also result in youth increasing smoking rates as well. so i think that we will hear a lot of research and relevant research as well. our tobacco license reduction act will over time through attrition reduce the number of licenses throughout san francisco, and we estimate that over ten to 15 years we will reduce the number of licenses in half. and i think that is an amazing accomplishment if we can do that with this legislation. and it does this by creating a cap of 45 licenses predict and that is based on the data that we will see, any new permits must be located 500 feet away from a school and i think that is an important one of protecting young people and students from being addicted to smoking and all of the marketing and targeting of young people by the various ecigarette companies and

tobacco companies as well. also, this act, also, limits these licenses, 500 feet away from a tobacco retailer and it is limiting the types of sales in communities, and no new permits for any restaurant or bar, and no permits in any location, and it also includes key provisions that protect the business owners by preserving the value of the stores and allowing them to sell the businesses without being adversery impacted by the regulations, i want to thank the association, and kamel and others for giving us a lot of input for this legislation to make it sensitive to the small businesses as well. and this act was crafted in coordination with the tobacco free coalition that has led the efforts over the years, and in addition to the stake holder groups as i mentioned, our department of public hel and this many community advocates

this tobacco license reduction ordinance is part of a coordinated effort that includes healthy retail sf that addresses health equity and supports the small independent businesses and strengthens our community. and i would also like to thank the co-responsers, supervisor jane kim for district six and scott weiner from district eight and our former president, and who worked with the young people and empowering them as well and the youth leaders that i mentioned earlier from the tobacco youth reduction force and a number of them will speak in a moment. but i wanted to specify the arab american and also, to shaeb, and for giving us such great input and nick from my

staff as well from corraling everything together and really crafting with our city attorney, and this important piece of legislation. and lastly, from the department of public health, the amazing leadership of susanna and derek smith as well. [ applause ] >> i wanted to just wrap up before turning it back over to supervisor campos, to say that this tobacco license reduction act will reduce drastically the number of tobacco sales outlets and it will advance health justice and health equity in a very common sense way and it will put our city back on the map as one of the strong leaders in the country that supports youth empowerment and healthy communities as well. let me ask if he has any remarks before i look to the speakers that we have >> thank you, i want to thank

you for your leadership and your staff and all of the work that has gone into this in this broad community that has pushing this issue forward. and i appreciately want to thank the young people for the important role that they have played. and i also would like to be added as a co-sponsor and it is important for us to be a lead when her it comes to these issues and it is gratifying to me to see the role that young people are playing, in making this issue a priority and i am proud of you. and very happy to be supportive of this effort and so with that i will turn it over to you and i know that you have a number of speakers so that we can hear from them. >> the first is san francisco city doctor eragon from our department of public health. and susanna labery a leader of a lot of the efforts in the department of public health.

>> i am with the department of public health and the public division and also, the staff healthy sf and our goal is to reduce this proportion of exposure to tobacco outlets in san francisco, we know that the more exposure the more at risk a community is to tobacco related health disparity and so this legislation will minimize the exposure in all district and create a level playing field. while the tobacco related public health crisis effects all districts, it is in san francisco's interest to address this over concentration of outlets in many of our neighborhoods. and this sends a message of approval and so think of it for a minute of the children walking through the tender loin in district six with hundreds of permits, that is more than 3 times the number in marina, it is saying that it is okay to use these products that this is

the norm. and social and unacceptable has been shown to help with norms and children and young people are experienced by cues that smoking is acceptable, all members of the community are affected. other research shows that communities are lower economic status and higher tobacco density have higher levels of individual smoking and my colleague, gary will illustrate this. this is a health equity issue, it is for these reasons that the institute of medicine has called for the development and the implementation for the legal mechanisms for restructuring the retail sales and restricting the number of tobacco out let's like we are doing today. supervisor mar, covered all of the different elements to reduce the density and the cap at 45 predict and no new permits in the new location and

the distance requirements it will not be made for available for retail food stores and it will be in existence for five years but also to a child of an existing permit holder. and i also want to agree with the supervisor and mention that this recognizes the critical role played by the corper store owners in our communities. we have met repeatedly over the past six months with the arab grocer's association to craft a formula that addresses our public health goals and meets the needs of small business. we are working hard with the coalitions, to assist corner store owners in becoming healthy retailers. we help them improve the physical environment with produce bins and units and help

them strengthen and engage the community, and reuse this to reduce the tobacco density is a 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