In November 2021, St. Paul, MN passed a set of retail tobacco policies that will help improve health equity, reduce youth tobacco use, and reduce the presence of tobacco across communities in the city. We had the privilege of talking with two representatives from the Association for Nonsmokers-Minnesota (ANSR-MN), an organization that helped lead the organizing and advocacy efforts that brought these policies to fruition, to learn more about their work: Jeanne Weigum, ANSR-MN President, and Esha Seth, ANSR-MN Technical Assistance Program Coordinator.

The policies included:

  • Minimum floor prices and a discount ban:The city set a $10 minimum price per pack of cigarettes and a $10 minimum price per standard pack of moist snuff or snus ($10 per 1.2 once package of moist snuff with an additional $2.50 per 0.3 ounces for larger size packages and a $10 minimum price per .32 ounce package of snus with an additional $2.50 per .08 ounces). The city already had a minimum price for cigars of $2.60 per cigar. They also banned the redemption of coupons and sale of discounted tobacco products, including e-cigarettes.  Raising prices is one of the most effective ways to reduce tobacco use, and these policies are likely to help do just that. Learn more about point-of-sale pricing policies.
  • Retailer density limits: The city created a separate license for “tobacco product shops” that are 21+ and derive 90% of their revenue from tobacco products and set a citywide cap of 25 “tobacco product shop” licenses and 150 other tobacco retail licenses (reduced from a current combined total of 242 licenses). Tobacco licenses will also not be issued to retailers located within a 1/2 mile of another tobacco retailer. These policies will reduce tobacco retailer density over time, which is important when density is higher (when there are more tobacco retailers concentrated in an area), smoking rates and youth initiation are higher and people have a harder time quitting. Learn more about ways to reduce retailer density.
  • Menthol sales restriction: They city extended its restriction on the sale of menthol and other flavored tobacco products to include liquor stores, leaving tobacco product shops as the only places allowed to sell flavored tobacco products. This is a win for health equity, given the historic and ongoing targeting of deadly menthol cigarettes (which are easier to start and harder to quit) to the African American community and other marginalized groups. Learn more about menthol.
  • Inclusion of synthetic nicotine: The updated city code clarifies the definition of “nicotine or lobelia delivery product” to include synthetic nicotine. While the state definition already included synthetic nicotine, updating the language in city code as well makes it easier for the city to enforce.
  • Increased retailer penalties: The new restrictions also come with an increase in penalties for retailers selling to minors to the following:  
    • 1st violation: $500 fine
    • 2nd violation within 36 months: $1,000 fine
    • 3rd violation within 36 months:  $2,000 fine and a 7-day suspension of their license to sell tobacco
    • 4th violation within 36 months: license revocation.

For other violations, such as improper display or multiple incidents of sales of single cigarettes, menthol, or other flavored products, the penalties include:

    • 1st violation: 10-day suspension
    • 2nd violation within 24 months: revocation of license.

Given the new caps on retailer licenses in the city, if a retailer loses their license, it is very unlikely they would ever be able to get a new one.

Who was involved in getting these policies passed?

ANSR-MN was part of a broad and diverse coalition that worked to advocate for these policies. St. Paul is located in Ramsey County, MN and the county-wide Ramsey Tobacco Coalition has been in existence for over 20 years. It includes school personnel, law enforcement, city staff, community partners, and community groups as well as public health workers. Ms. Weigum noted that it is broadly representative of the people of Ramsey County in terms of both organizations and in terms of race and ethnicity. See all organizations that signed on to the coalition’s resolution here. Past wins stemming from the coalition’s work across the county include a sign ordinance restricting the amount of advertising allowed on retailer windows, prohibiting the sale of imitation tobacco products (e.g., candy cigarettes); improving clean indoor air laws, and restricting the sale of flavored tobacco, including menthol.

The advocates also were supported by the statewide Minnesotans for a Smoke-Free Generation coalition.

After the city updated its ordinance restricting the sale of flavored tobacco to include menthol, the Ramsey Tobacco Coalition came together again and decided to pursue their next two goals: raising the minimum legal sales age to 21 and prohibiting price discounts. While the coalition decided to aim for passing a “Tobacco 21” policy first, they did not want price discounting to be just be put on the back-burner, and they started the groundwork to be able to tackle that goal next.  

ANSR-MN received funding from Blue Cross and Blue Shield of Minnesota to do community engagement and advocacy for this policy effort, which included creating a media campaign related to price discounting. They created the campaign “Don’t Discount My Life” and were able to create an impactful video (with both a short version and long version) and factsheet along with posters and postcards. The video is locally produced and features local residents. As Ms. Weigum said – “It looks like us, and it IS us – our neighbors and our friends.”

Building Community Support and Persuading Decision Makers

ANSR-MN focused on community organizing to build support for the policies, led by Esha Seth and past ANSR staff member, Tiffany Yang. This looked very different during the Covid-19 pandemic than in previous efforts, with lots of virtual meetings.

The organization has partnered with several community organizations representing a variety of different communities in the past, including faith-based communities, immigrant communities, as well as different racial and ethnic communities, and they have kept up those relationships over the years and kept those partners engaged throughout this campaign as well. When many had more immediate concerns related to the pandemic and couldn’t prioritize tobacco policy, ANSR-MN helped respond to those needs, providing masks, hand sanitizer, and other resources.

St. Paul is divided into 7 wards with a city councilmember representing each, but the city also has 17 district councils. These councils focus on local work, engaging residents in city planning, and also do some community organizing.  The councils regularly have city council staff attend to talk about ordinances being considered by the city. ANSR-MN went to some of the district councils, got on their meeting agendas, and talked with them about the issues. They presented alongside their community partners, who would also talk about why the policies were needed and what they’d seen over the years with the tobacco industry targeting their community. Most of the district councils they talked with ended up voting to support the proposed policies. This support is often something that city council members look to as a way to gauge community support. 

ANSR-MN similarly engaged various commissions that make recommendations to the city council, including the Youth Commission and Human Rights and Equal Opportunity Commission. Ultimately, they were able to get resolutions of support from a really wide range of groups, including youth groups.

They also were able to get key support from the Ramsey County Commissioners. This was a big lift for the campaign, since it is unusual for the county board to take a position calling on the cities within their county to act on a policy. However, since tobacco retailer licensing is handled at the city level, the county board couldn’t act on their own to create these changes and instead used their bully pulpit to help garner attention for the ordinance.

In the summer of 2021, after solidifying supports from these groups, ANSR-MN and their partners started meetings with individual city council members along with residents from the city council members’ wards to discuss support for the policies and explain the issues at hand.

They were able to get the support of the city council president, Amy Brendmoen, who ended up championing the policy along with another councilmember. Because of the impact of Covid on city council members, just like on many members of our communities across the country, it took a while to determine leadership on the issue amongst new time constraints and priorities.

However, ANSR-MN staff members make it a priority to build long-term relationships with councilmembers outside of any given policy campaign and actively participate in all aspects of the political process. According to Ms. Weigum, Because these are long standing relationships, we have a great deal of comfort with back and forth and doing shared problem solving.  We try not to be the outsiders but rather collaborators for good for the community.”

Public hearings were held on the policies beginning in September 2021, and the policy passed in November 2021.

While the bulk of ANSR-MN’s work was focused on garnering support for the pricing policies, it’s clear that other work across the region has created a substantial level of awareness of the problem that the tobacco retail environment represents, as all other parts of the package of policies that ultimately made it into the updated ordinance came from different sources, including from city councilmembers. For instance, one city councilmember was concerned about increased tobacco retailer density in her ward and introduced the provision requiring tobacco retailers to locate at least a ½ mile from other existing tobacco retailers. Similarly, the idea for the cap on the number of licenses came from another city councilmember who was inspired by nearby Bloomington, MN’s recent “endgame” policy that creates a sunset on existing tobacco licenses so that all tobacco sales will be eventually phased out in the city.  The idea for the separate types of licenses came from the Department of Safety and Inspections based on their experience conducting compliance checks for tobacco retailers. Other pieces of the policy package, such as the updated definition to include synthetic nicotine, came from recommendations from the Public Health Law Center.

Why these policies?

In making the case for these policies, the advocates found the most compelling rationale to be the history of the tobacco industry’s targeting and the resulting impact on youth initiation and health disparities. A little background: Prices are a key part of tobacco industry’s strategy to target different groups. Research has shown that cigarettes are often priced lower in neighborhoods that are low-income, that have a greater proportion of African American residents, and that have more kids.[2, 3] We also know that the tobacco industry has targeted menthol cigarettes to African Americans and other marginalized communities for decades. Price has been part of that strategy as well, with menthol cigarettes often being priced lower and more often discounted in African American neighborhoods. To target lower-income communities, the tobacco industry also offers steeper discounts than in other communities. The industry even once went as far as to distribute coupons for cigarettes along with food stamps.[4] All of these targeted promotion and pricing practices help drive the disparities we see in smoking and tobacco use and tobacco-related health harms today[8]

ANSR-MN’s “Don’t Discount My Life” fact sheet includes several key pieces of information, including:

  • MN youth adult nonsmokers who receive tobacco coupons are twice as likely to become smokers
  • About 50 percent of MN smokers have used tobacco coupons or promotions in the past year to save money on cigarettes
  • A third of adult smokers use tobacco coupons or discounts every time they see one
  • Tobacco companies spent $7.7 billion in 2016 to reduce the price of cigarettes and smokeless tobacco for consumers. That is nearly $900,000 every hour
  • Coupons hinder smokers’ attempts to quit. Minnesota adult smokers who redeemed coupons were much less likely to quit smoking than those who didn’t use coupons
  • Young and low income smokers are more likely to use tobacco coupons or promotions

They clearly illustrated the problem through their media campaign, in presentations, and in discussions with both community members and decision makers by sharing examples of tobacco industry coupons, including those sent through direct mail marketing. They made it clear just how big of a difference coupons and price discounts make, with their media campaign and presentations including an example of a receipt from a tobacco product purchase at local store where they were able to purchase two packs of American Spirit cigarettes for only $2 by using a coupon, when the full price without the coupon would have been $19.98.

Image of receipt of customer paying only $2 for 2 packs of American Spirit cigarettes instead of the full cost of $19.98
Image from ANSR-MN’s “Don’t Discount My Life” fact sheet

They were also able to make the connection for folks by drawing the parallels between how receiving coupons impacts people’s behaviors for other items as well, often starting presentations by talking about how people often buy things they don’t need just because they have a coupon for it, whether that’s for something at Target, at a restaurant, or elsewhere. And that while that may be relatively harmless most of the time – it’s a different situation when the coupon is for addictive and deadly tobacco products, and when the price discounts are disproportionately targeted at people who are low income and people of color.

Challenges Along the Way

Just as they were getting ready to release their media campaign and start advocacy for ending price discounts for tobacco in earnest, the COVID-10 pandemic hit. Community organizing during a global pandemic of course came with its own challenges and a need to shift modes of communication as well as needs for flexibility. As previously mentioned, ANSR-MN recognized the immediacy of the concerns that community partners were facing and helped them meet their needs.

Competing priorities are often a challenge when working towards tobacco control policy, and this case was no exception – in addition to the ongoing pandemic, issues around homelessness in the city were a top concern during the time advocates were trying to make the case for the pricing policies. In addition, the pandemic slowed down several processes, including communication, finding a champion, and drafting the policy. 

However, perhaps one silver lining of navigating this work in a pandemic is that some of the organizing was able to happen somewhat under the radar, and the industry opposition to the policies ended up being ineffective and lacking in a clear, consistent message. While retailers and industry representatives made the same tired arguments that are often made against any tobacco control policy (e.g. arguing that people will go to other nearby cities for their tobacco instead, that retailers will lose sales, arguing against government regulation, etc.) The opposition also tried to claim that the minimum price would really end up being $15 once taxes were added, but that was untrue – in Minnesota, taxes are applied at the wholesale level, before it ever gets to retailer, and those would already been included within the $10 minimum price.

While the package of policies that ultimately passed was pretty comprehensive, not all elements that the partners hoped for made it in the final version. For instance, while one councilmember advocated for the minimum floor prices to include an annual increase to account for inflation, as is best practice, that did not make it into the final ordinance.

How will these policies be enforced?

The policies will ultimately be enforced through the penalty structure outlined in the city’s tobacco retailer licensing program. However, ANSR-MN is taking care to make sure the retailers across the city know how to comply. The intention is not to get them in trouble but, as Ms. Seth stated, “The goal is to reduce youth access and to hold the tobacco industry accountable for the years of damage they’ve done”

ANSR-MN has been working with the Department of Safety and Inspections to educate retailers. Using the department’s list, they sent a list mailer to all tobacco retailers with information on the new ordinance and a window cling sticker for retailers to use noting that they don’t accept coupons. All liquor stores were also sent a postcard updating them on the new restriction on menthol tobacco sales.  The retailers will also be sent a guide that covers all components of the new ordinance with pictures to help explain what they can and can’t sell or do, contact information for any questions they have, and the penalty matrix so that they know what to expect for violations.

ANSR-MN will also conduct educational compliance checks in early spring or summer of 2022 to see if stores are complying or if they need additional education.

What’s next?

While ANSR-MN is focused on ensuring the implementation of the new policies goes smoothly in St. Paul for now, they’re hoping other cities in Ramsey County may be interested in these types of policies in the future as well.

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