Tobacco Free New Hampshire: State budget request for funding to support youth tobacco prevention and cessation and restoring funding for Division of Liquor Enforcement positions

Tobacco Free New Hampshire is a diverse network of public health advocacy organizations and healthcare professionals dedicated to reducing the health complications and death toll due to tobacco use. We are asking the state to consider the following items regarding the budget passed by the House of Representative and our concerns regarding the lack funding for youth cessation programs and the proposed elimination of the Division of Enforcement and Licensing under the New Hampshire Liquor Commission.

First, our organizations support a state budget that increases tobacco control funding by $220,000 per year to provide cessation resources for youth under the age of 18, who are now addicted to nicotine caused largely by electronic cigarette/vape use. This modest funding will enable the Department of Health and Human Services Tobacco Prevention and Cessation Program to launch an initiative to help keep Granite State youth healthy.

In the past the New Hampshire legislature has passed a few policies to help reduce tobacco use among youth and adult smokers. Policies including smoke-free restaurants, regulating electronic cigarettes under the tobacco statutes, and raising the minimum legal sales age to 21, which are all positive steps towards reducing youth tobacco use rates. However, tobacco prevention and cessation efforts have been woefully underfunded in New Hampshire. We need to adequately fund a comprehensive tobacco prevention program which is focused on new and emerging products as well as traditional cigarettes. The reason being that one third of Granite State youth are now using ecigarettes, which contain addictive nicotine as their primary tobacco ingredient.

• The 2019 NH Youth Risk Behavior Survey showed that 33.8 percent of high school students reported they used ecigarettes in the 30 days prior to taking the survey. The national average was 27.5 percent.

National data shows that 95 percent of adult smokers started before turning 21, when adolescent brains are rapidly developing and especially susceptible to lifetime nicotine addiction. This is a time when youth can be subject to negative brain development impact, addiction, and a wide range of adverse health effects, including cancer, lung disease, heart disease and stroke. Nicotine is a gateway to other substance use disorders – opioids, alcohol, amphetamines, and THC.

In addition to its efficiency budget request of a little more than $385,000 each year, the DHHS requested $220,000 yearly for a youth cessation initiative specifically tailored for those under age 18. Unfortunately, this modest amount of funding was not included in the governor’s or House budget proposal. Details about this initiative follow:

• The New Hampshire Tobacco Prevention and Cessation Program engaged youth and helped develop and launch a multi-platform prevention and intervention campaign called Save Your Breath NH, saveyourbreathnh.org, in SFY 2020/21.

• In SFY 2022/23, TPCP will evaluate the knowledge gained through data analysis and plans to relaunch the campaign with NH adolescents taking the lead as peer influencers. When adolescents visit saveyourbreathnh.org there is a link to My Life My Quit, a free and confidential adolescent helpline to quit smoking or vaping. This adolescent-focused quit line launched in October 2019.

• Ongoing evaluations of the impact of the campaign will be used to make improvements during phase two. TPCP plans to continue to work with adolescents to decrease youth initiation of electronic cigarettes. TPCP will also collaborate with local communities, school administrative units and school boards to encourage referrals to My Life My Quit when a minor violates tobacco use policies.

New Hampshire received $214 million in tobacco taxes in 2020 but spent less than $400,000 on initiatives to prevent kids from using tobacco and to help smokers quit. After years of not adequately funding tobacco prevention or cessation services, the time is right to increase resources for those impacted by tobacco-related illnesses and those wanting to quit. The return on investment is enormous both economically and for the health of our kids, the next generation.

Secondly, our organizations are opposed to the section in the House-approved budget which abolishes 21 enforcement positions within the NH Liquor Commission Division of Liquor Enforcement and renames it to the Division of “Licensing and Education.” Simply put, this move will jeopardize the safe operation of licensed vaping and alcohol establishments and the division’s ability to protect vulnerable aged youth.

In addition, this proposal would put in peril federal funding the Department of Human Health Services receives through the Substance Abuse Prevention and Treatment Block Grant. The $12.8 million grant supports substance misuse prevention, early-intervention, treatment, and recovery support services in the state. Under this grant, states are required to provide detailed information on progress made in enforcing youth tobacco access laws to comply with the reporting provisions of the Public Health Services Act (42 U.S.C. 300x-26) and Tobacco Regulation for the Substance Abuse Prevention and Treatment Block Grant (SABG) (45 C.F.R. 96.130 (e)). Under this grant the department provides $50,000 to the Division of Liquor Enforcement to perform the required compliance checks. If the division can no longer serve as the enforcement arm for this grant, this critical funding would be put at risk.

The TFNH network organizations are aware these are very challenging times for passing a balanced budget, but funding for tobacco cessation and a means to enforce laws to protect our young people need to be prioritized this legislative session for the health and safety of Granite State youth. For this reason, the members of the Tobacco Free NH network strongly urge inclusion of these important public health measures in the state budget.