Douglas Yee, MD, Masonic Cancer Center Director, Testifies Before the MN House Health and Human Services Policy Committee

Testifying in support of HF3032, banning the sale of all flavored tobacco products, at the MN House Health and Human Services Policy Committee - February 26, 2020
Rep. Laurie Halverson
Commerce Committee Chair
Chief author, HF3032

Madam Chair and members of the Committee-

My name is Douglas Yee and I am the Director of the Masonic Cancer Center, University of Minnesota and a Professor of Medicine. I am a laboratory researcher and a medical oncologist with a practice in breast cancer. I am here today in support of House File 3032, legislation to end the sale of all flavored tobacco products in Minnesota.

The Masonic Cancer Center and the state of Minnesota have been central in driving groundbreaking research in the causes of cancer, cancer prevention, and tobacco control research, to name a few key areas. The research on the smoking - cancer connection is indisputable. I think this legislative body knows how critical the data uncovered by former Attorney General Skip Humphrey during the tobacco litigation and eventual master settlement was key to reducing tobacco harm. Smoking use causes 13 different types cancer throughout the body.  26.7% of all cancer deaths in Minnesota are attributable to smoking. It is notable that bladder cancer, a tobacco-caused cancer, resulted in the death of Senator and Vice President Hubert Humphrey; it is fitting that Minnesota has led in the fight against tobacco. As an oncologist, I have seen the toll tobacco takes on Minnesotans.

On the positive side, the past two decades have seen falling cancer death rates. Much of this progress is due to decreased smoking rates. Because of effective public health policies like our Minnesota Clean Indoor Air Law, a high tobacco tax, and other tobacco prevention policies, we have seen smoking rates drop.  When fewer people use tobacco products, fewer people will hear the words ‘you have cancer.’ Yet, almost 6,000 Minnesotans still die each year from smoking-related illnesses. And that’s unacceptable, especially since we can do something about this with the legislation you are considering to end the sale of flavored tobacco products.

For example, menthol is a longstanding tobacco flavor proven to increase dependence and decrease smoking cessation success. More than half of youth who smoke use menthol cigarettes. Menthol-flavored cigarettes disproportionately impact communities of color and lower socioeconomic communities, and lead to a higher, unequal burden of disease and death. There is no question that the sale of any flavored combusted tobacco product should be restricted.

Unfortunately, we are now confronted with an alarming rise in youth e-cigarette use. E-cigarettes come in kid-friendly flavors and nearly all e-cigarettes contain nicotine, which is addictive and may prime the young brain for addiction. E-cigarette flavors like blue raspberry, green apple hard candy and gummy bear1 are clearly not aimed at established adult tobacco users – they are used to target youth.

In Minnesota, 67% high-school tobacco users use flavored products. Furthermore, flavors are a leading reason youth use tobacco products, and flavored products are incorrectly perceived to be less harmful.  While we acknowledge that adult smokers may also prefer flavors in products such as e-cigarettes, we also need to protect against another generation becoming addicted to nicotine.

You may hear that e-cigarettes are useful for adult smokers to quit. There is little evidence that this is true and even if it was, a role for adding flavors to these e-cigarette nicotine delivery devices has not been proven to reduce adult smoking of tobacco. So I don’t think we’ll miss these flavored products.

Thank you.

Additional supporters of HF3032 at the hearing:
LaTrisha Vetaw (Health Policy and Advocacy Manager for NorthPoint Health & Wellness Center)
Dr. Lori DeFrance, MD, FAAP (Pediatrician, Essentia Health – Duluth Clinic; President of the American Academy of Pediatrics – Minnesota Chapter)
Kelley Danielson (parent, volunteer for American Cancer Society Cancer Action Network)
Dr. Mark Steffen, MD, MPH (Vice President and Chief Medical Officer, Blue Cross and Blue Shield of Minnesota)