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�k NATO December 21, 2021 Mayor Vicente Sarmiento Members of the Santa Ana City Council 22 Civic Center Plaza Santa Ana, CA 92701 RE: Proposed Flavored Tobacco Products Ban Dear Mayor Sarmiento and Councilmembers: As the Executive Director of the National Association of Tobacco Outlets (NATO), a national retail trade association that represents more than 60,000 retail stores throughout the country including many Santa Ana retail stores, I am writing to submit our comments and concerns regarding Ordinance Prohibiting the Sale of Flavored Tobacco Products on your December 21, 2021, agenda. This would ban the sale of all flavored tobacco products, including menthol cigarettes, mint and wintergreen smokeless tobacco products, flavored cigars and flavored pipe tobacco. We would ask that the City Council not adopt this ordinance for the reasons explained below. Three Studies Find that Banning Flavored Tobacco Products Is Associated with Increased Youth and Young Adult Smoking According to a growing number of studies, the banning of all flavored tobacco products can result in increasing the number of underage youth and young adults that start to smoke, or return to smoking, cigarettes. This would result in a new public health issue that policymakers should avoid. Study No. 1: University of Memphis School of Public Health, Science Direct-Addictive Behavior Reports (June 2020): The first study, funded by the National Institute of Drug Abuse of the National Institutes of Health, investigated the impact of the City of San Francisco flavored tobacco ban ordinance after the ban was in force for nearly a year, finding that flavored tobacco product use was reduced, but cigarette smoking among 18-24 year-olds increased by over 35%. The study also found that most consumers of flavored tobacco find other sources for these products. Link: https://www.sciencedirect.com/science/article/pii/S2352853220300134?via%3Dihub Study No. 2: Yale School of Public Health Study, JAMA Pediatrics (May 2021): The second study regarding San Francisco's flavored tobacco ban ordinance was funded by the National Institute on Drug Abuse of the National Institutes of Health and the US Food and Drug Administration Center for Tobacco Products and conducted by the Yale School of Public Health. It compared youth smoking rates among high National Association of Tobacco Outlets,Inc.,17595 Kenwood Trail,Minneapolis,MN 55044 952-683-9270 www.natocentral.org