Duluth News Tribune: Training targets high tobacco use among addicts, mentally ill

By John Lundy

If someone is dealing with other addictions or mental health issues, it’s not the time to ask them to stop smoking.


Wrong, says an addictions psychiatrist from New Jersey who’s in Duluth to help lead a two-day training seminar on helping individuals with special challenges overcome tobacco use.

“The newer research suggests that when people address their smoking they actually have better long-term outcomes,” said Jill Williams, who specializes at Rutgers University’s Robert Wood Johnson Medical School in treatment of tobacco and other addictions in mentally ill populations. “When you cue the brain with nicotine, it’s really not different than other drugs.”

Williams is making her third visit to Duluth at the behest of the American Lung Association in Minnesota. After conducting a one-day session in the Twin Cities, she came to the Public Safety Building in Duluth on Thursday to work with about 60 behavioral health professionals from throughout Northeastern Minnesota; the training continues today.

The target is a topic that has “been shuffled to the side,” in the words of Pat McKone, regional senior director for the American Lung Association.

Even as tobacco use overall in the United States continues to decline to unprecedented lows, use by vulnerable groups such as addicts and the mentally ill remains stubbornly high, McKone and Williams said.

For instance, according to Williams:

  • Although the rate of smoking in Minnesota is down to 14 percent, the rate for Minnesotans with addictions or mental illness is between 40 and 60 percent.
  • The No. 1 cause of death in alcoholics is health problems related to tobacco use.
  • Fifty percent of people with mental illness die of tobacco-related causes.

“We always remark to the audience: Imagine if 50 percent of our patients died of suicide, how that would be front page news,” Williams said. “Fifty percent die from tobacco and we don’t do anything about it.”

People with serious mental illnesses die, on average, 25 years earlier than the rest of the population, McKone said. “And it’s not from suicide; it’s not from drug overdose. It’s from heart disease, COPD and cancer.”

Over a couple of years, Williams has offered the training to about a thousand specialists in Minnesota, she said. But they still represent a minority.

“What we hear them say … is that they’re the lone voice at their agency and everyone else is sort of opposed or still believes the myths or the idea that we should let people smoke and not pay attention to it,” Williams said. “So we still have a lot more people to get to.”

One sign of that is that only one in four mental health treatment centers has a smoking-cessation program, she said.

Families of individuals being treated for addiction or mental illness should advocate for treating their loved one’s tobacco addiction along with the other problems, McKone said. She called the reduced life expectancy for people with addictions and mental illness a social injustice.

Williams added: “Everyone has someone in their family with mental illness or addiction, and we can’t just look the other way.”

Duluth Budgeteer News: Bus in Minnesota advertises tobacco… for a purpose

By Duluth Budgeteer News

If you are downtown or near a Duluth Transit Authority Bus route, you might see a colorful bus advertising a soda drink. Or you may see a bus with larger-than-life television news personalities plastered on its side.

And now you might see a DTA bus advertising tobacco. But it’s not pushing everyday use of tobacco for smoking or chewing.


The colorful bus wrap was inspired by the work of Native American artist Jonathan Thunder. Duluth Budgeteer readers may remember the recent story on Thunder.

The wrap will adorn a Duluth bus for nine months. Each day the bus will be used on a different route.

The wrap was adapted from a mural that Thunder painted at the Lincoln Park Children and Families Collaborative (LPCFC), 2424 W. Fifth St., entitled “Keep Tobacco Sacred” and photographed by Ivy Vainio.

“We did the bus wrap because we want to start conversations about the difference between commercial and sacred tobacco,” said Jodi Broadwell, executive director of LPCFC.

The smoking rates among the American Indian population in Minnesota is 59 percent, compared to 14.4 percent for the general population. Commercial tobacco-related diseases are the top killers within American Indian communities, including the Lincoln Park neighborhood.

“Traditionally, tobacco was viewed as a sacred medicine central to the culture of some American Indian populations, but for generations the commercial tobacco industry has corrupted sacred tobacco practices,” Broadwell said. “They have also marketed directly to American Indian people by exploiting their images in advertisements.”

The LPCFC’s commercial tobacco prevention work is funded in part by the Center for Prevention at Blue Cross and Blue Shield of Minnesota.

LPCFC was founded in 2011 by a group of education, child development, health and social service professionals. The mission of the organization is to strengthen the Lincoln Park Community by connecting families who care about young children. LPCFC offers Anishinaabe Cultural Programming during its Monday Night Family Gatherings, which includes education on sacred tobacco and its traditional uses.

Wahpeton Daily News: Study: More nicotine found in smokeless tobacco

Users of smokeless tobacco are exposed to equal or higher levels of nicotine and NNK, a cancer-causing chemical in tobacco products, than cigarette smokers, according to a study from the federal government.
Researchers from the Food and Drug Administration and the Centers for Disease Control and Prevention say more data is needed on the toxic components of smokeless tobacco products and the health of those who use them.
In the study, researchers analyzed information from more than 23,000 participants in national health surveys between 1999 and 2012. They looked for markers used to measure the addictive stimulant nicotine and cancer-causing NNK from blood and urine samples. They found the level of cotinine, the marker for nicotine exposure, to be .043 nanograms/milliliter in nonsmokers compared to 180 ng/ml among smokeless tobacco users, about 131 ng/ml in cigarette users and 184 ng/ml among people who used both smokeless tobacco and cigarettes.

Jason McCoy, tobacco prevention coordinator at PartnerSHIP 4 Health in Moorhead, Minnesota, said he’s eager to get this surprising information out to the public.
“We know that in rural parts of the state, one in 10 young white men, basically high school boys, are using Snus and chewing tobacco, thinking it’s less dangerous than smoking,” he said.
He said the only difference is when they use chewing tobacco, they aren’t affecting others with secondhand smoke.
“The individual is potentially damaging themselves more,” he said. “It’s surprising.”
And many young smokeless tobacco users are choosing flavored products, which make it more attractive.
“This ties into other research we have that shows flavored tobacco is viewed, in self reports by teens, as less addictive than regular tobacco,” McCoy said. “On the other end, we know the flavoring makes it more addictive. The part of the brain that ties into the flavor of the product, similar to why you may like Coke over Pepsi, it’s the same triggering mechanism that happens. The flavor gets assigned in your brain along with the nicotine.”
McCoy works with four counties — Becker, Clay, Otter Tail and Wilkin — and gets reports showing that often high school athletes know they don’t want to smoke because of the smell, so they choose smokeless tobacco, also thinking it won’t affect their athletic performance.
“We know that short term, it’s going to cause gum disease and tooth decay, long term, possible mouth, throat and stomach cancers,” he said. “It’s every bit as dangerous as cigarettes.”
He said he’s been told by teachers that students are taking the Ice Breakers mints and filling those containers with Snus, so they can surreptitiously carry the smokeless tobacco around with them.
“When they open it up, it just looks like they’re getting a mint,” he said.
About 3.6 percent of Minnesotans regularly use smokeless tobacco, according to the latest Minnesota Adult Tobacco survey.
For those wanting to quit their nicotine use, the state of Minnesota offers QUITPLAN which provides proven methods of quitting successfully. The program offers phone counseling and nicotine replacement tools at no cost. To find out more, visit or call 1-888-354-7526.

MINNPOST: Proposed Minneapolis tobacco licensing changes will help curb youth smoking

By Jan Malcolm | 06/19/15

Imagine a future when tobacco is no longer the leading cause of preventable death and disease. To make this vision a reality, we must prevent more young people from getting hooked by deadly tobacco products. The Minneapolis City Council is poised to do just that by considering changes to the licensing ordinance to restrict the sale of all flavored tobacco (other than menthol) to adult-only tobacco stores and set minimum price limits for cigars. These measures strike at the heart of the tobacco industry’s strategy to sell their products to kids: flavoring and price.

While Big Tobacco is supposed to be prohibited from marketing to kids, it finds many ways around that ban. Tobacco executives know that unless they get to kids before they reach their 20s they’ve lost a customer. Documents released during the tobacco trials of the 1990s reveal how deliberately tobacco companies target young people. On the witness stand, the chairman of the Liggett & Myers Tobacco Co. said, “If you are really and truly not going to sell to children, you are going to be out of business in 30 years.” A Lorillard executive wrote that he wanted to exchange research data with Life Savers to figure out what tastes kids want. And a marketing plan from U.S. Smokeless Tobacco showed a deliberate strategy to start users on sweet flavors, then “graduate” them to plain tobacco.

Candy and fruit flavors

The appeal of flavoring to young people is the reason the FDA banned cigarettes in flavors other than menthol in 2009. Unfortunately, products such as little cigars, cigarillos, chew, e-cigarettes and others are still widely available in candy and fruit flavors such as bubble gum, grape and gummy bear – flavors that clearly appeal to youth. These flavored products are for sale in more than 250 stores throughout Minneapolis alone, and they are easy for children to purchase. One-third of Minneapolis boys under 18 report buying tobacco from a convenience store or gas station.

Research shows that young people mistakenly believe that flavored tobacco products are less dangerous than other tobacco products. In fact, they are just as dangerous, with the same health risks of cancer, heart disease and chronic obstructive pulmonary disease. Candy and fruit flavored tobacco products just mask the harsh taste and feel of tobacco.

Nearly 20 percent of Minnesota high school students have tried a water pipe or hookah, and almost all shisha (hookah tobacco) is flavored. More than 25 percent of Minnesota high school students have used an e-cigarette, and most e-cigarette liquid is flavored. More than 35 percent of Minnesota high school students report that they have tried flavored cigars, cigarillos or little cigars at some point in their lives. In fact, kids are now twice as likely as older people to be cigar smokers. Almost 20 percent of Minneapolis 12th-graders say they smoke cigar products like cigarillos regularly.

Young people known to be price sensitive

Nearly 75 percent of Minneapolis tobacco retailers currently sell cigars and cigarillos, many for less than a dollar. The proposed changes to our city’s tobacco licensing ordinance would set a minimum price of $2.60 for each cigar. Research shows that young people are very sensitive to price increases and are more likely to just quit using a product they can’t afford than adults are.

Flavored tobacco restrictions and price minimum requirements have been successfully implemented in other communities around the country – and right here in Minnesota. No one wants our young people to face a lifetime of addiction and other health problems. We know that policies that restrict access to flavored tobacco and raise tobacco prices keep kids from starting to smoke and help them to quit.

Support the proposed changes to the Minneapolis tobacco licensing ordinance. Stand up for our kids against Big Tobacco.

Jan Malcolm is the vice president of public affairs for Allina Health. She served as Minnesota state health commissioner from 1999 to 2003. Malcolm lives in Minneapolis.

Star Tribune: Mpls. considers restrictions on flavored tobacco products

By Eric Roper Star Tribune

The sale of flavored cigars in convenience stores could soon come to an end in Minneapolis, where city officials are mulling the state’s first ban on the products at most traditional locations to curb youth tobacco use.

Anti-smoking advocates and small retailers squared off at a packed City Council hearing Monday over a proposal that would restrict sales of flavored tobacco products from more than 300 allowed locations to just under two dozen specialty tobacco shops. Similar bans have been enacted in New York City and Providence, R.I.

A council committee delayed a vote on the proposal, which targets flavored cigars, smokeless tobacco, shisha for hookahs and e-cigarette juice — but excludes menthol flavors. It would also set a minimum price on all cigars at $2.60 — echoing measures passed in Bloomington, St. Paul, Maplewood and Brooklyn Center.

Supporters said low-cost flavored cigars, sold under brands like White Owl and Swisher Sweets, are especially harmful because they entice young people to start smoking. A recent study of 530 underage youth in north Minneapolis found that more than half of the 313 who had used tobacco reported at one point smoking a cigar or cigarillo.

“Luring people to an addictive product with cheap prices and candy flavors before they’re old enough to know better doesn’t … give kids much choice,” testified Latrisha Vetaw of Northpoint Health and Wellness Center. Some of the non-tobacco flavors mentioned in the ordinance include chocolate, honey and vanilla, as well as fruits, herbs and candy.

City records show that 362 businesses are currently authorized to sell tobacco products in Minneapolis, though about a quarter of them are bars that largely sell cigarettes. The proposal would limit flavored tobacco sales to approximately 21 “tobacco products shops,” which generate 90 percent of their revenue from tobacco-related sales. It also clarifies that customers must be 18 to enter those stores.

Convenience store owners at Monday’s hearing challenged the necessity of the change, noting that it is already illegal for them to sell tobacco to minors. City records show that out of more than 350 undercover compliance checks each year, only about 6 to 7 percent result in violations for selling to a minor.

They also said that restricting tobacco sales threatens one of their core revenue streams. “Forty percent of our sales in the convenience store industry comes from tobacco. … That’s the industry average: 40 percent,” said Steve Williams, owner of Bobby and Steve’s Auto World, which has several locations. “So we’re affecting the viability of a lot of convenience stores.”

Ahmad Al-Hawari, who owns four convenience stores around the city, said while flavored cigars account for less than 5 percent of their business, the change could result in lost customers.

“A customer will walk or drive to a smoke shop, buy his flavored tobacco as he wishes … and then he’s going to buy cigarettes and pop from there,” Al-Hawari said. “He’s not going to go back to the convenience store.”

The federal government banned all flavored cigarettes except for menthol in 2009, but did not apply the same restrictions to cigars. Cigars may also be sold individually, versus in packs like cigarettes, making a common price about 99 cents each, according to a city staff report.

Paul Pentel, an internist at Hennepin County Medical Center, said their low cost also makes cigars an appealing option for adults who already smoke.

“In my clinic, I am very alarmed by the number of patients I see who have switched to cheap cigars because of the cost of cigarettes,” Pentel said. “For these patients, cheap cigars are a missed opportunity to quit smoking.”

New York City banned the sale of flavored tobacco products in 2009, except for at a handful of tobacco bars. A ban in Providence, R.I., went into effect in 2013. The state of Maine has also enacted a ban on small, flavored cigars.

Four Minnesota cities have already established minimum cigar prices. The minimum is $2.10 in St. Paul and Brooklyn Center, and $2.60 in Bloomington and Maplewood, city staff said.

Council Member Blong Yang, a cosponsor of the ordinance change, said he was drawn to the issue after seeing in the recent study from Breathe Free North, a program of Northpoint, that children have too much access to flavored tobacco. It also appears to be disproportionately affecting minority communities, he said.

“Every single convenience store that you go to it seems has all this stuff right in front of people, basically,” Yang said. “And it’s screaming for people to buy it because it’s there.”

The council’s health, environment and community engagement committee is expected to vote on the measure in two weeks, with a final vote before the full council possible in July.

Forum editorial: Minnesota tobacco use down

The anti-tobacco work of ClearWay Minnesota in conjunction with other tobacco cessation efforts has had remarkable results in reducing smoking rates among all age groups in Minnesota. It’s a record worthy of high praise. It’s unambiguous evidence that focused, science-based anti-tobacco campaigns can work.

Numbers released last week by ClearWay show only 14.4 percent of Minnesotans smoke cigarettes, down from 22.1 percent in 1999. The decline through the time period has been steady, and corresponds to increased education and imposition of legal restrictions on smoking in public places. Add new medical research about second-hand smoke, and graphic anti-smoking television advertising, and it appears the multi-faceted message is getting through.

But not to every age cohort.

In ClearWay statistics from 2010 to 2014, smoking hardly dipped at all (1 percent) in the 25-44 year-old group, from 19.7 percent to 18.7 percent. A similar slight improvement was measured in the 45-64 year-old cohort, compared with a huge drop (from 21.8 percent to 15.3 percent) in Minnesotans age 18-24. Which could lead to the conclusion that some Minnesotans don’t get smarter as they age. But whatever the reason, the overall percentages of all Minnesotans who smoke is down over the longer study period, and that’s good news for smokers who quit, non-smokers and reduced impacts on health costs associated with tobacco use. The trends are good.

ClearWay is not resting on its excellent record. In the eight years it has left in its mandate (funded by the national tobacco settlement of a few years back), the agency’s agenda includes raising cigarette taxes, which all studies show discourage young people from purchasing tobacco, and raising the age for tobacco purchases from 18 to 21. Again, research finds that raising the age to beyond high school age contributes to fewer high school students trying tobacco. New York City and Hawaii have already taken that step.

There is still much to be accomplished to achieve as smoke-free a society as possible. A lot has been done, often led by private sector companies that banned smoking from the workplace before cities and states enacted overall smoking bans in buildings and, in many instances, outdoor public spaces. Decades of research into smoking-related illness and death, and the proven health hazards of secondhand smoke, have been the underpinnings of changing public policy. ClearWay’s work and similar complementary efforts have been pivotal in changing the way enlightened Americans view tobacco use.

Forum editorials represent the opinion of Forum management and the newspaper’s Editorial Board.

Opinion: E-cigarettes: Doctors' View: E-cigarette, tobacco smoke enough alike to warrant regulation

By Terry Clark, Mary J. Boylan and Joseph Bianco

What are e-cigarettes? Have you ever seen one? Do you know how they work? Are they as bad for your health as traditional cigarettes?

It is fair to say that three or four years ago these were new questions and we did not know the answers. But now we do, and it is certainly time for you to know — and for our St. Louis County Board of Commissioners to know as they consider a vote to help protect citizens of our county from the “invisible” harm caused by these gadgets if being used indoors.

Details about e-cigarettes and their health effects are well-described in a recent report from the California Department of Health, and even more recent good information on e-cigarettes can be found in the News Tribune’s “Our View” editorial on Friday, headlined, “County up next in quest for clear air.”

E-cigarettes is a good news/bad news story. Are they less toxic than traditional cigarettes? Likely. Are they really safe to use? Not likely.

First, how do they work? With no tobacco or cigarette paper to burn, there’s no smoke. They really are electronic gadgets with several sections, one with a small battery, one with a small amount of fluid usually containing some nicotine as well as flavoring and other chemicals, and a high-temperature chamber that converts the liquid into an aerosol or fog to be inhaled by the user (an action called vaping) and then exhaled where it is readily inhaled by those around the user.

What is in this aerosol emitted by the e-cigarette? At least 10 chemicals known to cause cancer, birth defects or other reproductive harm, including nicotine, formaldehyde, heavy metals and volatile organic compounds, according to the report. It’s not what you or your favorite teenager should be exposed to.

Nicotine, a key ingredient in the aerosol, is highly addictive. Of course, that is why so many users of traditional cigarettes said for years that they could quit whenever they wanted but usually never could.

We should all wonder why the three major tobacco companies purchased start-up e-cigarette companies. What do they know that we do not? One thing is this: Kids who start using purportedly safer e-cigarettes often switch and become traditional smokers or, even worse, dual smokers who use both e-cigs and traditional tobacco cigarettes. They are then addicted to nicotine for decades. Is that what the big tobacco companies are banking on?

Our elected county leaders soon will vote on this simple question: Should e-cigarette use indoors be regulated as a public health hazard just like traditional tobacco smoke? That is, no smoking in indoor places such as worksites, bars, restaurants, stores, arenas, etc.

The city of Duluth and many other communities in Minnesota already have answered this question in the affirmative: Yes, e-cigarette aerosol and tobacco smoke have enough in common to warrant being regulated in the same way under the Minnesota Clean Air Act.

In short, keep them outside.

Terry Clark and Mary J. Boylan are doctors from Duluth. Joseph Bianco is a doctor from Ely.

Our View: Do more to keep e-cigs, youths apart

The Times Editorial Board, SC Times

Surveys of Minnesota and U.S. youth show alarming increase in e-cigarette use. Lawmakers can slow this increase by immediately acting to limit access.

Two surveys released the past week — one state and one national — deliver a powerful message about the most pressing issue regarding e-cigarettes:
Government needs to lead a stronger charge to keep them out of the hands — and bodies — of minors.
To this point, most of the e-cigarette debate has been about whether e-cigarettes — which electronically convert liquid nicotine into vapor to be inhaled — are as harmful as traditional tobacco and secondhand smoke.
That debate has raged for years, even decades. A resolution seems months, or more likely, years away.
What’s more pressing to resolve — as evidenced by two surveys of youths’ nicotine use — is slowing the fast-rising number of minors who are trying these devices.
How fast?
The 2014 Minnesota Youth Tobacco Survey released Monday found 28 percent of high school students have tried e-cigarettes. On Thursday, the Centers for Disease Control and Prevention reported 4.5 percent of high school students nationally used e-cigarettes regularly in 2013 — triple the percent from 2011. Equally disturbing: 12 percent of U.S. high school students and 3 percent of middle-schoolers had tried them at least once.
And remember, e-cigarettes have been widely available in America for only about seven years.
Such findings make it clear e-cigarettes hold potential for creating countless new generations with unhealthy and high rates of nicotine addiction.
Hasn’t America learned enough hard lessons from 50 years of tobacco-based nicotine addiction to know it needs to snuff out that potential now instead of waiting for more research?
Ultimately, there is no debate that nicotine is a potent, addictive drug. E-cigarettes are simply a delivery mechanism.
So lawmakers should act now to keep the drug and the delivery system out of the hands of minors.
An easy decision is to enact a federal ban on selling minors e-cigarettes, “e-juice” and related products. Minnesota is one of about 35 states with such bans. However, sales via the Internet still provide youth access.
Another important step is to apply the same rules to the marketing of e-cigarettes that are applied to traditional tobacco.
After all, even a cursory glance at products and advertising makes it clear many producers are targeting youth. Think everything from trendy-looking e-cigarettes (and accessories) to bubble-gum flavored e-juice.
Finally, there is merit in increasing the taxes paid on all e-cigarette products.
Such an approach proved successful in reducing youth use of traditional tobacco. And it might even dissuade adults from nicotine addiction.
Again, too much of the debate about whether and how to regulate e-cigarettes remains focused on comparisons to traditional tobacco.
Seeing how e-cigarettes are gaining traction among youth, the focus needs to shift to keeping these nicotine-delivery devices out of their hands — at least until they are legal adults.

Fewer high school students smoking

Posted by: Colleen Stoxen
In the steepest decline ever found in Minnesota, the percent of high school students who smoked cigarettes in the past 30 days dropped from 18.1 percent in 2011 to 10.6 percent in 2014.
The 2014 Minnesota Youth Tobacco Survey also found fewer young people used used chewing tobacco and cigars between 2011 and 2014.
Efforts to curb cigarette smoking appear to be helping. They include a 2013 tobacco tax, bans on indoor smoking, and tighter restrictions on youth access to tobacco products.
For the first time, the survey also asked about e-cigarette use and found that 12.9 percent of high school students used or tried an electronic cigarette in the past 30 days. The survey found that 28 percent of high school students reported ever having tried an e-cigarette.
“These new findings indicate that our statewide efforts to reduce and prevent conventional tobacco use among Minnesota children are working,” said Minnesota Department of Health Commissioner Dr. Ed Ehlinger. “At the same time, we are seeing a wild-west approach toward e-cigarettes, which allows tobacco companies unlimited marketing access to young men and women. This has led to increasing numbers of Minnesota high school and middle school students using e-cigarettes.”
An estimated 85,900 Minnesota public school students in grades 6-12 have tried e-cigarettes, and 38,400 reported using them in the past 30 days. Nicotine is known to harm adolescent brain development. Nearly one-fourth of high school students who have tried an e-cigarette have never tried another tobacco product.
Read more from the Minnesota Department of Health.

St. Paul OKs ordinance targeting sale of cheap cigars

Article by: PAUL WALSH and KEVIN DUCHSCHERE , Star Tribune staff writers

Over the objections of retailers, St. Paul has approved an ordinance that targets the sale of inexpensive cigars that appeal to young smokers.

The ordinance, passed unanimously Wednesday by the City Council, sets a minimum price of $2.10 each for single cigars, whether sold individually or in packs up to four; for example, a three-pack would have to sell for at least $6.30.

Packs of five or more cigars would not be subject to price regulation.

Currently, cigars can be bought for far less — sometimes for as little as three for $1 and in flavors that make them particularly appealing to young people.

In June, Brooklyn Center became the first municipality in the state to pass such an ordinance. The city has seen a sharp decline in cigar sales since the ordinance took effect.

“This issue is about the underlying problem of the tobacco companies’ intentional marketing to youth and communities of color,” Council Member Dai Thao said during last week’s hearing on the ordinance, which he sponsored.

Jack McNaney, a freshman at Cretin-Derham Hall High School in St. Paul and a member of the Ramsey Tobacco Coalition, said, “It’s not right that you can buy three cigarillos for less than the price of a bottle of Mountain Dew.”

Alicia Leizinger, a coalition program and policy specialist, said Thursday that “St. Paul has taken a strong stand against the tobacco industry’s relentless efforts to addict young people to their deadly products. By raising the price of cheap cigars, they took an important step in breaking the cycle of addiction for the next generation.”

A state Health Department survey revealed that cigars rival cigarettes in popularity among underage smokers.

Steve Rush, director of government relations for Holiday convenience stores, countered last week that the ordinance “will cause us to remove about 70 categories of cigar products” from its 10 stores in the city. “The loss of these sales can be quite serious,” Rush added.

Tom Briant, executive director of the National Association of Tobacco Outlets, added that the ordinance will punish retailers in St. Paul, where stores have a “virtually perfect compliance” record of not selling tobacco products to minors.

Consumers who are of legal age to buy cigars will simply go elsewhere,” Rush said. “This is simply harming the honest, ethical St. Paul retailers who are enforcing the law.”

St. Paul retailers have about 30 days to change the prices on cigars covered by the ordinance.

In 2009, a unanimous City Council vote outlawed candy cigarettes and cartoon character lighters. The council cited a study showing that these products encouraged youngsters to take up smoking tobacco.