WSLCB - Executive Management Team
(December 18, 2019) - Summary

[ Event Details ]

Agency leadership learned about the Healthy Youth Survey (HYS) which provides perspective on alcohol, cannabis, and vapor product use by Washington children in grades 6-12.

Here are some observations from the Wednesday December 18th Washington State Liquor and Cannabis Board (WSLCB) Executive Management Team public meeting.

My top 3 takeaways:

  • Sara Cooley Broschart, the agency’s Public Health Education Liaison, reported on the State’s most recent Healthy Youth Survey.
    • Washington’s Healthy Youth Survey (HYS) is a bi-annual collaboration of the Washington State Office of the Superintendent of Public Instruction (OSPI), the Washington State Department of Health (DOH), the Washington State Health Care Authority (HCA) Division of Behavioral Health and Recovery (DBHR), and WSLCB. OSPI called HYS “an important source of needs-assessment data” for state policymakers that “measures health risk behaviors that contribute to morbidity, mortality, and social problems among youth in Washington state.” The survey focused on alcohol and drug use (including cannabis) by children in grades six through 12.
    • Broschart offered WSLCB’s leadership a presentation with highlights from the 2018 survey first released in March, noting that the state wouldn’t see newer HYS data until March of 2021. Her goal was to share what was learned from the 2018 survey and gather feedback from the agency’s executive management team (EMT) for supplemental information desired or prospective new questions to be added to the 2020 survey (audio - 43m).
    • The HYS had been administered since 2002 following a similar survey process the state initiated in 1988 and the results were “regarded as some of the best school surveys in the nation that’s done at a state level.” Broschart noted the survey was “voluntary and anonymous.” The 2018 HYS was “administered in October” with the results released in March 2019. Broschart mentioned the state was “already working a ton” preparing for the 2020 survey.
    • She described the interagency “planning committee” as “truly a collaborative effort” without an official lead agency, nor a designated “project coordinator.” She added that she was the “sole source contributing” on behalf of the WSLCB, whereas DOH sent “about five or six folks,” OSPI provided “two to four” staffers, and HCA sent “six or seven folks” to contribute to HYS. Broschart said she’d advised finding “somebody to drive the train” in organizing the committee as it “would be really helpful” but would necessitate securing dedicated funding.
    • Broschart explained that most of the survey’s funding came out of the state’s Dedicated Marijuana Account established in RCW 69.50.530 in addition to money from the U.S. Center for Substance Abuse Prevention (CSAP).
    • “The youth voice is incredibly important and it’s hard to get at,” was how Broschart explained OSPI’s impression of the survey’s merit. Data from the survey “contributes to policy, programs, and then ultimately behavioural change” with the survey questions in constant flux “because researchers and agency programs always want to know new things about what’s going on with our youth.” She said the majority of the questions were actually derived from other national-level surveys such as Communities That Care, Monitoring the Future, Youth Risk Behavior Surveillance System (YRBS), and the Global Youth Tobacco Survey from the World Health Organization (WHO). This practice helped Washington state “look at ourselves compared to other states.” New survey questions were agreed to by every agency on the HYS planning committee prior to approval by the Washington State Institutional Review Board (WSIRB). However, “anybody can suggest a question through AskHYS.net.” 
    • Broschart cautioned that data on youth use of “vapor products and flavors” was scarce as “it’s a very new topic that hasn’t been vetted yet.” She called the gap in knowledge a “gray area” that wouldn’t be addressed until the next survey was completed. Asked by Deputy Director Megan Duffy about the survey’s “core questions,” Broschart acknowledged that “there are core questions that don’t change and we maintain those for [tracking] trend[s].”
    • Broschart said HYS participation was “really great” and continued to increase over time. From more than 230,000 participants a state sample of 32,271 students were selected from 182 schools in 104 school districts to “get it to match what our state demographics are.” The state sample was also representative of the 39 counties which participated in the 2018 HYS with Broschart adding that some counties had “school districts that are too small to participate.”
      • Regarding the process for winnowing down results to create a representative statewide sample, the 2016 Analytic Report (p. ii) notes: “A total of 198 schools and 36,809 students contributed data to the statewide sample. In addition, 195,203 students in 943 schools participated in the survey as non-sampled schools. These additional schools received reports of their own results, but those results are not included in this statewide report because the schools were not part of the representative statewide sample.”
      • For more detail, see the Bias Analysis reports for the 2016, 2014, 2010, 2008, 2004, and 2002 HYS.
    • Broschart mentioned there were three forms, “form A, form B, and form C” which allowed for more questions to be asked as they were divided between the forms. She told the group that 250 survey questions were narrowed down to “about 100” questions on each form. Forms A and B were for 8th, 10th, and 12th grade students, whereas form C was for 6th graders and featured “more age appropriate” questions.
    • Broschart reported that her remarks would focus on 10th graders as they had the highest HYS participation rate at about 80%, and therefore the largest statistical significance. By contrast, 12th grade participation was around 50% which was below the survey’s desired response rate though Broschart added that the agencies on the planning committee were “trying to increase that” going forward.
    • Broschart reviewed HYS topics from the 2018 survey she believed were most germane to WSLCB’s work.
      • Broschart reported that the HYS indicated Washington state followed a nationwide trend of reduced teen consumption of alcohol. “It’s believed that investments in prevention are paying off but also just in general there’s a little bit different cultural thing happening with social norms and just getting together or staying at home going on with young people,” she said. She noted one in five students had used alcohol, and ten percent still engaged in binge drinking.
      • Broschart pointed out that cannabis use by teens in the state was “steady” despite being “five years into legalization,” but warned that youth perception of risk was declining as well. In “prevention science” Broschart said low perception of risk had been tied to increased cannabis use due to an absent “disincentive.” Furthermore, “many teens are driving” after using cannabis, which was very concerning to Broschart and her colleagues. The survey incorporated “dabbing” as a new cannabis use modality as well as asking more about “simultaneous marijuana and tobacco use.”
      • Though not reflective of the health scare around vaping which came to light in September following the survey’s completion, she said the HYS highlighted a troubling increase in youth vaping. She believed questions about vapor associated lung illnesses (VALI)---a continuing concern for the agency---were likely to be added to the 2020 survey.
      • Saying that “substance abuse and mental health are often a back-and-forth situation,” Broschart noted the two press releases on the survey had called attention to mental health and that “alcohol use remains at an all-time low while vaping use increases.” She pointed to results from Mental Health America (MHA) showing that Washington was 31st in the nation, putting the state “at the bottom of mental health outcomes.” For every 29 students surveyed in Washington, 12 experienced depression, ten experienced anxiety, and three had attempted suicide. Broschart said the information should be a “real red flag for the state and the legislature.”
        • At the time of publication, MHA rankings on youth data for 2020 placed Washington state even lower, 43rd in the nation. MHA indicates this ranking means “youth have higher prevalence of mental illness and lower rates of access to care.”
        • Director Rick Garza asked why there would be a “sharp increase” in anxiety among teens if cannabis and alcohol use had declined. Broschart responded that that question was being studied by a variety of experts with theories including “social isolation and social media” or issues of “connectedness.” She warned that “it’s not going to be a straight line between any of these things and this outcome but it’s all kind of a web.”
    • Broschart briefed on alcohol trends before proceeding to cannabis trends identified in the survey:
      • Rates of teen marijuana use have remained steady, despite the changing landscape. “Two percent [of surveyed Washington 10th graders] were using [cannabis] daily,” Broschart said, later noting that while there was not an increase in the overall youth use of cannabis, experts continued to have “suspicions” that those still consuming cannabis were doing so “differently than they would have been six/ten years ago.” HYS had not yet incorporated questions around products like “concentrates” but Broschart anticipated that would change following a Washington State Institute for Public Policy (WSIPP) report on measuring youth cannabis use.
      • Smoking marijuana is the most common way youth are using marijuana, over half reported usually smoking it. Asking current 10th grade cannabis users how they consumed cannabis found that the second-most popular method was dabbing at 13%. The third most popular method was cannabis edibles at roughly 11%. Vaping and drinking infused beverages were the least common ways 10th graders reported consuming cannabis. Broschart promised that “focus groups” of youth would be conducted to ensure the survey included updated “terminology.”
      • Perceived ease of obtaining marijuana remained stable [between] 2016 and 2018. 33% of youth reported that it would be “very hard” to obtain cannabis, higher than the 26% who felt that way about obtaining alcohol, which Broschart deemed “very good.”
        • Board Member Russ Hauge asked Broschart if the 2018 survey results had been transmitted to Washington’s two U.S. Attorneys. Broschart replied that while it was publicly accessible she didn’t believe anyone had passed it onto them. Hauge noted that federal officials had often asked about legalization’s impact on “youth access” and teen “attitudes” on cannabis. “If I was them, I’d want to know this,” he suggested.
      • Declining perceived risk of regular marijuana use among 8th graders should be carefully monitored. Broschart reiterated her opening remarks that declining perception of risks by teens was cause for concern as it was typically tied to a greater likelihood of use. “But we have not yet seen that in Washington which is a good thing.” Despite this, perception remained a top priority of prevention and health officials.
      • Too many teens are driving after using marijuana. Saying that impaired driving had remained a top issue for the Washington Traffic Safety Commission (WTSC) regardless of the driver’s age, Broschart reported that the survey found 24% of 12th grade students had ridden in a car with a driver who’d consumed cannabis in the prior three hours.” She asserted the behavior needed to be addressed in all age groups as “this is the health and safety of all of us.”
    • Looking at vapor trends…
      • Broshcart drew attention to statistics which indicated 21% of 10th grade students reported using an e-cigarette or vapor product in the last 30 days, a number that had increased over the past several surveys.
      • For cannabis vaping, 10% of 10th graders who reported vaping said they had used products with tetrahydrocannabinol (THC). Broschart indicated that the survey included a question about flavored vapor products, but not did not ask about “flavored THC.” She noted that she’d be having a meeting to discuss adding that as a separate question later that day.
      • Broschart predicted the 2020 survey would feature several new vapor product questions as the state endeavored to “assess if policy changes are effective.” Broschart added that reported vape use rates in the survey were “consistent among genders and across racial and ethnic categories,” a trend she said was not repeated for cigarette use. She predicted this topic would draw heavy scrutiny as lawmakers look to “see if our policy changes have any impact.” 
    • Broschart asked the group “what kind of data needs you may have,” eliciting a couple of questions from board members.
      • Hauge asked about an article he’d seen claiming “cannabis is overtaking alcohol” among teens and whether that trend was observed in Washington. “As of the 2018 data, it’s the same amount of 10th graders saying they’ve used both substances,” Broschart answered before commenting that she “wouldn’t be surprised if it did surpass just given the national trend of alcohol use lowering over time.”
      • Board Member Ollie Garrett wanted to know if HYS data was subdivided by race or “by county” to which Broschart said that while the state sample had not been divided that way the data was available. HYS’s planning committee didn’t typically organize data by county or factors like “students that have behavioral health issues.” Broschart amended her statement to note HYS data was available upon request to “researchers and school districts and other planning groups” which may want to utilize it.
  • Board Member Ollie Garrett discussed plans she was making to follow up on the recent Cannabis Advisory Council meeting.
    • The Cannabis Advisory Council (CAC), a collection of cannabis trade group representatives and stakeholders, was chaired by Garrett and last met on December 17th.
    • Garrett told the group she’d be meeting with WSLCB Director of Licensing Becky Smith to go over notes from the meeting.
    • Garrett then said she’d gotten a call from licensee Angel Swanson who requested information about retail title certificates, a board interim policy (BIP) adopted in 2018. Swanson was curious if the agency was “automatically renewing” certificates which expired. She noted title certificate holders were mostly racial minorities, tying WSLCB’s title certificate policy to its stated social equity ambitions. Becky Smith commented that “about nine” certificates had been sold, while some had been “reissued licenses” in jurisdictions which had lifted a cannabis business ban or moratorium. Garrett said that Swanson believed Lewis County was “strong” on continuing their ban with one official purportedly telling her it would be “over his dead body before that ban is lifted” (audio - 2m).
  • Brian Smith, the agency’s Director of Communications, discussed coverage of the WSLCB’s suspension of a trio of vapor retailers.
    • Earlier on December 18th, the agency announced that three western Washington vapor shops had been suspended for violation of the state’s ban on flavored vapor products. WSLCB reported that the suspensions “follow complaints from the public and investigations by the WSLCB, including onsite visits and repeated warnings correction orders by WSLCB officers.” The three retailers were the only vapor stores which the agency found repeatedly in violation of the ban.
    • Brian Smith said KIRO 7 had interviewed Enforcement Captain Lisa Reinke for the channel’s coverage of the suspensions at the agency’s offices earlier that day. He expressed confidence that “she always does a great job” (audio - 1m).
      • Two days later, the legal purchase age for vapor products was raised from 18 to 21 nationwide with language in a federal appropriations bill. In a comment to CNN, Vapor Technology Association (VTA) Executive Director Tony Abboud said “VTA stands ready to continue working with Congress on the many real solutions (rather than a misguided flavor ban agenda), that should be implemented to achieve the twin goals of restricting youth vaping and preserving flavored vapor as an alternative for adults desperately trying to quit smoking.” VTA is currently suing Washington state regarding its authority to pass a flavored vape ban.
    • On Christmas eve, WSLCB announced two other license suspensions involving cannabis.
      • The agency suspended and revoked the license of Seattle retailer Herban Legends, describing the circumstances as follows:
        • “Concerns include the licensee engaging in erratic and criminal behavior on the license premises. The substance of the complaints was validated by the WSLCB during onsite visits, interviews with complainants, and the SPD...There have been several SPD-involved incidents at the license premises, including a Nov. 21, 2019 incident where SPD responded to a report that the licensee was throwing marijuana products and other merchandise into the parking lot and street of the license premises. Upon arrival, SPD confirmed marijuana products were on the ground outside the business and they were told by individuals in the parking lot that the owner was giving away product – a violation of state law. Over the past several weeks there have been additional law enforcement actions and arrests of the licensee...Due to the public safety risk of the licensee being unable or unwilling to demonstrate that cannabis product is beings secured on the premises and entered into the state traceability system, the Board issued the emergency suspension. Because the license is held by a single individual, the legal oversight of the business cannot be temporarily assumed by another individual.”
      • The Smoke Shop, a Seattle retailer licensed by WSLCB to sell tobacco, non-THC vape products, and beer or wine, was suspended for illicitly selling cannabis.
        • The agency stated that “The suspension follows an investigation by the WSLCB and the King County Sheriff’s Office including onsite visits and several undercover sales of marijuana products. The licensee does not have a license to sell marijuana...The licenses will remain suspended for a period of 180 days, after which the WSLCB will pursue permanent revocation due to the aggravating circumstances of the case.”