[MaryAnn O'Connor]: Okay, welcome everyone to the DeSoto Medford Board of Health meeting. We have two of our board members, Jenny Vitale and Kathy Chabonier joining us today. Unfortunately, Dr. Platowicz had a work conflict he could not get out of. So I'll ask Kathy to, if you could unmute and unmute Jenny and Kathy. And Kathy, could you open the meeting for us, please?
[MCM00001784_SPEAKER_07]: All right, so sorry, my computer troubles are terrible. Can you hear me? Yes. Okay. Yes, open the Board of Health meeting for today, December 19th at 12.50 and I'm so sorry I'm late, I'm just having terrible computer issues.
[MaryAnn O'Connor]: All right, first on the agenda, we have the approval of the minutes of the Board of Health meeting from November 21st. Do we have any changes, discussion, concerns?
[MCM00001745_SPEAKER_07]: Well, good to me. Good to me as well.
[MaryAnn O'Connor]: Can I get a motion to approve, please?
[MCM00001745_SPEAKER_07]: Motion to approve the minutes.
[MaryAnn O'Connor]: Motion to approve by Jenny, seconded by Kathy.
[MCM00001745_SPEAKER_07]: Yes.
[MaryAnn O'Connor]: Okay, thank you. And it's approved. So today joining us is Maureen Busby from Domestic Valley Tobacco Control. She's our coordinator and does wonderful, great work. And she's going to do a presentation for us today for our information as a movement. Many communities have looked at and some have gone forward with called the Tobacco-Free Generation. And I wanted you all to be informed as to what's going on, and we could have some discussion around it and get your thoughts. But I'll turn it over to Maureen. If you can unmute Maureen Busby, please, Kevin, and let her share her video and screen.
[Maureen Busby]: Okay, I'm unmuted, but for some reason I can't start my video, which is fine, but you can all hear me?
[MaryAnn O'Connor]: Yes.
[Maureen Busby]: Kevin, can we let people... I'm fine being off camera.
[MaryAnn O'Connor]: Yeah, I don't know why a camera would be...
[Maureen Busby]: I can start. You can let me know if the video starts to work. What I'm going to do first is read some prepared remarks so that I remember to cover everything that I want to share with you, and then open it up to questions, because I'm sure you will have questions. Oh, I've got to start my video. Allow. I think we're going to... Here we are. Let me re-angle that, okay. Tobacco is still the leading cause of preventable death in the US. Every year, almost 500,000 Americans die prematurely of smoking-related disease. Billions of dollars are spent on smoking-related illness. And so what have we done about this? It's not new, we've known about it for a long time. What exactly have we done? Well, the feds have done some things. In 2009, the federal government banned flavored cigarettes, although their legislation exempted menthol, so we still had menthol-flavored cigarettes. The feds also have significant restrictions on tobacco advertising. And the FDA recently banned menthol cigarettes and flavored cigars on a national basis, a national level, but unfortunately, the White House has delayed signing the law, I'm sure for political reasons. Meanwhile, local boards of health have done a lot. Local boards led the campaign for smoke-free workplace law two decades ago against extreme pushback, especially from restaurants and bars. But the boards had the conviction and the courage to adopt this very progressive regulation. And now we can't imagine going into a restaurant, theater, or bar, or riding on a bus, train, or subway where someone is smoking. Local boards have adopted many tobacco control regulations to help reduce youth access to tobacco. Local boards like this one were early adopters of T21, pharmacy ban, flavor restriction, cigar minimum price, permit cap, and proximity bans. Some of these regulations have made their way into state law. In fact, the usual way that public health regulations get passed is that local boards adopt first, then when there's a critical mass of municipalities that have that regulation, a state law is passed, and eventually federal law. So what has happened with all this legislation, regulation, and policy change? What has it accomplished? It's moved the needle a bit. However, people still smoke. Millions are still affected by smoking and secondhand smoke. And vaping is still a serious issue in our schools. The tobacco industry is literally cooking up new and clever ways to attract new users. 10 years ago, it was the pink and purple foil-wrapped little cigars or cigarillos for 69 and 79 cents. And I know all of you are aware of the damage caused by Juul e-cigarettes, the cool, sleek design that came in appealing flavors like mango, fruit medley, and creme brulee. They look like flash drives, making it hard for parents and school personnel to recognize when seeing one on a desk or in a book bag. Now we have nicotine pouches. And by the way, Marianne does have some photos of these products, which she can share either now or later. But you will be able to see the products that I'm talking about. Nicotine pouches are made with nicotine salts, and they have a very high nicotine content. They're even more discreet than vapes, and they're very, very cheap. A tin of 15 little pouches contains more nicotine, or I'm sorry, I should say, contains the nicotine equivalent of two and a half packs of Marlboros. And while two and a half packs of Marlboros cost about $32 in Massachusetts, a tin of Zin costs as little as $3.49. These products are so new, although spreading widely and being used widely, the state DOR, Department of Revenue, doesn't even have an excise tax on them.
[MaryAnn O'Connor]: Can you see the screen?
[Maureen Busby]: Oh, and there's a display of ZIN. Thank you, Mary Ann. So there's a display with a sign indicating $3.49 a tin if you buy two. And then those are the little tins that the Zyn pouches come in. And they're typically, they're 15 pouches to a tin. There are other brands, but this is the most common in this area. We've heard that some young people start their gym workout by popping a Zyn pouch or even two pouches into their mouth before lifting weights because of the big hit or buzz that they get. This makes addiction even more likely, and I'm now seeing more and more store shelf space taken up by these products. As I mentioned earlier, Massachusetts banned flavored products almost four years ago. Earlier this year, we started seeing Newport non-menthol, and there's a photo in the packet for this also, cigarettes. It's the same green packaging, which we've been told can trigger an ex-menthol smoker to pick up again. It turns out that while these so-called non-menthol cigarettes do not contain traditional menthol flavoring, they do contain a chemical that tricks your brain into thinking that what you just inhaled is menthol. Menthol, you may be aware, is more addicting and harder to quit. The sign just above the display of packages of tobacco, that sign, which is a little small in this photo, says non-menthol for the menthol smoker. They're not even subtle. One of the latest products I've heard about is the highlighter vape. And again, there's a photo in the packet. Taking a page out of Jewel's playbook, this vape design is pretty hard for a parent or a teacher to spot. I'm guessing these were not designed with you or me in mind. You'll see what I mean when that photo comes up. That's actually a vape pen. What's next? Nicotine gummies? There are actually nicotine gummies on the market, just not in Massachusetts because of our flavor ban. This industry has billions and spends billions on research and development. We will never catch up or keep up. They're always one step ahead. Now may be the time for a strategy that will start us on the path of actually ending nicotine addiction. In 2020, the town of Brookline passed a bylaw that made it illegal for Brookline retailers to sell tobacco to anyone born after 1-1-2000. It's a pretty simple policy. As of 1-1-2020, anyone purchasing a tobacco product has to be born before 1-1-2000. Brookline retailers have to remember just one date, whereas now the minimum legal sales age changes every single day. No one who is already 21 loses his or her privilege to purchase and consume tobacco products. Those not yet 21 will never be able to legally purchase tobacco in Brooklyn. This policy slowly starts to move us towards the end of nicotine addiction, which again has harmed millions and cost billions for decades. There's no reason to allow this public health crisis to continue just so the tobacco industry can continue to grow their profits. In summary, retailers have a long time to get used to no tobacco or lower tobacco sales. Each year, just one year's worth of potential new buyers will not be able to legally buy tobacco products. So lots of lead time. No one has a privilege taken away. It's easy to administer. And finally, we move towards a truly nicotine-free generation. Now what I'd like to do is hear any questions that you might have. So it's not just tobacco products, it's all nicotine products. All nicotine. So including these vape pens that you see, including the nicotine pouches, that's correct.
[MaryAnn O'Connor]: So where does Brookline's regulations stand right now? I know they were challenged, right?
[Maureen Busby]: Exactly. So Brookline passed the regulation, or they actually passed it as a town law, a town bylaw. They are enforcing it. One of my colleagues has Brookline in her collaborative and she is enforcing and she has issued fines for sales to someone who was 21, but who became 21 after the birth date restriction. But meanwhile, six Brookline stores banded together with the support of the tobacco industry, sued Brookline. That lawsuit was dismissed in district court, Superior Court rather. And then the industry appealed it. So it went to the appellate court, but the SJC, the Supreme Judicial Court of Massachusetts, um sometimes looks down to the appellate court to see what cases are there and if they think there's a case with um broad reach or impact they will move or that it might come to them anyway they'll move that case up to their court which they did in this case so this case is not this lawsuit's not being heard in the appellate court it's being heard by or being decided by the supreme judicial court There were oral arguments on November 6th, and the justices are now reviewing all the arguments that they heard. And we hope for a decision, I'm guessing maybe, maybe next month, maybe in January. And then it's that's the top court in Massachusetts. Then it becomes law. And the Attorney General, by the way, already, when Brookline passed this as a bylaw, a bylaw has to be reviewed by the Attorney General's office, and the Attorney General's office already approved the bylaw.
[MaryAnn O'Connor]: Kevin, can you unmute Kathy?
[MCM00001784_SPEAKER_07]: Okay, I'm unmuted. That's great. Thank you. So I was just going to say, great presentation. I just, to add one thing, Maureen, I'll never forget this. I was an ICU nurse, and this was 35 years ago, at least. I was taking a patient over to test in the bathroom. I brought the patient into the bathroom, and it said, if you smoke, which was a menthol, we can't help you. And I'll never forget that. So that was 35 years ago. So, I mean, and being a nursing now over at Mass Eye and Ear seeing all these patients young with asthma and having lots of troubles from the vaping. So really great work. Thank you.
[Maureen Busby]: Thank you for sharing that, Kathy. That's pretty moving. Personal testimonies like that are so moving. We have all the data. We have all these reports. But when you hear things like that, it's very moving. It really was. And that was 35 years ago.
[MCM00001784_SPEAKER_07]: Yeah.
[MCM00001745_SPEAKER_07]: Crazy.
[MCM00001784_SPEAKER_07]: And I smoked coals then, so that really resonated with me. Oh, wow. Yeah. And it was having the menthol was the addiction, for sure. That's what we hear, it's so hard.
[MCM00001745_SPEAKER_07]: Is the goal for Medford to move to that one date as well? You might have said it and I dismissed it.
[MaryAnn O'Connor]: So that's kind of the point of the presentation, just so that you have an idea as to what the regulation is about and why, and then we can continue this discussion next month if that's okay. And then we can move forward, and especially looking and see what happens with Brookline. I know Mellows and Wakefield are also moving forward with this initiative as well. So this was just kind of wanted to put it out there. And then like for Dr. Platt, it was also to be at the next meeting. Hopefully we can continue the discussion.
[MCM00001745_SPEAKER_07]: Awesome. Yeah, definitely a great presentation, great materials, and looking forward to hearing more.
[Maureen Busby]: If I could, I'd like to update you on what's happened in the, I represent seven communities. So it's Malden, Medford, Melrose, Wakefield, Winchester, Stoneham and Reading. So tomorrow, I'll make a similar presentation to the Malden Board of Health. And then by tomorrow, all seven communities will have heard this presentation. In addition, three communities have already had a public hearing. So the next step would be a public hearing. You don't have to do a public hearing. A board doesn't have to do a public hearing to adopt a new tobacco regulation. But because in the past for When Medford Board of Health passed T21 and a flavor restriction and other tobacco regulations, you did hold a public hearing, then that's kind of expected and it would be wise probably to hold a public hearing. And at that public hearing, the board would listen to input from both sides or all sides if there are other sides, and they wouldn't respond in any way, but they'd hear that input, the tobacco industry would show up, and maybe some distributors and maybe some retailers, and they'd say why we shouldn't do this, but there would also undoubtedly be some tobacco control folks, advocates for reducing tobacco access, tobacco consumption, tobacco-related disease and death. So the board would listen to that input, and then maybe the following month, assuming that by then we've heard the SJC decision, and assuming that the SJC voted in favor of the Brookline bylaw, then you would be ready, all the communities would be ready to launch. So kind of how I see this happening. Three communities have done public hearings, I'm hoping that other boards would also vote to do public hearings. You have the public hearing. The public hearing is out of the way. The dust kind of settles on everything.
[MaryAnn O'Connor]: I'm going to interrupt for one minute. We have less than a minute in the meeting. So we're going to end it. And we decided if people want to rejoin and continue the conversation, that would be awesome.
[Unidentified]: So everybody, log back in. So if, you know, if you went forward with it. Recording in progress.
[MaryAnn O'Connor]: Okay, sorry about that.
[Maureen Busby]: Are we ready?
[MaryAnn O'Connor]: I believe so.
[Maureen Busby]: So anyway, if you if you decided to hold a public hearing sooner rather than later, then when the SJC made their decision, assuming that it's in favor of the of this policy, then you would be ready to launch. And what our goal would be is to have, if we can work this out, is to have all seven of our communities. And that's one of the reasons that Anthony Choi is on the call because he's the health director in Melrose, Wakefield and Stoneham. And it would be great to have this be a regional, each board would decide individually, but it would be great to have the launch date be the same in all seven communities. So we do a lot of education. You wouldn't vote until we had the Brookline decision. The effective date would be the same. My recommendation would be to have the effective date 10 months or 12 months out, so we have plenty of time for retailer education. And for people to get used to the idea, we'd be able to do education in the community, education in the schools, education in the health care community. and make sure everybody was aware of what this was and what it isn't.
[SPEAKER_05]: Thank you, everyone, for having me come with Maureen to just talk a little bit. But I think Maureen covered pretty much everything. The only thing I want to say, I also want to echo, I apologize if my video doesn't work too well. It'll turn on for a second and then turn off. Let's see if I can make it happen. Nope. Okay. I don't think my video is going to cooperate today. Um, but so I apologize, but so I'm the, uh, the health director for Melrose Wakefield and Stoneham. Um, but just two things I wanted to echo, um, that Maureen's already said has been that, you know, a regional approach to this would be most effective. You know, we, we have a great collaborative, our Mystic Valley, um, partnership works really well. All of our directors work together all the time to share ideas. Uh, a lot of our other initiatives work best in a, in a regional setting as well. So this would not leave any one town out. We hear all the time that they want to go across the border and go to another town. But what we're hoping to do is we're hoping to create a uniform group that would adopt this potentially, and then have the same policies that no one is left out. Um, and the only thing, the only other thing I would say is that, uh, I said before, we've, we've known tobacco is bad for a long time. Um, it's believe it started with in 1950 with the certain generals, um, certain general paper on tobacco and the negative consequences of using tobacco products. And so, uh, this has been going on for a long time. And I think, you know, we have to start looking at policies that spell the end game for tobacco. I think we're looking at a policy that can eventually actually get the tobacco free, which has been the mission for many organizations that work on tobacco prevention for a long time. I think that is the goal. All of our other measures have been absolutely necessary up to this point, but I think this is the one that makes sense. Thank you, everyone.
[Maureen Busby]: Marianne, I had a thought, since the doctor isn't here today, I can share with you my prepared remarks. I can send those to you if you wanted to send them along.
[MaryAnn O'Connor]: Yes, sure, and I can give them the packet as well with the photos. I did send the photos actually to the board yesterday.
[MCM00001784_SPEAKER_07]: Yeah, I got them there.
[MaryAnn O'Connor]: Yeah, so we'd be looking at the same date kind of thing. I guess when it happened, that'd be the 2020.
[Maureen Busby]: Right, so the effective date, you know, for discussion purposes, the effective date would be, say, 1-1-2025, so a year away. And the birth date would be 1-1, the birth date restriction would be 1-1-2004. Did I do that math right, Anthony? Shouldn't be hard math.
[SPEAKER_05]: I believe you're right. For some reason, adding 21 is difficult for me as well.
[Maureen Busby]: We'll check the date.
[SPEAKER_05]: But the effective date should be January 1st, 2025, correct?
[Maureen Busby]: Oh, and another thing that I wanted to add is that we've talked to a number of legislators about this, not all of the ones that represent Medford yet, but we will. But Senator Jason Lewis represents six of my seven communities, and he actually asked us for the language of the law, which we sent to his office because, again, public health starts at the local level, but when we move this along a bit, he's willing to file legislation in the state house. And then also I had a chance to meet with Mike Day, who represents Stoneham and part of Winchester, and he also asked for the language. He's a state rep, and he would be willing to file something in the House. So there's a lot of support for this kind of policy and people waiting in the wings. But again, it's usually local public health that makes the move and makes these things happen.
[MaryAnn O'Connor]: Any other questions or thoughts, sir? Jenny, I don't think you're muted, sir, but I mute you. Are you good? OK.
[MCM00001745_SPEAKER_07]: Yes. No other comments from me, Mary. And just, as I said before, looking forward to hearing more about how this progresses in our next meeting.
[MCM00001784_SPEAKER_07]: Kathy? Same here. No questions. Thank you again.
[MaryAnn O'Connor]: Yes, Mari. Thank you very much. And Anthony, thanks for joining in as well.
[Maureen Busby]: Thank you all for taking the time to listen. I'll send along my prepared remarks, Mary Ann, but also I'm always available for questions. As this settles in and you think about it and you have additional questions, please reach out.
[MaryAnn O'Connor]: Oh, and Maureen did give me, and I have these on my desk, so that must look really funny, but I'll put them away. But she did give me a tin of the scent. And this is what one of those little tobacco pouches look like.
[Maureen Busby]: Very discreet, very cheap, high nicotine, and what will be the next product? It's just every time we go out, we see new products.
[MCM00001784_SPEAKER_07]: Scary.
[Maureen Busby]: Well, thank you all very much. Have a great holiday, and hopefully we'll talk soon. Thank you, Mari. Thank you.
[SPEAKER_05]: Thank you, everyone.
[MaryAnn O'Connor]: Thank you. OK. Next, so the agenda is new business, but at this point, I don't really have any business unless we know that next in January 16 or the next meeting, we'll be discussing this tobacco free generation. overview a little bit more and maybe have some information on where the Brookline case stands. And then we also want to start to get into a discussion around our body art regulations and maybe doing some updates to that as well. So we'll have some information coming to you before January 16th on that, so you'll be prepared. With that, if there's nothing else, do we have a motion to adjourn?
[MCM00001784_SPEAKER_07]: Motion to adjourn. Kathy? May I have a second?
[MCM00001745_SPEAKER_07]: Second.
[MaryAnn O'Connor]: All in favor? Jenny?
[MCM00001745_SPEAKER_07]: Aye. Kathy?
[MaryAnn O'Connor]: Aye.
[MCM00001745_SPEAKER_07]: Yes.
[MaryAnn O'Connor]: Motion passes. Happy holidays, everybody. We'll see you next year. Thank you.
[MCM00001745_SPEAKER_07]: Happy holidays.