Loading...
HomeMy WebLinkAbout2019-09-26 Board of Health Minutes North Andover Board of Health Meeting Minutes Thursday—September 26, 2019 7:00 p.m. 120 Main Street, 2"1 Floor Selectmen's Meeting Room North Andover, MA 01845 Present: Frank MacMillan Jr.,Joseph McCarthy,Michelle Davis,Patrick Scanlon,Brian LaGrasse,Caroline Ibbitson,Stephen Casey Jr and Toni K.Wolfenden. I. CALL TO ORDER The meeting was called to order at 7:00 pm. II. PLEDGE OF ALLEGIANCE III. APPROVAL OF MINUTES Meeting Minutes from June 27,2019 were presented for signature. Motion was made by Joseph McCarthy to approve the minutes,the motion was seconded by Michelle Davis,all were in favor and the minutes were approved.(4-0-0) Meeting Minutes from July 25,2019 were presented for signature. Motion was made by Joseph McCarthy to approve the minutes,the motion was seconded by Michelle Davis,all were in favor and the minutes were approved.(4-0-0) IV. PUBLIC HEARINGS V. Proposed Amendments to Regulating the Sale and Use of Tobacco&Nicotine Delivery Products. A. MOTION made by Patrick Scanlon to open the public hearing.Motion seconded by Michelle Davis, all were in favor and the motion was approved.(4-0-0) Frank MacMillan reminds the audience that this is a public hearing,speak clearly into the microphone;this is recorded and will be broadcasted with live stream. All speakers must state your name,address and business name if applicable. Testimony will be limited to three minutes. The time limit will be strictly enforced,however,speakers may come back to podium after everyone has finished with limit of two trips to the microphone. B. DISCUSSION First regulation for discussion—1.Prohibit the sale of tobacco and vape products flavored with mint,menthol and wintergreen,except in adult-only retail tobacco stores(i.e.smoke and vape shops)where a.)Persons under the age of 21 are prohibited entry at all times,b.)Sales are 2019 North Andover Board of Health Meeting Page 1 of 6 Board of Health Members:Dr.Francis P.MacMillan,Jr.,MD,Chairman/Town Physician;Joseph McCarthy,Member/Clerk; Michelle Davis,RN,Member;Daphnee Alva-LaFleur,Member;Patrick Scanlon,DO,Member Health Department Staff: Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Caroline Ibbitson,Public Health Nurse;Toni K. Wolfenden,Health Department Assistant limited primarily to tobacco/vape and tobacco/vape parapbernalia,and c.)No food products requiring a retail food permit are sold.See Appendix A 1. Helen Picard,447 Waverly Road,Vice Chair of School Committee,however Ms.Picard is not speaking in an official capacity for the schools. The School Committee has heard numerous concerns about vaping from parents and students and how it is impacting individuals,peers and the community. Ms.Picard would like to encourage the Board of Health to do all that it can to limit access to vape products for all people under the age of 21 years. The School Committee has adopted policies in response to vaping but more importantly the Wellness and Health Committee continues to address it from an educational point of view. Ms.Picard asks for the town to take any measures that it can to limit access for people under 21. 2. Michael E.Brangwynne,representing the Coalition for Responsible Retailing(CRR),Attorney at Law -Fletcher Tilton. CRR is comprised of a group of retail stores in the Town of North Andover and throughout the Commonwealth of Massachusetts that have an interest because they sell tobacco/vape products. Teen vaping is a serious problem that needs to be addressed. Mr.Brangwynne believes that the regulation that relates to mint,menthol and wintergreen products has no logical connection to the problem that the board is appropriately attempting to address. The FDA conducts regular checks to the stores in the town. Convenience stores in the Town of North Andover hold a 98%compliance rate for the FDA checks which consists of 51 out of 52 meeting. The 52°1 time was due to a sting operation and a minor was sold some type of tobacco product,where it was a traditional combustible tobacco product or an e-cigarette. That is an exceptionally high compliance rate by these convenience stores. What the regulation is doing is taking products mint,menthol and wintergreen products specifically out of the convenience stores and focusing them in the adult only retail tobacco stores. There is no data to suggest that these adult only retail tobacco stores have any better compliance rate with sales to minors. Mr.Brangwynne suggests that the sales to minors is not by convenience stores. Convenience stores actually have an excellent ability to identify and stop these products from getting into the hands of children as suggested by the FDA data. Mr.Brangwynne also would like to address the recent developments with Governor Baker's ban of all vaping products. The FDA and the Center of Disease Control has shown that the traditional flavors of mint,menthol and wintergreen are not the sweet flavors that are more appealing to a younger audience. The regulation does not make any distinction for the traditional flavors associated with traditional tobacco products. 3. Suzanne Egan—North Andover Town Counsel. Ms.Egan requests to have the regulatory purpose be placed in the drafted regulations. When regulating particular activities,it is always a good idea to have. Ms.Egan asks what the Board of Health is basing their decision on? What kind of study are the findings the Board is basing the determination on? What are the available laws? Brian LaGrasse gave Ms.Egan a copy of the 2015 Tobacco Regulations,which had the regulatory purpose in it. Ms.Egan asks the board to update these with the new regulations. 4. Michael E.Brangwynne—second time addressing the Board. The traditional products of mint, menthol and wintergreen are shown to assist adult cigarette users from going to combustible tobacco products to electronic nicotine delivery systems,which the CDC has recognized as an effective way and a more safe way to get people off of combustible cigarettes and the path to quit. E-cigarettes are more effective than the patch. There are recommendations by the CDC that have shown this. Patrick Scanlon has requested the data. Mr.Brangwynne will submit the information to the board via email. He will also provide the report,the actual articles and support.See Appendix G. The flavors that are being banned are not the flavors that the led to this epidemic or the fact that they are available in convenience stores. With the four month ban in place,the town regulation will only ban the flavored products of mint,menthol and wintergreen in convenience stores,which has no relation to the vaping problem. Convenience stores are being punished by funneling all of the sales into specific stores with no data to suggest that the adult stores are any better at preventing sales to youth,which loses their stream of customer revenue. The ban will remove the revenue stream out of North Andover. Mr. Brangwynne suggests that there are better options for the board to address this problem that actually have a rational relationship to the problem that you are seeking to address. 5. Diane Knight—Northeast Tobacco Free Community Partnership. This is a program of the Greater Lawrence Family Health Center. It serves the community of North Andover. Ms.Knight has had the pleasure educating the staff in the Town of North Andover Schools. There is a tremendous interest and energy around the importance of this issue. Ms.Knight supports all of the proposed changes to the current tobacco regulations,which sends a clear message to the community that flavored tobacco products including mint,menthol and wintergreen and e-cigarettes belong in adult-only establishments. North Andover will join 15 other communities in Massachusetts that have included mint,menthol and wintergreen in their flavor restrictions. We have to do everything we can to protect our young people from nicotine,which is incredibly addictive. Adolescents and young people are particularly vulnerable to its effects.There are brain changes that happen to people who start smoking in the teens. Teens that North Andover Board of Health Meeting Minutes Thursday—September 26, 2019 7:00 p.m. 120 Main Street,211 Floor Selectmen's Meeting Room North Andover, MA 01845 smoke,smoke more,become addicted more easily and have a harder time quitting compared to people who start smoking or using products as adults. Ms.Knight appreciates the inclusion of menthol as a flavor because the flavor of menthol helps the poison go down easier. It allows a smoker to inhale deeper,which allows for more nicotine. Menthol helps increase the number of nicotine receptors in the brain and makes quitting more difficult. Menthol makes it easier to smoke and contributes to young people starting,so we must protect our children. Ms.Knight appreciates the commitment to health and the well-being of this community. 6. Cheryl Sbarra—Senior Staff Attorney for the Massachusetts Association of Health Boards. Ms. Sbarra responds to the previous comments.The FDA compliance rate is always low because they bring in 16- year-old kids from out of the area to purchase Marlboro and Newports. If you talk to kids,especially kids in Massachusetts,which the MAHB has,30%of the students can purchase products in non-age restricted stores(convenience stores). Minors go into convenience stores two-thirds more times than adults. This results in a hire exposure rate. The tobacco industry and vaping industry spends 96%of its marketing budget in convenience stores. This is the problem. The MAHB wants to get these products out of the places that kids see them in. Regardless of what the sales rate is,the exposure rate is what is really driving the epidemic. If we look at a survey from 2018—30%of the kids get these products in stores,additionally-2 1%give money to someone else who gets these products from the convenience stores,additionally-another 20%get it from people above the age of 21. If one combines all of this,one gets almost unfettered access to these products by kids. The flavor of menthol has an anesthetic quality which makes it easier to inhale. 54%of youth smokers 12-17 use menthol and 33%of adult smokers do. 7. Ashley Hall—Program Manager of the Northeast Tobacco-Free Community Partnership. This program is run out of the Greater Lawrence Family Health Center that serves North Andover. Ms. Hall shares a personal story about a co-worker who is a medical assistant. The medical assistant brought her son to a gas station,they went inside for a snack. Her 6yr old son is beginning to read. The child read apple juice and proceeded to ask for some but the sign was for apple a juice not an apple juice box. At the age of six,the child was exposed to the tobacco industry tactics because of its location in a gas station and not in an adult only retail establishment. We need to put these products into adult-only retail tobacco stores to keep our young children protected from these exposures and tactics. Having these products in 21 plus stores will be limiting the effects the tobacco industry has on our youth in North Andover. We can not continue to condone the normalization of these products by having them be in our everyday stores where both our youth and younger are shopping daily. The following are the names of individuals who have taken time to express their support in letters:Lindsey Carboni,the Assistant Dean of Graduate Health Sciences at Merrimack College;Katherine Wong, Health Sciences Librarian at Merrimack College;Denise Dwyer,Nurse Practitioner in Assistant Director of Health Services at Merrimack College;Dr.Eleanor Shonkoff,Assistant Clinical Professor in the School of Health Sciences;Dr.April Bowling,Assistant Professor of Health Sciences at 2019 North Andover Board of Health Meeting Page 3 of 6 Board of Health Members:Dr.Francis P.MacMillan,Jr.,MD,Chairman/Town Physician;Joseph McCarthy,Member/Clerk; Michelle Davis,RN,Member;Daphnee Alva-LaFleur,Member;Patrick Scanlon,DO,Member Health Department Staff: Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Caroline Ibbitson,Public Health Nurse;Toni K. Wolfenden,Health Department Assistant Merrimack College&Visiting Scientist at Harvard T.H.Chan School of Public Health;Dylan Drescher,student at Merrimack College;Andrew Muscleman,student at Merrimack College. 8. Cheryl Sbarra—second time addressing the Board. Ms.Sbarra addresses the comment made by Michael Brangwynne about the CDC's support for electronic cigarettes. What the CDC actually states is,if you are an adult smoker and completely stop using combustible products and use only electronic cigarettes as a means to quit,you will be taking in less chemicals than if you were using a combustible product however since Governor Bakers ban,the CDC reported 800 hospitalizations.The CDC is investigating and advising people not to use these. With the issue of harm reduction,if an adult wants to use them that is the adult's prerogative,but now we have an emergency order because we have so many cases of respiratory and pulmonary hospitalizations. The Commonwealth of Massachusetts is up to 61 cases with at least 10 new cases daily according to Commissioner Burrell's testimony at Congress in Washington DC. To not have the flavors of menthol,mint,and wintergreen be restricted is contrary to all of the evidence that the MAHB sees especially when you look at the African American smoking rate of these products and the NAACP&the Urban League have come out vocally in support of restricting the flavors of menthol,mint and wintergreen products. 75%of adults get their vaping products online or at a specialty store. Ms. Sbarra supports the North Andover Board of Health efforts to change the tobacco regulations. The Coalition for Responsible Retailers have sued several municipalities for adopting these regulations and in every single jurisdiction county that have heard their motions for a preliminary injunction which would prohibit cities and towns from enforcing these regulations they have lost. Second regulation open for discussion-2.Prohibit the sale of all electronic cigarettes and all other vape products,with or without flavors,except in adult-only retail tobacco stores(i.e.smoke and vape shops)where a.)Persons under the age of 21 are prohibited entry at all times,b.)Sales are limited primarily to tobacco/vape and tobacco/vape paraphernalia,and c.)No food products requiring a retail food permit are sold. 1. Bill Bucco,Quic Pic and McAloon Liquors—533 Chickering Road. Mr.Bucco asks to define Adult-Only Stores and asks if a liquor store would qualify. Brian LaGrasse explains that currently the BOH is in the process of creating a definition for adult only retail store. The proposed definition is:Adult-Only Retail Tobacco Store"An establishment that does not share space with another business,that shall have a separate public entrance,that does not sell food or alcohol,that does not have a restaurant license or lottery license,whose only purpose is to sell or offer retail sale tobacco products and/or tobacco product paraphernalia, in which the entry of persons under the age of 21 is prohibited at all times,and which maintains a valid permit for the retail sale of tobacco products from the(city/town)Board of Health and applicable state licenses. Entrance to the establishment must be secure so that access to the establishment is restricted to employees and to those 21 years or old or older. The establishment shall not allow anyone under the age of 21 to work at the establishment. As of the effective date of this Regulation,no new Adult-Only Retail Tobacco Stores shall be located within(Decision:25 to 500)Feet of a retailer with a tobacco product sales permit." See Appendix B 2. Ben Brar—Student,Merrimack College is in support of the new tobacco control regulations. 3. Liam Dennison—Student and member of the Men's Hockey Team,Merrimack College is in support of the new tobacco control regulations. 4. Regan Kimens—Student and member of the Men's Hockey Team Merrimack College is in support of the new tobacco control regulations. Third regulation open for discussion—3.Mandate that retailers require a government-issued photographic identification card be presented by all persons appearing under the age of 40 who wish to purchase to tobacco products. Brian LaGrasse explains that the previous law has the age at 27 but people that look 40 typically are not under 21. It helps to better determine the age of a customer. Fourth regulation open for discussion—4.Cap the total number of establishments holding a tobacco sales permits. Brian LaGrasse explains that the Town of North Andover currently has fifteen establishments that sell tobacco products. The idea is to cap that number close to where we are now to limit the number of retailers in the normalcy of tobacco products being sold in all of these establishments by limiting the number,the permits become more valuable for the businesses but they also limit the exposure and growth of particular retailers. North Andover Board of Health Meeting Minutes Thursday—September 26, 2019 7:00 p.m. 120 Main Street,2nd Floor Selectmen's Meeting Room North Andover, MA 01845 Fifth regulation open for discussion—5.Cap the total number of establishments holding a tobacco sales permits that operates as"adult-only retail tobacco stores"i.e.smoke and vape shops. Sixth regulation open for discussion—6.Prohibit smoking and vaping in all"adult-only retail tobacco stores"i.e.smoke and vape shops. Seventh regulation open for discussion—7.Provide further restrictions on discounts on tobacco and vape products prices. Eighth regulation open for discussion—8.Provide further restrictions of out-of- package sales of tobacco and vape products. 1. Helen Picard,447 Waverly Road,addresses the Board about the capped adult only tobacco shops. Ms. Picard asks if the Town of North Andover needs zoning by-laws to address location of the shops. Brian LaGrasse explains at this time the town does not have any adult only tobacco shops. By capping the shops,it will decrease the exposure under age children. With no more discussion,Dr.Frank MacMillan has continued the Public Hearing to the next Board of Health Meeting—October 24,2019 MOTION made by Patrick Scanlon to recess the public hearing.Motion seconded by Joseph McCarthy,all were in favor and the motion was approved.(4-0-0) VI. NEW BUSINESS A. Brian LaGrasse discusses Governor Charles D.Baker's declaration of public health emergency in the Commonwealth of Massachusetts due to severe lung disease associated with the use of e-cigarettes and vaping products. All vaping products,including CBD products have been effectively banned at this time. The ban is in effect until January 25,2020. All extensions will be through the state. The Town of North Andover Selectmen have been notified. See Appendix D. B. North Andover Mosquito Control Update—At this time North East Mosquito Control continues to do weekly testing. The town is at a moderate level with no positive mosquito pools tested. The Health Department continues to update residents on protecting themselves against EEE. Outdoor activities have been restricted to 6:30 p.m.,which is dusk,as the night gets shorter. This is a recommendation and not an order. Currently,there have been four deaths and eleven cases in the state,which is a very 2019 North Andover Board of Health Meeting Page 5 of 6 Board of Health Members:Dr.Francis P.MacMillan,Jr.,MD,Chairman/Town Physician;Joseph McCarthy,Member/Clerk; Michelle Davis,RN,Member;Daphnee Alva-LaFleur,Member;Patrick Scanlon,DO,Member Health Department Staff: Brian LaGrasse,Health Director;Stephen Casey Jr.,Health Inspector;Caroline Ibbitson,Public Health Nurse;Toni K. Wolfenden,Health Department Assistant high mortality rate. National average is about 10 cases a year. To date,North Andover is at the peak of EEE season. Brian LaGrasse has weekly conference calls with all the public health directors in the area,the state and any other regional partners that want to add to the discussion. Mr.LaGrasse has spoken to Mr.Gregg Gilligan, Superintendent of Schools several times to for the press release for the schools and to inform town residents. Mosquito Control has put up additional traps around where they find positive pools. This is to see where the illness is migrating too. Mosquitos travel a couple of miles but birds travel much further distances and an infected bird will affect a population of mosquitos elsewhere. Birds cause EEE to move geographically long distances. The weather needs to be at a very hard frost order to eliminate the threat.There was a positive West Nile Virus reading in a mosquito pool for the City of Haverhill last Friday. At this time,it is past its peak but it is still prevalent. The Health Department recommends the Five D's—dusk to dawn,dress,DET,and drain standing water off property. (See Appendix E.) C. 2019 Flu Clinics—The Health Department have received a small amount of flu vaccines. The Senior Center Clinics will begin Monday October 2119a.m.to 12p.m. The Family Flu Clinic is Tuesday November 1215p.m.to 7p.m.The Senior Housing Clinics start Monday November 41. (See Appendix F.) VII. ADJOURNMENT MOTION made by Joseph McCarthy to adjourn the meeting.Patrick Scanlon seconded the motion and all were in favor.The meeting adjourned at 7:47 pm.(4-0-0) Prepared by: Toni K. Wolfenden, Health Dept.Assistant Reviewed bv. All Board of Health Members&Brian LaGrasse,Health Director Wined bv: 4s&ep7e__arthy, Cler of the Board Date Signed Documents Used At Meeting: North Andover Board of Health Meeting Agenda Notice to all Retailers in North Andover Who Sell Tobacco Products Town of North Andover Board of Health Draft Regulating the Sale and Use of Tobacco Products Definition—Adult-Only Retail Tobacco Store Town of North Andover Tobacco Permit list expiration 6/30/2020 Town of North Andover Health Department Notice of Massachusetts Vaping Product Ban Letter—from Ronald Beauregard to Brian LaGrasse Definition—Vaping and Vape Products Letter of Support—from Rick Gorman to North Andover Board of Health North Andover Mosquito Control Update Flu Shot Clinics 2019 Email with Attachments from Mike Brangwynne—attached after meeting 10/1/2019 North Andover Board of Health Meeting Agenda Thursday,September 26,2019 7:00 p.m. 120 Main Street, 2nd Floor Selectmen's Meeting Room North Andover,MA 01845 I. CALL TO ORDER II. PLEDGE OF ALLEGIANCE III. APPROVAL OF MINUTES A. June 27,2019 B. July 25,2019 IV. PUBLIC HEARINGS A. Proposed Amendments to Regulating the Sale and Use of Tobacco&Nicotine Delivery Products V. OLD BUSINESS VI. NEW BUSINESS VII. COMMUNICATIONS,ANNOUNCEMENTS,AND DISCUSSION VIII. CORRESPONDENCE/NEWSLETTERS IX. ADJOURNMENT 2019 North Andover Board of Health Meeting-Meeting Agenda Page 1 of 1 Note: The Board of Health reserves the right to take items out of order and to discuss and/or vote on items that are not listed on the agenda. Board of Health Members: Dr.Frank MacMillan,Jr.,Chairmanlrown Physician;Joseph McCarthy,Member/Clerk;Michelle Davis,RN,Member;Daphnee Alva-LaFleur,Member;Patrick Scanlon,D.O.,Member Health Department Staff:Brian LaGrasse, Health Director;Stephen Casey Jr.,Health Inspector; Caroline Ibbitson,Public Health Nurse;Toni K.Wolfenden,Health Department Assistant North Andover Health Department Community and Economic Development Division September 10, 2019 Notice to all Retailers in North Andover Who Sell Tobacco Products On Thursday, September 26,2019 at 7 p.m.the Board of Health will hold a public hearing on proposed changes to its regulations governing the sale of tobacco products and smoking. The public hearing will be held in the Selectmen's Room,2' floor,Town Hall, 120 Main St.,North Andover. You are invited to attend and make comments or ask questions. If you wish to make comments and speak during the public hearing you may sign up prior to the meeting by going to www.northandoverma.gov/health and completing the form. This will ensure you the opportunity to ask questions and address your concerns. If you cannot attend you may also submit questions or comments prior to the public hearing by going to www.northandoverma.gov/health and submitting them online. The Board will try to answer as many of these questions as possible during the public hearing. Proposed changes to the North Andover Board of Health tobacco control regulations include,but are not limited to,the following: 1)Prohibit the sale of tobacco and vape products flavored with mint,menthol and wintergreen,except in adult-only retail tobacco stores(i.e. smoke and vape shops)where a.)Persons under the age of 21 are prohibited entry at all times,b.)Sales are limited primarily to tobacco/vape and tobacco/vape paraphernalia,and c.)No food products requiring a retail food permit are sold. 2)Prohibit the sale of all electronic cigarettes and all other vape products,with or without flavors, except in adult-only retail tobacco stores(i.e. smoke and vape shops)where a.)Persons under the age of 21 are prohibited entry at all times,b.) Sales are limited primarily to tobacco/vape and tobacco/vape paraphernalia,and c.)No food products requiring a retail food permit are sold. 3)Mandate that retailers require a government-issued photographic identification card be presented by all persons appearing under the age of 40 who wish to purchase tobacco products. 4)Cap the total number of establishments holding a tobacco sales permits. 5)Cap the total number of establishments holding a tobacco sales permit that operate as "adult-only retail tobacco stores"(i.e. smoke and vape shops). 6)Prohibit smoking and vaping in all"adult-only retail tobacco stores"(i.e. smoke and vape shops) Page 1 of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.9542 t September 10,2019 Continued 7)Provide further restrictions on discounts on tobacco and vape products prices. 8)Provide further restrictions of out-of-package sales of tobacco and vape products If you would like to view the proposed regulations or obtain copies, please visit the North Andover Health Department, 120 Main St.,North Andover or call (978) 688-9540. You may also view the proposed changes to the regulations at www.northandoverma.gov/health. Sincerely, Bri I LaO rasse, CEHT D rector of Public Health 9/10/2019 Page 2 of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.9542 LEGAL NOTICE On Sept. 26, 2019 at 7pm in Selectmen's Room, 211 floor, Town Hall, 120 Main St., North Andover, the Board of Health will hold a public hearing on proposed changes to tobacco/vape regulations, including restricting sales of tobacco/vape flavored with mint, menthol and wintergreen, restricting all vape sales, with or without flavor, and limiting the number of stores selling tobacco. The public is invited to submit comments or questions, and sign up to speak during the public hearing and review the draft regulations at www.northandoverma.gov/health. You may also go to the North Andover Health Dept., 120 Main St., North Andover or call (978) 688-9540. CHAPTER I I I PUBLIC HEALTH Section 31 Health regulations; summary publication; hearings; filing sanitary codes and related rules, etc. Section 31. Boards of health may make reasonable health regulations. A summary which shall describe the substance of any regulation made by a board of health under this chapter shall be published once in a newspaper of general circulation in the city or town, and such publication shall be notice to all persons.No regulation or amendment thereto which relates to the minimum requirements for subsurface disposal of sanitary sewage as provided by the state environmental code shall be adopted until such time as the board of health shall hold a public hearing thereon, notice of the time,place and subject matter of which, sufficient for identification, shall be given by publishing in a newspaper of general circulation in the city or town once in each of two successive weeks,the first publication to be not less than fourteen days prior to the date set for such hearing, or if there is no such newspaper in such city or town, then by posting notice in a conspicuous place in the city or town hall for a period of not less than fourteen days prior to the date set for such hearing. Prior to the adoption of any such regulation or amendment which exceeds the minimum requirements for subsurface disposal of sanitary sewage as provided by the state environmental code, a board of health shall state at said public hearing the local conditions which exist or reasons for exceeding such minimum requirements. Whoever, himself or by his servant or agent, or as the servant or agent of any other person or any firm or corporation, violates any reasonable health regulation, made under authority of this section, for which no penalty by way of fine or imprisonment, or both, is provided by law, shall be punished by a fine of not more than one thousand dollars. Boards of health shall file with the department of environmental protection, attested copies of sanitary codes, and all rules,regulations and standards which have been adopted, and any amendments and additions thereto, for the maintenance of a central register pursuant to section eight of chapter twenty-one A. 9-1-19 Town of North Andover Board of Health REGULATING THE SALE and USE OF TOBACCO PRODUCTS SECTION 1 PURPOSE It is the intention of the North Andover Board of Health to regulate the sale of tobacco products-and ^^+ifi^ delivery pi:edue*-s,primarily to reduce youth and underage access to nicotine aiid nieotine and to advance public health. SECTION 2 DEFINITIONS For the purpose of this regulation,the following words shall have the following meanings: 2.1 BLUNT WRAP: Any tobacco product manufactured or packaged as a wrap or as a hollow tube made wholly or in part from tobacco that is designed or intended to be filled by the consumer with loose tobacco or other fillers. 2.2 BUSINESS AGENT: An individual who has been designated by the owner or operator of any establishment to be the manager or otherwise in charge of said establishment. 2.3 CIGAR: Any roll of tobacco that is wrapped in leaf tobacco or in any substance containing tobacco with or without a tip or mouthpiece not otherwise defined as a cigarette under Massachusetts General Law, Chapter 64C, Section 1,Paragraph 1. 2.4 CHARACTERIZING FLAVOR: A distinguishable taste or aroma, other than the taste or aroma of tobacco,menthol, mint or winter=gFeen, imparted or detectable either prior to or during consumption of a tobacco oi---ai ootine deliver-.-product or component part thereof, including, but not limited to,tastes or aromas relating to any fruit, chocolate, vanilla, honey, candy, cocoa, dessert, alcoholic beverage, menthol, mint or wintergreen ,herb or spice; provided, however, that no tobacco product^r Hieotine delivery rrodi ^* shall be determined to have a characterizing flavor solely because of the use of additives or flavorings that do not contribute to the distinguishable taste or aroma of the product or the provision of ingredient information. 2.5 COMPONENT PART: Any element of a tobacco , including, but not limited to, the tobacco, filter,paper,mouthpiece, heating element battery and/or electronic circuits but not including any constituent. 2.6 CONSTITUENT: Any ingredient, substance, chemical or compound, other than tobacco, water added to a tobacco product or reconstituted tobacco sheet, that is added by the manufacturer to a tobacco ^r nieotin^ delivery product during the processing,manufacturing or packaging of the tobacco ornieotine ae iver-y product. Such term shall include a smoke constituent from a tobacco product and a vapor or aerolization constituent from a aie0tifle delivery-tobacco product. 2.7 DISTINGUISHABLE: Perceivable by either the sense of smell or taste. 2.8 E CIGARETTE! Any elcecreaie-nieetine-deliyery pfettuet eemposed ef-a fn�uthp•eee vx-cr n�v axr■ iccc- heating element, ba14ei=),and/er-eleelfenie eifesuits that ffevides a vaper of liquid nieetine to the user-, 0 relies en vaporization of solid nieetine er-afty liquid.This temi shall inelude sueh devieeswhether-the� 2.89 —EDUCATIONAL INSTITUTION: Any public or private college, school, professional school, scientific or technical institution,university or other institution furnishing a program of higher education. 2.9 ELECTRONIC CIGARETTE: Any electronic device composed of a mouthpiece, heating element, battery and/or electronic circuits that provides vapor of liquids,regardless of nicotine content, or relies on vaporization of any solid or liquid substance,regardless of nicotine content. This term shall include such devices whether they are manufactured as e-cigarettes,a-cigars, a-pipes or under any other product name.An electronic cigarette includes any component or part of an electronic cigarette, regardless of nicotine content,that rely on vaporization or aerosolization, includingIRB11 but not limited to, pods,vape juice containers and cartridges. 2.10 EMPLOYEE: Any individual who performs services for an employer. 2.11 EMPLOYER: Any individual,partnership,association,corporation,trust or other organized group of individuals,including North Andover or any agency thereof,which uses the services of one(1) or more employees. 2.12 ENCLOSED: A space bounded by walls,with or without windows or fenestrations, continuous from floor to ceiling and enclosed by one(1)or more doors, including but not limited to an office,function room or hallway. 2.13 FLAVORED TOBACCO PRODUCT: Any tobacco product or component part thereof that contains a constituent that has or produces a characterizing flavor. A public statement,claim or indicia made or disseminated by the manufacturer of a tobacco product,or by any person authorized or permitted by the manufacturer to make or disseminate public statements concerning such tobacco product,that such tobacco product has or produces a characterizing flavor shall constitute presumptive evidence that the tobacco product is a flavored tobacco product. 2.14 FLAVORED N14C--OTINE DELI VERY PRODUCT—Any nieetine delivei3=prodHet, as herein, of:by an),per-son authorized of per-mit4ed by the manufaetur-er-to make OF disseminate publie statements- defined tier-°;.. 2.145 HEALTH CARE INSTITUTION: An individual,partnership,association, corporation or trust or any person or group of persons that provides health care services and employs health care providers licensed, or subject to licensing, by the Massachusetts Department of Public Health under M.G.L. c. 112 or a retail establishment that provides pharmaceutical goods and services and subject to the provisions of 247 CMR 6.00. Health care institution includes,but is not limited to,hospitals, clinics, health centers,pharmacies,drug stores,doctor offices and dentist offices. 2.16 NICOTINE DELIVERY PRODUCTE Any manufaetured artiele or pFodttet made wholly oF but not iiieluding a pFoduet appFoved by the United Sta4es Food and Drug Administr-atioii fiaf sale as i:naflEeted and sold solely foF that appr-eved par-pose.Nicotine delivefy pFodaet iiieludes, but is not limited 2.157 NON-RESIDENTIAL ROLL-YOUR-OWN(RYO)MACHINE: A mechanical device made available for use (including to an individual who produces cigars, cigarettes, smokeless tobacco, pipe tobacco, or roll-your-own tobacco solely for the individual's own personal consumption or use)that is capable of making cigarettes, cigars or other tobacco products. RYO machines located in private homes used for solely personal consumption are not Non-Residential RYO machines. 2.168- OUTDOOR SPACE: An outdoor area,open to the air at all times and cannot be enclosed by a wall or side covering. 2.179 PERMIT HOLDER: Any person engaged in the sale or distribution of tobacco or products directly to consumers who applies for and receives a tobacco a• ewe delivery-product sales permit or any person who is required to apply for a tobacco and „ieefine delivery product sales permit pursuant to these regulations,or his or her business agent. 2.182A PERSON: An individual, employer, employee,retail store manager or owner, or the owner or operator of any establishment engaged in the sale or distribution of tobacco or nieetine deli eFy products directly to consumers. 2.1924 RETAIL TOBACCO STORE: An establishment which is not required to possess a retail food permit whose primary purpose is to sell or offer for sale to consumers,but not for resale,tobacco products and paraphernalia, in which the sale of other products is merely incidental, and in which the entry of persons under the age of 21 is prohibited at all times,and maintains a valid permit for the retail sale of tobacco products as required to be issued by the North Andover Board of Health. 2.2022 SELF SERVICE DISPLAY: Any display from which customers may select a tobacco product eF a nieetine delivo.=,pFadue+without assistance from an employee or store personnel, excluding vending machines. 2.2123 SMOKING(or smoke): The lighting of a cigar, cigarette,pipe or other tobacco product or possessing a lighted cigar,cigarette,pipe or other tobacco or non-tobacco product designed to be combusted and inhaled. 2.22-24 SMOKING BAR: An establishment that primarily is engaged in the retail sale of tobacco products for consumption by customers on the premises and is required by Mass. General Law Ch. 270, Section 22 to maintain a valid permit to operate a smoking bar issued by the Massachusetts Department of Revenue. "Smoking Bar" shall include,but not be limited to,those establishments that are commonly known as"cigar bars"and"hookah bars". 2.2325 TOBACCO PRODUCT: CigareAes eigafs, ^ho.,ing tebaeee pipe tebaeee bidis u or tebaee^ in a"^f its f fms. Any product containing, made, or derived from tobacco or nicotine that is intended for human consumption, whether smoked, chewed, absorbed, dissolved, inhaled, snorted, sniffed, or ingestedy any other means, including. but not limited to: cigarettes, cigars, little cigars, chewing tobacco, pipe tobacco, snuff, or electronic cigarettes. electronic cigars, electronic pipes, electronic hookah, liquid nicotine, "e-liquids" or other similar products, regardless of nicotine content, that rely on vaporization or aerosolization. "Tobacco Product" includes any component or part of a tobacco product. "Tobacco Product" does not include any product that has been approved by the United States Food and Drug Administration either as a tobacco use cessation product or for other medical purposes and which is being marketed and sold or prescribed solely for the approved purpose. 2.2436 VENDING MACHINE: Any automated or mechanical self service device,which upon insertion of money,tokens or any other form of payment, dispenses or makes cigarettes,any other tobacco product . SECTION 3 TOBACCO AND NICOTINE DELI VTJVY PRODUCT SALES TO PERSONS UNDER THE AGE OF 21 PROHIBITED 3.1 No person shall sell or otherwise distribute tobacco products to persons under the age of 21. 3.2 REQUIRED SIGNAGE In conformance with and in addition to Massachusetts General Law, Chapter 270, Section 7, a copy of Massachusetts General Laws,Chapter 270, Section 6, shall be posted conspicuously by the owner or other person in charge thereof in the shop or other place used to sell tobacco products at retail. The notice shall be made available from the North Andover Board of Health. The notice shall be at least 48 square inches and shall be posted conspicuously by the permit holder in the retail establishment or other place in such a manner so that it may be readily seen by a person standing at or approaching the cash register. The notice shall directly face the purchaser and shall not be obstructed from view or placed at a height of less than four(4)feet or greater than nine(9)feet from the floor.The notice shall also disclose current referral information about smoking cessation,as well as notice that the sale of tobacco products, to someone under the age of 21 is prohibited,and that the use of e- cigarettes is prohibited where smoking is prohibited in the Town of North Andover. 3.3 IDENTIFICATION: Each person selling or distributing tobacco products or nicotine delivery products shall verify the age of the purchaser by means of a valid government- issued photographic identification containing the bearer's date of birth that the purchaser is 21 years old or older. Verification is required for any person who appears to be under the age of-P 40. 3.4 All retail sales of tobacco or nieetiiie delivety products must be face-to-face between the seller and the buyer(except for the purchase of tobacco from vending machines)and all retail sales of tobacco products must occur at a location with a valid tobacco product sales permit. SECTION 4 TOBACCO PRODUCT SALES PERMIT 4.1 No person shall sell or otherwise distribute tobacco or- products at retail within North Andover without first obtaining a Tobacco and Nie tifie ile4ye...,Product Sales Permit issued annually by the North Andover Board of Health. Only owners of establishments with a permanent,non- mobile location in North Andover are eligible to apply for a permit and sell tobacco products or nieetine del iveFy products at the specified location in North Andover. 4.2 As part of the Tobacco and ATieetine Deli efy Product Sales Permit application process,the applicant will be provided with the North Andover Board of Health regulation. Each applicant is required to sign a statement declaring that the applicant has read said regulation and that the applicant is responsible for instructing any and all employees who will be responsible for tobacco and e deliveFy product sales regarding federal, state and local laws regarding the sale of tobacco and this regulation. 4.3 Each applicant who sells tobacco is required to provide proof of a current tobacco sales license issued by the Massachusetts Department of Revenue before a Tobacco Product Sales Permit can be issued. 4.4 The fee for a Tobacco and Nieetine Delivet=y Product Sales Permit shall be in accordance with the most current Board of Health fee schedule. All such permits shall be renewed annually by June 30'of every year. 4.5 A separate permit is required for each location where a retail establishment is selling tobacco er tine del:vo,-.,products. 4.6 Each Tobacco and Nieetine Delivefy Product Sales Permit shall be displayed at the retail establishment in a conspicuous place. 4.7 No Tobacco Product Sales Permit holder shall allow any employee to sell tobacco products until such employee reads this regulation and federal and state laws regarding the sale of tobacco and signs a statement, a copy of which will be placed on file in the office of the employer,that he/she has read the regulation and applicable state and federal laws. 4.8 A Tobacco Product Sales Permit is non-transferable 4.9 Issuance of a Tobacco and NTeed..r,e4ye...,Product Sales Permit shall be conditioned on an applicant's consent to unannounced, periodic inspections of his/her retail establishment to ensure compliance with this regulation. 4.10 Issuance and holding of a Tobacco Product Sales Permit shall be conditioned on an applicant's on-going compliance with current Massachusetts Department of Revenue requirements and policies including,but not limited to,minimum retail prices of tobacco products. 4.11 A Tobacco n.,a i.,ieetine Deliwf.,Product Sales Permit will not be renewed if the permit holder has failed to pay all fines issued and the time period to appeal the fines has expired and/or has not satisfied any outstanding permit suspensions. Permit Capping Options: a. "Basic" Cap: At any given time, there shall be no more than [number (XX)1 Tobacco Product Sales Permits issued in North Andover. [This phrase needs to be removed if NOT using subsection B and left in if using Subsection B: "reduced by the number of permits not renewed pursuant to subsection (b) below."1 No permit renewal will be denied based on the requirements of this subsection except any permit holder who has failed to renew his or her permit within thirty (30) days of expiration will be treated as a first-time permit applicant. NOTE: This is the "basic" cap. When a town has the maximum number of permittees allowed, a waiting list should be started with the name and contact information of prospective tobacco retailers who are waiting to be contacted when a permit frees up. OR b. Dual Cap: At any given time, of the allowed Permit number in subsection (a) above, there shall be no more than [number (XX)1 Tobacco Product Sales Permits issued to Adult-Only Retail Tobacco Stores, per the definition, in North Andover. No permit renewal will be denied based on the requirements of this subsection except any permit holder who has failed to renew his or her permit within thirty (30) days of expiration will be treated as a first-time permit applicant. NOTE: This is a subcap that can be used with either the"basic" cap above in subsection a, or the "advanced" cap in subsection b. It would provide a maximum number of permits within the general cap number that can go to qualifving "adult-only Retail Tobacco Stores (which includes both tobacconists and vane shops). c. New Retailers near Schools: A Tobacco Product Sales Permit shall not be issued to any new applicant for a retail location within five hundred (500) feet of a public or private elementary or secondary school as measured by a straight line from the nearest point of the property line of the school to the nearest point of the propertv line of the site of the applicant's business premises. NOTE: This bars NEW retailers from selling tobacco near a school, regardless of the cap policy used. d. New Retailers near Existing Retailers: A Tobacco Product Sales Permit shall not be issued to any new applicant for a retail location within five hundred (500) feet of a retailer with a valid Tobacco Product Sales Permit as measured by a straight line from the nearest point of the property line of the retailer with a valid Tobacco Product Sales Permit to the nearest point of the property line of the site of the applicant's business premises. NOTE: This bars NEW retailers from selling tobacco near an existing tobacco permit holder, regardless of the cap policy used. e. Required Paragraph!: Applicants who purchase or acquire an existing business that holds a valid Tobacco Product Sales Permit at the time of the sale or acquisition of said business must apply within sixty (60) days of such sale or acquisition for the permit held by the Current Permit Holder if the Applicant intends to sell tobacco products, as defined herein. Such applicant may choose to apply for a Tobacco Product Sales Permit for an Adult-Only Retail Tobacco Store if the Current Permit Holder possessed the same or if a Tobacco Product Sales Permit for an Adult-Only Retail Tobacco Store is available per subsection (b). NOTE: This provision should be included no matter which of the above five options are used by a board of health. It permits a buyer to "capture" the seller's permit regardless of the type of capping policy enacted. SECTION 5 CIGAR SALES REGULATED: 5.1 No retailer,retail establishment,or other individual or entity shall sell or distribute or cause to be sold or distributed a cigar unless the cigar is contained in an original package of at least four(4)cigars. A package of four or more cigars must be priced at the retail market price or at five($5.00)dollars, whichever price is higher. 5.2 This Section shall not apply to: (a) The sale or distribution of any cigar having a retail price of two dollars and fifty cents($2.50)or more. (b) A person or entity engaged in the business of selling or distributing cigars for commercial purposes to another person or entity engaged in the business of selling or distributing cigars for commercial purposes with the intent to sell or distribute outside the boundaries of North Andover. 5.3 The North Andover Board of Health may adjust from time to time the amounts specified in this Section to reflect changes in the applicable Consumer Price Index by amendment of this regulation. SECTION 6 THE SALE OF FLAVORED TOBACCO PRODUCTS AND FLAVORED NICOTINE DELIVERY PROHIBITED No person shall sell or distribute or cause to be sold or distributed any flavored tobacco products of fia )Fed iiieetine delivery P E)a••e*except in smoking bars and retail tobacco stores. SECTION 7 THE SALE OF BLUNT WRAPS No person or entity shall sell or distribute blunt wraps within North Andover,except that retail tobacco stores are permitted to sell or distribute blunt wraps. SECTION 8 FREE DISTRIBUTION AND COUPON REDEMPTION nieetifie a l pr-eduets for freeor- ette a4 a edueea priee below the minifflum + i 1. No person shall distribute, or cause to be distributed, any free samples of tobacco products, as defined herein; 2. Accept or redeem, offer to accept or redeem, or cause or hire any person to accept or redeem or offer to accept or redeem any coupon that provides any tobacco product, as define herein, without charge or less than the listed or non-discounted price in exchange for the purchase of any other tobacco product. 3. Sell a tobacco product, as define herein, to consumers through any multi pack discounts (e.g. "buy two get one free") or otherwise provide or distribute to consumers any tobacco product, as define herein, without charge or for less than the listed non-discounted price in exchange for the purchase of any other tobacco product. SECTION 9 OUT-OF-PACKAGE SALES The sale or distribution of tobacco products niee*ine aelive•.y produe as defined herein in any form other than an original factory-wrapped package is prohibited. No person may sell or cause to be sold or distribute or cause to be distributed,any cigarette package that contains fewer than twenty(20)cigarettes, including single cigarettes. 1. The sale or distribution of tobacco products, as defined herein, in any form other than an original factory-wrapped package is prohibited, includingtpackaging or dispensing of any tobacco product, as defined herein, for retail sale. No person may or cause to be sold or distribute or cause to be distributed any cigarette package that contains fewer than twenty (20) cigarettes, including single cigarettes. 2. Permit holders who sell Liquid Nicotine Containers must comply with the provisions of 310 CMR 30.000, and must provide the [city/town] Board of Health with a written plan for disposal of said product, including disposal plans for any breakage, spillage or expiration of the product. 3. All permit holders must comply with 940 CMR 21.05 which reads: "It shall be an unfair or deceptive act or practice for any person to sell or distribute nicotine in a liquid or gel substance in Massachusetts after March 15, 2016 unless the liquid or gel product is contained in a child-resistant package that, at a minimum, meets the standard for special packaging as set forth in 15 U.S. C.§§1471 through 1476 and 16 CFR 0700 et. Seq." 4. No permit holder shall refill a cartridge that is prefilled and sealed by the manufacturer and not intended to be opened by the consumer or retailer. SECTION 10 SELF SERVICE DISPLAYS 10.1 All self-service displays of tobacco products are prohibited. All humidors including,but not limited to,walk-in humidors must be locked. 10.1(a) EXEMPTION: Self-service displays that are located in facilities where the retailer ensures that no person younger than twenty-one(21)years of age is present,or permitted to enter,at any time. SECTION 11 TOBACCO VENDING MACHINES 11.1 All tobacco anai Hieeti•ie deliveFy product vending machines are prohibited. 11.1(a) EXEMPTION: Vending machines are permitted if equipped with a lock out device, in an establishment with a valid pouring liquor license,and located in facilities where the retailer ensures that no person younger than twenty-one(21)years of age is present, or permitted to enter,at any time. A lock-out device locks out sales from the vending machine unless a release mechanism is triggered by an employee. The release mechanism must not allow continuous operation of the vending machine and must be out of the reach of all consumers and in a location accessible only to employees. SECTION 12 NON-RESIDENTIAL ROLL-YOUR-OWN(RYO)MACHINES All Non-Residential Roll-Your-Own(RYO)Machines are prohibited. SECTION 13 RESTRICTIONS ON THE SALE OF TOBACCO AND NICOTINE DELIVERY—PRODUCTS AT HEALTH CARE INSTITUTIONS: The North Andover Board of Health strongly encourages health care institutions that sell tobacco ate# eatiiie delk�products to store these products in a manner that is hidden from the view of customers and the general public. The North Andover Board of Health reserves the right to enact regulations eliminating the sale of tobacco products at health care institutions if said institutions are unsuccessful in storing these products in the aforementioned manner. SECTION 14 PROHIBITION OF THE SALE OF TOBACCO AND NICOTINE DE LIVE` PRODUCTS BY EDUCATIONAL INSTITUTIONS: No educational institution located in North Andover shall sell or cause to be sold tobacco delivery products. This includes all educational institutions as well as any retail establishments that operate on the property of an educational institution. SECTION 15 VIOLATIONS/ENFORCEMENT/PENALITIES 15.1 It shall be the responsibility of the permit holder and/or his or her business agent to ensure compliance with all sections of this regulation pertaining to his or her distribution of tobacco ald,'OF mice*.., delivo. products. The violator shall receive: a) In the case of a first violation,a fine of one hundred(100)dollars; b) In the case of a second violation within twenty-four(24)months of the date of the first violation,a fine of two hundred(200)dollars and the Tobacco Product Sales Permit may be suspended for seven(7)consecutive business days. c) In the case of a third violation within a twenty-four(24)month period, a fine of three hundred (300)dollars and the Tobacco and Nieetine Deli .o...,Product Sales Permit may be suspended for thirty(30)consecutive business days. d) In the case of more than three violations within a twenty-four(24)month period,a fine of three hundred(300)dollars per additional violation and the Tobacco Product Sales Permit may be revoked. 15.2 Refusal to cooperate with inspections pursuant to this regulation shall result in the suspension of the Tobacco and Nieetine Pell ef. ,Product Sales Permit for thirty(30)consecutive business days. 15.3 In addition to the monetary fines set above, any permit holder who engages in the sale or distribution of tobacco or iiieetiHe deli ,eM,products directly to a consumer while his or her permit is suspended shall be subject to the suspension of all Board of Health issued permits for thirty(30) consecutive business days. 15.4 The North Andover Board of Health shall provide notice of the intent to suspend or revoke a Tobacco and Nieetine Delivefy Product Sales Permit,which notice shall contain the reasons therefore and establish a time and date for a hearing which date shall be no earlier than seven(7)days after the date of said notice. The permit holder or its business agent shall have an opportunity to be heard at such hearing and shall be notified of the Board of Health's decision,and the reasons therefore in writing. After a hearing,the North Andover Board of Health may suspend or revoke the Tobacco Product Sales Permit if the Board finds that a violation of this regulation occurred. For purposes of such suspensions or revocations,the Board shall make the determination notwithstanding any separate criminal or non-criminal proceedings brought in court hereunder or under the Massachusetts General Laws for the same offense. All tobacco products and meet..,delivo.....,,.,,duets shall be removed from the retail establishment upon suspension or revocation of the Tobacco Product Sales Permit. Failure to remove all tobacco aia Hieetine delivery products shall constitute a separate violation of this regulation. 15.5 Non-Criminal Disposition: Whoever violates any provision of this regulation may be penalized by the non-criminal method of disposition as provided in Massachusetts General Laws, Chapter 40, Section 21D or by filing a criminal complaint at the appropriate venue. Each day any violation exists shall be deemed to be a separate offense. 15.6 Enforcement: Enforcement of this regulation shall be by the North Andover Board of Health or its designated agent(s). Any resident who desires to register a complaint pursuant to the regulation may do so by contacting the North Andover Board of Health or its designated agent(s), and the Board may investigate. SECTION 16 OTHER APPLICABLE LAWS This regulation shall not be interpreted or construed to permit smoking where it is otherwise restricted by other applicable health, safety and fire codes,regulations or statutes. SECTION 17 PROHIBITING SMOKING IN WORKPLACES AND PUBLIC PLACES 17.1 The Board of Health adopts the Massachusetts Smoke-Free Workplace Law (Massachusetts General Law Chapter 270, Sections 21 and 22)by reference and any future revisions as a local regulation. 17.2 Pursuant to Massachusetts General Laws Chapter 270, Section 22 0)smoking is also hereby prohibited in the following locations: a) retail tobacco store, e ep4 that smoking• ill be ..o.... iaed in this establishment if it is housed in a freestanding building that is net eeettpied by any other-business, b) smoking bar c) outdoor spaces of restaurants,bars,taverns and any other outdoor space where food and/or alcoholic beverages,and/or non-alcoholic beverages are sold to the public and served to the public, or otherwise consumed or carried by the public. 17.3 The use of e-cigarettes is prohibited wherever smoking is prohibited per Massachusetts General Laws Chapter 270, Section 22 and Section 4.17.002 of this regulation. SECTION 18. SALE OF ELECTRONIC CIGARETTES OROHIBITEOfRB21: No person shall sell or distribute or cause to be sold or distributed anv electronic cigarettes, except in smoking bars and retail tobacco stores. SECTION 198 THROUGH 21 Reserved for future regulations,amendments,etc. SECTION 22 SEVERABILITY If any provision of these regulations is declared invalid or unenforceable, the other provisions shall not be affected thereby but shall continue in full force and effect. SECTION 23 This regulation supersedes the prior regulation titled"Regulations Affecting Smoking in Certain Places and Youth Access to Tobacco,"as adopted on January 1,2002 and thereafter amended. Effective Date: This regulation was adopted on This regulation shall take effect on Adult-Only Retail Tobacco Store "An establishment that does not share space with another business, that shall have a separate public entrance, that does not sell food or alcohol, that does not have a restaurant license or lottery license, whose only purpose is to sell or offer for retail sale tobacco products andlor tobacco product paraphernalia, in which the entry of persons under the age of 21 is prohibited at all times, and which maintains a valid permit for the retail sale of tobacco products from the[cityltown]Board of Health and applicable state licenses. Entrance to the establishment must be secure so that access to the establishment is restricted to employees and to those 21 years old or older. The establishment shall not allow anyone under the age of 21 to work at the establishment. As of the effective date of this Regulation, no new Adult-Only Retail Tobacco Stores shall be located within[DECISION: 25 to 500]Feet of a retailer with a tobacco product sales permit." 2020 Name c/o Mailing Address Town Tobacco exp 6/30/20 1 A.L. Prime Energy Att: Kim Follansbee 1725 Turnpike Street North Andover 2 Den Rock Wine &Spirits Att: Ankit Patel 54 Peters Street North Andover 3 J&M convenience Store Att: Mike Xenakis 701 Salem Street North Andover 4 Main Street Liquors Att.Joanne Melillo 64 Main Street North Andover 5 Market Basket Store # 12 Att.John Gordon 350 Winthrop Avenue North Andover 6 McAloon's Liquors Att. Bill Buco 531 Chickering Road North Andover 7 Mike's Market Att. Mike Xenakis 220 Middlesex Street North Andover 8 North Andover Race Way Att. Samer Bilovne 1503 Osgood Street North Andover 9 Quic Pic Att. Bill Buco 533 Chickering Road North Andover 10 Richdale#5 Att.Jignashu Patel 75 Chickering Road North Andover 11 Richdale #52 Att. Mohammed Alam 4 Main Street North Andover 12 Sam's Mobil Mart Att. Samuel J. Ameen Jr. 12 Mass Ave North Andover 13 Super Petroleum Att. Shana Warren 50 Braintree Hill Office Park 201 Braintree c'7 14 Town Mart Att. Nitesh Patel 260 Winthrop Ave North Andover 15 Wine & Beer at the Andovers Att. Dharmesh Dave 342 Winthrop Ave North Andover State Zip Code Permit# Email Location Phone # MA 01845 kimf@alprime.com 1725 TurnpikeStreet 781-246-0201 x 208 MA 01845 vipboston70@gmail.com 50 Peters Street 978-509-5034 MA 01845 miketakispizza@comcast.net 701 Salem Street 508-246-6798 MA 01845 joleet5319@aol.com 64 Main Street 978-360-6177 MA 01845 cbst012@demoulasmarketbasket.com 350 Winthrop Ave 10B MA 01845 chrisbucol@gmail.com 535 Chickering Road 978-682-8029 MA 01845 miketakispizza@comcast.net 220 Middlesex Street 508-246-6798 MA 01845 mbmenergygroup@gmail.com 1503 Osgood Street 978-682-0081 MA 01845 chrisbucol@gmail.com 535 Chickering Road 978-273-1854 MA 01845 jignashul4@gmail.com 75 Chickering Road 508-789-4089 978-686-5999 or 978- MA 01845 jalamb.desh@gmail.com 4 Main Street 382-2038 MA 01845 samueljameen@aol.com 12 Mass Ave 978-689-2719 MA 02184 superpetro96@comcast.net 79 chickering Road 781-356-1960 MA 01845 dailymart@comcast.com 260 Winthrop Ave 978-682-2951 MA 01845 yakshilllc@gmail.com 350 Winthrop Ave 978-686-1864 f� North Andover Health Department (ommunity and Economic Development Division NOTICE OF MASSACHUSETTS VAPING PRODUCT BAN September 25, 2019 Dear Tobacco Retailer: On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products, and the epidemic of e-cigarette use among youth. Pursuant to the Governor's Declaration and with the approval of the Governor and the Public Health Council, the Commissioner of the Massachusetts Department of Public Health, Monica Bharel, MD, MPH, issued an Order to temporarily prohibit the sale and public display of all vaping products in retail establishments, online, and by any other means in Massachusetts. This letter is to inform you that to comply with this Order you may not sell vaping products and must remove all vaping products from public display. What products are prohibited from sale and display? • All non-flavored and flavored vaping products, including mint and menthol; and products used to vape tetrahydrocannabinol (THC) and any other cannabinoid • Vape products are any product intended for human consumption by inhalation,regardless of nicotine content, whether for one-time use or reusable, that relies on vaporization or aerosolization, including but not limited to e-cigarettes, e-cigars, e-pipes, vape pens, hookah pens, and other similar devices that reply on vaporization or aerosolization. This includes any component,part, or accessory of these product or devices defined, even if sold separately When will retailers be able to sell vape products again? • The Commissioner's Order is effective immediately. The Order lasts for four months and may be extended. What will happen if retailers don't comply with this Order? This rule may be enforced by state and local officials and failure to comply may result in fines, seizure of vape products or other penalties. If you have questions, please visit: www.mass.gov/dph/mtcp or contact your local board of health. Thank you for following this new law. Sincerely, Health nspector Town of North Andover Office: (978) 688 9540 Enclosure: Commissioner's Order Massachusetts Vaping Product Ban handout The Commonwealth of Massachusetts 42) Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston, MA 02108-4619 7 V v CHARLES D.BAKER MARYLOU SUDDERS Governor Secretary KARYN E.POLITO MONICA BHAREL,MD,MPH Lieutenant Governor Commissioner Tel:617-624-6000 www.mass.gov/dph September 24, 2019 RE: ORDER OF THE COMMISSIONER OF PUBLIC HEALTH PURSUANT TO THE GOVERNOR'S SEPTEMBER 24,2019 DECLARATION OF A PUBLIC HEALTH EMERGENCY (Temporary Ban on Sale or Display of Vaping Products) On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products,and the epidemic of e-cigarette use among youth. A copy of the Governor's Declaration is attached at Appendix A. As of September 19,2019,the federal Centers for Disease Control and Prevention(CDC)had confirmed 530 cases across 38 states and U.S. territories, including seven fatalities in six different states. The commonality in all reported cases is a history of vaping, and a history of using vaping products containing tetrahydrocannabinol (THC), nicotine, or a combination of both. With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker's public health emergency declaration and with the approval of the Public Health Council, I issued an Order which provides in part: The sale or display of all vaping products to consumers in retail establishments, online, and through any other means, including all non-flavored and flavored vaping products, including mint and menthol, including tetrahydrocannabinol (THC) and any other cannabinoid, is prohibited in the Commonwealth. The purpose of this letter is to inform Massachusetts retailers of the Order, a copy of which is attached at Appendix B. The Order is effective immediately, and you must remove all vaping products from display and you must stop selling all vaping products. This order is effective immediately and remains in effect until January 25, 2020, and may be further extended. This Order may be enforced by state and local officials, and failure to comply may result in fines or other penalties. Massachusetts Vaping Product Ban On September 24, 2019 , Governor Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth . The Commissioner of Public Health has temporarily prohibited the sale and display of all vaping products and e-cigarettes until further notice. For help quitting: MakeSmokingHistory.org 1-800-QUIT-NOW OF V fir V Body of email/notice To Local Health Departments: On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products, and the epidemic of e-cigarette use among youth. Pursuant to the Governor's Declaration and with the approval of the Governor and the Public Health Council,today the Commissioner of the Massachusetts Department of Public Health, Monica Bharel, MD, MPH, issued an Order to temporarily prohibit the sale and public display of all vaping products in retail establishments, online, and by any other means in Massachusetts. The growing multistate outbreak of severe lung disease associated with vaping and the epidemic facing youth use of e-cigarettes has led to this necessary and important action. Attached you will find a copy of the Commissioner's Order, a copy of the Governor's Declaration of a Public Health Emergency, and a guidance document that details recommendations for enforcement of this Order and resources for municipalities. The role of local public health is critical in protecting the residents of the Commonwealth and I fully appreciate the work that being done on the municipal level, every day. Thank you for your partnership in the fight against this epidemic. Sincerely, Ron O'Connor September 24, 2019 Dear Tobacco Retailer: On September 24, 2019,Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products, and the epidemic of e-cigarette use among youth. Pursuant to the Governor's Declaration and with the approval of the Governor and the Public Health Council,the Commissioner of the Massachusetts Department of Public Health, Monica Bharel, MD, MPH, issued an Order to temporarily prohibit the sale and public display of all vaping products in retail establishments,online, and by any other means in Massachusetts. This letter is to inform you that to comply with this Order you may not sell vaping products and must remove all vaping products from public display. What products are prohibited from sale and display? • All non-flavored and flavored vaping products, including mint and menthol; and products used to vape tetra hydrocannabinol (THC) and any other cannabinoid • Vape products are any product intended for human consumption by inhalation, regardless of nicotine content, whether for one-time use or reusable,that relies on vaporization or aerosolization, including but not limited to e-cigarettes, e-cigars, e-pipes,vape pens, hookah pens, and other similar devices that reply on vaporization or aerosolization. This includes any component, part, or accessory of these product or devices defined, even if sold separately When will retailers be able to sell vape products again? • The Commissioner's Order is effective immediately. The Order lasts for four months and may be extended. What will happen if retailers don't comply with this Order? This rule may be enforced by state and local officials and failure to comply may result in fines,seizure of vape products or other penalties. If you have questions, please visit:www.mass.gov/dph/mtcp or contact your local board of health. Thank you for following this new law. Sincerely, Enclosure: Commissioner's Order The Commonwealth of Massachusetts W Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston, MA 02108-4619 Q"M SV a y`vr CHARLES D.BAKER MARYLOU SUDDERS Governor Secretary KARYN E.POLITO MONICA BHAREL,MD,MPH Lieutenant Governor Commissioner Tel:617-624-6000 www.mass.gov/dph TO: Local Boards of Health FROM: Patti Henley, Director, Massachusetts Tobacco Cessation and Prevention Program Ron O'Connor, Director, Office of Local and Regional Health DATE: September 24, 2019 RE: Implementation of DPH order regarding vaping products On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products, and the epidemic of e-cigarette use among youth (a copy of the Governor's Declaration is enclosed at Appendix A). As of September 19, 2019,the federal Centers for Disease Control and Prevention (CDC) had confirmed 530 cases across 39 states and U.S.territories, including seven fatalities in six different states.The commonality in all reported cases is a history of vaping, and a history of using vaping products containing tetra hydrocannabinol (THC), nicotine,or a combination of both. On September 11, 2019, Massachusetts Department of Public Health Commissioner Monica Bharel declared possible cases of unexplained vaping-associated pulmonary disease to be immediately reportable to the Department of Public Health (DPH)and further authorized DPH to conduct surveillance activities necessary for the investigation, monitoring, control and prevention of this disease. As a result of this declaration, more than 60 preliminary intake reports have been received by DPH. There is still much to learn about the causes and associated dangers relating to vaping. With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker's public health emergency declaration and with the approval of the Public Health Council,Commissioner Bharel issued an Order which provides in part: The sale or display of all vaping products to consumers in retail establishments, online, and through any other means, including all non-flavored and flavored vaping products, including mint and menthol, including tetrahydrocannabinol (THC) and any other cannabinoid, is prohibited in the Commonwealth. (A copy of the Order is enclosed at Appendix B). As Boards of Health,you have demonstrated the capacity and commitment to help protect our residents across the state. Your diligent work with retailers will be crucial to our success in preventing further illness and death from vaping products. DPH will notify all known tobacco and vaping retailers that they must not sell vaping products and must remove these products from their shelves. DPH will rely on your local expertise to help enforce this Order within each of your municipalities.This initial guidance is provided to assist Boards of Health in this enforcement. DPH will continue to update its guidance as necessary. • Board of Health should help retailers better understand this public health emergency by providing additional communication around this order.See Appendix C. • As you visit retailers, conduct inspections to ensure vaping products are not being sold and are not on display. • If vaping products are being sold or remain on display, issue a cease and desist letter and direct the retailer to immediately stop selling and/or remove vaping products from display.See Appendix D for a cease and desist order. • Revisit retailers within 24 hours of issuing a cease and desist order to ensure compliance. • MDPH has established a tobacco complaint line—1-800-992-1895 to assist in the monitoring and enforcement of this order. Complaints related to retailers in your municipality will be forwarded to you for follow-up. • Additional guidance for enforcement, including fines,will be forthcoming. For general questions related to the enforcement of the emergency order, contact the DPH Massachusetts Tobacco Cessation and Prevention Program (MTCP) at 617-624-5900. We recognize the importance of cessation, and are making cessation resources as readily available as possible on by increasing support on our quit line: 1-800-QUITNOW. We thank you for your continued work in our state, and for your significant contribution with this order. We look forward to working with you and supporting you in this and other statewide efforts. Additional Resources: • Visit the DPH website www.mass.gov/vapingemergency for updated information • For media and press inquiries for DPH,Ann Scales 617-624-5006 • For vaping cessation and smoking cessation resources, see makesmokinghistory.org, or call 1-800-QUITNOW • For general questions from the public, 617.624.5900 • To report a suspected pulmonary disorder related to vaping,go to https://www.mass.gov/news/clinical-advisory-on-vaping-associated-lung-inlury-reporting Appendices: • A: Governor's Declaration of emergency • B: Commissioner's Order • C: DPH notification to retailers • D. Cease and desist order • Press release This Cease and Desist Order is issued to: Name of Firm Address Date: CEASE AND DESIST ORDER Pursuant to the Commissioner of the Department of Public Health's Order dated September 24, 2019, the sale or display of vaping products is prohibited in Massachusetts. [Name of Firm] is hereby ordered to immediately cease and desist the violation of the Commissioner of the Department of Public Health's Order. [Name of Firm] violated the Commissioner of the Department of Public Health's Order by [agent shall check all that apply]: ❑ the undersigned witnessed the sale of vaping products by [Name of Firm] ❑ the undersigned witnessed the display of vaping products by [Name of Firm] ❑ other, see the below narrative description, with any necessary additional pages attached: Operation in violation of this Cease and Desist Order is a violation of law and may result in [enforcement detailed in final version of order] Signed by: Date: Name: As agent of[Department of Public Health/LBOH] Cease and Desist Order Received by: Date: Name: On behalf of[Firm Name] Instructions to DPH/LBOH agent:Two copies of this form should be completed,with one complete and signed copy given to the firm and one complete and signed copy kept by you. Local Boards of Health must provide a copy of the order to the Department of Public Health and keep a copy for your agency's records. 9/2019 The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston,MA 02108-4619 V V CHARLES D. BAKER MARYLOU SUDDERS Governor Secretary KARYN E.POLITO MONICA BHAREL,MD,MPH Lieutenant Governor Commissioner Tel:617-624-6000 www.mass.gov/dph September 24,2019 RE: ORDER OF THE COMMISSIONER OF PUBLIC HEALTH PURSUANT TO THE GOVERNOR'S SEPTEMBER 24, 2019 DECLARATION OF A PUBLIC HEALTH EMERGENCY(Temporary Ban on Sale or Display of Vaping Products) On September 24, 2019, Governor Charles D. Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products,and the epidemic of e-cigarette use among youth. A copy of the Governor's Declaration is attached at Appendix A. As of September 19,2019,the federal Centers for Disease Control and Prevention(CDC)had confirmed 530 cases across 38 states and U.S. territories, including seven fatalities in six different states. The commonality in all reported cases is a history of vaping, and a history of using vaping products containing tetrahydrocannabinol (THC),nicotine, or a combination of both. With the goal of protecting the health of Massachusetts residents, and in accordance with Governor Baker's public health emergency declaration and with the approval of the Public Health Council, I issued an Order which provides in part: The sale or display of all vaping products to consumers in retail establishments, online, and through any other means, including all non-flavored and flavored vaping products, including mint and menthol, including tetrahydrocannabinol (THC) and any other cannabinoid, is prohibited in the Commonwealth. The purpose of this letter is to inform Massachusetts retailers of the Order, a copy of which is attached at Appendix B. The Order is effective immediately, and you must remove all vaping products from display and you must stop selling all vaping products. This order is effective immediately and remains in effect until January 25, 2020, and may be further extended. This Order may be enforced by state and local officials, and failure to comply may result in fines or other penalties. 150 YEARS OF ADVANCING f PUBLIC HEALTH Governor Charlie Baker Declares Public Health Emergency, Announces Temporary Four-Month Ban on Sale of All Vape Products State responds to public health concerns about unexplained vaping-related illness; Prohibits online and retail sale of nicotine,flavored, non flavored and marijuana vaping products effective immediately BOSTON —Governor Charlie Baker today declared a public health emergency in response to confirmed and suspected cases of severe lung disease associated with the use of e-cigarettes and marijuana vaping products in the Commonwealth. The Governor called for a temporary four-month statewide ban on the sale of flavored and non-flavored vaping products in both retail stores and online. The sales ban applies to all vaping products and devices, including tobacco and marijuana.The ban takes effect immediately and lasts through January 25, 2020. The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) are currently investigating a multi-state outbreak of lung disease that has been associated with the use of e-cigarettes or vaping products (devices, liquids, refill pods, and/or cartridges). To date, the CDC has confirmed 530 cases of lung injury across 38 states. While many of the patients reported recent use of Tetra hydrocannabinol (THC)-containing products, some reported using both THC and nicotine products. No single product has been linked to all cases of lung disease. Earlier this month, the Department of Public Health (DPH) mandated that Massachusetts physicians immediately report any unexplained vaping-associated pulmonary disease to the department. As of today, 61 cases have been reported to DPH. Three confirmed cases and two probable cases of vaping-associated pulmonary disease in the state have already been reported to the CDC. The rest are pending further clinical analysis. "The use of e-cigarettes and marijuana vaping products is exploding and we are seeing reports of serious lung illnesses, particularly in our young people," said Governor Charlie Baker. "The purpose of this public health emergency is to temporarily pause all sales of vaping products so that we can work with our medical experts to identify what is making people sick and how to better regulate these products to protect the health of our residents." "Vaping products are marketed and sold in nearly 8,000 flavors that make them easier to use and more appealing to youth," said Lt. Governor Karyn Polito. "Today's actions include a ban on flavored products, inclusive of mint and menthol, which we know are widely used by young people. It is important that we continue to educate youth and parents about the dangers of vaping." Vaping consists of inhaling and exhaling the aerosol (often called vapor) produced by an e- cigarette or similar battery-powered device. E-cigarettes come in many different sizes, types and colors. Some resemble pens, small electronic devices such as USB sticks and other everyday items. The products are often compact and allow for discreet carrying and use—at home, in school hallways and bathrooms and even in classrooms. The U.S. Surgeon General has called teen e-cigarette use an epidemic. According to the CDC, since 2014 e-cigarettes have been the most commonly used tobacco product among both middle and high school students. In Massachusetts,41 percent of all youth in 2017 reported trying e-cigarettes and 1 in 5 reported using e-cigarettes regularly. Current use of e-cigarettes among high school students is 6 times higher than that for adults (3.3% of adults reported using e-cigarettes in the past 30 days). Last week, the Administration convened a group of pulmonary doctors and pediatric experts from Massachusetts to share what they have seen in their patients—especially our youth—and their concerns about the trajectory of vaping related lung disease. The experts shared concerning information about the rapid rate of addiction to e-cigarettes, use and overuse of marijuana vaping products and cases of youth becoming hospitalized within two weeks of using vaping related products. During the temporary ban, the Administration will work with medical experts, state and federal officials to better understand vaping illnesses and work on additional steps to address this public health crisis.This could include legislation and regulations. The Administration will also work on providing more resources for a public awareness campaign and smoking cessation programs. "Vaping is a public health crisis and it is imperative that we understand its impact at both the individual and overall health care system level," said Health and Human Services Secretary Marylou Sudders. "As a result of the public health emergency,the Commonwealth is implementing a statewide standing order for nicotine replacement products, like gum and patches, which will allow people to access these products as a covered benefit through their insurance without requiring an individual prescription, similar to what our Administration did to increase access to naloxone." Massachusetts has a long history of having a strong tobacco cessation and prevention infrastructure that requires close collaboration between DPH and local health departments which assist with the enforcement of tobacco control policies at the local level. The Administration will work with these groups to ensure the temporary ban is enforced while also increasing the availability of cessation resources and the capacity of the Massachusetts Smokers' Helpline.The Helpline is a free and confidential service for individuals who seek help to end their tobacco use.The service includes specialized coaching, including behavioral health counseling and connection to local support groups. Over 9,000 individuals are served annually. The Baker-Polito Administration has strengthened the Helpline's robust outreach about nicotine replacement therapies so individuals who were previously vaping are not inadvertently steered to traditional cigarettes. Individuals who would like help seeking treatment are encouraged to call the Helpline at 1-800-QUIT-NOW or visit makesmokinghistory.org. Massachusetts has made significant progress over the past two decades in curbing youth and adult tobacco use. In 1996, the youth smoking rate was 36.7%. Today, the youth smoking rate is 6.4%.The adult smoking rate is also low, with just under 14%of adults using combustible tobacco products. "Our priority is protecting the public health," said Public Health Commissioner Bharel, MD, MPH. "The Governor's actions today will help prevent more cases of this dangerous lung disease while getting people, especially young people, the help they need to quit." To further inform the public about the dangers of vaping and e-cigarette use, DPH is relaunching two public awareness campaigns aimed at educating parents and middle and high school-aged youth. "Different Products, Some Danger," originally launched in April 2019, links the dangers of vaping to cigarette smoking, and was developed with the input and feedback from middle and high school students across the state. "The New Look of Nicotine Addiction," originally launched in July 2018, seeks to spread the word that these high-tech products are harmful and contain nicotine which can damage a teenager's developing brain and lead to addiction. More information on both campaigns is available at mass.gov/vaping and getoutraged.org. Materials are also available for download on the Massachusetts Health Promotion Clearinghouse website. Over the next four months, the Administration will work closely with the Legislature, public health officials and other stakeholders to consider legislative and/or appropriate regulatory reforms. For more information please visit: mass.gov/vapingemergency Click here to read a copy of the declaration. i i OFFICE OF THE GOVERNOR - - COMMONWEALTH OF MASSACHUSETTS STATE ROUSE • BOSTON, MA 02133 j (617) 725-4000 { tr I J f I CHARLES D. BAKER KARYN E.POLITO GOVERNOR LIEUTENANT GOVERNOR GOVERNOR'S DECLARATION OF EMERGENCY WHEREAS,the federal Centers for Disease Control and Prevention(CDC),the-federal Food and Drug Administration(FDA),and state and local health departments nationally are investigating a multistate outbreak of severe lung disease associated with the use of vaping products including but not limited to e-cigarettes; WHEREAS,as of September 19,2019, the CDC had confnmed 530 cases across 38 states and U.S.territories, including seven fatalities in six different states; WHEREAS, all reported cases have a history of vaping and have indicated a history of using vaping products containing tetrahydrocannabinol (THC), nicotine, or a combination of THC and nicotine; WHEREAS, vaping products use an e-liquid that may contain nicotine, THC and/or cannabinoid oils,in addition to a combination of flavoring,propylene glycol,vegetable glycerin, and other ingredients and may also contain toxic chemicals such as formaldehyde,acrolein, acrylonitrile,propylene oxide,crotonaldehyde and acetaldehyde,as well as metal particles such as nickel,lead, and chromium,which can be inhaled into the lungs; WHEREAS, although the recent outbreak is associated with vaping products,the specific cause of this disease is unknown; WHEREAS, cases of vaping-associated pulmonary disease show diverse symptoms and signs of lung injury, including cough, chest pain, shortness of breath, low levels of blood oxygen, abnormal chest X-rays or CT scans, and pathologic evidence of damage to lung tissue that can be severe; WHEREAS,nationally from 2017 to 2018 vaping use among youth has increased 78% among high school students and 48% among middle school students and the total number of children who are currently vaping rose to 3.6 million in 2018; WHEREAS,in December 2018,the United States Surgeon General Jerome Adams officially declared vaping among youth in the United States an epidemic; I WHEREAS,Massachusetts youth usage mirrors national trends with 41%of all youth in 2017 reporting trying e-cigarettes and one in five reporting that they use e-cigarettes regularly; I WHEREAS,vaping products are marketed and sold in a wide variety of flavors that I make them easier to use and more appealing to youth; WHEREAS,nationally cases of vaping-associated puhnonazy injury have occurred in all age groups,with 83%of cases occurring in those younger than 35 years of age; 4 WHEREAS, on September 11,2019,the Commissioner of Public Health declared cases of unexplained vaping-associated pulmonary disease to be immediately reportable to the Massachusetts Department of Public Health(DPH) and further authorized the DPH to conduct surveillance activities necessary for the investigation,monitoring, control and prevention of this disease; WHEREAS,to date more than 60 Massachusetts residents have already been reported with lung injury potentially related to vaping to DPH; 4 WHEREAS,as of September 24,2019,five of these reports of lung injury meet the CDC case definition of confirmed or probable cases, and Massachusetts joins 38 other U.S. states in reporting cases to the CDC; WHEREAS,these confirmed and probable cases in Massachusetts are among both teenagers and older adults and are linked to a range of vaped products; and WHEREAS, it is necessary for the DPH to take action immediately to address this public health emergency; NOW,THEREFORE,I,Charles D.Baker,the Governor of the Commonwealth of Massachusetts,pursuant to M.G.L. chapter 17, section 2A, declare that an emergency exists which is detrimental to the public health in the Commonwealth. This declaration of a public health emergency is effective immediately and shall remain in effect until notice is given,pursuant to my judgment,that the public health emergency has terminated. Given this 24th day of September two thousand and nineteen. CHARLES D. BAKER GOVERNOR Commonwealth of Massachusetts ORDER OF THE COMMISSIONER OF PUBLIC HEALTH PURSUANT TO THE GOVERNOR'SSEPTEMBER 24, 2019 DECLARATION OF PUBLIC HEALTH EMERGENCY On September 24, 2019, Governor Charles D. Baker issued a declaration that a public health emergency exists in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth. For the reasons set forth in the declaration, in addition to evidence and facts presented at the Public Health Council meeting,and in consideration of the on-going federal and state investigation, I,with the approval of the Governor and the Public Health Council pursuant to M.G.L.c. 17§2A, issue the following Order: Over-the-counter(OTC) products approved by the federal Food and Drug Administration for the sale of or use as tobacco cessation products and marketed and sold exclusively for the approved purpose may be made available pursuant to a standing order. This Order takes effect immediately and shall remain in effect through January 25, 2020, unless extended with the approval of the Governor and the Public Health Council, or until the declared public health emergency is terminated or the Order is otherwise rescinded by me,whichever happens first. IT IS SO ORDERED. Monica Bharel, MD, MPH,Commissioner Department of Public Health 900 Date Massachusetts Vaping Product Ban On September 24, 2019 , Governor Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth . The Commissioner of Public Health has temporarily prohibited the sale and display of all vaping products and e-cigarettes until further notice. For help quitting: MakeSmokingHistory.org 1-800-QUIT-NOW 2P`TH OF M9SSS °s F I'I m f m 9MENT OF PUBV'' Massachusetts Vaping Product Ban On September 24, 2019, Governor Baker declared a public health emergency in the Commonwealth due to severe lung disease associated with the use of e-cigarettes and vaping products and the epidemic of e-cigarette use among youth. The Commissioner of Public Health has temporarily prohibited the sale and display of all vaping products and e-cigarettes until further notice. For help quitting: MakeSmokingHistory.org 1-800-QUIT-NOW f N OF NbS CEP S VV s vV� V1 lM V `j11 VENT of wd`' , ORDER OF THE COMMISSIONER OF PUBLIC HEALTH PURSUANT TO THE GOVERNOR'S SEPTEMBER 24,.2019 DECLARATION OF A PUBLIC HEALTH EMERGENCY On September 24, 2019, Governor Charles D. Baker issued a declaration that a public health emergency exists in the Commonwealth'due to severe lung disease associated with the use of e- cigarettes and vaping products and the epidemic of e-cigarette use among youth. For the reasons set forth in the declaration, in addition to evidence and facts presented at the Public Health Council meeting, and in consideration of the on-going federal and state investigation into the causes of vaping-;related disease,I,with the approval of the Governor and the Public Health Council pursuant to G.L. c. 17, §2A, issue the following Order: The sale or display of all vaping products to consumers in retail establishments,online,and through any other means, including all non-flavored and flavored vaping products, including mint and menthol, including tetrahydrocannabinol (THC)and any other cannabinoid, is prohibited in the Commonwealth. "Vaping products"means: 1)any product intended for human consumption by inhalation regardless of nicotine content,whether for,one-time use or reusable,that relies on vaporization or aerosolization, including but not limited to electronic cigarette, electronic cigars, electronic cigarillos,electronic pipes,electronic vaping product delivery pens,hookah pens,and any other similar devices that rely on vaporization or aerosolization;and 2)any component,part,or accessory of a product or device defined in subsection 1), even if sold separately. "Vaping products"does not include any product that has been approved by the federal Food and Drug Administration either as a tobacco use cessation product or for other medical purposes and which is being marketed and sold or prescribed solely for the approved purpose. While this Order is in effect the Department of Public Health,along with any board of health or authorized agent pursuant to G.L. c. 111, §30,may take any enforcement action permitted by law or this Order to effectuate this Order as it applies to sales of vaping products to consumers. Pursuant to the authority granted by G.L. c. 17, §2A,this Order may be enforced in the manner of a regulation adopted pursuant to G. L. c. 111, §31,and by injunction through proceedings initiated in the Superior Court. A person or entity found in violation of this Order may also be subject to the maximum fine provided in G. L. c. 111, §31; provided that violations shall be calculated on a per item and per transaction basis and may be punished cumulatively. Subject to valid court order issued by a court of competent jurisdiction, State Police or local law enforcement may seize any vaping products from entities or persons that continue to display or sell vaping products in violation of this Order. The Cannabis Control Commission and the Division of Agricultural Resources shall enforce this Order to the extent it applies to their registered or licensed entities. If any provisions of this Order or the application thereof to any person or entity or circumstance is adjudged invalid by a court of competent jurisdiction, such judgment shall not affect or.impair the validity of the other provisions of this Order or the application thereof to other persons, entities, and circumstances. This Order takes effect immediately and shall remain in effect, unless extended with the approval of the Governor and the Public Health Council, through January, 25,2020,or until the declared public health emergency is terminated, or the Order is otherwise rescinded by me, whichever happens first. 1T 1S SO ORDERED. Monica Bharel,MD,MPH, Commissioner Department of Public Health a � a Date k E i i j i I SECTION 1 PURPOSE: Whereas there exists conclusive evidence that tobacco smoking causes cancer,respiratory and cardiac diseases,negative birth outcomes, irritations to the eyes,nose and throat'; Whereas among the 15.7% of students nationwide who currently smoke cigarettes and were less than 18 years old, 14.1%usually obtained them by buying them in a store (i.e. convenience store, supermarket, or discount store)or gas station; Whereas nationally in 2009, 72% of high school smokers and 66% of middle school smokers were not asked to show proof of age when purchasing cigarettes 3; Whereas the U.S. Department of Health and Human Services has concluded that nicotine is as addictive as cocaine or heroin4 and the Surgeon General found that nicotine exposure during adolescence, a critical window for brain development, may have lasting adverse consequences for brain developments; Whereas despite state laws prohibiting the sale of tobacco products to minors, access by minors to tobacco products is a major public health problem; Whereas research on raising the minimum legal drinking age to 21 has reduced alcohol consumption among youth and protected drinkers from long-term negative outcomes in adulthood, including alcohol and other drug dependence 6; More than 80 percent of all adult smokers begin smoking before the age of 18; and more than 90 percent do so before leaving their teens? 1 Center for Disease Control and Prevention,(CDC)(2012),Health Effects of Cigarette Smoking Fact Sheet. Retrieved from: http://www.cdc.gov/tobacco/data statistice/fact_sheets/health_effects/effects—Cig_smoking/index.htin. 2 CDC(2009), Youth Risk Behavior, Surveillance Summaries(Morbidity and Mortality Weekly Report(MMWR) 2010: 59, 11 (No. SS-55)) Retrieved from:http://www.cdc.gov/HealthyYouth/yrbs/index.htm. 3 CDC Office of Smoking and Health,National Youth Tobacco Survey, 2009. Analysis by the American Lung Association(ALA),Research and Program Services Division using SPSS software,as reported in"Trends in Tobacco Use",ALA Research and Program Services,Epidemiology and Statistics Unit,July 2011. Retrieved from: www.lung.org/fmding-cures/our-research/trend-reports/Tobacco-Trend-Report.pdf. 4 CDC(2010),How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease. Retrieved from:http://www.cdc.gov/tobacco/data_statistics/sgr/2010/. 5 U.S.Department of Health and Human Services.2014. The Health Consequences of Smoking—50 Years of Progress:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p. 122 Retrieved from: http://www.surgeongeneral.gov/library/reports/5 0-years-of-progress/full-report.pdf. 6 DeJong W,Blanchette J 2013."Case Closed: Research Evidence on the Positive Public Health Impact of the Age 21 Minimum Legal Drinking Age in the United States." J. Stud.Alcohol Drugs, Supplement 17, 108—115,2014. 'SAMHSA,Calculated based on data in 2011 National Survey on Drug Use and Health. {�r Whereas many non-cigarette tobacco products, such as cigars and cigarillos, can be sold in a single"dose;" enjoy a relatively low tax as compared to cigarettes; are available in fruit, candy and alcohol flavors; and are popular among youth8; Whereas sales of flavored little cigars increased by 23%between 2008 and 20109; and the top three most popular cigar brands among African-American youth aged 12-17 are the flavored and low-cost Black&Mild, White Owl, and Swisher Sweets;10 Whereas the federal Family Smoking Prevention and Tobacco Control Act(FSPTCA), enacted in 2009,prohibited candy- and fruit-flavored cigarettes," largely because these flavored products were marketed to youth and young adults,12 and younger smokers were more likely to have tried these products than older smokers;13 Whereas although the manufacture and distribution of flavored cigarettes (excluding menthol) is banned by federal law,14 neither federal nor Massachusetts laws restrict sales of flavored non- cigarette tobacco products, such as cigars, cigarillos, smokeless tobacco, hookah tobacco, and electronic devices and the nicotine solutions used in these devices; Whereas the U.S. Food and Drug Administration and the U.S. Surgeon General have stated that flavored tobacco products are considered to be "starter"products that help establish smoking habits that can lead to long-term addiction;15 8 CDC(2009), Youth Risk Behavior, Surveillance Summaries(MMWR 2010:59, 12,note 5). Retrieved from: http:www.cdc.gov/mmwr/pdf/ss/ss5905.pdf. 9 Delnevo,C.,Flavored Little Cigars memo,September 21,2011,from Neilson market scanner data. 10 SAMSHA,Analysis of data from the 2011 National Survey on Drug Use and Health. 11 21 U.S.C. §387g. 12 Carpenter CM,Wayne GF,Pauly JL,et al.2005."New Cigarette Brands with Flavors that Appeal to Youth: Tobacco Marketing Strategies."Health Affairs.24(6): 1601-1610;Lewis M and Wackowski 0.2006."Dealing with an Innovative Industry:A Look at Flavored Cigarettes Promoted by Mainstream Brands."American Journal of Public Health.96(2):244-251;Connolly GN.2004."Sweet and Spicy Flavours:New Brands for Minorities and Youth." Tobacco Control. 13(3):211-212;U.S.Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p. 537, www.surgeongeneral.gov/library/reports/preventingj outh-tobacco-use/ull-report pdf. 13 U.S.Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p.539,www.surgeon eg neral.gov/librar reports/preventing- oy uth- tobacco-use/full-report.pdf. 14 21 U.S.C. §387g is Food and Drug Administration.2011.Fact Sheet:Flavored Tobacco Products, www;fda.gov/downloads/TobaccoProducts/ProtectingKidsfromTobacco/FlavoredTobacco/UCM183214.p U.S. Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p.539,www.surgeongeneral.gov/librarIreports/preventing, oy uth- tobacco-use/full-report.pdf. Whereas data from the National Youth Tobacco Survey indicate that more than two-fifths of U.S. middle and high school smokers report using flavored little cigars or flavored cigarettes;16 Whereas the U.S. Centers for Disease Control and Prevention has reported that electronic cigarette use among middle and high school students doubled from 2011 to 2012;17 Whereas nicotine solutions, which are consumed via electronic or battery-operated delivery smoking devices such as electronic cigarettes, are sold in dozens of flavors that appeal to youth, such as cotton candy and bubble gum;18 Whereas in a lab analysis conducted by the FDA, electronic cigarette cartridges that were labeled as containing no nicotine actually had low levels of nicotine present in all cartridges tested, except for one 19; Whereas according to the CDC's youth risk behavior surveillance system, the percentage of high school students in Massachusetts who reported the use of cigars within the past 30 days went from 11.8% in 2003 to 14.3%in 201 120; Whereas survey results show that more youth report that they have smoked a cigar product when it is mentioned by name, than report that they smoked a cigar in general, indicating that cigar use among youth is underreported2l; Whereas in Massachusetts, youth use of all other tobacco products, including cigars,rose from 13.3%in 2003 to 17.6% in 2009, and was higher than the rate of current cigarette use (16%) for the first time in history22; 16 King BA,Tynan MA,Dube SR,et al.2013."Flavored-Little-Cigar and Flavored-Cigarette Use Among U.S. Middle and High School Students."Journal of Adolescent Health. [Article in press], www.iahonline.org/article/S1054-139X'O2813%2900415-1/abstract. 17 Centers for Disease Control&Prevention.2013."Electronic Cigarette Use Among Middle and High School Students—United States,2011-2012,"Morbidity and Mortality Weekly Report(MMWR)62(35):729-730. 18 Cameron JM,Howell DN,White JR,et al.2013."Variable and Potentially Fatal Amounts of Nicotine in E- cigarette NicotineSolutions." Tobacco Control. [Electronic publication ahead of print], http://tobaccocontrol.bmj.comlcontent/early/2013/02/12/tobaccocontrol-2012-050604. ull;U.S.Department of Health and Human Services.2012.Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeon General.Atlanta:U.S.National Center for Chronic Disease Prevention and Health Promotion,Office on Smoking and Health,p.549,www.surgeongeneral.gov/librarlreports/preventing-youth-tobacco-use1fu11-report pdf 19 Food and Drug Administration,Summary of Results:Laboratory Analysis of Electronic Cigarettes Conducted by FDA,available at:hU://www.fda.gov/newsevents/publichealthfocus/ucml73146.htm. 20 CDC(2011) Youth Risk Behavior,Surveillance Summaries(MMWR 2012: 87(No SS-61)). Retrieved from: www.cdc.gov;and CDC(2003), Youth Risk Behavior, Surveillance Summaries(MMWR 2004: 53,54(No. SS-02)). 212010 Boston Youth Risk Behavior Study. 16.5%of Boston youth responded that they had ever smoked a fruit or candy flavored cigar,cigarillo or little cigar,while 24.1%reported ever smoking a"Black and Mild"Cigar. 22 Commonwealth of Massachusetts,Data Brief,Trends in Youth Tobacco Use in Massachusetts, 1993-2009. Retrieved from: http://www.mass.gov/Eeohhs2/docs/dph/tobacco—control/adolescent tobacco use_youth—trends-1993 2009.pdf. Whereas research shows that increased cigar prices significantly decreased the probability of male adolescent cigar use and a 10% increase in cigar prices would reduce use by 3.4%23; Whereas nicotine levels in cigars are generally much higher than nicotine levels in cigarettes24; Whereas Non-Residential Roll-Your-Own(RYO) machines located in retail stores enable retailers to sell cigarettes without paying the excise taxes that are imposed on conventionally manufactured cigarettes. High excise taxes encourage adult smokers to quit25 and high prices deter youth from starting.21 Inexpensive cigarettes, like those produced from RYO machines, promote the use of tobacco, resulting in a negative impact on public health and increased health care costs, and severely undercut the evidence-based public health benefit of imposing high excise taxes on tobacco; Whereas it is estimated that 90% of what is being sold as pipe tobacco is actually being used in Non-Residential RYO machines. Pipe tobacco shipments went from 11.5 million pounds in 2009 to 22.4 million pounds in 2010. Traditional RYO tobacco shipments dropped from 11.2 million pounds to 5.8 million pounds; and cigarette shipments dropped from 308.6 billion sticks to 292.7 billion sticks according to the December 2010 statistical report released by the U.S. Department of the Treasury, Alcohol and Tobacco Tax and Trade Bureau(TTB)27, Whereas educational institutions sell tobacco products to a younger population, who is particularly at risk for becoming smokers and such sale of tobacco products is incompatible with the mission of educational institutions that educate a younger population about social, environmental and health risks and harms; Whereas the Massachusetts Supreme Judicial Court has held that" . . . [t]he right to engage in business must yield to the paramount right of government to protect the public health by any rational means"28. 21 Ringel,J.,Wasserman,J.,&Andreyeva,T.(2005) Effects of Public Policy on Adolescents'Cigar Use: Evidence from the National Youth Tobacco Survey. American Journal of Public Health,95(6),995-998,doi: 10.2105/AJPH.2003.030411 and cited in Cigar, Cigarillo and Little Cigar Use among Canadian Youth: Are We Underestimating the Magnitude of this Problem?, J.Prim.P.2011,Aug: 32(3-4):161-70. Retrieved from: www.nebi.nim.gov/pubmed/21809109. 21 National Institute of Health(NIIH),National Cancer Institute(NCI)(2010). Cigar Smoking and Cancer. Retrieved from:http://www.cancer.govb/cancertopies/factsheet/Tobacco/cigars. "Eriksen,M.,Mackay,J.,Ross,H.(2012). The Tobacco Atlas, Fourth Edition,American Cancer Society,Chapter 29,p. 80. Retrieved from:www.TobaccoAtlas.org. 26 Chaloupka,F.J.&Liccardo Pacula,R.,NIH,NCI(2001). The Impact of Price on Youth Tobacco Use, Smoking and Tobacco Control Monograph 14: Changing Adolescent Smoking Prevalence) 193—200. Retrieved from: http://dccps.nih.gov/TCRB/monographs/. 27 TTB(2011). Statistical Report—Tobacco(2011)(TTB S 5210-12-2010). Retrieved from: http://www.ttb.gov/statistics/2010/201012tobacco.pdf. 21 Druzik et al v.Board of Health of Haverhill,324 Mass.129(1949). Now,therefore it is the intention of the North Andover Board of Health to regulate the sale of tobacco products. September 6, 2019 Hi Brian, Attached please find a draft copy of the North Andover Board of Health tobacco control regulations. These regulations include the following amendments: 1. A new, broader definition of"tobacco product" which includes all vapes and related components. (See Section 2.23) 2. Removal of all references to "nicotine delivery product" because this term would be unnecessary if the Board adopts the new, broader definition of"tobacco product." 3. Removal of the words "menthol, mint or wintergreen" in order to INCLUDE to include these flavors as part of the Board's flavor restriction. (See Section 2.4) 4. Insertion of definition of"Electronic Cigarette" in Section 2.9 and related restriction language in Section 18. These two provisions would remove all vape devices and components from all stores in North Andover who currently hold a tobacco sales permit and would only allow the sale of the vape products and related components in adult-only smoke shops and vape shops. (See provision after Section 2.9 and provision after Section 17.3) 5. Removal of"27" and insertion of"40" as the required age appearance of a customer that will not require a retailer to ID. (See Section 3.3) 6. A variety of options to set overall tobacco product sales permit caps, limits on the number of smoke/vape shops, and restrictions on the location of new stores selling tobacco products near schools. (See provisions following Section 4.11) 7. Further restrictions on the free distribution of tobacco,free samples, and discounted prices.(See Section 8) 8. Expansion of"Out of Package" provisions, particularly involving the sale of vape juice bottles and cartridges. (See Section 9) 9. Prohibits smoking or vaping in adult-only retail tobacco stores (Section 17.2.a.) Best Ron Definitions to consider adding: Vaping: Inhaling and exhaling the aerosol(often called vapor)produced by an electronic cigarette or similar battery-powered device. Electronic cigarettes come in many different sizes, types and colors. Some resemble pens, small electronic devices such as USB sticks and other everyday items. The products are often compact and allow for discreet carrying and use—at home, in school hallways and bathrooms and even in classrooms. Vape products: Any product intended for human consumption by inhalation, regardless of nicotine content,whether for one-time use or reusable,that relies on vaporization or aerosolization, including but not limited to electronic cigarettes, electronic cigars, electronic cigarillos, electronic pipes, electronic vaping product delivery pens,hookah pens, and any other similar devices that rely on vaporization or aerosolization. This includes any component,part, or accessory of these product or devices defined, even if sold separately. ce,VO - 23 SEe PNovvER Town of North Andover H Youth & Recreation Services Department Rick Gorman 33 Johnson St. Executive Director North Andover, MA 01845 NAYRS (978) 682-9000 September 19,2019 North Andover Board of Health 27 Charles St. North Andover,MA 01845 Dear Board of Health Members, As the Executive Director of North Andover Youth &Recreation Services, I would like to express my support for the proposed "Regulation of the North Andover Board of Health Restricting the Sale of Tobacco Products and Nicotine Delivery Products".I believe anything that you can do to further advance and protect the health of the residents of North Andover and our youth is a positive step forward. As Director of the Youth Center I am on the front lines of this growing problem every day. I am dealing with youth on a number of tobacco and nicotine issues, most notably our epidemic on vaping. We as a community must address these issues head on and we must be better. I support all proposed policy changes listed below: 1) Prohibit the sale of tobacco and vape products flavored with mint, menthol and wintergreen, except in adult-only retail tobacco stores (i.e. smoke and vape shops) where a.) persons under the age of 21 are prohibited entry at all times, b.) sales are limited primarily to tobacco/vape and tobacco/vape paraphernalia, and c.)no food products requiring a retail food permit are sold. 2) Prohibit the sale of all electronic cigarettes and all other vape products,with or without flavors, except in adult-only retail tobacco stores (i.e. smoke and vape shops)where a.)persons under the age of 21 are prohibited entry at all times, b.) sales are limited primarily to tobacco/vape and tobacco/vape paraphernalia, and c.)no food products requiring a retail food permit are sold. 3) Mandate that retailers require a government-issued photographic identification card be presented by all persons appearing under the age of 40 who wish to purchase tobacco products. 4) Cap the total number of establishments holding a tobacco sales permits. 5) Cap the total number of establishments holding a tobacco sales permit that operate as "adult-only retail tobacco stores" (i.e. smoke and vape shops). 6) Prohibit smoking and vaping in all "adult-only retail tobacco stores" (i.e. smoke and vape shops) 7) Provide further restrictions on discounts on tobacco and vape products prices. 8) Provide further restrictions of out-of-package sales of tobacco and vape products. I also want to applaud the Board of Health's efforts and actions and would like to take this opportunity to thank you for your hard work and dedication. Richar M. Gorman Executive Director,NAYRS ILED 16ga,' . •r North Andover Health Department Community and Economic Development Division North Andover Mosquito Control Update DATE: September 25,2019 CONTACT: Brian J.LaGrasse PHONE: (978)688-9540 The Board of Health reports that North Andover's risk level for Eastern Equine Encephalitis(EEE) remains at the Moderate Level as determined by the Massachusetts Department of Public Health. Warmer temperatures have kept mosquito activity high throughout the region. A mosquito pool tested positive for WNV in Haverhill last Friday,and another human case has been diagnosed with EEE in the area. As a result,and out of an abundance of caution,the Health Department has recommended that all outdoor events should conclude by 6:30pm until October 13. Please be aware and take common-sense precautions before dawn as well. North Andover High School will be releasing information about changes to sports,programming or other activities. By taking a few,common-sense precautions,people can help to protect themselves and their loved ones: Avoid Mosquito Bites • Be Aware of Peak Mosquito Hours-The hours from dusk to dawn are peak biting times for many mosquitoes. Consider rescheduling outdoor activities that occur during evening or early morning.If you are outdoors at any time and notice mosquitoes around you,take steps to avoid being bitten by moving indoors,covering up and/or wearing repellant. • Apply Insect Repellent when you go outdoors.Use a repellent with DEET(N,N-diethyl-m= toluamide), permethrin,picaridin(KBR 3023),IR3535 or oil of lemon eucalyptus [p-methane 3, 8-diol(PMD)] according to the instructions on the product label.DEET products should not be used on infants under two months of age and should be used in concentrations of 30%or less on older children. Oil of lemon eucalyptus should not be used on children under three years of age. Permethrin products are intended for use on items such as clothing, shoes,bed nets and camping gear and should not be applied to skin. • Clothing Can Help reduce mosquito bites.Although it may be difficult to do when it's hot, wearing long-sleeves, long pants and socks when outdoors will help keep mosquitoes away from your skin. Page 1 of 2 North Andover Health Department 120 Main Street North Andover, MA 01845 Phone: 978.688.9540 Fax: 978.688.9542 • Drain Standing Water—Many mosquitoes lay their eggs in standing water.Limit the number of places around your home for mosquitoes to breed by either draining or getting rid of items that hold water. Check rain gutters and drains.Empty any unused flowerpots and wading pools,and change water in birdbaths frequently. Always remember the 5 D's to make it easy DUSK—Mosquito activity starts around dusk. DAWN—Mosquitoes are active through dawn. DEET—Wear insect repellent with effective ingredients such as DEET. DRESS—Wear long pants and long sleeves to cover up and block mosquito access to your skin. DRAIN—Drain standing water from artificial containers on your property. Mosquito-Proof Your Home • Install or Repair Screens- Some mosquitoes like to come indoors.Keep them outside by having tightly-fitting screens on all of your windows and doors. The Health Department is working closely with Northeast Mosquito Control to increase surveillance activities and are analyzing data for additional control measures. Information about EEE and mosquitoes can be found on the Town of North Andover's website www.northandoverma.gov,,the state's website www.mass.gov/eohhs/gov/departrnents/dp and North East Mosquito Controls Website www.nemassmosquito.org/ Page 2 of 2 North Andover Health Department 120 Main Street North Andover,MA 01845 Phone: 978.688.9540 Fax: 978.688.9542 a / ` i FL U 2019 S HOT FLU CLINICS North Andover Senior Center Ages 19 and older (including High Dose for 65+) Monday October 21 st 9a-12p Wednesday October 30t" 9a-12p Thursday November 14th 9a-12p Senior Housing Ages 19 and older (including High Dose for 65+) Monday November 4tn Bingham: 9am O'Connor: 1 Oam Foulds: 1 lam Fountain: 12pm McCabe: 2pm Morkeski: 3pm North Andover High School Family Flu Clinic Ages 4 and older (including High Dose for 65+) Tuesday November 12t" from 5-7pm Please bring all insurance cards with you to the clinic. 2019-2020 Immunization Insurance Information and Consent Form The completion of this form is necessary for every vaccine recipient. If no insurance information is available, please fill out as much as possible. Please print and complete all required fields *). 1. *Information about person receiving vaccine: Do not use nicknames. *Name: (Last, First, MII *Birth Date:M/D/YR *Ace: *Sex:(circle) Male Female *Street: *City: *State: *Zip: *Phone: *For children 18 years of age and younger: Please complete for VFC (Vaccines for Children) Program. Has health insurance and is not American Indian (Native American) or Alaska Native _Enrolled in Medicaid (includes MassHealth and HMO's etc if enrolled through Medicaid) _Does not have health insurance Is American Indian (Native American) or Alaska Native 2. *Insurance: Include all numbers & letters of member ID OR attach a copy of all insurance cards to this form. *Insurance MEDICARE Number: (if applicable) Company: # *Member ID Number: Is Medicare Primary? YES NO Group ID if available): Is Subscriber Retired? YES NO 3. *Subscriber Information: Complete if the person receiving vaccine is not the insurance polic holder. *Name: *Birth Date: 'Sex: (circle) (Last,First,MI) (M/D/YR) Male Female *Street Address: *City: if different from above *State: *Z 'Phone: *Relationship to Patient: (circle) Spouse / Child / Other: 4. *SIGNATURE: I give permission to receive vaccine and for my insurance company to be billed. *X Date: (Signature of patient, parent or legal guardian) CLINIC/OFFICE USE ONLY---------------------------------------------------------------------------------------- ProviderlAddress: North Andover Health Department---120 Main St, N. Andover MA 01845---MDPH PIN: 11187 MANUFACTURER/ LOT EXP DATE DATE VIS STATEPRESERV VAX TYPE (Place Sticker) ON VIS GIVEN FREE? DOSE ROUTE SITE SANOFI 8/15/19 Same as Y N Y 0.5 ML IM LID RD FLUZONE IIV4 service date SANOFI 8/15/19 Same as N Y 0.5 ML IM LID RD HIGH DOSE IIV3-HD service date ASTRAZENECA Some as Intra- FLUMIST LAIV4 8/15/19 service date Y Y 0.2 ML Nasal N/A Signature of Vaccine Administrator: Service Date: 10/2/2019 Town of North Andover Mail-Tobacco Control Regulations 44aldl G NORTH ANDOVER Massachusetts Toni Wolfenden <twolfenden@northandoverma.gov> Tobacco Control Regulations 3 messages Mike Brangwynne <mbrangwynne@fletchertilton.com> Tue, Oct 1, 2019 at 11:56 AM To: "twolfenden@northandoverma.gov" <twolfenden@northandoverma.gov>, "blagrasse@northandoverma.gov" <blagrasse@northandoverma.gov> Hello Director Lagrasse, I have attached correspondence related to the Town of North Andover Board of Health's consideration of certain revisions to its tobacco control regulation. At the most recent hearing, the Board had asked for specific information regarding medical and scientific literature that was discussed at the hearing. Could you please provide this correspondence to the Board members prior to the next meeting of the Board? Thank you. Please feel free to get in touch if you have any questions or concerns. Very truly yours, Michael E. Brangwynne FLETCHER TILTON PC 12 POST OFFICE SQUARE 16TH FLOOR BOSTON, MA 02109 P: (617)336-2281 1 F: (617)336-4481 E: MBRANGWYNNE@FLETCHERTILTON.COM VISIT US AT: FLETCHERTILTON.COM Fletcher T i1ton to t;,,j I .., Attorneys at law BEST WORCESTER•FRAMINGHAM LAW FIRMS 805TON•CAPE COD .� MEDFIELD•PROVIDENCE 2010 FletcherTilton com To the extent that this communication contains any federal tax-related advice, please be advised that such advice is not intended to be used, and may not be used,for the purpose of: (i)avoiding tax-related penalties under the Internal Revenue Code, or(ii) promoting, marketing or recommending to another party any tax-related matter(s)addressed herein.This e-mail message is generated from the law firm of Fletcher Tilton PC, and may contain information that is confidential and may be privileged as an attorney/client communication or as attorney work product. The information is https://mail.google.com/mail/u/0?ik=aOc6f4e4cf&view=pt&search=all&permthid=thread-f°/o3Al 646207087027462268&simpl=msg-f%3A1 64620708702... 1/3 10/2/2019 Town of North Andover Mail-Tobacco Control Regulations intended to be disclosed solely to the addressee(s). If you are not the intended recipient, any disclosure, copying, distribution or use of the contents of this e-mail information is prohibited. If you have received this e-mail in error, please notify the sender by return e-mail and delete it from your computer system. • r� Itr N.Andover BOH 10.1.19 (03277221xA166B).pdf 2725K Toni Wolfenden <twolfenden@northandoverma.gov> Tue, Oct 1, 2019 at 12:19 PM To: Mike Brangwynne <mbrangwynne@fletchertilton.com> Cc: "blagrasse@ north and overma.gov" <blagrasse@northandoverma.gov> Received, thank you. Toni K. Wolfenden Health Department Assistant 978-688-9540 �vcid:image002.jpg@01 CD02Al.85A49B40 [Quoted text hidden] image001.jpg 4K Mike Brangwynne <mbrangwynne@fletchertilton.com> Tue, Oct 1, 2019 at 1:28 PM To: Toni Wolfenden <twolfenden@northandoverma.gov> Cc: "blagrasse@northandoverma.gov" <blagrasse@northandoverma.gov> Thanks Toni. Michael E. Brangwynne FLETCHER TILTON PC 12 POST OFFICE SQUARE 16TH FLOOR BOSTON, MA 02109 P: (617)336-2281 1 F: (617)336-4481 E: MBRANGWYNNE@FLETCHERTILTON.COM VISIT US AT. FLETCHERTILTON.COM https://mai l.google.com/mai I/u/0?ik=aOc6f4e4cf&view=pt&search=a II&permthid=thread-f%3AI 646207087027462268&sim pl=msg-f%3AI 64620708702... 2/3 10/2/2019 Town of North Andover Mail-Tobacco Control Regulations rletcherT lion pc E>:'t.....: Attorneys at law BEST WORCESTER-€RAMINGHAM LAW FIRMS BOSTON•CAPE COD MEDFIELD•PROVIDENCE FletcherTiltoncom From: Toni Wolfenden [mailto:twolfenden@northandoverma.gov] Sent: Tuesday, October 01, 2019 12:20 PM To: Mike Brangwynne <mbrangwynne@fletchertilton.com> Cc: blagrasse@northandoverma.gov Subject: Re: Tobacco Control Regulations CAUTION: EXTERNAL EMAIL [Quoted text hidden] All email messages and attached content sent from and to this email account are public records unless qualified as an exemption under the Massachusetts Public Records Law. Visit us online at www.northandoverma.gov. https://mai l.goog le.com/mai I/u/0?ik=aOc6f4e4cf&view=pt&search=a II&permthid=th read-f%3Al 646207087027462268&simpl=msg-f%3A164620708702... 3/3 FletcherTiltonpc Attorneys at law October 1, 2019 VIA EMAIL ONLY (blagrasse@northandoverma.gov) Town of North Andover Health Department, Board of Health c/o Brian Lagrasse, Director 120 Main Street North Andover, MA 01845 Re: Town of North Andover Health Department, Board of Health Proposed/Amended Regulation of Sale of Tobacco and Nicotine Products Dear Director Lagrasse and Members of the Board of Health: As you know,this firm represents the Coalition for Responsible Retailing ("CRR"). This letter is in follow up to the Board's public hearing of September 26, 2019,at which the Board considered amendments to its tobacco control regulation. I thought it would be appropriate to provide the following information in advance of the Board's continuation of the discussion at its next meeting. As you may know, in December of 2018, the City of Somerville Board of Health voted in favor of a city-wide ban on the sale of menthol,mint and wintergreen tobacco products from retail stores. Said ban also includes a prohibition on the sale of certain non- combustible electronic products from retailers(e.g. e-cigarettes or vape pens). Other municipalities,including Barnstable, Walpole, Framingham, and Swampscott have passed similar flavor bans which include a prohibition on the sale of menthol,mint and wintergreen products. Please note that certain retail storeowners and clients of Fletcher Tilton PC have filed civil lawsuits against the foregoing boards of health in connection with the above-described ban. We do anticipate the initiation of future, similar actions against municipalities that seek to follow suit. Further, it is our position that the mint,menthol and wintergreen products are widely used by adults,not youth, as a method to quit combustible,traditional tobacco products. As a part of the lawsuits that have been filed to date,we have also obtained the support of Dr. Michael Siegel, a physician,tobacco control researcher,anti-tobacco advocate, and professor in the Department of Community Health Sciences at the Boston University School of Public Health. Dr. Siegel has submitted affidavits in support of CRR's position in the pending civil lawsuits in which he sets forth the basis for his opposition to the regulations that are being considered by the North Andover Board of Health,as well as citations to medical and scientific literature supporting his position. (See Attachment A). Client Files/48106/0001/03277056.DOCX FletcherTilton.com WORCESTER I FRAMINGHAM I BOSTON I PROVIDENCE I CAPE COD FletcherUton Town of North Andover Health Department, Board of Health October 1, 2019 Page 2 of 3 In any event,the current lawsuits allege, among other things, that the menthol, mint and wintergreen ban does not constitute a public health decision, is arbitrary and capricious, and exceeds the subject board's authority. In other words,the ban constitutes an abuse of discretion and must be stricken. Indeed,the ban simply stands to keep on retailers' shelves the more dangerous combustible tobacco products,while removing e-cigarettes,which have been recognized as less harmful than, and an important tool in reducing the use of, combustible cigarettes by health experts at the New England Journal of Medicine, among many others. Moreover, a number of recent news stories regarding mysterious health complications,or even deaths, were linked to marijuana"vape pens"—not the e-cigarettes that my client retailers sell to legally purchasing adults. For example,the Washington Post recently stated that: The nationwide investigation has found no particular vaping devices or products linked to all cases and is looking into potential contamination or counterfeit, as many victims report buying marijuana on the street rather than from a store. See"What we know about the mysterious vaping-inked illness and deaths", Washington Post, September 12,2019(https://www.washin toonpgst.com/health/2019/09/07/what-we- know-about-mysterious-vapiny,-linked-illnesses-deaths/?noredirect=on) (emphasis added). If the North Andover BOH affirmatively votes to effectuate any restriction on the sale of menthol,mint or wintergreen tobacco products and/or electronic cigarettes, we expect that other retail owners and clients of Fletcher Tilton PC will seek to prosecute similar litigation against this BOH. It is our understanding that many prudent cities and towns are now waiting to confirm the outcome of the foregoing litigation matters before promulgating any further restrictions relative to the sale of tobacco products and/or electronic cigarette products. We respectfully suggest that the North Andover BOH do the same. It is important to note that, from 2017 to the present, convenience stores within the Town of North Andover have a compliance rate of 97%, as reflected by available FDA records regarding compliance check inspections performed in the Town. (See Attachment B). This data indicates that underage use and access of these products is not a result of convenience store sales. Rather,underage use of these products is stemming from other accessible sources, such as the internet. Client Files/4 8 1 06/000 1/0327705 6.DOCX FleteherTilton ,Attorneys at law Town of North Andover Health Department, Board of Health October 1, 2019 Page 3 of 3 Last, I do hope the North Andover BOH recognizes that its contemplated restrictions will unquestionably compel tobacco and nicotine consumers to purchase combustible products. There is ample, valid evidence that combustible products, e.g. certain Marlboro or Camel products, are far more dangerous than the non-combustible e-cigarettes. The contemplated ban simply communicates to your adult tobacco and nicotine consumers that the more dangerous combustible products somehow warrant greater accessibility in the Town of North Andover. Respectfully, how is that a public health decision? Please do not hesitate to contact me directly with any questions or concerns. Thank you for your professional courtesies and for your consideration. Very truly yours, - l ' ('�) Michael E. Brangwyn FLETCHERTILTON PC �T 12 Post Office Square, 6th Floor Boston, MA 02109 P: 617-336-2281 1 F: 617-336-4481 Email: mbrangwynnegfletchertilton.com MEB Enclosures Client Files/48106/0001/03277056.DOCX ATTACHMENT A COMMONWEALTH OF MASSACHUSETTS MIDDLESEX, ss. SUPERIOR COURT DOCKET NO.: 1981 CV366 HIMGIRI ENTERPRISES, INC.,d/b/a ) K2 BEER AND WINE,BIKAS PRADHAN, ) GHULAM ABBAS,FAISAL ABBAS, ) GOHA LLC d/b/a STOP AND SAVE, ) and HAJURI SINGH, ) Plaintiffs, ) V. ) BRIAN GREEN,PAULA MACHADO,and ) ROBERT CICCIA,as they are Members of the ) City of Somerville Board of Health, ) Defendants. ) AFFIDAVIT OF NIICHAEL SIEGEL 1,Michael Siegel,hereby depose as follows: 1. I make this Affidavit based on my personal knowledge of the factual statements contained herein,and my stated opinions are based upon the sum of my education,training,reading and extensive professional experience. The cited reference material,scientific or medical literature upon which I rely for certain factual information,research data,and in supporting my expert opinions, is typical of the types of reference material,scientific or medical literature upon which I and other medical experts in my field regularly rely upon in our professional work. 2. I am a physician and a professor in the Department of Community Health Sciences at the Boston University School of Public Health. For the past 32 years, I have been a tobacco control researcher and anti-tobacco advocate. Client Filesl48106/0001/03072568.DOCX 1 3. I have testified in eight(8)different lawsuits against the tobacco industry. I consider myself to be a long-time, committed anti-tobacco researcher and advocate. 4. I summarize my educational background as follows: a. University of California at Berkeley/UCSF General Preventive Medicine Residency Program August, 1991 to June, 1993 M.P.H. completed: May, 1992(Epidemiology) b. Berkshire Medical Center, Pittsfield,MA PGY-1 Year in Internal Medicine July, 1990 to June, 1991 c. Yale University School of Medicine M.D. completed:May, 1990 d. Brown University B.A.,Environmental Studies: May, 1986 5. Affixed hereto as Tab 1 is a true and accurate copy of my current curriculum vitae. 6. I am intimately familiar with the Somerville Board of Health's (the"Board")recent December 13,2018 decision whereby the Board enacted a modification to its tobacco control regulation. In pertinent part,the Board decided,effective April 1,2019,that Somerville convenience stores and retailers shall be prohibited from selling: (i)tobacco products of the mint,menthol and wintergreen variety;and/or(ii)e-cigarettes of any flavor, including tobacco flavor(the "Regulation"). 7. The Regulation will allow Somerville convenience stores to only sell non-menthol combustible cigarettes,e.g., most Marlboro and Camel brand cigarettes,while excluding menthol cigarettes, e.g., most Newport cigarette brands, since the vast majority of Marlboro and Camel brands are non-mentholated and the vast majority of Newport brands are mentholated. Adult only stores, also known as 21-and-up stores,will be permitted to sell e-cigarettes and tobacco products of all Client Filed48106/0001/03072568.DOCX 2 flavors and varieties. I do not know how many such adult only stores, if any, exist in Somerville. The Regulation Only Serves To Harm Public Health In Somerville. 8. Based upon my approximate 32 years of experience and knowledge of the subject matter relative to underage and adult use of tobacco and nicotine products, it is my expert opinion to a reasonable degree of medical probability and certainty,that the Board's enactment of the Regulation does not constitute a decision in the interest of public health. Stated differently, in my expert opinion,the net result of the Regulation will be to harm the public health and the citizens of Somerville. I will set out the basis and rationale for my expert opinions below. 9. It is my understanding that the Board enacted the Regulation as a purported method to reduce the number of Somerville youth who use tobacco and/or e-cigarette products. The Board seemingly ignored the fact that adults,not teenagers,are far more inclined to use e-cigarette products. Indeed,millions of former adult smokers rely upon non-combustible tobacco products, like flavored e-cigarettes,to help themselves abstain from the highly addictive and deadly tobacco burning cigarettes. Unlike combustible tobacco products,non-combustible tobacco products do not contain tobacco or as many of the other toxins and carcinogens that are the leading causes of lung disease and cancer in users of combustible tobacco products. 10.Notably,the current commissioner of the Food and Drug Administration("FDA"), Scott Gottlieb,M.D., issued a press release in November of 2018, stating that we"must acknowledge the possibility that the availability of... flavors in [e-cigarettes] may be important to adult smokers seeking to transition away from cigarettes."' Commissioner Gottlieb went further by stating that we must avoid creating"a situation where the combustible products have features ' Statement from FDA Commissioner Scott Gottlieb,M.D.,FDA Statement. November 15,2018. https•//www fda ov/NewsEvents/Newsroom/PressAnnouncements/ucm625884.htm Client Files/4 8 1 0 6/000 1/0 3 0725 6 8.DOCX 3 ..._.._._.. that make them more attractive than the non-combustible products"or"a situation where those who currently use menthol-flavored cigarettes might find it less attractive to switch completely to an e-cigarette." 11. Moreover, a recent peer-reviewed study provides that 85%of adults using non-combustible tobacco products prefer flavored e-cigarettes.' This study from the Harm Reduction Journal, surveyed approximately 16,000 adult former smokers who had quit smoking combustible cigarettes by using e-cigarette products. 12. The Board simply cannot ignore the fact that there are at least 2.5 million adults in the United States who rely upon e-cigarettes as a method for quitting the use of combustible cigarettes.3 13. Furthermore,the New England Journal of Medicine recently published a study finding that e- cigarettes are twice as effective as nicotine patches in helping smokers quit completely.4 It cannot be overstated that these non-combustible e-cigarette products are literal life-savers for millions of former smokers. 14.Accordingly,the truth of the matter is that this Regulation will simply eliminate the sale of all e- cigarettes at Somerville convenience stores and allow for the sale of the majority of combustible cigarettes to continue unabated. In my expert opinion to a reasonable degree of medical probability and certainty,this will result in many former smokers going back to smoking combustible cigarettes—which are undoubtedly far more dangerous than e-cigarettes. Indeed, a 2017 Working Paper from The National Bureau of Economic Research, a private,non-profit, z Russell C,McKeganey N,Dickson T,Nides M.Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA.Harm Reduction Journal 2018; 15:33. httRs://harmreductionioumal.biomedcentral.com/track/pdf/10.1 186/sl2954-018-0238-6 3 Rodu B.FDA Tobacco Director Ignores 2.5 Million"Anecdotal Reports"About E-Cigarettes.Tobacco Truth. October 28,2016.https•//rodutobaccotruth blogspot com/2016/10/fda-tobacco-director-ignores-25-million.html 4 Hajek P,et al.A randomized trial of e-cigarettes versus nicotine-replacement therapy.New England Journal of Medicine 2019;380:629-637.https://www.neim.org/doi/full/10.1056/NEJMoal8O8779 Client Files/48106/0001/03072568.DOCX 4 and non-partisan organization,found that a ban on all e-cigarettes flavors would increase the number of combustible smokers.5 15.According to the American Cancer Society's February 2018 position statement,"Combustible tobacco products,primarily cigarettes, are the single greatest cause of cancer and kill about 7 million people worldwide each year. In the United States, 98%of all tobacco-related deaths are caused by cigarette smoking."The statement goes on to observe that,"[b]ased on currently available evidence,using current generation e-cigarettes is less harmful than smoking cigarettes...."Accordingly,the American Cancer Society concludes that, although it is preferable for smokers to quit"cold turkey,"those who will not stop smoking cigarettes"should be encouraged to switch to the least harmful form of tobacco product possible," i.e.,e-cigarettes or other non-combustible products,because "switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products."6 16. Respectfully, it is my expert opinion to a reasonable degree of medical probability and certainty, that there is simply no public health justification for banning e-cigarettes while allowing combustible tobacco cigarettes to remain on convenience store shelves. Assuming there is a government interest in protecting youth from access to electronic cigarettes,then there is a much stronger government interest in protecting youth from access to real,combustible tobacco cigarettes. I do not believe there is any public health justification for banning the sale of a less dangerous product while allowing the sale of a much more dangerous product in the same product category to continue unfettered. 5 Bucknell J,Marti J,Sindelar JL,Should Flavors be Banned in Cigarettes and E-cigarettes?Evidence on Adult Smokers and Recent Quitters from a Discrete Choice Experiment,Tobacco Control 2019;28:168-175. https•//tobaccocontrol bmi com/content/tobaccocontrol/28/2/168.full.pdf. 6 American Cancer Society Position Statement on Electronic Cigarettes,February,2018. https•//www cancer org/healthy/stayaway-from-tobacco/e-ciearette-position-statement.html Client Files/4 8 1 06/000 1/0 3 0725 6 8.DOCX 5 17. The Regulation will have the net effect of harming the public health in Somerville because it serves to remove the safer non-combustible products from convenience store shelves, leaving behind the more dangerous,traditional combustible cigarettes. Such a scenario will make it far easier for Somerville residents to purchase tobacco products which are far more harmful than the non-combustible flavored products. In my opinion to a reasonable degree of medical probability and certainty,this will result in many former smokers returning to cigarette smoking, as the electronic cigarettes they are currently relying upon to keep from smoking,or. could transition to in the future, are taken off the shelves of the stores where they typically purchase these products. A Decision To Ban Certain Ciearette Brands Over Others Is Arbitrary. 18. In addition to actually harming the health of Somerville's citizens,the Regulation also will give a competitive advantage to the manufacturers of the Marlboro and Camel cigarette varieties, which are traditional combustible cigarettes,and most of which shall remain on convenience store shelves if the Regulation proceeds,because most Marlboro and Camel varieties are non- mentholated while nearly all Newport varieties are mentholated. 19. In my opinion to a reasonable degree of medical probability and certainty, by choosing to ban menthol cigarettes,but leaving all other cigarettes untouched,the Board would be making a decision that is arbitrary and capricious. Practically speaking,the Regulation essentially bans the Newport,Kool and Salem brands,but allows the continued unfettered sale of Marlboro and Camel brands. There is no public health rationale for singling out certain cigarette brands because all such brands have proven to be equally deadly. Treating Newport,Kool, and Salem brands differently from the similarly situated Marlboro and Camel brands is dangerous because there is no difference in public health risk associated with these cigarette brands. Scientific Client Files/48106/0001/03072568.DOCX 6 evidence shows that menthol cigarettes are no more dangerous than non-menthol cigarettes.7 Further,the FDA has made it clear that there is no cigarette brand that is any safer than another cigarette brand. In fact, it is unlawful for any cigarette brand to claim that its product is any safer than another cigarette brand.' 20. What the Board also has ignored is that the majority of youth smokers prefer non-menthol cigarettes. The overwhelmingly most popular brand among youth smokers is Marlboro,with Newport being a distant second.9 It thus defies logic that the Board has decided to ban Newport sales,but not Marlboro sales,even though we know that youth smokers undoubtedly prefer the Marlboro brand. 21. Public health laws,by definition,must have the effect of protecting the public's health and saving lives—and they must not be arbitrary.For all of the reasons I have stated in support of my opinions,the Regulation at issue will actually harm the public's health in Somerville by making it more difficult for ex-smokers to choose a less harmful option. Moreover,the Regulation is irresponsible and unreasonable because, among other things, it seeks to regulate cigarette brands differently with no valid health justification. [Intentionally Blank—Signature Page Follows] 7 Lung Cancer Study Finds Mentholated Cigarettes No More Harmful Than Regular Cigarettes,Journal of the National Cancer Institute(May 18,2011)hns:Hacademic.oup.com/inci/article/103/10/810/2516529 8 See Family Smoking Prevention and Tobacco Control Act(Public Law 111-31),section 911(21 U.S.C.§387k). 9 Perks SN,Armour B,Agaku IT.Cigarette brand preference and pro-tobacco advertising among middle and high school students—United States,2012-2016.Morbidity and Mortality Weekly Report(MMWR)2018;67(4);119- 124.httt)s://www.cdc.gov/mmwr/volumes/67/wr/mm6704a3.htm Client Files/4 8 1 0 6/0 00 1/0 30725 6 8.DOCX 7 i Signed under the pains and penalties of perjury this day of March,2019 Michael Siegel F? 1. ' 1 i 1' Client Files/48106/0001/03070502.DOCX o t r i ATTACHMENT B Compliance Check Inspections of Tobacco Product Retailers Through 08/31/2019-Search Results You searched for: City contains:North Andover State is:MA Decision Date:01/01/2017 through 1 010 1 20 1 9 Minor Involved:Yes 34 record(s)returned RETAILER FOR SALE PRODUCT INSPECTION DECISION INSPECTION NAME ADDRESS INVOLVED TOTYPE BRAND DATE DATE RESULT CHARGES 525 TURNPIKE ST NO RITE AID NORTH YES NO N/A N/A NOT 12/192017 VIOLATIONS N/A ANDOVER AVAILABLE OBSERVED MA-01845 NORTH 980 OSGOOD ST NO ANDOVER NORTH YES NO N/A N/A NOT 12/192017 VIOLATIONS N/A ANDOVER AVAILABLE OBSERVED SHELL MA-01845 342 WINTHROP WINE AND AVE NO BEER AT THE NORTH YES NO N/A N/A AVAILABLE 12/192017 VIOLATIONS N/A ANDOVERS ANDOVER OBSERVED MA-01945 342 WINTHROP WINE AND AVE NO BEER AT THE NORTH YES NO N/A N/A AVAILABLE 02/132019 VIOLATIONS N/A ANDOVERS ANDOVER OBSERVED MA-01845 350 WINTHROP NO MARKET AV VI BASKET NORTH YES NO N/A N/A AVAILABLE 12/192017 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 350 WINTHROP MARKET AV NOTNO BASKET NORTH YES NO N/A N/A AVAILABLE 02/132019 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 J AND M 701 SALEM ST NO CONVENIENCE NORTH YES NO N/A N/A NOT 12/192017 VIOLATIONS N/A ANDOVER AVAILABLE OBSERVED STORE MA-01945 1503 OSGOOD RACE WAY STREET NO CONVENIENCE NORTH YES NO N/A N/A AVAILABLE 1v192017 VIOLATIONS N/A STORE ANDOVER OBSERVED MA-01845 1503 OSGOOD NO RACE WAY STREET CONVENIENCE NORTH YES NO N/A N/A AVAILABLE 02/13/2019 VIOLATIONS N/A STORE ANDOVER OBSERVED MA-01845 1503 OSGOOD NO RACE WAY STREET NOT CONVENIENCE NORTH YES NO N/A N/A AVAILABLE 01262017 OBSERVED OLATIONS N/A STORE ANDOVER MA-01845 J AND M 701 SALEM I I NO CONVENIENCE NORM y NO N/A N/A NOT 05/082019 VIOLATIONS N/A STORE AND AVAILABLE OBSERVED DELI ANDOVER MA-01845 DEN ROCK 54 PETERS ST O WINE AND NORTH YES NO N/A N/A NOT :J4 OLATIONS N/A ANDOVER AVAILABLEBSERVED SPIRITS MA-01845 DEN ROCK 54 PETERS ST O WINE AND NORTH YES NO N/A N/ANOT 02OLATIONS N/A ANDOVER AVAILABLE OBSERVED SPIRITS MA-01845 Page 1 of 3 Compliance Check Inspections of Tobacco Product Retailers Through 08/31/2019-Search Results 1725 TURNPIKE A L PRIME ST NOT NO 12/19/2017 VIOLATIONS N/A ENERGY NORTH YES NO N/A N/A AVAILABLE ANDOVER OBSERVED MA-01845 1725 TURNPIKE A L PRIME ST NO ENERGY NORTH YES NO N/A N/A NOT 02/13/2019 VIOLATIONS N/A ANDOVER AVAILABLE OBSERVED MA-01845 4 MAIN ST NO RICHDALE NORTH YES NO N/A N/A NOT 12/19/2017 VIOLATIONS N/A FOOD STORES ANDOVER AVAILABLE OBSERVED MA-01845 4 MAIN ST NO RICHDALE NORTH YES NO N/A N/A NOT 02/13/2019 VIOLATIONS N/A FOOD STORES ANDOVER AVAILABLEi OBSERVED MA-01845 64 MAIN ST NO MAIN STREET NORTH YES NO N/A N/A NOT 12/19/2017 VIOLATIONS N/A LIQUORS ANDOVER AVAILABLE OBSERVED MA-01845 NO - 531 CHICKERING RDMCALOONS NORTH YES NO N/A N/A NOT 12/19/2017 VIOLATIONS N/A LIQUORS AVAILABLE OBSERVED ANDOVER MA-01845 64 MAIN ST NO MAIN STREET NORTH YES NO N/A N/A NOT 02/13/2019 VIOLATIONS N/A LIQUORS ANDOVER AVAILABLE OBSERVED MA-01845 - - 531 CHICKERING RD NO MCALOONS NORTH YES NO N/A N/A NOT AVAILABLE 02/13/2019 VIOLATIONS N/A LIQUORS ANDOVER OBSERVED MA-01845 220 MIDDLESEX NO MIKES ST NOT MARKET NORTH YES NO N/A N/A AVAILABLE 02/13/2019 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 _ - 220 MIDDLESEX ST NO MIKE'S NOT 12/19/2017 VIOLATIONS N/A NORTH YES NO N/A N/A MARKET AVAILABLE OBSERVED ANDOVER MA-01845 12 MASSACHUSETTS NO MOBIL MART AVENUE YES NO N/A N/A NOT 12/19/2017 VIOLATIONS N/A NORTH AVAILABLE OBSERVED ANDOVER NIA-01845 - — — - 12 - I MASSACHUSETTS NO MOBIL MART AVENUE YES NO N/A N/A NOT 02/13/2019 VIOLATIONS N/A NORTH AVAILABLE OBSERVED ANDOVER MA-01845 79 CHICKERING NO SUPER RD PETROLEUM NORTH YES NO N/A N/A AVAILABLENOT 12/19/2017 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 79 CHICKERING NO SUPER RD PETROLEUM NORTH YES NO N/A N/A AVAILABLENOT 02/13/2019 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 800 WAVERLY RD NO 7PHARMACY LGREENS NORTH YES NO N/A N/A AVAILABLE 12/19/2017 VIOLATIONS N/A ANDOVER OBSERVED MA-01845 Page 2 of 3 Compliance Check Inspections of Tobacco Product Retailers Through 08/31/2019-Search Results 533 CHICKERING ROAD QUIC PIC NORTH YES NO N/A N/A NOT NO ANDOVER AVAILABLE 12/19/2017 VIOLATIONS N/A MA-01845 OBSERVED 533 CHICKERING _ - ROAD QUIC PIC ANDT ANDOVER YES NO N/A N/A NOT NO AVAILABLE 02/13/2019 VIOLATIONS N/A MA-01845 OBSERVED L:n75 CHICK BRING RD RICHDALE NORTH YES NO N/A N/A NOT NO ANDOVER AVAILABLE 12/19/2017 VIOLATIONS N/A MA-01845 OBSERVED 75 CHICKERING RD RICHDALE NORTH YES NO N/A N/A NOT NO ANDOVER AVAILABLE 02/13/2019 VIOLATIONS N/A MA-01845 OBSERVED 757 TURNPIKE ST STOP AND NORTH YES NO N/A N/A NOT NO SHOP ANDOVER AVAILABLE 12/19/2017 VIOLATIONS N/A MA-01845 OBSERVED J AND M 701 SALEM -- CONVENIENCE STREET WARNING 1140.14(b)(1}Sale to a STORE AND NORTH YES YES ENDS/ JUUL 02/13/2019 04/11/2019 LETTER Minor; ANDOVER &liquid 4( )( )() DELI ISSUED 1140.1 b 2 i-Failure MA-01845 to verify age Page 3 of 3