JUUL furor, flavor bill hearing, state budget… July was anything but a sleepy summer month. Outdoors and in the halls of the State House (and definitely in stifling hearing rooms), things are heating up!
The legislature increased the budget for the Massachusetts Tobacco Cessation and Prevention Program (MTCP) by $400,000 to a total budget of $4,618,872 for FY 2020! The Governor didn’t veto the budget line, so it stands—a $900,000 increase to the program over the last two years. We’re heading in the right direction! MTCP is critical to the fight against tobacco in Massachusetts. It implements and enforces laws, funds local boards of health and community organizations to do enforcement and education, runs the state’s quitline, produces materials educating about tobacco and nicotine, and provides surveillance and evaluation for tobacco issues, including the rise in e-cigarette use among young people. Strong funding for MTCP will allow the tobacco program to educate parents and other adults about e-cigarettes, Juul and other emerging products; provide more enforcement of local tobacco laws protecting youth; and work more effectively to help all smokers quit.
As you may recall, the Senate’s and Governor’s versions of the budget included an excise tax on e-cigarettes, but that was left out of the version voted out by the conference committee. This is good news because it allows us to continue pushing for a comprehensive tobacco tax that includes increases to the excise tax on cigars and cigarettes while creating an excise tax on e-cigarettes, e-liquids, and other associated vape products that is on par with the level of taxation on cigarettes (see second bullet in priority legislation section below). You’ll hear a LOT about this from us in the fall!
Status of Priority Legislation
- Banning the sale of all flavored tobacco products. The Joint Committee on Public Health held a hearing on July 16 that included the bills concerning flavored tobacco products. TFM assembled two panels to speak and many other TFM members attended in support. Thanks to those who testified, and HUGE thanks to all the TFM organizations that sent in written testimony – it was quite an impressive array of impressive organizations! Before the hearing, young people from across the state held a press conference in support of the legislation filed by Senator John Keenan and Representative Danielle Gregoire: An Act regulating flavored tobacco products (Senate Bill 1279 and House Bill 1902, respectively).This is a TFM priority bill and would ban the sale of flavored tobacco products in Massachusetts. The ban would include flavored Juul and other e-cigarettes and vape products. Menthol and other mint flavors are included in the definition of flavor. In Massachusetts, many communities have already restricted the sale of flavored products to adult-only establishments (see Local Action section, below), and Somerville, Needham, and other communities have included mint/menthol/wintergreen in their restrictions. The bills will be reported out of the committee soon and as soon as they are, we’ll let you know about next steps!
- Raising the cigarette tax and instituting an excise tax on e-cigarettes and vape products. Senator Harriette Chandler and Representative Marjorie Decker filed An Act protecting youth from nicotine addiction (Senate Bill 1606 and House Bill 2436, respectively). This bill would add an excise tax of 75% of wholesale to e-cigarettes, increasing their prices and making them harder for young people to afford. It would also increase the tax on cigarettes by $1.00, bringing it to a more reasonable $4.51, and increase the tax on cigars from 40% of wholesale to 80% of wholesale. Increasing the price of cigars and cigarettes is one of the most effective ways to help smokers quit and prevent kids from starting. History and evidence show that this will reduce the smoking rate, saving some of the more than $4 billion in health care costs annually attributed to tobacco use in Massachusetts. The Joint Committee on Revenue held a hearing on June 18, and many TFM member organizations sent in written testimony—thank you! We’ll let you know when we have an update on next steps.
- Close the loopholes in the MassHealth tobacco cessation benefit. Senator Jason Lewis and Representative Christine Barber have filed An Act to provide Medicaid coverage for tobacco cessation (Senate Bill 704 and House Bill 1129, respectively). This bill seeks to expand access to the program by allowing trained and approved dentists and behavioral health practitioners to provide cessation counseling to patients on MassHealth as recommended by the CDC. The MassHealth smoking cessation benefit was a huge success when it was introduced in Fiscal Year 2007, but certain providers, including dentists and behavioral health providers, were not included. Closing the loophole would enable certified professionals in these fields to counsel, and bill for, tobacco cessation for their MassHealth patients. Referred to the Joint Committee on Health Care Financing, which held a hearing back in May. Thanks to all the TFM members who submitted written testimony or spoke on behalf of the legislation! We’ll let you know when the bill moves.
As we head deep into the summer, preemption and other tobacco industry strategies remain a very real threat. As we gain momentum, that threat intensifies. We’re watching vigilantly for any efforts to preempt local authority on tobacco issues, to criminalize youth possession of tobacco products, and any efforts to undermine the statewide smoke-free workplace law.
Interesting Articles from an Interesting Month
- Exposing the tobacco industry’s tactics is essential to defeating it. An article in the New York Times showed how these tactics worked to defeat a New York City menthol ban. The American Cancer Society Cancer Action Network released a report about the specific strategies the industry is using to weaken or derail tobacco legislation across the country. Though it’s focused on raising the legal sales age to 21, the issues apply equally to our priority legislation.
- JUUL is working hard to position itself as the good guy, using full-page ads in the Globe and countless digital placements trying to position itself as a darn nice, caring company. It’s continued its efforts to court medical and scientific professionals by hiring a noted researcher on adolescent addiction, a move that was widely criticized. The FDA has launched its own counter campaign aimed at young people, that feature street magician and social media personality Julius Dein performing illusions with people’s vapes by appearing to turn them into traditional cigarettes. I have never heard of this guy either, but apparently he’s quite a big deal.
- Former FDA Commissioner David Kessler wrote a damning opinion piece for the New York Times: Juul Says It Doesn’t Target Kids, but Its E-Cigarettes Pull Them In. A group of national health organizations have launched its own assault on JUUL’s credibility with an ad campaign of its own that shows the link between Big Tobacco and JUUL while highlighting the high level of nicotine in JUUL pods; the two ads are attached to this email as individual pdfs.
- Here in Massachusetts, the hearing on the flavored tobacco bills and the youth press event beforehand generated quite a bit of media: FOX 25, 7 News, NBC 10, NECN, MassLive, Telegram and Gazette, Boston Herald (also see the Herald’s video), and the State House News Service story that ran in the Patriot Ledger, the Sentential & Enterprise, WGBH, and the Lowell Sun. Thanks to Allyson Perron for assembling this media list! One common reporting error to note: the fact is that online sales of flavored tobacco products *would* be banned, just like in-store sales. In municipal flavor news, the Lowell Sun ran an editorial supporting a menthol restriction in Lowell.
- Let’s switch back to the national scene for a moment. On July 24 and 25, House Oversight and Reform Subcommittee on Economic and Consumer Policy held a two-day hearing examining JUUL’s role in the ongoing youth tobacco epidemic. Here’s what CNN and NBC News had to say about it (a shoutout to Dr. Jonathan Winikoff, who testified). Responding to the information from the hearings, Congresswoman Ayanna Pressley tweeted about JUUL using the same menthol targeting of African Americans that the combustible tobacco companies have.
- In other national news, a federal judge set a 10-month deadline for e-cigarette manufacturers to apply to the FDA and submit their products for public health review if they want to keep them on the market. This order is the result of a lawsuit brought forward by several national public health groups and organizations. That oversight would be a really good idea, considering a new study finding damaging chemicals in JUUL’s e-liquids. Bloomberg ran an editorial calling for faster action, saying that 10 months is too long.
- People are starting to open up about how hard it is to quit using JUUL and other vape products. But new resources are being developed to help people quit vaping. The Massachusetts Medical Society and Massachusetts Department of Public Health teamed up to film a 3-minute PSA aimed at increasing medical professionals’ awareness of and ability to respond to patients addicted to vaping. And I’ll put another plug in for MTCP’s excellent resources on vaping.
- We’re almost through here. I promise.
- In July, we learned that 64% of American adults support stricter regulations on e-cigarettes, and that 81% of American adults favor requiring cigarette makers to lower the nicotine levels in cigarettes. And we learned a little bit about IQOS – though the thing everyone really wants to know about IQOS is how to pronounce IQOS (it’s EYE-kose). If you’re still hungry for knowledge, the National Behavioral Health Network for Tobacco & Cancer Control has archived webinars on a variety of tobacco and tobacco cessation topics.
Tobacco Free Mass Membership Dues
Tobacco Free Mass has switched to a dues-based model, so your dues contribution is essential to allowing us to fight the good fight! Your organization should have received its annual dues notice unless you have talked with me about having a different schedule. Dues-paying members have voting rights and receive a ticket to the September Policy Forum, among other perks! If I’ve received your check, you’ve received a confirmation notice. If you have questions or need more information before you can pay, please let me know!
Upcoming Tobacco Free Mass Meetings
The next full coalition and Advocacy Committee meetings are coming up later this week! Remember that we’ve switched to alternating months for Executive and Advocacy committee meetings, so the meetings are less frequent.
- August 22 – Executive Committee meeting from 10:00 AM to 11:30 AM at The Strategy Group’s offices at 40 Court Street, 11th Floor, Boston
- September 5 – Full Coalition meeting from 10:00 AM to 12:00 PM – Massachusetts Medical Society, Waltham
- September 5 – Advocacy Committee meeting from 12:15 PM to 1:15 PM (following full coalition meeting) – Massachusetts Medical Society, Waltham
- October 24 – Advocacy Committee meeting from 10:00 AM to 11:30 AM at The Strategy Group’s offices at 40 Court Street, 11th Floor, Boston
See the full calendar on our website, at tobaccofreema.org.
Upcoming Events and Opportunities
- September 16 – An Analysis of Menthol Cigarette Pricing in Boston, Massachusetts. Webinar from 2:00 – 3:00 PM. This webinar will provide an overview of a paper published in Health and Place, “The Association between Neighborhood Racial Composition and Menthol Cigarette Pricing in Boston, MA” that examines the association between the price of menthol cigarettes (Newport) and neighborhood demographic make-up on a block-group level in Boston, Massachusetts. Tobacco industry targeting, with a focus on pricing practices, will be discussed to show the disproportionate impact of menthol on certain communities. Provided by the Massachusetts Tobacco Cessation and Prevention Program. Free. No registration required. Use this link to connect to the webinar.
- September 24 – From Kool to JUUL: The Flavored Tobacco Crisis — Tobacco Free Mass Policy Forum from 10:00 AM to 12:00 PM; registration at 9:30. Massachusetts Medical Society, Waltham. Dues-paying TFM member organizations receive one or two free tickets! This year’s policy forum will focus on flavor, and we’ve lined up some excellent speakers: Valerie Yerger, Board Member at the National African American Tobacco Prevention Network (NAATPN), Phil Gardiner, African American Tobacco Control Leadership Council (AATCLC), and Brian King from the CDC. This is guaranteed to be a fascinating discussion of a complex and nuanced topic that has a major impact on tobacco prevention efforts in our state. Registration is open!
- September 26 – Tobacco Retail Environment in Massachusetts. Webinar from 2:00 – 3:00 PM. The built environment in our communities plays an important role in determining health. Tobacco and nicotine products are widely available in neighborhood stores where people live, work, go to school, and play. The number of tobacco retailers, alongside widespread advertisement and availability of tobacco products, normalizes the presence of tobacco in communities such that people think it is common to use these products. This webinar will discuss tobacco industry influence in neighborhoods, including the disproportionate impact on low-income communities and communities of color, as well as policy action taken by municipalities in Massachusetts to counter tobacco industry tactics in the point-of-sale environment. Provided by the Massachusetts Tobacco Cessation and Prevention Program. Free. No registration required. Use this link to connect to the webinar.
- October 24 – Flavored Tobacco Product Restrictions in Massachusetts: Impact on Availability and Youth Use. Webinar from 2:00 – 3:30 PM. In response to the proliferation of alcohol, candy and fruit flavored tobacco products in stores, cities and towns across the nation have taken policy action to remove flavored tobacco products from youth-accessible retailers. This webinar will cover the ongoing evaluation of flavored tobacco product restrictions passed in several municipalities across the state of Massachusetts. Evaluators from Massachusetts will discuss the impact of such policies on statewide availability of flavored tobacco products, retailer compliance, and the state’s enforcement infrastructure. Results from the policy’s short-term impact on youth tobacco use in two communities and a detailed overview of flavored tobacco product availability before and after policy implementation in Boston, Massachusetts will also be discussed. Provided by the Massachusetts Tobacco Cessation and Prevention Program. Free. No registration required. Use this link to connect to the webinar.
TFM Working Groups
- TFM’s E-Cigarette Working Group held a meeting in July and is planning its next meeting or call for the fall. If you would like to participate in the E-Cigarette Working Group but are not on the list, please email Annegret Klaua or Jonina Gorenstein, who are heading up the working group.
- TFM’s Menthol Working Group is monitoring the movement of local regulations that restrict menthol sales. The group is contacting people who it thinks would be important to the menthol conversation in Massachusetts and starting to invite those people and groups into the discussion. If you have thoughts on who the group should be reaching out to, are interested in joining the group, or would like to come to the next meeting, please contact Chris Banthin, who’s heading up the TFM Menthol Working Group.
Local Flavor (policies)
Tobacco policies passed on the local level build the case for statewide policy… and that they protect people who live, work, and visit those places. This is very much the case for flavored tobacco regulations, and as municipalities work to restrict or ban the sale of menthol, they need community support. If you’re interested in these policies, definitely attend the free webinar on October 24 (see above).
Many communities have flavor restrictions in place that are based on Providence, RI’s model, which restricts the sale of all flavored tobacco products to adult-only tobacco stores. These regulations *exempt* mint, menthol, and wintergreen. As the situation has evolved, many of these cities and towns are now removing the exemption for menthol, mint, and wintergreen, creating a restriction on *all* flavored tobacco products. As communities tackle the flavor question and grapple with how to restrict e-cigarettes, different versions of this policy have emerged. DJ Wilson created a handy sheet for sorting out this policy scramble; it’s attached as a pdf called Flavor Ban Chart. Note that the statewide legislation we support is a complete ban of all flavored tobacco, including mint, menthol, and wintergreen.
Local Tobacco Policies
While you and I go about our fascinating daily lives, things are steadily changing on the local level. Cities and towns across Massachusetts have been passing tobacco policies that fight the tobacco industry’s influence in communities and pave the way for statewide policy. Every month, a few more cities and towns pass laws, adding up to a substantial number! Here’s a sampling of what’s going on…
- Restricting the sale of flavored tobacco to adult-only establishments. This is the backbone of the statewide flavor ban we’re trying to pass—and these local policies have shown that a statewide ban would work and be popular. This policy prohibits the sale of all flavored tobacco products and flavored e-cigarettes, except for in qualified retail tobacco stores and “smoking bars.” 162 cities and towns have passed this policy, covering two-thirds of the state’s population, at 67%. Thirteen of these policies do not have an exemption for mint, menthol, and wintergreen for any tobacco products; other municipalities are in the process of removing the exemption or passing a flavor restriction with no exemption.
- A full 130 municipalities limit, or cap, the number of tobacco sales permits they will issue, covering 43% of the state’s population. Of these, thirteen cities and towns also have a cap on the number of tobacco-only Retail Tobacco Stores they will allow. This is stated in language such as: “This municipality limits tobacco sales permits to X number and of that X number, only Y number can be issued to Retail Tobacco Stores.” When specific tobacco products, such as flavors, are restricted to adult-only tobacco retailers, the “Retail Tobacco Stores” are the stores the regulations refer to.
Information about local policies can be found on the Massachusetts Tobacco Cessation and Prevention Program’s website, MakeSmokingHistory.org.