Monday, March 14, 2016

Why are Some Massachusetts Health Boards Willing to Protect Youth Smoking?

In what I can only call a bizarre phenomenon, a number of local boards of health in Massachusetts are sacrificing the public's health and protecting youth smoking under the guise of protecting adolescent health. These health boards have declared that flavored tobacco products represent a huge health threat to teens. But rather than banning the flavored cigarettes that are addicting and ultimately killing people, they are taking away the far less harmful electronic cigarettes that have helped many adults quit smoking.

Case in point: Saugus, Massachusetts.

Last week, the Saugus Board of Health voted unanimously to ban the sale of flavored electronic cigarettes, while allowing flavored cigarettes - which are favored by nearly 50% of Saugus youth smokers - to remain available in stores throughout the town.

This means that although every gas station, convenience store, and pharmacy in Saugus will have to take most of their e-cigarettes off the shelves, they will not have to touch the flavored Marlboro, Camel, and Newport cigarettes that are so popular among the youth of Saugus. They will also be able to continue selling the mint and wintergreen smokeless tobacco products that are also popular among Saugus youth.

In other words, the Board of Health is removing from the market products which probably kill no one, while protecting the sale of deadly consumer products that we know are killing hundreds of thousands of Americans each year.

This makes absolutely no sense, and it is boggling to me why a board of health would go to such lengths to protect cigarette and smokeless tobacco sales.

The Rest of the Story

Last Wednesday, the Saugus Board of Health adopted a regulation that purportedly bans the sale of all flavored tobacco products in the town. Although that's not a route that I would choose to go, it at least sounds reasonable if applied equally to all flavored tobacco products sold in the town.

But in a show of hypocrisy, the health board decided not to ban all flavored tobacco products in the town. The board voted to exempt from the ban the flavored tobacco products that are most responsible for harming the health of youth in the town (menthol cigarettes, and to some extent mint and wintergreen smokeless tobacco) and to include in the ban flavored non-tobacco products (e-cigarettes) that have not been associated with any significant adverse health effects among youth, but are helping many adult smokers to quit or cut down substantially on the amount they smoke.

You see, the board exempted from regulation three flavors: menthol, mint, and wintergreen. There is no public health rationale for excluding these three flavors. However, this is an economic rationale. Banning these three flavors would put a significant dent in smoking and smokeless tobacco use. In contrast, banning only flavored cigars and cigarillos will have no appreciable effect on overall tobacco sales, or on the public's health.

But where stores in Saugus will see a substantial loss of sales is in the electronic cigarette category. Now, adults in Saugus who quit smoking using e-cigarettes will find it less convenient to access the vaping products which are maintaining them as former smokers, and many of them will undoubtedly decide to return to smoking, since cigarettes will remain readily available in gas stations, convenience stores, and pharmacies throughout the town.

The director of the Northeast Tobacco Free Community Partnership was quoted as stating: "Where adolescent brains are still developing, nicotine can produce structural and chemical changes to the brain and can lead to future alcohol and other drug addiction, panic attacks and things like depression. My concern is really for the health and safety of the youth of Saugus."

Baloney! If her concern was really for the health and safety of the youth of Saugus, then certainly she would have insisted that the Board of Health protect youth from the sale of all nicotine products, not just the least harmful ones.

A similar regulation is under consideration by the boards of health in Fitchburg and Leominster, although those laws would apparently allow flavored cigars, cigarillos, and e-cigarettes to be sold in adult-only tobacco retail stores (there are no such stores in Saugus, so in that town, the regulation amounts to a de facto ban on the sale of flavored cigars, cigarillos, and e-cigarettes).

A proponent of the regulations was quoted as stating: "We're pretty much eliminating youth access to flavored products...".

Baloney! Youth will still have access to the most dangerous flavored tobacco product in Fitchburg and Leominster: menthol cigarettes.

It is one thing for a legislative body to compromise the public's health to protect cigarette sales. At least legislative bodies are supposed to take economic factors into consideration. But a board of health is supposed to be primarily protecting the public's health. More importantly, they are expected to actually mean what they say. Neither of those is happening these days in many Massachusetts cities and towns.

The rest of the story is that what these boards of health are essentially telling kids is: "We don't care if you use flavored tobacco products, as long as you are using the most deadly and toxic flavored products. We just don't want you to use mildly risky flavored tobacco products. If you use a flavored tobacco product, we want to make sure that it's actually going to kill you, or at least cause substantial health damage."

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