Most Public Hearing Testimony Supports Tightening Tobacco Regulations

Report on the Public Hearing of the Amherst Board of Health, February 6, 2025

This meeting was held over Zoom and was recorded.

Present
Risha Hess (Chair), Premila Nair, Betsy Brooks, Daya Mena, and Jack Jemsek

Staff: Kiko Malin (Public Health Director) and Maheen Ahmed (Assistant)

The Board of Health (BOH) held a public hearing on February 6 to gather testimony on the proposed revised Tobacco Use Regulations, entitled “Restricting the Sale of Tobacco and Vape Products.” A summary of the proposed changes includes:

• Retitle the regulations to “Restricting the Sale of Tobacco and Vape Products.”
• Changes to tobacco sales permits, including number of permits, and reasons for revocation of permits. 
• Adopt a unified fining structure for all tobacco violations.
• Require the BOH to hold a hearing if there are four violations by a single entity within a three-year period.
• Eliminate the regulation prohibiting anyone under the age of 21 from selling tobacco products (as henceforth tobacco products can only be sold in adults-only stores).
• Eliminate ‘tobacco quiz’ requirement for tobacco sellers.
• Update regulations on oral nicotine pouches.
• Update the price of cigars to match state regulations.
• Clarify the definition for tobacco product flavor enhancer to include flavored rolling papers.
• Updates to other definitions.

Most significant are the prohibiting the sale of nicotine products in any establishment that is open to patrons under age 21 and including oral nicotine pouches in the regulations.

BOH Chair Risha Hess clarified that the hearing was being held to gather information and that there would be no discussion. The proposed updated policy will be discussed at a future BOH meeting. In addition to previously submitted testimony and statements at this meeting, the public has another 22 days, or until February 28, to comment on the proposal. Comments should be submitted to Health Director Kiko Malin (malink@amherstma.gov) or mailed to the Health Department at the Bangs Center, 70 Boltwood Walk. If the new regulations are approved, they will be posted in the Daily Hampshire Gazette and on the Public Health website.

Those offering testimony included people involved in tobacco regulation across the state. Much of the discussion centered around nicotine pouches, which are less expensive than a pack of cigarettes and can contain much more nicotine. The majority of commenters favored increased regulation of tobacco products and many spoke in favor of adding language from the Nicotine Free Generation, which prohibits sales of tobacco to those born after a date set by the town, gradually increasing the age at which tobacco can be purchased. A bill introduced in the state legislature would prohibit tobacco sales to anyone born after January 1, 2006. Fourteen municipalities in Massachusetts, including Belchertown and Pelham, have passed a Nicotine- Free Generation bylaw.

Malin summarized the eight emails received regarding the new regulations, three in support and five against. Anthony Isaac, a clinical pharmacist in Brookline and Mark Gottlieb, an attorney at Northeastern Law School, spoke in favor of adding the Nicotine-free Generation wording to the updated regulations. Gottlieb said in oral testimony that his organization, the Public Health Advocacy Institute’s Center for Public Health Litigation, defends towns for free if the Nicotine-free Generation law is challenged. He said that it has been upheld in the Supreme Judicial Court. Isaac stated that 95% of tobacco users begin using when they are underage and emphasized the high health care costs for users.

Heidi Garrow of Amherst called attention to the ease of access to vapes at the high school and urged the BOH to implement stronger policies to prevent youth access to tobacco and vaping products.

Jonathan Bowen Leopold, Paul Neff, and Stephen Heller of Cambridge Citizens for Smokers’ Rights submitted testimony citing a CDC report from September 2024 that teen cigarette use is at a 10-year low and that most stores selling tobacco products are owned by immigrants of color, and tobacco regulations hurt their businesses. In his oral testimony, Bowen Leopold noted that smoking helped him deal with his anxiety and other mental health problems beginning as a teen. Peter Brennan, the Executive Director of the New England Convenience Store and Energy Marketers Association testified that studies show that nicotine pouches are significantly less harmful than cigarettes. Ben Brooks, manager of Nouria convenience store in Amherst, said that removing tobacco products from stores that allow people under 21 to enter makes those stores less competitive.

Robert Melvin and Jeff Smith of Integrated Harm Reduction noted that nicotine pouches are part of programs for quitting smoking, although they do support preventing youth to access those products. They asserted that a National Youth tobacco survey from last fall found that only 1.8% of youth reported using nicotine pouches, and that limiting their sale would adversely affect those struggling with addiction or trying to quit smoking.

At the hearing, Heather Warner, coordinator of the Hampshire Franklin Tobacco-free Partnership who grew up in Amherst said she purchased her first cigarette at a convenience store at age 14 and it was 10 years until she quit smoking. She challenged the assertion that youth were not interested in nicotine pouches saying that a survey in Hampshire County in 2023 showed that 4.5% of 12^th graders had used pouches. She added that, while some pouches have only three or six milligrams of nicotine, others contain more than 40 milligrams. A pack of cigarettes has 24 milligrams in the entire pack.

Maureen Buzby the tobacco prevention program manager in the Mystic Valley region noted how the tobacco industry entices young people to try trendy appealing nicotine products. She said that although hardly any young people smoke, the tobacco industry “has been hard at work developing new products that don’t look, feel, or smell like cigarettes and cigars.” Vaping came on the market about 10 years ago, and pouches, which can give an immediate buzz, were introduced in 2019. She said some of the newest vapes come with video games to entice young users.

Cheryl Sbarra, Executive Director of the Massachusetts Association of Health Boards said that use of nicotine pouches has doubled among those under age 21 in Massachusetts, and that many use both pouches and cigarettes.

Jonathan Winnickoff ,a pediatrician at Mass General Hospital, stated that use of nicotine pouches has doubled in the past year among adolescents, a problem he sees every day. He said that is is very hard to get people off of nicotine products once they start, and then they transition to other products. Although nicotine can produce euphoric sensations, he said, developing brains of adolescents and young adults are uniquely susceptible at even low levels of nicotine, and they are prone to worsening depression, anxiety, ADHD, and suicidal ideation with nicotine use.

Warner, Winnickoff, Ken Elstein of the Belchertown BOH, Kate Silbaugh of Brookline, and Sbarra all encouraged Amherst to adopt the Nicotine-free Generation language into the new regulations, as did Ginny Chadwick, a Ph.D. student at Brandeis University who is studying tobacco use. Chadwick cited the popularity of nicotine pouches among college students, and that that should be a concern for Amherst, with its large population of college students.

Those speaking against the new regulation stated that stores selling tobacco products keep them locked behind the counter and check identification before selling them. They asserted that underage users were obtaining their products on the street, not from stores. However, Ken Elstein of the Belchertown BOH said that a recent spot check of tobacco sellers in Belchertown showed that all 10 had violated the town’s tobacco regulations.

Theresa (no last name given) identified herself as a nicotine user and said, “I don’t think it’s fair to try to ban nicotine. There’s a lot of regulations on smoking, but you’re not banning alcohol, you’re not banning marijuana. Why are you going after tobacco?”