A.
Whereas:
(1)
There exists conclusive evidence that tobacco smoking causes cancer, respiratory and cardiac diseases, negative birth outcomes, and irritations to the eyes, nose and throat;[1] and
[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.htm.
(2)
Among the 18.1% of students nationwide who currently smoke cigarettes and are less than 18 years old, 14.1% usually obtain them by buying them in a store (i.e., convenience store, supermarket, or discount store) or gas station; and among 11th grade males this rate was nearly 30%;[2] [3] and
[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 (2013) Youth Risk Behavior, Surveillance Summaries [MMWR 2014: 63 (No SS-04)]. Retrieved from: www.cdc.gov.
(3)
The U.S. Department of Health and Human Services has concluded that nicotine is as addictive as cocaine or heroin[4] and the Surgeon General has found that nicotine exposure during adolescence, a critical window for brain development, may have lasting adverse consequences for brain development,[5] and that it is addiction to nicotine that keeps youth smoking past adolescence;[6] and
[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/50-years-of-progress/full-report.pdf.
[6]
Health and Human Services. 2014. The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General, 2014 U.S. Surgeon General's Report Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Executive Summary p. 13. Retrieved from: http://www.surgeongeneral.gov/library/reports/50-years-of-progress/exec-summary.pdf.
(4)
A Federal District Court found that Phillip Morris, RJ Reynolds and other leading cigarette manufacturers spent billions of dollars every year on their marketing activities in order to encourage young people to try and then continue purchasing their cigarette products in order to provide the replacement smokers they need to survive and that these companies were likely to continue targeting underage smokers;[7] and
[7]
United States v. Phillip Morris, Inc., RJ Reynolds Tobacco Co., et al., 449 F.Supp.2d 1 (D.D.C. 2006) at Par. 3301 and Pp. 1605-07.
(5)
More than 80% of all adult smokers begin smoking before the age of 18, more than 90% do so before leaving their teens, and more than 3.5 million middle and high school students smoke;[8] and
[8]
SAMHSA, Calculated based on data in 2011 National Survey on Drug Use and Health and U.S. Department of Health and Human Services (HHA). The Health Consequences of Smoking — 50 Years of Progress. A Report of the Surgeon General, 2014.
(6)
The Institute of Medicine (IOM) has concluded that raising the minimum age of legal access to tobacco products to 21 years old will reduce tobacco initiation, particularly among adolescents 15 to 17 years old, as well as improve health across the lifespan and save lives;[9] and
[9]
IOM (Institute of Medicine) 2015. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington DC: The National Academies Press, 2015.
(7)
The sales of flavored little cigars increased by 23% between 2008 and 2010,[10] and 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 youth;[11] and
(8)
Although the Federal Family Smoking Prevention and Tobacco Control Act (FSPTCA), enacted in 2009, prohibited candy- and fruit-flavored cigarettes,[12] largely because these flavored products were marketed to youth and young adults,[13] and younger smokers were more likely to have tried these products than older smokers,[14] neither federal nor Massachusetts law currently restricts the sales of flavored non-cigarette tobacco products, such as cigars, cigarillos, smokeless tobacco, hookah tobacco, and electronic devices, nor the nicotine solutions used in these devices; and
[13]
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 O. 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/preventing-youth-tobacco-use/full-report.pdf.
[14]
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/library/reports/preventingyouth-tobacco-use/full-report.pdf.
(9)
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] and
[15]
Food and Drug Administration. 2011. Fact Sheet: Flavored Tobacco Products, www.fda.gov/downloads/TobaccoProducts/ProtectingKidsfromTobacco/Flavored.Tobacco/UCM183214.pdf.
(10)
The U.S. Surgeon General recognized in his 2014 report that a complementary strategy to assist in eradicating tobacco-related death and disease is for local governments to ban categories of products from retail sale;[16] and
[16]
Health and Human Services. 2014. The Health Consequences of Smoking — 50 Years of Progress: A Report of the Surgeon General, 2014 Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, p. 85.
(11)
The U.S. Centers for Disease Control and Prevention has reported that electronic cigarette use among middle and high school students tripled from 2013 to 2014;[17] and
[17]
Centers for Disease Control & Prevention. 2015. - Tobacco Use Among Middle and High School Students — United States, 2011-2014, 11 Morbidity and Mortality Weekly Report (MMWR) 64(14): 381-385.
(12)
Nicotine solutions 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] and
[18]
Cameron JM, Howell DN, White JR, et al. 2013. - Variable and Potentially Fatal Amounts of Nicotine in E-cigarette Nicotine Solutions. Tobacco Control. [Electronic publication ahead of print], http://tobaccocontrol.bmj.com/content/early/2013/02/12/tobaccocontrol-2012-050604.full; 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/library/reports/preventing-youth-tobacco-use/full-report.pdf.
(13)
The Massachusetts Department of Environmental Protection has classified liquid nicotine in any amount as an acutely hazardous waste (310 CMR 30.136); and
(14)
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] and
[19]
Food and Drug Administration, Summary of Results: Laboratory Analysis of Electronic Cigarettes Conducted by FDA, available at: http://www.fda.gov/newsevents/publichealthfocus/ucm173146.htm.
(15)
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 was 10.8% in 2013;[20] and
[20]
CDC (2013) Youth Risk Behavior, Surveillance Summaries [MMWR 2014: 63 (No SS-04)]. Retrieved from: www.cdc.gov.
(16)
Data from a 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;[21] and
[21]
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.jahonline.org/article/S1054-139X%2813%2900415-1/abstract.
(18)
Research shows that increased cigar prices significantly decreased the probability of male adolescent cigar use and that a 10% increase in cigar prices would reduce use by 3.4%;[23] and
[23]
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.
(19)
Data collected shows that 59% of high school smokers in Massachusetts have tried flavored cigarettes or flavored cigars and 25.6% of them are current flavored tobacco product users; 95.1% of 12-17 year olds who smoked cigars reported smoking cigar brands that were flavored;[24] and
[24]
Massachusetts Department of Public Health, 2015 Massachusetts Youth Health Survey (MYHS); Delneve CD et al., Tob Control, March 2014: Preference for flavored cigar brands among youth, young adults and adults in the USA.
(20)
The 2015 Massachusetts Youth Research shows that 5.8% of Massachusetts youth currently use e-cigarettes and 15.9% have tried them;[25] and
[25]
Massachusetts Department of Public Health, 2015 Massachusetts Youth Health Survey (MYHS); Delneve CD et al., Tob Control, March 2014: Preference for flavored cigar brands among youth, young adults and adults in the USA.
(21)
The Surgeon General found that exposure to tobacco marketing in stores and price discounting increase youth smoking;[26] and
[26]
U.S. Department of Health and Human Services. 2012. Preventing Tobacco Use Among Youth and Young Adults: A Surgeon General. Atlanta: U.S. National Center for Chronic Disease Prevention and Health Promotion, Office on Health, p. 539, www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf.
(22)
The sale of tobacco products is incompatible with the mission of health care institutions because these products are detrimental to the public health and their presence in health care institutions undermines efforts to educate patients on the safe and effective use of medication, including cessation medication; and
(23)
Educational institutions sell tobacco products to a younger population that 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; and