2021-11-03 00:00:00 - Joint Committee on Public Health

2021-11-03 00:00:00 - Joint Committee on Public Health

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[SEN COMERFORD:] Um Today we're going to hear 27 bills pertaining to several topics including tobacco-related issues COVID-19 health records and other concerns before the committee

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[DEANA LYKINS:] [SB1392] [HB2244] Thank you. Chair and members of the committee for allowing me to speak to you today. My name is Dina lichens. I'm the head of state government affairs for Glasgow SmithKline Consumer Healthcare GSK Consumer Healthcare were the maker of Nicorette Nicoderm, which has been over the counter for about 25 years and as part of that, we have been proudly part of kind of the national anti smoking coalition of advocacy groups. So to that end, I'm here today to encourage your support of Senate Bill 13 92 and House Bill 22 44. These bills would ensure that all the citizens of massachusetts regardless of where they live have ready access to help them have the tools to quit411 smoking and improve their412 health. So right now There is less than 3% of nicotine replacement therapies, that's what we used to refer to smoking cessation programs or NRT. So less than 3% of NRT is sold at convenience stores, while over 92% of all tobacco is purchased there. So in the theater there at um435 we're concerned about the lack of access for these health care um solutions to certain people.

So convenience stores, as you guys probably know, are disproportionately located in urban areas and in communities that face health equity and healthcare access issues. So the lack of access to the arts in these places and in these stores is really a barrier to quit smoking for people that need a little extra help. They can't just quit cold turkey. And it actually further kind of fuels disparity in tobacco use and and associated kind of health469 problems. So research that we've seen shows that with the greater availability of and exposure to tobacco products that result from kind of high retail density and proximity. It's associated with increased smoking rates in both youth and adult populations. So with almost half of the, You know, people don't quit. Um you don't plan it out like the quitting is spontaneous. That sometimes like within the last 45 minutes after last cigarette, a person thinks of, you know, they start getting cravings and want to smoke again.

So it is something that kind of needs to be a convenience store when the person has that kind of intention to quit smoking and has those kind of acute nicotine cravings. So the effectiveness of NRT helping people quit smoking is really kind of a science. That's why it's been approved by the FDA for a long time. It helps people quit smoking by relieving those nicotine cravings. And it shows that it can help alleviate those cravings and then it can double the chances of quitting smoking. So, massachusetts has long been a leader in kind of anti smoking efforts and reducing smoking rates, but you know, we found that we're kind of running out of new547 solutions and so we're hoping that you'll take a look at this kind of new thought about helping people quit smoking kind of really need a so thank you so much.
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[COMERFORD:] Next up Lindsay Lewis Um I believe Lindsay you're going to speak on a number of different bills before us. Um H two to584 H 337 and S 2485 which is an act relative to tobacco harm reduction. Uh and then another H 2244, S 1390 to enact further regulating the sale of tobacco products and there's H 2310 and S. 1459. An act to protect youth from the harms of tobacco and e cigarettes, and H 2357. An act protecting you from second hand smoke.

[LINDSAY LEWIS (PROGRESSIVE POLICY INSTITUTE):] Good morning. And thank you for allowing me to speak this morning. And uh you have 27 bills to get through today. So I'm going to keep my comments as short as possible, and I'm happy to follow up with anybody afterwards. Uh I'm Linsky Lewis on the executive director of P. P. I were an independent Policy think tank in Washington. We've been around636 since 1989, uh doing a wide range of, you know, original research on issues in the US and globally. One of those core647 uh policy as we focus on is harm reduction, uh not just in tobacco, but in other uh areas like alcohol and food. And um you know, we think uh reducing harm in tobacco is a huge upside opportunity.

And we want to commend this committee for having a forward, taking a forward look at the issue. Um and, you know, I want the committee to understand that, you know, and for if you shoot short years, we have680 written witnessed a dramatic switch globally from the harmful use of tobacco smoking tobacco. And we at P. P. I would like to see the end of smoking in the next 5-10 years. And we think uh having a smart pragmatic approach to alternative nicotine products is a smart way to do this. You know, we've seen places in like Japan that in three years have switched 40% of the adult smokers off cigarettes. Uh something we did not we could not accomplish in 30 years of tobacco control in the us and uh is a something that we should be embraced. This is a risk based policy. Um you know, we have to all weigh the risk of uh new nicotine delivery devices with uh the potential to attract new users to nicotine.

But the risk for adults is important and the opportunity for them to quit smoking. Uh something we should all embrace. And I think my understanding of the bill having read uh last week is that you're taking the smart approach here and you've got ways to mitigate the risk with both 21 plus on nicotine. And frankly the PMT a process of the FDA is something that we should all um embrace. But it's not just the FDA. We've seen global health uh England that um has reviewed all these products and while most of these products and has also approved them and you know, it's a really good science based uh public policy and you know, the780 FDA and others are not going to uh approve products that directly appeal to a new generation of nicotine users and we are not going to see uh flavors791 like Bubblicious uh come through A. P. T. M. P. M. T. A process. So I commend the committee and I appreciate your effort in this. Uh, taking this up.
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[ALLYSON PERRON (AMERICAN HEART ASSOCIATION):] [HB2337] [SB2483] Thank you so much. Chair Comerford and chair Decker and members of the committee. My name is Alison parent drag and I am the government relations director with the american Heart Association. As part of our mission. We're working towards ending tobacco use and nicotine addiction in the United States. That is why we are here testifying in opposition of several bills today and act to repeal the statement all ban and act to protect communities of color and act relative to the sale of electronic nicotine delivery systems and act relative to tobacco harm reduction. We are so thankful for the leadership of the massachusetts Legislature when you took the871 first in the nation step to protect our kids from deadly nicotine products by eliminating all flavors and all tobacco products and these bills before you were rolled back these efforts when the star in massachusetts.

There were strong bipartisan support and eliminating flavors and putting the health of our residents over the profits from deadly products. The legislature knew the biggest beneficiaries of the law would be future generations who do not start smoking because they are not bombarded with mental ads and other flavored products. The bills were also intentionally written to anticipate new tobacco products, ensure they were included in the law. We're asking you to continue to stay strong and not allow for any exemptions. House Bill 2337 and Senate Bill 2483 would allow for any product that is classified as a modified risk tobacco product to be allowed to be exempted from the flavor law. It should be noted that modified risk tobacco products are not classified as smoking cessation products, but in fact are regulated as tobacco.

We believe the FDA set a dangerous precedent that puts kids in public health at risk. Authorizing the market marketing of Philip Morris is Aiko's heated cigarette as a modified risk tobacco product. Despite the FDA is acknowledgement that Philip Morris failed to show that Ecos presents a reduced risk of tobacco related disease and without recording evidence that the products marketing won't appeal to kids with this action, the FDA has created a real danger that kids and adults will falsely believe Ecos has been proven to present a lower health risk and that kids will be exposed to marketing that portrays Aiko's a highly addictive tobacco product as an appealing cool alternative to cigarettes in much the same way as e cigarettes did in its decision.

The FDA acknowledges that the impact on youth of allowing ICO street market is modified risk. Tobacco products is unclear. Such doubt should be resolved by protecting our kids not by making them guinea pigs in the tobacco industry marketing experiment. When the flavor elimination law was passed, the legislature made sure that they were thinking about future products like ecos and made sure that the language do not allow for our kids to again be targets for such products because the last thing we need is yet another tobacco product that indicts kids and misleads consumers about health risks. We appreciate your time and consideration of not reporting out these bills. Thank you.

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[GWENDOLYN STEWART (TOBACCO FREE MASS):] [HB237] [] Hi, thank you. Chairs Comerford and Decker and members of the committee. My name is Glenn Stuart. I am the executive director for tobacco Friedman rest, which advocates for legislation, policies and programmes that counteract the tobacco industry's impact on the people of massachusetts when the massachusetts, Legislature stopped the sale of flavored tobacco products in the commonwealth. It greatly reduced the attractiveness of tobacco products to young people. The landmark flavor provision is intentionally written to anticipate new1056 tobacco products and ensure their inclusion under the law allowing even one product type and an exemption would substantially weaken the law. A blanket repeal with the flavor provisions would set us back years, even decades in our efforts to protect young people from the tobacco industry. So we oppose House bill 2337 instead of bill to 4283.1076

Um, these bills would weaken the new tobacco flavor law by allowing flavoured products that are classified as modified risks risk products We oppose, house 2406 senate 1433 and Senate 13:37 and 1373, which would reverse the mental provisions of the law and allow menthol flavoured tobacco to be sold in Massachusetts. Massachusetts has made great strides against tobacco, but the fight is not over. In fact, the tobacco industry is very active in massachusetts working behind the scenes to undermine public health laws and spreading from misinformation. For example, Philip Morris International is running an expensive public relations campaign in our state claiming that it is using science to solve the problem of cigarette smoking.

Of course the company caused and continues to promote the very problem they say they are solving so far from being forthcoming about their product1130 products. The tobacco companies are secretive about the mechanisms and chemicals involved in our silent about how much more addictive these new products may truly be. Um, so in his public relations campaign, Philip Morris bemoans misinformation as an obstacle like few others. Yet tobacco companies have a long history of straying from the truth. They've marketed light and filtered products as healthy options. They added mental and claimed it was less harsh and harmful than unflavored cigarettes and these claims were all false, but they caused people to stay addicted instead of quitting, causing untold death. This is an industry that lied to the public for decades about the very real health impacts of smoking. Why would we believe them now?

You will hear them talk about their new non combustible tobacco products as part of a plan for improved public health. We've heard that already. However true harm reduction aimed at helping people who have been unable to stop smoking does not require the introduction of new, heavily marketed and flavored consumer products such as vapes are heated cigarettes sold at the corner store at every turn. The tobacco companies have acted against the best interests of public health and social justice and they have done so while promoting themselves as good corporate citizens. We ask that you remain1202 firm under commitment to protecting young people from the tobacco industry and refuse all efforts to weaken massachusetts landmark tobacco law. Um, and last we support house 23-10 Senate 1459 and act to protect you from the harms of tobacco and the cigarette products.
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[MARC HYMOVITZ (AMERICAN CANCER SOCIETY):] [HB2237] [SB2483] [HB2406] [SB1433] [SB1373] Thank you. Chairwoman Comerford Chairwoman Decker and members of the committee. My name is Mark and Events and I'm the director of government relations in massachusetts for the american Cancer Society Cancer Action Network or A C. S. Can thank you for allowing me time to testify today in opposition to House Bill 2237 and Senate bill 2483 regarding Modified Risk Tobacco Products and House Bill 2 406, Senate Bill 1433 and Senate bill 1373 which help chip away at the state's ban on menthol flavoured products. So you've heard some of my colleagues talk about the modified risk so I'll focus on the flavor band law flavors are marketing weapon used by tobacco manufacturers to target young people for a lifetime of addiction products like flavoured flavoured products like jerry, cotton candy and gummy bear are clearly not aimed at established adult tobacco users and years of tobacco industry documents confirm the intended use of flavors to target youth Mental mental specifically acts to mask the harsh taste of tobacco with minty flavor and it reduces irritation in the back of the throat with a cooling cessation and additionally it may enhance the delivery of nicotine

Adding insult to injury. Tobacco manufacturers have aggressively1311 targeted certain communities with their mental products leading to an unequal burden of death and disease. Nearly 90% of African Americans who smoke reports1321 smoking menthol cigarettes compared to less than a third of whites who smoke. This is not just coincidence. Internal tobacco industry documents show that companies were intentionally targeting African american communities. The tobacco industry has used their insidious tactics for decades to continue to hook their customers and profit off of their health so nicotine addiction will not end overnight. But while you will hear from those who have financial interests in keeping flavoured tobacco on the shelves that the flavor band law has failed.

The facts show that that's just not true. In fact, a recent study by the massachusetts tobacco cessation and prevention program that we can share with the committee. Uh, the study found that while there was an increase in mental sales in new Hampshire, immediately following the law's implementation, the increase was not sustained and total tobacco sales in new Hampshire have changed minimally. So we thank the House Senate and governor baker for seeing the law through the finish line and refusing to1380 be coerced into tactics, it's a scare tactics to repeal what we know is both a lifesaving and long term cost saving measures because when we talk about lost revenue and things like that, the real, the real cost is that our kids health and also there is a huge health care cost to, um, because of smoking related illness in massachusetts. So we thank you for your commitment to the law and thank you for passing that law two years ago this month1406 and thanks for the time today.

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[DECKER:] Thank you Senator. Um just wanted to say thank you to to1419 Mark and to the others who testified and just to share that my colleague, representative Daniel Gregoire who was really a champion who had worked closely with on this in the last session, had hoped to be on1430 here. She is unable to, but she has submitted um testimony as well in her opposition and um it's always helpful to have um science um leading public health um in our work and our decisions. So thank you for all the work that you're doing

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[COMERFORD:] Well said, um and I'm actually pleased I also very much appreciate Representative Gregoire's leadership and now I'm I'm pleased to welcome senator keenan who was our Senate side champion of this issue last session. Senator Keenan has1466 come on to say a few words,

[SEN KEENAN:] Well, good morning and I welcome the opportunity to say a few words about these bills and also one other bill, if I may I first start with the tobacco bills as you recall, we passed landmark legislation back in 2019 that banned flavored tobacco products to reduce young people's access to tobacco and nicotine products and as noted by chair Decker and I thank you Chair Comerford as well for the opportunity. Um and in the words but worked with the legislation with a great colleague Gregoire some incredible advocates, many of whom you've already heard from today and will continue to hear from and and middle school students from the town of Holbrooke in my district1505 and from middle high school and even elementary school students from all across the commonwealth.

And during the legislative process, we were very intentional with the language to contemplate any new products such as heat, not burn or synthetic nicotine and to make sure that no flavors were left on the market to create a loophole for our kids. And several of the bills that are being heard today that seek to create exemptions for certain flavored tobacco products and to um, two of them support continued protections for our young people, which I think are great. So I'd like to speak to those that look to weaken what we did. One would weaken the tobacco flavor law by allowing flavoured products that are classified as modified risk products by the FDA, whether they modified risk outrageously risky. Whichever phrase you may want to put on it. I know that there are scientific terms that are used and that's modified risk but inflated products without a doubt or what attract young people to cigarettes and to vaping.

And so regardless of whether they considered modified risk products or what they considered the flavors what attracts young people and that bill H 2337, Senate 2483 would weaken the tobacco law by allowing flavoured products, um, if they're classified as modified risk. And then, uh, there's been some discussion, excuse me about the mental, we know that the industry over time has done everything they possibly can to keep mental on the market. They know how effective it is at drawing people to their products. And Mark talked about it just a couple minutes ago. They know it works and they will do everything they can to keep mental on the market. They did it back when the federal government banned flavors, they went down there, they lobbied heavily and they succeeded in keeping mental on1616 the market and we, as a society have paid the price for that ever since. We know that young people are more likely1622 to smoke menthol cigarettes than any other age group and reversing this would undermine a significant goal.

The legislation we passed just two years ago. And then there's uh, Senate 1373, an1632 act to protect community of colors and communities of color. And this would change the effective date for many sections of the legislation that we passed and changed that day to 2022 sort of event, uh, effectively would reverse the ban that we put in place. And that gives a toehold for the industry to come in and market those products, addict people to those products and and build their support for them. So we have1655 to really work to make sure that that piece of legislation is not passed either. Um, and then I do want to, as I mentioned, vocalized my support for H 231 oh and Senate 1459, which is an act to protect you from harms of tobacco and cigarettes filed by rep Gouveia and senator Lewis. Uh, I want to thank them for for filing that legislation and I think that's important. We can't open the door again. We have seen what happened over time.

Whenever that door is just left slightly ajar, the industry comes through, they target their marketing, They target young people and while they may claim that an older generation switches from combustible cigarettes to vaping products and that may be good. And we've left that we, we've allowed for that because we didn't ban vaping overall. Um, but in the process of doing that, we have to be very careful that they don't target young people and that's what these bills are designed to do to open the door again to allow young people to be targeted. And I noticed, uh, moments ago there was a reference to Japan is certainly, there has been a historic switch in Japan from combustible cigarettes to vaping products. The long term health impact of that remains to be seen. But in that switch there has been an increase in the use of vaping products by young people despite Japan's relatively tough tobacco control laws.

So we've got to be mindful of that. Japan while it's a model in some respects, is not a perfect model by by any means. And so I urge that we stand strong that we resist these efforts to weaken the landmark legislation that we passed and that we stand up for a generation of young people to prevent them from becoming the next generation addicted to tobacco and nicotine products. And if I can switch just quickly madam chairs to Senate 1450, which is a bill that I've filed relative to notification. Frontline health care workers to exposure coronavirus. Um, this bill is a companion bill to that file. Barber Meschino which is house to 368. It's pretty straightforward bill that requires employees to notify the health care providers of exposure to covid within 24 hours of exposure or the confirmation of a contact, covid positive status issue. There's currently no consistent protocol Across the healthcare facility to notify workers if they're exposed to COVID-19. This leaves work is unable to properly isolate and get a covid chest following exposure and puts them and their1799 families and their patients all at risk.

So we've seen firsthand1803 why this type of notification is so important and why knowledge of exposure is better to share as early as possible given the opportunity to get tested to quarantine if necessary and to1813 do the things to protect themselves and other. So this legislation would apply to any medical provider, It who comes in contact while acting in a professional capacity with the patient, a colleague or on the individual Who has COVID 19. It will help reduce the spread of covid and strengthen trust within healthcare environments. I think that's very, very important. And as cases continue to be less prevalent than a year ago, we have to stay diligent in protecting1838 one another, particularly our healthcare workers from the unnecessary risk of exposure. And so I respectfully requested if the this bill was reported out favorably, which I hope it will be that we be reported out with an emergency preamble attached. I think it's that important. So I thank you very much for the opportunity to1855 testify on these bills. I'm happy to answer any questions and uh thank you.

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[JOHN SHAER (NECSEMA):] [HB2483] [HB2426] [SB1433] Thank you. I'll start chair Comerford chair Decker and members of the committee. My name is john share and I'm the executive director of the new England convenience store and Energy marketers Association. Thank you for the opportunity to speak in support of two bills today H 2483 And H 2426 and its companion S- 1433. I've also submitted more extensive written comments on these and other bills before you today. Age 2483 would allow tobacco products.1936 The FDA authorizes through its premarket tobacco application or1939 PM. T. A. Process to be sold by licensed tobacco retailers in massachusetts. These are products the FDA determines are quote beneficial to the protection of public health, quote their their process is rigorous and science based. in fact, of the nearly seven million product applications they've received only 22 so far have been1958 granted PMT authorizations. When the legislature debated and subsequently passed an act modernizing tobacco control in 2019, it was a very different time. Youth Vape rates were far higher than they are today tainted THC vapors were making many sick and even caused some to die.

The federal political landscape was toxic and there was a high degree of scepticism that the FDA would act to reduce youth vaping rates with that as contacts. The legislature banned all flavoured tobacco but chose not to exempt PMT A Excuse me, authorized products today you have an opportunity to rectify that by giving a favorable report of age 24 83 allowing massachusetts residents access to products that the FDA has determined offers a benefit to public health for those seeking a less harmful alternative to certain other tobacco products. I'd also like to ask for your support of H- 24-06 and S- 1433. These bills would repeal the ban on flavoured tobacco in Massachusetts. The state remains the only one in the country with the statewide flavoured tobacco ban. Again, I draw your attention to 2019 and what a different time it was. There were literally millions of flavored vapor products on the market. Youth vibrates were alarmingly high and the federal government had not yet demonstrated action flash forward to today and we are in a very different world, driven largely2033 by a tremendous amount of federal action capped by the PM to a process that as I said earlier has removed millions of products from the market. Bottom line.

The2042 vapour market is a sliver of what it once was an FDA approved and only FDA approved products will remain legally available. But as as you know, the massachusetts ban extended to adult preferred products such as menthol cigarettes and meant to Wintergreen smokeless in this regard.2058 The ban has failed in whatever goals it had2060 intended for the products and the data backs that up In the 12 months that followed the band New Hampshire and Rhode Island combined to sell 84% of the excise tax stamp sales no longer sold in Massachusetts with the balance largely made up of an increase in traditional cigarettes, tobacco flavored Vape sales and other tobacco products and of2080 course there are the illicit sales that filled the void when massachusetts exited the market. Although those sales are harder to identify and quantify from a retailer's perspective, this is very difficult to watch as your customers get the products they once bought in your stores now buying them in Rhode island new Hampshire with a guy in the corner. It's particularly hard when the state cannot demonstrate evidence of any positive health related impact as well. To that end, we respectfully ask the committee to favor favorably report H 24 oh six and S. 14 33. Thank you for the opportunity to present these remarks and I'll turn it over to Kyle.

[KYLE FELDMAN (NCD):] [HB2406] [SB1433] Good morning everybody thank you so much to the massachusetts Joint Committee on Public Health. I want to discuss H 2406 and S 1433. An act to repeal the statements that have been, my name is Kyle Feldman and I am the vice president, the national communities distributors, N. C. D. A full line convenience stored in the Northeast. We sell anything from grocery to frozen refrigerated food beverages, school supplies, health and beauty products as well as general merchandise, cigarettes and Essex we have always recognized the value of our services. So it's not surprising that during the pandemic, we were deemed both federally and within all the operating states and essential business Providing the various essential services and products that our customers who supply communities for their needs. n. c. d. is one of the largest privately held companies in the northeast.

Over the last 100 plus years, we have grown to over 15,000 customers, which includes nearly 1500 customers in the state of Massachusetts. In addition to all of this, we are a very large tax collector in massachusetts, We proudly remit upwards of $200 million Commonwealth of Massachusetts that enables us to employ so many individuals and touched many lives in a positive way. I had a speech prepared, but I noticed this is a very intimate group and I just want to put some some facts on the table and get rid of my speech that I prepared. Um when the mental cigarettes were banned in the state of massachusetts last june until June 2021, that was 12 months of no mental sales in the state of Massachusetts. My company is one of the largest uh, cigarette suppliers in the northeast and what I can tell you what is fact based is the sales in New Hampshire has jumped 60% over the last year. My Connecticut sales have jumped 15% and my Rhode island sales have jumped 20%.

I also want to mention, I have roughly 90 or sell salesman in the streets in the state of Massachusetts that report back to myself as well as others at home base. Um, and tell us that there's trunk slammers vans and buses of cigarettes coming up from Virginia north Carolina as well as south Carolina. Entering the state of massachusetts, menthol cigarettes and being sold at your local corners, being sold out of the trunks and being sold at the back of trucks. Those statistics and those facts that you cannot fight with that. It's 100% accurate evidence based, but it's hard for researchers of third parties2283 to grasp because it's not possible. Thank you so much for your time. I love to discuss this and have further dialogue with anybody. And once again, thanks again.
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[JARED REILING] [HB2273] Thank you. Chair Comerford chair. Decker members of the committee. Thank you for the opportunity to discuss H 2 to 37. My name is Jared riling. I'm an attorney at King and Spalding and I'm here today to provide comments on H 2 to 37 on behalf of my client Reynolds american and its affiliated tobacco company, R. J. Reynolds vapor company. We share the state's interest in tobacco harm reduction and we share the state's interests of keeping tobacco products out of the hands of youth rather than through the current categorical ban on flavoured tobacco products. These interests, however, can be better addressed by incorporating FDA regulatory oversight of tobacco products as H 2237 allows. Thus we fully appreciate and support the exemption provided in H. 2237 for products for which a marketing granted order has been issued or modified risk of apple products application has been granted by FDA. This exemption makes sense from a public health perspective by virtue of the fact that a marketing granted order for them to use the word premarket tobacco products application.

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Thank you very much. This exemption makes sense from a public health perspective by virtue of the fact that a marketing granted2398 order for a PM to a or premarket tobacco products application. It means that FDA has determined that a product can be marketed because the agency has determined that the marketing of the product is2408 quote appropriate for the protection of public health and in order granting an M. R. T. P. A. Or modified risk tobacco products application means that FDA has determined that a product can be marketed with a claim that the product reduces harm and or risk of disease to the individual tobacco user and will benefit the population as a whole, as a state is well aware. FDA acted last year to remove most labour products from the2432 market. These products can only re enter or new flavored products can only enter the market. FDA Issues of marketing granted order on the PMT A. Importantly FDA requires manufacturers satisfied strict scientifically evidence based PMT process and PMT A. And M. R. T. P. A. Submissions are voluminous and require large amounts of scientific data.

For example, FD requires PMT is to include extensive design data, information about constituents, information about manufacturing processes, marketing plan information and rigorous scientific analyses. As part of the FDA's review of PM2470 to US, Congress directed FDA to weigh certain factors, including the following public health effects, risks and benefits to the population as a whole, including people who would use the proposed new tobacco products as well as non users. Whether people who currently use any tobacco products would be more or less likely to stop using such products if the proposed new tobacco products were available and whether people who currently do not use any tobacco products would be more or less2496 likely to begin using tobacco products if the new products were available and weighing these factors and ultimately issuing a marketing order, FDA must find that appealing to provide scientific evidence and clinical data that demonstrate the marketing of a product is appropriate for the protection of public health.

In other words, any decision by FDA to grant and marketing order for a PMT means that the federal government will have decided based on its technical and scientific expertise that the marketing of the product is appropriate for the protection of public health. As I mentioned before for FDA to grant an order on the MRT pia, it has determined that a product can be marketed with the claim that the product reduces farm and2534 or risk of disease to the individual tobacco user and will benefit the population as a whole. Conversely, FDA must deny a PM to if it finds that marketing of a specific product including flavor products is not appropriate. Thank you for the opportunity to present will submit written comments to finish our statements. Thank you

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[ELLEN MACINNIS:] [HB2368] [SB1450] [SB1435] Good morning chair Comerford Decker committee members, thank you very much for holding and inviting me to this hearing today. My name is Ellen MacInnis. I'm a registered nurse. I work in the emergency department at ST Elizabeth's medical center here in boston. I'm here today to testify in support of House Bill 2368 and Senate Bill 1450 and Act relative to notification of frontline healthcare workers of exposure to coronavirus and Senate Bill 1435 resolve relative to the establishment of a joint oversight oversight committee on personal protective equipment. Both of these bills address protections for front line health care workers of which I am one and tied to the covid 19 pandemic As a nurse on the front lines of the pandemic for over 18 months. Now I can tell you that these bills address the very real conditions were still dealing with in our hospitals. House 2368, Senate 1450 would require healthcare employers to notify health care workers who come in direct contact with an individual capable of transmitting covid 19 of their exposure within 24 hours and assess a fine for noncompliance.

Right now this is not the practice in all hospitals because the C. D. C. Is still only requiring notification and testing in cases of high risk exposure for healthcare workers um defined as prolonged contact where the worker or the patient was not wearing a mask. The and yet for the general public a person is still considered a close contact and must be notified even if they were wearing a mask while they were around someone with Covid 19. While it's true that universal masking can2709 reduce the risk of contracting COVID-19 unless the health care worker is wearing a specific respiratory protection masks such as an N- 95 respirator. He or she should be considered exposed and notified of such an exposure. Even if the health care worker is and remains a symptomatic, It cannot be overstated that those healthcare workers and patients facing rules, nurses in particular are at greatest risk of these types of exposures. I ask you to please take action on house 2365 Senate 1450 to address this.

Additionally, we're asking for an oversight committee to look at the state of PPE2750 personal protective equipment and the PPE supply chain to make sure we do not have a repeat of what happened in 2020 that went on much too long. We're now experiencing supply chain issues that me and my that make me and my the folks I work with nurses, tax aids, respiratory therapists, very, very nervous or Um for whatever reason, hospitals in the state were caught off guard2779 by the pandemic2780 in 2020. This put front line healthcare workers like myself and their patients in a trip. We want to ensure this doesn't happen again. Thank you. Thank you Alan, thanks for your frontline service and for coming to speak to these two important bills when your colleagues um questions from the committee.
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[BEN BROOKS (NOURIA ENERGY CORP):] [HB2406] [SB1433] Hi everyone. Thank you for your time this morning. My name is Ben brooks and I am the tobacco category manager for career and Maria Energy Corporation were based in worcester Massachusetts. We operate 148 gas stations in New England 83 of those are in Massachusetts2842 and we employ over 900 people in Massachusetts. Today, I'm testifying in support of H 2406 and S 1433, an act to repeal the statement all ban. In the months that followed the Massachusetts flavoured tobacco ban. We2857 monitored our cigarette business and saw our mass business declined 25%, while our New Hampshire business increased by 12% Rhode Island 30% in Maine 6%. These types of increases are unheard of in a traditionally declining category. This shift in business happened essentially overnight after the effective date of the massachusetts mental ban and those trends are continuing today. Almost a year and a half later, we saw similar trends in our smokeless tobacco and alternative nicotine2884 categories as well.

It was clear very early on that the stated intention of the massachusetts metal band was not working. These products are still finding their way onto the streets and into the homes of massachusetts residents. The main reason for this is simple. It's that tobacco users want what they want and we'll find a way to get it. They simply get it by travelling to neighbouring states and often buy in bulk and resell to friends and family members. We see this that are existing border stores in new Hampshire and Rhode island every day. What happens is this increases the number of private sale tobacco transaction and transactions in the communities in massachusetts. And I think collectively, we can all agree that we don't want any tobacco sales happening outside of licensed retailers operations. These transactions are dangerous, mainly because proper age verification practices are not taking place and Maria, we continue to feel the financial impact as well of this law.

Today, while we were fortunate to not have to lay off any employees or close any stores in massachusetts due to the ban, we are now faced with a new challenge of retaining employees in an ultra2942 competitive hiring landscape. The loss of profit from these products has hindered our ability to increase wages enough to retain qualified health without enough help. We must reduce hours of operation. When we reduce hours of operation, the public loses essential goods such as gasoline, milk, bread and prepared food are not available when people need them, but we continue to invest in new locations in the state of massachusetts, it is no longer our top priority state to do business in in New England. In closing,2970 I ask that you please pass H 2406 and S. 142973 33 as it will seriously help essential businesses in the state and reduce the amount of private sale tobacco transactions taking place in massachusetts. Thank you for your time.
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[ANNA BETTENCOURT:] [SB2406] [HR1433] wonderful, thank you for your time and the opportunity to testify. I want to testify in support of to 406 and 1433. Much like Ben, I am a category manager, I worked for Energy North Group were3012 based out of Lawrence massachusetts. I am3015 now in New Hampshire resident and I was up until May in a lifetime massachusetts resident. Um, I would like to speak on behalf of what I have seen on both sides. I previously, I moved in May to take a new job of Energy North Group. I'd like to talk to you about what I have seen in the state of massachusetts. I was opposed3037 to the flavor ban from the beginning because I knew that it would not solve the issues that the state was aiming to. Um you know, I had seen one off town bands before, so I was familiar with illicit trade and different things like that. Um my biggest concern was the band never allowed for products that received a P. M. T A. Or an M. R. T. P. And just previously stated to receive an M. R. T. P. From the FDA.

Um, there is a big step and there's a lot of science based information and involved in it. Um, I know that the several manufacturers large ones when they submit A PM to or an M. R. T. P. They're sending millions of pages to the FDA. So obviously there's a lot3085 of science in that. Um, I just don't understand why if a product was received an M. R. T. P. Or an PM to why we would not bring it back into the market because it may be a safer alternative Than a combustible cigarette. Um, I don't believe this has worked because to Ben's3105 point, I see sales numbers, I can tell you that my previous company, um, we had a store just over the border. It was the very first story you've got to, as soon as you hit the state of New Hampshire on 93 In May of 2020, they sold 44,000 packs of cigarettes, June of 2020, they sold 100 and 10,000 packs of cigarettes. The lion's share of that was meant all. So that tells me that that wasn't working and the business sustained like that through the whole year.

And I see those same types of numbers here where I currently work because we also operate in New Hampshire, We also operate in Maine as well in massachusetts. Um, I just see that3151 it's not doing as we had hoped with the flavor ban because people are still getting the product, massachusetts is out the excise tax and they're still having the health consequences. I believe that true public health is education and that we should put more resources into youth prevention, but I believe a grown adult has the right to make a choice. I hear us speak about big tobacco and how they were in the past. I can't speak for them, but I can tell you that I see a different companies, different companies when we talk Philip Morris and R. J. Reynolds than we have3186 before and it's not about them is about giving the retailer's the ability to sell what other states do. Thank you for your time. If there's any questions or comments, I would be more than happy to speak to it. I will also submit written testimony to finish my argument or my statement rather.

[COMERFORD:]Thank you. Um, thank you so much for taking the time to come and speak before the committee. Um, I agree with you that public education is, I mean public health is about education in part. I do and thank you sir please.

[DECKER:] Yeah. You know, it's interesting. You know, I don't tend to comment too much3225 on this is we're moving these bills along. But you know, on the one hand, we talk about wanting those who are profiting off of the sales of3233 nicotine and tobacco. Talk about education being an important part of public health and in the very same breath we hear, you know, one of them talk about tobacco users want what they want and the searing painful image that I sit here with is dropping my father off of the V. A. For lung cancer surgery and um dropping him off and my mother who now also has um lung disease, dropping them off at the of a for that surgery3258 so that they wouldn't have to walk while I parked the car. And then I parked the car and this idea that tobacco use is want what they3265 want um really belies the fact that education alone is not enough and as I walked up as we were getting ready to prep my dad for lung cancer surgery who both parents were addicted and had tried for decades3277 to quit with many of the tools that were out there at the time

there they were3282 smoking and I just remember falling and crying and thinking here we are, you know that you are literally dying because of what this poison has done to your lungs from an industry that new that um but tobacco users want what they want and that's why I am so proud of the work that my colleague Senator Gregoire did Senator keenan did and that this body did to really understand that education alone is not enough and that the cost of our health care and the cost of life is also the responsibility that we take as elected officials to move into the space and to um take really brave choices and understand that the cost of life ultimately is the thing that we are mostly responsible about when we can make better policy choices. So, um just Senator Keenan, I didn't comment3333 when you spoke, but I see you on there and just to always say, um I'm always so grateful for your leadership around harm reduction. Um and that is my colleague, representative Gregoire So, um, at this time I think uh, you know, bearing no other questions, Senator Comerford, I'm happy to have you go on to the next speaker.

[COMERFORD:] Thanks madam Chair, Thank you for sharing your personal uh your personal history. My mother ended her life on an oxygen machine after smoking and trying to quit every day of her life. Um and that's how she died from a pulmonary disease um as a result of her smoking history. So I am also um a believer in the necessity of putting parameters on what's dangerous for our health in the commonwealth. Um so, thank you so much, Madam Chair,

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[MICHAEL MADDEN:] [HB2237] Um my name is Dr. Michael Madden. Uh and I've been a family physician for 35 years and I share the legislators concerns about smoking because my mother also died of smoking related illness. I speak in support of H 2237 which would establish an exception to massachusetts. Uh, commonwealth wide flavor ban uh for products approved by marketing under the FDA S. M. R. T. P. Or P. M. Ta processes. This exception is crucial to ongoing efforts to reduce the burden of cigarette related diseases on the3436 public health of massachusetts. While our AI services Reynolds has compensated me for my time in preparing this testimony. The opinions are perfectly3444 my own the FDA S. P. E. N. T. A. And on our Tv processes required tobacco product manufacturers to establish their products as appropriate for the protection of public3455 health in september the FDA authorized the marketing of3458 the first E. Cigarette in U. S. History and other products including a snow, which is a type of oral tobacco and and heated tobacco products.

I have also received the MRT P3469 authorizations and also about half of those products sold in the United States do have some kind of flavour3475 including tobacco flavor.3477 Under the current law, commonwealth residents cannot have access to them if cards smokers who are unable or unwilling to quit. I don't find alternative products acceptable and reasonable and a reasonable trying to cigarettes. They likely will continue smoking just as your parents did. And remember smokers die prematurely not because they consume nicotine, which is not a carcinogen, but because of how they consume it in a tobacco burning cigarette. The products authorized for marketing under these FDA processes have been determined to provide a beneficial off ramp for smoking adults without opening an on ramp3517 for youth. Use the FDA is review of flavors is focused on their attraction on youth and other non users of tobacco products. And to date the only flavor that has been authorized under3528 the Markey processes, methanol and the FDA is still reviewing those flavors and E cigarettes. H 2 to 37 is sound public policy. It leads to FDA scientists the responsibility for making science based determinations on the right balance between supporting tobacco, harm reduction for adult smokers while protecting youth from tobacco and nicotine addiction. Thank you for listening. I encourage you to read my written testimony that further explains these positions and include scientific references. And I'm happy to answer your questions.

[COMERFORD:] And dr Maddie, just for the record. You're getting paid for your testimony today by R. J. Reynolds.

[MADDEN:] I am

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[SUSAN LOVEJOY:] [HB4167] Thank you for this opportunity to address the committee. My name is3592 Susan Lovejoy and I'm a retired senior who lives in subsidized housing right now in Upton. I'm testifying on behalf of H4167. It's an amendment to an existing law that protects residents of public housing, but not residents who live in other types of subsidized housing. I would like to thank Representative Muradian3611 for his submitting this amendment. When I first moved in the middle house apartments, it's a privately owned hud subsidized building. I was told it was a no smoking policy here and that it was enforced. And I was really happy because I have asthma and I have recuperated from a heart attack that took required five stents. Imagine how surprised I was to wake up in the middle of the night looking a gagging on smoke that I had no idea was allowed in the building. Um, when I was told to the manager, she told me that the person that smoke was coming from had denied it repeatedly. So what I did was I kept a log From to 22 1114 and I recorded 49 instances in that nine month window.

At one point we even had the3654 police come because it was after hours, but by the time they got here, his apartment was aired out. So it's always after four PM. And on weekends then we're bombarded with the smoke. So I moved to another apartment within the building because of my allergies and I was happy there was no apartment above me. But then the sidewalk smokers started and they came out in groups and they would stand in front of the building and do their social smoking where they would be like, They could be up to 10 of them all their smoke went into3681 the apartments along the front of the building, into the windows, sucked3684 in through the air conditioners. So it was really upsetting. They would block the front awning, they would smoke in front of the doorways, so we couldn't leave the building or come in without smoke. Hunt told me that we were not protected under the current law because we're not considered public housing, which I didn't realize it was a big difference.

Management has been working on the issues, but they're3705 fighting a an uphill battle.3707 The fact remains those of us that live in other types of subsidized housing. We need the same protections that's afforded to those who live in public housing. We don't have3717 a lot of other affordable options either. Can't just run out and get any apartment we want, we need the amendment to pass, it will no longer be just a management policy. It3726 will instead fit the umbrella under the state law that protects people that are in public housing. So we would like to also protect the Children3734 and families who live in the same type of housing that we do. So I'd like to thank you for your time and consideration and just in protecting all the families in massachusetts from the dangers of secondhand3745 smoke for those who require subsidized housing outside of public housing and to remind you that the most vulnerable populations that live in these types of places, our Children, the disabled and seniors. And I'd like to thank you for your time

[COMERFORD:] Susan, I'm very grateful that you came forward to speak today and um and have taken on this as an advocate, a strong advocate have taken on this really critical issue of secondhand smoke and the safety of public supported housing for everyone in that housing. And I'm very, very grateful thinking that you're ringing the alarm bell. I do think it's an issue. Um and I'm grateful to look at it with my co chair. Yeah, thank you, Susan. It's really always um something that we cherish when residents um come on to tell their stories and there is certainly an irrational disconnect that you are bringing to light between what is technically considered public housing versus what is subsidized housing and it's incumbent upon us to really understand what the intent of the law was when we defined public housing and did not include subsidized housing. So thank you for bringing this to us and I wish you the best.
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[SEN TIMILTY:] [SB1534] [SB1535] You're warmly welcome Senator, thank you very much. Senator Comerford, Madam Chair jr Decker greatly appreciate this opportunity to appear before you today, virtually Of course, uh I'm here today to testify in support of two bills that I filed Senate Bill 1534 and Senate Bill 1535. Uh and with your permission Madam Chair, I will address uh Senate Bill 1534 1st. Thank you. Uh Senate Bill 1534 is an act to require the Department of Public Health to conduct a study of the health impacts of airplane3865 flights on the resident communities that are represented on the massachusetts Port Authority Community Advisory Committee. This is a refile from last session. Senate Bill 1534 will require the Commissioner of DPH to conduct a health annoys study on the overflight impact to residents that reside within the mass port. See a C jurisdiction at a minimum overhead flights cause extreme disruptions to daily life negatively impact sleep patterns and decrease individual productivity.

That is a baseline, for instance, both the constant barrage of noise and the public health risk posed by inequitable flight traffic patterns foisted upon the member communities by the FAA are3907 completely inexcusable. This legislation will establish a clear avenue to work towards alleviating3911 these deplorable conditions. Specifically, the goal of this study is to illustrate the threat to public health and provide concrete evidence to supplement the anecdotes that we hear on a daily basis. It is my belief that the study will further demonstrate the dire need for reduction in airplane traffic in these impacted3929 communities moreover, numerous academic studies have found evidence of wide raging harmful health effects as a direct by product of airplane overflight traffic.

For example, the MIT Partnership for Air Transportation, noise and emissions reduction in conjunction with Purdue University conducted a literature review on the topic and found the harmful manifestations to include cardiovascular issues, sleep disturbances and cognitive impairment in Children. Additionally, the Harvard School of Public Health and the BU School of Public Health found on average zip codes with higher volume and aircraft endure an increased cardiovascular hospital3971 admission rate per capita as such. These studies are merely a sample of the work that has been done to identify the way in which overwhelmingly overwhelming air traffic can prove detrimental to3983 local communities. In short, this bill, maintaining a DPH study will be the first step in promoting a concrete understanding madam, Chair of the public health crisis at hand. Would that I respectfully request your favorable support of this legislation and of course and more than happy to answer any questions whenever you would like to uh ask them up, Chair Decker and chair Comerford and of course members of the committee

And with that Madam Chair, I'd like to delve into briefly 1535. Thank you which is a resolve relative to the establishment of a joint oversight committee on personal protective equipment. I filed this bill in collaboration with the in a uh and specifically Ellen Mcguinness from ST Elizabeth Hospital where I incidentally was born many years ago. Uh Mr Mcguinness has testified, of course, earlier today for the M. And A. And I thank you very much mrs Mcguinness and the committee.4032 First this legislation will create a joint oversight committee to determine the current4036 personal protective equipment supplies on hand at acute care hospitals, non acute hospitals and state owned facilities to meet pre crisis standards. Moreover, the lack of PPE for front line health care workers has been an ongoing issue as we all know throughout the COVID-19 pandemic. In many cases, frontline workers like our dedicated nurses, must request new PP and sometimes I questioned as to whether they really needed in short, inadequate PP endangers our healthcare workers and their patients and of course their families.

Furthermore, nurses believe the problem of PPE supply is compounded by the lack of clarity4073 and transparency about what supplies are on hand at hospitals and facilities. Additionally, existing larger supply chain issues have exacerbated this acute problem. In order to better serve our nurses and our frontline workers in health care. We must first determine what our baseline is regarding PPE supplies. Then it is my belief that we must determine the amount of PPE needed in this commonwealth nurses want the commonwealth to be able to measure how far we are from meeting The science based standards that were in place pre COVID-19. Therefore, the legislature in my estimation should create a means where we can conduct a public accounting of where we are and to use that information if necessary for sound policy decisions about PPE. Going forward with that chair. Comerford and chair Decker I respectfully request a favorable report of Senate Bill 1534 and 1535. I look forward to collaborating with this out standing committee. And of course I'm more than happy to answer any questions. And thank you.

[COMERFORD:] Thank4134 you so much. Senator timilty for grateful for both of those bills proposals that you're bringing for our consideration today and grateful that Ellen was able to testify in advance of your testimony. It helps us to deepen the understanding for the imperative of the bill as you say.

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