 Waiting for Senator Lyons to introduce the vaping bill to us, but if she's not coming, we'll start with Jen, Harvey first and hopefully Senator Lyons will be here. Oh, Jen's here. Is that a general on the record? Yes. I'll attempt to make my mirror. Yeah. You don't have to spend much time with Jen. It's always the truth. That's it. So, it's the first time we're hearing about it. You recall we had this bill in this committee and Senator Lyons urged me strongly because she had already scheduled witnesses to relieve ourselves of the bill. We have jurisdiction over tobacco regulation and she assured me that we would get the bill back. And so, assuming we will, I'll start taking some testimony on this bill. Jen, can you, as opposed to walking through the bill, can you give us an overview of 60,000-point view of what this bill attempts to do, what this state of the law is in the country and maybe even in some other states at this point? I will do my best. Jennifer Harvey, Legislative Counsel. So, we are looking at S-288 and act relating to banning flavored tobacco products and e-liquids. As far as what the bill does, it has a number of findings in the first section with use of e-cigarettes and flavored e-cigarettes and regulation of menthol products. So under the federal law, the FDA has for a number of years now banned all flavored cigarettes except menthol. So they allow menthol and they allow traditional tobacco flavored cigarettes but no other flavors of cigarettes. For e-cigarettes or vaping products, the FDA has just recently announced it will be, actually I think the enforcement starts in May, but enforcing some pre-market approval authority that they have over flavored products, the sort of, up top of that is a ban on flavored cartridges and pods. Do you want me to? Yes. We have a very important witness who is joining us. Thank you very much. The chair is over here. And Cheryl is over here. Senator Lyons, welcome here. Thank you. Thank you. I was just waiting for my quorum to get formed because I had some people in the meeting. I know I should be with you. Oh, we are so well-deserved. We're just starting out expressing our interest in this bill as well as yours. And we don't worry little. I'm just trying to get a lay of the land, both in Vermont, nationally, what the bill's major goal is. I've already, from what Jen has said, I've already understood there's a difference between menthol and other flavors. I'm not curious as to why. But perhaps you can give us a one-on-one on this vaping situation. So I'll be very brief because I think that Jen will be able to walk through the bill with you. The overall goal is to reduce the sales of flavored e-cigarette and tobacco products in the States who reduce the accessibility of those products by kids. So we're trying to keep kids from becoming addicted to nicotine. And we have found that flavors are, by far, in fact, the things that draw kids into nicotine addiction. And so the findings that you will see in the bill will provide the basis for understanding how kids become addicted and the data that's available. We have some excellent resources in the state of Vermont at the University of Vermont, Dr. Andrea Balanti, who testified in our committee. And we also have the Youth Ritz Behavior Survey that has recently been done by our Department of Health indicating that kids will migrate if all flavors, except menthol, are eliminated. Kids migrate to menthol. And so our goal here is to eliminate all flavors, menthol being a mint flavor, eliminating that as well so it's not accessible to kids. The federal government and Jen can, we're putting together a table, a chart that indicates what the federal government does and does not do, but in 2009 the federal government banned flavors in many products, not all, except for menthol. And so menthol has become the go-to, I would say kids smoking flavors. What distinguishes menthol from all the flavors? Well, I think it's something that the tobacco company has promoted over time. The marketing of menthol has been pretty direct to specific groups. And because menthol, as you know, if you have a sore throat, you take a menthol lozenge and make your throat feel better. So menthol lets the heat and the chemicals of the cigarette or the e-cigarette feel better. So that, I think, it's really, it doesn't help with reducing addiction. There's no evidence of that. The FDA has not approved a cessation, because to my knowledge they've approved any cessation product at all that contains menthol. And in fact, none of the e-cigarette or cigarette companies have applied to have any of their products considered as cessation products. So it just seems arbitrary to have that particular flavor identified and sorted out. Especially when we see the results of the Youth Risk Behavior Survey or the results of other studies indicating that kids will migrate to menthol for the flavors are gone. So just a broad question. So we did several things last year to reduce you smoking. But because there are flavor products out there that are still an incentive for kids to skirt those laws, flavors in cigarettes or flavors in vaping or flavors in both? Yes, in both. Flavors generally. Yes. So there are flavored cigarettes out there right now? Menthol. Oh yeah, I think there's clove. I forgot what else. Just menthol. Oh that's right, clove has been dropped. So the federal government already banned flavored cigarettes? They banned flavors but not in every product. So there's some distinctions to be made. So if you're a kid you can access a flavor single use vape and then you discard it. Okay so the federal government did not ban the single use flavors. That's right. And what is the administration's position on this bill? The Department of Health, we've heard from the Department of Health, they're very positive. Very positive. I didn't go so far as to ask the commissioner to say he would support the bill but he very much supports I think the ban of all flavors. He indicated that in his testimony. And we will remember his testimony here in the last two years. Jewel and all the flavors there. He gave very strong testimony about that. So the issue, there are a number of frequently asked questions that we could go into and I thought I will save those questions until we have a broader group of people to talk with but the things that we did we have done are good steps forward including going to 21 but they don't solve the whole problem. As long as you have these flavors out in the market and available one way or another they will attract use and will fill addiction. The result will be that we'll have to put money into our health care system. The first finding I think in the bill indicates how much it costs each of us each year to pay for health care related to vaping or tobacco. Whether it's cardiovascular disease or whether it's lung disease. So the costs are astronomical. It's $759 a person a year. Each way out of our pockets. So can you describe what you think happened on the federal level if there was a desire to ban flavored tobacco products? Why distinguish between single-serve and a pack of? What is a single-serve cigarette? Electronics cigarette. So you buy a device Well you buy one device it's a single smoke. And then you put cartridges in? Yeah. No, it's in. It's held. There's a couple different things that are staying here and so I think it's really important for us to understand that there are many different ones. There are lots of different ones. We have pictures of those and maybe we should make sure that you get some of those. So there's various single-serve. I'm really just learning. They're not all single use. That's what I want to say. They're not all single use. So they're marked closed systems. So here there are some that have a whole lot of eliquid in them and so you can use those today, tomorrow, the next day until it runs out. Are those legal under federal law? Yes. Yeah, they're legal. And so as long as what we're trying to do is take the flavors out of those. Right, but are the flavors legal under federal law? The eliquids, yes. Yes. What is illegal under the flavor law? All the flavors. Not eliquids. I'm going to have to have Jen sort this out for you because I'm not reporting the bill yet but I'm going to tell you that we do have a table that will help us understand that. So it's not as simple as it sounds. It's not as simple as it sounds. No, it's more complicated than that. But the biggest loophole in the bill, in the FDA rules is having, allowing for you to go and purchase a single e-cigarette. Single use e-cigarette with flavors. Any flavor. That's a big loophole. So flavors are banned in other areas. So people, I'll wait for Jen to give me more of it. People actually go and buy one cigarette at a time? Well, I don't know how many they buy. Well, they buy a small good one. Okay. They buy a box full of them? No, and the problem is that's the insidious other aspect is environmentally these are made of metal and you don't know what that is. There's another bill we have in here to set up a recycling system for this cart. Right. Exactly. So let me ask a question. Absolutely. Jen, Ginny, do I understand correctly that you are saying that addiction at the moment costs Vermont taxpayers about $745 million? $348 million annually to treat tobacco costs. $348, because it's $759 a person. It ends up being more like $400 million. Well, it's only $7.2 million each year in Medicaid expenses. Yeah. What was that in Medicaid? Productivity losses. It's in our finance. So I think this is like one of the critical points of discussing this. We're not just talking about people's health. We're talking about the health to the budget as well. We're talking about two things that are avoidable and preventable. Okay. Addiction and burden on the budget. So what I'd like to do, Senator Clarkson, is Jen has to leave at 10.30 as well. So I'd like, I think maybe the most productive, of course, to get grounded is for Jen to walk us through the findings and we'll ask questions as we go. I'm sure there'll be a lot of questions. And the findings may not explicate the things that you're asking me about right now. And that is what does the FDA ban, what did they not ban in terms of the current product that's out on the market because it goes from the loophole to Okay, well that's what I actually want to get. And then the other piece you asked me is how did this happen? In this state alone, as I understand it, we've had an influx of $100,000, maybe $200,000 pushed back on this bill. So imagine what it's like at the federal level. Has any state done what we're trying to do in here? Massachusetts. Massachusetts has done this. And they've included menthol as well? Yes, they have. Okay. And other states are considering it and probably we're looking at what we're doing. Okay, good. Thank you. I'm sorry that I am not more helpful at this time, but don't you worry. I'm not worried at all. So cost is if they say the findings is per household, not per individual. So it's not 70. Oh, thank you. Yeah. So that. Thank you, Madam Chair. Okay, good. Thanks. Can you join us for 15 minutes? Jenna, you know what I'd like you to do if you can in the 15 minutes? Just pray and ground us in this issue. What's going on? What the bill tries to do? Where things are at this point, as opposed to any kind of words in the bill, because your time is valuable to us and we're just getting started. So. I think it would be a pleasure. Mr. Chair, for us to hear, does this bill mirror the Massachusetts bill or are there differences? That would be useful. And also recently, New Jersey also passed a labor ban. It had not, when I last looked, been signed by the governor. But I think it has been. It's been signed. But I think it did pass you to that in New Jersey. So, okay. So under the current state of things, as you know, in Vermont last year, you raised the smoking age to 21. And there are a number of flavored vaping products, e-cigarette products available. You need to be 21 to process them legally in the state. At the federal level, the federal government is effectively banning, going forward, one of the three categories of what we call your e-liquids, sort of the substance liquid or gel that goes into the e-cigarette. So the three types are the pods or cartridges, like the jewel ones that a lot of people are familiar with. Those are the ones that the federal government is targeting. The other two types are the open tank, which is where people can fill a reusable device with liquids. Sometimes that means filling them at a vape shop or getting a bottle of liquid and putting it into the device. And then the third is disposable, one-time use e-cigarettes that already have the flavor included in it. So the disposable ones and the open tank e-liquid ones, flavors would still be allowed in those at the federal level unless and until they take some action on those. So those are the ones that this bill, which bans the sale of any flavored e-liquid, e-cigarette, which we call tobacco substitute under the statutes, or tobacco product. That's what this bill would affect. And so if I could, Mr. Chair, what is the legal age to buy tobacco in Massachusetts? I'm going to consult with other graduates. 21. I believe right. So Massachusetts, a lot of their municipalities went to 21 before the state did. And in just looking at the Massachusetts language, so no person retailer or manufacturer shall sell it, distribute, cause to be sold, or distribute it, offer for sale any flavored tobacco product or tobacco product flavor enhancer in any retail establishment online or through any other means, any consumer in the Commonwealth, except there's an exception for a smoking bar of flavored tobacco products or tobacco product flavor enhancers for on-site consumption. So some sort of a smoke shot in the bar. The hookah bar. The hookah bar and the vellage. Images of it. They do allow the sale of flavored tobacco products for nicotine, electronic nicotine delivery systems, e-cigarettes, by online phone or other means, so that you just couldn't buy them in the store if you could get them online. Looks like for Massachusetts. You can buy them online? That's what the language appears to say. So we're just driving more online? A person may make a sale of flavored tobacco products as it applies to electronic nicotine delivery systems by online phone or other means for delivery to a consumer located. Oh, I'm sorry. To a consumer angry to the end, located in another state. The retailers can sell. You can come in and listen if you'd like. Yep. Thank you. Are you guys here for opiate? Yes. Here, come on over. These are all our anti-smoking, anti-vaping youth activists. Thank you for letting us. Excuse me. What's the right from on end? Richmond. Richmond. There. And does it include the closed containers? The Massachusetts? Yes. Massachusetts. So we have to look at their... Oh, that comes out. I'm sorry. I'm sorry. We have to look at their definition of flavored tobacco product. I was asking about the closed system. The closed system? Yes. So the ones you can buy in bulk or the ones you purchase as a closed tent? No, these are the ones that you have a reusable... Yeah. The device that you filled with the liquids. Right. You can buy that. The open tent. The product is the bulk purchase in a closed system. You can refill them from it. No, no. I understand. Yes. So I think... So before we go too deeply into the Massachusetts one, I think it's important that you understand what is in the bill in front of you, especially as potentially amended... The draft we're going to be looking at in a few minutes. So one of the changes that this bill would make to the existing law and going forward as well would be to eliminate the penalty for possession of tobacco products by minors. So currently there is a $25 penalty for a minor who is possessing a tobacco product, tobacco substitute or tobacco paraphernalia. This bill would eliminate that penalty for possession and actually eliminate the prohibition on possession. It would just apply the ban to minors purchasing or attempting to purchase. What page? Nine. So that's important. Can you explain the rationale to that decision? That was a request from the tobacco advocates. I would let them speak to you about their reasons, but that was language that the committee discussed on Friday, wanting to see in the next draft. Okay, would you discuss that last year as I recall? That was under big discussion last year. Right, it has been an ongoing discussion. I think that the short version of the argument is not to penalize addiction. You will hear so. People have become addicted to nicotine and are continuing to use it. There is concern from some about a penalty for that. The other piece that I want to bring to your attention, especially in light of reading to you some of the Massachusetts language, the prior version of the bill that was in the health and welfare committee was a ban on the selling, offering for sale, giving, providing, transporting, manufacturing or otherwise distributing flavored tobacco products, flavored e-liquids or flavored tobacco substitutes. I'm on page 17 and the review is crossed out. What this bill would do instead is limit, and this was again a decision from the committee on Friday, limit just to a prohibition on the retail sale. No person shall engage in the retail sale of any flavored tobacco product, flavored e-liquid for flavored tobacco substitutes. And there was discussion in the committee on Friday about people being able in particular to bring menthol cigarettes purchased in another state back to friends or family in Vermont and an interest in maintaining that opportunity. So they have now limited it to retail sale but not a prohibition on giving, providing, transporting, manufacturing or distributing. So the supply chain could be from out of state as gifts? As gifts or other, or gifts or sale, it's the retail sale that would be prohibited. So you couldn't go into a store and buy flavored products. But you could buy it from the truck around the car if there was a whole set up operation? Yeah. Potentially. There's a whole lot of markets out there. There are certainly enforcement provisions that may come into play but our existing statutes prohibit the retail sale of products without a tobacco license. So this would be consistent with keeping it in the vein of retail sale. Right. But it seems to be promoting a black market sale. I mean, really, that's what it that enables. Right there. I will. John. John. She is our target. She is not to weigh in on policy. Right. Or characterization. So those are the main things. So in that I wanted to focus you on as far as kind of what the moving pieces are at the moment. So the bill does give a number of findings. They're findings about youth use of e-cigarettes and flavored e-cigarettes and the potential impact of regulating menthol cigarettes which are still allowed under federal law. The, yeah. And then I made a number of conforming changes throughout both 7BSA chapter 40 and some other statutes. There is also language. This will be familiar to the chair at the end of the bill that would direct the Attorney General's office to report on whether and to what extent Vermont could legally restrict advertising and regulate the labels for e-cigarettes and other vaping related products. That's section eight. That's section eight. So just in terms of the disposable birth purchase and open tags has there been any testimony as to what's more prevalent in terms of sales in the state of Vermont? So my understanding is that currently the most popular form is the pods, the cartridges and pods that will be banned by enforcement action at the federal level. But I have I mean I've read news articles suggesting that people are starting that children or youth are starting to turn to the disposable single use ones that are still allowed and I don't know about the use of the open tags. I know that's happening. Can you describe what we need to show and tell what is a disposable vaping product of cigarette look like? This is where I would love to have the etiquette to give you more information because I'm not personally familiar with it. The last question I have before we have to leave is where is, as you can tell at this point the committee on the menthol issue? I think they are split. I don't think there is full consensus on the menthol issue. I think there are some members are actively want to include it and have concerns about including it in the ban. I'm trying to understand the difference why menthol is similar to that because the historical fact that there has been menthol cigarettes for ever in this country? I think it was a bit of a compromise at the federal level to retain menthol. They have been popular testimony that the Health and Welfare Committee heard and that the chair has a numbing effect. It suppresses the cough reflex and so it makes it more comfortable historically to smoke these or use these products. Has it been I'm going to just try historically smoking for adults cigarettes they have up until recently been allowed to be flavored and this new federal prohibition is on all flavors except for menthol? For cigarettes this has been since 2009 the ban on flavored cigarettes e-cigarettes weren't really a thing or not big anyway so I don't know that they reached federal attention and the federal government hadn't given itself deeming authority over e-cigarettes in order to regulate at that point. So menthol has been excluded from the ban on cigarettes at the federal level flavored cigarettes at the federal level for a little over 10 years my understanding. This new regulation on flavored e-cigarettes would prohibit all flavors except tobacco and menthol for the pods only. So you still got all flavors available in the other two types and it's tobacco and menthol that would be allowed by anybody who's one just consulting like you're whispering that's like a friend didn't help in that channel I know you got the deer and the headlights yeah so the the federal government is focusing on mint and fruit flavors and other flavors like that but not menthol and tobacco flavor and the disposables they're like a cigarette but they have liquid in them as opposed to tobacco so I don't know if you can say my understanding is that they tend to look more similar to a traditional cigarette sidewise you know those old Hollywood movies where the woman walks in and she has the long thing right that's it so it's got the liquid in it but the way these work is instead of burning tobacco like you do with a combustible cigarette a traditional cigarette it heats it uses a battery or other electronic mechanism to heat the liquid or gel turn it into a vapor aerosol the first time it burns it inhales into their lungs or otherwise absorbs into their tissues and generally has nicotine generally has nicotine does not always have nicotine the bill is not specific to those products that contain nicotine so the definition of eliquid is with or without nicotine it's more after the flavor than the nicotine in terms of I think it depends on the person I mean nicotine is addictive so once somebody has begun to use nicotine that may also be a target to start hopefully the advocates could give us a round out of a bunch of this as to what's going on here just getting our feet wet that's a huge additional waste issue so I have the order here is Andy playing here there's somebody in the hall someone here from MMR Matt McMahon MMR I think that Andrew had communicated with your staff person that he'd be available later this morning when he's tied up right now I'm sorry I know that he told me in the hall that he was trying to testify here this morning it's fine because I think it makes more sense here for the proponents first so Jennifer good morning I think my testimony may clear up some of the questions that you all had so Jennifer has the government relations director for the American Cancer Society Cancer Action Network so I have a PowerPoint but since you're a paper committee I have copies for everyone we are economic development paper I would remind us is a good Vermont product I'm fine with paper we need one for Cheryl so I think that's Denise and this is Cheryl oh Denise so we're here to talk about ending the sale of flavor tobacco the American Cancer Society Cancer Action Network supports ending the sale of all flavor products with no exception so what does that mean that's all flavors so including mint and menthol and all products e-cigarettes regardless of their nicotine content menthol, cigarettes and other tobacco products so you're that's a big statement we're going to have menthol cigarettes I mean I grew up with my mother so 50 years ago that's who you're talking about getting rid of menthol cigarettes I'll get there another tobacco product your dip your chew why now there was a question that came up flavor tobacco is a racing years of games Vermont has made in tobacco cessation and prevention I'll talk more about that as we look at the 2019 results of the Youth Risk Behavior Survey which are quite concerning I think it's important to remember that smoking remains the number one cause of preventable death in Vermont this year in the state we'll lose a thousand Vermonters to smoking and if smoking continues our life today will die prematurely from smoking related illnesses as the senator mentioned smoking is expensive costing Vermont taxpayers hundreds of millions of millions of dollars every year and most importantly flavors hook kids if you will indulge me for one minute I'd like to share a video from Counterbounds I think I have this sound on my computer this is the health department part of the health department youth campaign the chocolate ball in ours the virus just one minute long that's why I think it's the A.D.A. action against flavored tobacco or just let month's kids need your help to speak up and fight for their health come to a community event and talk with your key decision makers about the dangers of flavors tobacco products visit counterbalancept.com to learn more what these kids are doing here today kind of wanted to share that with you one to give you a sense of where the health department is at and to just to show that this is an issue that is about youth prevention and youth in our state obviously by the folks in the room today that matters to them so this is what we started to talk about with senator Lyons tobacco's price tag it's enormous smoking costs Vermont every year in medical expenses Vermont's Medicaid costs by smoking are nearly 88 million smoking cost productivity losses in Vermont are 233 million roughly and then the clarification of the point the senator made is Vermont taxpayers state and federal tax burden from smoking cost government expenditures is $759 per Vermont household and then I think it's also important to talk about this bill is important to big tobacco too and they spend almost $17 million a year pushing their products in Vermont as public health organizations why this is a critical bill to us is that we know that flavors hook kids flavors are nothing more than a marketing weapon used by the tobacco industry to lure kids into a lifetime of addiction tobacco flavors like cherry grape, cotton candy, gummy bear they're clearly not aimed at the established adult tobacco user years of tobacco industry own documents confer that the intended use of flavors is to target children altering tobacco products, ingredients and design like adding flavors can increase the products appeal by masking the harsh effects of tobacco making the nicotine inhalation easier and I'll talk about that a little bit more when we get to mental so it's no surprise that you say that flavors are the leading reason they use tobacco products and they perceive tobacco products as less harmful as a result of these kid enticing fun flavors next page flavors are also a big business they flooded the market as we talked about there's some confusion around the different types but there's lots of different brands, lots of different vehicles if you will for this but in terms of flavors there's currently more than 15,500 distinct flavors of tobacco available to consumers that those unique flavors have doubled in five years I didn't even know that there were 15,500 flavors period let alone of tobacco so I was surprised that last time I testified the flavors were 7,700 that was what we had available to us for a number and now since 2014 that has doubled to 15,000 I want to give you a sense of some of these flavors and you can make your own about who they're appealing to some of the more popular flavors gummy bear, mango birthday cake, s'mores creme brulee, cotton candy unicorn cube that's really attractive unicorn vomit is another popular one very very slushy apple pie, strawberry shortcake skittles and buttered alcohol so if I could so Mr. Chair this is what I was talking about and I do have pictures of all the products that I'm talking about I like the dots, I used to eat those dots I love the dots we need 11 C's but it looks like a cigarette holder and on the next slide so consequently this is the gummy bear slide more than 80% of teens who have ever used tobacco started with a flavored product more than 80% and then if you look at current use so that was ever used that number is from the CDC on the left hand side of your page 7 out of 10 middle school and high school students who currently used tobacco to use a flavored product the numbers are did the CDC do a breakout for them? I'm not sure if they all of those same group of kids if they did I do have statistics specifically related to them later and the next slide so let's talk about Vermont's impact the youth tobacco use rates are rising more than one in four kids now use some form of tobacco last time we talked to you it was a little less than one in four and now we're up to 28% for Vermont kids using some form of tobacco I want to dive specifically into the Vermont risk behavior survey so as you all know it's completed by high school students in Vermont every two years so as we've testified in your committees over the last couple of years we've had old data we had a sense that the data was going to be outdated and our fears unfortunately were confirmed so the first slide is ever tried any flavored tobacco product you'll see in 2017 that number was 21% in 2019 so this data was released in January of this year we're up to 27% so in high school you're seeing a 6% rise in the public health world a 6% rise is incredibly significant in a two year period if you look at the before the age of 13 in 2017 we had 10% of kids younger than 13 had tried a flavored product now we're up 5% to 15% of under 13 year olds have tried a flavored product and I do just want to call this is not in the slides but just looking closer at the youth risk behavior survey we are of course concerned about any substances that kids are using under age but this is on page 45 of the youth risk behavior survey tobacco alcohol marijuana used before age 13 if you look at all of the substances alcohol marijuana cigarettes and flavored tobacco this is substance used before the age of 18 flavor tobacco is by far the highest and although it's close to alcohol you'll see that over 10 year periods the other substances are all seeing decreases while flavor tobacco in our youngest children is seeing a market increase so it's just something that I wanted to point out the next slide talks about ever tried electronic vapor product that's the e-cigarette fancy word for e-cigarette so in 2017 we had 34% of high school students have tried an e-cigarette we have 50% so one out of every two of our high school students have tried an e-cigarette that's a 16% increase in just two years at the bottom you can see this is the breakout by year so right now we're at one and two but back in 2015 it was 30% so we had 30%, 34% and now we're up to 50% so we see the steady increase between male and female it's pretty much the same and then you'll see the grading that's 9th grade, 10th grade, 11th grade, 12th grade you'll see that similar curve as we go along the next one is white non-Hispanic and the other one is students of color and then heterosexual and LGBTQ and you'll notice for some of these slides that students of color and those who identify as LGBTQ have significantly higher rates of tobacco use going to the next slide this one's current e-cigarette use and I think this one is critical because these are kids who are actively using not have I ever tried it but are actively using an e-cigarette in 2017 we had 12% of kids now our reality is 26% so we have more than doubled our e-cigarette usage in two years that's astounding and if you again look at the breakout by year in 2015, we had 15% and then we went down we did better, we're at 12% then Juul came on the market in 2017 and we're skyrocketed to 26% you'll also notice by grade level 34% of our high school seniors are now currently using e-cigarettes on to the next slide this is I think one of the more disturbing slides this is the frequency of vaping use so in 2017 of the kids who were using an e-cigarette 37% were using it just one to two days a month if you look at 2019 now we have the complete opposite happening we have 31% of those kids using their e-cigarette every day I think it is testimony to the addictive power of these products and so if you look at 2020 and more days you are up to 40% 43% in 2019 use their e-cigarettes 20 and more days a month and if you look again at high school seniors we are almost at 50% who are using it 20 and more days a month next slide this is current tobacco product use so this takes into account cigarettes, cigars, smokeless tobacco e-cigarettes in 2017 we had 19% so slightly less than that one in four now we are at 20% so we have seen almost a 10% increase in kids using some form of tobacco so we are going the wrong direction in terms of public health and youth prevention and if you look specifically at high school seniors that number jumps even higher to 37% of high school seniors in Vermont now use some form of tobacco can you give us a notion of the cost of a jewel not a one time well we'd love to know the one time too what's the cost to the student actually do you know what the current cost of the jewel is I know before it was before our e-cigarette tax which was great because we know a way to reduce the youth initiation is to raise the price but it was $4.50 for one pod and I believe they come in four packs so but now the tax essentially doubled the price and then that doesn't include the actual device you'd buy the device, the battery part one time and then the pods plug in like a USB and you buy those some of you might know do any of you know the cost of a jewel I know that there's like starter kits that are like 50 bucks that come with pods and not 19 pods Tina just handed me this it says $20 but I don't know if that's in Vermont so this starter kit 50 total okay so the jewel device is 20 the jewel device is 20 and the pods now are 30 that's a lot of money for the kid unless they have a robust part time job or parents they can give them very healthy allowance anecdotally what we hear from kids too is that somebody has it and it becomes a social safety school and whoever has the jewel they meet and they all use it so it's the sharing of the device that's a public health challenge right there moving on to the next slide this is current cigarette use this is where we do have a glimmer of hope in Vermont in terms of tobacco use cigarette use is the one place that we saw a slight decrease which is great in 2017 high school use of cigarettes excuse me was 9% now in 2019 we're at 7% so we did see a decrease and this is why it is critically important to us and I'm going to move to this in a minute that menthol is included we do not want to see that progress get erased too and our fear is if you take every other flavor off the market that leave menthol cigarettes that we will now have kids move to menthol cigarettes and in two years the public health advocates will be back talking to you about remember that 7% number well we left menthol and now that has skyrocketed we've erased our cigarette so in terms of the current tobacco product use 28% of high school when you said 2019 what's the date of this survey for all of 2019 the survey was given to high school students in 2015 in the fall I think that's right and then it's calculated and released in January of the fall here so we just got the results and we won't have new results except for I will talk Senator Lyons mentioned Dr. Andrew Polanti she's at the UVM medical school and she is doing the pace study which will give us incrementally three month data it's not as large of a sample as all of Vermont high school kids but it's it's incrementally do you expect this 28% to go down in the next report I think it depends on what we do here in Vermont well last year you came and told us do all these things and we did and you were saying you're not going to see any reduction as a result of that I will get to that I think that's a very valid point I think that let's wait and see is a message that the tobacco industry pushes because as we wait and see kids keep using and kids keep getting addicted two years ago as the legislature started talking about T21 look what happened in two years that we debated this issue and thought it through rightfully so but at the same time the use rate doubled and so what I think is we did a fantastic job addressing the availability so and the accessibility the accessibility by like the age the availability by the internet bill and the price what we didn't do is address the enticability the demand why do kids want to try to get these products why do they want the products they want the products because they have these cool fun enticing flavors so our feeling is if you add this component of flavors it will kind of close the circle and make those three laws that we passed last year work even better so we've done some work we've done great work to address accessibility and availability but now we have to remove the incentive for kids to try to get these things in violation of our laws let me just ask though what's the historical data regarding the use of menthol products before vaping even came on the scene what percentage of menthol products were being consumed by youth as opposed to okay I can jump ahead to that just so you have a visual and we talked about let me just I will promise I'll get back to that in just one second this is what's happening around the country Massachusetts I think it's the next one this goes into all before you even get there just two current tobacco use slides you have one that was a point in time current use last winter which is the slide before the next one which it says current tobacco use where it actually goes down where we have the graph that's cigarette use oh that's just cigarette yes that's why I was saying menthol that's why I was talking about menthol got it got it got it so this is all tobacco yeah current tobacco use there includes cigarettes cigar smoke with tobacco cigarettes so the highlight of Massachusetts like top line 60,000 foot view is that it bans the sale of all flavored tobacco products including e-cigarettes, menthol, cigarette cigar, pipe and other loose tobacco those other bullet points go into some of the other things the bill does it was a very robust bill if I don't need to take the community's time to walk through that bill because it's doing some of the things that were not in terms of well I just let you read that you're marketing revenue collected increasing penalties but moving on to menthol so menthol I say is like the OG it was the original flavor long before cigarette companies started adding fruit candy and alcohol flavorings to cigarettes they were manipulating levels of menthol to addict new young smokers and do we know the date menthol was introduced I believe it I don't know the 30s a long time a long time but it's been in the mainstream of tobacco use for decades so in 2009 the tobacco control act outlawed flavored cigarettes but exempted menthol and Senator Frackin you asked this question that was in large part due why did they leave menthol on the market that was a large part due to very strong tobacco industry lobbying they were able to keep menthol and this is struggling because menthol makes cigarettes easier to smoke and harder to quit and I think I can give you a visual think a cough drop how your throat feels when you suck on a menthol cough drop it's that sensation of a cooling so menthol acts mask the taste of tobacco with a minty flavor it creates a cooling sensation in the throat reduces the harshness of cigarette smoke and suppresses coughing I do have this this is from the CDC and I just want to read one highlight tobacco companies add menthol to their cigarettes to make them seem less harsh and more appealing to new smokers and young people menthol and cigarettes likely leads people especially young people to experiment with smoking it could also increase a young person's risk of becoming dependent on nicotine compared to adults who smoke non menthol cigarettes adults who smoke menthol cigarettes make more attempts to quit and have a harder time quitting and so I just included the drug facts of a cough drop because it it shows that it's a cough suppressant and an oral and an aesthetic so it numbs the throat engines of the next slide our position is that big tobacco has seamlessly targeted communities of color for decades and young people knowing that youth who experience less negative physiological effects of smoking are more likely to continue smoking regularly the tobacco industry has spent decades manipulating its menthol brand specific cigarettes to appeal to youth and in particular African Americans black adults who smoke have the highest percentage of menthol cigarette use of any racial and ethnic group so if you look at the chart on this side this was between 2008 to 2010 and then 2012 to 2014 arguably both before the boom of e-cigarettes and so you can see here that black smokers have nearly double the rates and almost triple the rates of any other racial or ethnic group other high-risk groups include women those identified as LGBTQ people with lower economic educational levels and those with mental health issues and the next slide goes directly to your question Senator Brock more than half of youth ages 12 to 17 who smoke use menthol cigarettes that's 54% specifically and again that number was taken 2012 to 2014 so before the boom of jewel which came on the market in 2017 and you can see that 12 to 17 year olds are by far the age that is the largest consumer of menthol cigarettes 50 plus is 33% and it goes up from there with the second group being 18 to 25 at 50% that's a percentage of current smokers and again my question was really aimed at the larger population as a whole as to how has there been any change over time pre-jewel in consumption of menthol cigarettes by youth what percentage of youth smoke menthol cigarettes as opposed to smoke in general and did that change over time well I think it's 54% of youth who smoke menthol cigarettes of youth who smoke menthol cigarettes does I answer your question and for African American it's higher 7 out of 10 Senator Brock are you trying to distinguish between smoking tobacco cigarettes and vaping I'm trying actually to distinguish what percentage of kids smoke menthol so we know right now Vermont the percentage of kids who smoke is 7% so of that in Vermont specifically we can look further down but that's obviously change over time too because that's going down well this is the pay study so this was Dr. Andrew Bollanti study just done in 2019 this is among Vermonters age 12 to 25 27% of those youth who smoke use menthol or mint cigarettes 56% of those who use e-cigarettes use menthol or mint these are Vermonters but over time I just have that 2019 data the most recent data so but to your point also in terms of the discrepancies for black youth who smoke that number rises to 7 out of 10 and the reason for that last figure which 2756% what do you attribute the doubling of menthol and mint cigarette menthol and mint use in an e-cigarette versus a cigarette I think more kids smoke e-cigarettes than smoke cigarettes but then also the next slide will show you most kids smoke jewel and that doesn't answer the question it says among youth 12 to 25 those who use cigarettes only 27% use menthol and mint but those who use e-cigarettes 56% use menthol and mint why is there a doubling in the usage of menthol and mint in an e-cigarette versus a cigarette I think because two things more kids are using e-cigarettes and jewel voluntarily pull its flavors from the market but left mint and menthol so you could get flavors in jewel online but then Vermont passed the law last year but you could still go into a brick and mortar store and get mint and menthol jewel so I think that's why in Vermont it's availability a kid can go into a store and I can't get mango in the store anymore but I can get mint and menthol still but you could also get mint and menthol in a cigarette still but I think that goes to the more kids use e-cigarettes e-cigarettes are definitely more popular than cigarettes are easier to hide but you can't buy them anymore and a kid can't buy them anymore well they never could before you could buy them 18 but 21 and above I mean they aren't actually able to go in and buy anything right now correct but yeah they're still getting them somehow there's some of that supply line you know we have three kids in the room maybe we just maybe chairs just hold the three of you and find out how our kids get them and how are they affording these products just to identify yourself for the record I'm Ian from Richford I know that a lot of the kids in our school either get them from their parents or they have other friends who have from the stores or they have other friends which is a lot you had so many to say I know most of you Ryan's lazy from Richford I know kids mostly get them from their parents or an adult that is old enough to buy but are they stealing them from adults I mean adults know that it's illegal for kids to have them some adults might just buy them they're trash true they had a kid on our field trip who brought a jewel because their mom bought it for them for the field trip and the mom gave it to the child but while knowing that they're not supposed to have it and how are they affording I mean when you say it's 50 bucks to get a starter kit how are kids affording some kids can get the jewels from jobs that cannot money to buy them the next slide parents really should be licensing parents Senator Brack this may answer your question too this is what I was talking about in terms of of jewel so mid and middle makes up the largest majority of jewel sales with estimates as high as 80% the evidence indicates that if any e-cigarette flavors are left on the market kids will switch from one to the other well in November of 2018 jewel removed its other flavors I think mango was the most popular at one point from stores in response mango was easily replaced with mint and menthol at the same time 2018 youth use of fruit and flavors fell while youth use of mint and menthol increased by 50% so you can see that mint and menthol went from 51% up to almost 64% while fruit went from 75 down to 65 the FDA warns that menthol harms public health but has failed to take action since 2009 the FDA has commissioned two separate reports which conclude that the removal of menthol cigarettes from the marketplace would benefit public health and save thousands of lives almost one third of those lives would be black lives another study looked at if menthol cigarettes were removed from the market 39% of all menthol smokers 45% of black menthol smokers and nearly 65% of young menthol smokers report they would try to quit the FDA has failed to take action on menthol which is why we are appealing to states to take action so I wanted to go through briefly what the FDA guidance released in January 2020 does so what it removed from the market it removed flavored clothes pod systems what does that mean the best example is jewel but it left jewel version of menthol on the market so it gets rid of the mango and the cucumber and the mint but it leaves menthol what can say on the market all menthol products including flavored e-cigarette menthol and then flavored tobacco e-liquids in refillable tank based systems so those are cotton mods that's what you see at the bottom the black one you put the e-liquid in there all of those 15,000 flavors can stay on the market and then disposable products which is the biggest loophole right now and I did want to pass this out for reading your reading pleasure this is a recent New York Times article in January 30th and this talks about there is one for Denise as well this is how teams have already figured out there are 10 steps ahead of us so we're still talking about jewel and trying to address jewel because jewel is what most kids use well in light of the FDA ban that targets jewel kids have moved to disposable so now jewel's sold last year some of the things that kids are using now are called puff bars and these are the disposals they look just like jewel so it's a closed pod system but there's no pod you just use it once and you throw it out but those because of what the FDA's rules say all the flavors can stay on there so kids have just there's just one quote that's pretty telling it's a teacher that they interviewed for this article and says we're still back on jewel we're having school administrators approach to policing team vaping she says her students tell her jewel's sold yesterday we've moved on she concluded teams are very savvy and if they're addicted they're going to continue they're going to do what it takes to continue the habit that isn't helping in their lives so the article goes on to talk about how the FDA action doesn't really do much to address the youth vaping and make it leverage in general may I just ask our students because I know you have room 11 at 11 how do you notice the behavior of your friends who have gotten hooked because clearly you guys must have friends who use this a lot what do you notice is the behavior difference they're always talking about it and they're always like are they more agitated because we heard in testimony last year that they were much they got angry quicker they were more agitated you guys noticed any of that so the next couple of slides are just visual pictures because I know we were trying to talk and describe about these so these are devices sold with empty refillable pods that are exempt after jewel sworn in smoke with the most popular e-sacred devices and then the next one disposable products that are exempt so that's the puff bar the mango mojo so which one of these is the puff bar next page oh not any of these well because those are refillable okay so refillable pods are still able to be on the market so if you have a refillable pod if you smoke that for a longer period of time than a disposable puff bar you can get like multiple cigarettes out of those you just refill it when the e-liquid runs out you fill it back up the co-op has not got it in the bulk section yet or it won't really that's sort of what you could buy is you can buy a bulk tank and keep retailing it and then the next page is those are the disposable products that are now becoming really popular amongst kids the puff bar, the mango mojo stick, posh, fog how much so this stick here you get three of them it says how much is that how much is that posh these are all, these are just so new, we're like chasing our tails to try to keep up with as we pass laws but these also these also heat up a liquid inside but it's just one cigarettes worth or something similar to that so you can take a couple of puffs and then in the afternoon you can take a couple more puffs out of that and okay I guess it would, I mean it depends on how much how quickly you go through it and then the next page just shows you the packaging these are the e-liquids that you can refill the devices with fruit pop pebbles, donuts iHeart popcorn, drip and vape ice cream cake and then just my last slide is we ask you not to erase the progress that has been made. Cigarette use is the only area in Vermont that in terms of improvement that we see, we cannot leave any flavors on the market including menthol cigarettes we believe we should place blame work belongs on the industry selling addiction the evidence shows that the committee addressed this we don't want users penalized it's an addiction, the tobacco industry has marketed to kids has made it cool amongst kids they're addicted at high rates and we don't believe that trying to come off that addiction assessing fines is appropriate or effective but it sounds like the senate health and welfare committee removed the penalty for kids so the question I have and go back a long time because many years ago I represented the cancer long and hard on these issues we're dealing mostly with second hand smoke at that point and you used the tobacco but there was a a man, some of you may have known his name is Bruce Cunningham yes he was a gat fly kind of person who really came down hard on the state in terms of them doing compliance testing sales to minors etc you used the term chasing our tail I'm starting to get the feeling no matter what we do there will be a new way or product for the tobacco industry to hook kids and I'm wondering what your organization feels or has done to promote compliance to go after people who are selling the products to kids illegally for that process and he kept parking upon and one of those things he was a lone voice in the wilderness but he did have a ton of statistics that showed that the state was doing very well in terms of enforcing well I think one thing we can do to not chase our tails is take away why kids want this and kids want it because if these things didn't taste good if you remove the coal factor there's they're just not going to be using it at the same degree if your option is to vape tobacco flavor or a cigarette which you can't do like kids are vaping in class because they can get rid of it I would get away with it when the teacher's back is turned around the bus can't really do that with a cigarette I think we'll see a huge drop in kids using tobacco if we and there won't I mean I'm sure big tobacco is inventive and they'll always try to come up with the next product but I think 80% of kids who use tobacco use a flavored product if you don't have the flavors maybe we won't need to chase our tails because there'll be less kids using it there'll be something else so we have three kids what's the biggest thing we could do to prevent addiction on tobacco I think we could do to prevent addiction because like some flavors might bring back some of the salvage from when they were a child like if they just vaping tobacco then they're not going to really like it what else if it's good it's more of a drive to go for it like mango it's sweet it's tasty it's fruit people are going to want it if the flavors are gone and they're trying to just vape tobacco tobacco is nasty people won't like it anything else I know some of my friends really like no vape ones take away all the flavors and our fear too is what is mint and what is menthol that will just vape tobacco rebranding all of their mint flavors as menthol because menthol is allowed to stay on the market this committee is charged with overseeing tobacco regulation and I'd like to at some points as we go through just to get into the compliance section we should hear from Patrick where is that if you want to send a health and welfare counseling from DLC and he talked about compliance rates I have a couple other handouts I don't need to talk anymore and there is one for but the commissioner would be the compliance person and would department health also be miss most of Patrick's charge with compliance okay so so one for yours truly anybody here you have that one so Andy's MMOR we just saw Andy this is the last one this is just a few more specific guidance on where the American cancer studies we're ready for you if you're ready for us oh jeez ready for him too thank you very much is he ready to testify when Andy's gone when Denise calls I just created those I can give those to you email those to me right now all that stuff it's great I'm going to go to get the water I think one is to four we're going to see him it's very awesome oh oh thank you is there one for you one for I think you already have this here you go Denise I've got a copy of it I I I emailed your clerk so I think you got it but thank you Jerry Andrew McLean I'm here with MMOR I represent well formally Reynolds tobacco that became Reynolds American now it's British American tobacco all the same in the discussion here we manufacture and sell electronic cigarette called views and on the menthol cigarettes new ports my issue last year on S86 we came in here and supported the raise of the smoking H21 I don't know 47 came to this committee about raising the tax on the vaping products or not but wait a minute it wasn't finance and our position on that was we were agreeable to raise the tax but not all the way up to the 92% because of some distinction between combustible tobacco and vaping with regard to S288 is that this primarily this bill impacts adults the FDA as you see there has banned flavored vaping products and they specifically targeted those products that are designed primarily look at the kits the cartridges if you look at on that the piece I sent you it's the one two three third paragraph on the first page as we work to combat the troubling epidemic of cigarette use the enforcement policy we're issuing today confirms our commitment to dramatically limit children's access to flavored cigarette products that we know are appealing to them so-called cartridge based products that are both easy to use and easily conceivable and if you look at also in the packet the 2019 risk, youth risk survey looked about what type of vapor product used by high school students dual rechargeable pods 80% so when we had the discussion last year with AS86 it was dual, dual, dual it was everything about dual and it was the fact you get these things out it was a dramatic spike and so let's raise and the advocates all indicated let's raise the age to 21 because that's the most important thing that you can do to get this out of the hands of kids that bill went into effect in September of 2019 September 1, 2019 none of the statistics that are given to you about rise raise the impacts of tobacco people using tobacco how this works that was all calculated before this bill went into effect it's only been in effect for four months I would argue that if that was the most important thing to do look at that and see how it works the FDA on top of that now has indicated a process where the products that were indicated as being the problem flavored, dual and other conceivable products that are easy discreet etc it's done and so my issue now is what's left is adults the other thing I would say is last year when age 47 was discussed I believe it was the cancer society indicated made a calculation that said for every 10% rise in the price of the product usage decreases 6.5% that built that tax went into effect on vapor products in July so 100% increase you increase, you double the price 100% increase means according to those statistics a 65% reduction in the usage so I think last year you made two powerful statements with regard to youth usage of tobacco so right now what we're left with is adults and I would make the argument that banning menthol cigarettes we've looked at bans and bans don't work bans just don't work and I can give you three which I think are pretty good examples of the first is marijuana or cannabis alright despite the fact that in the youth during the youth risk survey 27% from 2019 from my youth risk survey 27% of high school students tried flavored tobacco product 40% of high school students tried marijuana 55% of high school students tried alcohol so we're not looking to ban marijuana in fact we're looking to unban marijuana we're looking to legalize marijuana for public health and safety reasons because you'll bring the product into the area of commerce and for tax reasons so that you're recognizing financial benefit for it my anecdotal experience is that during the ban 40-50% of adults smoke marijuana I mean a lot so that ban did not work I'm talking to people in my colleagues right that ban didn't work prohibition didn't work 100 years ago the 100-year anniversary of prohibition was January it was January didn't work you know it led to a rise in organized crime you know financially fueled the mafia etc and now today you look at in New York City I saw a stat the other day I'm going to try to get it verified 87% of the cigarettes sold in New York City are illicit they do not have a state stamp 87% I saw an article yesterday in the New York Post that talked about 60% of the bodegas in New York City sell unnon state tax stamped cigarettes adults are going to smoke menfall you know Franklin County you can go to not very far you can go to New York and buy them Rowland County same thing Windsor, Wyndham counties you can go to New York New Hampshire is not very far adults will smoke it's just how they get it where they get it possibly the quality of the product that they get so I guess I'd be glad to answer questions I'd leave two different I'd leave two thoughts in your mind for adults now if this bill 288 passes you're going to be able to smoke a joint but not be able to smoke a new board and you know as an adult kids I agree I think you've done a lot with kids and then the other thing is that Massachusetts passed a vaping bill in the height of the vaping epidemic and that vaping epidemic has been basically found by the CDC and the FDA now to be caused by vaping vitamin E acetate principally from illicit products principally cannabis marijuana and other nicotine issues and wouldn't it be ironic that your response to this you know this epidemic or this illness outbreak would be to enact a ban which would therefore force adults to find these products in illicit areas that would cause the same health problems that started the problem to begin with I just think that's not a great reaction I also heard a couple of other things I just want to comment about I heard a couple of things mentioned today New Jersey passed a flavor ban but that flavor ban did not include menthol New York is pulling back from a menthol ban I understand Maine had a discussion about this topic yesterday and pulled back from the menthol those aren't you that's the information that I've gotten so again I think that there are a bunch of kids and I think age 21 has I think has a potential to change that you don't see a lot of high school seniors who are 21 and that was said by the advocates last year is the most important thing you can do to deal with this you've dealt with that issue the regime has been in effect for four months and now what you're doing in response you've seen it over and over again adults will be able to get the product they'll be able to and I think from the economic from the economic activity or economic development aspect of your role here the people that are going to be here with us are going to be the stores that sell and that sort of thing I just think that this isn't necessary I think doing the Parts S88 that strengthens the protections against youth fine just think that except for relative to adults I don't think you need to so I guess my overarching question for you is seems like this is all about med ball yeah okay I might not say 100% yes you're right absolutely I mean these new design products with all the flavors that are loopholes from the federal law that talk about individual things that's not our concern we don't sell them our concern is adults when views you're not concerned that those kind of vaping products as long as mental cigarettes continue give you the small percentage here to get their products we don't we don't sell them we don't have that is not our concern I just say that when views was the leading seller of vaping products not that long ago three years ago or so the youth issue was nowhere near as pronounced as it was as when jewel got into the game and that issue was you know and so we think that I just Reynolds positions Reynolds sells products to adults Reynolds sells menthol vaping products to adults that are trying to transition from cigarettes into that marketplace but our primary concern is menthol cigarettes absolutely any other questions we have one more witness by phone thank you thank you Andy welcome Kim Elliott yes hi Mr. Elliott this is Denise Gunn-Brun the committee assistant for the senate committee in economic development and we're calling you per Brendan Cosgrove and you're on the record great thank you this is Michael Sorato chair of the committee when you want to introduce and we want to just let him yeah Ken Elliott is the director of government affairs for the vapor technology association Ken you can correct the title there but Ken is an expert on this issue and I'm going to let him take over from here Mr. Chairman okay we have about 15 minutes or there were about so why don't you get started thank you Mr. Chairman and members of the committee my name is Ken Elliott I represent the vapor technology association we're the association retail shop owners manufacturers distributors we are not big tobacco companies and we don't have the biggest player in this industry electronic cigarette industry we have a lot of mom and pop and small business I want to start by talking about the safety v. Cigarettes we know that they're 95% safer than traditional combustible cigarettes we know this from the United Kingdom's Royal College of Physicians who's conducted a thorough analysis of the data available to make this determination and in fact in the United States the 3.6 million vapors 54% have fully given up smoking in an October of 2019 they reaffirmed their position one that they stated a number of times over the last few years saying that the risks associated with long-term vaping are unlikely to exceed 5% of the harm from smoking tobacco I'll say that there's been some concern about the illnesses associated with some vaping products from last summer and fall there are a number of publicities that accurately reported the cause of the oil which had been used in illegal PHD cartridges with a cutting agent to be used in an electronic cigarette a product that was never designed to be used for those sort of liquids these entities included the New York Department of Health and the New England Journal of Medicine and in early January of this year the CDC made a definitive statement on the safety of end products or electronic hygiene delivery systems and the illnesses linked to vitamin D activate oil now the BPA is committed to preventing use access to e-ciderates and we favor meaningful reforms designed to target access to these products as a result it's an important thing to do to examine the real issues around use usage the most recent national youth tobacco survey conducted by the CDC provides some insight into youth behaviors in that 2019 survey 2.4% of those surveys said that flavors were the reason they tried to product in other words 80% of the respondents said that something other than the neighbors led them to try and e-figure it and these reasons range from curiosity to peer pressure and in addition to that we know that the FDA is determining that 86% of the use usage is driven through social sources meaning that a friend or a relative provides access to the device that they tried but we don't have to rely on national data in fact Vermont has the data of their own that we had a survey done by the public health department that they do every two years and they just publish their own use risk survey the data in this reveals an interesting insight 10% of the respondents who tried to e-figure it in Vermont in the last 30 days that was 10% of the total subjects 10% of those who tried an e-figure it said that they did so due to the availability of flavored products that means 90% of the kids who tried an electronic cigarette in Vermont did so for some other reasons and that can be found on page 59 of that report in addition we know that 6% of those underage who tried the product and it was 18 at the time the purchase date was 18 6% of those bought the product in a really retail location and 3% bought it online so for 91% of you who tried the product received it through some other source and finally 8% of respondents stated that they use an open system meaning that 92% use some other type of product a closed system device primarily leading 8% to try the open system which are primarily used by bills and I know that there's been some new concern about disposable products but that survey also shows that only 2% of the 26% of kids who tried a flavored product did so using a disposable product so this legislation is targeting really good products that are used by bills and I'll take it one step further last year dual pulled all their flavor products from the market not the most popular product in the marketplace and on February 6th the FDA banned all five banned all five based flavored products from the market that's the date that they went into effect leaving only flavored products for open systems primarily so I'd like to suggest that there's really no need for a flavored van in Vermont the state's youth risk behavior survey makes it clear that youth are not a product by flavors they accept it through friends and family and they use pod based systems where the flavors are already banned in addition just recently testimony given to the Senate Health and Welfare committee by the Vermont Department of Health and Control Chief revealed that in a five month period since the legal age to purchase McTeen's product was raised to 21 science rates have risen from 90% to 95% and we stated that that was he's never seen a single rise of 5% that is the largest he had ever seen was 2% the unintended consequences of the proposed legislation from target adults who are speaking in alternative public figure out and really just pushing back for the more harmful product I'm saying we don't need the flavor ban but if you want to act for forms that are really designed in targeting this issue there are other things that can be done we can implement strict marketing standards designed to prevent McTeen products from being marketed or attracted to youth that would be banning print advertising to adult only publications ban advertising and sponsorships and big outdoor venues we can prevent the use of terms like candy candy variants and those sorts of things we can prevent the use of terms like cake or cake variants we can remove all cartoons and all kid friendly packaging from these products and that is something that should be done in addition we would recommend point of sale age verification so that an ID is checked and the validity of the ID is checked in a retail location there should be running times in brick and mortar stores we should end bulk sales to an individual who's not licensed to sell these products to allowing somebody to buy a bunch and then turn around and sell it there should be split bonds and wait if you're selling a product without a tobacco license so I'll pause there I know I've thrown a lot at you and take any questions that members of the committee might have thank you Mr. Chairman so for adults are you suggesting that there's a great need to keep all these flavors available to them or are you focused mostly on mint and menthol over 90% of adults who use an electronic cigarette as an alternative to a traditional cigarette use some flavored products other than tobacco or menthol so what we're saying is keep responsible flavors available for all adults and adults overwhelmingly use these open system products I hate to single one out but Brendan Costa Road sitting there in the room eating a cigarette product and he uses a flavored product other than tobacco or menthol other than tobacco or menthol so there are flavored products that don't have tobacco or nicotine in them or they all have nicotine there are both there are flavored products for open systems they contain nicotine that are some other flavor than tobacco or menthol other than tobacco and menthol, they contain no nicotine. In fact, there are open system users that who wants to wean off nicotine will start with a 3% nicotine content, wean down to 1%, and then because smoking is such a habitual thing, they will bake zero nicotine content flavored products just because of the habit of the hand-to-mouth piece of smoking. But you say open system, can you describe that to me? Yes, sir, so there are two systems, the two types of systems that dominate the market. There's the closed system, which you know of as a jewel, where there is a divide with a pod that's manufactured by that company, and only that pod is to be used with that divide, and the pods are not designed to be refilled in any way, once the pod is empty, it's disposed of. Then there are the bigger devices that you've seen, sometimes they're called mods, there's the bigger open systems that have a tank on them, in which you go by the liquid of your choice and put it in that fight and base it. So those are the two predominant systems out there. There is a small, very small market of disposable products that are more similar to the pod-based products, the two kinds of products that dominate the market are closed systems like a jewel, and then the open systems. And the open systems are what I was referring to earlier, the overwhelming majority of use of those products is by itself. Like in the Merlot survey, 92% of kids use a closed system, not an open system. And that's what you surmise is the reason why the federal government banned flavors but only applied those to closed systems. Does that want them? Yes, sir, that was exactly the reason it was to leave flavors available for adults, the systems that adults use. Any other questions? Appreciate your time, thank you very much. Thank you very much, I appreciate the opportunity to do this by phone, I really do, thank you very much. Do you have a copy of your testimony that you can get to us? Yes, sir, I'll send it to Brenda if he can provide it to you. Yeah, it would be great if it could be emailed to us. Thank you. Thanks. Yeah, I'll send it to Brenda if he can send it over to you. Great, thanks. Thank you. Thank you. Yeah, bye-bye. Okay, so we will be in contact with the Health and Welfare Committee to see where they're going with this and whether or not we need to formally take this bill into our committee, and if we do, we'll be more testimony. But, we're done a little early, which is good, and I have a meeting in about five minutes, I think. So, thank you very much. You're welcome. We wanted to come by, that's what you have to ask for. Let's go through what we've delivered.