Good evening. I'm calling >> Recording in progress. >> Good evening. I'm calling to order the Yarmouth Board of Health meeting for January 5th, 2026. Our first meeting of the new year. This is a uh in-person meeting, but it is also available by
YouTube on the town um channel as well as by Zoom and the the instructions for accessing those are on the town website. I'd like to call the attendance first. I'm Mary Craig, vice chair. I'm sitting in for Hillbosski, the chair this
evening. Eric, >> present. >> Larry, >> present. >> Thank you. So, we do have a quorum. I'm going to move on to public comment. This is section is for people who wish to comment on something that is not on the agenda tonight. We will not be
responding to the comments, but you're welcome to make them. >> I do have something, Mary. Um, the original Zoom link from 2025 has expired. The new Zoom link is on the town website and on our health website.
So for the audience looking in there, they're trying to get in and it says expired that we do have a new Zoom link. So >> And is that on the agenda that was >> uh No, we just got it this afternoon. So, but it is already updated on our website. >> Okay. So, >> and it will be on the agenda
>> from Yeah. moving forward. Yes, it will be. >> Thank you. Any other comments for issues that are not on our agenda for this evening? >> Looks like we have one hand up. Is there a hand up out there? >> Yeah. >> Um,
>> yeah. I apologize. You It's on the agenda, so I guess I can wait till then to comment or do I comment now about banning cratom? >> Yes, I'd like you to wait until it's on the agenda, please. >> Okay, very good. I apologize for that. >> That's no problem. Thank you.
>> Y and now we will move on to item number four, which is theratom discussion. This is probably the third time that we have discussed it so far. Um, pretty much we
agreed last time at the last meeting um that we would look at u regulation of this um substance. Um, I'm going to ask Larry in a few minutes to kind of um um
do a summary of what our discussion was, but um in the meantime, I just want to mention that I had asked we pursue the option of putting it into an already existing policy that we had, I thought, adopted in 2017 on canabonoids and
synthetic canabonoids. When Barry researched that, he found that that policy had never been sent forward through the proper channels. So, it was in in effect not in effect. So, that's why that policy is included in your
packet for this evening. Um, it will give us the opportunity um to review it and to um and to get it started on the official process. So, it will indeed become a board of health regulation. So, um, Larry, would you like to give us
a little >> I just like to give a little summary of the information that I found that was credable. Um, because I was totally unfamiliar with the substance until I did a little bit of research and then we we discussed it here. Um so I'll just go
over what I found is uh cratto is a psychoactive substance derived from the leaves of mraagna species tree a topical evergreen a topical a tropical evergreen in the coffee family native to Southeast Asia. It is unique because it produces
both a stimulant and opioid like effect depending on the dosage. At low doses, cratto acts as a stimulant leading to an increased energy, alertness, and talkiveness. At high doses, it has an opioid like seditive effects such as pain relief, relaxation,
and euphoria. [snorts] The primary active chemical compounds, alkyoids, and are metrogenine and seven hydroxygenine, which primarily interact with brains opioid receptors.
Legal status. It's not currently a controlled substance, though the DEA has listed it as a drug of concern, and its legal status varies by state and locality. The FDA has issued warnings against its use due to potential health risks, including addiction, liver
toxicity, and seizures. The US Food and Drug Administration has warned people not to use because of possible harm it may cause. Known side effects include weight loss, dry mouth, nausea, vomiting, constipation, liver damage,
muscle um pain, high blood pressure. Kratto also affects the mind and nervous system causes dizziness, drowsiness, hallucinations, delusions, depression, trouble breathing, confusion, tremors, and seizures. That would all be dose related. Incidentally, poison control
center in the US received more than 3400 uh reports about use of crayon from 2014 to 2019. These include reports these report these include reports or include death. Nearly all reports of death though were also involved with other
drugs or substances that may have been harmful. Tom also affects babies during pregnancy. Um, in that it can induce opioid dependency in in a newborn, same as opioid uh would in in
pregnant mothers. Great products because they are currently not controlled by any established quality control organization have been found to contain heavy metals such as lead and harmful germs such as salmonella. The FDA has linked more than
35 deaths to salmonella tainted craton. So that was our main concern I think when we discussed it was the fact that it's really not controlled or the uh quality control is uh uh non-existent um currently. And our big concern was
whatever's out there over the counter is uh produced totally uh uh you know unregulated and that was uh considering the um potential side effects that was at least I think the the concern of the
uh our our board. >> Right. Right. >> So I I do have a >> right >> I do have a drug fact sheet from the DEA but it's it's readily available uh if you Google it. Uh it's called a drug fact uh fact sheet cratom uh and it's uh
published by the department of justice uh uh justice drug enforcement administration and that's you could google that >> and is there a date on that? Uh the date on this uh let's see. No, I don't have a date. Uh AP Well, I've got April 20th.
Yes, it was April 20th. >> 2020. >> 2020. April 2020. Yes. >> Yeah. This >> So that was the other issue. You know, all this data that I could find was not current and and it's much more
prevalent. The use of it is much more prevalent since. So, um, the data I found was dated. So, it's very possible that that we're even these, uh, statistics could be even more concerning if they were brought up to date.
>> And there's been no clinically uh, controlled studies. >> There hasn't been >> and probably um would not be um, readily done because it is a natural product if you're talking about just a leaf. So, it's not something that can be licensed
or >> Yeah. It's not proprietary. >> Yeah. >> Yeah. So, there's no company that could patent a a a product, >> right? >> So, that's why it's unlikely that they'll there'll ever really be a a lot of research done unless it's done independently, right,
>> by a university or or or the government >> or if the um association um theraton association that's out there if if they can privately fund it. >> Yeah. if we could depend on that source of information. Yes.
>> Right. Right. Um Eric, do you want to add anything to that? We have um also in our packet um a proposed um regulation that um Hillard
had put together. Um did you all have a chance have a chance to look at that? Any comments on that? I I read through that and I propose that we accept that. >> Well, um >> we're we're not doing any votes tonight tonight. It's just a discussion.
>> Not entertaining a motion for that right now. Um I would like to add a couple of things. I'd like to add um the definition for consumption on the first page because um it it does talk about it under the unregulated novel intoxicating
products but it doesn't talk about it in terms of the entire regulation. So I just put in that definition and >> [snorts] >> I I just had a couple of grammatical
comments so I can give those later. Eric, did you have anything that >> I I really didn't know. I mean, I thought it thought it looked >> Isn't this the one we edited in the last meeting? Did we ed edited this? He based
it on um at least one of the other towns >> from two towns. He combined two towns and then his knowledge and expertise >> combines is a combination of the of everything. >> So that's why it sounds familiar. >> Yeah. >> Yeah. >> Okay. Well, if there's no other
comments, um I know that there are people out in the audience and I'm guessing they might be here to talk about Kraton or comment on it. And if you'd like to come up and identify yourself, your name and who you're representing >> and where you're from >> and where you're from. Right.
>> Uh uh I'm Vishal Shukla. I'm owning the Yarmatur Village store as well as the Station Avenue convenience store. >> Can you speak a little bit closer? >> Yep. So uh the study wise I think uh when I talked to the companies who does sell us
uh the cratoms bags and the tablets and everything. So they did say uh like if I scan back of the barcode, it will show the lab report and everything. And uh if you guys uh you know want to see it, I
will I will do that tomorrow and bring everything up and send it to uh Barry and see what you guys feel about that. they do have all the uh lab reports from the labs and say what's going on with
the the product itself. So I will happy to do that and uh we'll provide every information that uh I can. >> So you're talking about it tells you what the ingredients are in >> what the ingredients are and what uh the whole panel. Yes, the lab panel. They do
have the whole lab panel and uh u what they made out of or what they do and all the obviously that effects side effects and everything in that pamphlet also. So I will happy to provide those and we go from there I think.
>> What is the name of the company that supplies it? >> It's called whole herb. Uh they have a >> whole earth. >> No whole the whole herb. >> Herb whole herb. uh and they have a remark remarkable that's the second one but they have they have the information
on website also but uh I will provide you individual uh bags like the all the different kinds of cratom what they made out of it lab results and what they side effect and effects >> do they have just one product one type
of bag >> no they have a different product so I can give you all the datas that you know it can be available And is it a product that's sold pretty much widely or is it >> Yes. Yeah. No, it is it's sold widely
and it's probably you know the whole whole United State probably. Yes. >> Now is this a single company and there are other companies that produce the same product or does this company control all the products? No, they have a different company and they have all
have those labets and everything once you scan the barcode in the back. That's like when you go in any venue and you scan the barcode, it'll give you the information. Same exact thing. We didn't know that until we call them up and say,
"Listen, we do need some information so we can at least present to the board and find out what's going on." and he says, "Yeah, so you can just scan the barcode and the information is right there for sure." >> Well, thank you. That that is
interesting. Um again though, probably because there have been no clinical studies. There won't be any information on studies of the particular ingredients, especially in combination, but it's interesting to
know that they're listing that and I I would like to see that. >> Yes, absolutely. Yeah. Yeah, we'll provide that. >> Do you have my email address and everything? >> Yeah, I do. Perfect. Thank you. >> I think this is very similar to different dog foods. They all list their ingredients and the the the the
difference is that with there's no official organization that scrutinizes what's on that label and that you have to accept the the statement from the company of what's there. And that that's
the big issue with it. >> There any other people that would like to comment or >> Looks like we have a couple hands up. >> Okay, we'll take >> As long as they're from Yarmouth, that'd be great. So, we take the first one. We can take
>> Hi. Uh my name is Allison Smith. I'm the government relations director for the global coalition. >> I just want to flag something really quick. There are uh studies regarding the safety ofratom. Um the FDA did a study last year on it's called a single ascending dose and I'm more than happy
to to share that with you. Um but they found with um participants of you know adult age um who took um from four gram from like four to eight or 12 grams of natural cratom product that there were no adverse effects. Um additionally
there's another adverse study that I'm more than happy to to share with you guys to demonstrate the safety and efficacy of of natural cratom products. because I just I just want to flag that really quick. >> Allison, thank you. Would you give the name of your organization again, please? >> Yes, it's the Global Cratratum
Coalition. And um we also have lists of of products that are considered natural products um versus the synthetic concentrated products that are dangerous in a public uh health risk. And I would be happy to share that information with you as well.
>> Thank you. Couple more hands up. >> Other hand. >> So I'm I'm here. I don't know. >> Uh we'll we'll let John speak because >> Okay, great. I didn't know if you were calling on us or Yeah. Go ahead, John.
>> Thank you, Laura. I'm John Shenholster. I am the advocacy director for American veterans for cratom safe. I'm a United States Marine Corps veteran. And there are the American cratom association. They do have an organization of vendors
who all their products meet rigorous standards to meet all the safety factors for cratom. But natural cratom leaf products, yes, there's a there's an alkyoid that does attach to an opioid receptor, a very small amount, but it
doesn't have any alkoids that adapt to the receptors that suppress your respiratory system. So there there's over 600 scientific studies done over 200 peer-reviewed. John Hopkins has been doing clinical trials for the last two
years and and Nor Vulco the director of NAIDA. She's spent over hund00 million dollars and spent 15 years doing these studies onratom andratom it's true it's a plant and nobody wants to invest the billions to get an FDA medication
because you can't patent a plant but in in the marketplace every day in America somebody actually dies from one of those caffeine drinks. There's over like 300 deaths a [snorts] year from these those little shots you buy at the Mini Mart. But but they're not trying to ban coffee
that what what they're really trying to do is is restrict the bad products and a good cratum consumer protection act that you can enact if you get rid of all the chemical problems all the synthesized pro uh products the the problems
basically go away and and it's got over 200 years of documented use going back to the 1800s where they actually used cratom to get people off of opiates. So, it's a great product if you can't get access to any other medical help or
attention to to it helps alleviate opiate detoxes. So, there there's many uses. There's estimated 10 to 20 million consumers in America who safely consumeratom. There is a small addiction profile that's been proven. However,
those are very uh they're not some of them are pretty bad case, but most of them aren't that bad. There have been some deaths associated with creating, but typically there there's other products involved. So most of the problems that you hear it is really what
product were they using, where did they get it, but but to you know to to to try to ban them, it's like you you put so many people at risk that rely on it for their quality of life and and it has been proven to save thousands of of
addicts who pivoted from a a one pill kills to a to you know a natural product. So, you know, I just feel like if you if you dig a little deeper and and actually look into the science behind it and and really see what's what's available and out there, you
know, your your opinion and your thoughts, I'm certain would would shift to a more practical regulation versus a ban and and you do have access to great information from the Americanratom Association, the American Veterans forum
safe, uh the plant life people. So, and I do appreciate your time and I don't want to take up a lot of time, but if you have questions, I'll be happy to answer them and but more important, I I can provide you with so much information if you'd like to review it. Thank you. >> Thank you, John. I'm interested in the
600 peer-reviewed studies that you cited. Do you have >> 200 peer-reviewed? There's over 200 peer-reviewed of of over 600 known studies and it might be closer to 800 scientific studies. University of Florida, John Hopkins, they're they're they've been University
of Florida been working on cratom for 20 years. They they have if you Google University of Florida andratom, you'll see hundreds of you know, yeah, I would say hundreds of studies pop up on their website. >> So, University of Florida, John's Hopkins, and who else's?
>> Those are the two big ones. And Laura might know of some other universities. Um and and and the leading scientists from there, they they all agree that natural cratom products that they are safe for the marketplace, but they also agree it's the it's the it's the
chemicals, the adulterated products, the synthesized products, the 70 products. They're very very dangerous. And I and I hope you ban those from your community, but please don't confuse it with naturalratom products. that that's the big problem we're having is the
demonization ofratom and its consumers. And it's actually the chemical products that are it's it's just like what they did to cannabis. You know, they take natural CBD and then they do the Delta products. The same companies that did that, they're doing it to theratom industry and and it's just it's
horrifying to know what's taking place out there. >> Thank you, John. >> Thank you. >> Okay. Can I can I speak now? Yes. >> Great. Yeah. So, I'm Laura Romney. I'm with the International Plant and Herbal Alliance. I work really closely with the
American Credum Association and um I I really appreciate you letting me talk today. I highly um suggest that you look at the email that I sent you today and there's one I also sent you about a month ago that gives you a lot more information. Watch the little video specifically because it ties into what
I'm going to say next. Um, so I know you've heard a little bit about uh, you know, I know you're concerned about, you know, what the FDA and things are saying about, but it's very, very important to understand that on July 28th, there was a press conference that the FDA and um,
health and human services held. And at that press conference, they announced that they are wanting the DEA to schedule 70 products as schedule one. And they wanted them to start that progress or that process. But what was very clear and again that little video
that's in that clip that you'll see on your email shows numerous times where um you know Commissioner McCary said we are not after whole leaf natural. We are only after the synthetics. That's the only thing we want banned because there is you know proven health um and
wellness benefits to theratom product. Um, a lot of the studies that you quoted, you know, things about like seizures and, you know, hallucinations and all that, if you actually dig into the actual studies that people are um are referencing, it's literally like a
single case study, like someone will have walked in that's actually a bipolar or has other um hallucination type, you know, schizophrenia, and they'll say, "Well, this person is a cratom consumer." And they tie it together. So again, it's it's a little bit um you
know deceptive as far as um you know some of those you know you can't necessarily say without looking at every one of those studies uh you know to know that there is not the health there is health benefits and not it's not as scary as it sounds. Um, and again, I
there's a book out there. In fact, I'll just give you the the author. Um, it's a it's a great book. It's actually for sale on Amazon. It's called History, Science, and Therapeutic Potential. It's by Dr. Jack Henningfield. H E N I N G F
I E L D. and he um he has an entire book that's set aside with all of those uh not all of them but a huge number of theratom peer-reviewed studies so that you can see that there is a lot of um information. One last thing is I wanted to say is that I appreciate the
gentleman who spoke about the um product that's in his uh in his store. I am aware of those two companies and it's correct they have there are great companies out there that have reputable laboratory results. These are outside labs. These are not, you know, just they
went down to the store and did a little test. These are um, you know, outside lab, third party labs that make sure that there's no salmonella, heavy metals, and you know, what they're saying is in the product is in the product. So, there is a way to do it.
Um, again, I highly suggest that you put an age gate in so that 21 and up is only people that are allowed access because, you know, it's an adult product anyway. Um, you also want to make sure that there are products like he referenced that have, you know, laboratory um,
findings and that have proper labeling. And then of course that, uh, the, um, the restrictions on the amount of 70 allowed in the product, which will eliminate all of those synthetic 70 products from the shelves. And so there's an absolute way to do this the
correct way, but it allows people like myself who has have relied on this product for over nine years for my chronic health condition. If I didn't have it, I cannot even tell you how miserable my life would be. And again, I I'll leave you by saying, look, just
look at those screenshots of that I sent you today of just what the last couple weeks of some of the people throughout the country saying how difficult it is to get any form of pain medication these days. And so it's just so important that alternatives like are available. Thank
you so much and I'm here to answer any questions. >> Uh thank you Mora. I'm interested. Um this is a national organization that you're in. It says National Plant Alliance, correct? >> No, it's International Plant and Herbal Alliance.
>> Okay. International Plant, right? I understand that there are some other states that states that have banned. >> Yes. Yeah, and I can explain those in um very easily. So, back in 2016, the FDA
um actually went after whole plantratom. They said, you know, we think that this product needs to be, you know, needs to be banned and they were very nervous about it. So, they said, well, we want to do the same thing. It's called an eight factor analysis. They go in and they study it and they they have to they
have to meet eight qualifications. And if they meet those qualifications, they they asked it to be scheduled as a schedule one. Well, they did um they actually did that eight factor analysis and it failed and they said no, it does not qualify to be scheduled. Um there
are health potential benefits and there it just didn't meet the qualifications. What had happened is um several of the states back then they just jumped on the bandwagon thinking that this was going to be scheduled and they went ahead and initiated a ban. Um, and so we've been
working closely to try to re-educate some of these states. And in fact, Rhode Island, which is very close to you, just reversed that ban. And as of April 1st, they will actually allow whole plant natural, not 70 and synthetics, but just
whole leafratom will be will be legal in Rhode Island. So that's been the majority of the cases for the state bans. It's just we're it's just taking some time to re-educate and help them understand especially now with uh 70 in
the mix. >> Thank you. >> You're welcome. Oh, and by the way, there are 20 states in the nation that have passed theratom consumer protection act which basically mirrors all of those um you know those factors like the age
gate and the 70 content. All of that is very mirrors that um and you could pass a similar ordinance in your city that would mirror those states that have done it correctly. >> And what's what's a state closest to us?
>> That would be Well, again, you can look at Rhode Island. That's a perfect example. You can see what their their latest one because they just barely passed that. And um again, it will go into effect on April 1. So, I highly suggest and again I can send you some
examples of that. I'm from Utah and we are one of the states that have a KCPA, but there are several states around you that do, but the most current one that just barely passed is that Rhode Island. So, it would be a really good one for you to look at. >> Thank you.
>> Yeah, no problem. >> Is there someone else who would like to speak? I think I'll take a couple more and then we need to move on. Hi. Can you guys hear me? >> Yes. >> Yes.
>> Sorry, I had my volume down. Um, no. I just wanted to let y'all know I testified at the last hearing that you guys had and just wanted to let y'all know that I was here in attendance and I want to like kind of piggyback off of what Laura and John have said. You know, I survived.
Well, not really what they said, but I survived the overprescribing opioid epidemic. Um, you know, I've been consuming for this would be my seventh year. I'm a recovered addict now because of it. You know, I found whole leafratom by accident. I was not looking for
recovery when I found it. I was just looking for something to help my withdrawals that I was going through at the time. And little did I know, here I am today, you know, be I can proudly say that I'm a recovered addict. So, um, and I don't take it every day. You know,
it's not something that I crave. I take one to four days off every week. I'm not on any cratom right now. You know, my pain is a little bit elevated. You know, my degenerative disc disease that I have in my back, but it's not something that I crave. Now, the issue that y'all need
to tackle though is the synthetic 70. Because if you're having problems in your community, it's because of those synthetic products, not the whole leafratom powder. You have to know how to differentiate it. And I'll be here to answer any questions if you have any. >> Thank you. And would you give your name
and where you're from again? >> My name is Misty Brown and I live in Colorado. >> Thank you, Mity. >> You're very welcome. >> Well, a question I had for Mity, is that something you would get at the convenience store or do you have a source to purchase what you're using?
When I foundratom, I walked into the smoke shop and it was sitting behind the counter in a glass case and it was locked up and I had to show my ID to get it. Um, so that's how my journey started. Right now I do order online, you know, and I go through the companies
that follow the good manufacturing practices, which is what they mirror the FDA, you know, regulated goods, you know, general GMP compliance. So that's where I get mine from. and the gentleman that spoke in the audience who um talking about whole herbs and remarkable
herbs, they followed those same practices as well. >> Thank you. >> One more. >> One more, please. >> Hello. >> Hello. >> Can you hear me? Yes, ma'am. >> Yes, we can. >> All right. Um my name is Dr. Heidi
Squire. I'm a retired healthcare executive and nurse practitioner and I currently serve as chief uh scientific officer for the International Plant and Herbal Alliance. I work closely with Laura Romney and I know that she sent a detailed email with a lot of education.
Um and um unfortunately um you know the this information that was shared tonight um isn't um actually uh evidence-based. Um I mean I heard that causes seizures
and all kinds of other issues. And I just want to say I think it's important to to really remember that correlation does not mean causation and there truly has not been um a demonstrated um cause
of death um in forratom products for naturalratom products and I think that's extremely important to remember the even the FDA says that deaths byratom alone are very rare and Um so and often it's
poly substance or underlying conditions. I think that's very important. Um the other thing I wanted to say is um I I heard you know the confusion about Kraton being an opioid. It really is not a classical opioid. It's a partial moo
um opioid agonist just like coffee um cheese. And so um the natural product has a excellent balance and multiple alkaloids that balance each other. The primary being
the metroinine. Um 77 hydroxy metroinine actually is not in the natural leaf. It only is produced um as it metabolizes through the liver and in the natural powder concentration
um and natural extract concentration in very low levels. Um so those products are actually very safe. So why should you regulate instead of um ban allratom products? Most important reason that
naturalratom does not cause people to stop breathing. Other products do obviously opioids. That's the number. That's the reason that people stop breathing when they take an opioid. I mean that's the reason they die is because they stop breathing
when they take an opioid. So um so those people that are using instead of opioids now if you banratom you really put them at risk for death. Um and so I think that's very important. Um and I know
that your time is short so I I think that Laura and John and other people have shared um important things and if you have any questions I'm here to answer them. >> Thank you very much Shannon. >> Thank you. That was Heidi Sakura. Dr. Sakura.
>> Dr. Sakura. Sorry, >> Heidi. >> It's okay. >> Can I make a comment on that? Um, >> yes. >> We didn't say that when I read it. I the the uh the um Mitra Gynan works on opioid receptors. I didn't say it was an
opioid. And the information that I got came from the FDA and the DEA uh websites directly. That's they were evidence-based information. Um they were extreme, but that's that's the information. That's where the information came from.
>> Yeah, I understand. >> And the other the other um >> the other issue is that unfortunately what we're concerned about is these products being sold anywhere. Um and and they're basically unregulated. And
that's the concern for us here at at in the county of Yarmouth that the board of health is that >> I would say I would I would say that the you can do a local consumer protection ordinance and there you go. Now you have your regulation that will keep people safe and that's been done all over the
country. >> There's been a lot of that work. Um, well, I I I do believe that I think Laura already sent you a copy of an example of that, but basically what you do is you just um make sure that it follows um the guidelines of the
theratom consumer protection act, which means that the products are lab tested, that the alkaloids are um in line with the natural plant, that there's no more than, you know, 1 to 2% of 70 in any product, then you know it's a natural
product. >> Mh. >> Um, age gating 21 and above. Um, labeling. Um, so the things that remarkable herbs and um, and I forgot the other company, but the things that they're many many companies are already doing these standards and they are uh,
preparing it according to good manufacturing practices. So, they're following all the FDA guidelines um, under, you know, for dietary supplements. they're following all those guidelines and they're very safe products and so you could even have them
register those products and say okay these are the products that you know so a shop could come to you and say these are the products we'd like to sell and you know you limit the number of SKs that they have limit the number of licenses um in your community so that
you don't have every you know you don't have it on every corner or whatever um and then you can even charge a licensing fee so that can help um fund the enforcement that you need. >> Okay. Thank you, >> Mary. We did >> more than healthy to help. We did get a
lot of emails late this afternoon, like today and later this afternoon that um Riley has put together in the in the power in the in the file that we have sent you before, but we will send you an updated one also with all these emails and and powerpoints that they're talking
about today. So, we just didn't have time to get them to you promptly. So, they came later this afternoon. >> We are still discussing. So that's that would be helpful. And I'd certainly like to move the discussion uh to continue at the next meeting. >> Sounds good.
>> And after we have the the additional information that some of these speakers have um talked about, um I'd like to go on now to the next item, which is the nicotine free generation
discussion. Again, this is a discussion that we've I think this is the third time it's come to the board to discuss. Um, and I don't have anything new except for
that wonderful Excel spreadsheet that Riley put together for us, um, like she did form um, with all of the, um, mostly emails that we've gotten, some business owner letters. Um,
and, uh, Barry, I know you've had some comments from people. Do you want to kind of give us some background as to what's been going on with this? >> Yeah. Um, just again, kind of like the cratom, we're getting lots of emails and concerns from the public about thinking
that we're banning all tobacco products. Um, I got an email today. Someone said, "Please do not ban outdoor smoking." This nicotine-free generation is not does that's not what we're about. It's we're not trying to ban smoking from adults. It's to prevent the the youth of
our future from starting to smoke and giving them the ability to be able to start to buy nicotine products. It's to prevent the future generations. Not any anybody currently over 21 would not be
affected by this. >> Does that seem to be the main concern people have who are sending you? A lot of people think that we're banning all nicotine products in town, which we are 100% not doing. So,
>> um, >> well, we're discussing to ban all nicotine products in town, which we're we would not >> right >> do. So, >> right. And this um nicotine uh free is something that has
been adopted by other what 19 or more >> 19 plus communities and there's some growing in the state. Yes. >> Massachusetts. Right. And it started with Brookline and they were sued and the Massachusetts Supreme Court said that this was a valid um
>> upheld their decision. Yes. >> Decision by a health board to protect the public health. >> Yep. Um, any comments from the board in terms of the additional information we've been sent about it or the original
information? Well, I'll just reiterate what I said the last time about there are two main concerns that folks have about um this uh nicotine-free uh generation ban um or or the banning
or the proposed uh program that we came up with. And number one was the concern for the economic impact of the um these businesses. The other concern is that people ought to be able to choose, make
free choices as to what they'd like to do. And as I said at our last meeting, I'm an old guy and I've never met anybody my age bracket that's ever told me that they wish they'd never started smoking. So
>> hasn't told you that >> that hasn't told me that they wish they hadn't started smoking. Um so the to me the um to answer the uh economic impact
it's a tremendous uh economic impact to um the [snorts] society in in the um the the health issues that smoking causes and the strain it puts on our um um
health care system. And um also um it's been shown that if you're a chronic smoker, you stand a 50% d uh chance of dying in your lifetime from complications from smoking. So, I don't really think looking at looking at from
that perspective, I don't really think that there's really any impact on anybody's uh bottom line in a business that would warrant us continuing to carry on the way we're carrying on. So I think we need to make an adjustment in
that and that my sense is that the impact economically that that makes on a business that will be that'll be absorbed by other uh ex uh expansions in business. Uh the other the other um
point that I'd like to make is that um as far as a free choice issue, it's not the general public's free choice to have to support the cost the health care costs that are imposed by uh the consequence of these uh chronic smokers
that the the health care costs that that they place on our health care system. So I think based on that uh information that we got at at the um meet uh meeting uh two meetings ago by that group that
their their um proposal uh is is a compelling one. Uh and I would support uh us uh continuing that with that proposal. >> Eric, do you have any comments?
Um, I think yeah, what's happening right now, if we continue, is we're killing off customers who >> Well, that's that's the point. And plus, nobody wants to who wants to to have their business based on the backs of uh, you know, of people's health. I I think
that it's shortsighted to do that. >> Um, one of the things that I think um, helps with that particular concern because I it's a business concern and we're public health but but we live in a business community too. Um is that it's
a gradual kind of thing. It you know just >> a person drops off or a cohort drops off each year but um it's not a complete ban. So you've still got people out there smoking and you know as long as they
they don't get cancer or you know get hit by a car or whatever they're still alive smoker and they're going to be smoking because it is addictive and um people tried to stop smoking and um so I think that that's you know that's
it's certainly means that eventually at least in this town there might not be any people buying cigarettes or smoking products. But um >> it'll be quite a ways years from now in the future.
>> Yes, it will be many years from now and um we'll have a healthier community for it certainly. >> And like you said, maybe some new products will come up that will get people into the stores and they'll be healthier for it. And it still remains
probably the third or fourth question you're you're asked whenever you go to any healthcare facility. Do you smoke? >> There's a reason for that. >> Absolutely. And I I was surprised to find out that you cannot become a a police person or a fireman person. Um if
you are a smoker or in the military, you're not accepted. >> Not accepted. >> That's something fairly new then. That shows you what um you know what certainly the government thinks about smoking. >> Um
I'm guessing there might be some people out in the audience that would like to speak to this one. And if so, you're going to do again. Okay, come on up. Did a good job first time. >> Yeah. Uh this is Vishal Shukla. I just
mentioned it before. Uh owner of the station avenue convenience store as well as the Yamat port. >> Speak a little bit closer >> right here. That's good. Okay. So [clears throat] uh when we say economic impact on the
business uh a convenience store we do probably 60 to 80% uh close to 60% to 80% business selling cigarettes and stuff like that. Candies,
sodas and stuff like that should be like only 20% or 25% to 40%. So taking the portion out of the business it will impact in the future definitely not right now. So after 21 years
uh what's the other options we going to have that you can think it will support our that gap. Um tell you you're you are saying that 60% of your sales are
>> convenience store uh strictly a 60% sale of the nicotine product. >> So if that 60% out of our business and I would like to mention we are like a we are like a tourist towns.
>> I'm sorry. We are tourist towns and the people who adopt >> those uh regulations they are in a heavy population town. we are I don't know how much you know how much percentage we
have visitors coming every year to the Yamoth maybe 20% or maybe 30% I don't know so that would be the impact also like they will say is like you know one town does it and second town doesn't so we obviously going to lose the that
business also because the other town did adopt all the regulations like a Brooklyn you can imagine how many people are there. So they can grab business somewhere else or the neighborhood towns
get th those business too. So that's my question like what we can do to fix that 60% gap in the future is something else would you think it would comes up and say okay you can fill that gap
>> I you know I can't see the future and know what might come up that would become a product that you could would account for 60% of your sales. Um >> that's but but you know we talked about
that um when we had public meetings and we did our um regulation about 21 years. Um, I know Hillard talked about looking at your business plans and looking ahead because um, back then, you know, we this
is something that we saw and it wasn't just us. Um we we've tried to be a leader on the Cape anyway, but um you know now it's statewide and we could see um this momentum coming because because
we this is public health is our b our business. Absolutely. We know that all of these um new studies, actual studies showing the the effect of smoking um on the human body, right?
>> Um and the whole society as Larry has talked about >> um was going to becoming more and more of an issue, right, >> that people were going to address. So, I guess that's, you know, that's I think one of the things I would say is that I
understand um I I had no idea it was 60% and that's kind of scary, but um yeah, I think you need to look at business plans and what can you sell that might take up that slack. Um but like I said, this is not going to happen all at once. So,
you're gonna you're already not selling to people who aren't 21. So that part of your business has already been taken away. Um and then gradually year by year you'll be selling to um fewer people and
there are other towns on the Cape that are looking at this right Barry. >> Yes ma'am there are. >> Yeah. So >> I have a question. You said 60% is that 60% of number of sales or 60% of your profits come from >> 60% of number of sale. >> So number of sales. So it's not
>> Okay. So it's not >> your revenue >> about 60% of your revenue 60% >> sale sell is when it when the property comes from the sale. So yes 60% of the revenue too. >> So what I could add to that is if you
look at the numbers 60% of your sales but we're only talking about 21 year old people per year. Now, you look at the the um uh age of your population that buys your cigarettes, and they're going
from 21 up to 80 years old. So, that's it's going to be spread out over that whole age group. So, this is only going to be a small percentage of that 60% each year. and then it'll give you a
chance to adjust to that loss of revenue by >> trying to find another source of revenue. But at the same time that in a sense is shouldn't be our priority because our priority as Mary
said is the health of our community and if we good we can't support a business um if that doesn't support the health of our community. I mean that's really important for us to take that into consideration. No health health is the
first thing that's you know and we always you know for it like when we did the 21 >> year uh uh limit we did support that >> yes >> we did the flavor ban I think we are the first one in the cape who did the flavor
band if I'm not mistaken >> yes >> and so we did support every single time for that but this is like little little unnecessary you know if if I may but if you think it is a good thing to do it. It's fine. And the one one question is
like is that the the marijuana is the same effect as nicotine or is it different? >> Different. >> No. >> Yeah, it's different. >> Totally different. >> Comparing apples to oranges on this one, >> right? >> So, >> so take the oranges and give us apple.
>> What was the question? >> So, what my question is like what's the effect from marijuana? Uh and uh what's the difference between the effect for the marijuana and nicotine product? >> Well, nicotine [clears throat] products
take their toll from a chronic disease over time. They're a chronic irritant to the body and your body reacts to that. Whereas marijuana is not. Marijuana is a transient um psychoactive
drug that's in and out of the body. it, at least as I'm aware, it doesn't cause any dilitterious long-term effects as chronic use of tobacco would. So, they're totally different. >> Right. So, marijuana is probably better
than nicotine. Am I right? If I'm understanding right. >> Yeah. I'm not I I'm not very adver uh, you know, up on marijuana. So, I I couldn't I do know [laughter] that marijuana, as far as I'm concerned, doesn't cause any long-term health
issues if it's used properly. >> Right. >> But but again, you know, if you're smoking marijuana, if you're vaping marijuana, >> you know, you're still going to get that effect in your body in terms of your lungs at least, like you said, the irritants. So, >> that's inflammation. And inflammation,
chronic inflammation is one of the leading causes of chronic disease. It's been proven over and over. particularly cancer that smoking is related to one of the major causes of bladder cancer >> because of chronic inflammation,
>> right? I mean that's that's scary when it affects everything. >> So when [snorts] the bicy says you know you comparing apple to oranges so for example >> apple is nicotine and oranges is marijuana. So take the apple and give us
an orange. >> Thank you. Anybody [laughter] else would like to comment? Yes. >> Yes. >> Hello. My name is Harry Patel. I'm from B, Massachusetts. All I want to say is I am opposed to this.
Um, I just don't like this uh nic, you know, like all that things going on right now. just my friend was talking about it about marijuana and uh nicotine all that stuff. I can start smoking joint right now. It's going to be a
problem too, just so you know. Thank you. >> Thank you. >> Anybody else? >> Eric, anything you want to add? >> I don't think so. >> You want to weigh in on marijuana versus nicotine? >> No, I'm not going to touch that one.
He might know more about marijuana than I do. [laughter] >> It's very old information. Um, okay. Let's get back to the agenda here and see what we've got. >> We do have a couple hands up on the >> Oh, I'm sorry. Online. All right. I'll
take a couple of people online. >> Take two online. Somebody want to speak up on >> Oh, >> can you hear me? >> Yes. >> Yes, you can. >> Oh, hi. Okay. Hi. Good. Good evening, members of the board. My name is Paula
Cody. Um, I sorry I couldn't make it there in person tonight. I have another engagement in a little bit that I need to be at. Um, I am from the town of Bourne, but I work with a few small businesses >> in the town of Yarmouth.
>> Can you hear me? Okay. Yeah, we're good. Some I'm sorry. >> Yeah. >> Yes, we can hear you. >> Oh, okay. I just heard stuff in the background. Um, >> I'm also a consumer support local businesses in Yarmouth. Um, I want to
specifically express my concerns regarding the created nicotine region by permanently banning the sale of nicotine products to people born after a certain year. While the goal of protecting public health, especially youth health, is important and shared by many of many
in our community, I believe this polishing includes more problems than it solves. Laws that single out one generation for permanent restrictions raise concerns about fairness and equal treatment. Two adults of the same age could be treated differently under the
law simply because of their birth year, which may undermine trust in local governance. Additionally, this type of ban may be difficult to enforce and could lead to unintended consequences. History has shown that prohibition can encourage black markets to reduce
which could lead to potentially more dangerous. Um, at least when you get a pack of cigarettes, it will say, you know, hazard to, you know, unborn fetuses. It's right on the package all Uber it that it's bad. something on the black
market. These kids could be just buying it and taking someone's word for it that it's it's gonna be okay for them. Um, education, prevention, and support have proven to be more effective long-term strategies.
Investing in evidence-based education programs, clear age restrictions, and resources to help people avoid or quit nicotine use addressed the same issue without creating permanent legal divisions among youth, adults, I'm
sorry. In addition, small businesses could lose income and governments may lose. I respectfully ask the board to consider alternatives that focus on education, harm reduction, and consistent enforcement of existing laws rather than
adopting a policy that may have lasting and unintended impacts on the community. Thank you for your consideration and and listening. >> Thank you, Paula. Thank you. >> And uh technically what's happening here? It sounds as if some people are
talking. >> I I don't I'm not for sure >> what's on. >> Is she on speaker? You think? >> No, I think there's >> I'm very challenged when it comes to these phones. >> No, I don't think it's you because we kept seeing names of other people and I
wasn't sure if maybe they were trying to speak at the same time you were talking and not realizing it or what. But we'll try one more person. Stephen, >> Stephen, are you ready to talk? >> I'm ready to talk. Uh,
>> and I hope you can hear me. It doesn't seem as if my camera is working. >> That's okay. >> But okay, >> we can hear you. >> I would like to address several issues. Um, one issue is that Professor Kate
Silva, who was a uh sponsor of this uh prohibition in Brooklyn, uh said that for people not paying attention uh there would this ban would be very
fast acting. In fact, the goal of this ban is total tobacco and nicotine prohibition to adults 21 and over. And uh that is the goal. So I don't
think it's way in the future uh at least not according to the proponents in Brooklyn. Um, a gentleman on the board uh said that tobacco and smoking is a great
expense borne by um the public in terms of medical care. I would like to point out that in the 1970s uh when about 40 to 50% of adults smoked
uh medical uh care costs was 17th in inflationadjusted dollars of what it is today. even though only 10% of adults now smoke.
So in inflationadjusted dollars, medical costs in the United States have skyrocketed as the number of adults who smoke has dropped.
I would like you to consider that if you would. Uh, I would also like to say that immigrants of color own most of the stores that sell niticotine and tobacco products.
Now, this ban or prohibition uh may not close their stores, but it will devalue them and hurt their businesses. Brookline
merchants have seen drops in overall sales. Not just sales of tobacco and nicotine products, but overall sales because when people go to convenience stores, they buy several items. And if they can't get their tobacco or nicotine product there, they don't go to the
store. Uh so as I say the stores in Brooklyn have seen overall drops in sales since this proposal was put uh into effect. Now
if the tobacco companies are trying to lure young people to smoke or to use nicotine products, they are not succeeding. Uh, according to the CDC,
the a the teenage smoking rate is at a 25-y year low. Uh, and according to the FDA, the youth vaping rate is at a 10-year low and their nicotine pouch use is still very
low. So all of the kids who evidently were smoking and vaping, etc. are no longer doing that. And as far as the adult smoking rate,
it's at an 80year low. And according to the CDC, two of every three adults who ever started smoking have quit. So that means it is not a lifelong habit for most people. I will finish up pretty quickly because
I thank you for the time you've allotted me. Uh, in Massachusetts, we deem residents 21 and over competent to use intoxicants like marijuana and alcohol.
I think adults 21 and over are competent to make up their own decisions regarding tobacco and nicotine products, neither of which impair judgement or compromise driving skills.
Uh, I ask you not to pass this prohibition which does not affect you but limits the autonomy of adults in Massachusetts 21 and over. Thank you.
>> Thank you. >> Thank you, Stephen. Where did you say you were from, please? >> I'm sorry I did not introduce myself. My name is Steven Hur. I am from Cambridge, Massachusetts. I belong to a group called Smoker uh
Cambridge Citizens for Smokers Rights. We accept no funding from any source whatsoever. >> Thank you very much. >> Thank you. >> Okay. >> Hello.
>> Hi. Can you hear me? >> Yes. Um, I wasn't going to take another person, but go ahead. Uh, you will be the last. >> Okay, that's fine. Hi, my name is Jonathan. I am a member of uh this the organization Steven founded, Cambridge
Citizens for Smokers Rights. And uh just very briefly, I'm I'm just concerned. I don't appreciate nicotine Free Generation. You know, if I was a young adult these days and I knew in the future that I would not be able to purchase a pack of cigarettes, I'd be
very upset. How would I definitely hold honest work? You know, a [clears throat] lot of people who hold honest work or honest studying really depend on nicotine products, ideally smoking to have to pay attention, to take breaks,
to stay focused, to look forward to. And uh I just, you know, I mean, I I I think it's completely unfair. somebody's a grown-up, they should be able to choose to smoke. You know, they can join the Marines and carry a machine gun and
drive a giant pickup truck and, you know, so on and so on without being able to count on purchasing a pack of cigarettes or a cigar to enjoy after a day's work or for breaks during honest work. Um, I just think that this is
ridiculous and it's just not a good idea at all. So I um you know when I was young adult I completely counted on smoking and made made me a productive citizen and I really don't see any other way to look at it. So that's it.
>> Thank you. >> Thank you. >> Okay. Um is everyone all right with our calling it on the comments for now? Think we've >> just one question. >> Oh yes. >> Yes certainly.
So again, uh can you just provide when you have a board of uh meeting for tobacco and stuff, can you just guys email to the retailers? >> I'm I'm sorry. You're going to have to say that again for me. >> So we didn't know about this meeting
until, you know, somebody told us >> this meeting is is our board's discussion. >> Okay. The way it works is that if we decide to go ahead and do a regulation, >> it has to have two public hearings. >> Okay.
>> And at that time that will be advertised in the paper >> and um you know I'm I'm certain >> as a retailer, right? >> Yes. >> Like we paying the fees for the tobacos and all that, right? So you should email it to us. >> Have the opportunity to come in and speak.
>> But how would how would we know that we have meetings? >> It will be in the newspaper. It has to be posted and um >> it's posted on our website and the town website also. >> It'll be on the website. >> So you you guys want to send email to the retailers
>> business? Really? >> So you can sign up on the town of Yarmouth website. >> Okay. >> And I'd be happy to send you an email with some steps to help you do it where you can sign up for notifications from the town. Okay. And all meetings that are put on the town calendar, we can do
>> send message. So we send a message to anyone that's signed up for the town >> notification. So they'll be told when we have a meeting and it'll be a few days before the meeting. It'll say board of health meeting. Okay. >> January 5th. And then the agenda is attached to the calendar as well.
>> Okay. Thank you. Here you go. >> Thank you. >> Thank you, Riley. Yep. >> Okay. So, I have a feeling next on the agenda is the um here it is >> is to review and approve the minutes for
December 15th. >> Are we going to decide how we want to proceed with this? >> I think we're going to I I'd like to just go ahead and continue discussion on this next week. >> Okay. Um I um I guess right now I have more
questions about than I do about the nicotine regeneration. Did you have >> Well, I I thought I know I understood your position on the craton. I'm fine with that, but this NFG I'm wondering if we can't just move forward with it.
>> I'd rather wait until here too. >> Fine. That's fine. Okay. >> Um Okay. So the minutes for December 15th, additions, corrections over and they looked fine to me. >> Can I have a motion for that, please?
>> I make a motion that we accept the U board of health meeting minutes for December 15th. >> Second. >> I'll approve. I >> I >> Okay, so they are approved. Thank you.
Um the uh the flax pond blond drive is still January 23rd still in the future. Also the fall analysis on February 6th. Are there any spots left now? Yes, still some spots left. And I told Barry that I
looked it up on the CDC. It's a CDC program from before and it's very good. So, um I'm hoping if there are any people out there who have some concerns about falls or have fallen that they will look into this. Um the number to
call is 508-9577423. Um Barry, new or old business? Um we over the holiday season again we had the um the giving tree as for those of you that are watching online. These are all
the presents that were donated to and from the the town to local children in need. It was amazing. We literally filled up offices in the hallway and those are three of our health trucks uh SUVs that are full. Um just taking them
to the schools. It was a great just watching the the administration's eyes just they thought they're going to get a couple small things and we were taking these large bags and it took six of us time to take them in and give them out. It it was a it was a great great project
that the that Riley, Sarah, Deb all put together up front. It it they did a wonderful job. I want to thank >> give them a big round of hand for that. So >> yeah, I think it's kudos to Sarah Riley, whoever was involved in that. That was
wonderful. I We all enjoyed participating in that. >> Very nice. >> I think these kids got a lot more than I did. So, >> but it was great. Uh we will 100% do this again next year. So the the giving tree, it was it was good. So
um from CBC, great day. Uh what else we the health budgets are coming together. We have not there's a town meeting tomorrow night. They're going to kind of briefly talk about it but the next following
town meeting I'll be there talk about the health budgets. Um we have put in the letter from Hillard. Um we are right on track for all of our budgets and our goals and everything like that which is
nice. Um the plastic reduction ban, the committee that we're on, that is absolutely 100% in full effect. Um it started January 1st, 4 days ago. If any of the um establishments out there have
questions, please feel free to to call in, talk to the health department, ask the girls, they can ask the the ladies up front, they transfer them back to me, I can answer questions. We've already gotten a lot of questions, not not questions of
why can't I do why I can't of what are my options? Um, and people are coming along and agreeing with it and following along. So, it's nice. It's we're seeing it. I'm sure we're going to get calls saying, "Hey, such and such has this."
But again, we're not making everybody just throw stuff away. We're giving everybody a time frame to work through their their product and and lower their inventory. So, we want to keep businesses going from that. So, that's
good with that one. >> I have a a question. And um I know that that Haley had asked if if you were going to be researching products and of course you're not. But as you find out and the inspectors obviously um Phil um
find out about products that are available, are they going to kind of jot it down so they can pass it on to the next person if they call and ask? >> 100%. I had one uh one establishment stop in said show me something they found which I hadn't seen before. Um, it
was a packet of uh to-go silverware that was in um a a corn starchbased container and it had cornstarch based utensils and stuff. I hadn't seen those before. So, they're bringing it to us. Say, hey, this is what we found. And
>> I think, hey, if I have to buy this, >> yeah, >> and it's a little more expensive, but this is what everybody else should be getting, too. So, >> just take a picture of it and put it in a looseleaf binder and >> Yeah. have it available for people. >> There's I have a feeling once it becomes more and more prevalent there's the
range of products out there that will people be asking for variances or waiverss. It's going to be not as great as everybody. It's kind of a I've been in the hospitality industry all my life prior to coming to the health department
health world and everybody uses the same products whether it's A, B or C. So, it's a it's a narrow thing. we'll we'll be able to get it down and I think we're doing a great thing for the town as a as a again Yarmouth is stepping up and being the leader in this uh in this
initiative to help save the community and stuff whether it's nicotine uh flavor tobacco Yarmouth is Yarmouth health board is always on top of it and a front forerunner for everybody so I thank you guys for that
>> so next meeting >> we need one Yeah, next meeting is uh February 2nd. >> No, it'd be the 1st and 3rd is when we meet. >> Well, there's a holiday at the next one. So, that's right. So, that's why >> be February. >> Yep.
>> February what, Larry? >> I'm just following uh Riley's >> Oh, it's already up there. >> February 2nd. >> February second. >> Groundhog Day. >> Groundhog Day. >> You did a great job on that. >> We're going to talk about all this again. >> Happening and happening and happening, right? >> Great. It's way ahead of us. [laughter]
Oh gosh. Okay. I think I was doing okay until just then. >> You did great. I mean, God, keeping us in order. >> Yes. >> You know, it's great. >> Well, you're such a rowdy bunch, you know. >> We were trying to do the right thing, but >> I was quiet tonight.
>> Okay. Um, do I have a motion to adjurnn? >> So moved. >> Second. >> All in favor? I >> I thank