Board of Health to test stricter smoking laws

By Jay Turner

Cigarettes and other tobacco products will soon be harder to come by in the town of Canton after the Board of Health, moved by the impassioned pleas of two local pediatricians, verbally agreed to increase the legal age of purchase to 21 while also banning small cigars and “blunt wraps” in colorful packaging and assorted fruit flavors.

Click the image to view the Board of Health meeting on Canton Community TV.

While the new regulations have not yet been voted on — let alone drafted — both BOH members in attendance, Dr. Julie Goodman and Dr. Richard Levrault, along with Director of Public Health John Ciccotelli, publicly agreed at a meeting earlier this month to back the proposed measures, albeit on a trial basis.

“You guys are going to be the poster child for public health … you’re going to get a citation from the governor of Massachusetts,” beamed Dr. Jonathan Winickoff after getting the board’s assurance that they would at least try the stricter regulations for a period of five years.

Both Winickoff, a professor of pediatrics at Harvard Medical School, and fellow pediatrician Dr. Lester Hartman, a senior associate with Westwood-Mansfield Pediatrics, had spent the better part of an hour attempting to sell the board on the benefits of raising the purchase age to 21 — a recommendation that has since become the official policy of both the American Academy of Pediatrics and the American Medical Association.

The current smoking age in Massachusetts and in 45 other states is 18; however, the final decision rests with local communities, and in the past few years several area towns have raised the age to 19, including both Westwood and Walpole in the last two months alone.

Hartman’s hometown of Needham, which has long been the standard bearer when it comes to tobacco control policies, raised the age to 21 in 2005 and also banned tobacco products from being sold in pharmacies.

Hartman, a self-proclaimed anti-smoking crusader, has already spoken to 10 communities about this very issue, and he assured Canton health officials that neighboring Sharon was on the verge of becoming the second community to go to 21, perhaps as early as this week.

“I will be going back to Dedham and working with them as well on this,” said Hartman, whose pediatric practice currently serves 384 kids from Canton. “And I will go to every town that surrounds Canton and talk to them. I will be going to Randolph; I will be going to Milton; and I will be going to Stoughton. I plan not to stop right now.”

“It’s time to be more aggressive,” he added. “If you don’t do this, the other towns will, and you will be behind the eight ball and not viewed as a progressive town.”

Yet the biggest sticking point among board members throughout most of the evening was the lack of scientific data backing the two doctors’ claims. And while board members repeatedly stressed that they oppose tobacco use in all forms and want to keep these products out of the hands of children, they questioned whether a legislative change would be the most effective approach.

“I’m dead set against smoking,” said Goodman. “I also do not agree with the argument that companies are going to lose money; I don’t care if people lose money from not selling cigarettes. What you haven’t convinced me is that this legislation is going to stop teens who start from smoking.”

Goodman also suggested that the town’s time and money might be better spent on education programs in the schools, to which Winickoff replied that she was “absolutely” and “100 percent” wrong.

“If you raise the purchase age, you will do way more good than shouting with a megaphone and increasing education about tobacco and the harms of tobacco,” Winickoff said. “Because for kids it’s about access; it’s about social smoking; it’s about who’s smoking around you, who’s going to the corner store, buying it and bringing it back and showing you that they’re not going to die. That’s what it’s about. If you can limit access, you will bend the trajectory of smoking rates in Canton.”

Winickoff said studies show that raising the purchase age would reduce smoking among teens by more than half, thus creating a “wave of [improved] health down the road” for the population of Canton.

“You basically have interrupted a black market and interrupted a disease process early on before people get addicted,” he said.

“There’s a common sense guideline here too,” added Hartman, “and to me that common sense is going to 21 is not going to harm anyone. You may feel it may do nothing, or it will probably help.”

Two residents who were in attendance at the meeting also spoke up in support of Winickoff and Hartman’s proposal.

“I’m listening to [the two sides] argue about numbers and I find it ridiculous,” said one woman. “I’m a nurse, and I can tell you right now if you stop one child from smoking, it is worth it.”

“I believe that we need to take a chance and do this for our kids,” added another woman, who also identified herself as a nurse. “It’s not about the numbers. We know what’s right … If we can eliminate a whole generation of kids or a portion of a generation of kids from starting smoking and living that lifelong addiction, what is the harm in that?”

Ultimately, the board agreed to move forward with the age increase, with the caveat that they would collect data on teen smoking habits and revisit the legislation in five years.

“I just want a greater degree of surety that this will have a positive effect,” said Ciccotelli, who described the current research on the subject as “all assumptions.”

Ciccotelli said he would get to work on drafting the new regulations — including a ban on products targeted to younger audiences, such as flavored cigars. The proposal would then go before the board for a formal vote, although no timeline was discussed at the meeting.

Winickoff did say he would donate his time and expertise to help establish a baseline for smoking data in Canton and then analyze the changes over the next five years.

“If you do it for a couple of years, then I think you’ll see an effect,” Winickoff said. “I know you will.”

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