MEETING PACKET JULY 2016 • w LJ
CITY OF SALEM, IVIASSACHUSETTS
BOARD OF HEALTH
As 120 WASHINGTON STREET,4"'FLOOR PaNcHean
Prevent.promote.Protect.
TEL. (978) 741-1800 FAx(978) 745-0343
KIMBERLEY DRISCOLL lramdin@salem.com
Lr\It1tY RA fllIN,RS/121�.1�IS,CI-IO,CI'-F
MAYOR HEALTH AGENT
NOTICE OF MEETING
You are hereby notified that the Salem Board of Health will hold its regularly scheduled meeting
Tuesday July 19, 2016 at 7.00 PM
City Hall Annex 120 Washington Street 3rd Floor Room 313
MEETING AGENDA
1. Call to order
2. Approval of Minutes
3. Chairperson Communications
4. Public Health Announcements/Reports/Updates
a. PHN Report V _
b. Health Agent
c. Administrative
d. Council Liaison Updates
5. Tobacco regulation draft discussion with Joyce Redford, DJ Wilson and Victoria Cotdwell
on flavor suspension and suspension language update, continuation
6. Organization of the Board
7. Racism in structural government, requested by Board member Nancy Crowder
8. New Business/Scheduling of future agenda items
• Items that could not be anticipated prior to the posting of the agenda
Larry Ramdm
Health Agent
cc: Mayor Kimberley Driscoll, Board of Health, City Councilors
Next regularly scheduled meeting is September 13,2016 at 7:00pm at City Hall Annex, 120
Washington Street 3'd Floor Room 313.
Know your rights under the open meeting law MGL chapter 30A ss. 18-25 and City Ordinance
section 2-2028 through 2-2033
This ` e ` „ oosted on "G3!Ff� "�' ;letin Board"
City � i.t- -dem, Mass. c r-A Ili dab
at in accosdars(.c: with GL Chap. 30A,
s�t31� : zs.
CITY OF SALEM
BOARD OF HEALTH
MEETING MINUTES
June 14, 2016
DRAFT
MEMBERS PRESENT: Dr. Shama Alam, Chair, Nancy Crowder, Paul Kirby, Janet Greene, &Jeremy Schiller
OTHERS PRESENT: Larry Ramdin, Health Agent, Erica Rimpila, Public Health Nurse &Heather Lyons-Paul
Clerk of the Board, Joyce Redford Dir. NSTACP, Beth Gerard Council Liaison
TOPIC DISCUSSION/ACTION
1. Call to Order 7:05pm
Dr. Schiller motioned to take agenda out of order. N.
Crowder 2nd All in favor. Motion passed.
2. Minutes of Last Meeting Dr. Schiller motioned to approve minutes. J. Greene 2°d All
(May 10, 2016) in favor. Motion passed.
3. Chairperson Announcements * The Board would like to congratulate Elizabeth Gagakis on
the birth of her son.
*Dr. Alam informed the Board that she submitted her
resignation today to the Mayor's office. Her term ends June
27, 2016. Dr. Alam will stay for up to 4 months and until a
new member is sworn in. Next month's agenda will include
organization of the Board
* Summer break discussion.
J. Greene Motioned to cancel the August meeting Dr.
Schiller 2°d all in favor
4. Monthly Reports-Updates
A. Public Health Erica Rimpila in conjunction with the state lab are working on a
Nurse's Report food borne illness investigation. Erica will continue to update
the Board when information becomes available to her.
Copy available at the BOH office
B. Health Agent's The budget is in. There was no additional staff added for the
Report Department of Health this fiscal year budget. Dr. Alam
suggested a work load assessment might help support and
advocate for more positions.
Copy available at the BOH office
C. Administrative Copy available at the BOH office
Report
P. Kirby motioned to accept the reports. Dr. Schiller 2nd All
in favor. Motion passed.
D. City Council *No update on the Board reduction from the State.
Liaison Updates *Resident contacted Councilor Gerard about organizing a
petition to declare gun violence as a public health crisis.
*There is an influx of rodent complaints in North Salem. The
department has baited the storm drains in the problem areas and
will continue to monitor the situation
5. Bunghole Liquors— Discussion on action to suspend or revocation of permit. The
Yd tobacco owner did not show to the hearing. The Board asked the Health
violation hearing Agent to notify the Licensing Board of the offenses. Joyce
Redford suggested the suspension dates coincide with the
suspension date for the other 2"d offense suspensions. The Board
advised Larry Ramdin to coordinate the suspension dates as
requested by J. Redford
P. Kirby motioned to suspend Bunghole Liquors Tobacco
Permit for 30 days and that the Board authorized Larry
Ramdin, Health Agent to set the dates of suspension and
notify the establishment of those dates. Dr. Schiller 2"d All in
Favor
Michelle Gottlieb, Member from the Marblehead Board of
6. Plastic Bags Health, spoke with the Board about the process her Board of
Discussion- Salem Health went through to pass a plastic bag and polystyrene ban.
Student Initiative The Marblehead Board of Health decided to go through a Town
and Michelle Meeting to have an article passed instead of creating a Board of
Gottlieb Health regulation. The reasoning behind going to the Town to
(Marblehead Board pass an article was to have the community as a whole decide on
of Health Member) this initiative. There was mixed reviews from residences and
store owners, however, the Town voted in favor. Looking back,
they might have added a fee for paper bags.
Dr. Alam Opened the floor to questions.
*Dr. Schiller—Did Crosby's have any issue with the change?
Michelle - They were the first to jump on board.
*J. Greene—Asked about concern for reusable bag cleanliness?
' Michelle—Most reusable bags are washable.
*Dr. Alam—What was the length of time took to pass a town
article? Michelle—discussions started 3 months before The
Board brought it in front of the Town to vote upon. They also
gave the businesses a full year before the article was enacted.
Education material and some of the reusable bags came from
health department budget. Some money was able to be given to
merchants for help on purchasing reusable bags.
*P. Kirby- Asked if the polystyrene article was voted on at the
same time as plastic bag banned. Michelle- Yes
*L. Ramdin—Agreed with the idea of bringing this to the City
Council to create an Ordinance rather than a Board of Health
Regulation. There could be more push back due to the amount
of small businesses in the city. He suggested we work with the
Recycling Committee to get the message out on how plastic
bags and polystyrene effect the environment. This would be a
good starting point.
*Councilor Gerard—Market Basket in Danvers seems to be
moving towards using boxes vs bags. She suggested the Salem
Chamber be informed and weigh in on this initiative too.
Victoria Kako and Lisa Nguyen, Salem High School Senior
graduates, spoke about their internship at The Talking Trash for
Clean Oceans at The Salem Sound Coastwatch.
Handouts were given out to the Board.
*Presently 28 communities in Massachusetts have banned single
use plastic bags.
* In two years over 571 plastic bags were removed from the
environment by Salem Sound Coastwatch events.
* MA residents are estimated to use more than 2 billion bags per
year.
*Plastic bags photodegrade, meaning sunlight breaks them
down but chemicals still remain and will eventually be ingested
by marine life.
The students would like to keep informing the community. They
would also like to see Salem moving forward in banning single
use plastic bags.
Barbara Warren from Salem Sound Coatwatch spoke about their
Noah funded program. Summer hires will be continuing work
on this initiative and cleanup efforts, and provided her contact
email.
J. Green motioned to show a vote of support to develop two
(2) ordinances regarding single use plastic bags reduction
and poly styrene food and beverage container reduction. Dr.
Schiller 2nd All in favor. Motion passed.
Discussion—Dr. Schiller will send an email with a statement to
7. Draft Tobacco the Public Health and Safety Committee from the Board.
Regulation - Paul Kirby handed out proposed edits made to the draft
discussion with regulation in collaboration with Victoria Caldwell, Assistant
Joyce Redford on City Solicitor.
flavor suspension The Board discussed the changes proposed to the draft including
and suspension separating suspension and revocation language (4a. suspension
language update &4b. revocation). Also discussed was whether to add a section
continuation for annual mandatory training in order to receive a tobacco sales
permit.
The Board invited Joyce Redford to join them for July's
meeting for further discussion of the draft. DJ Wilson, Tobacco
Control Director and Public Health Liaison for the
Massachusetts Municipal Association and Victoria Caldwell,
Assistant City Solicitor, will be contacted to join them as well.
8. Janet Greene - Beth Janet Greene spoke to the Board about a grant, for up to $1500,
Israel Deaconess that the BIDMC is offering their employees. It is a small grant
Medical Center's for community volunteer work. The application for the grant
(BIDMC)Office of deadline is June 28, 2016. This grant must be related to a
Community volunteer project that a Beth Israel employee is involved in.
Relations Volunteer work must target general health like addiction and the
Community Health environment. J. Greene has a strong interest in the plastic bag
Fellows Grant reduction initiative.
Program
9. New Business/ Scheduling of future *Organization of the Board
agenda items *Racism in structural government, requested by Board member
Nancy Crowder
*Draft Tobacco Regulation continuation
MEETING ADJOURNED: Dr. Schiller motioned to adjourn the meeting. 2°d by N.
Crowder All in favor. Motion passed.
10:15pm
Respectfully submitted,
Heather Lyons-Paul
Clerk of the Board
• Next regularly scheduled meeting is July 10, 2016 at 7pm
At City Hall Annex, 120 Washington Street,Room 313 Salem.
i
Erica Rimpila RN BSN BA
Salem Board of Health
Public Health Nurse
Public Health Nurse Report
Reporting on June 15th, 2016 to July 12th, 2016
Disease Prevention and Health Promotion
• Investigated reportable diseases and reported case information to MDPH.
• Coordinating follow up with North Shore Pulmonary Clinic on 2 current active
tuberculosis cases. Coordinating follow up with BMC TB Pulmonary Clinic on 1 current
active tuberculosis case.
Meetings/Trainings
• On June 14th inspected Marblehead Lynch/van Otterloo YMCA camp.
• On June 141h On June 28"held Wellness Clinic at Salem Senior Center. Provided blood
pressure checks and answered health and wellness questions.
• On June 16th inspected Camp Fire North Shore.
• On June 17th inspected Salem YMCA
0 • On June 20th and 24th inspected Children's Island YMCA.
• On June 11"and June 27th inspected Salem State University Sports Camp.
• On June 29th attended North Shore Emergency Preparedness Coalition Meeting.
Received Sheltering Go Kits for community.
Monthly Report of Communicable Diseases: June 2016
Disease New Carry Over Discharged/ Total#Of Running Piotal for Total for
Reported Closed Cases this Total for 2015 2014
Month 2016
Tuberculosis 1 2 0 3 4 4 5
(Active)
Latent 1 0 1 1 19 5 31
Tuberculosis*
Arbovirus* 0 0 0 0 0 0 0
Babesiosis 0 0 0 0 0 1 0
Calicivirus/No 0 0 0 0 0 1 1
rovirus
Campylobacte 2 0 1 2 8 11 10
riosis
Chikungunya 0 0 0 0 0 0 1
Dengue* 0 0 0 0 1 0 0
Ehrlichiosis 0 0 0 0 0 0 1
Enterovirus 0 0 0 0 0 1 0
Giardiasis 0 0 1 0 3 2 0
Group A 0 0 0 0 0 4 2
Streptococcus
Group B* 0 0 0 0 1 7 6
Streptococcus
Human 0 0 0 0 1 1 0
Granulocytic
Anaplasmosis
Haemophilus 1 0 1 1 1 1 0
Influenzae
Hansen's 0 0 0 0 0 0 0
Disease
Hepatitis B* 0 0 0 0 6 0 2
Hepatitis C* 9 0 9 9 32 29 37
fluenza* 0 0 0 0 16 29 27
Legionellosis 0 0 0 0 0 1 0
Lyme 2 0 2 2 14 2 7
Disease*
Malaria 0 0 0 0 0 0 1
Measles 0 0 0 0 1 0 0
Meningitis 0 0 0 0 0 0 2
Mumps 0 0 0 0 2 0 0
Pertussis 0 0 0 0 0 1 2
Salmonellosis 0 1 1 0 6 6 3
Shigatoxin 0 0 0 0 0 0 1
Producing
Organism
Shigellosis 0 0 0 0 1 0 4
Streptococcus 0 0 0 0 7 3 2
Pneumoniae*
Varicella* 0 0 0 0 1 0 3
4 Vibrio 0 0 0 0 0 0 0
West Nile 0 0 0 0 0 0 0
Yersoniosis 0 0 0 0 0 1 0
Zika Virus 3 0 3 3 3 0 0
Infection
Total 19 3 19 21 127 98 148
June 2016
*Notifications only, LBOH not required to follow up or investigate per DPH.
Summary of Current Communicable Diseases
Active Tuberculosis:
One new case of Active Tuberculosis 6/1/16. Case discharged from hospital 6/3/16.DOT started 6/6/16.
Case 1: Continuing to provide Directly Observed Therapy for case. Case's expected completion
of treatment is August 2016.No new updates.
Case 2: Continuing to provide Directly Observed Therapy for case. Case's expected completion
of treatment is August 2016. No new updates.
isCase 3:New case. Follow up started 6/6/16.
Campylobacter:
Case 1: Case does not attend daycare setting. Parent does not suspect food but suspects water in
Dominican Republic during recent travel. Contact attends daycare setting but parent reports that
contact does not currently have symptoms. Case is closed.
Case 2: Follow up in progress.
Haemophilus Influenzae:
Case 1: Hib vaccination history unknown. Case closed.
Salmonellosis:
Case 1: Case does not work as foodhandler or in a daycare setting. Onset of illness started while
traveling in Dominican Republic. Case closed.
Zika Virus Infection:
Case 1: Confirmed case traveled to Dominican Republic and reported symptoms of fever and
rash. Case not pregnant at time of diagnosis.
Case 2: Suspect case meets criteria for testing.
Case 3: Suspect case meets criteria for testing.
15 cases of Zika Virus Infection previously listed as contact cases have been revoked after lab tests.
I
•
Health Dept. Clerical Report FY 2MB
Burial Permits Certificate of
Permits Plan Reviews Copies / Fines Revenue Permit Fees
$25 Fitness $50
July-14 $475.00 $2,210.00 $1,950.00 $4,635.00 Food Service Est. <25seats $140
August $700.00 $985.00 $1,500.00 $3,185.00 25-99 seats s28o >99 seats $420
September $1,475.00 $2,165.00 $4,300.00 $300.00 $8,240.00 Retail Food <i000sq' s7o
October $725.00 $3,295.00 $1,400.00 $5,420.00 1000-10,000 s28o >lo,000 $420
November $600.00 $2,384.14 $180.00 $1,400.00 $200.00 $4,764.14 Temp.Food 13days s3oo
December $1,375.00 $52,268.00 $2,600.00 $56,243.00 4-7days $600 >7days $
Example of>7 day temp food permit.
January-15 $325.00 $10,780.00 $650.00 $11,755.00 14(da s)dividedb 7=2x$600=$1200
February $750.00 $7,470.00 $2,500.00 $10,720.00 Frozen Desserts $25
March $1,450.00 $890.00 $360.00 $1,550.00 $300.00 $4,550.00 Mobile Food s210
April $550.00 $1,000.00 $1,450.00 $3,000.00 'Plan Reviews New si8o
May $625.00 $2,095.00 $540.00 $1,150.00 $4,410.00 Remodel sgo
June Catering $25 per event/s2oo
$850.00 $1,115.00 $1,950.00 $3,915.00 catering kitchen
Body Art Est. $315
Total $9,900.00 $86,657.14 $1,080.00 $22,400.00 $800.00 $120,837.14 Body Art Practitioner 135
Review Plans s18o
Fiscal Year Budget 2016 Suntan Est. $140
Rec.Day Camp $10
Salary Starting Ending Expenses/Budget Ext.Paint Removal s35
Full Time $357,223.00 $10,500.18 Starting Ending Transport Off.Subst. s1o5
Part Time $16,545.00 $9,307.71 $18,300.00 $0.00 Tobacco Vendors $135
Overtime $2,000.00 $0.00 Swimming Pools Seasonal $140
Balance $375,768.00 $19,807.89 Health Clinic Revolving Account 'Annual$210 Nonprofit$40
$13,591.87 Title V Review s18o
Well Application s18o
Disposal works $225118o
I
i
SALEM BOARD OF HEALTH
PUBLIC COMMENT NOTICE
RESTRICTING THE SALE AND
USE OF TOBACCO PRODUCTS &
NICOTINE DELIVERY PRODUCTS
The Salem Board of Health will
be accepting public comment on
proposed amendments to Regula-
tion #24, Restricting the Sale and
Use of Tobacco Products &-Nicotine
Delivery Products on Tuesday Sep-
tember 13, 2016, 7:00.PM;,ih'.Room
313, City Hall Annex,-120 ,,Washing-
ton Street, Salem-MA�01970. The
amendments will,,rest'rict the sale of
flavored tobacco products in Salem
and clarify enforcement procedures.
The publicmay°submit written com-
ment up toi12:,00 pm on September
23, 2016. Copies of the regulation
are available at our website
http://www.salem.com/sites/sa-
lemma/files/uploads/draft_regula-
tion changes_sales_reg_w_2016_
edits 8.23.16_O.pdf
For more information or a copy of
the regulation, please call 978-741-
1800
SN - 9/7/16
i
DRAFT — 4-22-16
Regulation 24 of the City of Salem Board of Health
g Y
Restricting the Sale and Use of Tobacco Products
A. Statement of Purpose:
Whereas there exists conclusive evidence that tobacco smoke causes cancer, respiratory
and cardiac diseases, negative birth outcomes, irritations to the eyes, nose and throat
(Centers for Disease Control and Prevention(hereinafter "CDC'),Health Effects of Cigarette Smoking
Fact Sheet, (January 2012)); whereas among the 15.7% of students n tionwide who currently
smoked cigarettes and were aged less than eighteen(18) N 1 - °o_ ally obtained
their own cigarettes by buying them in a store (i.e., con. fence s , upermarket, or
discount store) or gas station during the thirty(3D)day efore t s DC, Youth Risk
Behavior, Surveillance Summaries. 2009, MM"2010:59(No. S at ; wher` tion ly in
2000, sixty-nine (69%)percent of middle school age chi ho smoke nce a
month were not asked to show proof of age when purch rettes (CDC, oath
Tobacco, Surveillance Summaries. 2000, MMWR 2001:50(No. SS-04)); the U.S.
Department of Health and Human Services has coja&Wded that m as addictive as
cocaine or heroin (U.S.Department of Health and . es.How Tob o Smoke Causes
Disease: The Biology and Behavioral Basis for Smok' -Attrib isea e: eport of the Surgeon
General,Atlanta, GA: U.S.Department of Health an ma e ers for Disease Control and
Prevention,National Center for Chronic DI'se r for nd He motion, Office on Smoking
and Health, 2010.); whereas despite stat s prohi ng t sale of tobacco products to
minors, access by minors to tobac oducts is a oblem; whereas according to
the CDC, cigarette price increas e the deco r cigarettes and thereby reduce
smoking prevalen c nsu , and youth initiation of smoking (U.S.
Department of He ces.Re o cco Use:A Report of the Surgeon General.
Atlanta, GA. U epartment o nd Hurm ices, Centers for Disease Control and Prevention,
National Ce -for Chronic Diseas ntoon a ealth Promotion, Office on Smoking and Health,
2000 at
Whereas t U.S. Surgeo neral's Report on Preventing Tobacco Use Among
Youth and Y dults, rep that in 2005 Ringel, Wasserman, &Andreyeva (U.S.
Department of Hea uinia rvices,Nicotine Addiction,Atlanta, GA: U.S.Department of Health
and Human Services, al Center for Chronic Disease Prevention and Health Promotion, Office
on Smoking and Health, conducted logistic regression analyses to examine whether
increased cigar price nd state tobacco control policies affected the rate of cigar use.
(U.S.Department of Health and Human Services.Preventing Tobacco Use Among Youth and Young
Adults,Atlanta, GA: U.S.Department of Health and Human Services, Centers for Disease Control and
Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking
and Health, 2012 at 706). Using the 1999 and 2000 iterations of the National Youth Tobacco
Survey, Ringel and colleagues analyzed data from 33,632 adolescent participants aged
nine to seventeen. They found that increased cigar prices significantly decreased the
probability of male adolescent cigar use and found that a 10% increase in cigar prices
would reduce the sample's cigar use by 3.4% (Ringel JS, Wasserman J,Andreyeva T, Effects of
Public Policy on Adolescents'Cigar Use:Evidence From the National Youth Tobacco Survey, 95 Am.J.
Pub:Health 995-8(June 1, 2005); whereas according to the CDC's youth risk behavior
surveillance system, the percentage of high school students in Massachusetts who
reported the use of cigars within the past 30 days went from 11.8%in 2003 to 14.9% in
2009 (CDC, Youth Risk Behavior. Surveillance Summaries, 2009. MMWR 2010;59(No. SS-55)at 72;
CDC, Youth Risk Behavior. Surveillance Summaries, 2003. MMWR 2004;53 (No. SS-02)at 54); whereas
nicotine levels in cigars are generally much higher than nicotine levels in cigarettes. (Nat'l
Cancer Institute at the Nat'l Inst. of Health, Questions and Answers About Cigar Smoking and Cancer
(Oct. 27, 2010));
Whereas commercial Roll Your Own (RYO)machines enable loose, unpackaged tobacco
to be poured into a machine and placed into empty, unpackaged cigarette tubes to be
inhaled by individuals who smoke them. This procedure provides risk of contamination
of the tobacco and unsanitary conditions in the machine and is injurious to public health;
whereas commercial Roll Your Own (RYO)machines located in retail stores enable
retailers to sell cigarettes without paying the federal and state excise taxes that are
imposed on conventionally manufactured cigarettes (RYO FILLING STATION,
www.rwofillinkstation.com (Feb. 27, 2012). High excise taxes encW dul okers to quit
and deter youth from starting (Kenneth E. Warner, Smoking ah bons of a Change in
the Federal Cigarettte Excise Tax, 255 J AM. WD.Ass N 1028 986), Fran oupka&Rosalie
Liccardo Pacula, The Impact of Price on Youth Tobacco Use, in MOKI A ACCO
CONTROL MONOGRAPHS: CHANGING ADOLESCENT SMO ALEN ` S. ep't
Health and Human Services et al. eds., 2001)). Therefore, inex cigarettes, se
produced from RYO machines, promote the use of tob ing in a neg ive impact
on public health and increased health care costs, and severely ut the evidence-
based public health benefit of imposing high excj',5Ajhkxes on toba
Whereas the federal Family Smoking Prevention and Tobacco Control Act (FSPTCA)
enacted in 2009,prohibited candy- and fruit-flavored cigarettes 21 U.S.C. §38791 largely
Vbecause these flavored products were marketed to youth and young adults, Carpenter C
ayne GF,Pauly JL, et al. 2005. "New Cigarette Brands with Flavors that Appeal to Youth: Tobace
IIrI arketing Strategies."Health Affairs. 24(6): 1601-1610;Lewis Mand Wackowski O. 2006. `Dealin wit
Ian Innovative Industry:A Look at Flavored Cigarettes Promoted by Mainstream Brands."America
ournal of Public Health. 96(2):244-251; Connolly GN 2004. "Sweet and Spicy Flavours:New Brand
or Minorities and Youth."Tobacco Control. 13(3):211-212; U.S.Department of Health and Huma
ervices. 2012. Preventing Tobacco Use Among Youth and Young Adults:A Report of the Surgeo
eneral.Atlanta: U.S.National Center for Chronic Disease Prevention and Health Promotion, Office o
moking and Health,p.537, w�tnv.surs�c onceneral.gov/librar•ti/rcportsiprc vetrtiW-youth-tobacco-use/ull
e ort. d and younger smokers were more likely to have tried these products than olde
I mokers, U.S.Department of Health and Human Services. 2012.Preventing Tobacco Use Among Yotit
sand Young Adults:A Report of the Surgeon General.Atlanta: U.S.National Center for Chronic Diseasdi
prevention and Health Promotion, Office on Smoking and Health,p. 539, w"'w.surgeongeneral.gov
ibr•aryh-eporzs/prevetrting-vouth-tobacco-use/irll-reportpdfneither federal nor Massachusetts law
restrict sales of flavored non-cigarette tobacco products, such as cigars, cigarillos
mokeless tobacco,hookah tobacco, and electronic devices and the nicotine solution
sed in these devices; and the U.S. Food and Drug Administration and the U.S. Surgeo
eneral have stated that flavored tobacco products are considered to be "starter"product
ghat help establish smoking habits that can lead to long-term addiction; Food and Dru
dministration. 2011. Fact Sheet:Flavored Tobacco Products,www. da. ov/download
TobaccoProducts/Protectit: Kids rontTobacco/FlavoredTobacco/UCMI83214. d- U.S.Department o
Health and Human Services. 2012.Preventing Tobacco Use Among Youth and Young Adults:A Report o�
ke Surgeon General.Atlanta: U.S.National Center for Chronic Disease Prevention and Heal'
�romotion, Office on Smoking and Health, . 539, ivww.sur eon eneral. ov/libra /re orts/ reventin
outh-tobacco-use/ull-report. d
S
1
Whereas the sale of tobacco products are incompatible with the mission of health care
institutions because they are detrimental to the public health and undermine efforts to
educate patients on the safe and effective use of medication;
Whereas educational institutions sell tobacco products to a younger population, which is
particularly at risk for becoming smokers and such sale of tobacco products are
incompatible with the mission of educational institutions that educate a younger
population about social, environmental and health risks and harms;
Now, therefore it is the intention of the City of Salem Board of Health to regulate the
access of tobacco products.
B. Authority: `
This regulation is promulgated pursuant to the authorit nt o the f Sa in
Board of Health by Massachusetts General Laws Chapt Section 3 ards of
Health may make reasonable health regulations".
C. Definitions:
For the purpose of this regulation, the follow' g wor 1 have t following
meanings:
�dult-only retail tobacco store: An establishment that is not required to possess a retai
ood permit whose primary purpose is to sell or offer for sale but not for resale, tobacco
products and tobacco paraphernalia, in which the sale of other products is merel
ncidental, and in which the entry of persons under the minimum legal sales age i
rohibited at all times, and maintains a valid permit for the retail sale of tobacco roduct
s re uired to be issued by the Salem Board of Health
Blun ny tobacco produ anufactured or packaged as a wrap or as a hollow
tube mad or in part fro bacco that is designed or intended to be filled by the
consumer wi e tobacco o her fillers.
Business Agent: A al who has been designated by the owner or operator of any
establishment to be t nager or otherwise in charge of said establishment.
CCharacterizing
flavor: A distinguishable taste or aroma, other than the taste or aroma o
` bacco, menthol, mint or wintergreen, imparted or detectable either prior to or durin
onsumption of a tobacco product or component part thereof, including,but not limite
o, tastes or aromas relating to any fruit, chocolate, vanilla,honey, candy, cocoa, dessert
alcoholic beverage, herb or spice; provided,however, that no tobacco product shall b
determined to have a characterizing flavor solely because of the provision of ingredien
formation or the use of additives or flavorings that do not contribute to this
istinguishable taste or aroma of the product.
Cigar: Any roll of tobacco that is wrapped in leaf tobacco or in any substance containing
tobacco with or without a tip or mouthpiece not otherwise defined as a cigarette under
Massachusetts General Law, Chapter 64C, Section 1, Paragraph 1.
2
i
Commercial Roll-Your-Own (RYO) machine: A mechanical device, by whatever
manufacturer made and by whatever name known, that is designed to roll and wrap
tobacco into products. RYO machines located in a private home, used for personal
consumption, are not Commercial Roll-Your-Own machines.
omponent part: Any element of a tobacco product, including, but not limited to,the
obacco, filter and paper, but not including any constituent:
onstituent: Any ingredient, substance, chemical or compound, other than tobacco
ater or reconstituted tobacco sheet, that is added by the manufacturer to a tobacc
roduct during the processing,manufacturing or packa ing of the tobacco product. Suc
kerm shall include a smoke constituent.
Distinguishable- Perceivable by either the sense of smell or taste
- Cigarette: Any electronic device, not approved by the United States Food and Dru
Administration, composed of a mouthpiece,heating element, battery and/or electrons
ircuits that provides a vapor of liquid nicotine to the user, or relies on vaporization o
my liquid or solid nicotine. This term shall include such devices whether they ar
manufactured as e-cigarettes, e-cigars e- i es e-hookah or under any other produe
Lame.
Educational Institution: Any public or at 11 e, sch rofessional school,
scientific or technical institution, uni or of inst' tion furnishing a program of
higher education. _
Employee: Any i t I_ per rvices for an employer.
Employer: y individual, p hip, as `ation, corporation, trust or other organized
group o ividuals that uses t rvices f one (1) or more employees.
lavored tobacco product: Any tobacco product or component part thereof that contain
a constituent that has or produces a characterizing flavor. A public statement, claim o
�ndicia made or disseminated by the manufacturer of a tobacco product, or by any perso
authorized or permitted by the manufacturer to make or disseminate public statements
i oncerning such tobacco product, that such tobacco product has or produces
haracterizing flavor shall constitute resumptive evidence that the tobacco product is a
avored tobacco product.
Health Care Institution: An individual, partnership, association, corporation or trust or
any person or group of persons that provides health care services and employs health care
providers licensed, or subject to licensing, by the Massachusetts Department of Public
Health under M.G.L. c. 112 or a retail establishment that provides phannaceutical goods
and services and subject to the provisions of 247 CMR 6.00. Health care institution
includes, but is not limited to, hospitals, clinics,health centers, pharmacies, drug stores,
doctor offices and dentist offices.
Minor: Any individual who is under the age of twenty-one (21).
3
I
Permit Holder: Any person engaged in the sale or distribution of tobacco products
directly to consumers who applies for and receives a tobacco product sales permit or any
person who is required to apply for a tobacco product sales permit pursuant to these
regulations, or his or her business agent.
Smoke Constituent: Any chemical or chemical compound in mainstream or sidestre
`obacco smoke that either transfers from any component of the tobacco product to th
moke or that is formed by the combustion or heatingof tobacco additives or othe
,om onent of the tobacco roduct.
moking Bar: An establishment that primarily is engaged in the retail sale o4bars"
roducts for consumption by customers on the premises and is required by Mera
aw Ch. 270, §22 to maintain a valid permit to operate a smoking bar issued
assachusetts Department of Revenue. "Smoking bar" shall include, but noe
o those establishments that are commonly known as "cigar bars" and "hookobacco Product: Any product containing, made, or derived from tobacco orthas intended for human consumption, whether smoked, chewed, absorbed, dissnhaled, snorted, sniffed, or ingested by any other means, including,but not l :
ligarettes, cigars, little cigars, chewing tobacco,pipe tobacco, snuff; or electroni
igarettes, electronic cigars, electronic pipes, electronic hookah, liquid nicotine, "e
iquids"or other similar products, regardless of nicotine content, that rely on vaporizatio
r aerosolization. "Tobacco product" includes any component or part of a tobacc
roduct. "Tobacco product" does not include any product that has been approved by th
nited States Food and Drug Administration either as a tobacco use cessation product o
or other medical purposes and which is being marketed and sold or prescribed solely fc
he approved urpose.
Vending ine: Any auto or mec cal self-service device, which upon
insertio money, tokens or her fo of payment, dispenses or makes cigarettes,
any o cco product.
D. Tobacco Sales to rs Prohibited:
1. No person shal o products or permit tobacco products to be sold to a minor;
or not being the min rent or legal guardian, give tobacco products to a minor.
2. Required Signage
a. In conformance with and in addition to Massachusetts General Law, Chapter 270,
Section 7, a copy of Massachusetts General Laws, Chapter 270, Section 6, shall
be posted conspicuously by the owner or other person in charge thereof in the
shop or other place used to sell tobacco products at retail. The notice shall be
provided by the Massachusetts Department of Public Health and made available
from the City of Salem Board of Health. The notice shall be at least 48 square
inches and shall be posted conspicuously by the pen-nit holder in the retail
establishment or other place in such a manner so that it may be readily seen by a
person standing at or approaching the cash register. The notice shall directly face
the purchaser and shall not be obstructed from view or placed at a height of less
4
than four(4) feet or greater than nine (9) feet from the floor. The owner or other
person in charge of a shop or other place used to sell tobacco products at retail
shall conspicuously post any additional signs required by the Massachusetts
Department of Public Health.
b. The owner or other person in charge of a shop or other place used to sell tobacco
products at retail shall conspicuously post signage provided by the City of Salem
board of health that discloses current referral information about smoking
cessation.
c. The owner or other person in charge of a shop or other place used to sell tobacco
products that rely on vaporization or aerosolization, as defined herein as "tobacco
products", at retail shall conspicuously post a sign g t" e sale of
tobacco products, including e-cigarettes, to min er rs of age is
prohibited."The owner or other person in char of a sho r place used to
sell e-cigarettes at retail shall conspicuously po i ating `The I#e of e-
cigarettes at indoor establishments may be prohi y local I Wtices
shall be no smaller than 8.5"by 11" and shall be onspicuous _ _the
retail establishment or other place in such a in er so ey may be readily
seen by a person standing at or approaching the cash regi notices shall
directly face the purchaser and shall no cted from or placed at a
height of less than four(4) feet or gre er th (9) eet m the floor.
3. Identification: Each person selling h t i tobac _ ducts shall verify the age
of the purchaser by means of valid ent-is _ d p ographic identification
containing the bearer's date of bi t the purch lyears old or older.
Verification is required for any der the age o 27.
4. All retail s o a cts in e-to-face between the seller and the
buyer.
E. T oduct Sales Permi
1. No person ell or other e distribute tobacco products at retail within the City of
Salem without ainin obacco Product Sales Permit issued annually by the City
of Salem Board o ly owners of establishments with a permanent, non-mobile
location in Salem are le to apply for a permit and sell tobacco products at the
specified location in em.
2. As part of the Tobacco Product Sales Permit application process, the applicant will be
provided with the City of Salem Board of Health regulation. Each applicant is required to
sign a statement declaring that the applicant has read said regulation and that the
applicant is responsible for instructing any and all employees who will be responsible for
tobacco product sales regarding both state laws regarding the sale of tobacco and this
regulation.
3. Each applicant who sells tobacco is required to provide proof of a current tobacco sales
license issued by the Massachusetts Department of Revenue before a Tobacco Product
Sales Permit can be issued.
5
4. The fee for a Tobacco Product Sales Permit shall be determined by the City of Salem
Board of Health annually. All such permits shall be renewed annually.
5. A separate permit is required for each retail establishment selling tobacco products.
6. Each Tobacco Product Sales Permit shall be displayed at the retail establishment in a
conspicuous place.
7. No Tobacco Product Sales Permit holder shall allow any employee to sell tobacco
products until such employee reads this regulation and state laws regarding the sale of
tobacco and signs a statement, a copy of which will be placed on file in the office of the
employer,that he/she has read the regulation and applicable state laws.
8. A Tobacco Product Sales Permit is non-transferable. o f an establishment
that sells tobacco products must apply for a new permi o new ill be issued
unless and until all outstanding penalties incurred by t evi pen der
satisfied in full.
9. Issuance of a Tobacco Product Sales Permit shall be condi on an applicant's
consent to unannounced, periodic inspections of his/her retail es'- t to ensure
compliance with this regulation.
10. Issuance and holding of a Tobacco Prod al e I be conditioned on an
applicant's on-going compliance with Amen as chuse partment of Revenue
• requirements and policies includin , of limit o, imum retail prices of tobacco
products.
11. A Tobacco Pr ermit t be renewed if the permit holder has failed to
pay all fines i an eriod the fines has expired and/or has not
satisfied a utstanding pe pensio
12. Number of Toba roduct Sales Permits.
At any gi e, there sh ; e no more than 60 Tobacco Product Sales Permits
issued in Ci lem. permit renewal will be denied based on the requirements
of this subsecti any permittee who has failed to renew their current permit
within(30)days iration will be treated as a first-time permit applicant.
Applicants who chase a business that holds a current Tobacco Product Sales
Permit at the time of the sale of said business may apply within sixty(60) days of
such sale, and if complying with all application requirements shall receive, the permit
held by the Seller if the Buyer intends to sell tobacco products. New applicants for
permits who are applying at a time when the maximum number of permits have been
issued will be placed on a waiting list and will be eligible to apply for a permit on a
"first-come, first-serve"basis as issued permits are either not renewed or are returned
to the Board.
F. Cigar Sales Regulated:
1. No person shall sell or distribute or cause to be sold or distributed a single cigar.
6
2. No erson shall sell or distribute or cause to be sold or distributed any original actory-
ra e package of two or more cigars, unless such package is priced for retail sale at
• $5.00 or more.
3. This Section shall not apply to:
a. The sale or distribution of any single cigar having a retail price of two dollars and
fifty cents ($2.50) or more.
b. A person or entity engaged in the business of selling or distributing cigars for
commercial purposes to another person or entity engaged in the business of
selling or distributing cigars for commercial purposes with the intent to sell or
distribute outside the boundaries of Salem.
4. The Salem Board of Health may adjust from time to me the a ecified in this
Section to reflect changes in the applicable Consumer I by ent f this
regulation.
G. Prohibition of the Sale of Blunt Wraps
No person or entity shall sell or distribute blun _ ithin the Salem.
H. Free Distribution and Coupon Redem ti
No person shall distribute, or cause t istribu any ee samples of tobacco
products. No means, instruments vices that the redemption of tobacco
products for free or at a reduced ow the minnnum retail price determined by the
Massachusetts D s _ even 1 be accepted by any permittee.
I. Out-of-P a e Sales:
No p sell or cause to id or distribute or cause to be distributed, any
ciga ette that contains er than twenty (20) cigarettes, including single
cigarettes.
J. Self-Service Di
All self-service displ s of tobacco products are prohibited. All humidors including, but
not limited to, walk-in humidors must be locked.
K. Vending Machines:
All tobacco product vending machines are prohibited.
L. Commercial Roll-Your-Own Machines
All commercial Roll-Your-Own machines are prohibited.
• I
M. Prohibition of the Sale of Tobacco by Health Care Institutions:
7
No health care institution located in City of Salem shall sell or cause to be sold tobacco
products. No retail establishment that operates or has a health care institution within it,
such as a pharmacy or drug store, shall sell or cause to be sold tobacco products.
N. Prohibition of the Sale of Tobacco Products by Educational Institutions:
No educational institution located in City of Salem shall sell or cause to be sold tobacco
products. This includes all educational institutions as well as any retail establishments
that operate on the property of an educational institution.
O. E-Cigarette Use:
The use of e-cigarettes is prohibited wherever smoking is i p G.L. Ch.270,
§22 and the Salem Environmental Tobacco Smoke (ET ati
in
Sale of Flavored Tobacco Products Prohibited:
o person shall sell or distribute or cause to be sold or distributed any flavored tobacc
product except in smoking bars and adult-only retail tobacco stores
Q. Violations:
1. It shall be the responsibility of the establi ent e r and/or his or her
business agent to ensure compliance wjjjWl1 ti s of t lation pertaining to his
or her distribution of tobacco product e viola shal eceive:
a. In the case of initial observed a an inspection within a 36-month
perio hun Lars ($100.00)per violation.
b. e case of vio obsery t the second inspection within 36 months
f the date of a cuff olatio , a fine of two hundred dollars ($200.00)per
lation and the To o Product Sales Permit shall be suspended for seven
nsecutive busi days.
c. In t of vio ons observed at the three or more inspections within 36
months nt violation, a fine of three hundred dollars ($300.00) and
the Tobac oduct Sales Permit shall be suspended for thirty(30)
consecuti business days.
In the case of four violations, or repeated, egregious violation7Health
egulation within a thirty-six (36)month period, the Board ofhal=obacco
aring in accordance with .4b and may permanente
Product Sales Permit;
2. Refusal to cooperate with inspections pursuant to this regulation shall result in the
suspension of the Tobacco Product Sales Permit for thirty(30) consecutive business days.
8
3. In addition to the monetary fines set above, any pen-nit holder who engages in the sale
or distribution of tobacco products directly to a consumer while his or her permit is
suspended shall be subject to the suspension of all board of health issued permits for
thirty(30) consecutive business days.
Sus ensions:
a. The Salem Board of Health, through the Health Agent, shall notify the permi
i older of its intention to suspend a Tobacco Product Sales Permit and such notic
hall contain the reasons for the suspension, the length of the suspension, the date
hat the suspension period shall begin and that the permit holder has twenty-ona
(21)days from the date of this notice to request a hearing before the Board o
Flealth. The beginning date for any suspension shall be more than twenty-one(21
lays from the date of the notice, to allow time for the permit holder to request
hearing. If a hearing is requested within the twenty-one (21 da eriod th
puspension shall be held in abeyance pending the hearing
The Salem Board of Health, through the Health Agent, shall provide notice of th
pntent to permanently revoke a Tobacco Product Sales Permit, which notice shal
lI ontain the reasons therefore and establish a time and date for a hearing whic
ate shall be no earlier than seven(7) days after the date of said notice. Th
I)ermit holder or its business agent shall have an opportunity to be heard at sue
fearing and shall be notified of the Board of Health's decision and the reason
herefore in writing. After a hearing, the Salem Board of Health may revoke th
obacco Product Sales Permit if the Board of Health finds that a violation of this
egu!ation occurred, or may iin ose other penalties at its discretion.
For purposes of such suspensions or revocations,the Board shall make th
p etermination notwithstanding any separate criminal or non-criminal proceeding
)rought in court hereunder or under the Massachusetts General Laws for the sam
offense. All tobacco products, as defined herein, shall be removed from the retail
establishment upon suspension or revocation of the Tobacco Product Sales
ermit. Failure to remove all tobacco products, as defined herein shall constitute
se arate violation of this regulation.
R. Non-Criminal D1 _ on:
Whoever violates an provision of this regulation may be penalized by the non-criminal
method of disposition as provided in General Laws, Chapter 40, Section 21 D or by filing
a criminal complaint at the appropriate venue.
Each day any violation exists shall be deemed to be a separate offense.
S. Enforcement:
Enforcement of this regulation shall be by the City of Salem Board of Health of or its
designated agent(s).
9
Any citizen who desires to register a complaint pursuant to the regulation may do so by
contacting the City of Salem Board of Health or its designated agent(s) and the Board
shall investigate.
T. Severability:
If any provision of these regulations is declared invalid or unenforceable, the other
provisions shall not be affected thereby but shall continue in full force and effect.
U. Effective Date:
This regulation shall take effect on September 1, 2012, with the exception of Section F
(Cigar Sales Regulated) which shall take effect on Febru 0
Amended August 7, 2014
The amendments to Regulation 24: Restricting the Sale e of To cts &
Nicotine Delivery Products will become effective Janu 015. }
After a vote of the Board of Health at a special meeting eld ust 7, 2014 the
amendments passed: 3 affirmative 2 negative
Pursuant to MGL Chap. 111 § 31, a summary ulation was ed in the Salem
Evening News on September 5, 2014
Vote reaffirmed on September 24, 201 A ve 1 e, 1 abstain
City of Salem Board of Health
120 Washington Street, 4th Floo
Salem MA, 0117
Dr. Barbara P a Chair e Sullivan
Dr. Shama am, MD anielle oux M.D.
Paul Ki
La Health Agent her Lyons-Paul- Clerk of the Board
10
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