HHSITEM#1
January 29,2015
Worksession
MEMORANDUM
January 27,2015
TO:
FROM:
SUBJECT:
Heath and Hwnan Services Committee
Amanda Mihill, Legislative
Attome~
Worksession:
Bill 56-14, Health and Sanitation Smoking - Electronic Cigarettes
Bill 56-14, Health and Sanitation - Smoking - Electronic Cigarettes, sponsored by Councilmember
Floreen, then Council Vice President Leventhal, and Councilmembers Branson, Navarro, Rice,
EIrich, Riemer, Katz, Hucker and Berliner, was introduced on November 25,2014. A public hearing
was held on January 20 at which testimony was both in support and opposition to Bi1156-14.
Bill 56-14 would:
• prohibit the use of electronic cigarettes in public places where traditional tobacco smoking
is prohibited;
• restrict the sale of certain liquid nicotine or liquid nicotine containers in retail outlets unless
the nicotine is in a container considered child resistant packaging;
• prohibit the sale of electronic cigarettes in any place that is accessible to buyers of the
product without the intervention of the seller (similar to tobacco products); and
• generally amend County law regarding smoking, electronic cigarettes, and health and
sanitation.
Background
Before the introduction of Bill 56-14, the Health and Hwnan Services Committee met twice on the
issue of electronic cigarettes. All the materials from those worksessions are not reproduced in this
packet, but can be found at the following links:
• July
21:
http://www.montgomerycountymd.gov/council/Resources/Files/agendal
cmJ20141140721120140721
HHS1.pdf
• September 18:
http://~ww.montgomerycountymd.gov/council/ResourceslFiles/agendal
cmJ20
141140918/20
140918 HHS l.pdf
At the July 21 worksession, the Committee received briefings from the National Institutes of
Health and the Legal Resource Center for Public Health Policy on electronic cigarettes. These
briefings included a discussion of the current medical understanding of the health risks and public
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policy concerns with electronic cigarette usage. The presentation from Dr. Walton and Dr. Boone
from the National Institute on Drug Abuse is on ©1O.
After the briefmgs, Committee members expressed specific concerns about the use of electronic
cigarettes by minors and directed staff to provide options to restricting youth access to electronic
smoking devices. Committee members discussed these options, including a prior draft of
Councilmember Floreen's bill, at its September 18 worksession. Also at its September 18
worksession, Committee members received a briefing from the Department of Liquor Control's
Licensing and Regulatory Enforcement staff on its program to identify entities that are selling
tobacco to minors.
Health concerns ofelectronic cigarettes.
Many individuals that oppose the prohibition of using
electronic cigarettes in places where traditional cigarettes are prohibited argued that electronic
cigarettes are less harmful than traditional tobacco products. Less harmful does not mean harmless.
In prior worksessions, the Committee discussed the health concerns regarding electronic cigarettes.
Some items noted in the attached presentation from the National Institute on Drug Abuse (©1O­
35) include:
• 90% of smokers begin while in their teens or earlier.
• Electronic cigarette use by high school students increased from less than 5% to almost 10%
from 2011 to 2012.
• 1 in 5 middle school students that reported ever using electronic cigarettes have never tried
conventional cigarettes.
• Reasons students gave for using electronic cigarettes include: curiosity, attraction of
flavors, use by friends and family, desire to quit smoking, availability, and it is a sign of
independence.
• Adult use is primarily by current smokers who give health reasons as the primary motivator
for use (less harmful than conventional cigarettes, desire to cut down or quit conventional
cigarettes, prevent relapse to conventional cigarettes, don't want to disturb others, use in
smoke free places.)
• Concerns about electronic cigarettes include:
o They are in general use but risks and benefits are not fully evaluated.
o Lack of standards over design and contents.
o May renormalize smoking or encourage poly-use.
o Marketing that may attract kids (kid-friendly flavors, characters or famous actors,
ads in media). The presentation noted that ads during the 2013 Super Bowl reached
10 million viewers and that from 2011 to 2013, electronic cigarette ads that reach
children increased by 256%.
With regard to Secondhand and Thirdhand Exposure, the NIDA presentation noted:
Electronic cigarettes have no sidestream emissions like a conventional cigarette.
Exhaled aerosol may be inhaled by nearby individuals (secondhand exposure).
Surfaces can be coated with the nicotine-containing aerosol as it settles (thirdhand
exposure).
Health effects of indirect aerosol exposure are unclear.
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A 2014 World Health Report (©70-82) stated that "bystanders are to the aerosol exhaled by ENDS
users, which increases the background level ofsome toxicants, nicotine as well as fine and ultrafine
particles in the air" and acknowledged that the levels were lower than that oftraditional cigarettes.
The report noted, however, that "it is not clear if these lower levels in exhaled aerosol translate
into lower exposure, as demonstrated in the case of nicotine." The report further stated that
"It
is
unknown if the increased exposure to toxicants and particles in exhaled aerosol will lead to an
increased risk of disease and death among bystanders as does the exposure to tobacco smoke.
However, epidemiological evidence from environmental studies shows adverse effects of
particulate matter from any source following both short-term and long-term exposures." The
report further noted that existing evidence shows thate-cigarette aerosol is not merely water vapor.
Food and Drug Administration regulation.
The Committee has heard in prior worksessions on
this topic about the FDA's pending regulation. The Family Smoking Prevention and Tobacco
Control Act gives the FDA the authority to regulate the manufacturing, marketing, and sale of
tobacco products. The law applies to cigarettes, cigarette tobacco, roll-your-own tobacco, and
smokeless tobacco products, and to any other tobacco product "deemed" by regulation to be
subject to the law. The FDA has issued a "deeming" regulation that would, among other actions,
subject e-cigarettes to regulations already applicable to cigarettes, including:
minimum age of purchase;
prohibition on free samples;
health warnings;
prohibition of certain vending machine sales; and
report to the FDA product and ingredient listings.
The "deeming" regulation would not address flavorings (which may be attractive to youth
smokers). The docket is no longer open on this deeming regulation.
Legal status ofelectronic cigarettes in Maryland.
At the public hearing, Bruce Bereano, on behalf
of the Maryland Association for Tobacco and Candy Wholesalers, argued that the County did not
have the authority to regulate electronic cigarettes and in prior correspondence cited 2 Court of
Appeal cases as the basis for that statement. Council staffhas reviewed the legal status ofelectronic
cigarettes with the Committee in prior worksessions. In short, the FDA does not currently regulate
electronic cigarettes (see discussion immediately below). And, of the 3 state regulatory schemes
that are relevant to tobacco control (the Clean Indoor Air Act, Title 16 ofthe Business Regulation
Article (cigarettes), and Title 16.5 of the Business Regulation Article (other tobacco products»,
none regulate electronic cigarettes. Of particular relevance, (s)16.5-101(i) of the Business
Regulation Article defines "other tobacco products" to include "any other tobacco or product made
primary from tobacco, other than a cigarette, that is intended for consumption by smoking or
chewing or as snuff." This definition does not include electronic cigarettes. The only state law on
point to Council staff's knowledge is §24-305 ofthe Health-General Article ofthe Maryland Code,
which prohibits distribution of electronic cigarettes to a minor.
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In
support of his contention that the County does not have authority to regulation electronic
cigarettes,
Mr.
Bereano cites
Atladis U.S.A., Inc.
v.
Prince George's Countyf
and
Allied Vending
v.
City ofBowie
2.
Neither ofthese cases support the conclusion that the County is preempted from
regulating electronic cigarettes.
In
Atladis,
the Court of Appeals held that state law occupies the
field of regulating the packaging and sale of tobacco.
In
Allied Vending,
the Court held that the
state occupied the field of cigarette sales through vending machines.
The County Attorneys Office has similarly concluded that the County is not preempted from
regulating electronic cigarettes (<042).
Action in Marylandjurisdictions.
In
November 2014, the Baltimore City Council enacted, and
the mayor later signed into law, a bill that includes electronic smoking devices in its tobacco
smoking prohibitions. Using an electronic smoking device is not prohibited in a restaurant or
tavern (or in a designated area of a restaurant or tavern) if the restaurant or tavern notifies
customers that the use of electronic devices is not allowed on its premises. Using an electronic
smoking device is also not prohibited in a facility that
was
awarded a video operation license.
Issues for Committee Discussion
Should the Council wait until the Food and Drug Administration regulates electronic
cigarettes?
Debra Robins, on behalf of Century Distributors urged the Council not to regulate
electronic cigarettes until the FDA regulates cigarettes (©51). As noted
in
the background section
of this memorandum, although the FDA has proposed a regulatory framework for electronic
cigarettes, it is unclear when (or whether) the FDA will adopt a final rule, what the contents ofthat
rule will be, and when that rule will take effect. The County has a history of protecting the public
health by taking action before other agencies with concurrent jurisdiction do so. As a recent
example, the FDA recently (2014) finalized a rule to implement menu labeling throughout the
country; the County has had this requirement since 2010. Council staff sees no need to wait until
the FDA regulates electronic cigarettes to do so locally.
Should using an electronic cigarette be prohibited in public spaces?
Bill 56-14 would prohibit
using an electronic cigarette in any public place where smoking a traditional cigarette is also
prohibited. Places in which smoking a traditional cigarette is prohibited generally include:
• Elevators
• Health care facilities
• County-owned or County leased facilities or property, including bus stop areas and bus
shelters
• Theaters
• Businesses or organizations open to the public
Places in which smoking a cigarette is not prohibited include:
• In a tobacco shop
1431 Md. 307 (2013).
2332 Md. 279 (1993).
4
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When smoking is necessary to conduct certain research
Up to 40% of sleeping rooms in a hotel or motel
In the bar and dining area of a restaurant (subject to certain restrictions)
On a golf course
Several individuals supported certain portions of the bill (banning sales to minors and/or
requirement of child resistant packaging), but opposed the prohibition of using an electronic
cigarette in these public places. Many ofthese individuals related their personal experiences using
electronic cigarettes as a smoking cessation device. Chris Webber encouraged the Council to
amend Bill 56-14 to follow the exemptions for restaurants and taverns in the Baltimore City law.
Several other individuals supported the Bill as introduced on this issue and specifically opposed
additional exemptions such as what was enacted in Baltimore.
Council staff first notes that Bill 56-14 would not ban the use of e-cigarettes entirely, as some
individuals may believe. Rather, as mentioned above, Bill 56-14 would prohibit the use of
electronic cigarettes only in places in which traditional smoking is prohibited.
Council staff does
not recommend
amending Bill 56-14 to allow using an electronic cigarette in public places where
smoking traditional cigarettes is prohibited.
In
Staff's view, the health concerns of electronic
cigarettes outweigh the inconvenience of an individual needing to retreat to an area where smoking
is permitted (i.e., outdoors).
Should FDA-approved devices be prohibited?
As introduced, Bill 56-14 would exclude from the
definition of electronic cigarette (and therefore the prohibitions of Bill 56-14) "any product
approved by the Food and Drug Administration for sale as a drug or medical device." The ACS
CAN recommended that this language be removed (©49).
Council staff recommendation:
Although Council staff understands the concerns expressed by the ACS CAN, we believe that if
the FDA has determined that something is a medical device or drug, then residents should be
allowed to use them. If the FDA determines an e-product is a medical device or drug in the future
and it becomes a significant issue in the County, the Council could amend the law to remove this
exemption.
Should the definition ofelectronic device be broadened?
As introduced, Bill 56-14 would define
an electronic cigarette in part as "an electronic device that delivers vapor for inhalation, including
any refill, cartridge, or any other component of an electronic cigarette." The ACS CAN
recommends the following definition:
any product containing or delivering nicotine or any other substance intended for
human consumption that can be used by a person to simulate smoking through
inhalation of vapor or aerosol from the product. The term includes any such device,
whether manufactured, distributed, marketed, or sold as an e-cigarette, e-cigar, e­
pipe, e-hookah, or vape pen, or under any other product name or descriptor. (©49)
Council staff recommendation:
Council staff is comfortable with this expanded definition,
although as noted in the issue above, we recommend that the FDA-approved medical devices and
drugs are excluded from the definition.
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Should electronic cigarettes be included in the definition of smoking or tobacco product?
In
several recommendations, the ACS CAN recommends that the definition of smoking or tobacco
product include e-cigarettes (©49-50). Although this would simplify parts of the bill, Council staff
reminds Committee members that e-cigarettes is not a tobacco cigarette or an "other tobacco
product", which are both regulated by the State. Rather, as explained above, electronic cigarettes
are a nicotine product and the County has broad authority to regulate them.
Should Bill 56-14 prohibit the sale to, or purchase by, minors?
As introduced, Bill 56-14 would
prohibit the use ofelectronic cigarettes by minors. The ACS CAN recommends the bill be amended
to prohibit the sale of electronic cigarettes by minors. Bill 56-14 does not address the sale of
electronic cigarettes because state law already prohibits this (see ©50).
Should tobacco stores and vape stores prohibit minors from entering?
The ACS CAN
recommended that Bill 56-14 be amended to restrict minors from entering tobacco stores and vape
stores (©50). Council staff does not have any concerns with this recommendation.
Should· the child resistant packaging of liquid nicotine requirement sunset when FDA
regulations are promulgated?
In
an e-mail to Councilmember Floreen, Ashlie Bagwell, on behalf
of Lorrilard Tobacco Company, urged that Bill 56-14 be amended to sunset the child resistant
packaging requirement once FDA regulation mandates packaging requirements for liquid nicotine
containers. Ms. Bagwell recommended the following language, which in her view would "simply
allow for a standardized approach once the FDA comes out with their guidance/rules":
The provisions of subdivision A 2 shall sunset upon the effective date of [mal
regulations issued by the U.S. Food and Drug Administration or by any other
federal agency where such regulations mandate packaging and labeling
requirements for liquid nicotine containers.
Council staff recommendation:
Council staff understands the desire for standardized approaches
rather than having piecemeal requirements. Although Council staff is not opposed to this provision,
Council staff would redraft it to ensure that there is no lapse in time between when the Council
provision would sunset and the FDA regulation would take effect
County Attorney amendments.
The County Attorneys Office recommends several clarifying
amendments to prevent perceived enforcement difficulties (©43). These are detailed below and
Council staff recommends the Committee adopt these amendments:
• amend Section 24-9(e)(2) to permit the use of "vaping" on signage;
• replace the phrase "using an electronic cigarette" with "vaping" throughout the bill;
• add a definition of vaping;
• amend Section 24-9(f) to add "vaping" after "who smokes" on line 76 and after ''to smoke"
on line 78; and
• cross reference the federal regulations for special packaging in Section 24-14.
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This packet contains:
Circle #
Bill 56-14
Legislative Request Report
Presentation from National Institute on Drug Abuse
Fiscal and Economic Impact statement
Select testimony and correspondence
Dr.
Ulder Tillman, on behalf of the County Executive
County Commission on Health
American Cancer Society Cancer Action Network
Century Distributors
Maryland Environmental Health Network
Maryland GASP
Maryland Public Health Association
Judy Ackerman
Heather Kusnetz
Charles Frederick Chester
Mike Shanahan
Ronald Ward, Jr.
Chris Webber
Steven C. Weiss
World Health Organization Report
State law
1
9
10
36
41
47
49
51
53
55
56
58
60
62
63
64
67
68
70
83
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Bill No.
56-14
Concerning: Health and Sanitation ­
Smoking - Electronic Cigarettes
Draft No._4_
Revised:
9/9/2014
Introduced:
November 25, 2014
Expires:
May 25,2016
Enacted: _ _ _ _ _ _ _ _ __
Executive: _ _ _ _ _ _ _ __
Effective: _ _ _ _ _ _ _ _ __
Sunset Date: _N:....:.o=n:""e":-_ _ _ _ __
Ch, _ _, Laws of Mont. Co. _ __
COUNTY COUNCIL
FOR MONTGOMERY COUNTY, MARYLAND
By: Councilmember Floreen, Council Vice President Leventhal, and
Councilmembers Branson, Navarro, Rice, EIrich, Riemer, Katz, Hucker and Berliner
AN
ACT to:
(1)
(2)
(3)
(4)
(5)
prohibit the use of electronic cigarettes in certain public places;
restrict the sale of certain liquid nicotine or liquid nicotine containers in retail
outlets unless the nicotine is ina container considered child resistant packaging;
restrict the accessibility of certain tobacco products in retail settings, and require
retail sellers of those products to take certain actions;
prohibit the use of electronic cigarettes by minors; and
generally amend County law regarding smoking, electronic cigarettes, and health
and sanitation.
By amending
Montgomery County Code
Chapter 24, Health and Sanitation
Section 24-9
By adding
Chapter 24, Health and Sanitation
Sections 24-13 and 24-14
By renumbering
Chapter 24, Health and Sanitation
Sections 24-2,24-3,24-4,24-5,24-6,24-7,24-8, 24-9B, 24-9C, 24-9D, 24-10, 24-11,
24-11A
By repealing
Chapter 24, Health and Sanitation
Section 24-9A
By renaming
Chapter 24, Health and Sanitation
Article II
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BILL
No. 56-14
Boldface
Underlining
[Single boldface brackets]
Double underlining
[[Double boldface brackets]]
* * *
Heading or defined term.
Added to existing law by original bill.
Deletedfrom existing law by original bill.
Added by amendment.
Deletedfrom existing law or the bill by amendment.
Existing law unaffected by bill.
The County Council for Montgomery County, Maryland approves the following Act:
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BILL
No. 56-14
1
Sec. 1. Sections 24-2, 24-3, 24-4, 24-5,24-6,24-7,24-8,24-10,24-11, and
24-11A are renumbered as follows:
24-2,24-3. [Reserved.]
24-[4]2. Communicable diseases generally - Warning signs.
2
3
4
5
*
24-[5]3. [Same]
warning signs.
*
*
Unauthorized removal of
6
7
8
Communicable diseases
*
24-[6]~.
*
*
*
*
*
*
9
10
[Same] Communicable diseases - Control in food establishments.
*
24-[7]~.
11
Use of certain shoe-fitting devices or machines prohibited.
12
13
14
15
16
17
18
19
24-[11]~.
24-[8]~.
*
*
*
Massage.
Commitment of chronic alcoholics.
*
*
*
*
*
*
*
*
24-[10]1. Catastrophic health insurance plan.
*
*
24-[IIA]8A. Fitness centers - defibrillators.
Sec. 2. Article II is renamed; Section 24-9 is amended; Section 24-9A is
repealed; Sections 24-9B, 24-9C, and 24-9D are renumbered; and Section
24-13 is added as follows:
Article II. [Reserved] Smoking, Tobacco, and Nicotine.
24-9. Smoking and using electronic cigarettes in public places.
(a) Definitions.
In
this [Section] Article, the following words and phrases
have the meanings indicated:
20
21
22
23
24
25
26
27
28
*
*
*
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BILL
No.
56-14
29
30
31
32
33
34
Electronic cigarette
means an electronic device that delivers vapor for
inhalation. including any refill, cartridge. or any other component of
an electronic cigarette.
Electronic cigarette
does not include any
product approved
Qy
the Food and Drug Administration for sale as
drug or medical device.
~
*
*
*
35
36
Smoking
or
smoke
means the act of lighting, smoking, or carrying a
lighted or smoldering cigar, cigarette, or pipe, of any kind.
37
38
39
*
*
*
~
Vape shop
means any store that primarily sells electronic cigarettes.
Vape shop
does not include an area of
electronic cigarettes are sold.
(b)
larger store in which
40
41
Smoking and using an electronic cigarette are prohibited in certain
public places.
A person must not smoke or use any electronic
42
43
44
45
cigarette in or on any:
*
(c)
by this Section:
(1)
(3)
*
*
Exceptions.
Smoking or using an electronic cigarette is not prohibited
In a tobacco shop or
~
vape shop;
*.
46
47
48
49
50
*
*
When smoking or using an electronic cigarette is necessary to
the conduct of scientific research into the health effects of
tobacco smoke and is conducted at an analytical or educational
laboratory;
51
52
53
54
*
(d)
*
*
Notwithstanding paragraph (b)(ll), the Director of the Department of
Health and Human Services may designate .an outside area on
55
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BILL
No. 56-14
56
57
property that is owned or leased by the County where smoking or
using an electronic cigarette is allowed if the Director finds that a
complete prohibition on that property would impede a program's
mission or effective delivery of services.
(e)
58
59
60
61
Posting signs.
(1)
Except as provided in paragraph (e)(4), signs prohibiting or
permitting smoking or using an electronic cigarette, as the case
may be, must be posted conspicuously at each entrance to a
public place covered by this Section.
62
63
64
65
66
67
68
69
(2)
Where smoking or using an electronic cigarette is prohibited by
this Section, the sign either must read "No smoking or' using an
electronic cigarette by order of Montgomery County Code § 24­
9. Enforced by (department designated by the County
Executive)" or be a performance-oriented sign such as "No
Smoking or Using an Electronic Cigarette" or "This is a Smoke
Free Establishment."
The international no-smoking symbol
70
71
72
73
74
75
76
77
78
may replace the words "No smoking."
*
(f)
*
*
Duty to prevent smoking in certain areas.
The owner or person in
control of a building or area covered by this Section must refuse to
serve or seat any person who smokes where smoking or using an
electronic cigarette is prohibited, and must ask the person to leave the
building or area ifthe person continues to smoke after proper warning.
79
80
*
(k)
*
*
Enforcement and penalties.
(1)
81
Any violation of this [Section] Article is a class C civil
violation. Each day a violation exists is a separate offense.
82
(J)
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BILL
No. 56-14
83
84
85
(2)
The County Attorney or any affected party may file an action in
a court with jurisdiction to enjoin repeated violations of the
Section.
86
87
88
(3)
The County Executive must designate
Qy
Executive order one
or more County departments or agencies to enforce this Article.
ill
The Director of the Department of Health and Human Services
may suspend a license issued under Chapter 15 for up to 3 days
if the Director finds, under the procedures of Section 15-16,
that the operator of an eating and drinking establishment has
knowingly and repeatedly violated any provision of this
Section.
89
90
91
92
93
94
95
[24-9A. Reserved.]
24-[9B] 10. Availability of tobacco products to minors.
96
97
*
*
*
*
*
*
24-[9C]l1. Distribution of tobacco products to minors.
24-[9D]12. Tobacco and electronic cigarette [Products - Placement] products
98
99
100
101
102
103
104
105
106
107
=
placement.
(a)
Placement.
A retail seller of any tobacco or electronic cigarette
product must not display or store the product in any place that is
accessible to buyers of the product without the intervention of the
seller or an employee of the seller.
(b)
Definitions. Tobacco product
means any substance containing
tobacco, including cigarette, cigars, smoking tobacco, snuff, or
smokeless tobacco.
108
(c)
Applicability.
This Section does not apply to:
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BILL
No. 56-14
109
110
111
112
(1)
the sale of any tobacco or electronic cigarette product from a
vending machine that complies with all requirements of state
law; and
(2)
any store where only or primarily tobacco or electronic
cigarette products are sold.
113
114
115
116
[(d)
Enforcement.
The County Executive must designate by Executive
order one or more County departments or agencies to enforce this
Section.]
117
118
119
120
121
122
123
[24-12. Reserved.]
24-13. [Reserved]
Use
of electronic cigarettes!!y minors prohibited.
A person under
.lli
years old must not use an electronic cigarette.
24-14. Child Resistant Packaging
of Liquid
Nicotine Container Required.
W
Definitions.
In
this Section, the following words have the meanings
indicated:
Child resistant packaging
means packaging that is:
124
125
126
ill
designed or constructed to be significantly difficult for children
under
~
years of age to open or obtain
~
toxic or harmful
~
amount of the substance contained therein within
time; and
reasonable
127
128
129
ill
not difficult for normal adults to use properly.
Child resistant packaging
does not mean packaging which all such
children cannot open or obtain
reasonable time.
~
130
131
132
133
toxic or harmful amount within
~
Liquid nicotine container
means
~
container that is used to hold liquid
containing nicotine in any concentration.
(j)
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BILL
No. 56-14
134
135
136
137
138
139
140
141
142
143
144
145
146
ill
Child resistant packaging required
A retail seller of any liquid
nicotine or liquid nicotine container must not sell, resell, distribute,
dispense, or give away:
ill
ill
any liquid or
W
substance containing nicotine unless the
substance is in child resistant packaging; or
any nicotine liquid container unless the container constitutes
child resistant packaging.
W
Exceptions.
This Section does not apply to
~
liquid nicotine container
that is sold, marketed, or intended for use in an electronic cigarette if
the container is prefilled and sealed
Qy
the manufacturer and not
intended to be opened
Qy
the consumer.
24-[12]15-24-21. Reserved.
Approved:
147
148
149
150
Approved:
President, County Council
Date
151
152
153
Leggett, County Executive
Date
154
This is a correct copy ofCouncil action.
155
156
157
Linda M. Lauer, Clerk of the Council
Date
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LEGISLATIVE REQUEST REPORT
Bill 56-14
Health and Sanitation
-
Smoking
-
Electronic Cigarettes
DESCRIPTION:
Bill 56-14 would prohibit the use of electronic cigarettes in public
places where traditional tobacco smoking is prohibited; restrict the
sale of certain liquid nicotine or liquid nicotine containers in retail
outlets unless the nicotine is in a container considered child resistant
packaging; prohibit the sale of electronic cigarettes in any place that
is accessible to buyers of the product without the intervention of the
seller (similar to tobacco products); and prohibit the use of electronic
cigarettes by minors.
Electronic cigarettes are not currently regulated by the FDA or the
state. Many youth could perceive electronic cigarettes as less hannful
than traditional tobacco smoking. Current statistics show that e­
Cigarette use by high school students increased from less than 5% to
almost 10% from 2011 to 2012 and that reasons students gave for
using e-Cigarettes include: curiosity, attraction of flavors, use by
friends and family, desire to quit smoking, availability, and it is a
sign of independence.
In part, to protect the health of minors by restricting the use and
availability of electronic cigarettes to minors.
Health and Human Services
To be requested.
To be requested.
To be requested.
To be researched.
Amanda Mihill, Legislative Attorney, 240-777-7815
To be researched.
PROBLEM:
GOALS AND
OBJECTIVES:
COORDINATION:
FISCAL IMPACT:
ECONOMIC
IMPACT:
EVALUATION:
EXPERIENCE
ELSEWHERE:
SOURCE OF
INFORMATION:
APPLICATION
WITIDN
MUNICIPALITIES:
PENAL TIES:
Class C violation.
f:\law\bills\1456 electronic cigarettes\lrr.doc
(j)
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Electronic Cigarettes:
An Overview
Presentation to
Montgomery County Council
July 21, 2014
Kevin Walton, PhD
Division of Pharmacotherapies and Medical Consequences of Drug Abuse
Ericka Boone, PhD
Office of Science Policy and Communications
National Institute on Drug Abuse, NIH
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Conventional Tobacco Use in the U.s.
Associated morbidity and mortality
-
-
480,000 Americans die each year from smoking
16 million suffer from tobacco-related illnesses
(~1
in 5 deaths)
Economic cost: nearly
$3008
annually
-
-
$133B in direct medical care
$156B in lost productivity
18.1%
of all
u.s.
adults smoke
(42%
in
1965)
However, in the past year
68.9%
of adult smokers wanted to stop smoking
42.7%
of adult smokers made a quit attempt
Source: HHS, The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General.
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Youth Smoking Continues as a Concern
• 90%
of smokers begin while in their teens or earlier
• 14%
of high school students (grades
9-12)
smoke
• Use of multiple tobacco products is common
• With current trends,
6
million teens alive today will die
from smoking-related diseases
However...
• The percent
of
teens who are
current smokers*
has been declining
for more than a
decade
.....Sth Grade
-ll-10th Grade
-.-12th Grade
1997 1999 2001 2003 2005 2007 2009 2011 2013
Source: HHS, Preventing Tobacco Use Among Youth and Young Adults, A Report of the Surgeon General, 2012
CDC, MMWR 62(No. 45), November 15, 2013; Johnston, MTF National Results on Drug Use:1975-2013
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Electronic
Cigare.tte
(E-cigarette) History
• An e-cigarette is a smokeless nicotine delivery device
o E-cigarettes can also contain no nicotine, just producing a flavored
aerosol (vapor)
• First introduced in China in
2003
• Available in the
u.s.
since 2007
.
• Made by
u.s.
tobacco companies and independent
non-conventional-tobacco companies
-
-
Lorillard (blu), Reynolds American (Vuse), Altria (MarkTen)
Independent large players include NJOY and Logic
• Over 250 e-cigarette brands in the
u.s.
• E-cigarette use has doubled every year since 2010
• Estimated to be
greater than $1.58
industry
@
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Most People Are Aware of
Electronic C. garettes
.
i
90
80
70 .
60
50
40
30
20
10
0
Heard
of
e-cigs
Radio
TV
~
-
.18-24
.25-44
.45+
--
-,- -
~
c
-a
c
b.O
1_
&.
cu
'"
a::
~
In
Social
Person Network
Media
INFORMATION
SOUIRCE
Source: Zhu et ai, 2013
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Adult Use of Electronic Cigarettes
Primarily by Currel t Smokers
n
25
20
~
15
..__ .w._
.w ..... _ . _ ••• _ _ . _
.~._
.2010
••
~.
_ _ •••• _ •• '
._.~
..............._
. ' • •_ . _ . _ _ •••• _ . _ _ " , _
. . . . ._ . _ . _ . _
0_'" ._." 0_'",
•••••••••••••••
_._
._. _ _ • _ _ • _ _ ._ ••••••••• _ ••••
_
- 0_'" ._....... _
:::l
>
w
Qj
10
~--.-.-~.-.--.---.--.--
...
-.-.~.-
"#.
5
..........
-
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..
-
.-.-
-
.-
...
-
-
.-.
-
._.
-
.w
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ow ••••• _
.......... _
._._ .... _
.2011
.w..••
. _ ••_
~80%
'W'" ._.... _. _.
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-.-
...
-
..
--.---.--------.---~- --.---.---.--.-.~
.
...
-
.....
_.- _.-
-
..
-
....
-
.-.
-_. -
.--
_.
-
.-
....
_.-
._.-
-
.....
of current users
report dual use with
conventional
cigarettes
0
Current
Smoker
Former
Smoker
NeverSmoker
• .Health
reasons primary motivator for e-cigarette use
Believe less harmful than conventional cigarettes
Desire to cut down
and/or
quit conventional cigarettes
Help with reducing cravings and w'
thdrawal
symptoms
i
Want to prevent relapse to conventional cigarettes
Don't want to disturb others with smoke or for use in smoke-free
places
Source: King et ai, 2013; Pearson et ai, 2012; Lee et ai, 2014; Brown et ai, 2014;
Etter, 2010; Kralikova et ai, 2013; Pearson et ai, 2012; Vickerman et ai, 2013
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Electronic Cigarette Use
!
.2011
by
Youth Increasing
76.3% of students
who used in the past
month also s'moked
conventional
cigarettes
15
-;....._
..._
........._
............................_
........._
._
...-.,............_
....._
............_
.._
....__.__.__.__._
._
........_
...._
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5:
=:
cu
~
10
L_..
_.
______
. --
_
_
.
~
.
....
"
.
.
..
,
. -_._ . '-
.._
-_
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.
.
.
-_-...
. ...-.
'" -
-
2012
.
.
. .
.
.
.
.
.
U.I
>
5
..;...._
.............•......
-
..
....._._.
o
High School
Middle School
• 1
in
5
middle school students that reported ever using e-cigarettes
have never tried conventional cigarettes
• Reasons gi'ven for using e-cigarettes
Curiosity
Attraction of flavors
Use by friends and family
Desire to quit smoking
Availability
Sign of independence
Source: CDC, MMWR 62:893-97, 2013; Camenga, et ai, 2014; Kong et ai, 2014
®
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Current E-Cigarette Regulation is
Li.m ited
• E-cigarettes mostly unregul,ated under federal law
-
-
FDA
currently seeking to regulate the sale, manufacture, and
distribution of e-cigarettes
Unknown when regullations will be finalized
• There are no official standards of design or contents
• There is no requirement to provide public information
on the contents of e-cigarettes
• Many states, including Maryland, regulate the sale of
e-cigarettes to minors
Source: http://tobacconomics.org!wp-content!uploads/2014/06/EcigStateLaws_SCTCENDS.pdf
@)
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What are the
C'o ncerns
About
Electronic Cigarettes??
• In general use but risks and benefits not fully evaluated
• Lack of standards over design and contents
• Potential relapse for former smokers or use by never
smokers
• May renormalize smoking or encourage poly-use
• Potential for use with controlled substances
• Marketing that may attract kids
- Kid-friendly flavors (e.g., chocolate, fruit, gummi bear, cotton
candy, etc) and characters or famous actors; ads in media
ch
- -
-
- - -
•• 1-
1 -
- -
-
.
-
• L
- -
­
®
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Anatomy of an Electronic Cigarette
Consists of a power source,
heating device
(aerosolizer/vaporizer), and
liquid-containing cartridge
Puffing activates the
battery-powered heating
device, which heats the
nicotine solution into afl
aerosol (vapor), which is
then inhaled
"
,
.
\lbltage Control
• Earl,y devices designed to
resemble conventional
tobacco cigarettes
Source: http://science.howstuffworks.com/innovation/everyday-innovations/electronic-cigarette1.htm
~
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Types of Electronic Cigarettes
Disposable
~Igarette
NJOV,
White Cloud,
,
-- ,..
"
i'
:
~
-.
,!",~."
....
~.,,~.,
~
" ...
....
"~.;."-~
•.•.,,... "1::
....._.;"
_........
:'.oM....:'.,
Greensmoke
:a
Rechargeablee-cigarette
Sealed device
or cartridge
Markten, Mistic,
blu,
VUSE
Pea-style,
medium-8~.
rechargeable e-clgarette
eGo, Vaporking,
Totally Wicked
~1I-
User adds liquid
Iarge.-slzed
rechargeable e-elgarette
Tank-styl~
to
d .
eVlce
Volcano Lavatube
Source: Grana,-et ai, 2014
®
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Tank Systems and liquid Refills
• Tank systems give users access to an extensive
assortment
of
flavors and nicotine concentrations
..
.
100+ FLAVORS
• These devices are gaining in popul,arity
Can have larger} mlore powerful batteries
.'
Concerns about accidental
liquid
nicotine poisoning
CDC
reports increase in poison control center calls regarding
e-cigarettes: 1 call/month in 2010, 214 calls/month in 2014
Regulatory efforts discussed to require child-safe packaging
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Electronic Cigarette Liquid Contents
1. Nicotine (0% to 3.6%)
2. Propylene Glycol (PG)
3. Vegetable Glycerin (VG)
(Glycerol)
• Experience with PG and ,VG
-
The Food and Drug Administration classifies PG and VG as
"Generally Recognized As Safe" (GRAS)
,
PG/VG used in medicines, cosmetics, and food products
PG for inhalation (e.g., asthma inhalers) at concentrations
much lower than in e-cigarettes
-
VG does not have a history of use for inhalation
PG and VG used to create artificial theatrical fog
4. Water
5.
Flavorings
®
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Electronic Cigarette Aerosol Contents
• Long-term safety of aerosol inhalation is unknown
-
-
-
It is not just water vapor; little experience with some constituents
Some compounds same as in tobacco smoke: acrolein,
acetaldehyde
Generally lower levels of toxins (9-450x) than in tobacco smoke
• Variable voltage devices can alter the aerosol
-
-
-
Higher voltage produces higher temps, more nicotine in aerosol
This can increase levels of toxic compounds: e.g., formaldehyde
Levels can approach those measured in conventional cigarettes
• E-cigarette aerosol is less complex than tobacco smoke
There are an estimated
5000
compounds in tobacco smoke
Tobacco smoke includes
70
known carcinogens
Many fewer compounds ine-cigarette aerosol
Goniewicz et ai, 2014; Kosmider et ai, 2014
@
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Addiction Potential:
Conventional vs. Electronic Cigarette
Conventional cigarette delivers nicotine rapidly
25
20
*
[PLASMA
--
~
NICOTIN~-
Arrow indicates
smoking initiation:
10 puffs/30 seconds
5
15 30 45
.
• Other compounds in smoke may enhance addiction
• Association of smoking with specific behaviors
-
Social interactions, drinking, stress
• Children and teenagers may be highly susceptible to
nicotine addiction
Source: Vansickel, et ai, 2010
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Addiction Potential:
Conventionalvs. Electronic Cigarette
E-cigarettes have been less effective at nicotine delivery
30
20
10
However
-Newer devices can deliver
more nicotine
-Nicotine delivery can be
by puffing behavior
'--------fl
o
~I'~------------------------------~
0 10 20 30 40 50 60
minutes
Unknown effects of flavors and additives
Situational use is similar - social, drinking, stress
Use by children and teenagers is a significant concern
Source: Farsalinos et aI, 2014
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Secondhand and Thirdhand Exposure
• E-cigarettes have no sidestream emissions like a
conventional cigarette (generates smoke while holding)
• Exhaled aerosol may be inhaled by nearby individuals
(secondhand exposure)
• Surfaces can be coated with the nicotine-containing
aerosol as it settles (third hand exposure)
• Health effects of indirect aerosol exposure are unclear
• Extensive experience with conventional cigarettes is
being used as a guide to investigate these questions
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Electronic Cigarettes: Nicotine Cessation
Nicotine replacement therapy (NRT) is an approved
cessation treatment
E-cigarettes may be a uniquely effective
NRT
due to
their potential to mimic conventional cigarettes
More rapid nicotine delivery than approved NRT
Behavioral aspects: mouth feel, exhaling aerosol, touch
Only a few
peer-reviewed
clinical studies
Li mited effect
Little nicotine
delivered
.U')
j-g
't-
~
~
c::
QJ
c::
180
160
-
-
-
E-cigarette with nicotine.
E-cigarette w/o nicotine
Nicotine patch
I
~
+-'
I
40
III
..0
..0
:= \
20
ro
c..
el 0
12 week
treatment
III
o
50 .
100
150
200
Days
to
Relapse
Source: Bullen et ai, 2013
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Electronic Cigarettes: Harm Reduction
• IIPeople smoke for the nicotine but they die from the
tar" Prof Michael Russell, 1976
• In a harm reduction model, smokers would replace
conventional cigarettes with e-cigarettes
• There is active debate on the proper approach
Some advocates support the immediate routine use of e­
cigarettes to replace conventional cigarettes
A more cautious view seeks a better understanding on safety
and heir impact on conventional cigarette use
t
• No peer-reviewed harm reduction studies
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NIH
Supported Research into
Electronic Cigarettes
Device design and function
Health effects of aerosol constituents
Biomarkers (physiological measures of exposure)
How does marketing influence use
What are the effect of flavorings on preferences
Longitudinal surveys of use by youth and adults
Potential for cessation and harm reduction
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There are More Questions than
Answers for Electronic Cigarettes
• How safe are e-cigarettes for long term use?
• Will conventional cigarette smokers who use e-
cigarettes completely switch or become dual users?
• Will e-cigarettes alter a smoker's intentions to quit?
• Can e-cigarettes be an effective tool in cessation?
• Will non-smoking youth routinely use e-cigarettes?
• How will e-cigarettes affect youth smoking of
conventional cigarettes?
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o
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en
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EI',e ctronic
Cigarette Advertising
Advertising of traditional
,cigarettes
TV
ads banned since
1971
Increased youth exposu re to e-cig ads
- Between 2011-2013, e-cig TV ads that reach
children increased
by
256% and young adults
by
321%
.
~'-~"";Qp:~:
.
.
;
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.
Ads during
2013
Super Bowl reached
more than
10
million viewers
.
L~'~hl~:\·Y::'~:Y~/~
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.:":;;
~;"'
:":':;';)~'c:
$
;,6
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',
.
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01
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~:~.:..
~ ~.~- ,":"'~
. :
.
"
In
2013, $30
mHlion spent on ads in
for 'blu' e-Cig brand
(increase planned for 2014)
"
.
.
,
.
In
2014, $30
million budgeted to
promote NJOY e-Cigs in the US
(spending
triple that of 2013)
;~~I~~
Source: Wall Street Journal (online) - Dec 2013; Duke, et al (2013) - http://pediatricsde.aap.org/pediatrics/juIL2014?pg=59#pg59
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Regulatory Options Enacted by States
• Taxing e-cigs similar to tobacco products
• Restrict or prohibit redemption of coupons for tobacco
products, including e-cig products
• Prohibit distribution of free samples
• Regulate sale and distribution of flavored non-cigarette tobacco
products with characterizing flavors (similar to New York)
• Comprehensive youth access laws prohibiting sale to minors,
requirement to be kept behind counters, sold only in places
where adults permitted to enter and raise minimum age to
purchase
• Include e-cigs in smoke and tobacco-free restrictions
• Regulate the sale and marketing of e-cigs, health warnings at
pOint-of-sale
Source: http://publichealthlawcenter.orgfsites/defau It/files/pdf/tclc-fs-regulatory-options-e-cigarettes-2013.pdf
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Current State Regulations
United Stales 100% Smokefree Air Laws
American Nonsmokers' RIghts Found.tlon
Tenlwd•• 1Uld
Aa
f;J
.July
3, 201'"
Commonwvallh.
Oaeoa....""
--..-..
........
s'h
GI
,r
~Ds......
u.s.
State and Local
T....ltod•••nd
Cornm~.
Laws Regulating Use of Electronic Cigarettes
As
oIJu1y
3. 20'4
American Nonsmokers'
RIghts
Foundation
....
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..
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-
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CINIII:J._
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Physiological Effects of Nicotine
• Nicotine is rapidly delivered to the bloodstream via
conventional cigarettes.
• Nicotine stimulates the adrenal glands to release the
hormone epinephrine (adrenaline), increasing blood
pressure, respiration, and heart rate.
• Nicotine increases release of the neurotransmitter
dopamine, affecting brain pathways controlling reward
and pleasure.
• Long-term brain changes induced by continued nicotine
exposure result in addiction-a condition of compulsive
drug seeking and use, even in the face of negative
con seq uences.
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ROGKV1LLE, MARYLAND
MEMORANDUM
January
12,2015
TO:
George Leventhal, President, County Council
FROM:
SUBJECT:
Jennifer
A.
H.Ughes.
Director, Office of
. . . .
Joseph F. Beach, Director,
J)epartment~~\.1
f.~~~udget
U
FEIS for Bill 56-
J
4. Health and Sanitation - Smoking ­ Electronic Cigarettes
Please find
attached
the fiscal
and
economic
impac(statements
for the above­
referenced
legislation.
JAH:fz
co:
Bonnie
Kirkland, Assistant Chief Administrative Officer
Lisa Austin. Offices ofthe County Executive
Joy Nurmi, Special
Assistant
to the County .Executive
Patrick Lacefield,
DireGtor,
Public
Information
Office
Joseph F. Beach, Director, Department
of Finance
Uma Ahluwalia,
Director,
Department of Human Health Service
David Platt, Department of Finance
Pofcn
Salem.
Office of
Management and
Budget
Alex Espinosa,. Office of Managem\"'Ilt and
Budget
Naeem
Mia,
Otfice of Management and Budget
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Fiscal Impact Statemetit
Council Bill 56-14
Health
and
Sanitation - Smoking - Electronic Cigarettes
1. Legislative Summary.
Bill
56-14 would:
• prohibit the use ofelectronic cigarettes in public places where traditional tobacco
smoking
is
prohibited;
• restrict the sale of certain liquid nicotine or liquid nicotine containers in. retail
outlet.~
unless
the
nicotine is in a container considered child resistant packaging;
• prohibit the sale of electronic cigarettes in
any
place
that
is accessible to buyers of the
product
"'lthout
the intervention of the seller (similar
to
tobacco
products);
and
• generally amend County law regarding smoking, electronic cigarettes, and health and
sanitation.
2.
An estimate
of
changes
in
County revenues and expenditures regardless of whether the
revenues
or
expenditures are assumed in
the
recommended or approved budget.
Includes source of information, assumptions, and methodologies used.
.
There will be no increase
in
revenues.
Based
on experience from other smoking related
legislation~
response to complaints is
minimal.
Enforcement ofchild resistant
packaging will have a fiscal impact
if
the Department of
Health
and Human Services (HHS)
is
charged with enforcement through inspection.
based on 857 markets requiring
bi~annuaJ
inspection
is
428 inspections
annually. Checking for child resistant packaging would add approximately 15 minutes to
each inspection which results in an additional 107 hours of inspection or .05 PTE. At $50
per hour, the additional county expenditure would
be
approximately $5,350 annually.
The Department ofGeneral Services (DGS) estimates expenditures of $18,220 for 400 sigtl$
to
be
posted conspicuously at each entrance
to
a public place covered under the legislation. :
.
Costs are for new sign fabrication
($8,000)~
installatIon ($10,000) and hardware ($220).
The Department of Transportation (DOT) estimates expenditures of $341,000 are needed to:
redesign and install Ride-On signs reflecting proper No Smoking or E-Smoking
s}1Dools .
and enforcement language in order to fully implement the
law.
3. Revenue and expenditure estimates covering at least the next 6 fiscal years.
Ex~itures
The expenditure identified in Question 2 would remain the same for each subsequent
fiscal year.
DGS estimated costs would
cover
the next six fiscal years.
4. An actuarial analysis tbrough the
entire
amortization period for each bill tbat would
affect retiree pension or group insurance costs.
Not applicable.
5. An estimate
of
expenditure$ related
to
County's information
technology
(IT)
~ystems,
including Enterprise Resource Planning (ERP) systems.
Not applicable.
@
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6.
Later actions that may
a1feet
future
revenue
ad
expenditures
if
the
biD
authorizes
future spending.
Not applicable.
7.
An
estimate
of the
staff
time needed
to
implement
the
bilL
It wou1d require 20 hours
training based on one hour
for 20
Environmental
Health
Specialists.
DGS estimates 672 staffhours for sign instal1ation. inspection, and
contractor
oversight
Hours deployed for this effort are assumed during normal working
hours.
However, this will
reallocate staff from other facility
repairs and
emergencies,
such that backfill
overtime may
be
incurred.
The average overtime cost
for
nos
~ff
(public
Sei"vice Craftworker, G
J
5) is
$36.4
per
hour.
8.
An explanation of how the addition of new staff responsibilities would affect other
duties.
Overall
average time
to
inspect
a food
service
facility is two
bours.
Based
on
an
additional
107
bOUTS
oftime
to inspect for child
resistant
packaging,' it would
result
in
approximately 53
fewer food
service inspections completed
annually.
9. An estimate of costs when an additional appropriation
is
.needed.
Not applicable.
10. A description of any variable that could affect revenue and cost estimates.
If
enforceme.t'lt
ofchild resistant packaging is moved from HHS to
Liquor
Control there
would be
little or no fiscal impact on
HHS.
11. Ranges of revenue or expenditures that are uncertain or difficult
to
project.
Not
applicable.
12.
If
a bill
is
likely
to have no fiscal impact, why that
is
the ease.
Not applicable.
13. Other
ClScaI
impacts or comments.
None.
14. The following contributed to and concurred with this analysis:
Clark BeB, Sr. Administrator. Licensure and Regulatory Services. DHHS
Kenlleth Welch, Environmental Health Manager, Licensure and Regulatory Services, DHHS
Patricia Stromberg. Budget Team Manager, DHlIS
Beryl·
L.
.Feinberg.
Deputy Director. Department of General Services
Richard Jackson.
Division
Chief,
Department of General
Services
Darlene Flynn, Chief of Management Services for Transit, Departm.ent of Transportation
Pofen Salem, Senior
Management and
Budget
Analyst,
Office
of
Management
and
Budget
Dat6
'
@
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Economic Impact Statement
BiB 56·14, Health and Sanitation - SmokiBg - Electronic Cigarettes
Backgronnd:
This legislation would:
• prohibit
the use ofelectronic cigarettes
in
public
places ,were
traditional tobacco
smoking is prohibited.
• restrict the sale of certain liquid nicotine or liquid nicotine containers in retail
outlets unless the nicotine is in a container considered child resistant
packaging~
and
• prohibit
the sale ofelectronic cigarettes in any place
that
is accessible
to
buyers of
the
product 'without the intervention ofthe seller.
1. The sources of information, assumptions, and methodologies used.
Sources of information include the Montgomery County Department of Health
and
Human Services (HHS) and the U.S. Center for Disease Control and Prevention
(CDC).
The methodology used in the preparation ofthe economic
impact statement
is a
review
of various
documents from the CDC related to the
Use
of
the
products
prohibited
and restricted under Bil156-14 and infonnation provided
by
HHS.
Included in the review is a description of the products, the results
of
a study
conducted by the journal entitled
Nicotine
&
Tobacco Research,
and
information
pro'vided
by HBS.
According
to
the latest issue
of
lt40rbidity and Mortality Weekly Report
from the
CDC dated December )
2~
2014, "electronic nicotine delivery systems (ENDS),
including electronic cigarettes (e.-cigarettes) and other devices such as electronic
hookahs, electronic cigars, and
vape
pens, are
battery~~wered
devices capable of
delivering aerosolized nicotine and additives to the
user:~
According
to
the
article,
experimentation with and current use of e-cigarettes has risen sharply among youths
and adults.
A new studypublishcd in
Nicotine
&
Tobacco
Research
focused on middle and
high
school students \vbo never smoked cigarettes but who
used
e-cigarettes. According to
researchers from CDC, Food and Drug Administration (FDA), and Georgia State
University, the number of youths who
had
never smoked a cigarette but
had.
used e­
cigarettes at least once increase three-fold. That is, the number or"never-smoking
youth' who used e-cigarettes increased from 79,000 in 2011
to
more than 263,000 in
2013.
The study also focused on the impacts of advertising on students. The findings reveal
that ninety percent
of'thever~smoking
youth"
reported some level of exposure to
advertising or promotions for cigarettes or other
tobacco
products. Researchers
Page 1
of2
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Economic
Impact
Statement
Bill 56-14, Health. and Sanitation - Smoking - ElectroDic Cigarettes
concluded that the greater number of advertising sources to which young people were
exposed, the greater their rate ofintention to smoke cigarettes.
According to data collect from websites, there are 52 e-cigarette and vapor stores in
Maryland and eight stores are located in Montgomery County. According to
infonnation provided
by
HHS
t
there are no data on the number ofe-cigarettes or
vapor devices sold in the County. However" there are 847lieensed markets
in
the
County including grocery stores, mini-marts, and gas stations
that
could sell e­
cigarettes but currently may not Therefore data on the sale and consumption of e­
cigarettes and vapor devices in the County are not available to estimate \Vith any
degree of certainty the economic impact ofEill 56-14.
2. A
description
of
any variable
that
couJdaffect
th~
econoinic impact estimates.
The variables the could affect the economic impact estimates are.tbe number of e­
cigarettes and vapor devices $Old in the County and the consumption of such products
by minors as defined by the CDC study.
3. The BiD's positive or negative effect,
if
any on employment, spending, saving,
investment, incomes, and
property
values
in
the County.
"Without
sped
fie data on the saleSt businesses
that
sell e-cigarettes and vapor devices,
and on consumption, it
.is
difficult
to
detennine the Bill's effect on employment,
spending, savings, investment, incomes, and property values
in
the
County. Such
data could be obtained through a survey of establishments that are likely to sell such
products.
.
4.
If
a Bill
is
likely to nave
DO
economic impac4 why is tbat tbe
ca.~e?
It
is dift1cultwithout specific data as noted in paragraph #3 to determine the Bill's
economic impact.
5.
Tbe following contributed to or concurred
with
tbis analysis:
Mary
Casciotti,
David Platt and Rob Hagedoorn, Finance; Patricia Stromberg, HHS
.~./l?i~
J
sep F. ach, Director
J
Date
!
D
ment of Finance
Page 2 of2
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/
Testimony on behalf of County Executive Isiah Leggett
Bill 56-14, Health and Sanitation--Smoking-Electronic Cigarettes
January 22, 2015
Good evening Council President Leventhal and Councilmembers. I am
Dr.
Vlder Tillman. I am
here tonight to testify on behalf of County Executive Leggett in support of Bill 56-14, which
would place limits on the sale and use of e-cigarettes. The County Executive offers his
enthusiastic support for
this
bill as
it
addresses a serious potential threat to the health of our
residents.
v
se of this product
has
grown dramatically since its introduction to the
V.S.
market in 2007,
with sales doubling every year since 2010. E-cigarettes are being aggressively marketed by
manufacturers even though risks are not fully understood and there are no real standards for their
contents or design.
While the FDA
is
moving to regulate e-cigarettes, the Rulemaking process
is
a lengthy one and it
is likely to be years before a fmal Rule is adopted. We are pleased that the State of Maryland has
banned the sale of e-cigarettes to minors, but further action
is
needed to discourage'the easy
availability and increased use of
this
product. Montgomery County should not wait for the
federal or State government to enact· needed protections.' While there is much we do not know
about e-cigarettes, what we do know
is
very concerning:
V
se among youth is growing,
stimulated by aggressive marketing and the use of flavorings in e-cigarettes that appeal to
younger consumers.
Health advocates fear that the use of e-cigarettes by minors will normalize smoking-like
behavior and that these youth may moye on to use traditional tobacco products. Young children
.
are at particular risk ofharm caused by accidental ingestion of nicotine in e-cigarettes.
Nationwide poison control centers report an alarming increase in calls related to ingestion of
liquid nicotine by young children ages 0-5. Bill 56-14 will further limit youth access to e­
cigarettes and will require nicotine refills to be in child resistant packaging-a measure that
helps to insure the safety of children in homes where refillable e-cigarettes are being used.
Montgomery County
has
a long history of being out in front of efforts to limit the use oftobacco
in our community, including bans on smoking tobacco products in county buildings, restaurants,
and
other public spaces. We have had remarkable success in reducing smoking rates across all
segments of the population. The County Executive
has
.been a strong supporter of these
measures, including legislation adopted unanimously by the County Council in 2013 that
prohibits smoking in all county-owned or leased property. The County Executive believes that
wherever possible county law should treat e-cigarettes as
if
they were a traditional tobacco
product and urges passage of this legislation;
The County Attorney
has
offered some suggestions for minor technical changes in the bill. A
copy of that memorandum
is
also being submitted for the record. Executive staff will work with
Councilmembers and their staff to address those suggestions.
Thank
you for the opportunity to testify in support ofthe bill.
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Tsiah Leggett
County Executive
OFFICE OF THE COUNTY ATTORNEY
MEMORANDUM
Marc P. Hansen
County Attorney
TO:
Vma Ahluwalia, Director
Department of Health and Human Services
Marc
P.
Hansen
County Attorney
VIA:
/,v\u..rc..
Kc"..r.~~
A
(J.
.AA'UC)'
FROM:
/'/1"
,J
_
fA
l~.
Kristen M,l(. Kalaria
Associate County Attorney
p,~'
Bonnie Kirkland
Assistant Chief Administrative Officer'
December
8,
2014
Review of Bill No. 56-14
cc:
DATE:
RE:
Summary
Bill No. 56-14 (..the Bill"Yis designed to address public health concerns raised by the
increasing popUlarity of electronic cigarettes.
E~cigarettes
consist of a power source, a heating
device, and a liquid-filled cartridge. The devices deliver a smokeless vapor, which is usually
flavored and often, but not always, contains nicotine. The cartridges used in e-cigarettes do not
contain tobacco.
The Bill would prohibit the use of e-cigarettes
in
public places where traditional smoking
is already banned, require that certain
llicotine~containing
liquids be sold in child-resistant
packaging, place restrictions on the display and saJe of electronic cigarettes, and prohibit use of
electronic cigarettes by minors. Although tobacco products are heavily regulated by the state and
federal government, e-cigarettes are not covered by the existing regulatory scheme. State law
prohibits sale of e-cigarettes to minors, but is otherwise
~ilent
on the subject. The FDA recently
announced its intention to regulate e-cigarettes, but there are no regulations currently in effect.
Therefore,
Bm
56-14 is unlikely to be preempted by the existing state or federal regulatory
10 I Monroe StI-eet, Rockville, MlI.ryland 20850-2540
7 • 7
7 -
4 • '
.6705
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Vma Ahluwalia
December 8, 2014
Page
2
scheme. There are some concerns about ambiguities found in the language of the proposed Bill,
which
are
detailed below. These ambiguities are likely to result in confusion and enforcement
difficulties.
Legal Implications
I.
Ambiguities
Section 24-9{e) Posting Signs
Section 24-9(e)(2) requires specific wording on no smoking signs.
As
amended, it would
give several options, including ''No smoking or using an electronic cigarette by order of the
Moh~gomery
County Code
§
24-9. Enforced by (department designated by the County
, Executive)." The statute goes on to allqw that "the'international no-smoking symbol may replace
the words 'No smoking.''' it is unclear if the international rio-smoking symbol can also
be
used
to indicated "no using an electronic cigarette" or if signs using the symbol would still need to
contain those words. For the sake of brevity, it may also make sense to permit
the
use of the term
"vaping" rather
than
"using an electronic cigarette" on signage.
~
that case,
"vapin~" ~ould
be
added
to
the definitions in Section 24-9(a) and defmed simpJy as t'using
an
electronic cigarette."
The term could then be used
to
simplify
language throughout the
Bill.
Section 24-9(j) Duty to prevent smoking in certain areas
As amended, section 24-9(0 requires the owner of a building.or area covered by the
statute to "refuse to serve or seat any person who smokes where smoking or using an electronic
cigarette
is
prohibited .... " Presumably, the statute also intends to prohibit serving or seating a
person who
is
using
an
electronic cigarette
in
these areas. The term "smoke" is defined in 24-9(a)
and does not include using an electronic cigarette. Likewise, the section goes on
to
state'that the
owner "must ask the person to leave the building or area,
if
the person continues to smoke after
proper warning."
This
provision is presumably meant to apply to persons using electronic
cigarettes as well. Both ofthese provisions are easily clarified by adding "or using an electronic
cigarette" after the word "smoke.
t,
Again, use of the term "vaping" would make these provisions
tess
wordy.
Section
24-14
Child Resistant Packaging ofLiquid Nicotine Container Required
The proposed section 24-14(b) would prohibit retail sales of
any
liqUid or,gel substance
containing nicotine or
any
nicotine liquid container unless the product is
in
child resistant
packaging. Section
24~14(a)
defines "child resistant packaging" as packaging
"(1)
de~igned
or
constructed to be significantly difficult for children under 5 years of age to open or obtain a toxic
or harmful amount of the substance contained therein
within
a reasonable time; and (2) not
difficult for normal adults to use properly."
It
goes on to state that 'tchild resistant packaging
@
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Uma Ahluwalia
December 8, 2014
Page 3
does not mean packaging which all such children cannot open or obtain a toxic or harmful
amount within a reasonable. time." Although there is no reference to the federal regulation, this
.language is taken almost verbatim from the definition of "special packaging" found in 16 CFR
§1700.1. The federal regulations are promulgated by the Consumer Products Safety Commission,
which is charged with administering the Poison Prevention Packaging Act of 1970, 15 V.S.C
§§
1471-1476.
There is no indication how the County would evaluate compliance with this provision.
While the CPSC does not approve or endorse certain packaging, it has promulgated regulations
that provide ror standardized package testing procedures, 16 CFR
§
1700.20, and specific
requirements"for child-resistant packaging based on the results of that testing, 16 CFR
§
1700.15.
The County liB.opted the definition of special packaging from 16 CFR §1700.1, but doesn't
address the
s~ecific
requirements or testing procedures found in the federal regulation. As a
result, the
BiiI
as proposed would likely resu1t in significant confusion and would be difficult to
enfofQe. This could be resolved by simply requiring compliance. with the federal regulations for
speciaJ packaging and cross referencing the federal regulations. At least one other state has taken
this approach. Minnesota recent1y enacted a state law requiring child-resistant packaging for e­
cigarette cartridges that provided: "For purposes of this section,
~child-resistant
packaging' is
defined as set forth in Code of Federal Regulations, title 16, section
1700.15(b)(l)~
as in effect on
January 1,2015, when tested in accordance with the method described in Code of Federal
Regulations, title 16, section 1700.20, as in effect on January 1, 2015." Minnesota Statute 461.20
(effective Jan 1,2015)..
II.
Preemption
As tobacco is heavily regulated by the state, it is necessary to consider the possibility that
local regulation in the area may be preempted. Generally speaking, state and federal tobacco
regulations
fall
into two categories: regulation of sales and :regulation of smoking in public
places. There is no express preemption of electronic cigarette regulation in either state or federal
law. Preemption may also be implied, either by conflict or because the state or federal
goveinment has regulated a field so forcibly that its intent to occupy the entire field must be
infelTed.
Mayor and City Council o/Baltimore v. Sitnick,
254 Md. 303,323 (1969). For the
reasons described below, implied preemption of Bill 56-14 is not a concern at this time.
Tobacco Sales
Maryland regulates the sale and manufacture of Cigarettes and other tobacco products,
imposing license requirements and other restrictions on vendors. Title 16 of the Business
Regulation Article governs sale and manufacture of cigarettes, defined as "any size or shaped
roll for smoking that is made of tobacco or tobacco mixed with another irigredient and wrapped
in paper or in any other material except tobacco." Md. Code, Business Regulation
§16-101(b):
.
.
(jJ)
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Uma Ahluwalia
December 8, 2014
Page 4
Title 16.5 govems sale of "other tobacco products," defined as "(1) any cigar or roll for
smoking, other than a cigarette, made in whole or
in
part of tobacco; or (2) any other tobacco or
product made primarily from tobacco, other
than
a cigarette, that
is
intended for consumption by
smoking or chewing or as snuff." Md. Code, Business Regulation §16.5-101(i). The tobacco
tax regu.lation relies on a substantially similar definition.
See
Md. Code, Tax-General §12-1OI.
The Criminal Law Article prohibits sale of tobacco products to minors. Md. Code Cr:irpinal Law
§10-107. "Tobacco product" is defined simply as a substance containing tobacco, "includ[ing]
cigarettes, cigars, smoking tobacco. snuff, smokeless tobacco, and candyiike tobacco products."
Md. Code Criminal Law §10-10I(d). Possession by a minor is also prohibited. Md. Code
Criminal Law ,§10-108 (civil offense only).
None of the above statutes apply to electronic cigarettes. The detailed definitions of
"cigarette" and "tobacco product" exclude e-cigarettes entirely, as e-cigarettes do not contain
tobacco. Presumably recognizing this, the legislature enacted a new statute in 2012 prohibiting
sale of Helectronic nicotine devices" to minors:Md. Code, Health-General, §24-305. The 2012
statute represents the only state regulation of e-cigarettes
at
this time. As Bill 56-14 does not
contlict with the state law prohibiting sales to minors, there is no existing contlict between the
Bill and state law.
Local e-cigarette regulation is also easily distinguishable from the local regulation of
cigarette vending machines, which was invalidated by the Court of Appeals in
Allied Vending
Inc. v. City ofBowie,
332 Md. 279 (1993).
In
Allied Vending,
the local regulation imposed
restrictions on the placement of cigarette vending machines and required an additional
municipal license for
~e
location of each vending machine.
Id
at 282-83. The Court found
that
the regulations were preempted because the State had exercised exclusive control over
regulation of cigarette sales dating back to 1890
t
and the current state regulatory scheme
included extensive regulation of sales via cigarette vending machines, requiring two different
licenses for owners of such machines.
Id
at 302.
In
contrast, electronic cigarettes are subject to
exactly one state regulation
dating
back to 2012.
It
is possible that state regulation
will
expand
in the near future.
In
the meantime, however, there is no concern that the state has regulated so
forcibly in the area as to impliedly preempt local regulation on the matter.
Smoking in Public Places
The state also regulates smoking
in
certain public areas, See Md. Code, Health-General,
§§24-501-51 I ("Maryland Clean Indoor Air Act").
In
that context, smoking is defined as I'llie
burning of a lighted cigarette, cigar, pipe, or any other matter or substance that contains
tobacco." Md. Code, Health-General, §24-501(g). Again, use of electronic cigarettes is
~doubtedly
excluded from this definition, as e-cigarettes do not contain tobacco. Thus, for the
same reasons described above, Bill 56-14' s restrictions on e-cigarette use in public is
distinguishable from the cigarette vending machine regulations struck down
in
Allied'Vending
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Vma Ahluwalia
December 8, 2014
Page 5
.and is not preempted by existing state laws.
It
is worth noting that a bill was proposed in the 2014 session that would have included
"vaping" in Maryland Cle.an Indoor Air Act's definition of "smoking."
See
H.B. 1291
(Introduced February 7,
20]4).
The bill had 19 co-sponsors, but never got out of committee.
Even if it had passed, the state law would not have preemptect Bill
56-14,
but it does suggest at
least some support for further state regulation of e-cigarettes.
Federal
Laws
Cigarettes and other tobacco products are also subject to various federal laws and
regulations, including regulation of labeling, marketing, internet sales, and sales to minors. None
of these laws' appear to apply to e-cigarettes. The Food and Drug Administration recently
announced its intention to develop regulations for e-cigarettes, which it considers to be tobacco
products. Federal Jaw gives the FDA broad authority to regulate "all cigarettes, cigarette tobacco,
roll-your-own tobacco, and smokeless tobacco and any other tobacco products that the
Secretary[ofHealth and Human Services] by regulation deems to be subject to [the Tobacco
Products subchapter' of the Food Drug and Cosmetic Act]." 21 U.S.C. 387a
(b).
It's anticipated
that the rulemaking process will take years, but any regulations developed by the FDA will
supersede conflicting local laws.
to
The federal government also regulates product packaging, as described above
in
the
discussion of child-resistant packaging (See Section I, above). There is legislation currently
pending before Congress that would require the Consumer Products Safety Commission to
promulgate rules for liquid nicotine containers,
See
Child Nicotine Poisoning Prevention Act of
2014
S.
2581/H.R.
5486
(l13
th
Congress). Ifpassed, the resulting regulations would preempt
Section
24-14,
to the extent of
any
confl ict.
If you have any concerns or questions concerning this memorandum please call me.
krnkk
Enclosure
(bill)
",
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Isiah Leggett
Uma S. Ahluwalia
County Executive
January 22, 2015
Director
-George Leventhal, President
Montgomery County Council
100 Maryland Avenue
Rockville, Maryland 20850
Dear Council President Leventhal:
The Commission on Health (COR) thanks the County Council for addressing the issue of e-cigarettes.
The COH recommends passage ofBil156-l4 prohibiting the use of e-cigarettes in public spaces where
tobacco smoking is prohibited, requiring child resistant packaging of nicotine containers, prohibiting the
use of e-cigarettes by minors, prohibiting the purchase of nicotine refills without the intervention of a
seller, and amending County laws to treat e-cigarettes as conventional cigarettes.
The COH has deep reservations about claims that e-cigarettes are safe. According to the U.S. Food and
Drug Administration (FDA), "e-cigarettes have not been fully studied so consumer do not know: 1) the
potential risks of e-cigarettes when used as intended, 2) how much nicotine or potentially harmful
chemicals are being inhaled during use, and 3) whether there are any benefits associated with using these
products. Further, it is not known whether e-cigarettes may lead young people to
try
other tobacco
products, including conventional cigarettes, which are known to cause disease and lead to premature
death."l While some consumer groups support e-cigarettes, the reports by FDA and U. S. Centers for
Disease Control and Prevention (CDC), the limited scientific data, and the rapid rise in poison control
reports give us great concern about the safety of these products and their potential danger to children.
The Consumer Advocates for Smoke-free Alternatives Association (CASAA)2 claims the e-cigarette
vapor contains no second hand smoke. CASAA points to a literature review article
3,
which they funded,
that concluded that e-cigarettes vapors "do not warrant concerns." However in the review, Burstyn
conceded that the data are poor. We question drawing such a strong conclusion from poor data. CASAA
builds a case that e-cigarettes are safer than conventional cigarettes and smokeless tobacco. However, the
COH believes that cigarettes and smokeless tobacco should not be held as the safety threshold.
A recent review of e-cigarette toxicological profiles
4
pointed out that the publicly available data are
insufficient to evaluate the safety of e-cigarette vapor. Studies within the review show the presence of
1
http://www.fda.gov/NewsEvents/PublicHealthFocus/ucml72906.htm
2
www.casaa.org
3
Burstyn,
I.
BMC Public Health, 14:18
4-
Orr MS.
Tob ControI2014;23:ii18-ii22.
_________________________ _ __is_s_io_D o_D_H_e_B_lt_h _________________
C_o_m m
__
_
401 Hungerford Drive 2
nd
Floor •
--------EED
Rockville, Maryland 20850 • 240-777- 4422
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low levels of tobacco-specific nitrosamines, which are known to be carcinogenic. The study authors of
the review noted that toxicity varied with type and level of flavor additives; however, without an adequate
characterization of exposure and safety margins, we remain concerned about long-term health effects.
Unlike the demographic suggested by CASAA, CDC reported that e-cigarette use is growing rapidly
among high school students
5 •
The percent of high school students who used an e-cigarette rose from
4.7% to 10.0% between 2011 and 2012. Over 76% of students who used an e-cigarette also reported
smoking a conventional cigarette. According to CDC, cigarette smoking remains the leading preventable
cause of disease, disability, and death in the United States. We know of no scientific study that assesses
the effect of dual cigarette and e-cigarette use.
Exposure to e-cigarette vapors residues deposited on surfaces has not been studied. However, in a small
study of homes with hookah smokers, researchers measured the levels of nicotine and nitrosamines in
children, and the levels of nicotine on surfaces in living rooms and children's bedrooms
6 •
Although
nitrosamine and nicotine levels are much lower in e-cigarette vapors than in hookah smoke, the deposition
pattern of vapor may be similar. High levels of nicotine may accumulate on surfaces due to repeated
deposition of e-cigarette vapors. Also referred to as third hand smoke, this deposition can expose non­
smokers to potentially high levels of nicotine. This is especially concerning in the pediatric population.
The COH is also concerned about the growing number of calls to U.S. poison control centers due to
exposure to e-cigarettes or their liquids. As e-cigarette use increased, the number of calls to poison
control centers also increased from 1 call in September 2010 to 215 calls in February 2014. More than
half of the calls to poison centers due to e-cigarettes involved children under age 5.
In
contrast, the
number of calls due to cigarette exposure remained constant during this time frame,except for annual
peaks in the summer. Tim McAfee, M.D., M.P.H., Director of CDC's Office on Smoking and Health
noted that this finding is echoed by the National Youth Tobacco Survey showing that e-cigarette use is
growing fast, as is the incidence of e-cigarette related poisonings
7 •
Common complaints included
vomiting, nausea and eye irritation. At least one suicide from intravenous injection of nicotine liquid was
reported
8•
ABC News reported that in Fort Plain, New York, a I-year old child died after ingesting liquid
nicotine
9 •
For these reasons, the Commission on Health recommends passage of Bill 56-14 by the County Council.
Sincerely,
~~~
Ron Bialek, MPP, CQIA
Chair, Commission on Health
RB:dk
Cc:
Isiah Leggett, County Executive
Uma Ahluwalia, Director Montgomery County DHHS
Dr. Ulder
J.
Tillman, County Health Officer
http://www.cdc.gov/media/releases/20 13 /p0905-ecigarette-use.html
6
Kassem,
N.D.F.,
etal.,
Nicotine Tob Res,
2014 Jul;7:961-975
7
http://www.cdc.gov/mediajreleases/20 14/p0403-e-cigarette-poison.html
B
Chatham-Stevens,
K,
etal.
Morbidity and Mortality Weekly Report,
63:13, Apr. 4, 2014, p292
9
http://abcnews.go.com
IH eal th
Ichi!
ds-death-liQ uid -nicotine- reported -vaping-gains­
popularity/story?id=27563788
5
Commission on Health
401 Hungerford Drive 2
nd
Floor
Rockville, Maryland 20850 • 240-777- 4422
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--
~cancer
Action
miNetwork'"
American Cancer Society
Cancer Action Network
801 Roeder Road, Suite 800
Silver Spring.
ytD
20910
301.758.1255
\\ww.acscan.org
a
\
.
~.
January 22, 2015
TO:
FROM:
George Leventhal, President
Members Montgomery County Council
Bonita
M.
Pennino,
MS,
Government Relations Director
RE:
Position:
Bi1l56-14, Health and Sanitation Smoking -Electronic Cigarettes
Support with amendments
The American Cancer Society Cancer Action Network (ACS CAN) strongly supports prohibiting the use of electronic
smoking devices in restricted areas in parity with traditional tobacco products, as well as
prohibiting the sale of
cigarettes to minors.
The American cancer Society Cancer Action Network has significant concerns about the potential public health effects of
electronic smoking devices such as electronic-cigarettes. There are concerns that they may create new tobacco users,
keep people smoking rather than quit, and reverse efforts that have made smoking socially unacceptable. There is still
no scientific evidence that electronic smoking devices can help smokers quit. Much more research is needed to
determine what ingredients these products contain, how they are being used and what health effects they have on both
users and those around the user.
Although ACS CAN supports the inclusion of electronic smoking devices in smoke-free laws, caution must be exercised
when opening an existing law to ensure that it is not weakened in any way. In addition, to eliminate any confusion and
strengthen the bill, ACS CAN makes the following recommendations:
1. Remove the exemptions for FDA approved electronic cigarettes. If the FDA approves electronic cigarettes as
cessation product, allowing their use in public places due to social norming issues, involuntary exposure to
aerosol emitted by product, and inability of business owners and public to distinguish between products
approved by FDA and those that are not.
2.
Amend the definition of smoking devices as follows:
"Electronic Smoking Device" means any product containing or delivering nicotine or any other substance
intendedfor human consumption that can be used by a person
to
Simulate smoking through inhalation of vapor
or aerosolfrom the product. The term includes any such device, whether manufactured, distributed, marketed, or
sold as an e-cigarette, e-cigar, e-pipe, e-hookah,
or
vape pen, or under any other product name
or
descriptor.
3. Amend the definition of smoking as follows:
"Smoking" means inhaling, exhaling, burning,
or
carrying any lighted or heated cigar, cigarette,
or
pipe,
or
any
other lighted or heated tobacco or plant product intended for inhalation including hookahs and marijuana,
whether natural
or
synthetic, in any manner
or
in any form. "Smoking" also includes the use of an electronic
smoking device which creates an aerosol
or
vapor,
in
any manner or
in
anyform,
or
the use of any oral smoking
device for the purpose of circumventing the prohibition of smoking in this Article.
4. Amend the section regarding product placement to include a broad definition of tobacco products. We
recommend amending the definition for tobacco products for inclusion in youth access laws is as follows:
"Tobacco product" means:
@
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o
(a) Any product containing, made, or derivedfrom tobacco or nicotine that is intendedfor human
consumption, whether smoked, heated, chewed, absorbed, dissolved, inhaled, snorted, sniffed, or
ingested by any other means, including, but not limited
to
cigarettes, cigars, little cigars, chewing
tobacco, pipe tobacco, snuff, snus; and
o
(b) Any electronic device that delivers nicotine or other substances
to
the person inhaling from the
device, including, but not limited
to
an electronic cigarette, cigar, pipe, or hookah.
o
(c) Notwithstanding any provision ofsubsections (a) and (b)
to
the contrary, Htobacco
produ~
includes
any component, part, or accessory of a tobacco product, whether or not sold separately. '70bacco
product" does not include any product that has been approved by the United States Food and Drug
Administration for sale as a tobacco cessation product orfor other therapeutic purposes where such
product is marketed and sold solely for such an approved purpose.
5. Amend the section referring to vending machine sales to limit vending machine sales to establishments allowed
in places open only to adults.
6. Include terms "tobacco shop" and "vape shop" in the section referring to "any store where only or primarily
tobacco or electronic cigarette products are sold" and restrict minors from entering these establishments, or if
minors is allowed require all tobacco products to be placed out of reach and require clerk intervention.
7.
As
drafted, section 24-13 page 9 line 118-119 only prohibits use of e-cigarettes by minors and does not prohibit
sale to or purchase by minors. Prohibiting sales to minors should be included in the bill language.
Until more research has been done regarding the potential health consequences caused by electronic smoking devices,
ACS CAN supports restricting their use in parity with traditional tobacco products. Comprehensive smoke-free laws,
along with regularly and significantly increasing the price of all tobacco products, and adequately funding tobacco
prevention and cessation programs, are proven, effective ways to reduce tobacco's toll.
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...............,"
Century
Distriblttors~
Inc.
,
15710 Crabbs Brandt Wn.l'
Rochille,
tim
20855·2620
www.centurydist.('c1H
Tel: 301·212·9100. Fax 301-212-9681
Council Members:
I am here today not to talk about the effects of smoking and whether or not nicotine is an
addictive substance.
Today I am here to tell you about a family business right in Montgomery County that I
am president of, Century Distributors. What make us unique, we are the only wholesaler
of our kind in Montgomery County, with the three owners living and educated in the
County. Currently we have 183 employees, a fleet of 45 vehicles, and work out of
100,000 square feet of warehouse space. Most of our employees reside in Montgomery
County.
Century's product mix is 82% Tobacco and 18% other consumer goods to retail. Our
revenue is dependent on tobacco and now included in that category e-cigarettes. Without
the tobacco revenue, I am certain Century would struggle
to
maintain our current level of
viability as a business in Montgomery County.
In
addition to the revenue Century derives from tobacco, we are the collecting agent for a
significant portion of tax revenue for the State. Century is responsible for affixing the
Maryland Tax stamp on each pack of cigarettes, currently at a price of$2.00 per stamp.
In
2014, Century stamped a total of 20,850,000 cigarette packs just for the state of
Maryland representing almost $41 million in revenue which trickles right down to
Montgomery County and its residents. That number only represents what Century was
responsible for in 2014, not what other wholesalers who provide cigarettes into
Maryland.
Why, at this time, do we need another bill to limit where consumers can smoke or vape?
Why is this even a discussion? I believe that most adult smokers are aware of where they
can, and cannot, smoke. When was the last time someone received a citation for
smoking at a bus stop or a public park? I know
it
is still legal to smoke on a public golf
course because of the Montgomery County resident's interest in enjoying a cigar while
playing golf. Will this also include vaping?
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The FDA has stated on their web site
"it is not known whether e-cigarettes may lead young people to
try
other tobacco
products, including conventional cigarettes, ... "
Until the FDA regulates e-cigarettes, it is too soon for Montgomery County to make any
regulations.
Having an age restriction is and should be required, for any item with nicotine. Century
and all manufactures want all Vaping products to be used only by adults. Vaping
products should not be sold to minors.
There are so many vaping devices, but your concern is around open tank systems and all
disposable units are closed systems. Are any of you aware of the differences?
Just this past Friday, Gov. Rick Snyder from Michigan vetoed a package of bills seeking
to regulate electronic cigarettes because it would not regulate and
tax
the devices like
tobacco products. "We are fully supportive of sensible regulation. We believe it's an
adult product," McCormick said. "(But) it is not a tobacco product, ...." Until the FDA
regulates e-cigarettes,
it
is too soon for ,Montgomery County to make any regulations.
Debbie Robins
President
Century Distributors,
I1JC.
www.centurvclist.com
it
(301) 212-9100
A (301) 212-9681
I:8l
drobins@centurydist.com
Certified Women-OWned - Since
1999
BECOME
A
FAN ON FACEBOQK Century Distributors Inc
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MARYLAND
ENVIRONMENTAL
HEALTH NETWORK
Testimony in Support of: Montgomery County Council Bill #56-14
January 22, 2015
Council President and Members. of the Council,
My name is Rebecca Rehr and I am the Public Health Advocacy Coordinator for. the
Maryland Environmental Health Network.
Our
work focuses on energy and toxics policy as
health policy, with asthma as a particular health outcome of concern. While tobacco policy is
slightly outside the scope of our work, we are compelled to submit testimony supporting this bill,
as mounting evidence shows the danger of electronic cigarettes to human health and the
environment.
Last July, I attended the National Association of City and County Health Officials'
(NACCHO) conference, where I learned that although companies producing e-cigarettes claim
them as cessation products, none ofthese companies have actually applied to the FDA to be
labeled as such. The entire e-cigarette industry, from production to point-of-sale, is completely
bypassing the existing regulatory framework for traditional combustible cigarettes. With no
regulation on sales or labeling, teens have started smoking e-cigarettes at astonishing rates.
Recent research from the University ofMichigan found that twice as many 8
th
and 10
th
graders
reported smoking an electronic cigarette as a traditional cigarette and
17%
of
12th
graders had
used an electronic cigarette in the previous 30 days, where
14%
had smoked a traditional
cigarette. E-cigs are now the nicotine delivery method of choice for teens.
In
addition, without
regulations prohibiting smoking e-cigs inside, adults trying to stop smoking traditional cigarettes
are just replacing them with e-cigs and are actually getting higher doses ofnicotine as they can
just take a puff whenever they like, instead of having to go outside to take a smoke break. Most
egregious is the increase in the number of calls to poison control centers reporting children's
consumption of the liquid nicotine in e-cigarette cartridges. The packaging looks appealing
because the nicotine comes in flavors like bubble gum and cherry bomb and the packaging is not
always childproof. The nicotine in these cartridges is highly concentrated and wreaks havoc on
children's vulnerable systems when they are exposed.
In addition to the health outcomes of concern, there are also a number of unknowns about
the environmental impact of e-cigarettes. Nicotine residue and heavy metals may be discarded
when the e-cigarette and cartridges get thrown away.
If
they end up in landfills, they may leach
into waterways and poison wildlife. There is no comprehensive recycling program for e-waste
and packaging is not required to have proper disposal instructions.
Finally, we are learning more about the ingredients added to the electronic cigarette
liquids, including diacetyl and acetyl propionyl. Diacetyl is used in food flavouring (most
commonly in the butter flavouring on popcorn) and is safe to be eaten, but when inhaled has
adverse effects on the lung. We know this because manufacturers of diacetyl have high rates of a
rare lung disease that has come to be known as "popcorn lung." We are now putting products on
the market that contain diacetyl in the form in which it is most toxic.
2 East Read Street, 2
nd
Floor
Baltimore, MD
21202
410-727-1205
www.MDEHN.org
@>
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Since e-cigarettes are not regulated on the federal level, it is up to state and local
jurisdictions to protect public health and safety. Provisions in this bill would protect children
from the harmful effects of e-cigarettes and nicotine cartridges and protect patrons ofrestaurants
and businesses. We applaud the Montgomery County Council for taking up this measure and
appreciate this opportunity to provide comment.
2 East Read Street, 2
nd
Floor
Baltimore, MD 21202
410-727-1205
www.MDEHN.org
e
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~
Maryland GASP
~
Testimony
in
support of
Bill 56-14, Health and Sanitation - Smoking - Eledronic Cigarettes.
First I would like to thank Council Member Floreen and the other sponsors of this bill for
your concern about the health and well being of your constituents.
On behalf of the more than 100 members of the Maryland Group Against Smokers
Pollution who reside in Montgomery County. I ask you to vote for passage
of
Bilt 56-14
as currently drafted for the following reasons. The bill is meant to:
*
Protect people who do not use E-cigarettes from the potential harmful ingredients
found in the vapor
*
Protect our children from the misuse of these deadly devices
*
Keep our youth from becoming prematurely addicted to nicotine and possibly even
illegal and hallucinogenic drugs like DMT.
Harry Shapiro, from the British charity Drugscope, recently stated that, "e-cigarettes are
an ideal tool for consuming a wide spectrum
of
drugs". He states
"You can adapt those e-eigs to smoke just about anything. Not just what
you're supposed to."
Many people believe that E- Cigarettes are hannless. How can anybody reach such a
conclusion about a product that is totally unregulated and is primarily manufactured in
foreign countries? As a scientist, who has measured the respirable suspended air
particulates and the ionization radiation in tobacco smoke, I find this belief to be
groundless. Even
if
some brands of E-cigarettes are less harmful than combustible
cigarettes, what is true for one brand is not necessarily true for any other brand.
This legislation does not impose any new restrictions on smokers of normal cigarettes.
It simply restricts the use of E-cigarettes to places where normal cigarettes can be used.
Please pass
Bill 56-14
as it is currently wRtten.
Respectfully,
John
0' Ham; Ph. D
President
Mazyland Group Against Smoker's Pollution
Box 863, Bowie, MD 20718
(P)
301-262-3434
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:.Maryland
.
Public Health
.Association
MISSion: To improve public health in Maryland through education and advocacy
VISion:
Healthy Marylanders living in Healthy Communities
Testimony
in
Support of Bill 56-14
Health and Sanitation - Smoking - Electronic Cigarettes
January 22, 2015
Presented by Anne Marie O'Keefe, PhD, JD
Chair, MdPHA Advocacy Committee
Thank you for this hearing today. I am Anne Marie O'Keefe.
It
is my privilege to teach in the
graduate Public Health Program at Morgan State University. I am also very proud to say that I
live in Silver Spring, recently selected the
Most Caring Suburb in America.
My family and I
have long known that Silver Spring is the best place in the world to live.
Thank
you for
all
you
have done to preserve and protect the health of Montgomery County residents, and for making it
such a privilege to live here.
I am here today representing the Maryland Public Health Association as its Advocacy
Committee Chair. MdPHA is the state affiliate of the American Public Health Association, a
142-year-old professional organization with more than 50,000 members. I will testify today only
about the pending Bill 56-14 to regulate e-cigarettes. But I want every member of this august
body to know that MdPHA believes very strongly in
Health in All Policies,
and we stand ready
to assist you in every way that we can to continue your excellent record ofprotecting the public's
health.
Montgomery County leads the state in many important ways.
It
ensured the right of its residents
to breathe clean indoor air - everywhere -
in
2003 - four years before the Maryland General
Assembly caught up and did so for the entire state. Hopefully, this Council's actions on the issue
of e-cigarettes will also lead the state to do the right thing.
The manufacturers and sellers of e-cigs - i.e., the Big Tobacco Companies who bring you the
conventional cigarettes that kill 440,000 Americans every year - want you to believe that e-cigs
are "harmless," "safe alternatives" to tobacco, and can even help addicted smokers quit.
As was true with tobacco, the promotion of e-cigs is way ahead of reports on the research that
honestly examines the health effects ofthese products. But from
all
that we know so far, e­
cigarettes are certainly
not
safe. Rather:
• E-cigs are designed to deliver nicotine as former Surgeon General Koop told us long
ago, the most addictive drug we know.
• The vapor exhaled bye-cigarette smokers is
not
"pure" or ''water.'' Rather, it contains
nicotine and other toxic and carcinogenic metals and chemicals including tobacco­
specific nitrosamines.
• Even short-term exposure to propylene glycol, one of the primary components ofthe
aerosol emitted bye-cigarettes, causes eye, throat and airway irritation. Long-term
exposure can result in children developing asthma.
Maryland Public Health Association (MdPHA)
12320 Parklawn Drive III Rockville, MD 20853 III
Phone~
443.475.0242
marylandpublichealth@gmail.com III www.mdpha.org
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• The secondhand "vapor" from e-cigarettes may not be as dangerous as the secondhand
smoke from conventional cigarettes which is estimated to kill 50,000 people every year in
this country alone. But that does not make it "safe." And it does not justify allowing it to
pollute our indoor air.
Tobacco companies also want people to believe that e-cigs are really "cessation devices" that
will help people kick their tobacco cigarette addictions. This assertion is also ludicrous. Why
would tobacco companies manufacture, promote and sell a product designed to put them out of
business? And why would their stockholders allow them to do so?
As CNN reported on December 31
st,
at least 2 million teens have tried or are using e-cigs. They
are not doing so to kick conventional cigarette addictions. Teens who might never try
conventional cigarettes are being attracted to e-cigs with flavors including "cotton candy,"
"cherry crush" and "Gumi Bearz." In fact, the Centers for Disease Control and Prevention
reported that e-cigarette use doubled among middle and high school students between 2011 and
2012. This is not surprising considering that between 2011 and 2013, the number of youths
exposed to television ads for e-cigarettes increased 321
%.
Because e-cigarettes are not yet regulated by FDA - or any health agency - their quality, their
ingredients, and even their levels of nicotine are largely unknown. One of the few things we
know for sure is that e-cigs have brought a huge surge in nicotine poisoning. CDC reported in
April of last year that e-cigarette related calls to poison centers went from an average of one per
month in 2010 to 215 per month in February 2014. More than half of these were about children
under the age of five who had been poisoned through ingestion, inhalation and absorption
through the skin and eyes.
For all of these reasons, the World Health Organization's Framework Convention on Tobacco
Control recommends regulating e-cigarettes just like conventional cigarettes, including bans on
indoor use, advertising restrictions, bans on sales to kids, health warnings, etc. Several
jurisdictions across this country have already done so.
Thank
you again for Montgomery County
being in the vanguard of this effort.
There is simply no reason to expose people to airborne toxins, and lead our kids to lifelong
addictions, when there are no counterbalancing benefits except profits for the drug dealers who
manufacture and sell this product.
Thank you.
--------------------------------------------------------------------~
@
Maryland Public Health Association (MdPHA)
12320 Parklawn Drive
I!l
Rockville. MD 208531!l Phone: 443.475.0242
www.mdpha.org
marylandpublichealth@gmail.com
m
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Judy E. Ackerman
9305 Friars Road
Bethesda, MD 20817
Jeackerman18@gmaiJ.com
January 16, 2015
The Honorable Nancy Floreen
Montgomery County Council
100 Maryland Avenue
Rockville, MD 20850
Dear Councilmember Floreen,
Thank you for introducing Bill 56-14, legislation that contains a number of provisions
related to electronic cigarettes. I am particularly appreciative of the portion that would
p~ohibit
the use of electronic cigarettes in public places where traditional tobacco
smoking is prohibited. Quite simply, e-cigarettes do give off vapors that many, including
me, do not wish to be exposed to. Since there is no regulation of these products, the
chemicals and fragrances in these products vary significantly. This makes doing
research on the effects of these products on the user and bystanders difficult.
Additionally, the use of e-cigarettes makes enforcing existing policies that prohibit
smoking very challenging.
Although I am writing this as an individual citizen, I was very involved in the
development and implementation of Montgomery College's tobacco-free policy and
procedures. There was a dramatic difference in the air quality and cleanliness of our
campuses when tobacco-free went into effect at the College. Today, when we see
someone who appears to be smoking on campus, we have to go over to that person to
determine whether they are smoking or vapping. Currently I can only "suggest" to them
that it is inappropriate to vap, since e-cigarettes did not exist when our policy and
procedures were approved. Some individuals on our campus challenge us by vapping
in buildings. Once again, when they do this, we can only "suggest" that vapping is
inappropriate since it resembles smoking, but we really don't have policy, procedure or
law to back us.
Once our tobacco-free policy and procedure was in place, I did not receive a single
letter or email from students, employees or visitors to the campus that said that they
could no longer continue coming to the campus because their medical condition was
worsened by going through cigarette smoke to get into buildings. I fear that without
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adding e-cigarettes to policies and laws that prohibit or substantially limit smoking, we
will once again disenfranchise students, employees and campus visitors who are
impacted bye-cigarette vapors. Since September my office has received a number of
complaints about e-cigarette use on campus.
A bill such as 56-14 covers public spaces and does not require that policies and
procedures for each public space be changed. Thank you for initiating this bill.
Sincerely,
Judy
E.
Ackerman, Ph.D.
cc:
Councilmembe'r Leventhal, President Montgomery County Council
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From: de Ban, Heather (NIHlNHLBI) [F]
Sent: Thursday, January 22,20154:40:28 PM
To: County Council
Subject: e-cigarette bill testimony
Heather Kusnetz, PhD
debarih@mail.nih.gov<mailto:debarih@mail.nih.gov>
11800 Old Georgetown Rd
Rockville, MD 20852
Bill56-14
Nancy Floreen E-Cigarette Bill
Ruthann Eiser or applicable person:
I've been a postdoctoral fellow at the National Institutes ofHealth for a little over 2 years now, and I have 11 years of
experience in the biological sciences. Thank you for the opportunity to put my ideas to written word on the Maryland E­
Cigarette Bill (56-14). I wanted to draw your attention to the fact that research on the long-tenn effects ofE-Cigarettes is
unavailable and that my statements are based on research to-date.
It's obvious that there's a growing curiosity towards E-Cigarettes among youth. Not surprisingly, E-Cig manufacturers target
youth by offering flavorings into e-juices. While flavorings and solvents can be safe when ingested, they can change
chemically when heated, resulting in breakdown products that are unsafe to the user.
In this case, a minor or child can self-deliver toxic chemicals through use ofan E-Cigarette. Would I want my child or teen to
get a hold ofE-Cigarettes and use them in an unlimited fashion? Absolutely not, and I think other parents and caregivers
would stand beside me in my assertion. Minors should not be allowed to purchase E-Cigs because some E-Cigs do in fact
contain nicotine even though they are labeled as nicotine-free. Just to put this into perspective, I wanted to point out that
YOUR teen can go to an E-Cigarette kiosk (not in-store) located in the center isle at a mall in Rockville, MD.
I read peer-reviewed, scientific publications, and it is my current understanding that there is no evidence pointing towards e­
cigarettes as a viable smoking cessation method. Ifyou are allowed to use E-Cigarettes in public places, why would you
have to quit traditional cigarettes? The answer is that you wouldn't have to. In fact, E-Cigarettes are rarely used exclusively;
in other words, E-Cigs are often used along with traditional cigarettes, which have been proven to cause cancer.
I boast to friends back in New York State how wonderful Maryland is--how many awesome cultural restaurants you can eat
at, and the availability oftechnology resources, among countless others. I would personally stop going to my favorite
restaurant if! saw a sign outside that somehow intimated that E-Cigarettes could be used by customers.
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Let's think about workers for a moment. Workers in restaurants and other public places would be exposed to an unknown
amount ofsecondary nicotine, in addition to fine and ultra-fine particles that can deposit in the lungs. Nicotine has been
shown to cause birth defects. Maryland would be taking a step back by allowing E-Cig use in public places because
(l)
it
weakens smoke-free air legislation that lawmakers have worked so hard to enact, and (2) it gives the precedence that we are
willing to take a public health risk without explicit ruling from the FDA.
Most people I know DO NOT know that E-Cigarettes are NOT regulated by the FDA. Furthermore, they have been
misinformed that E-Cigarette aerosol is simply water vapor. They are confused as to why something resembling a
conventional cigarette isn't regulated. All we can do is wait for the official FDA ruling. Until then, we need to protect
Maryland Youth and to maintain the highest standards that we can for smoke-free airin the workplace, restaurants, and other
public places where our fellow Marylanders frequent.
Thank you for taking the time to read my input on the matter.
If
you want to see actual numbers, 2 national surveys (one from
the CDC and the other from the University ofMichigan) have recently posted findings ofE-Cigarette use among youth:
http://W'\\'W.cdc
.gov
Ito
bacco/youth/e-ci garettesl
http://www.drugabuse.gov/related-topics/trends-statistics/monitoring-future/monitoring-future-survey-overview-findings­
2014
(look at 'Areas ofConcern')
With great concern,
Heather Kusnetz, PhD
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LAW OFFICES
OF
CHARLES FREDERICK CHESTER
51 Monroe Place, Suite 707
Rockville, MD 20850
(301) 294-2500· Fax (301) 294-2185
Email: ChesterEsq@aol.com
Cllaries Frederick Chester (Md., D.C.)
January 22,2015
BALTIMORE OFFICE
Hon. George Leventhal, President
Montgomery County Council
50 Maryland Avenue
Rockville, Maryland 20850
Re: Bill No. 56-14 E Cigarettes
Dear President Leventhal:
200 East Lexington Street
Suite 801
Baltimore, MD 21202
(410) 685-1156
Fax (410) 783-1765
I Chair the Governor's Council on Fitness, which has a statutory focus on Youth, Schools
and Student Health.
In
addition, I attended Woodward High School in Montgomery County and
partially as a result ofthe emphasis on health and fitness, eventually competed nationally
in
triathlon and served as a legal counsel to USA Triathlon.
As
part ofmy legal career, I have also served as Counsel to the Montgomery County
Senators and former Administrative Assistant to its Chair, former Senator Victor Crawford from
District 20. Vic became a national figure in the fight against youth smoking, nicotine addiction
and the struggle against The Tobacco Institute, a former law firm client.
The bill sponsored by Councilwoman Nancy Floreen deserves passage, along with any
necessary amendments to broaden the definition of"e-cigarette, e-cigar, e-pipe, e-hookah or vape
pen" and most importantly, to place an emphasis on what the device really is: a nicotine delivery
system.
My reasons are as follows. First, there is already a ban in public places for cigarette
smoking. Second, there already is a ban in place against cigarette sales to minors Thirdly, the
device in question is still burning nicotine, an addictive chemical that maintains or attracts a new
dependency.
As
the NIH report to the Council highlighted, 90% ofsmokers
start
in
their youth
and can be lured by these flavored devices into the wrong direction through targeted marketing
Thank: you for your attention. Please continue with the existing public policy that bans
sales to minors and
any
exposure ofsecond hand smoke
in
public places.
CFC:om
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\'1/
I started smoking when I was 9 years old. 30 years later I had a heart attack and was faced
with the choice of life or death. Needless to say it was an easy choice, I chose life. After
my heart attack I tried to go cold turkey. I found myself still drawn by the smell of
cigarettes and after 5 years of fighting the urge I fell off the wagon, knowing by doing so
I was risking my life.
Then I found vaping.
After two weeks of vaping I went to visit my cardiologist. He asked me if I was still
smoking. I triumphantly said ''No, I am vaping". He told me that's ok. I was surprised by
his response and asked him why. He explained to me that nicotine was not the problem,
and that it was the combustion of the tobacco that was the problem. I see my cardiologist
every 6 months and I've been vaping for over 3 years now, every visit he comebacks
from my tests saying that I am looking good and doing well. I feel great and the urge to
smoke is completely gone.
As an owner of a local vape shop I am rewarded everyday with opportunities to helps
those in my community to quit smoking. Although my store is new in the area, our
company has been able to help thousands ofpeople over the years to find a healthier
alternative to cigarettes. I hear stories daily like mine.
To ban vaping in public would be detrimental to public health. When people see me vape
they are able to see that there is another way to quit. That there is still hope of a healthier
life. Second hand vapor has been proven to be harmless. Studies from Boston University
and there is a study in progress at the University of Maryland studying just this subject. I
urge you to please consider the stories of the ex-smokers here this evening and use
resources like CASAA to learn more.
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Ronald A. Ward Jr., Esq.
707 Cedarcroft Road
Baltimore, MD 21212
443-921-5190 (mobile)
410-878-0404 (office)
410-878-0405 (fax)
nvard472@gmail.com
Written Testimony to the Montgomery County Council
Bill 56-14
January 22nd, 2015
Dear Councilmembers:
My name is Ronald Ward and I am a life-time resident of Maryland. I am also an
electronic cigarette or "e-cigarette" user for the past 5 years and a volunteer, unpaid activist for
electronic cigarettes, serving as Director with the non-profit group The Consumer Advocates for
Smoke-Free Alternatives Association (CASAA). For the last year I have owned an electronic
cigarette retail store in Maryland. I am also a practicing attorney in the State of Maryland.
E-cigarette activists fully support reasonable regulation such as keeping these devices out
of the hands of minors and setting e-liquid safety standards but this proposed bill goes too far. I
ask that you amend Bill 56-14 tQ allow for the use of electronic cigarettes in public places.
1.
What we know so far
Numerous studies point to electronic cigarettes being up to 99% less harmful than
smoking traditional cigarettes. Even the FDA's own study of obsolete vaping devices found no
more ofparticular carcinogens than other FDA-approved nicotine products.
There seems to
be
no issue with "second hand vape" as there is with cigarettes since 99%
of nicotine is absorbed by primary user. Additionally, the vapor leaves no odor on your body,
hair or clothes, and the smell does not linger in a room.
Recently, Dr. Igor Burstyn of Drexel University conducted a comprehensive study
entitled "Peering through the mist: systematic review of what the chemistry of contaminants in
electronic cigarettes tells us about health risks".
In
this study, he compiled the existing data on
the subject of electronic cigarettes and concluded that "Current state ofknowledge about
chemistry of liquids and aerosols associated with electronic cigarettes indicates that there is no
evidence that vaping produces inhalable exposures to contaminants ofthe aerosol that would
warrant health concerns by the standards that are used to ensure safety of workplaces. However,
the aerosol generated during vaping as a whole (contaminants plus declared ingredients) creates
personal exposures that would justify surveillance of health among exposed persons in
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conjunction with investigation of means to keep any adverse health effects as low as reasonably
achievable. Exposures of bystanders are likely to be orders ofmagnitude less, and thus pose no
apparent concern."
http://www.biomedcentral.com/1471-2458/14/18/
II. Maryland Legislative History Regarding Electronic Cigarettes
As you are probably aware, the FDA has announced its intent to regulate e-cigarettes as