Vermont Legislature SmartTranscripts:

[Sen. Alison Clarkson (Chair)]: Okay. Welcome back to Senate Economic Development Housing and General Affairs. We're in the general affairs part of our jurisdiction, which is consumer protection. We're gonna shift from housing revenue to Beeks. Yeah. To face. So we're moving to consumer protection. Okay. And we ran out of time last time. This is a priority of the AG's office that's come to us and of our healthcare community and whole community that cares about young people. So there's lots of interest in this and I think we're probably gonna end up honing this bill down to bit. But we left off with Rose Kennedy, our AG, our Deputy AG who has been overseeing consumer protection issues. So Rose, we turn to you and it is yours.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Thank you very much for having me. So my name is Rose Kennedy. I'm an assistant attorney general. I've been at the attorney general's office since June 2022 and in the Consumer Protection Division since May 2024. Obviously, have some prepared remarks in support of S-one 198. We think it's a good bill that will help combat nicotine use. Oh, okay. It's like a reserve bill. Okay. Obviously, free to interrupt me and ask questions as I go along. Generally speaking, my primary responsibility since joining the Consumer Protection Division has been tobacco enforcement. As you know, Vermont is a signatory to the Master Settlement Agreement from 1998 in which the sale and distribution of traditional combustible cigarettes and rolling around tobacco is highly regulated. The diligent enforcement of the terms of the MSA is important work that our office, the OL, and Department of Tax does together all year long to make sure that every cigarette that's sold in Vermont is compliant with state and federal laws. In 2025, under the MSA, Vermont received a payment of $23,000,000 and over time, since its inception, Vermont has received approximately $800,000,000 So a lot of money in this industry. We all want to see what we're getting for it. Right. However, the MSA payments that Vermont receives have been decreasing and we expect that they will continue to decrease largely because of what's known as the tobacco substance market. So that's why we're here. We're on a prop. This is the MSA, in case you've heard about it but never knew it, what it was. It's pretty thick. It actually controls every element of manufacturing, production, sale, advertising of cigarettes. None of that exists for vapes and nicotine products and that's why we're here. Tobacco substitute products were first introduced sometime in 2006, around then. There was a hope that these products would help adults who were smoking tobacco cigarettes to quit and have potentially a healthier alternative. However, the reality is that none of these products have actually been approved by the food and drug, or the vast majority have not been approved by the Food and Drug Administration as cessation devices and or medicines, and all the products contain nicotine or synthetic nicotine, which is highly addictive. The Attorney General's office believes that tobacco and nicotine products are harmful to Vermont consumers, especially our youth, and has attempted throughout the years to combat their illegal sales. Foremost in our minds as we do this work is the concern that while the MSA may have helped curb traditional cigarette smoking amongst Vermont's youngest generations, those born after Joe Campbell, the ENDS or nicotine pouch market is growing a new generation of nicotine addictive youth. Kids who would never have picked up a cigarette

[Sen. Alison Clarkson (Chair)]: are picking up a fruity flavored vape. I think we have examples of that.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: I sure do have examples. So

[Sen. Alison Clarkson (Chair)]: when we get to you, let's bring it up. Because you could just show one right now. Just show them. It's

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: very attractive, fun. I have some too that I'll pull up on my screen. You learned last time we were here, according to a 2023 study from the Department of Health, sixteen percent of Vermont high school students reported that they used e cigarettes, but what's most concerning about that number is that thirty seven percent of them said they used them daily, which we believe suggests addiction. We know that approximately eighty six percent of kids that start using nicotine products do so using flavored products that are designed to look youth friendly and downplay the addictive impact of the product. What we're also hearing is that these youth start off using these fruity vapes and at some point feel like they've grown out of them and then revert to traditional tobacco cigarettes. So, we may, in fact, start to see an increase in cigarette sales again. For background's sake, it's important to understand that the authority to regulate this nicotine market falls primarily within the federal government. In 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act that gave the FDA the authority to regulate tobacco products. In 2016, that authority was extended to tobacco substitutes,

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: what's known as the deeming rule. However, since the adoption of

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: the deeming rule, there has been an extraordinary growth in this market and the FDA, tasked with reviewing new products, has been inundated with 6,500,000 pre market tobacco product applications. Most of which are for e cigarettes. Six? Yeah, it's an high So, it's not unreasonable to understand that the FDA was quickly overwhelmed. To date, they have only authorized 39 e cigarettes and 26 nicotine pouches to be lawfully sold in The US. So what that means is when you go into the stores and you see all these products on their shelves, they have not been authorized by the FDA and they technically are not legal to be sold. Why are they there then? How are they? So, because they were overwhelmed, they developed a policy where if a product had already been in the market by August 2016 and had already submitted an application by September 2020, they would let them stay in the market thinking it wouldn't take them that long to review all the applications. However, we are now five and a half years out and we have this problem in our markets where there's things on the shelves that haven't been authorized. We don't really know what is in them. They're being sold, especially to youth, and we, the states, are waiting for the feds to do something about it. You should know that I'm in constant contact with my colleagues across the states to try to figure out what authority we can do, and that's why we're here. This is something that we've come up with that we think

[Sen. Alison Clarkson (Chair)]: is in state law purview. And and just to go to enforcement while we're here.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Yes.

[Sen. Alison Clarkson (Chair)]: You partner with DLL to enforce both the illegal sale of vapes and cigarettes.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Well, they don't really have much authority in the land of vapes yet. That's why we wanted That's why this bill is one ninety eight to be passed. And just while we're there, DOL does routine brick and mortar audits. So they go into stores all across Vermont and they can look at cigarette packets and cartons. They have a list of what we have deemed appropriate for sale in Vermont, and they can check to make sure the tax stamp has been adhered to on the packaging. So they know just from looking at it if it's a legal product. Nothing like that exists for vapes

[Sen. Alison Clarkson (Chair)]: and pouches. So we don't have stamps for the 39,000,000 And dollars that's

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: why we're proposing that. Yeah.

[Sen. Alison Clarkson (Chair)]: I just tried to get to Sorry.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: That's fine. There's a lot in this bill. I just want to highlight a few things. To begin with, we wanted to discuss the deceptive product span that is in S-one 198. Brought with me today some images and hopefully I can share my screen. Alright. So you all see that?

[Sen. Alison Clarkson (Chair)]: Yep. Yeah. Yeah. You can make it a little bigger.

[Unidentified Committee Member]: In addition both lower leg.

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: Like that.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Right there? Thank you. Alright, so these are products that we think should just be flat out banned in Vermont. They're designed to look like toys.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Or

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: to be stealthy, so that adults or teachers, parents won't actually know that they are vapes and delivering bigotine to youth. Some of these are gaming devices, so they actually have a smartphone element, and we've been told that some of these have the ability, the more puffs you make, the higher your score is. Right. So kids have an incentive to continue playing and to puff more. That's cute. Again, stealthy devices, things that look like inhalers, like teachers would be afraid to take that, but actually it's a vape, markers, highlighters. That's one portion of the bill that we are hoping that you will agree with us on, that those should just be banned completely in Vermont. Secondly, S-one 198 attempts to strengthen licensing requirements and clearly alcohol, tobacco license is thrown in for free and for an additional $50 they can have a license to sell nicotine products. S-one 198 proposes to make those independent of each other and to raise the fees so that people who actually are licensed want to sell these and know what they're getting themselves into. We're asking for the provisions in S-one 198 that increase the penalties for those who sell to underage folks or sell without elephants. And then, especially what we just talked about, the regulatory framework that would give DLL the ability to go into these brick and mortar stores, look at what's on the shelves, determine if the tax that Vermont is owed has been paid. We understand, we've talked to industry and we've talked to the wholesalers, we understand that these vape products are very different than a packet of cigarette or a carton of cigarettes. They're not as uniform, and so currently putting things like those through a tax machine is a lot more simpler. However, we think the time is coming. There are tobacco heated tobacco products that will need to be tax stamped. So again, I was in a conference last week with a lot of my fellow AAGs that do tobacco work. They're working on these sort of issues. How are they gonna put tax stamp on those products, for instance? So, we think this is an opportunity for Vermont to be a leader on this front, and it's a clear way of making sure Vermont is getting the tax that they deserve on these products. The other part of the S-one 198 that we're hoping it'll support is increasing the tax to 100% for any of these products that are over five milliliters per gram of nicotine. We're starting to see a large increase in the nicotine content. The danger of that, I'm sure the folks behind me can talk more in-depth about that, but these are very potent nicotine products. And so we're hoping that by increasing the tax, we'll incentivize not doing that.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: That's great. Is that in the bill? It is. And and like a cigarette is two milliliters, and these other things could be up to, like, 200 for a a piece that lasts for a long time

[Sen. Alison Clarkson (Chair)]: or something. Right. Yeah. Yep. Okay. So,

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: obviously much has changed in the tobacco market since the day of Joe Camo and the Marlboro Man. S-one 188 seeks to return some balance to this non traditional nicotine market as it involves ensuring proper regulation, appropriate taxation, and the protection of Vermont youth. I'm happy to take questions, and also, with your permission, I think there are some technical amendments that we would like to propose to Legislative Council and we can do that in writing.

[Sen. Alison Clarkson (Chair)]: We can do that when we maybe next take it up because I think our time is precious today and we have time, but we have advocates here. Yes. And we also have others coming in who are not as fond of it who will be in testifying as well. So we want to make sure we have it balanced. You, Rose, have you sent your testimony to Kiara?

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: I sent her the images. I didn't know if I have prepared remarks, but I'm happy to send them to you. That would

[Sen. Alison Clarkson (Chair)]: be lovely. I need to have you send them. If somebody has prepared remarks, if they you'd send them to Kiara, that would be great. See me at. Any questions for Rose?

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: And I kind of wanted to address your question from last time about getting rid of the penalties for kids or youth that are caught with these vapes. I mean I think other folks on this panel will address it as well but it is a little different than alcohol. Yeah

[Unidentified Committee Member]: so to put it in context proposal in the bill was to remove penalties for the the themselves or actually The users. The users.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Yeah. Not like anyone who's spelling.

[Unidentified Committee Member]: Right. Wanna make sure though.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Right. And I do think, like, you know, as a former state's attorney, when I think of youth using alcohol, that's usually in a community setting or a party setting or, you know, This is a little different, most of the interaction is happening at school. I wouldn't say there's not consequences. When I talk to school nurses or counselors at schools, they're hoping to generate more voluntary coming forward with this addiction issue. Ultimately, the $25 fee or whatever it is that the youth would have to pay if they were caught with a baby, gonna be completely outweighed by the lifetime of addiction. So, hopefully making it less punitive and more supportive would have more kids coming forward and sort of giving up their babes and helping, trying to get help for their addiction. So I think, again, other folks on the panel will address that more, but I wanted to talk to you about it as well. Anything else?

[Sen. Alison Clarkson (Chair)]: No, I think with that, let's shift to, if this works, Amy Brewer. You want me to go to that? Yeah.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Could I is it okay if I switch with Matt? So, Matt, you can go first. Matt? I don't know why. Yeah. Alright.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: So, my name is Matthew Menier. I am a student assistance program counselor at Franklin Valley Union High School.

[Sen. Alison Clarkson (Chair)]: That's my favorite. So

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: an SAP, just to kinda give an idea, work with students who use mental health issues, substance use issue, or who may violate our school policy because of substances. And so it it works a lot like a mental health counselor or a school social worker. So along with my job at CBU

[Sen. Alison Clarkson (Chair)]: How many of there are you?

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Oh, there's one of us. Community. Community in the high school.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: For how many students?

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: I think we're at about thirteen fifty right now, less campus, something like that. We have I think there's four of us in our district, so every single building, middle and up in the Champlain Valley School District has one SAP. So I think there are four of us throughout the district.

[Sen. Alison Clarkson (Chair)]: But I I also Must be a busy man.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: I I am. But I I love it. So Good. But that's why I'm here. Right. Thank you. So I prepared some remarks to kinda speak a little bit to Right. What we're here for. But yeah. So I'm here today to support the provisions in the bill that eliminate the penalties for possession, and purchase, because my goal would be to shift accountability towards this systems and the retailers that supply those products. From my perspective, youth nicotine use is a serious health issue and very often a coping issue. Many students I work with are using nicotine are not using nicotine to be rebellious. They're anxious, depressed, overwhelmed, or trying to manage stress. When the response is a ticket for a legal consequence, it doesn't address why students are using in the first place. More times than not, it creates sane and secrecy. Students become more worried about getting in trouble than about than getting help. That fear makes it harder for them to be honest with adults and delays the moment that we can actually intervene and help support students. I'd like to share a brief example of a student that I've worked with. I've worked with a family for a little over a year now with a son who's struggling with nicotine use. His parents were extremely engaged. They were proactive. And over the course of this year, they contacted online retailers to block deliveries to their home and did everything they could to prevent access. They contacted me and tried to track down where he was getting products locally after they were able to kinda stop the deliveries coming to their home. And unfortunately, despite all those efforts, we're still not able to stop them from using nicotine. Yeah. And so this is a student that I work with, you know, weekly at this point and is still using nicotine pretty heavily, and is still able to get them locally, whether that be from friends at school, that be from, you know, other adults potentially, just places locally. And so, ultimately, I think the impact of this bill, I think about those students and those families who are doing everything that they can on their own, and I think need a little bit of help from us in the system to be able to change that. I think punishing the student in this situation does not fix the real issue, which is access to it. My experience in schools has informed me that this issue is a supply issue, not so much was that your issue. Students are getting these products from older friends, adults, online sources, or local connections. And I think holding the young person accountable after the fact doesn't reduce that supply. It is my belief that the bill shifts the focus in a more effective direction towards retailers in the system providing access, from a school perspective. I think this change would allow us to focus more on what actually works, prevention, honest conversations, early interventions, and cessation support. When student when students know that they won't face legal penalties, I think they're more apt to be honest, and they are far more likely to open up and hopefully accept help at some point in time. And to conclude, my prepared statement, I think eliminating penalties for youth possession and shifting accountability to to the supply side aligns with the law and what we know works in schools. It gives students a better chance to be honest, seek help, and hopefully make healthier choices.

[Sen. Alison Clarkson (Chair)]: Great, thank you, Matt. That's terrific. Many students are you working

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: I mean, I think weekly, I probably see, 20 to 30, like individually, but I'm in and out of classrooms every day. I work with our alternative program within the school quite often. And frankly, a lot of those students are, I think, probably the number one thing that they struggle with other than their mental health is nicotine. I would say like

[Sen. Alison Clarkson (Chair)]: So of your 30 kids that you see weekly, how many would you say have this, are really struggling with the nicotine shots?

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: I mean, would say probably sixty percent of them, at least, if I think about it. I think the math, twenty out of thirty, are are definitely using nicotine. And when I say using nicotine, like, they're using nicotine daily. Like, I think one thing that I have seen and started to see at the high school level, I've been at SAP for five years now, is by the time students get to high school, they have already kind of been faced with the choice of using or not using. And so at the point in time that they get to ninth grade, they're either, like, using daily and act like nicotine addicts and eat it every day, or they're not using it all a lot of times. It's not this middle ground as much anymore. Like, it's still there, but it's much less. And so I think what's happening to me and what I see is that students are kinda needing that nicotine to be able to get through the day. Like, that's I I would say a lot of my conversations over the course of the day are talking about how to manage stress because students are like, yeah, I can't hit my vape or I got caught hitting my vape to the hand and so they took it. We don't necessarily send them home. And so it's like, what do I do for the rest of the day? Right? Something happened in the morning where my big detector where the big detector went off. We took the bait. Now they're in my office, and you can see they're very elevated and having a very difficult time trying to manage their their feelings and their stress at this point.

[Sen. Alison Clarkson (Chair)]: Thomas.

[Sen. Thomas Chittenden (Member)]: Great testimony. Thank you very much. This is really helpful. And then you said that it it sort of validated my impression that it's not necessarily the stores that the kids are buying it from. They're getting it from their older cousins. The people they know that are over the age. If if that is true, do you think we should be looking at penalties for not necessarily retailers of these products, but also making it more serious consequence for an older individual to provide these products to the kids? Not going out to the kids, I agree with you there, but the actual adults that are either selling them to these kids or handing them to these kids or buying them for them, is that where we should look at some penalization?

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Yeah. I mean, I think I think it would all be helpful.

[Sen. Alison Clarkson (Chair)]: Right? Supply chain is Yeah.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Because I I think ultimately, to me, that that that is a huge problem. I think it's a huge frustration. I think I have personally, if I'm being frank, is I I have some students that I work with, and the place that they get their nicotine bakes from is is their parents. You know? I think there's a lot. I think I have a a lot of empathy and a lot of understanding for what people are going through, and I think it really frustrates me because the thing that happens is, I I think I just have a firm belief that regardless of if students may use nicotine or not, I think as adults, it's our job not to make it easier on them to do that. And so I think I I have conversations with parents sometimes where I'm almost pleading with them to, like, don't don't buy them their negative teen pain. Like, I know that they may be very uncomfortable. It may cause arguments. You may not have very good communication for a period of time because they're struggling. And I feel like that struggle there is a much better struggle to have than what we might be dealing with down the road because they've been using nicotine, regularly since they

[Sen. Alison Clarkson (Chair)]: were 14 years old. Right. Thank you, Matt. Really great Got a kitchen.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Rose might know what the current penalty is for furnishing.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: I don't know. I mean, I don't know it off top of the head. I mean, there are penalties for online sales if someone were to sell it that way, But I'm sorry, didn't get that to you.

[Sen. Alison Clarkson (Chair)]: Jen can answer. Jen Carter, the Office

[Jen Carter, Office of Legislative Counsel]: of Legislative Counsel. So currently anyone who sells or furnishes, which I think would fall in supplying somebody under 21 years of age subject to a civil penalty currently of not more

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: than $100 for

[Jen Carter, Office of Legislative Counsel]: a first offense, or $500 for a subsequent offense, the bill would increase the $100 to $1,000 for a first offense, and then you may need to look a little bit at some of the increased penalties for the subsequent events because they do get tied to sublicense suspension, which doesn't make sense for non licensees. They would increase those fair day schemes actually to $1,000 $2,000 And the other sort of

[Sen. Alison Clarkson (Chair)]: really tough thing about this is creates yet another sort of illicit market, which is such an insidious thing. Everybody's trying to get used to using illicit networks Yeah. To do business. And that to me is a kind of an additional insidious aspect of this, which is we are have tried to address with cannabis and making some inroads on, but, you know, to have created yet you know, to have another product that is creating this kind of insidious illicitness is just, like, so frustrating. I think given our time, let's move to our next

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Yeah. Thank you very much.

[Sen. Alison Clarkson (Chair)]: Matt, thank you for taking time out

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: of your Yes.

[Sen. Alison Clarkson (Chair)]: Of day, which we appreciate. And thank you for your work with all their mental health challenges. Learning how to cope with life is one of our big needs.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: It

[Sen. Alison Clarkson (Chair)]: is. Well, all the way through. Amy comes. Yeah. We're still But then we get through new things like children. Oh my god. Yes. Okay. Amy, welcome.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Thank you. Thank you for having me. I will see quickly. But I did ring baits if anybody wanted to push any buttons or

[Jen Carter, Office of Legislative Counsel]: I see how they

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: do. Good luck.

[Sen. Thomas Chittenden (Member)]: I've seen them

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: before. This is one. Is this one. We push the button and something lights up

[Sen. Alison Clarkson (Chair)]: on all of them. That's for fun. Introduce yourself and go for

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: I am Amy Brewer. I coordinate the Franklin Grandell Tobacco Prevention Coalition. I've worked for tobacco control for about twenty five years, twenty years in St. Albans. I am a parent to teenagers. I grew up in a household of smokers to lung cancer, soup to nuts, I've been involved with tobacco control. In my region, what I've been up to is going into middle school, right? Before they even get to math, there you are, before I get to math, I'm trying to give them all the information they need. Right? So what are the facts? What are the myths? How are you being targeted? What's the long term effect? Do we know? What don't we know? And I try to give them all the information so that they can make better decisions. One of the things I ask them is, you know, why do you think young people use? The answer is, the first thing out of their mouth is cool, right? Flavors, interesting design is a new one in the past couple of years, and peers. They share that with me all the time, and you wonder how they learn so much about these products, and then I ask them where are you seeing information about them?

[Sen. Alison Clarkson (Chair)]: Yeah,

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: they're seeing media. They're seeing a lot of information, press influencers, and peers and on YouTube and TikTok, and a lot of information that presents itself in a really intriguing way. So young people are, as all the adults that we share these with today, are very intrigued by these. They are cool, they are interesting, they are tech board. They light up. They light up. Tell you how much flavor's left. They are now becoming Bluetooth enabled, you can listen to music through them, and even make a phone call with your phone nearby. Right? They are very intriguing, Youth are intrigued by them. I've been partnering with school administrators to find ways to handle all the things that Matt did. So what happens if we have a violation? What do we do? How do we support that person so that they can sit through class and learn without having anxious feelings, withdrawal feelings, right? That's withdrawal. Without having all those feelings and sit in class and learn. And that's that crossover. They're having trouble. They're addicted at an early age and struggling to sit in class. So we're working on policies on helping that. Thank you for sharing this. Students share these products with each other, and so one of the places you'll find is, these are the kids who lived through COVID. They are in the bathroom sharing each day with each other. And I heard at CBU we've got like 200 students, about two hundred students got sick. They are sharing their Oh, they're getting sick together.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Yes.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Yes. Very much so. Very much getting sick together. They're sharing them. One of the hopeful things I have is that the cell phone bag in schools will help them to not communicate. I'll meet up in this bathroom at this time. There's a little bit of glimmer Also, approach in that one of the things I did bring is nicotine pouches, another nicotine product that is out there that schools are seeing more and more, kids are using, there's high level nicotine, kids are using two or three because kids are goobers like that, and my pediatrician was like, I've had students pack out. The impact of them being able to sit in a secure day when they're very Elevated. Elevated is a great word. Yeah. The advertising is very directed at young people, helps you pay attention, helps you get your sports workout better, all things that appeal to kids.

[Sen. Alison Clarkson (Chair)]: And that advertising is all social media,

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: I said, for most of it.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Lots of it, yes. Yes. And in fact, they're doing sponsorships with, like, Elmer Khan, and then he's doing a sponsorship with him, so really pairing things that kids are looking at with a product that companies want them to use. So addiction is happening fast. These are little people, they're poor decision makers, they have trouble understanding long term effects of what they're doing, and by the time they've experimented, school are interesting, or other peers were doing it, they are ending up in math department, kind of like, I didn't want to do it, but here I am, I can't get through the day. The other piece of the puzzle that I'm doing that is somewhat related is each is a hazardous waste to dispose of. So we are working with our high schools to collect any other confiscated vapes, and I am using my grant funds to pay to appropriately dispose of them.

[Sen. Alison Clarkson (Chair)]: Don't forget, you have anonymous disposed spots here?

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: We haven't gone that far. I'd love to, but right now, it's just the confiscated vapes, stuff that the administrators take. What do these cost? A short So based on kind of rough data, they look like they're about $25. Are refilling? These are not none of these was refillable.

[Sen. Alison Clarkson (Chair)]: Oh, I was wondering they're so also bad. Oh. It's a long waste.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: So when it says switch your nick on and off, it's saying you could have a flavor without nicotine. No. You can boost. You can put more energy and get more nicotine out you can go lower. This one, you can change the flavors. You can mix and match.

[Sen. Alison Clarkson (Chair)]: Oh, Oh,

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: it's on Nick level. Yep.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: What was the last one?

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: I don't know. I I don't know.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Do you know? I mean, a lot of times, it depends on, like, how often the students Right? Use Like, I think there are some students that that may last them a week. There are some students that might go through something like that in a few days.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: It's like how many draws can you get, right? How many buffs? Many buffs you can get. First thing,

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: products with, like, 50,000 puffs.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Yeah. And then just throw it away

[Sen. Thomas Chittenden (Member)]: and then just get a new one of these.

[Sen. Alison Clarkson (Chair)]: Each one is 50,000 puffs.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Been an increase of how many puffs you can get out of

[Katie Holman, Public Health Response (VDH grantee)]: these. And are

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: you collecting them for middle schools too or just high school? All of the high schools have a middle school in them. So I Oh, okay. Whatever, right? And two of them I did get from a middle school. Okay. Some type. Yeah, and it's the other crossover, you know, with tech design is that if you think about how often you touch your cell phone, and I always tell kids, like, have no social life, no one texts me, so there's nothing important going on, but I touch my cell phone all the time. Not only are you having a nicotine craving regularly, but you're thinking about this tech thing in your pocket all the time. And these, can, unlike cigarettes, you could touch it, take a hit, put it back, whereas a cigarette is that five minute commitment and a really noticeable So these are really really engaging to young people. So what is the effective like, or not effective, but what are how are you trying to combat this with, you know, cessation? Mhmm. So I tell lawmakers all the time, or Senator Brock has to hear me all the time, at the local level, I'm doing everything can, a, to prevent people from using, but b, to take the shame out of it and encourage young people to talk to an adult Mhmm. And have that adult connect them to cessation resources like my wife might quit, or So you don't have her patches on hand? Hatcher hasn't been shown to work with kids, although that was with cigarettes. We haven't

[Sen. Alison Clarkson (Chair)]: caught up with research for these products.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Okay. They are not the first line for kids. For kids, it's coaching, it's support, whether it's mat, a nurse, any size coach. Oh, coaching is hard. Yeah. Keeping them from being attracted attractive to kids would be so much more effective. Right. Right. I was like, what do you even do to combat this? You try really hard and you work with them for a year. Yeah. A year's worth of time that somebody is investing. Could we just ban, like, vapes that have games on them and things like that?

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Well, that's part of our proposal.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Oh, it is? Okay. Okay. Great. So didn't fill. Maybe I'll sit down. Yes. Or did you

[Sen. Alison Clarkson (Chair)]: have a question? No. Are you not is that what else do you have?

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: That is all I had.

[Sen. Alison Clarkson (Chair)]: Would you be kind of all of you, I've already asked, but please submit your testimony to care.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: I did. So more out of myself. I the do bag. You don't want them here. They stink.

[Sen. Alison Clarkson (Chair)]: Well, so they stink, but the people who use them don't. Correct.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Not

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: with a cigarette. Well, I mean, if you're around someone who they I mean, I know somebody who attaches it to their computer, and it does smell. It it does smell. All these again. That that that's Would you like this one? There's something you pour, you can smell. Okay. Oh. I will open up the bucket for you. Uh-oh. Okay. So

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: What? Here.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: Just face. Okay.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: There's nothing treaty in there.

[Sen. Alison Clarkson (Chair)]: There's no economic trouble. So give me at the smell test.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: It's like It's like

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: my god. And you don't have laughing that. Holy. Yeah. Dirtman plus. Like, she shook her.

[Sen. Alison Clarkson (Chair)]: Okay. Okay. Amy, thank you. You're welcome. That thank you. Pictures are worth it. Okay. Prospero.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Welcome. Thank you, thank you

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: very much.

[Sen. Alison Clarkson (Chair)]: Great, I'm gonna have you introduce yourself and Great, for it.

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: My name is Prospero Vildo. I'm a neurovascular cardiologist at CVS, and I'm also the medical director of the cardiac catheterization labs, and the chair of the American Heart Association of Neurological Medicine at Krissy. You. And I'm coming here today as a clinician, but also I don't have formal training in health economics, but I do want to reflect some of the costs that this may have in respect to monitoring both today, for the healthcare costs, as well as in the future. And so, you know, I think you guys are all spending your time right now with many crises to affordability in Vermont. And as the world goes around, this bill will affect some of the affordability in So, mainly by affecting the impact of tobacco on public health. It is expensive. Jill actually tested last week about the costs of tobacco related illnesses in the world. Dollars 400,000,000 a year spent on tobacco related illness. MSA and taxes come with nowhere near covering that cost. This is actually borne by everyone who have both a share of our taxes to the federal government, your Medicare taxes, as well as our public insurance, our private insurance costs go into this, and it's disproportionate. I'll tell you more about that. Vaping companies targets kids. You've just seen a lot of testimony about that. They are bearing some of the cost of affordability. That money has to come from somewhere to pay for those vapes. It's been very strong in terms of getting kids to adopt these products. One in three young Vermonters report recent boosts according to the case of Vermont. But here's some of the costs. So today, about half of Vermonters who have coronary artery disease as a diagnosis on their chart have recent tobacco use. One in two. The penetration of smoking amongst adult Vermonters is about one in six. So that's a disproportionate share of the people that we take care of for coronary artery disease. When we take care of patients at UVM who have a heart attack, forty percent of those people who have heart attacks who come in at that moment have smoked a cigarette or have had some kind of tobacco product in the last thirty years. So it is a high burden and a reversible risk factor for people with heart disease. Now, some of the costs of some of those diagnoses. If you come in and you need a stent because you have an antidote, that's around $18,000 That's a really important reimbursement from Medicare. We did six seventy eight of those last year at Efgabir. Well, this could be as high as $45,000 for bypass surgery. We did around four fifty of those. That's just one per year cost of a reversible risk factor that could prevent a lot of this from happening. So, know, the Florida, the estimated spend for UVM, just UVM alone is around $40,000,000 due to treatment acquired by Medicare. It's a lot of higher when you bring in private insurance, okay? And so here's the cost shift. The issue is that tobacco is utilized disproportionately by Vermonters with lower associated drugs. So there are a higher burden of Medicaid patients, and I'll talk to you more about what happens when someone who has a younger person has a consequence of baby, as well as Medicare's, just based purely on age. The age group of Medicare is also reflected by a lot of tobacco related illnesses because of the long lead time. Develop tobacco related illnesses like COPDs, like coronary disease. So, but just to bring in the Medicaid population, there is something called vaping associated lung injury. That is a major inflammatory consequence to your lungs. From vaping. From vaping. It's not common. It's actually a pretty rare consequence, but the consequence is, if it does happen, it's severe. If you get a baby associated lung injury, you may actually be in the intensive care unit for a long time, for several weeks. You may need something called ECMO, which is extracorporeal membrane oxygenation, because your lungs are so diseased from that inflammation that you need a machine to breathe for you through your bloodstream. If you have an admission like that, it costs more than a half $1,000,000 just for that admission, for one person, okay? The average cost in Utah, they did a study looking at the cost of vaping and dissociation. Average cost of a vaping admission was for this entity was $125,000 Of course, it's not common, but amongst the Medicaid population, you have one or two of these per year, that's a fair amount. Have we seen one yet? There was one, a year and a half ago, it was a person in their mid 20s. So this is the gray rhino. This is the analogy I like to use. Gray rhino is existential threat that is way out there but you know it's coming. It's like climate change. It's like smoking, right? You can hear the footsteps. It's a 200, I don't know, it's a four ton animal coming at you, but only at five miles an hour. So you got time, but you know it's coming, right? Got time to move. We have time to move and we're gonna try to divert the right of it. Tobacco has a long history of research, but it took a long time. Yeah. In fact, way back in the 1950s, there was so little research on the harms of tobacco that physicians like myself not like me. Interesting. Who took money to be on those advertising on magazines, newspapers, even television. So if you go on YouTube, can actually see a wonderful set of physicians in white coats with their cigarettes. So you're not gonna see that from us, from me today about raking poop. The point is that this is so new. As we heard, the first electronic cigarettes came out in 2006. This is so new. Tobacco itself, when you take a cigarette, takes so long, it takes two to three to four decades for a large portion of people who use that cigarette actually experience the health related effects. It's a delay, it's a big delay. It's delayed, but

[Sen. Alison Clarkson (Chair)]: And expensive. It's delayed and incredibly expensive. Personal cost, just real cost, cost of time and effort and loss work, also the workforce community. So I guess the other question of that is when you stop, it takes how long for the lungs and the body to recover because I've heard seven years.

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: I want to address the lung problem because actually, so what they do teach in medical school is that you have a finite amount of lung capacity throughout your life and it kind of goes down like this. The threshold down here for where you actually have serious issues with shortness of breath on a daily basis is way down and you should intersect that in your 90s or, you know, basically way past your normal life. When you smoke, the average line gets significantly steeper. But that line actually flattens out a little bit when you put smoking. You still have all this damage from smoking, but you may not hit that threshold for a long time if you put smoking. For heart disease, your risk for a heart attack goes down a year after you put smoking. Okay, so you get back to the normal risk for a population for heart attack if you quit smoking after.

[Sen. Alison Clarkson (Chair)]: So lung impact longer term, more damage? Improves, yeah. Study out part almost with meat, I mean, that's very

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: Not right, but yeah, it's good, it's good. I'll tell you, one of the highest risks of, so here's the summary impact. The number one factor for someone who dies during a marathon is someone who formerly smoked who's trying to afford it. Oh, interesting. Just like that. So that's some of the data. We had a guy from Massachusetts General Hospital coming to

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: talk to us about this.

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: So anyway, this is an existential threat for people who's diabetic. It really is. And kids who are starting to pick up vaping. The problem with vaping is that we don't have the data for the consequences of vaping, which may take thirty to forty years. We don't take people. The gold standard randomized trial you get for anything in medicine is you take some people and you give them this thing and you get some people and you don't give them that thing and then you follow them out for a couple of decades to see where are the risks. We have a natural experiment on that and it's on our kids because we're not gonna do that. We're not gonna randomize someone to a potentially lethal drug. But there is data. So the data is that there are markers of risk. We can actually take blood samples of people and see what happens to markers for inflammation, see what happens to vascular reactivity. A ton of these markers are showing potential future harm for these kids from strep methane. For example, increased LDL oxidizability compared to non smokers, that was JAMA cardiology in 2018. There are impacts on young people who are pregnant who use ESAIDs. For example, ESAID exposure during pregnancy impairs uterine artery blood flow and fetal placental function. That was a toxicology and science in 2026, just last month. E cigs and nicotine pandemic statement from the International Pediatric Association. So this is what they said just this past November. Dual using e cigarettes and cigarettes at the same time and long term nicotine dependence are common. E cigarette use is associated with cardiovascular, metabolic, respiratory, oral disease, diseases, and cancer, with dual users facing greater health risks than cigarette smokers alone. Drawing on global data and recommendations from APAX public health organizations, the International Pediatric Association calls for comprehensive bans on stringent or stringent regimen regulation on the manufacturing sale and use of these. So that's from the pediatric, International Pediatric Association. So lots of data developing. We're not gonna tell you what your risk of, the lethal risk of vaping is because we don't have enough data till people start dying.

[Sen. Alison Clarkson (Chair)]: And how are we seeing, what are you seeing at UVM in terms of increased youth, seeing youth in this arena?

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: Yeah, I can't say personally I see youth because my average patient age is around 64. So, I'm sure that we could find some data. I think it would just be interesting for us to see that this is growing, I guess, a growing impact on our medical community. Yeah. So that was all I really had to share with you. I'd be happy to take any questions, but again, this is a very expensive thing and all the stuff we've gotten from the tobacco companies and from taxes, nowhere near the cost of this system. Well, there's huge cost

[Sen. Alison Clarkson (Chair)]: of the tax payer, just like alcohol is.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: I was gonna

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: say about the cost shift actually is because there's a disproportionate number of people who write tobacco related illnesses and government insurance, that's why our private insurance costs are going because all use costs are being used, but they don't actually quite cover the cost of emissions. So this is one of the affordability issues of the month. Cost shift towards private insurance is partially driven by reversible risk factors like these matters. Prospero, would

[Sen. Alison Clarkson (Chair)]: you be kind enough to send your testimony to Kiera? That was very helpful. And just given our time, thank you so much. It's so hard to I mean, name is so fabulous. As a theater a former theater producer,

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: I just break

[Sen. Alison Clarkson (Chair)]: your magic wand and what will happen to our world. But, anyway, it's so it's so good to have

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: you together. I will see everyone next week at the concert. Yeah. Exactly. I'm 14. Yes.

[Sen. Alison Clarkson (Chair)]: Well oh, and Farmers Night is on the eleventh.

[Prospero Gogo, MD, Interventional Cardiologist, UVM Medical Center]: Farmers Night is is on the Yeah.

[Sen. Alison Clarkson (Chair)]: Exactly. It's so good to have you. Thank you. So next on deck, we have Katie. Katie Ellman, welcome. Katie is I think oh, you could feel free to end up. Andrea, is that you? Are you Andrea? Andrea. I agree. Okay. Katie and then Andrea, and then we're gonna have to go to floor. Thank you. This has been terrific.

[Katie Holman, Public Health Response (VDH grantee)]: Hi. Can you all hear me okay?

[Sen. Alison Clarkson (Chair)]: We could do with hearing you more loudly, but I think that may be on our end.

[Katie Holman, Public Health Response (VDH grantee)]: Okay. I'll project. I'm gonna share my screen with you all. Give me just a moment here. Thank you all so much for having me. It's been so amazing hearing from so many folks so far and people who I've met already in this work. So my name is Katie Holman. I am working with Public Health Response to Research, and we are a grantee of the Vermont Department of Health. And today, I'm just gonna talk a little bit about our confiscated vape collection and testing project that, occurred over the twenty twenty three, twenty twenty four school year and the twenty twenty four, twenty twenty five school year and how it relates to this bill being proposed today. So over these two school years, we collected 512 confiscated nicotine vapes and vaping related products from high schools and middle schools across the state of Vermont. And we did this to try and understand what does the youth vaping landscape actually look like in Vermont to try and get a really good accurate picture of that, to identify some potential health risks that are emerging. We also did this to serve as an early warning system to see, okay, what types of products are coming on the market that might need closer attention. And we've also been collaborating with scientists from across the country and around the world with the Vermont Department of Health and hosting a summit series where they speak about the research they do. And they've been sort of like a reference points for us in our work. And I see Rolf is in there today who, hi Rolf, is my coworker on this project. So our process involved, connecting first connecting with the scientists and getting input and guidance from them. And then we worked with, high schools and middle schools by either going directly to the school and sort of like Amy was showing you. Amy was a huge collaborator in this project, either getting like a bag full of vapes, and all, you know, some THC vapes, but mainly nicotine vapes. A lot of the THC vapes, it's hard to tell, it's hard to distinguish what's what, but also getting some things in those bags like some grinders or knives. It's clear that schools don't really have a clear protocol for how to be disposing of these products, But we collected those both from the schools directly and from working with prevention workers around the state who would pick up from their local schools. We cataloged and documented all of those vapes. So we have a spreadsheet of all of the brands, models, flavors, and then we sent a sampling of those in for testing. So I'm mainly gonna be talking about the collection data, but we do have, some of the testing results back as well that I'm happy to talk about if you all would like to hear that. So from the twenty twenty three, twenty twenty four school year, there were 300 vapes and vaping related objects. So sometimes like cartridges or parts of modular vape, products. We collected from all 14 counties. In Essex County, we bought from a store. 24 schools were represented and 56 brands. And this, demonstrates sort of the spread of the different brands that we found throughout the state. And one of the key most, prominent data points is that there are some clear dominating brands in the market. This first one that we have here is the Loon, which makes up over a third of the collection. And then there's about, you know, five or six brands that are above 4%, and then a handful of brands and models that only show up one or two times.

[Sen. Alison Clarkson (Chair)]: Katie, just I want to interrupt apologize. But we have Andrea in the room, and we have seen a lot of

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: Okay.

[Sen. Alison Clarkson (Chair)]: Is it possible for you to go to your conclusions? You have a very long presentation.

[Katie Holman, Public Health Response (VDH grantee)]: Yeah. I'm not gonna go through the whole thing but I will add something that I

[Sen. Alison Clarkson (Chair)]: We all have it.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Oh, great. Great.

[Sen. Alison Clarkson (Chair)]: If you could go to the conclusions and then we could fit in Andrea before the bell starts ringing.

[Katie Holman, Public Health Response (VDH grantee)]: Sounds good. Let's do it.

[Sen. Alison Clarkson (Chair)]: So I apologize but I

[Katie Holman, Public Health Response (VDH grantee)]: think No, totally understandable. Lots of important voices here in the room. So, the most important takeaways were how quickly the landscape was changing. Also, that this correlation between the top brands that we found in our collection and availability in stores. Super high nicotine levels in our top brands as the vapes get bigger, their cartridges get bigger, there's more e liquid, there's more nicotine. Most of them were flavored and disposable, nearly all of them. And then

[Sen. Alison Clarkson (Chair)]: are they?

[Katie Holman, Public Health Response (VDH grantee)]: They No. No. This is Hazardous. Echoing Amy's hazardous waste piece. Yeah. And then the six methyl nicotine, which are these nicotine analog products that are starting to come up in the market as well. And there's a lot more like research that needs to be done into that work. I'm sure some folks will be talking more about the six methyl nicotine, but yeah, that's that.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Can I ask one question? If we banned certain vapes along the lines of whatever is supposed to be in the bill about games and things like that, would you say that's 99.9 percent of No. No. Okay. Because it's very that's true.

[Sen. Alison Clarkson (Chair)]: It's not

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: We're barely seeing those in the collection. Oh.

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: So, we just got the most fun ones, but No.

[Matthew Menier, Student Assistance Program Counselor, Champlain Valley Union HS]: No. So,

[Katie Holman, Public Health Response (VDH grantee)]: like Okay. Well, like, these some of them have the screens and such like this and they'll, like, light up as you use them and so that would cover some of that. But this loom

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Loom would not be covered.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: There's still quite a bit of

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: Lunes in the mix. Okay.

[Katie Holman, Public Health Response (VDH grantee)]: Yeah. But I think the trend is generally, like, you can see we didn't have the pricing information for the Geekbars because that was not in the audit that was done. But if you look at the, like, the LUN is 6.5 milliliters e liquid cartridge and the Ras is 12, so basically double and the price is about the same. So I think the trend is gonna continue to be towards these larger vapes and probably vapes that are also having these different components.

[Sen. Alison Clarkson (Chair)]: Katie, thank you more,

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: more color.

[Katie Holman, Public Health Response (VDH grantee)]: Thank you. Thanks everyone.

[Rose Kennedy, Assistant Attorney General (Consumer Protection Division)]: But we need to shift to Andrea. Sounds great. You're at 11:20 We're

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: gonna start. All right. Start. Do it.

[Sen. Alison Clarkson (Chair)]: And we have your presentation as well, so that if we don't quite finish, it's

[Amy Brewer, Coordinator, Franklin–Grand Isle Tobacco Prevention Coalition]: on us I'm to gonna go quickly and just share. I'm a public health researcher. I'm a professor at public health at the Rutgers School of Public Health, I Thank you for coming up. And yeah, I live here, I'm a Vermonter. I have two Vermont teenagers, and I work with the health department on a study called the PACE Vermont Study, where we collect information from youth and young adults in the state.

[Andrea Villanti, ScD, MPH, Professor, Rutgers School of Public Health (PACE Vermont Study)]: So, I'm gonna share a couple of findings from data we collected this fall, from 300 teens and young adults aged 12 to 25. What we saw was a high proportion of young people in our sample, and this is not a representative sample, but we saw high proportion reporting after day use of cigarettes or electronic nicotine products, including vapes, 38% reporting cigarette use and 26% vape for product use. We know that the retail environment is a really important place where young people are exposed to products, and that they can impact their access and use of the products. We asked young people how easy or hard it would be for them to get nicotine or tobacco products, and of the folks who are under age, under the age of 21, sixty one percent reported that it would be sort of or very easy for them to get products. We also asked them about exposure to marketing for electronic nicotine products like these vapes. And the thing that I wanna highlight is a difference. This is daily or weekly exposure to marketing. We saw a higher proportion of teens than young adults reporting that they would see these products when they were out and about, including in stores in the retail environment. So they're being exposed to these products on many sources. We talked about social media, we talked about online, but they are seeing these things in the

[Sen. Alison Clarkson (Chair)]: real world in the retail environment. And on that, I have to go back to the world. Do you have one thing you wanna add, Rick? Because I'm a got that.

[Andrea Villanti, ScD, MPH, Professor, Rutgers School of Public Health (PACE Vermont Study)]: We talked before about these products largely coming to young people through informal sources like parents. We're seeing that the top sources of these products are vape shops or tobacco shops, gas stations or convenience stores, and on the internet.

[Sen. Thomas Chittenden (Member)]: So it's direct to the kids?

[Sen. Alison Clarkson (Chair)]: Direct to the kids. And that's enforceable or it could be.

[Andrea Villanti, ScD, MPH, Professor, Rutgers School of Public Health (PACE Vermont Study)]: Thank you all very much. We're gonna follow.

[Sen. Alison Clarkson (Chair)]: We will take this up again, and so this is just helping us set the table. This is just terrific. Thank you very much. We're gonna go offline. We'll see you Tuesday. Thank you. It's incredible. Thanks, Ed.