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Meeting Summary of the Regular Meeting of the Chicago Board of Health CDPH Board Room, 2 nd Floor DePaul Center, 333 S. State Street Wednesday, August 21, 2013, 9:00 AM Roll Call Board Members Present: Carolyn C. Lopez, M.D. Carl C. Bell, M.D. Melanie Dreher, Ph.D., R.N., F.A.A.N. Joseph B. Starshak Caswell A. Evans, Jr., D.D.S., M.P.H. Steven K. Rothschild, M.D. Horace E. Smith, M.D. Adele Joy Cobbs, M.D. Board Members Absent: Victor M. Gonzalez For the Department: Bechara Choucair, M.D., Commissioner

BOARD OF HEALTH MEETING August 21, 2013 DePaul Center, 333 S. State Street Meeting Summary Call to Order: Dr. Carolyn Lopez called the meeting to order at 9:02 a.m. Approval of Minutes: The July 17 Board of Health meeting minutes were approved. Commissioner/Healthy Chicago Update: Commissioner Bechara Choucair provided an update on the following items: Two new staff members were introduced. Joe Hollendoner is the new First Deputy for the Department. Joe Hollendoner was formerly Senior Vice President Programs at AIDS Foundation of Chicago. Juleigh Nowinski- Konchak, M.D. is a Director/Community Liaison who was hired to help advance policies. She will be taking the lead on advancing menthol cigarette related work. The decision on the Department s accreditation is embargoed, but will be coming soon. Earlier this month CDPH partnered with Health & Disabilities Advocates to release Enroll Chicago: A Profile of Chicago s Uninsured. The report provides the most recent data on the city s uninsured residents and is intended to help target outreach, education and enrollment efforts. The Mayor issued a letter to the Board of Health regarding menthol cigarettes. Responding to the Mayor s letter is the focus of today s meeting. Within hours of the announcement regarding menthol-flavored cigarettes, the American Lung Association, Campaign for Tobacco Free Kids, Respiratory Health Association, and Y2 Kwanzaa released supportive messages. Social media was active, with supportive tweets, Facebook posts, and listserv announcements from a variety of organizations. The National African American Tobacco Prevention Coalition contacted CDPH to offer its congratulations and offer to help with the process. Thus far, the announcement has generated very little controversy and responses have been almost entirely supportive. Comments by the Board President: Dr. Carolyn Lopez welcomed guests to the meeting and provided some background on the Board of Health. She said that the meeting would address the request from the mayor to engage the community in feedback about menthol, which was a new kind of request for the Board.

Policy/Legislative Update Kelvy Brown presented the Policy/Legislative update with the following information: City At the July 24 City Council meeting, 5 th Ward Alderman Leslie Hairston introduced a resolution urging the President to issue an executive order empowering the Environmental Protection Agency to move forward with rulemaking to restore protections to the Great Lakes under the Clean Water Act. At the July 24 th City Council Meeting, 1 st Ward Alderman Joe Moreno introduced an ordinance calling for a new enforcement provision that would revoke a tobacco license for three years for any establishment that had its liquor license revoked. State During the months of July and August, Governor Quinn signed legislation regarding the following: Legalization of medical cannabis Mental Health First Aid training for members of the public to identify and assist someone who is experiencing a mental health, alcohol, or substance abuse disorder or crisis Creation of a Violence Prevention Task Force Judicial A New York State appellate court ruled unanimously that the New York City Board of Health lacks the authority to limit the size of sugar-sweetened beverages specifically that the Board was engaging in policy making, not rule making. The court acknowledged that the same law, if passed by a legislative body, would not violate the Constitution. The City plans to appeal the ruling. Presentation: Menthol: To Regulate or Not to Regulate, It Shouldn t Even Be a Question was presented by Dr. Alicia Matthews from the University of Illinois at Chicago College of Nursing. The presentation emphasized the additional population health harm posed by menthol cigarettes and the high prevalence of menthol use among minority smokers including African Americans, young people, women and the LGBTQ community. Menthol cigarettes have historically been developed for and marketed to the African American community. There is public support for a ban on menthol cigarettes, with support coming from current menthol smokers, many of whom would try to quit if menthol cigarettes were banned. Dr. Matthews then responded to the following questions from the Board:

How do levels of menthol appeal specifically to African Americans? During WWII, tobacco companies noticed African American soldiers weren t using their cigarette rations. To understand this, the industry convened focus groups. African Americans complained about the taste and harshness of the cigarette. Flavoring options were discussed. Menthol had already been on the market since the 20s. Working with these groups doing market research, the industry developed new menthol products. The marketing related to cool, smooth, jazz culture and was successful to target the African American population. What leverage does the city have to regulate a product that is not yet banned, and currently legal? The town halls are intended to both educate and devise strategies for regulating menthol products. The city has the authority to regulate the sale and distribution of tobacco products and is open to a variety of solutions. What is the background on the exemption for menthol in the flavoring ban? Pressures from the tobacco industry resulted in this compromise on menthol to pass the flavor ban. Has there been any analysis of the likely leakage or black market response that would come from a ban? There needs to be more research. It s important to engage the community in education efforts to reduce demand for the product. Most people want to quit, so this would reduce that demand. Where does the idea that menthol is less harmful come from? People might associate menthol with other menthol products that aren t harmful, such as cough drops. Responding to Mayoral Request for Town Hall Meetings on Menthol Cigarettes: Proposed calendar for town hall meetings approved Collaborations with special constituencies the Board will reach out to community collaborators, professional associations, youth organizations and the LGBTQ community to participate in the process. Ideas from Board

Members included reaching out to African American radio stations and athletes. Consideration of Resolution on Menthol-Flavored Cigarettes: Approved, pending further review by absent board member Victor Gonzalez. New business: No new business came before the board. Old business: No old business came before the board. Public comment: Badonna Reingold said the Board should engage the mentally ill population in menthol cigarette discussions. Badonna Reingold addressed the City s enrollment efforts, concerned about shortfalls in resources for the mentally ill population. The Commissioner responded that current efforts now are on enrollment of 500,000 persons who are not enrolled using connections with community partners. A nurse that works on tobacco efforts commented that the Department needs to make sure that cessation interventions are a part of any regulations. Meeting Adjourned: Meeting adjourned at 10:17a.m. Next Board Meeting: September 18, 2013 at 9:00 a.m.