Viewpoint: Public health wins and losses in state budget 

By Rebecca Boulos  

Executive Director, Maine Public Health Association 


Public health is supposed to be nonpartisan. It’s unfortunate when legislators play politics with people’s health, yet that’s just what happened when Maine legislators serving on the Joint Standing Committee on Appropriations and Financial Affairs voted unanimously to remove provisions from the Governor’s proposal that would have ended the sale of all flavored tobacco products and added funding to the state’s tobacco prevention and control program at $5 million per year in each year of the biennium. At a time when millions of dollars were added to the rainy-day fund, there was no investment in tobacco prevention and control. None. Not one additional dollar to prevent youth tobacco use. 

Ignoring hundreds of pieces of testimony from concerned Mainers working in public health, health care, education and youth sports, calls from constituents, and dozens of published opinion letters, Maine’s legislators chose to side with Big Tobacco. This is the same industry that lied to Americans about their products for decades and are doing the same thing now with flavored tobacco. Just this week in North Carolina, e-cigarette manufacturer, Juul agreed to pay a $40 million settlement for accusations of marketing to youth. The Appropriations Committee’s collective, unanimous vote underscores the hold that Big Tobacco has on Maine’s legislators, and their actions will adversely impact the health and job readiness of Maine’s youth. 

Maine voters aren’t so easily fooled. According to a comprehensive poll conducted by DRI-Critical Insights, commissioned by Maine Public Health Association, and funded by Maine Cancer Foundation, 85 percent of Maine voters believe it is important to prevent Maine youth from using tobacco products. The poll found that a large, bipartisan majority of Maine voters support prohibiting the sale of all flavored tobacco products (including cigars and e-cigarettes) to prevent youth tobacco use. 

For decades, policymakers have been hearing about the negative health effects of tobacco use. Over the past several years, they have been learning about the exponential rise in youth e-cigarette use. Data from the 2019 Maine Integrated Youth Health Survey show a near doubling in youth e-cigarette use since 2017 (28.7 percent vs. 15.3 percent), with some of the greatest increases seen in Piscataquis (26.6 percent vs. 6.7 percent) and Oxford (30.9 percent vs. 12.3 percent) counties. The e-cigarette epidemic is putting our children and their future in jeopardy. 

Legislators know these statistics – and their consequences. They also know that flavors are the leading reason for youth use: they make it easier to start and harder to quit tobacco. More than 85 percent of e-cigarette users ages 12-17 use flavored e-cigarettes, and more than 90 percent of young adult e-cigarette users use ones flavored to taste like menthol, alcohol, fruit, chocolate or other sweets. The Flavors Hook Kids Campaign, a partnership of dozens of public health partners across Maine, has met with legislators, held town halls and issue briefings, prepared fact sheets and testified for hours on legislation about this issue. 

This past legislative session brought much hope for turning the tide on the youth vaping epidemic. Governor Mills demonstrated strong leadership, including a provision in the supplemental budget to end the sale of all flavored tobacco products and funding for the fiscal note. The Joint Standing Committee on Health and Human Services voted unanimously to include $5 million per year in each year of the biennium to fund the state’s tobacco prevention and control program. 

We cannot let the tobacco industry destroy the health of another generation with addiction, cancer, and heart and lung disease. Maine legislators abdicated their responsibility to protect youth from the predatory tobacco industry. Thirty years ago, when we learned that Maine’s youth smoking rate was the highest in the nation, Maine took strong action to turn things around. We can and must respond appropriately again. In the midst of a global pandemic that adversely impacts respiratory health, we must act now to invest in tobacco prevention and control through program funding and ending the sale of flavored tobacco products. 

To be sure, there were notable public wins in the bipartisan budget, including funding for schools and municipalities, Land for Maine’s Future program, public health workers, clean drinking water, and essential health care support workers. The budget includes funding for MaineCare expansion coverage for immigrants under age 21 or who are pregnant, regardless of their immigration status (but does not expand benefits to all adults – an inequitable limitation). The budget provides National School Breakfast and Lunch programs to all Maine students at no cost. These are all investments that will protect the health of people in Maine, across ages and geographies, and should be applauded. However, we must continue to push for ending the sale of flavored tobacco products and funding for tobacco prevention and control. Maine’s youth deserve our perseverance and courage. 


The Maine Public Health Association is a nonprofit organization dedicated to improving and sustaining the health and well-being of all people in Maine through health promotion, disease prevention and the advancement of health equity. For more information, visit 

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