OKLAHOMA CITY — A state health board on Tuesday approved strict new regulations for the state’s fledgling medical marijuana industry, including a sales ban of smokable forms and a requirement that pharmacists work at every dispensary.

Medicinal marijuana proponents, meanwhile, said the State Board of Health’s actions violated the spirit of State Question 788 and the will of 57 percent of voters, who legalized cannabis for medicinal purposes at the ballot box last month. Most voters expected being allowed to purchase smokable forms of the drug, proponents said after the vote.

Neither the ban on smokables nor requiring pharmacists to work at dispensaries were included in the draft of proposed regulations released to the public ahead of the meeting.

Chip Paul, chairman of Oklahomans for Health, who co-wrote the ballot measure, said “it’s a little bit annoying” that board members came in at the last minute to make “major, major” changes.

“I can tell you, in general, I mean no one is going to particularly like these changes at all in our downstream,” he said.

However, he said at least the state now has a known program in place that gives definition to businesses that want to open.

“Regardless of whether we all love it or hate it, we now have a structure or framework that we put out under 788,” he said.

Dozens attended the standing-room only meeting at the State Department of Health where the board considered 75 pages of rules and regulations. Still, more attendees were told when they arrived 45 minutes early that the meeting room and an overflow viewing area had reached capacity.

Matthew Campbell, who hopes to provide consultant services and open a cannabis research facility, said he arrived at 9 a.m. to ensure he could attend the 11 a.m. board meeting. He said he wasn’t even the first on the sign-in list.

The board’s decision to adopt stricter regulations came a day after a group of high-profile medical professionals criticized the proposed rules. They said the guidelines did not go far enough to govern the industry or adequately protect patients and other Oklahomans who may be exposed to cannabis secondhand.

The health care professionals, including the head of the Oklahoma State Medical Association, demanded that smokable products be banned, that pharmacists be required in dispensaries and also that the number and locations of dispensaries be limited to 50.

The health board adopted two out of three of those recommendations — against the advice of their own attorney. The board’s lawyer warned that she believed it didn’t have the legal authority to implement such changes, and it would leave the state’s regulatory framework vulnerable to legal challenges.

Some board members argued that allowing smokable forms of the drug to be sold would violate their roles as protectors of public health. Patients who legally cultivate their own marijuana at home can still smoke the drug.

“As I think it was said by one of our board members today, I would expect some kind of litigation to be filed about these rules regardless, even if they had passed the rules as submitted,” said interim health Commissioner Tom Bates after the vote.

Bates, who is also an attorney, said he did not know whether a lawsuit would delay implementation. His agency, which is required by law to oversee the program, is supposed to start issuing licenses in less than 60 days.

In a statement on Twitter, Ryan Kiesel, the executive director of the Oklahoma chapter of the American Civil Liberties Union, said the action to ban smokable products was “completely inconsistent” with the state question and a responsible cannabis program.

“In banning all (smokable) forms of medical cannabis in Oklahoma, the Oklahoma Health Department just guaranteed litigation,” he said.

Bud Scott, executive director of New Health Solutions Oklahoma, said the Health Department is obviously subject to the whims of its board members. The organization serves as Oklahoma’s trade association for medical marijuana.

In a statement, he said the board’s actions are intended to disrupt the implementation of the state question, not make it safer.

“This is an attempt to kneecap the program, not a good-faith effort to implement it safely,” he said.

Republican Gov. Mary Fallin still needs to approve the emergency rules before they take effect.

Janelle Stecklein covers the Oklahoma Statehouse for CNHI’s newspapers and websites. Reach her at jstecklein@cnhi.com.