Evidence of meeting #44 for Health in the 40th Parliament, 3rd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was warnings.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Paul Glover  Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health
Robert Strang  Chief Public Health Officer, Department of Health Promotion and Protection, Government of Nova Scotia
Cathy Sabiston  Director General, Controlled Substances and Tobacco Directorate, Department of Health
Jane Hazel  Director General, Marketing and Communications Services Directorate, Department of Health
Steve Machat  Manager, Tobacco Control, Chronic Disease and Injury Prevention, Department of Health Promotion and Protection, Government of Nova Scotia
Garfield Mahood  Executive Director, Non-Smokers' Rights Association
Geoffrey Fong  Professor, Ontario Institute for Cancer Research, University of Waterloo
Rob Cunningham  Senior Policy Analyst, Canadian Cancer Society
Cynthia Callard  Executive Director, Physicians for a Smoke-Free Canada

11:05 a.m.

Conservative

The Chair Conservative Joy Smith

I want to welcome you all to the health committee today.

We're pleased to have you here to present this morning, pursuant to Standing Order 108(2), the study of the examination of Health Canada's development of new regulations for tobacco packaging warning labels.

From the Department of Health, we have Paul Glover, assistant deputy minister. Welcome again, Paul. So nice to see you here. Cathy Sabiston is director general. Welcome, Cathy. And Jane Hazel is director general. Welcome.

From the Government of Nova Scotia, we have Dr. Robert Strang, chief public health officer. It's very nice to have you here at committee, Dr. Strang. And we have Steve Machat, manager of tobacco control, chronic disease and injury prevention. It's very nice to have you here. Welcome.

We will have 10-minute presentations, and we will begin with Mr. Glover.

11:05 a.m.

Paul Glover Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Thank you, Madam Chair.

I appreciate the invitation to speak to the Standing Committee on Health regarding the subject of Health Canada's warning messages on cigarette packages.

There has been much media attention to this recently.

As you are aware, the Minister of Health has indicated that the department continues to examine the renewal of health warning messages on tobacco packaging. I am pleased to outline for you today what has been done to date and what remains to be completed on the project.

Canada is a world leader in tobacco control. I know there are some who will argue that we have slipped a bit; however, no country in the world with a similar political and economic environment has a lower smoking rate than Canada. Only 18% of Canadians smoke, and 13% smoke daily. This is a substantial decline from the over 50% who smoked in 1965.

This did not happen accidentally. Successive tobacco control strategies and actions since the 1990s—a strong Tobacco Control Act, collaborations with provinces, territories, non-governmental organizations, and community organizations, as well as the changing attitudes of Canadians towards smoking—have all contributed to the smoking rate of 18%.

These actions include measures such as taxing tobacco products, banning advertising in newspapers, magazines, television, and radio, ensuring that retailers do not sell to youth, banning smoking in workplaces and public places, making sure that tobacco products are not sold individually, putting health warning messages on tobacco products, creating smoking cessation programs, and legislating the ban on the display of tobacco products at retail venues, as most provinces have done.

This represents a comprehensive and integrated approach to tobacco control that has been undertaken across the country. Canada has a very strong tobacco control environment. We know this from our research that clearly demonstrates that 95% of Canadians know that smoking is bad for them.

It should come as no surprise that Canada has greatly influenced international tobacco control efforts. Aspects of the World Health Organization's framework convention on tobacco control, an international treaty that now involves 172 countries, was modelled upon Canada's tobacco control activities.

Canada continues to lead the way. The Cracking Down on Tobacco Marketing Aimed at Youth Act, which received royal assent last year, represents another first of its kind in the world and at the country level.

Canada's ban on flavours and additives in little cigars, cigarettes, and blunt wraps recently received acclaim from the 130 countries that participated at the conference of the parties to the framework convention on tobacco control, which was held in November in Uruguay. In fact, the conference of parties agreed to embed this idea as a key best practice for countries to adopt in the guidelines to support the regulation of tobacco contents and emissions, or smoke.

Regarding health warning messages, Canada was the world leader in implementing full-colour pictorial messages covering 50% of cigarette packages in 2000. Many countries have since followed suit.

Canada is also one of the few countries in the world to have rigorously tested the effectiveness of health warning messages. Our results indicate that the messages encourage smokers to quit and discourage youth from starting to smoke.

As an active player in international tobacco control efforts and a leading member of the WHO framework convention on tobacco control, we fully support any country's efforts to implement health warning messages. Where possible, we provide technical assistance as well as the rights to use our graphic health warning messages.

Health warning messages on tobacco packaging are an important tool, but they must be factored into the larger tobacco control strategy. Health Canada is of the view that hard-hitting health warning messages on the dangers of tobacco should not be treated as a stand-alone initiative. The social environment has changed significantly since health warning messages were introduced 10 years ago. Now is a good time to refocus our efforts to ensure the warnings reach the largest numbers of smokers possible, while remaining effective and cost efficient.

While the qualitative and quantitative research conducted in recent years on potential images for new health warning messages has allowed us to refine them and ensure they appeal to a wide spectrum of smokers, we recognize there are better and emerging social marketing techniques that could improve this project. As such, we are examining innovative ways to complement the health warning messages project by strengthening our Internet presence and extending it with social media, such as Twitter and Facebook, to reach more Canadians.

In 2009, 80% of Canadians aged 16 and older, or 21.7 million people, used the Internet. We have not asked smokers which of these channels, or a combination thereof, would be most beneficial to help them quit. We are engaged in policy development and research to determine the best path forward, recognizing that new forms of media offer new opportunities to reach smokers with effective health warning messages that will continue Canada's role as a world leader in tobacco control.

So, is Health Canada committed to revising the health warning messages? Yes. Absolutely. They are one very important and proven effective mechanism in providing information to help people stop smoking.

Health Canada will continue to seek innovative approaches to tobacco control and implement the necessary measures to reduce smoking rates and protect the health of Canadians.

Thank you. Merci.

We welcome your questions.

11:10 a.m.

Conservative

The Chair Conservative Joy Smith

Thank you very much, Mr. Glover.

We'll now go to Dr. Strang.

December 9th, 2010 / 11:10 a.m.

Dr. Robert Strang Chief Public Health Officer, Department of Health Promotion and Protection, Government of Nova Scotia

Thank you, Madam Chair, and thank you to the committee for the invitation to appear today on this very important public health matter to Nova Scotians and to all Canadians.

I would like to take a moment to acknowledge my colleague, Steve Machat, manager of tobacco control for the Department of Health Promotion and Protection, who's attending these hearings with me today. Steve is Nova Scotia's representative on the F/P/T Tobacco Liaison Committee and has been directly involved in the discussions regarding health warnings that have taken place at that committee over the past two to three years.

Before speaking directly to the need to urgently renew health warning labels on tobacco products, I would like to provide some context for the committee.

Tobacco does remain the leading cause of illness and premature death in Canada. Despite common perception, the work in tobacco control is far from done.

Internationally, Canada has been a leader in tobacco control in general and health warning labels in particular, being the first country to require these in 2001. However, as has been outlined in a recent report from the Canadian Cancer Society, Canada has now fallen to 15th alongside 18 other countries when ranked on cigarette package health warnings.

In Canada, we've made substantial progress in tobacco control, reducing our overall smoking rate from 28% in 2000 to 17.5% in 2009, and our youth--which are 15- to 19-year-olds--smoking rate from 28% in 2000 to 13% in 2009. This progress has been the result of a comprehensive, multi-faceted approach with leadership at all three levels of government on critical policy areas such as pricing, advertising, and protection from exposure to second-hand smoke. Leadership from the federal government has been critical and much appreciated in the first two of these areas.

However, much of the decrease in smoking rates occurred from 2000 to 2005, with very little change in smoking rates since then. Tobacco control in Canada has stalled. As long as there's an industry with a mandate to make profits for shareholders from the sale of tobacco products, maintaining our progress to date, let alone achieving further reductions in smoking rates, will require a continuation of the comprehensive, multi-faceted approach with the renewal and change of tactics based on the latest evidence.

In Canada, tobacco product packaging is the key remaining source of tobacco advertising. Renewed health warnings comprising at least 75% of the package space will decrease this advertising, make the health warnings more effective, and provide smokers with a single 1-800-quit line. All this will play a major role in continuing to decrease our smoking rates. That's why the tobacco industry does not want these renewed health warnings and it is exactly why we need to do it now.

Provincial and territorial governments remain puzzled as to why the initiative to renew health warnings was stopped at the last minute, with no consultation. The background work on this initiative, which was shared through the F/P/T Tobacco Liaison Committee, had been completed, and there was no hint of concern or reluctance on the part of Health Canada officials as this work progressed.

It's also extremely disappointing to learn that the tobacco industry was informed about Health Canada's decision several months before provincial-territorial partners or the tobacco control community.

One has to wonder what role the tobacco industry played in the decision not to move ahead with the renewal of health warning labels on tobacco packages. After all, their historic tactics are delay, distract, and distort, and it is known they have access and influence. As was presented recently to this committee, Health Canada held four private meetings with the tobacco industry between November 2009 and May 2010.

The delay in the visual health warning and the toll-free number has only one beneficiary: the tobacco industry.

In addition, Health Canada's rationale for the delay does not stand up to scrutiny either. We do not need more study on the effectiveness of health warnings and the need for Canada's to be renewed. We just need to do it. We do not need more study to further restrict tobacco advertising on tobacco packaging. We just need to do it. We do not need to hold up the renewal of health warnings on cigarette packages while we work to find more effective ways to use the Internet and social media to communicate health warnings and other information about tobacco products. Implementing cigarette package changes can happen now and the remaining complementary approaches can be implemented as they are developed.

Lastly, as important as it is, we cannot focus just on contraband. Contrary to what the aggressive advertising campaign of the tobacco industry would have you believe, the vast majority of cigarettes smoked by young people across Canada are legal. As stated earlier, continued success in tobacco control will require a comprehensive, multi-faceted approach. The best way to prevent contraband use is to prevent people from smoking cigarettes, period, and that's through a comprehensive approach.

The tobacco industry wants and needs to distract us from such an approach because they know it will work to further reduce smoking rates. As an individual whose professional and legal responsibility is to work to protect the health of Nova Scotians, I need to ask why the interests of the tobacco industry are being placed above the health of Canadians and the interests of provincial and territorial governments.

The federal government has shown leadership in tobacco control over many years. Bill C-32 is a shining example. It prohibits flavoured tobacco and advertising of such products. Nova Scotia, along with all other provinces and territories, had urged the federal government to address this issue. I am fully aware that Bill C-32 was and continues to be a lightning rod for the global tobacco industry. We know they don't like it. And let me say to the federal government, thank you for staying steadfast and resisting calls to weaken the legislation.

The renewal of health warning labels on tobacco products needs similar political will and leadership. The rationale is clear, the background work has been done, and there are no valid reasons to not move ahead now. Failure to act will weaken the tobacco control efforts of other levels of governments and society, it will create avoidable cost utilization of already stressed provincial and territorial health care systems, and, above all, it will cost lives.

Thank you. We welcome your questions.

11:15 a.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Dr. Strang.

We'll now go to our first round of seven minutes, Qs and As, and we will begin with Mr. Dosanjh.

11:15 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Thank you very much.

Thank you all for coming here.

And thank you, Dr. Strang, for actually providing all of the reasons that the move by this government to stop this project dead in its tracks is a dumb move. I need say no more.

Mr. Glover, you're a civil servant and you're doing your job, but I found your presentation rather intriguing. Dr. Strang said that we are falling behind and you said we're doing fine. Sir, we're not doing fine.

I have some questions for you.

Let me just first say that children or youth or other people don't draw cigarettes out of the computer screen by watching the Internet or BlackBerry screens. They go and buy them, and they need to be presented with those startling images when they purchase those things. So my biases are pretty clear.

I understand that as far back as 2009, Mr. Glover, you were ready to start drafting the regulations. You had, in fact, all of the refreshed and renewed images ready to go.

First of all, I'd ask you to produce, at the earliest possible time, the October 2009 version of those images to this committee and any other later version that you may have prepared.

Secondly, I'd ask you whether or not you did share with the NGOs and other people who worked with you over the years that you were ready to draft the regulations. In fact, I'm told you were actually encouraging those people who work on this issue to start working on the plain packaging as well and removing the brands. Is that true or not?

11:20 a.m.

Conservative

The Chair Conservative Joy Smith

Who was that question directed at?

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

To Mr. Glover.

11:20 a.m.

Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Paul Glover

Thank you, Madam Chair, for the member's questions.

There are a number of points to respond to.

First off, the honourable member indicated that this project was stopped dead in its tracks. I believe the minister was eminently clear that this is not the case. She has instructed the department to do further work to actually continue to improve this package, as she was not satisfied with the package as presented to her. That is not stopped dead in its tracks. The department is actively working to respond to the concerns expressed by the minister so that we can continue to be a world leader in this area.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

And what were those concerns, sir?

11:20 a.m.

Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Paul Glover

Furthermore, with respect to the notion that youth buy these cigarettes, that is absolutely correct. We do have research that shows these images, these health warnings that are on current packages, do work for youth, because they are not stale. This is the first time they are seeing these images, and they continue to be effective for new smokers.

While we recognize that and continue to work to improve the images, to suggest that they are ineffective for everybody would not be consistent with the research that shows that youth who do buy these cigarettes are exposed for the first time to these images and they do have an impact.

With respect to the images we have, those have all been filed with Library and Archives Canada, so all of the public opinion research and all of the archives are already available on that website. We would be happy to provide the link to it. Those are the images that we have been working with, that we continue to work with, and they were part of our briefings to the minister and her staff as we moved forward.

With respect to plain packaging, the department looks at all options, from 50% to 75% to 90%--and plain packaging. That was part of the analysis we did with respect to potential options for the government in our advice as we moved forward.

I believe I've responded to all of the member's questions.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Let me present to you, Mr. Glover, what was given to me as the tobacco product labelling renewable project stakeholders meeting log from the department. The last entry on it says,“Imperial Tobacco Canada, May 26, 2010”, and there is a notation that says “Federal Strategy, Contraband, Suspended regulatory projects”.

That implies to me that this was when they were informed that the drafting of the regulations was suspended.

The question I have for you is why the public was not informed. Why did the tobacco industry know on May 26, 2010? Why did the people of Canada not know what you had done?

11:20 a.m.

Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Paul Glover

We have been involved, Madam Chair, in ongoing work with health NGOs, which had expressed concerns about some of the images available on the public opinion research website. They had been involved in various working groups with us. We had indicated that further work was being done to refine all of those images and that we continued to consult with all stakeholders. So there was never an attempt to provide one group with information in advance of the others. Health Canada was working with all stakeholders in a transparent manner.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Did you tell other stakeholders, on or around May 2010, that the regulatory project had been suspended? Did you tell anyone other than the tobacco industry?

11:20 a.m.

Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Paul Glover

We were, at that point, as I said, Madam Chair, working with all stakeholders to indicate that further work was necessary on the package to refine the images.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Did you tell them, sir? Did you tell anyone else, other than the tobacco industry, that the regulatory project was suspended? Yes or no.

11:20 a.m.

Assistant Deputy Minister, Healthy Environments and Consumer Safety Branch, Department of Health

Paul Glover

I believe I've answered the question.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

No you haven't, sir.

11:20 a.m.

Conservative

The Chair Conservative Joy Smith

Excuse me, Mr. Dosanjh.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

No, I'm sorry. I'm asking a question. He is not answering, and he is saying that he has answered it.

11:20 a.m.

Conservative

The Chair Conservative Joy Smith

I'll turn off your mike, Mr. Dosanjh, if you're going to keep this up. He said he answered the question.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

No, he has not, Madam. I have the right to ask the question.

11:20 a.m.

Conservative

The Chair Conservative Joy Smith

He does have a right to say that.

11:20 a.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

I have the right to ask the question again, Madam.

11:20 a.m.

Conservative

The Chair Conservative Joy Smith

You've asked it twice.

Mr. Glover--