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

12:20 p.m.

Cynthia Callard Executive Director, Physicians for a Smoke-Free Canada

When I was listening to the testimony in the last hour, I was reminded of what I remember, as I'm getting older, of the situation in the sixties, seventies, and early eighties, when there wasn't political will to support tobacco control or clamp down on tobacco marketing. Health ministers were left kind of twisting in the wind, so they would latch on to what there was political will to do, which in those days was to educate young people. The results for public health were disastrous, because many people started smoking. It took decades to prove that these other systems--school-based programs and so forth--were ineffective, and a whole generation was lost.

It's ineffective and wrong-headed to put the burden of responsibility on the shoulders of young people to access information and use it properly. The responsibility should be on the shoulders of the adults in the system--the governments and the companies that have the responsibility to regulate and to be regulated. Let's be clear: the government can't Twitter or Facebook its way out of its regulatory responsibilities.

Focusing on youth is not a very good public health strategy, as 94% of smokers are over 20 years old and four out of five smokers are over 24 years old. Adult smokers are the ones looking to quit who need information and help. They deserve to have renewal as well.

Reference was made that 21,000 kids, due to the drug strategy, are latching on to Facebook. Well, that's less than 1% of Canadians between 12 and 19 years old. Health Canada doesn't have a good track record in reaching young Canadians. There's no research basis for suspending proven methods to go to an undeveloped, unresearched, unknown quantity. I think I heard reference to the fact that they might even want to abandon the work they developed over the years and take time to rework images and text. That would result in a delay of three or four years before we'd be in a position....

There are many ways of saying no, and I think today we are being told “not yet”, and we'll wait one more year, two more years, or three more years before the department is ready to come forward with something. But we know they're actually ready to go now, because they shared things with us last year. What they shared with us last year are not things that were tabled in the committee and they are not available in the public archives.

Delaying to use social media will not protect youth; it will harm youth, because it will delay putting on package warnings. Health Canada did pioneering research. They took the existing warnings and moved them from 50% to 75% to 90% to 100% of the package. These were familiar warnings. They found that just increasing the size made young people and young adults say they were more likely to reduce tobacco use. They were better at communicating the health effects of smoking, and they increased the number of people who disapproved of smoking—and that goes back to the social networking. They discouraged people from starting to smoke and increased the number of people who quit smoking. They also found that plain packaging was an equally effective way with young people.

So the government knows what to do. They know they should increase the size of the warnings and take the branding off. Other research recently published from New Zealand with young adult smokers shows exactly the same thing.

I think there are two issues at play here. One is the health warnings—why they were delayed and what should happen now. But the other is perhaps a bigger issue: the integrity of the health regulation and the protection of public health and safety from commercial interference.

The problems, at least until last year, were not with Health Canada. They did a very good job of consulting with us and others and doing the research. There were delays. This work was done under five health ministers between 2003 and 2005. Much of the research had to be suspended during election periods, when they couldn't do public opinion research. But they soldiered on in an excellent way. I may have had some frustrations, but I had no major complaints about the way the file was treated then. But something happened after this file left Health Canada, and that has been our challenge.

Health Canada manages the development of regulations for many other products in addition to tobacco: therapeutic drugs and devices, foods, pesticides, cosmetics, consumer products, and others. What happens when Health Canada scientists recommend a regulatory action and it's overruled outside of Health Canada? This should be a major concern to the committee, and it should be a major concern to parliamentarians and all Canadians.

In many ways this file exposes the vulnerability of the health protection system to commercial pressure. We urge you to support the government to protect health and accelerate the implementation of the warnings that have been developed.

Thank you.

12:25 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you so much

We're going to go directly to our first round of seven minutes of Q and A with Mr. Dosanjh.

12:30 p.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Thank you.

Thank you very much to all of you for coming here and sharing your thoughts with us.

Ms. Callard and others, including Mr. Mahood, you received documentation or material from Health Canada in your consultations, including possibly what was called a resource book, planned as early as October 2009, with images. I would urge you, as a member of the committee, to table those documents here. Once these are requested, you then have the obligation and the right to be able to do that. So I would urge you to provide the committee with all of the materials you may have received over the years as the research was going on and your conversations with the committee were continuing, including the images you might have in your possession that they developed. Thank you.

I only have three or four questions, and I'd like to have some brief answers.

I understand from the log that we received with respect to lobbying that on May 26, 2010, at least one of the big tobacco companies was advised that the regulations were suspended, or the regulatory project was suspended.

I'd like to know whether any of you, in your subsequent conversations with Health Canada or with anyone else related to Health Canada, including the PCO and PMO, had ever been advised that this work had been suspended, until the minister said so at the health ministers' meeting.

12:30 p.m.

Conservative

The Chair Conservative Joy Smith

Mr. Mahood.

12:30 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

To my knowledge, no one in the health community was advised that the whole process had been suspended until it came out in The Globe and Mail or came out of the provinces. We certainly were not given that information.

12:30 p.m.

Executive Director, Physicians for a Smoke-Free Canada

Cynthia Callard

I don't know the exact date—it's on the record of communications—but I met with someone in the section after May 26, I believe, and at that time, the impression I had was that the file was in trouble and there was lots of correspondence, but I did not get the feeling they'd given up, but were fighting hard against those who wanted to suspend it.

12:30 p.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Thank you.

I understand there may have been discussions between various officials, including some who appeared here today, and yourselves with respect to the fact that the regulations were ready to be drafted sometime in the fall of 2009, and that because of the ongoing research they were doing, the officials were excited about removing branding as well and going to plain packages.

Are any of you at liberty to tell us that you were told that?

12:30 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

An honest answer would be that the department knows full well the importance of plain and standardized packaging, but the enthusiasm was especially significant for standardized packaging, because the multitude of packages in the marketplace makes it very, very difficult to draft regulations for regulating this industry when it comes to packaging.

One package that I believe may be here today has eight sides. I'm not a lawyer—Rob is a lawyer—but I wouldn't want to draft that particular regulation.

But more than that, what happens, of course, is that by having an eight- or six-sided package, you reduce the size of the major face, so you can in fact very artfully decrease the size and impact of the warning and increase the beauty and allure of the package, because there's more space then going to the other five or six or seven sides of the package—or four or six sides. You see, it's so complicated, I can't even get the numbers out properly relating to the sides of the packages.

But the fact is that standardized packaging is absolutely critical and meshes perfectly with plain packages, which is where the whole world is going. And Health Canada will have to go there, but we first have to get rid of the stale packages and get these out.

I must say, I echo what Cynthia Callard said, that the department, in my opinion, was completely committed to doing a good job on this. I believe there are all kinds of members of the government who would like to see this come forward. That's why it should be non-partisan and we should get this out in a heck of a hurry.

12:35 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

Just on your question, we were advised in September 2009 that they hoped to make an announcement in January 2010 with respect to new warnings, as the regulatory process would be complete by May 31, 2010.

12:35 p.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Thank you.

I have a very general question as my last question.

Mr. Mahood, you actually told me this morning, with respect to breast implants, that when 1 in 5,000 people were at risk in California, the state declared an emergency and actually—

12:35 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

Took the product off the market.

12:35 p.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Yes, they recalled the product.

We have 37,000 people dying as a result of tobacco-related diseases in Canada—37,000 a year. You say that one out of every two long-term smokers actually falls prey to tobacco-related diseases. This is a national emergency, and in view of that—

12:35 p.m.

Conservative

The Chair Conservative Joy Smith

Your time is just about to end, Mr. Dosanjh.

12:35 p.m.

Liberal

Ujjal Dosanjh Liberal Vancouver South, BC

Thank you.

Why is there no royal commission on this evil disaster?

12:35 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

Frankly, there's been a royal commission on the steel industry, the pharmaceutical industry, the marine industry, and virtually every industry, including the potato industry. There has never been a royal commission on the tobacco industry. This situation is almost inexplicable, but it's true.

In the case of the—

12:35 p.m.

Conservative

The Chair Conservative Joy Smith

Thank you, Mr. Mahood. We'll have to end it there, as we want to make sure everyone gets to their questions.

Monsieur Dufour.

12:35 p.m.

Bloc

Nicolas Dufour Bloc Repentigny, QC

Thank you very much, Madam Chair.

I would like to thank the witnesses here today. It is very helpful for the committee.

Ms. Callard, you said earlier that, some years ago, there was no political will to solve this problem. That is perhaps what you are sensing at the moment. I share your indignation with the situation. Let me remind you that there are members of Parliament who do have the political will.

Mr. Fong, you made an extremely interesting comment that is very relevant to the committee. You said that, like any communication, health warnings become less effective over time. I must say that you do not need to be a psychology professor or an eminent economics professor to understand that. What surprises me is that the government doesn't seem to understand.

However, in a final report prepared for Health Canada by the firm Corporate Research Associates Inc, it says that, although some health warning messages stand out, their impact decreases and, sometimes, they are completely ignored. Let me read a passage from the report to you: “A major factor is the novelty of warnings against health hazards, since messages have a greater effect when they are new.”

Can you comment on that for us?

12:35 p.m.

Professor, Ontario Institute for Cancer Research, University of Waterloo

Dr. Geoffrey Fong

Thank you for the opportunity to comment on this.

Yes, novelty is important, because when messages are repeated over and over again, naturally, they are going to lose their effectiveness.

The evidence shows very clearly, and it's one of the basic principles of communication, that you have to change your message over time. It's so basic that it's hardly even worth mentioning. I'm sure, of course, Health Canada knows about the importance of “wear-out” and the decline in the message's effectiveness, and that's why they should be moving forward with these warnings.

So it's a very powerful principle, and it's realized in the ITC data, which show there's no other explanation for this than “wear-out”. Yes, the warnings have become significantly less effective.

12:40 p.m.

Bloc

Nicolas Dufour Bloc Repentigny, QC

Thank you very much.

Mr. Mahood, just now, Mr. Carrie told us that it cost the government almost $400,000 to produce information documents for witnesses. But you mentioned something very interesting. If Health Canada does not renew the warnings, it stands to lose $3 million. There's kind of an imbalance there.

Could you quickly tell us how we encourage the government to put the renewal program into effect? And what should it be doing in the next few months?

12:40 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

A strong recommendation from the committee to move on the warnings would be extremely helpful. I think the complete production of the documents.... It's true that it might cost something to produce the documents, but on the other hand, it's going to cost a lot more to leave them wasting on a shelf.

So the production of the documents and telling the full story about the lobbying and the various interactions that led to the decision...I think the fact that those documents are going to come out in the future will create an incentive for them to do what I believe virtually everybody in Health Canada knows must be done.

And when you produce that motion, I wish you'd add as an addendum my apologies for not being able to answer you in French.

12:40 p.m.

Bloc

Nicolas Dufour Bloc Repentigny, QC

No problem.

12:40 p.m.

Executive Director, Non-Smokers' Rights Association

Garfield Mahood

I'm a unilingual anglophone and handicapped.

12:40 p.m.

Bloc

Nicolas Dufour Bloc Repentigny, QC

From the outset, we have talked a lot about young people and the desire to target those young people in the fight against tobacco. According to Mr. Glover's answer just now, the government intends to try its hand at Facebook, YouTube and so on.

Regrettably, I have heard less about measures for adults who have been smoking for a number of years. It is all very well to plan strategies for young people, but we also have to come to grips with the problem of people who have been smoking for 10, 20 or 30 years.

Do you think that just getting on Facebook and YouTube could be of any use in fighting tobacco use in adults?

12:40 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

Not as a stand-alone strategy, no. We need a comprehensive strategy.

Young adults have these new media, perhaps, but we need regulations and programs. We feel that we must move ahead immediately with the new warnings.

If that announcement were made today, it would take another six months for the regulatory process and maybe another three, five or six months before the warnings appeared on the packaging. So we need nine to twelve months to develop a new communications system.

We could do both. We could in fact move forward with the new warnings immediately.

12:40 p.m.

Bloc

Nicolas Dufour Bloc Repentigny, QC

What do you think about the government's side of the story? The government says that it wants to set the warnings on packaging aside so that it can really concentrate on the fight against contraband cigarettes.

Isn't there a way to do both at the same time.