Health Committee on Dec. 2nd, 2014

[The Chair, Conservative, Ben Lobb]

Good morning, ladies and gentlemen. Welcome to our meeting on e-cigarettes.

We apologize for the brief delay. We're just getting our laptops and PowerPoints and everything else set up.

We have a number of guests here. We have two panels today. We have three guests this morning, from 11 until 12, and we have a couple of guests from 12 until 1 o'clock.

We'll start off first with Neil Collishaw, and we'll go from my left to right.

Good morning, and welcome. You have 10 minutes or so to present.

[Neil Collishaw, Research Director, Physicians for a Smoke-Free Canada]

Thank you, Mr. Chair. Good morning everyone.

My name is Neil Collishaw and I am the research director at Physicians for a Smoke-Free Canada, an organization that has existed since 1985. I am not a physician. However, all of our members are physicians, from everywhere in Canada.

I have been working in the public health field since 1969, more specifically full-time in the anti-tobacco struggle since 1981. First I worked at Health Canada in the 1980s, then with the WHO in the 1990s, and I have been with Physicians for a Smoke-Free Canada since then.

You have our written presentation. I will be happy to answer your questions in English or in French about that document and the comments I will make today.

As a former civil servant responsible for tobacco legislation and regulation in this country, I have lived the challenge of trying to control tobacco with no legislation and little political enthusiasm for creating the needed legislation. That was the situation in my job before 1987. Some days I thought it was a hopeless task. But I also saw how dramatically things could change when the Progressive Conservative government in 1987 directed us to create Canada's first tobacco control law, the Tobacco Products Control Act. The lesson learned by me was that public health protection requires strong direction from Parliament. Once again, now, strong political direction is required, this time on electronic cigarettes, and this committee is in an ideal position to make sure that this Parliament provides that strong policy direction.

These new electronic nicotine delivery systems, or ENDS, present both a challenge and a threat. You have already heard from other witnesses, and I'm sure you'll hear from more today, from my colleagues and others, of the benefits that could come to smokers who switch to e-cigarettes. You have also heard, and you will hear, of the potential danger of these products, both to individuals and to public health. Harm could be reduced or possibly increased. Public health could benefit or possibly be made worse. You've heard of many other potential harms and benefits, too. All of this is happening in what I would describe as a virtual policy vacuum. Since 2009, these products have supposedly been banned in Canada.

The March 27, 2009, notice stated that:

To date, no electronic smoking product has been authorized for sale by Health Canada. [...]

Further on, the same notice states:

Persons importing, advertising or selling electronic cigarette products in Canada must stop doing so immediately.

That notice of 2009 has neither been rescinded nor enforced.

I know that you heard earlier from the public servants working in the therapeutic products directorate. I assure you they are all fine people, who must work, like I once did, without strong political direction. And they were taking a risk management approach, I think that's what they told you. Now let me translate that little bit of bureaucratese for you: it means, in the absence of any political direction or proof of immediate danger to health from these products their hands are tied.

You also heard from those responsible for administering the Tobacco Act. They told you that there's no tobacco in e-cigarettes, so these products are not covered by the Tobacco Act. Until they receive new direction from Parliament, their hands are also tied.

Our health protection system has demonstrated that it has been unable to deal with the challenges posed by e-cigarettes. The system is broken, and it is Parliament that needs to fix it.

We need a system that is science based. We need a system that will ensure the benefits are maximized and the risks are minimized. But they're ever-changing: we need a public health system with both the responsibility and the capacity to respond quickly to whatever devices might be out there and whatever new ones might be coming along. The system should also address the public health issues created by new and existing tobacco products and other nicotine products.

We also need to protect the system from the effect of the tobacco companies, something that has delayed action over the last half-century.

You've heard from two branches in Health Canada, but now we need the right hand and the left hand to work together. Dealing with electronic nicotine delivery should mean improving the way we are trying to control tobacco use. We need to integrate ENDS control and tobacco control. We need to have the best of both worlds: tools of regulation and enforcement that can be used both pre-market and post-market.

These better systems can be embedded in a modernized tobacco control strategy, one updated from the current strategy, which was designed more than 15 years ago. Provinces have been effective. There are some effective measures for tobacco and e-cigarette control in a bill currently before the Ontario legislature, but only the federal government is equipped with the reach and infrastructure to deliver the needed comprehensive system of tobacco and nicotine policy that will be responsive and effective.

I urge this committee to provide the leadership on nicotine and tobacco policy that has so far been lacking at the federal level.

There are many highly skilled people working within Health Canada. As a former WHO official who once worked with government tobacco control officers around the world, I can assure you that Canada is privileged to have one of the best trained and most experienced tobacco control teams anywhere. They are capable of returning to Parliament with draft legislation that will create effective ways to integrate sound public health management and control of all existing and new tobacco products and nicotine products. Please, ladies and gentlemen, please direct them to do so.

Thank you.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Next up we have Melodie Tilson, director of policy for the Non-Smokers' Rights Association.

Go ahead.

[Melodie Tilson, Director of Policy, Non-Smokers' Rights Association]

Good morning. Bonjour.

Thank you very much for the opportunity to address the committee on this important public health issue. As you heard, my name is Melodie Tilson. I'm the director of policy for the Non-Smokers' Rights Association, better known as the NSRA.

The NSRA has been at the forefront of tobacco control in Canada for the past 40 years, leading many campaigns for precedent-setting measures to reduce the scourge of disease and death from tobacco industry products, including comprehensive tobacco control legislation through the 1988 Tobacco Products Control Act and its successor the federal Tobacco Act, and the world's first graphic warnings on cigarette packs, to name a few.

I personally have been working in tobacco control for 24 years. I have devoted most of the past three and a half years to understanding the potential risks and benefits of e-cigarettes and to providing leadership to the health community on this issue. I can honestly say that e-cigarettes are the most challenging and divisive issue that I have faced in my career in tobacco control.

The fact that this issue is so challenging underscores the importance and urgency of the committee's deliberations, as you just heard from my colleague. There has been an explosion in the promotion, sales, and use of e-cigarettes, as well as in research on the subject, since Health Canada issued its regulatory notice in March 2009, and yet Health Canada's response has been to ignore the rapid changes in the marketplace and in the science. lt is essential that the federal government develop and implement, on an urgent basis, a new regulatory framework for e-cigarettes that reflects current knowledge and is responsive to new developments.

Let me state from the outset that the Non-Smokers' Rights Association believes that e-cigarettes hold great promise as aids to help smokers quit cigarette smoking, but aIso that they present potential serious risks to tobacco control. The current regulatory framework, however, does not serve the interests of either smokers or non-smokers. Although e-cigarettes with nicotine and e-cigarettes that make a health claim cannot legally be marketed or sold in Canada, both are readily available from retailers. Experience over the past five years has made it clear that having a different set of measures governing e-cigarettes without nicotine merely provides an enormous loophole that undermines controls over the promotion and sale of e-cigarettes with nicotine. Moreover, as you heard from the Health Canada officials who addressed the committee, there has been almost no enforcement of the prohibition on the sale of e-cigarettes with nicotine.

The intent of a new regulatory framework governing e-cigarettes should be to maximize the benefits for smokers while minimizing the risks to users, to non-smokers, especially youth, and to bystanders.

ln terms of the benefits to smokers, there is a growing scientific consensus that e-cigarettes are much safer than cigarettes. They contain no tobacco and there is no combustion. Smokers deserve access to a safer form of nicotine delivery that can also satisfy their addiction to smoking behaviours. Committee members heard from witnesses such as Dr. Gaston Ostiguy that e-cigarettes have been valuable in helping hard-core smokers quit smoking. My colleagues and I likewise know of smokers who were finally able to quit smoking using e-cigarettes. However, there is a paucity of high-quality scientific studies proving that e-cigarettes are an effective cessation aid. Only two randomized controlled trials, considered the gold standard in research, have been published to date. Both were small studies of first-generation devices. Both showed cessation rates on par with those produced using the patch. ln the United Kingdom, e-cigarettes are now the preferred quitting aid among smokers, and smoking rates have declined at the same time that e-cigarette use has increased, but that does not mean that the relationship is causal. The research, both small studies and large surveys, consistently shows that most smokers who use e-cigarettes continue to smoke. lt is not yet known, however, whether this dual use of tobacco and electronic cigarettes is a stage on the road to quitting or whether it serves in fact to forestall quitting.

Many of the potential risks to health and safety from e-cigarettes could be reduced or eliminated fairly simply if manufacturing standards for e-cigarette devices and liquid were developed and enforced to ensure that the products operate consistently and reliably, that no impurities are introduced during the manufacturing process, and that the products do not malfunction under normal use, such as through leakage of the e-liquid or overheating or explosion of the battery.

With regard to the risks to tobacco control from e-cigarettes, the research findings are contradictory concerning whether the promotion and use of these new products will renormalize tobacco use and serve as a gateway to nicotine addiction and/or tobacco use among youth. Research from the U.K. is often cited as proof that there is no e-cigarette uptake among non-smoking youth and no gateway effect. However, research in other countries paints a different picture.

Research in Poland on 15- to 19-year-olds found a substantial increase in both experimentation and current use of e-cigarettes from 2010-11 to 2013-14, as well as a substantial increase in both the dual use of e-cigarettes and cigarettes and smoking rates. In Finland, 10% of adolescents who experimented with e-cigarettes were non-smokers. Research in both Canada and the U.S. found relatively low but increasing rates of ever and current use of e-cigarettes among non-smoking youth and young adults. Furthermore, it is still relatively early days in Canada, where we have not yet seen a no-holds-barred approach to e-cigarette promotion, as they have right now in the U.S. The use of e-cigarettes where smoking is banned is still relatively rare.

For these reasons, NSRA believes the federal government must take a cautionary approach by legislating tight controls on marketing and use of e-cigarettes until the research provides definitive evidence that e-cigarettes pose no risk to tobacco control or to non-smoking youth.

The most straightforward way to regulate e-cigarettes would be to include them in the federal Tobacco Act. Doing so would accomplish a number of important regulatory objectives. It would end the current perverse situation whereby e-cigarettes with nicotine are subject to a much stricter regulatory regime than the most hazardous nicotine delivery device: the cigarette. lt would ensure that e-cigarettes with nicotine are legally available to smokers. lt would reinforce the perception of e-cigarettes as a consumer product, which is important to trial and acceptance by smokers. lt would help ensure continued product innovation and affordability, which are adversely affected when products are regulated as drugs. lt would also ensure equal treatment of e-cigarettes both with and without nicotine, and it would help safeguard critical tobacco control gains by subjecting e-cigarettes to similar controls as tobacco products.

Whether e-cigarettes are included under the Tobacco Act or are regulated under different legislation, there are a number of specific measures that the NSRA believes to be of critical importance: a ban on sales to minors; restrictions on advertising and promotion, including a ban on lifestyle advertising, celebrity endorsements, the use of cartoon figures, and sponsorships; a ban on false and misleading claims; a ban on advertising that evokes a tobacco product; and a ban on cross-branding of an e-cigarette with a tobacco product.

We also believe it's important to ban the use of e-cigarettes in indoor public places and workplaces where smoking is banned, and to prohibit product characteristics that target youth, in particular, such candy flavours as bubble gum and sweet tart.

We also believe that mandatory product labelling is critical, including full ingredient disclosure, information on the presence and strength of nicotine, and meaningful warnings regarding the possible risks of e-cigarette use as well as the relative risks of e-cigarette use as compared with smoking tobacco cigarettes.

We know with certainty that one out of every two long-term smokers will die from their tobacco use and that for every death there are about 20 smokers suffering from a tobacco-caused illness. Most smokers want to quit, but the success rate of current cessation aids is abysmally low. E-cigarettes hold great promise for their ability to deliver nicotine effectively and to mimic smoking behaviours, but it is these same qualities that create risks to tobacco control.

While we await more conclusive research, the federal government must act to ensure that smokers have access to the safest possible e-cigarettes with nicotine, while implementing measures to prevent youth uptake and a new form of socialized nicotine addiction.

Thank you.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

Geneviève Bois, from the Quebec Coalition for Tobacco Control, please go ahead.

[Geneviève Bois, Spokesperson, Quebec Coalition for Tobacco Control]

Thank you for the opportunity to present today. My name is Geneviève Bois, and I'm a physician by training. I work for the Quebec Coalition for Tobacco Control as a spokesperson.

The issue of e-cigarettes is definitely one that needs an urgent regulatory framework. I think you have heard a lot from many groups already, but I would urge the committee to show some leadership on the issue. The rise in new products is happening right now and we do not think the regulatory void in Canada is to the benefit of smokers or non-smokers. Risks could be reduced if a decent set of regulations were put into place and enforced.

We would encourage the committee to look at approaches taken in other jurisdictions, but also what the WHO recommends—all our recommendations are in line with WHO's recommendations—and also to follow the public health principle of precaution. We know very little about those devices yet. The science will continue to advance, but you only know what happens in the long term when long term actually happens. So at the very least for now we should show a little bit of precaution.

We should also base recommendations on the best possible data that's out there but data that's also devoid of conflicts of interest. Unfortunately, and it's in the brief we submitted to you, a recent analysis showed there are some very significant conflicts of interest in about a third of the research published on the safety of electronic cigarettes. That also needs to be addressed when looking at data.

Increasingly also, the e-cigarette market is dominated by tobacco companies. This is something that has been increasingly happening in the last couple of years and seems to continue as a trend. This should also be considered.

There seems to be a certain effect as far as the tobacco control situation is concerned. The examples of the United Kingdom and Poland were mentioned. It seems that those two countries were at different points in their tobacco control journey. At the same time that e-cigarettes became very popular in the U.K., tobacco control continued to be strengthened, and there we did not seem to see any gateway effect for youth. But it's been very different in Poland, where tobacco control was not as strong and was not being strengthened significantly, and where it did seem to show a very significant gateway effect. So it is possible that the effect of e-cigarettes at a population level, or looking at youth specifically, is also influenced by the set of tobacco control measures. This is also something that should support regulating tobacco better in Canada, especially since the flavouring aspect is an issue with both e-cigarettes and in tobacco products. I have brought products for you to look at, if you want, with cigarillos that are grape flavoured and e-cigarettes that are labelled without nicotine but are also grape flavoured, and they're strikingly similar products.

We believe it's very necessary to act before health issues arise. This could take time, and although it seems from the best data we have now that e-cigarettes are much less risky than tobacco, it is certainly much more risky than no tobacco use whatsoever. We believe that users should have access to a very safe product, which is not necessarily always the case right now, and non-users should definitely be protected.

A set of regulations would make sure that labelling, for example, is appropriate. This is something that is not currently the case. A study financed by the Canadian Cancer Society in Quebec has shown that nine of thirteen brands of e-cigarettes that were tested by chemists at the University of Montreal were labelled as without nicotine, but actually had significant levels of nicotine in them. This is a pretty serious labelling issue.

It is also clear that although it's less risky than tobacco, this is by no means a harmless product. Although we believe it should be made accessible to all smokers who look to reduce the harm they might suffer from their addiction, it should definitely not be a way to banalize nicotine addiction or nicotine use. Unfortunately, the uptake in youth shows that this is seen as a very trendy product.

Regarding the cessation aspect, there's a paucity of very good evidence. There's a lot of anecdotal evidence on the matter. I know of a lot of colleagues—I practise as a physician—who have seen their patients successfully quit tobacco with e-cigarettes, but also the majority of them see an increasing number of their patients simply using both tobacco and e-cigarettes at the same time. Unpublished data from the public health agency in Montreal, which should be released within a week, show that on the Island of Montreal, two-thirds of the smokers who were using e-cigarettes were reporting dual use. Albeit there might still be a benefit, it is not clear how much benefit there is to this dual use, if any, and the false sense of security that might be conveyed to the smoker might be used as a forestalling method for any quitting attempt. That is definitely a concern.

From a medical aspect, it's more the duration of tobacco use that is relevant than the intensity of the tobacco use. If somebody continues with dual use for a longer period of time, despite having reduced the number of cigarettes one would smoke per day, it is really not clear that there is any health benefit. This has been well exemplified in the WHO report on the matter.

If e-cigarettes are only as effective as the nicotine patch, this is still good news. This should still be made available to smokers. Another option is always a good option. There are many options for tobacco cessation, but none of them are fantastic. There will not be a silver bullet. The e-cigarette is not a miracle, but it could be another way for smokers to attempt quitting and they should be made available to them. Making it available to smokers doesn't mean continuing in this regulatory void and there is no benefit to smokers. Right now they have to put their faith in whoever is making this product, but tomorrow this product could be a completely different one, labelled the same, and they wouldn't know any better.

It's very difficult to prove that there is a gateway effect. There is no data in Canada, to my knowledge, that shows this at the moment. The youth use that we have seen in Quebec has been enormous and is growing, ranging from 8.5% in the sixth grade at age 12 to 40.9% by the end of high school.

Another surveillance study, the ETADJES in Quebec which was published last week, showed 28% use in high school and 20% among non-smokers.

Attempting to use the e-cigarette and using it regularly are not the same thing for youth as for adults. The good news in that data is that the number of youth using it on a more regular basis was more about 4% to 6%. Unfortunately that's also true for adults, where a very large proportion of smokers are using the product once or twice with some of them graduating to using it on a more regular basis. The number who use it strictly as a cessation method to completely stop tobacco use is much lower.

We know that for example in Montreal—and that new set of data will be published—about half the smokers have tried the e-cigarette. A small proportion used it daily and among those, there was a high rate of dual use. We must not confuse the simple attempt to use the product with the use of the product as an effective cessation method.

We have also seen advertising booming in other countries, albeit much slower in Canada, and this is of particular concern.

These are a few advertisements that we have seen around. They are definitely not promoting a cessation method. I don't know the last time you saw a nicotine patch promotional magazine, but the last time I saw one in a medical journal it involved a lightly dressed woman.

We also see a lot of health claims that are not necessarily substantiated. We see health claims that are strikingly similar to what we used to see with the so-called light cigarettes, which didn't turn out to be so light.

We also see a lot of messaging in the advertisements that is not compatible with a tobacco control message whatsoever, as the image being shown clearly indicates.

You can also see the image of an old advertisement for a tobacco product and a new one for an e-cigarette. The similarity is striking.

Here you can see more advertisements for e-cigarettes.

The message here is not a tobacco control message, “Why quit? You just need to switch to such-and-such a brand”.

I added some data on average usage versus uptake, but this is a point that I've already made.

This image shows dual use.

We would recommend that, at the very least, it should be subject to federal and provincial legislation on tobacco, and that a global federal framework should be considered with Health Canada's responsibility to protect the public.

As evidence accumulates, it's always time to update regulations, but the fact that evidence is not conclusive does not mean we should wait as this product is used widely across the country. We cannot stand by and wait for everybody to say exactly the same thing in the science community while a significant proportion of Canadians are using this product and they don't know what's in it.

At the very least, ENDS sales should be banned to minors, which is not the case right now. We should ban sales where tobacco products cannot be sold. We should ban all lifestyle advertising and any advertising geared towards youth, and also the cross-promotion that could be done with tobacco brands. Any health claims should be banned unless they are certified by Health Canada. It is not appropriate that products are using health claims that are not substantiated. Point of sale displays in convenience stores should be in line with the tobacco regulations.

We have a series of regulations that we suggest Health Canada consider regarding safety of the product, nicotine content, proven carcinogens, and also the appearance of the product. These are all aspects that should be considered by Health Canada.

In conclusion, e-cigarettes are an extremely heterogeneous category. It is very hard to know what to do when there are 466 devices out there. We agree it's a bit of a legislator's nightmare, but although they are much less toxic than tobacco, they are still not a harmless product and we should protect both smokers and non-smokers in Canada from the potential pitfalls. This should allow us to maximize the benefits and minimize the potential ill consequences of these cigarettes.

Thank you.

[The Chair, Conservative, Ben Lobb]

Thank you very much.

We are going to get into our rounds of questioning.

Ms. Davies, go ahead.

[Libby Davies, NDP, Vancouver East, BC]

Thank you to the witnesses for coming today. I appreciate your being so specific. It's very helpful. I certainly would agree with the observation being made that there are lots of folks out there who are using e-cigarettes and are trying to do the right thing from a health point of view in terms of a lower risk but they actually have no idea what they are using. I've actually talked to people personally who said that they've been very confused about whether or not they are using a product that has nicotine or no nicotine, so I think that's a very real situation.

I also hear you all saying, and we've heard this from other witnesses, that a regulatory framework is urgently needed even though we don't have all of the research that needs to be done. We are in this interim stage. I don't know what Health Canada has been doing since 2009, but really we have to get serious about this and start moving quickly.

I'm going to jump into some more specific questions.

I'm not quite clear if you are saying that all advertising should be banned or whether you are just referring to advertising that makes lifestyle claims or health claims and so on. Could you clarify that?

Ms. Bois, I wasn't clear whether you were saying that we should allow both nicotine and non-nicotine.

Ms. Tilson, I think you said that we should allow nicotine. If so, do you have a recommendation as to what the level should be? Earlier, I think somebody said that it was a maximum of 18, would it be milligrams? I don't know. Do you have any thoughts on that?

The other question I have, if there's time, is on the connection to the tobacco industry. Are you suggesting there shouldn't be any connection? I hear what you're saying in terms of advertising about the similarity and all that, but are you also saying that tobacco companies shouldn't be allowed to produce e-cigarettes and that it should be completely separate? I wasn't quite clear on that.

[Geneviève Bois]

As far as advertising is concerned, we'd like it to be brought in line with the current legislation on tobacco.

[Libby Davies, NDP, Vancouver East, BC]

Which means no advertising.

[Geneviève Bois]

It's slightly more complicated than that, the way it's written in the law. Generally it bans most advertising and certainly all advertising that could appeal to youth and would have a young person in it and would make some lifestyle advertisement or would make unsubstantiated health claims. It does not ban all advertising that could be factual or something such as, “We sell e-cigarettes here”, but it would definitely ban all the problematic advertising.

The examples I was showing were definitely the most problematic ones that we knew about.

[Libby Davies, NDP, Vancouver East, BC]

By the way, were those ads from Canada?

[Geneviève Bois]

No, those ads were from the U.K. and the U.S. mainly, but they're also widely circulated on the Internet. There's also a significant amount of advertising being done on Facebook via websites, via contests, and also on the radio, and that is happening and being seen by people in Canada.

[Melodie Tilson]

Perhaps I could add that in the U.S. and other foreign magazines that are sold in Canada, you can see some of that advertising as well.

[Libby Davies, NDP, Vancouver East, BC]

On nicotine, Ms. Tilson, you have said clearly that we should allow nicotine e-cigarettes and they should be regulated.

Ms. Bois and Mr. Collishaw, what are your positions on that?

[Geneviève Bois]

We definitely think that both nicotine and nicotine-free e-cigarettes should be available on the market and be legal, but standards should be set and enforced because of the very obvious labelling issues that we see right now where products might say that they have a certain amount of nicotine and it is not accurate or they say they don't have nicotine and that also might not be accurate.

To answer the rest of your question, we are not saying that tobacco companies should be forbidden in any way to invest in a new product. This is their prerogative. But we should be aware of the type of product that's on the market and who's selling them. Despite the fact there are hundreds of brands out there, who is dominating the market is all the main cigarette companies, which also have invested in e-cigarettes, and that allows for potential cross-promotion and dual use to be really pushed forward. The messages we see in a lot of advertisements is not a quitting message; it's when you cannot smoke your actual cigarette or brand, please use this one and when you go back home, keep doing exactly what you were doing. We are seeing a messaging that is much more entertaining a nicotine addiction and using two products to satisfy it rather than actual cessation.

[Libby Davies, NDP, Vancouver East, BC]

Would you have any information or research about what percentage of the tobacco industry is now dominating the e-cigarette market? How high is it? Do you have any idea?

[Geneviève Bois]

We know that all main cigarette makers have an electronic cigarette brand right now, and they are all widely available and sold. As far as which percentage of the e-cigarettes that are sold pertain to the tobacco industry, I do not have this number, but that's something I could attempt to get.

[Libby Davies, NDP, Vancouver East, BC]

Okay.

Mr. Collishaw, if there's still time, what are your thoughts about nicotine or no nicotine in e-cigarettes?

[Neil Collishaw]

Insofar as level, I really think we're at a very early stage to be able to say it should be definitively this level or that level. But what I did say, and which I will repeat, is we most certainly need legislative and regulatory framework in which those levels could be specified based on careful research and evaluation to be done in the future.

With respect to the products that are currently available without nicotine in them, I really see no benefit of those at all. I don't see any reason that we should have those in the marketplace. Something is being inhaled. It can't replace nicotine because it doesn't have nicotine in it. But once again, I would defer to further research, careful research, by regulators and researchers on that.

[Libby Davies, NDP, Vancouver East, BC]

Do you agree that in the meantime we have to bring in some kind of regulatory framework, that we just can't wait any longer, or are you in favour of doing more research and then figuring out the big picture, and acting then? Mr. Collishaw?

[Neil Collishaw]

Oh, I think we need to proceed very quickly with changing our entire legislative and regulatory framework. I have great confidence that it can be done quickly.

[The Chair, Conservative, Ben Lobb]

Okay, thank you very much.

Mr. Lizon, you're up for seven minutes, sir.

[Wladyslaw Lizon, Conservative, Mississauga East—Cooksville, ON]

Thank you, witnesses, for coming here this morning.

Mr. Collishaw, maybe I can ask you a first question for clarification. You talked about the risk management approach and the fact that the officials' hands were tied. I don't think they were tied. I think within the existing legislature they could have acted and banned these products from appearing on the store shelves.

Could you clarify what you meant?

[Neil Collishaw]

Yes. The therapeutic products directorate did in fact ban the products through the notice that was issued on March 27, 2009. The problem was that they then did not enforce the regulation for reasons that are not particularly well known to me. But what we've been told is they said, “Well, people aren't smoking these and then dying right away. We're busy with other things. We're busy with other regulatory approaches.” So the way they look at it is to say, “Well, we'll call that a risk management approach. There are other products that are creating more immediate risks than these ones, so we're going to leave those ones alone.”

I don't think that's a very good tradeoff, immediate risks versus potential risks in the future. I think we need sensible control of both.