Health Committee on April 30th, 2018

[John Oliver, Liberal, Oakville, ON]

So it's the regulations that provide the exemption.

[Karen McIntyre]

That's right.

[John Oliver, Liberal, Oakville, ON]

Okay, so again, the committee could make a very clear recommendation that we believe all alcoholic beverages should contain that information. Then at least some would know exactly how much sugar and what the caloric intake is in that beverage, which is important regardless.

The third area of questioning I have is around advertising. It has come up a few times. I heard you say you're doing consultation with the industry, and a few of my colleagues have raised it. Here at the committee, under the cannabis legislation, we dealt specifically with advertising directed at minors. Under tobacco and plain packaging, we dealt specifically with advertising directed at minors. As well, under the vaping act that we looked at, we dealt with advertising directed at minors. In the food thing we're just working with, the whole issue is around how to restrict products that are high in sugar and the advertising to youth. Why is that not federal jurisdiction in alcohol? Why do we not have the capacity to regulate that?

[Karen McIntyre]

As I mentioned, in the act we have provisions surrounding advertisement, in section 5, I think.

[John Oliver, Liberal, Oakville, ON]

It's in the Food and Drugs Act?

[Karen McIntyre]

It's in the Food and Drugs Act, but it's related to deception—advertising, marketing, and deception, misleading, fraud—

[John Oliver, Liberal, Oakville, ON]

I understand, but is it because there is no federal jurisdiction or because it's not built into the act itself?

[Karen McIntyre]

That's right; it's not in the act itself for us to—

[John Oliver, Liberal, Oakville, ON]

Back in 2004, in the journal Archives of Pediatrics and Adolescent Medicine, they found that “exposure of underage girls to alcohol advertising is substantial and increasing”. Concerning young girls' exposure to alcohol ads in magazines, researchers showed that:

...girls between the ages of 12 and 20 were exposed to ads for beer, ale and liquor, as often as women aged 21 to 34. [But] when it came to sweet-flavoured “low-alcohol refreshers,” such as coolers, ...younger girls were 95 per cent more exposed to advertising for those products than women over age 21.

Also, children in the seventh grade exposed to alcohol advertising, if they liked the images, “increased their alcohol use in the subsequent few years”, and they had “severe alcohol-related problems by grade 10”. Also, there's a failure of the industry to self-regulate and a significant need for further action.

That's a 2004 study and report that came out. It sounds to me as though it's time, just as we restricted lifestyle advertising using famous people, and celebrity advertising, that we need to get on top of advertising of alcohol to children, and it sounds as though it needs an amending act. It's not that we don't have the federal authority to do it; we just haven't, as legislators, put the power in your hands to create regulations around that. Is that correct?

[Karen McIntyre]

Yes.

[John Oliver, Liberal, Oakville, ON]

Is that something else you might like to see from this committee, then, or is it something you would encourage?

[Karen McIntyre]

There's the CRTC code as well, which doesn't have the force of law.

I think there are different options. We could certainly explore this in terms of what the best way is to go forward in order to address it.

[John Oliver, Liberal, Oakville, ON]

But surely this is a health issue and belongs with Health, doesn't it?

[Karen McIntyre]

Absolutely.

[John Oliver, Liberal, Oakville, ON]

It's not really telecommunications.

Is there a section of the Food and Drugs Act you think would most merit including advertising restrictions?

[Karen McIntyre]

It would be in the act itself. Probably, in the same way that Bill S-228 introduced a new section 7, it would be another section.

[John Oliver, Liberal, Oakville, ON]

This was such a blatant thing. The name of this drink was FCKDUP. We know that adolescents' executive functioning is under-displayed during this cycle and that they are more inclined to risk-taking and doing things we would otherwise view as highly risky.

Here's advertising directed right at an adolescent market and geared to saying “take a risk”. We have a death because of it, I think a very predictable one, and if it's predictable, it's preventable. I think it's time we got legislation in place, personally.

[The Chair, Liberal, Bill Casey]

Thanks very much.

That completes our seven-minute round. Thank you very much to our panellists.

We will suspend for a minute while we change panellists and go to our next panel, but thanks very much for your help in understanding this.

[The Chair, Liberal, Bill Casey]

Welcome, panel.

We welcome Mr. Hubert Sacy from Éduc'alcool, Director General and Founder of the organization. From the Canadian Centre on Substance Use and Addiction we have Catherine Paradis, senior research and policy analyst.

I will invite Mr. Sacy to give us a 10-minute opening statement. Then we will go to Ms. Paradis for 10 minutes.

Mr. Sacy, you're up.

[Hubert Sacy, Director General, Éduc'alcool]

Thank you very much, Mr. Chair.

Ladies and gentlemen, thank you so much for allowing me to appear by video conference. I am very grateful to you, especially in these moments when time is extremely precious.

I will start by introducing Éduc'alcool briefly.

Éduc'alcool is a non-profit organization that has been working for 27 years to improve the relationship with alcohol of Quebeckers who choose to drink. You probably know our motto: "Moderation tastes better." The latter has become a saying in Quebec, and we are working hard to make it a way of life.

We also step in to influence the settings where alcohol is consumed. That's what it's all about today.

First of all, let me say that it is extremely regrettable that it took the death of a young girl for us to meet today to discuss this subject. Yet it was a death foretold. Since last July, warnings have been issued here and there, including by Éduc'alcool, to indicate that sugary, alcoholic beverages were dangerous. They are dangerous in their very essence, as we will see later. Now, we must look forward and hope that the death of Athéna Gervais will not have been in vain.

I want to point out that sugary, alcoholic beverages are not just alcohol and are not harmless drinks. In fact, they are dangerous drinks. Their level of danger isn't related to the percentage of alcohol or the amount of sugar, guarana, stimulant or anything chemical. I urge you not to get caught up in a discussion about the percentage or quantity of one product or another. The danger of sugary, alcoholic beverages comes from their very DNA, from conception to marketing, from packaging to promotion, from their price to point of sale. In these products, everything, absolutely everything, from A to Z, and even more, is fundamentally dangerous. The consequences are there. In 11 months, 2,300 young people aged 12 to 24 were received in Quebec's emergency departments for acute alcohol poisoning. A fifth of them were under 18 years old.

I will be very clear with you: you must not content yourselves with half measures. If the decisions taken in Ottawa or Quebec—I am talking about Quebec because I don't know the situation in the other provinces—are unclear, if they are not radical and clear, they will be skirted around by manufacturers. If you like, during the question period, I can list the many ways manufacturers of these products will managed to get around all the acts and the regulations that aren't crystal clear. If the rules are like jell-O, they will be bypassed.

We must also be consistent. Health Canada can't, on the one hand, state on its website that these beverages are dangerous and, on the other, allow them. Either they're dangerous or they're not. In this case, the products are dangerous.

You'll tell me that in the history of humanity, there have always been mixtures of alcohol and sweet or stimulating products. Irish coffee is alcohol and caffeine. Brazilian coffee is the same thing. Rum and Coke is a mix of rum, an alcohol, and Coca-Cola, a sweet and stimulating drink. As for mimosas, they are made of Champagne and orange juice. There have always been mixtures of alcohol and sugary or stimulating drinks, and there has never been a need for warnings about them. Why? Because they aren't deceptive drinks.

However, the sugary, alcoholic beverages we are talking about are dangerous because they mask the taste and effect of alcohol. People drink them without knowing that they are consuming alcohol. Stimulants mean that they don't receive messages that the body sends when they have had too much alcohol to drink.

Beer isn't a deceptive drink. Beer tastes like beer. The same goes for wine, Scotch and cider, but this isn't the case for sugary, alcoholic drinks. They are a public danger and must therefore be banned, period.

Of course, you're going to tell me that banning them won't prevent people from making mixes, and that's true, but when people make their own mixes, they know what they're putting in their glass. There isn't masking going on.

Our first recommendation is to ban the production and sale of sugary, alcoholic drinks containing stimulants, regardless of the level of alcohol, sugar or stimulants. These mixes shouldn't be on the market, period.

If, despite everything, you decide to authorize them, at the very least, make sure that you limit the ways in which consumers are misled, especially young people. Whether consumers of these products are young or not, lovers of one taste or another, it remains that these products are misleading, and it must be ensured that the people who consume them do not need to hold a diploma in nutrition or be licensed chemists to know what they are consuming.

Our second recommendation is that any premixed products be sold and marketed only in containers—reclosable or not, it doesn't matter—containing 13.5 grams of alcohol. So we're talking about a content equivalent to a standard glass. If anyone wants to drink more, they can buy two, three or four. There shouldn't be a single can containing the equivalent of four glasses of alcohol, as is the case now. The equivalent of a standard glass of alcohol per container is what we recommend.

Lastly, the target must be adults. The federal government has jurisdiction over packaging and labelling. However, premixed sugary, alcoholic drinks are marketed in packaging with labelling and lettering that clearly targets the very young. You need only look at one of these cans to realize that the product isn't intended for seniors. The number of young people who get this product, consume it and become addicted is huge. This problem isn't arising in the homes of the elderly, I assure you. Lettering, packaging and colours need to target adults. It's fundamental. This doesn't mean that the packaging has to be ugly, repulsive or hideous, even if it might be relevant, given what it contains. At the very least, it must be ensured that these products can't target young consumers in any way.

Our third recommendation is that the packaging, labelling and lettering for these products be clearly designed to target adult consumers and that it not be possible to market them before authorization is granted and assurance is given that only adults will be targeted.

That said, the federal government isn't the only party involved. The Quebec government also has its part to play. Some time ago, it took a step in the right direction—although it was quite insufficient, I'll tell you right off the bat—by establishing advertising and promotion controls and prohibiting the sale of products containing more than 7% alcohol anywhere but at Société des alcools du Québec stores. Unfortunately, it flatly refused to introduce a minimum price for these drinks. The minimum price was established by scientists: $1.70 per standard glass, regardless of the nature of the product. It is an effective measure to protect the young and the most vulnerable.

I will end there by inviting you to take action, and quickly, without dithering, without making too many nuances. Otherwise, there may be other cases like Athéna Gervais's, and if there is another, this time, no one can say that they didn't know.

Thank you very much.

[The Chair, Liberal, Bill Casey]

Thank you very much.

Now we go to the Canadian Centre on Substance Use and Addiction.

Ms. Paradis, you have 10 minutes.

[Catherine Paradis, Senior Research and Policy Analyst, Canadian Centre on Substance Use and Addiction]

Good afternoon.

My name is Catherine Paradis, and I am a Senior Research and Policy Analyst at the Canadian Centre on Substance Use and Addiction, or CCSA for short.

The CCSA was created by an act of Parliament to provide national leadership to address substance use in Canada. A trusted counsel, we provide national guidance to decision-makers all over the country by harnessing the power of research, curating knowledge, and bringing together diverse perspectives.

One of my roles at the CCSA is chairing the Postsecondary Education Partnership–Alcohol Harms, or PEP-AH, which brings together more than a third of Canada's post-secondary institutions. In this capacity, I have been working since 2014 to gain a better understanding of the student drinking culture on campuses across the country.

Unfortunately, I appear before you today in the wake of a heartbreaking tragedy, the death of Athéna Gervais, who was found lifeless in a stream behind her high school after drinking at least one can of the beverage FCKDUP during the lunch hour.

While the situation in Quebec has highlighted the link between the consumption of highly sweetened alcoholic beverages—so-called alcopop—and the health of young people, numerous American studies have shown that the availability of these products was also associated with various legal problems, including assault, mischief, uncivil conduct, drinking and driving, and underage drinking.

I am here this afternoon representing the CCSA and PEP-AH for two reasons. First, I want to share with you our recommendation for restricting access to alcopop. Second, I'd like to propose three points that should be addressed in order to better control the sale of alcohol in Canada, more generally.

Before arriving at a recommendation, the CCSA carried out research and asked several questions. The first question that came to mind was this. Why are highly sweetened alcoholic drinks, which are so clearly harmful and dangerous, so popular with young people?

Australian researchers had already asked themselves that very question. They demonstrated that the main reasons young people consume this type of product are sugary taste, of course, but also and above all, price.

In fact, economic availability is one of the main determinants of alcohol consumption and its associated problems. Studies have shown that the higher the price of alcohol, the lower the incidence of alcohol consumption and its associated issues. Inversely, the lower the price of alcohol, the higher the consumption of alcohol and its associated issues.

At the time of Athéna Gervais' death, the price of sugary alcoholic drinks in Quebec was as low as 74¢ per standard serving, which is far below the recommended reference price of $1.71.

In Canada, it is generally accepted that the economic availability, as well as the physical availability—that is, the number of points of purchase and their days and hours of operation—of alcoholic drinks are the responsibility of the provincial and territorial governments.

However, via its excise tax, the federal government has the power to ensure that alcohol is not sold at reduced prices. Until now, sweet and alcoholic beverages, which are produced through the fermentation of malt, have been taxed as though they were beer—the alcoholic beverage with the lowest tax. If sweetened alcoholic beverages were produced from spirits, their sale price would be higher. It is worth remembering that, under the Food and Drugs Act, alcohol products are subject to the specific requirements of their manufacturing methods. This means that Health Canada could impose manufacturing methods on producers of highly sweetened alcoholic beverages.

That brings me to our recommendation.

The CCSA recommends that Health Canada require the manufacturers of alcoholic beverages having a sweetness threshold of more than 5% to manufacture their products from ethyl alcohol rather than alcohol obtained from the fermentation of malt. I realize this recommendation might come as a surprise, but it would maximize public health and safety benefits, while not disadvantaging the alcohol sector as a whole.

Allow me to explain.

First off, were highly sweetened alcoholic beverages to be manufactured from ethyl alcohol, they would automatically be subject to the excise tax imposed on spirits, rather than that imposed on beer. For example, a can of FCKDUP made from ethyl alcohol would be subject to a tax of 82¢ per can, rather than the current malt alcohol tax of 18¢. In other words, these products' economic availability would be reduced.

Second, were highly sweetened alcoholic beverages to be manufactured from ethyl alcohol, they could not be sold at convenience stores, grocery stores, or Beer Store locations. They would be available only at publicly owned outlets such as the LCBO in Ontario and the SAQ in Quebec. As a result, their physical availability would be significantly restricted.

Finally, by adopting the sweetness threshold as the determining criterion for the type of alcohol to use in the production of highly sweetened alcoholic beverages, Health Canada would guarantee that the new Food and Drugs Regulations would apply exclusively to highly sweetened alcoholic beverages and would not impact other product categories, including strong beer.

The idea of placing highly sweetened alcoholic beverages in a higher taxation category has been explored and, in some cases, implemented in other regions of the world, notably Australia, Germany, the United Kingdom, Switzerland, as well as a number of U.S. states.

In countries where data is available, results suggest that, following the reclassification of highly sweetened alcoholic beverages as spirits, the consumption of these products was significantly reduced. Once the new tax was adopted in Australia, it led to a 28% drop in the sales of these products. In the United Kingdom, after highly sweetened alcoholic beverages were classified as distilled spirits, the price of these products increased dramatically and sales dropped 43% over four years.

With that recommendation put forward, the CCSA would like to take the opportunity presented by this consultation to issue a reminder that alcohol is no ordinary commodity.

In a few weeks, the CCSA and the Canadian Institute for Substance Use Research will release a report on Canadian substance use costs and harms. The report will reveal that alcohol-related costs are now higher than the costs associated with all other substances, including cannabis, opioids, and even tobacco.

This illustrates that alcohol should be made available in a responsible and ethical manner in order to reduce alcohol consumption and its associated problems.

To accomplish this, the CCSA proposes that three distinct areas be addressed by the government: the advertising of alcoholic beverages, the labelling of alcoholic beverages, and the National Alcohol Strategy.

The advertising of alcoholic beverages through traditional media influences the consumption of alcohol, particularly among young people. Over the past few years, the industry has turned to social media, where content is user-generated and therefore more effective because it gives the impression that it was produced by a real person, such as a peer, another young person, or a friend.

Currently in Canada, the only code governing the advertising of alcoholic beverages is the CRTC code—the Code for Broadcast Advertising of Alcoholic Beverages—which is outdated and somewhat obsolete, having last been updated in 1996. That means the code is older than the young people consuming the very products we are talking about.

In addition, advertising on web platforms slightly violates CRTC rules. A recent study we conducted with fellow researchers at the University of Victoria found that, on the Facebook and Instagram pages of the most popular student bars, an average of seven of the 17 CRTC rules were violated.

This shows the urgent need to review Canada's regulations respecting the promotion and advertising of alcohol, as well as their enforcement.

Now I will turn to labelling.

There is a broad consensus that nutrition information should be provided on a wider range of food products, including alcoholic beverages. For the sake of their health and safety, people should know how many drinks they are consuming. Were Canada to proceed with labelling of alcoholic beverages, standard drink labels could help consumers overcome the challenge of accurately monitoring their consumption in terms of standard drinks. Such labelling would contribute to a culture of moderation, because the labels would supplement other interventions of proven effectiveness that require the monitoring of personal alcohol intake.

In order to help consumers estimate their alcohol intake and be aware of the nutrient value, including the number of calories, of the alcoholic beverages they consume, there is an urgent need to review the way alcoholic beverages are labelled.

Finally, I'd like to discuss the National Alcohol Strategy.

Reducing alcohol-related harm in Canada requires a collaborative, multi-faceted, and long-term approach. The approach needs to deploy social marketing, community education, regulation, and enforcement activities, as well as other tactics.

To address this need, in 2007, the CCSA partnered with Health Canada and the Alberta Alcohol and Drug Abuse Commission to co-chair an expert working group, which developed 41 recommendations for a national alcohol strategy. Several initiatives stemming from these recommendations have been completed, while others are currently under way. Nevertheless, 11 years have passed since the Strategy was developed. Today, we are asking you to encourage all partners, including Health Canada, to pursue their involvement and invest in updating the Strategy.

In conclusion, the CCSA recommends that the physical and economic availability of highly sweetened alcoholic beverages be restricted through amendments to the Food and Drugs Act or by requiring that these beverages be produced from ethyl alcohol and classified as spirits rather than beer.

From a broader perspective of protecting the health and safety of Canadians, the CCSA proposes that the regulations governing the advertising and labelling of alcoholic beverages be reviewed and that the National Alcohol Strategy be updated.

Thank you for listening.

[The Chair, Liberal, Bill Casey]

Thank you very much.

We'll go to our seven-minute round of questions, starting with Mr. Ayoub.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

Mr. Sacy and Ms. Paradis, thank you both for your compelling presentations.

The purpose of the committee's study is to identify lasting solutions that the government can implement. Some recommendations were put forward back in 2007, as you mentioned. I'd also like to thank you for bringing up the fact that the CRTC rules date back to 1996.

There is no denying that, in 2018, we still have a problem. It is clear that manufacturers of these products care about only one thing: making money. It is true that, in an effort to respond swiftly and responsibly, a convenience store owner voluntarily pulled certain alcoholic beverages off his shelves because, in his view, they should never have existed. The fact remains, those products did wind up on store shelves.

What emerged clearly from our discussion with the Health Canada officials who were here before you is that the federal and provincial governments have been passing the buck back and forth. That's nothing new. What I really care about is achieving some regulatory consistency. I would like to see some consistency around product availability and drinking age, for instance. Quebec's regulations should, at least, be as stringent as Ontario's or those of another province.

You've studied the problem. What kinds of regulatory measures do you want to see from the federal government?

Of course, the provinces should be able to retain some autonomy, but there are major differences across their regimes.

As far as alcohol consumption goes, it is clear that provincial borders are porous. Young people engage in certain activities. We were talking earlier about spring break. Quebec's spring break isn't at the same time as that of other provinces. Young people go off on organized trips and drinking is commonplace.

Could you tell us, in very specific terms, how the federal government should deal with situations like these? Would you care to go first, Mr. Sacy? Then, I'd like to hear from Ms. Paradis.

[Hubert Sacy]

Thank you for the question, Mr. Ayoub.

My proposal would solve your problem with unbelievable ease. It would put an end to the federal-provincial bickering and make your question irrelevant. All you would have to do is prohibit the sale of these filthy products and you wouldn't have a problem on your hands. Case closed.

Now that would probably be the best solution. Barring that, any other measure would simply be a band-aid.

We aren't going to tell you to go meddling in provincial affairs, since that wouldn't be appropriate and would simply spark a turf war. Nothing at all would come of it. Consider, however, what does clearly fall under federal jurisdiction: the container. The federal government has the authority to restrict the amount of alcohol per container to one standard drink. That's a very easy thing to do and would apply country-wide. Labelling and packaging are a federal responsibility. At least do something on that front.

Yes, points of purchase are in the provincial domain. In that regard, the CCSA's recommendation that these alcoholic beverages be made from ethyl alcohol is a good one. Honestly, though, the problem would disappear altogether if the government were simply to ban them from the marketplace.

That wouldn't stop people from mixing their own beverages, of course, but they would be doing it themselves and would know what they were doing.