Good morning, Mr. Chair and committee members. Thank you for the invitation to present to you today.
I will preface my comments this morning by noting that, throughout my remarks, my references to cannabis use relate to recreational use, not the use of cannabis for medical purposes.
On behalf of the Canadian Public Health Association, I am pleased that the Government of Canada has committed itself to a public health approach to the legalization and regulation of cannabis. We are further pleased that Bill C-45 does in fact embody such an approach.
Different from the publicly funded health care system, public health is the organized efforts of society to keep people healthy and to prevent injury, illness, and premature death. As such, a public health approach is based on the principles of social justice. It pays attention to human rights and equity. It is based on the evidence, and it addresses the underlying determinants of health. A public health approach is organized, comprehensive, multisectoral, and it emphasizes pragmatic initiatives.
As a colleague recently noted, in some ways public health is like that darling child who's always asking, “Why?” In the case of cannabis, we want to know why people use it, so that we can develop policies and interventions that meet their needs. The human relationship with cannabis ranges from abstinence to a spectrum of consumption. This spectrum ranges from beneficial to non-problematic, to potentially harmful use, to the development of use disorders. At the federal level, the legal and regulatory response to cannabis needs to be sufficiently broad to encompass the entire spectrum of consumption, while at the provincial and territorial levels, the response begins to narrow to meet the particular needs of each jurisdiction. Then at the regional or local levels, the response is honed to the specific needs of particular populations.
There has been considerable discussion and unfortunately a lack of consensus regarding the appropriate legal age for the possession of cannabis. The Canadian Public Health Association supports the provisions in Bill C-45 establishing the minimum legal age at 18 and allowing provinces and territories to set a higher age, as appropriate, in their jurisdictions. From a practical perspective, it is important and appropriate for provinces and territories to establish a legal age for cannabis consumption that matches the legal age for alcohol consumption. In that way, confusion should be reduced and education efforts can be better coordinated.
While we would prefer that no Canadian use cannabis or any other psychoactive substance, a public health approach recognizes that cannabis will be consumed for a number of different reasons, regardless of efforts to discourage it. You are already familiar with the statistics: 12% of the general population, 21% of youth aged 15 to 19, and 30% of young adults aged 20 to 24 reported in a 2015 survey that they consumed cannabis in the previous year. Since more than one in five youth aged 15 to 19 are consuming cannabis now and we have no reason to believe that rate will change, the responsible policy option is to create a legal and regulated market for cannabis that is accessible to adults 18 years of age and older.
Bill C-45 will establish a supply of cannabis of known potency and quality. Currently, anyone consuming cannabis is playing a game of Russian roulette, never knowing the product's quality before consuming it, or if it has been laced with other, more powerful psychoactive substances. From a public health perspective, the Canadian Public Health Association is encouraging provincial and territorial governments to limit the sale of cannabis to government-controlled entities to ensure that the focus remains on harm reduction, not profit.
The prohibition model currently in place in Canada has severely hampered health promotion and harm reduction efforts. The only message we had at our disposal was, “Just say no”, and clearly that has failed. Beyond simple health education, health promotion is the process of enabling people to increase control over and to improve their health. It is our view that legal cannabis sales must therefore be preceded by comprehensive, non-judgmental, non-stigmatizing health promotion campaigns across Canada that have a clear and consistent message. These campaigns must be supported on an ongoing basis and should be complemented by in-person health promotion and harm reduction messaging at the point of sale. We need to normalize the conversation about cannabis, not its consumption.
There are concerns that the legalization will result in significant increases in cannabis use, especially among young people. While the Canadian experience may be different, two recent reports from Washington state both indicate that youth cannabis consumption has remained stable since legalization in that jurisdiction. One of these reports, however, indicates an increase in older adults' cannabis use, while another indicates an increase in the number of people who consume cannabis daily or near daily.
These early reports out of Washington remind us that we need to pay attention to the entire population, with a particular focus on why certain individuals go on to potentially problematic use.
Concerns have also been raised about the impact cannabis consumption has on the developing brain. While the studies quoted are important pieces of the research puzzle, they focus on young people who are daily and heavy cannabis users. I think we can all agree that if a child is consuming a large amount of cannabis on a daily basis, there is a cause for concern. If a child were drinking alcohol heavily on a daily basis, there would be a similar cause for concern. Once again, from a public health perspective we want to know why that child is consuming heavily and daily; then we can focus our interventions accordingly.
At the moment, we lack robust data on the health impacts of casual use of cannabis and we hope that legalization will allow research on that issue to take place. Having understood that people are going to continue consuming cannabis for various reasons and in various amounts, it is crucial that our policies and interventions focus on harm reduction efforts. Harm reduction can take many different forms, including ensuring a product of known potency and quality; effective education and health promotion activities; ensuring that consumers and health and social service providers know about safer consumption methods; and adopting and promoting the lower-risk cannabis use guidelines.
I understand that you have a panel dedicated to that subject later today, so I won't go into these guidelines in detail but I will say that they are an important tool that should be adopted in all jurisdictions.
The Canadian Public Health Association does have one recommendation for an amendment to Bill C-45 that I believe one of your witnesses mentioned yesterday. As it currently stands, subclause 10(5) of the bill will result in the crime of possession for the purpose of selling becoming an indictable offence punishable by up to 14 years in prison for those convicted, including young people between the ages of 12 and 18. Clause 8 concerning possession and clause 9 concerning distribution provide similar sentencing options for people over 18 years of age, but permit referral to sentencing under the Youth Criminal Justice Act for those between 12 and 18.
The Canadian Public Health Association's viewpoint is that an option for sentencing under the Youth Criminal Justice Act for young people should also exist under subclause 10(5). In many cases these offences are related to possession for sale by young people to their peers, and the stigma established by such a conviction may cause irreparable harm to their futures, outweighing the actual offence. Care should be taken to apply the proposed rules concerning possession for the purpose of sale to reflect the severity of the crime.
You have also heard calls that we are not ready for legalization. Unfortunately, we don't have the luxury of time, as Canadians are already consuming cannabis at record levels. The individual and societal harms associated with cannabis use are already being felt every day. The proposed legislation and eventual regulation is our best attempt to minimize those harms and protect the well-being of all Canadians. Our first efforts may not be perfect, but perfection is not required as we can modify our approaches as we learn from our experiences. At the end of the day, we all want to do the right thing for the broad range of Canadians who already consume or may choose to consume cannabis for a variety of different reasons.
The Canadian Public Health Association believes that Bill C-45 and provincial responses such as Ontario's are steps in the right direction. Key lessons learned from jurisdictions that have travelled this road before us include the following: regulators must have the flexibility to adapt to changing conditions in the marketplace; upfront investments in education and health promotion are essential; law enforcement and public health need to work together; and the interests of the private sector cannabis industry are rarely aligned with the interests of public health.