Evidence of meeting #89 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was cigarettes.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Neil Collishaw  Research Director, Physicians for a Smoke-Free Canada
Rob Cunningham  Senior Policy Analyst, Canadian Cancer Society
Lesley James  Senior Manager, Health Policy, Heart and Stroke Foundation of Canada
Gaston Ostiguy  Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

1:45 p.m.

Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

I have another question about age. The bill we have here defines young persons as being under 18, and there are some provinces that don't allow tobacco products for those under 19.

What should we do in the bill? Should we go to the highest denominator and call it 19? Should we say it's whatever the age in the province is? What would you recommend?

1:45 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

Lesley James

Keeping it out of the hands of young Canadians is vastly important, so if there's an opportunity to increase the age to 19, that would be beneficial.

1:45 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

One option is that there could be a regulatory authority to increase the age in the future.

1:45 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

I'll add that in Europe the maximum concentration of nicotine in the e-liquid is 20 milligrams per millilitre, and this has been adopted by most of the countries that have adopted the tobacco coalition. It's a reasonable target.

1:45 p.m.

Liberal

The Chair Liberal Bill Casey

Thank you.

Mr. Davies, you have four minutes.

1:45 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Collishaw, I wanted to get your opinion on the heat-not-burn product.

1:45 p.m.

Research Director, Physicians for a Smoke-Free Canada

Neil Collishaw

Regrettably, these are already on the market in Canada. We have no way of keeping recreational nicotine products off the market. In the United States they're currently under review in premarket approval, and much ink has been spilled in the United States in this premarket approval process. A scientific committee has recommended to the FDA that they not be allowed to make health claims. We'll see what happens.

In Canada what concerns me is even though all tobacco products are covered under the current Tobacco Act, there isn't a proper set of regulations for heat-not-burn products, and there is an opportunity to at least partially correct this situation with some further amendments to Bill S-5. I don't want to go into a lot of detail here since there isn't a lot of time, but I can show all of you some proposals that I have in that regard later on.

1:50 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Mr. Cunningham, Mr. James, or Mr. Ostiguy, whoever wants to answer this, I remember my dad telling me that when he started smoking in the fifties people kind of knew it was bad, and it was frowned upon, but they didn't know that it caused cancer. In my lifetime, I've seen the development of tobacco products lead to to a light cigarette, a slim cigarette, and lower tar. There has been a gradual movement of the industry to adjust and to try to convince people that smoking is less harmful.

Here, we're standing on the cusp of a new product. We have vaping and we have heat-not-burn products. I'm not sure what else is ingested when you suck in the liquid nicotine. I'd be curious to know if there are any other chemicals. Do we have any concern that we're not going to be having a conversation 20 years from now, like my dad did with me in the fifties, when we'll be saying, gee, we wish we knew back in 2018 that there were more harmful effects from vaping or heat-not-burn products? Or are we sure at this point that this is not the case?

1:50 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

Over the decades, the experience over time has been that products turn out to be much more harmful than we initially thought they were. Also, some years ago, there were some predecessors to these heated products launched in the United States. The tobacco companies didn't disclose all their research. They cherry-picked a bit what research they disclosed and, of course, we have that concern today.

1:50 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Ms. James, do you have a comment?

1:50 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

Lesley James

For the reason you mention, I think we need to be very cautious about who is using e-cigarettes. As I've said before, the only group that should see marketing of e-cigarettes are current tobacco smokers. Other than that, there's no benefit to anyone trying e-cigarettes. We need to make sure that they stay out of the hands of young people and that non-smokers aren't persuaded to try them.

1:50 p.m.

NDP

Don Davies NDP Vancouver Kingsway, BC

Yes. We have had a lot of talk in this committee about the cannabis legislation, etc., over so-called gateway drugs, and there's a great debate over whether cannabis is or not. Is there any concern that people who start vaping could eventually migrate over to smoking cigarettes? Is that a concern? We're talking about it the other way. We're talking about moving smokers of cigarettes over to vaping as a bit of a harm reduction tool, but I'm wondering if there is any research or concern about it going the other way.

Let's say this legislation goes forward and my children are in their twenties and thirties, they're in a bar, and they see this beautiful vaping advertising. They start vaping. Is there any concern they might eventually move to cigarettes?

1:50 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

Lesley James

There definitely is a concern, because there will be nicotine in these products once Bill S-5 is passed, and who is to know what will happen in terms of addiction from choosing to use either an e-cigarette or a tobacco product? From research that came out and was published by CMHA, we do know that youth who use e-cigarettes are more likely to be using tobacco products a year later.

1:50 p.m.

Liberal

The Chair Liberal Bill Casey

Your time is up.

Mr. Oliver, you have four minutes.

1:50 p.m.

Liberal

John Oliver Liberal Oakville, ON

Thank you once again. I think this is the last round of questioning you'll have to endure from us.

I've heard from all of you that you think there should be greater restrictions on advertising of vaping. Both the Cancer Society and Heart and Stroke, I think, have come up with some advice on that.

There were four areas where you thought there should be vaping product amendments: one, limit vapour product advertising to be only information advertising or brand preference advertising; two, remove the provision that allows lifestyle advertising in bars and in publications sent to adults; three, restrict permitted vaping product incentive promotions to speciality vaping product retail stores, which is similar, actually, to cannabis; and, four, strengthen restrictions on the location of permitted incentive promotions to match the Tobacco Act restrictions.

To the Cancer Society, is there any else that you want to add to those four?

To the other three, do you agree with those restrictions on vaping advertising? Is there anything else you would like to see our committee add to reduce the amount of advertising possible for vaping products?

1:55 p.m.

Senior Policy Analyst, Canadian Cancer Society

Rob Cunningham

I think you've summarized the key categories of amendments for the act.

1:55 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

Lesley James

Heart and Stroke fully endorses the Canadian Cancer Society's recommendations and the rationale for them.

1:55 p.m.

Liberal

John Oliver Liberal Oakville, ON

Is there anything Heart and Stroke would add to those restrictions?

1:55 p.m.

Senior Manager, Health Policy, Heart and Stroke Foundation of Canada

1:55 p.m.

Research Director, Physicians for a Smoke-Free Canada

Neil Collishaw

In terms of correcting the problems we see with advertising, we also support this position. However, as I mentioned in my remarks, we have other concerns about how we should further restrict and diminish use of combustible cigarettes, but that's another topic.

1:55 p.m.

Liberal

John Oliver Liberal Oakville, ON

Dr. Ostiguy.

1:55 p.m.

Chest Physician, Associate Professor and Past Director, Smoking Cessation Clinic, McGill University Health Centre, As an Individual

Dr. Gaston Ostiguy

I agree with the ban on advertising. The popularity of this gadget never came from the health professionals of the medical society. It has come from the population. It doesn't need to be advertised. They'll go to it. The only thing is not to create barriers for the highly addicted smokers to be allowed to get the electronic cigarettes if they want to stop smoking.

1:55 p.m.

Liberal

John Oliver Liberal Oakville, ON

To be fair, recommendations from the Cancer Society also had a number around smoking. I wanted to focus because you're all very strong that vaping manufacturers shouldn't be allowed to advertise at levels beyond tobacco.

That's the end of my questions.

Thank you very much.

1:55 p.m.

Liberal

The Chair Liberal Bill Casey

I want to thank you all for your presentations.

I want to go back to the introductions. Ms. James had a line that really caught my attention. I checked to see if it was accurate, and apparently it is. Tobacco use in Canada remains the leading risk of premature death in Canada, killing 45,000 people each year.

I didn't think that number could be right but it looks as if it's the one that's most often used. Then I compared the automobile fatalities: 1,858 per year. Based on that number, 20 times more people died from tobacco use than in cars. I think of all the things government has imposed on the automobile industry to reduce car fatalities: headlights on, back-up cameras, seat belts, airbags, and so on. The government has required the companies to change their product to make it safer, then they've tested it.

You've made me do a lot of thinking.

I'm so glad you didn't get into all those books, Mr. Cunningham. I was looking at them, and I was scared during the whole meeting.

You've been great presenters and you've helped us a lot.

Thanks very much.

The meeting is adjourned.