Good afternoon, Mr. Chair, and members of the committee. I'm Lesley James, senior manager of health policy at the Heart and Stroke Foundation of Canada. I'm also a doctoral researcher.
It's an honour to speak to you today about Bill S-5, a key piece of legislation in achieving Heart and Stroke's vision of a Canada free of commercial tobacco use.
Your committee will hear from many of our health coalition partners and tobacco control experts on this subject. Our common agreement is that we support aspects of Bill S-5 as related to plain and standardized packaging but have significant concerns with the bill's permissiveness around the wide-scale marketing of e-cigarettes. As such, we recommend amendments.
Bill S-5 represents an important step to strengthen tobacco control. It aims to protect the health of our children and youth from the industry tactics that target young Canadians and hook them to addictive and harmful products.
While Bill S-5 in its current form recognizes the power of tobacco marketing in appealing to young Canadians, it fails to protect that same vulnerable group as well as non-smokers from persuasive, e-cigarette advertising. In this regard, Bill S-5 contains a fundamental flaw, and we hope to see amendments made to address this disconnect between marketing restrictions.
The federal government has committed to a goal of less than 5% tobacco use by 2035. Despite efforts to reduce tobacco use in Canada, smoking rates remain unacceptably high at 17%. We support the 5% target and strongly believe that Bill S-5 is a key piece of legislation to achieve this target.
Getting to 5% is important because tobacco use remains the leading cause of premature death in Canada, killing over 45,000 Canadians each year; that's 120 of us every day. Nearly one in five deaths in Canada can be attributed to tobacco use. We have much work ahead of us, especially as it relates to young Canadians.
Smoking rates are greatest among young adults, aged 20 to 24, at 18.5%. Sadly, almost 10% of 15- to 19-year-olds in Canada identify as current smokers. We know that most smokers start as teenagers, but 20% of Canadians try their first cigarette as young adults.
How do we address this issue and reduce tobacco use among all Canadians, with a particular focus on youth and young adults? The answer is plain and simple. Heart and Stroke strongly encourages and supports the adoption and expedited implementation of plain and standardized tobacco packaging. Our organization has been urging for the adoption of this policy measure for decades, and I would like to show you why it's so important.
I have examples of packs sold in Canada. This is a pack targeted towards young men. We call it the hipster pack. It's trendy. It's kind of rustic looking. These ones are targeted towards young females. They're meant to look like cosmetics packages. The lipstick that I bought last week looks just like this. You can see that the product inside is equally as appealing as the outside. It's appealing and glamourous.
As a woman who understands and recognizes that these products shrewdly appeal to gender-specific beauty norms and ideals, I want to emphasize that these gender-oriented tactics, preying upon young and vulnerable women, are offensive, demeaning, and need to be stopped.
The use of the words “slim” and “vogue” along with the delicate but sparkly cigarette also demonstrate that the product itself should be mandated to be unappealing. This would entail banning slim cigarettes and would provide an opportunity to use the product itself for health messages.
As such, we ask for an amendment in this bill providing the regulatory authority to require health messaging on the product itself. This is already the case for e-cigarettes in this bill. Messages like “tobacco kills” or the promotion of cessation programs on each cigarette would be highly effective in dissuading use and increasing quit attempts.
Plain packaging has been endorsed by the World Health Organization and adopted in many countries. Evidence indicates it has a variety of benefits including accelerated declines in tobacco use, curbing deceptive marketing messages, increasing the visibility and effectiveness of health warnings, reducing the appeal of tobacco among youth, and increasing smoking cessation attempts.
After the policy's implementation in Australia, positive image associations across all tobacco brands fell, and the greatest decline was seen among adolescent smokers.
Concerns about contraband in relation to plain packaging are inaccurate, overstated, and exaggerated by the tobacco industry. Contraband concerns are often used as an industry narrative to stall tobacco control policies.
We applaud all parliamentarians for forging ahead with plain packaging and recognizing the tactics used by the tobacco industry and its front groups. Plain packaging is a powerful policy measure fully endorsed by Heart and Stroke and hundreds of health experts in Canada.
With regard to vaping products, Heart and Stroke's position on e-cigarettes has evolved over time with advances in research, and while the evidence regarding e-cigarettes continues to grow, there is still much left unknown. We continue to strive for a balance between potential risks and benefits and to that end it is important that regulations ensure product safety and protect Canadians against potential harm.
Experts agree that complete tobacco cessation over the long term rather than reducing the number of cigarettes smoked per day is the most effective way to reduce risk for disease and premature death. Heart and Stroke encourages people in Canada to strive for complete cessation as the best means of reducing tobacco-related illness.
We recommend Canadians use cessation tools like nicotine replacement therapy, quit medications, and counselling. Some Canadians may find cessation benefits for reductions in tobacco consumption from the use of vaping products, but in Canada, as elsewhere in the world, dual use of both e-cigarettes and tobacco is common, which puts into question the public health benefit of these devices.
Heart and Stroke agrees that e-cigarettes are less harmful than combustible tobacco, and for this reason we support increased access to e-cigarettes for adults. However, e-cigarettes are not without risk. Claims made by researchers that quantify the difference in associated harm between e-cigarettes and combustible tobacco are based on faulty methods and draw inappropriate conclusions.
We have known for years that e-cigarettes are appealing to Canadian youth. A study found that 18% of non-tobacco-using Canadian high school students had tried e-cigarettes and another 31% were interested in trying them. Current use of e-cigarettes among 15- to 19-year-olds has more than doubled in the past few years. Studies also show that more teens are using e-cigarettes, seeing them as cool and fun, and research in Canada shows a link between e-cigarette use among youth and later tobacco use.
We want to ensure that e-cigarettes do not result in nicotine addiction and tobacco use. It is essential that young Canadians be protected from marketing exposure aiming to increase the use of these products. Not only are there potential harms with the liquid constituents of vaping devices but we need to protect non-smokers and youth from nicotine, which will become legal and more readily available once Bill S-5 is passed. Nicotine is a highly addictive drug that increases blood pressure, makes your heart work harder, and can cause blood clots.
It is essential that Bill S-5 be amended to further restrict the marketing of e-cigarettes in Canada. In its current state, wide-scope marketing would be permitted for advertisements everywhere and anywhere, television, online, video and advergames, newspapers, magazines, billboards, public transit, social media, and the list goes on.
Of great concern is that marketing can happen in bars and night clubs, places where young people often congregate and are under the influence of alcohol. This can make them more susceptible to marketing messages and create opportunities for young Canadians to experiment with e-cigarettes. There is no need for marketing in places frequented by young people or the widespread marketing of vaping products to the general public. The only group that should be exposed to the marketing of these products are current tobacco smokers.
The proposed ban on lifestyle advertising will not be strong enough to protect young people from the multi-billion dollar marketing machinery of the industry. As such, we ask that Bill S-5 be amended in relation to vaping products to include strengthened restrictions on e-cigarette advertising to align with the restrictions in the Tobacco Act and proposed cannabis act and the removal of the provision that allows lifestyle advertising in bars and adult publications.
Heart and Stroke also formally endorses the recommendations proposed by the Canadian Cancer Society.
To conclude, Heart and Stroke strongly supports the proposed legislation related to plain and standardized packaging and is recommending amendments to increase the impact of the bill. We urge that this committee make Bill S-5 a key piece of legislation that truly protects our kids and prevents uptake by non-smokers in further restricting e-cigarette marketing.
In adopting these amendments, Bill S-5 will become a strong and powerful piece of legislation to drive down tobacco control and put the health of Canadians first.
Thank you for your time.