Health Committee on Feb. 12th, 2018

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Thanks to all the witnesses for appearing today.

My first question is for Mr. Cunningham. It's on the subject of contraband. We know that we have a significant problem today in Canada. Across the country, 40% is one of the numbers I've heard, although in Ontario I think it's even higher—60%.

I just want to confirm that the outside of the plain package still contains the protections designed by Health Canada. I think there were 17 different kinds of technology preventions to keep them from being copied.

Could you talk a little bit about those and about what to do to the actual cigarettes themselves in terms of the alphanumeric code that we spoke of?

[Rob Cunningham]

This is, again, a package from Australia. The brand name still appears, so you're able to tell which brand is which. On the inside, on the cigarette—and companies are allowed to do this—there are letters and numbers that are unique to each brand. That's one way they are allowed, and they do in Australia, to make it a distinctive brand. Health Canada is contemplating that as well.

In Canada we do have on the package a tax marking. It's like money. It's a unique number for every different package. That will continue. But I think we can enhance that with a marking directly on the cigarette so we can tell what is intended for legitimate sale in Canada and what is not. It will be a bilingual message, and short, ”Every cigarette is doing you damage. Smoking kills”, and a toll-free quit number. You wouldn't have it on exported product. If somebody's in the United States or some other country, and they want to divert something to Canada, it's a different step to have a marking. If it has a marking intended for Canada, and they say it's for the United States, they're going to get caught. If it doesn't have the Canadian marking, it's not. It's a further tool to help enforcement authorities. There's good research to support it as well.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I have another question for you as well, because you seem to have quite a number of reports that show that implementing plain packaging will reduce the number of people who are smoking. You talked about the France situation. I did see the Minister for Solidarity and Health had come out and said the program was a failure. But you're indicating that's because they didn't take into account the fact that people had lowered their inventories in advance of the implementation. Japan also had Japan Tobacco International stating that the plain packaging had failed and called to end it.

Could you just summarize the 150 studies and tell us what kinds of reductions they are consistently seeing, and who had a problem, so that we can clear that part up.

[Rob Cunningham]

Clearly, it's still early years, Australia being the first. For some of the others it's just been a year or so that it's been in place. The full benefit is going to be over 20 years. Australia had a post-implementation review to conclude that it's been effective. All the evidence, except that funded by the tobacco industry, points in the same direction. It's intuitive. Billboards increase tobacco advertising. The package is a type of advertising. It increases consumption. It increases the impact of health warnings, the reviews that have been done, and supported by the World Health Organization, on and on.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

My next question can go to anyone who's knowledgeable.

I've heard that when it comes to vaping, and the flavours that are used in vaping, there's a specific concern about an additive called diacetyl that causes popcorn lung. It's a very serious respiratory condition, but I see a lot of myths on the web, and whether it's true or not true...

Can you give us any information that you have about that condition?

[Dr. Gaston Ostiguy]

Yes, there was a case report. First of all, I would like to say the electronic cigarette has been available in Europe for the last 10 years. If there were any harmful results or effects on the lungs, it would appear in our scientific literature.

If you look back at this report, of course popcorn lung did happen in the industry manufacturing popcorn. We haven't seen much popcorn lung in the cinemas, although they're exposed to diacetyl.

If you look at this report, it's a very bad report. I don't understand why the editor accepted to publish the thing because they start by talking about hypersensitivity pneumonitis, like farmer's lung, for example, and then they conclude that it is a bronchiolitis obliterans. It's illogical. They didn't have a lung biopsy to document the case. We have to be extremely careful about these sorts of reports, which are very alarming.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Right. So you think it's really not substantiated at this point?

[Dr. Gaston Ostiguy]

No, not at all.

On the other hand, with the use of electronic cigarettes we've seen that it's easier to control high blood pressure, you reduce the readmission or the exacerbation of COPD, and asthmatic patients have better control. It's been in use for the last 10 years. For these short-term ill effects of the electronic cigarette, it would appear in the literature....

Now for the carcinogenic effects of electronic cigarettes, the concentrations are far lower than in the tobacco cigarettes. We still face the use of carcinogenic substances. We haven't stopped taking X-rays. We haven't stopped all the silica mines because it can cause silicosis.

It's a matter of the dose-response relationship. It is very often forgotten that when you're talking about a risk you have to consider the dose-response relationship.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Very good.

My last question is for Ms. James. We're talking about the harm reduction we see with the e-cigarettes. I know you mentioned that Health Canada can put that in their regulations, but do you think we should have that in Bill S-5 so there is a well-thought-out message that would be standard for everyone's use?

[Lesley James]

Are you asking if Bill S-5 should contain details around putting a message right on the tobacco product itself?

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

I'm asking about vaping products. What should we allow in terms of their ability to claim harm reduction?

[Lesley James]

The claims around harm reduction should be stipulated by Health Canada. We should not be allowing industry to decide what claims are made. Health Canada is the one to evaluate the evidence and make the messaging that is appropriate for Canadians to interpret.

[The Chair, Liberal, Bill Casey]

Thank you.

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

I have questions for all of you, but I want to have a quick yes or no from each of you.

Mr. Oliver certainly articulated my view on this. He said that we want to do everything we can to prevent young people and non-smokers starting to consume nicotine.

Does this legislation do that? Is it doing everything we can?

[Neil Collishaw]

No. It does not, but it should.

[Rob Cunningham]

It does in part. It can do more.

[Lesley James]

It needs improvement.

[Dr. Gaston Ostiguy]

No.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Mr. Collishaw, I want to come back to you. You talked about key changes you would like to see in the legislation. You mentioned expanding the purpose of the bill, expanding the scope of the act. You said you thought we should be imposing new requirements on the tobacco industry.

Can you please expand on what you would like to see in terms of new requirements on the tobacco industry that are not in the bill?

[Neil Collishaw]

With this bill we're going to legalize a new product, and give the opportunity to tobacco companies to sell some other form of nicotine addiction to people, and they are going to claim it's less hazardous. Dr. Ostiguy has presented some evidence that supports that view.

If that's so, we think steps should be taken to oblige the tobacco industry, at the same time as they are bringing in a new product, to reduce the supply and demand for the very hazardous products, combustible cigarettes, that they're already selling. This comes back to what I said: let's move from a slogan to a plan on less than 5 by 35. If we're going to have less than 5% by 2035, let's have a plan with milestones to be reached, targets to be reached, corrections to be made if they are not, so we do in fact achieve this noble goal that the government has set.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Mr. Cunningham, I have a quick question on vaping and on the plain packaging. On the vaping side, you said the government said that vaping should be limited to brand preference only, but the legislation doesn't reflect this.

Why would that be?

[Rob Cunningham]

Perhaps it's just an oversight in drafting. They have made that statement publicly in what they said related to the bill and regulations under the bill. That's part of the review of committees, so that's an opportunity for us to have an amendment.

[Don Davies, NDP, Vancouver Kingsway, BC]

Okay.

We've heard a lot of testimony on this so I don't want to belabour it. If Bill S-5 currently allows lifestyle advertising in bars targeting young non-smokers of the benefits of vaping with things like allowing draws and contests, winning beach vacations, access to invitation-only parties, tickets to concerts or sporting events, if that's allowed that strikes me—I'm no marketing expert—as something that's probably going to cause a lot of non-smokers and young people to start using nicotine. That sounds to me like more of a drafting oversight.

[Rob Cunningham]

We think it's an important deficiency and it can be remedied through an amendment to ban all lifestyle advertising, period.

[Don Davies, NDP, Vancouver Kingsway, BC]

Do all of you agree with that?