Health Committee on Feb. 28th, 2018

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

Correct.

[The Chair, Liberal, Bill Casey]

Mr. Ayoub.

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

Even if the words “heat sticks” were removed, an unnecessary exemption would be created in the bill, because it is not prohibited anyway. The focus would be on vaping and on heat sticks. I'm not sure that we should agree to this amendment, despite the amendment that Ms. Gladu introduced. I don't see what it will add.

[The Chair, Liberal, Bill Casey]

All right, Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Well, again, maybe I'll ask a question to our ministerial staff.

I think the sentiment of this motion is good. If I take it at face value, I think it is basically trying to make clear that a physician—someone entitled to practise medicine, anyway, by the laws of the province—who is directing a patient using a tobacco product should be able to inform that patient of the lesser health hazards and health effects of vaping products.

My question then, following up from Mr. Ayoub's comments, is this. Is there anything in the bill that prohibits a physician now from talking to patients about the health benefits of vaping products?

[James Van Loon]

I am happy to be able to clarify, or I hope I'll be able to clarify.

In the existing Tobacco Act, or paragraph 18...whatever...section 18 is the start of the promotion section. It starts to say what sorts of promotions are not permitted. The second item there, 18(2), is to what does this section on promotion not apply. It says:

(2) This part does not apply to

(b) a report, commentary or opinion in respect of a tobacco product or a brand of tobacco product if no consideration is given by a manufacturer or retailer, directly or indirectly, for the reference to the tobacco product or brand...

If a doctor wants to tell a patient, “I think, in my medical opinion, these are better for you”, that is not a promotion. It is not covered by the Tobacco Act even today. We don't need an amendment to make that safe.

We do have the same language for vaping, by the way.

[The Chair, Liberal, Bill Casey]

Ms. Finley.

[Diane Finley, Conservative, Haldimand—Norfolk, ON]

My question is to Mr. Van Loon. Under the amendments to this act that we're reviewing now, as I understand it, there would be no advertising to the doctor to advise him or her of these benefits. If they're not aware of them, if nobody's promoted and advertised to them, even through educational promotion, how would they know to be able to do that?

[James Van Loon]

This whole section is all about promotion of tobacco products and it's not about scientific research on tobacco products. Nothing will stop people from doing research on the relative risks, if that's their interest, for tobacco products, publishing the results of that research, or discussing it in professional communities, as long as they're not endorsing particular products for money.

[The Chair, Liberal, Bill Casey]

Go ahead, Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Further to that, I won't say that there is not advertising of medications to physicians, but the vast majority of medications that physicians prescribe have not been advertised to them. It's standard medical practice to review the medical literature and make your decision based on that, not because of advertising. A very, very small proportion of the drugs that I ever prescribed in 20 years of practice were made available to me from advertising.

[The Chair, Liberal, Bill Casey]

Ms. Gladu.

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

I guess what I had in mind when this was drafted was that when products became available, there would be some kind of brochure that would come to the GP's office that he could pass on to folks who would benefit from that. I would see that as being promotion.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

Unless I'm missing something, what the words say are clearly not about promotion of vaping products from a manufacturer to a doctor. It says:

(d) a promotion by a person who is entitled to practise medicine by the laws of a province that is directed at a patient using a tobacco product....

If I read this correctly, this amendment has nothing whatsoever to do with affecting any kind of promotion from a manufacturer of a vaping or tobacco product to a doctor. This is purely about a doctor informing a patient.

Since we've already heard that there would be nothing in this act that would prohibit a doctor from discussing the health benefits of harm reduction tool like a vaping product, I just don't think it's necessary.

[The Chair, Liberal, Bill Casey]

All right, I'm going to call for a vote on the subamendment by Ms. Gladu, and the subamendment is to remove the three words “and heat sticks” in paragraph (d).

(Subamendment agreed to [See Minutes of Proceedings])

[The Chair, Liberal, Bill Casey]

Now we will vote on CPC-5.

(Amendment as amended negatived [See Minutes of Proceedings])

(Clause 23 agreed to)

(Clauses 24 to 26 inclusive agreed to)

(On clause 27)

On clause 27 we have CPC-6.

[Diane Finley, Conservative, Haldimand—Norfolk, ON]

This is to ensure the minister has flexibility in the future to identify and respond to changing market circumstances, whether that be products that are available or distribution sources.

Years ago, we didn't have such a thing as nurse practitioners, and there are many different health service infrastructures that didn't exist 10 to 20 years ago. This is intended to ensure this legislation has the flexibility to survive the changes—both structural and market—in the next lengthy period of time.

[The Chair, Liberal, Bill Casey]

Mr. McKinnon.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

I find this amendment troublesome. It will allow tobacco manufacturers to market products as less harmful than other tobacco products.

We've seen this throughout the course of time with the selling of tobacco products. You bring forward a new product with a filter on it and use it to market to a new demographic, or you bring forward a smaller, slimmer version and use it to market to young women. You're always marketing it on the basis of how it's safer, how it's smaller and there's less tobacco.... I think this is akin to asking a smaller hungry wolf to guard the henhouse. I think it's a dangerous thing to support. I will oppose it.

[The Chair, Liberal, Bill Casey]

Ms. Finley.

[Diane Finley, Conservative, Haldimand—Norfolk, ON]

Perhaps I wasn't clear. This would give the minister the discretion to set regulations in that regard, not the manufacturers. It will impose regulatory flexibility: rather than coming back and trying to alter the law, it puts the implementation in the hands of regulations to provide flexibility.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Is it going allow her or whoever the minister might be to allow tobacco manufacturers to do this kind of promotion? I don't see that. I wonder if our officials could give us an opinion on this. Does the existing law allow the minister to authorize the promotion of products as less harmful than others?

[James Van Loon]

As Bill S-5 is currently drafted, it would not allow that.

[Ron McKinnon, Liberal, Coquitlam—Port Coquitlam, BC]

Thank you.