Evidence of meeting #139 for Health in the 44th Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was nicotine.
A recording is available from Parliament.
Bloc
Luc Thériault Bloc Montcalm, QC
Okay.
We know that nicotine is highly addictive and that tobacco replacement products, which are available to young people, are as addictive as smoking tobacco, if not more so. Would you consider the bill acceptable if these products were removed from it?
Co-Director and Spokesperson, Coalition québécoise pour le contrôle du tabac
I want to make sure I understand. Are you talking about excluding nicotine products from the scope of Bill C‑368 ?
Bloc
Luc Thériault Bloc Montcalm, QC
Yes, exactly.
Nicotine products would fall under Vanessa's Law again. That way, they could be regulated, as was proposed in the ministerial order.
Co-Director and Spokesperson, Coalition québécoise pour le contrôle du tabac
As long as the measures remain in the ministerial order, that's fine. That's what we're trying to protect.
Bloc
Luc Thériault Bloc Montcalm, QC
Okay.
I personally appreciate hearing your points of view, ladies. They are important. Earlier, we talked about the fact that we need to have a serious discussion about a $13‑billion industry. The global tobacco industry was worth $694 billion in 2021, but that did not stop us from introducing regulations and controls for the industry. It took a lot of energy and a lot of litigation to get there.
When it comes to natural health products in the broadest sense of the term, it became clear that the industry itself did not want to side with the bad actors. It wanted to protect its reputation.
With that in mind, we could make two other amendments, which would give the minister the authority to recall and ensure that the fines were appropriate, as permitted by the natural health products regulations. The legislative context is completely different from that of pharmaceutical products. As it happens, natural health product companies are not multinationals with 20-year patents whose products are not taxed. We're not talking about the same industry. However, we have to make sure that these products are safe for the public.
In short, the minister would have the authority to recall; there would be appropriate fines based on the legislative framework that we are trying to define; and the industry would be more strictly regulated, not harmed.
In fact, the reason we are here—and no one has said this—is that Health Canada didn't do its work until 2018.
The industry is already regulated. There are already voluntary recalls. The minister will be given the authority to recall, but that authority does not relieve Health Canada of its obligation to carry out the necessary inspections and checks, which the industry was not subject to for a long time. There should be no confusing those things or thinking that bringing in a law necessarily means we're protecting the public.
Health Canada has a duty to educate. It will be the duty of Health Canada to talk about the interactions between natural health products and pharmaceutical products, as well as between pharmaceutical products themselves.
Ladies, your comments are relevant. We heard you, and we are going to propose amendments to Bill C‑368 to lessen the adverse consequences and respect everyone's interests including those of consumers. They must have easy access to products and be assured of their safety when they buy them.
Liberal
The Chair Liberal Sean Casey
Thank you, Mr. Thériault.
Mr. Julian, you have the floor for six minutes.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
Thank you, Mr. Chair.
Thank you to our witnesses.
We passed this bill in the House, and then it was sent to the committee. Our committee's intention is always to improve bills. There are probably some gaps in the natural health products bill. We know very well that it is essential for these products to be accessible and for the industry to continue to prosper. All of these things are important, but we have to look at the gaps.
You all mentioned problems, especially with nicotine products. That needs to be taken into consideration, as Mr. Thériault said. He raised the fact that we were considering making amendments to improve the bill.
Ms. Doucas, I would like to come back to two points you raised in your remarks. Thank you, by the way, for being here today.
You mentioned the approval of Zonnic in July 2023. Could you tell me if there was any consultation before the product was approved?
You also mentioned that the tobacco industry often says that nicotine is not problematic. Could you briefly talk about all the negative health effects of nicotine?
Co-Director and Spokesperson, Coalition québécoise pour le contrôle du tabac
Thank you for your question.
As my colleague said, the Health Canada approval process essentially takes place behind closed doors. No group is consulted. Companies don't want competition and don't want anything divulged to competitors. The process is based on clinical data, not public health. Nicotine raises public health issues that go beyond the clinical aspect.
We see it in the case of vaping products. It's not about demonizing nicotine products. The important thing is to know who the product is for and how it is promoted in order to avoid unintended consequences.
Very few studies have been done on nicotine pouches. The product is relatively new in Canada and other markets. Before it got to Canada, it had been around in the United States for a few years. The fact remains that there isn't an abundance of research on the product because it's relatively new.
The effects of nicotine pose many risks. It has long been hard to distinguish the effects of smoking tobacco from those caused by nicotine alone. Now, with the new product varieties, the studies are starting to draw clearer conclusions.
I know that people from the Heart and Stroke Foundation of Canada appeared before the committee. It is clear that nicotine increases the risk of cardiovascular disease. It also affects all precursors, including cholesterol. There are also emerging concerns about the damage nicotine causes to organs such as the liver. The science is evolving.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
Thank you.
Ms. Hoffman and Ms. Hyland, I am looking through the figures. As we look to improve the bill, we want to ensure that natural health products continue to do the good work they do across the country. We have an industry that is virtually 100% compliant. I'm just looking at your figures and the figures that were presented by the Minister of Health when he came before this committee. They are very similar. The government talked about 350 voluntary recalls. You talked about 400 incidents in 2019. I believe the definition you're using is a little looser.
The Minister of Health talked about the fact that in virtually every one of those voluntary recalls, except three cases, there was compliance by the companies. In those three cases where the companies were non-compliant, those companies no longer exist.
What do you think of the argument that has been put to us, which I find very valid, that a wide variety of tools can be used now by the government to ensure that companies are compliant and that they conform with voluntary recalls when there is risk?
Chief Executive Officer, Institute for Safe Medication Practices Canada
It's important to clarify initially that, clearly, the data the minister presented is separate from the data that I just presented. There will be some interrelationships, but those are two different data streams.
In terms of the discussion about any changes and possibly any detail around the three cases that the minister spoke to, we're not in a position to speak to those details. We are not privy to the specific details around those cases.
I'll just check with my colleague on whether or not she has anything else to add.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
I want to get clarity on the question again.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
Oh, yes—it's on what we think about the tools and authorities that Health Canada has now.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
Yes. It's about what the government has now.
The Minister of Health, I believe, admitted that of 350 voluntary recalls, only three companies were non-compliant.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
Right now, I think Health Canada is positioned to have authorities and tools through Vanessa's Law. They've designed it carefully and made a decision that it works well, that it's very good and that NHPs should fall under it. By doing that, Health Canada could compel a label change to add a warning to inform the consumer. Health Canada could—with consultation, as they always do—develop regulations for the reporting of serious adverse reactions by hospitals.
Those are the things that they have now and that this bill will remove.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
I think we're talking at cross-purposes. These are voluntary recalls.
NDP
Peter Julian NDP New Westminster—Burnaby, BC
The legislation was not needed in almost all of these cases.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
The legislation is needed when a voluntary recall doesn't work.
Liberal
The Chair Liberal Sean Casey
Thank you. That's your time.
Mrs. Goodridge, go ahead for five minutes.
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
Thank you, Mr. Chair.
I'd like to thank all our witnesses for being here.
Ms. Hoffman, I want to follow up a bit. You used the number 700, and then, when my colleague was asking questions in regard to allowing us to see this documentation, you skirted around the issue, saying that you couldn't give us an exact list. Well, the number 700 clearly comes from somewhere.
I understand privacy. Each and every one of us is bound by freedom of information in our offices and is used to dealing with sensitive information on a regular basis. Parliamentary privilege does give us some immunity and space to actually ask witnesses to provide us with this information. Depending on the sensitivity of the information that is given to us, there are a variety of checks and balances that go into determining how that information can be used. If you're coming here and giving us a specific number, 700, and we ask you for that number, we expect you to show your work.
Are you telling us that you can't show your work?
Chief Executive Officer, Institute for Safe Medication Practices Canada
Thank you for the opportunity. We can definitely show our work.
I'd like our privacy officer to speak to what we can provide.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
There's nuance here. Can we show our work? Yes. Can we table a report to this committee? With pleasure. Will it be, as was originally suggested, each and every report copy just handed over? No. It will—
Conservative
Laila Goodridge Conservative Fort McMurray—Cold Lake, AB
No, no. At no point did we say, “Hand over every single document from everything.” Frankly, we have a pretty busy course load and a pretty large amount of stuff. We want to see the list of 700 so we can determine whether these are people reading a label wrong or actually getting hurt. A number of 700, in a country as large as Canada.... We need to see how severe these are.
Vice-President, Operations and Privacy Officer, Institute for Safe Medication Practices Canada
Thank you for that. We heard something different.
A list is possible in terms of de-identified information, which product is involved and what information we might have on how those instances—