Mr. Speaker, I am pleased to follow my hon. colleague in speaking to Bill C-32, as I believe it is vitally important to curb tobacco use among children.
Most smokers begin smoking in childhood or early adolescence. Ninety per cent smoke before the age of 18. Early starters are more likely to become addicted daily smokers. Partly because the tobacco industry targets adolescence, 82,000 to 99,000 young people start smoking every day.
Tobacco smoke contains over 4,000 chemicals, 60 of them known or suspected carcinogens, such as arsenic, DDT and methanol. Cigarette smoke is directly linked to an increased risk of many diseases, including cancer, heart disease and even sexual impotence. In fact, 30% of all cancer deaths can be attributed to smoking. Cancers other than lung cancer that are limited to smoking include bladder, cervical, kidney, liver, pancreatic and stomach cancer.
Even light smokers risk their health. For example, a 2005 British Medical Journal study showed that smoking only one to four cigarettes per day was associated with a significantly higher risk of dying from heart disease. According to the World Health Organization, smoking accounts for one in ten deaths worldwide. As a result, Gro Harlem Brundtland, former director general of the organization, repeatedly and angrily spoke out against the tobacco epidemic, “Civilized nations protect their people under 18—they do not let them play around with a product which statistically kills one out of two of its permanent users”.
The Standing Committee on Health did work collegially and heard testimony from anti-smoking groups to small business owners to the tobacco industry. Much of the questioning focused on contraband tobacco, smokeless products and menthol flavouring and whether more work needed to be done in these areas.
We have a crisis in Canada, namely contraband tobacco, which lacks government control, inspection, taxation, is cheap and is easily bought by youth. Research tells us that the price of cigarettes is an important factor in determining whether young people begin to smoke, whether current smokers continue and how much they smoke. We know low cost contraband cigarettes are particularly attractive to vulnerable populations such as young people. Lab analysis of contraband shows that dead flies, insect eggs, mould and even human feces have appeared in contraband cigarettes.
Our children are smoking contraband cigarettes in disturbing numbers, 25% of youth in Ontario and 32% of youth in Quebec. Dave Bryans, president of the National Coalition Against Contraband Tobacco, reports:
We've got the wild west of illegal tobacco manufacturing and distribution right under our noses and most Canadians don't know it's happening.
The reality is that trade in cigarettes undermines prevention and smoking cessation strategies.
In a 2009 example from Hamilton, Hamilton's public health department and the Canadian Cancer Society blame the jump on easy access to contraband and tax-free cigarettes that sell for a fraction of the regular price. Smoking increased by a third in one year. Public Health estimates that contraband cigarettes cost $8 to $15 compared with the usual $55 to $80.
A last point regarding contraband tobacco is that while it may rob government of enormous tax revenue, at least $1.6 billion each year, it is statistically likely to kill one in two of the youth it sucks in.
While contraband is growing in popularity among youth, so too is smokeless tobacco, better known as chew, snuff or spit tobacco. Spitless tobacco is a cleaner, friendlier version of chewing tobacco, developed in an effort to convince more smokers to consider using smokeless products in places where smoking is prohibited.
Regardless of the name or form, smokeless tobacco causes serious health problems. Chewing tobacco hooks users on nicotine, similar to the way cigarettes do, and makes it difficult to stop using chewing tobacco. Over time, users develop a tolerance for nicotine and need more tobacco to feel the desired effects of the drug. Some switch to brands with higher nicotine content or use tobacco more frequently and longer.
Severely addicted users may leave the chew in their mouths overnight and swallow the tobacco juices. Smokeless tobacco causes gum disease to tooth decay because it contains high amounts of sugar as well as coarse particles that can scratch away tooth enamel, making teeth more vulnerable to cavities.
More seriously, smokeless tobacco increases blood pressure and heart rate, and may increase the risk of heart attack. Smokeless products also increase the risk of developing small white precancerous patches inside the mouth where the chew is most often placed or worse, oral cancer, including those of the cheek, gums, lip, mouth, throat and tongue. Surgery to remove cancer from any of these areas can leave the chin, face, jaw or neck disfigured.
Smokeless is not harmless. Joe Garagiola, a former spit tobacco user, played major league baseball and later worked in broadcasting. He reported:
I chewed tobacco because it seemed to be the thing to do if you were playing baseball. Everybody chewed when I was playing, and nobody knew the dangers of it.
He has since become a crusader against smokeless products because he lost three close friends to oral cancer. He said:
You won't die of gum disease or yellow teeth, but develop oral cancer and it's a terrible way to go. Here you are with oral cancer from using spit tobacco, your jaw has been removed and you have to eat through a tube. You die one piece at a time. Spit tobacco is a horrible, horrible thing. I just wish I could get this message across to everyone.
Today, more than 600 additives including caramel, cocoa, coffee extract, vanilla and menthol can legally be added to tobacco products.
Many appear to be present simply to add flavour, but some may have more sinister effects. For example, cocoa when burned in a cigarette produces bromine gas that dilates the airways of the lung and increases the body's ability to absorb nicotine.
Researchers at the Harvard School of Public Health explored tobacco industry manipulation of menthol levels in specific brands and found a deliberate strategy to recruit and addict young smokers by adjusting menthol to create a milder experience for the first time user. Menthol masks the harshness and irritation of cigarettes allowing delivery of an effective dose of nicotine. These milder products were then marketed to the youngest potential consumers.
Howard Koh, professor and associate dean for public health practice said, “For decades, the tobacco industry has carefully manipulated menthol content not only to lure youth but also to lock in lifelong adult customers”.
We know that younger smokers use menthol at higher levels. About 44% of current smokers, age 12 to 17, have tried menthol. That compares to 31% with older smokers.
To be fair, a spokesperson for Philip Morris said:
We disagree with the author's conclusion that menthol levels in our products were manipulated to gain market share among adolescents...The company's various brands, including our menthol brands, are designed to meet the diverse taste preferences of adults who smoke. We believe kids should not use tobacco and our marketing methods are designed to minimise reach to unintended audiences--
Regardless, there are significant knowledge gaps regarding menthol: the role of menthol in tobacco reinforcement and addiction; the relationship between menthol cigarettes and cancer of various sites; the effect of menthol cigarettes on cardiovascular disease; and the association between use of menthol and illicit drugs.
Importantly, this year there will be a second scientific conference on menthol cigarettes.
In closing, Bill CC-32 is important and necessary. I am encouraged that it is receiving strong support from anti-smoking and health groups. Rob Cunningham, senior policy analyst at the Canadian Cancer Society, said, “We're hopeful that MPs will adopt this bill quickly. It's a very important gain for us”.
Going forward, however, we have to close the loop on contraband tobacco. This may mean looking at the Criminal Code as 49% of cigarettes smoked in Canada are contraband. We also need to look at smokeless tobacco and menthol cigarettes.