Government inaction on tobacco is costing lives

Monday, January 19, 2004

OTTAWA -  A coalition of  health groups, formed to battle the tobacco epidemic in Canada, today called on Minister of Health Pierre Pettigrew and Minister of State (Public Health) Carolyn Bennett to address 10 urgent items in the tobacco control file which have been simmering on the back burner for some time now.

“To move forward in the battle to reduce tobacco use, we must first attend to some pressing issues, many of them long-standing,” says Lorraine Fry, chair of the Canadian Coalition for Action on Tobacco. “If properly acted upon, these 10 measures will reduce the burden of the tobacco epidemic.”

The demand for action comes at the start of National Non-Smoking Week, and on the heels of an alarming Health Canada report which found tobacco killed more than 47,000 Canadians in 1998 – accounting for almost one in every four deaths.

The coalition is urging the government to restore funding to its Tobacco Control Programme, adopt promotion regulations, and prohibit misleading cigarette descriptors such as 'light' and 'mild'.

In April 2001, to much applause, the Health Minister and the Finance Minister (then Paul Martin) jointly announced a five-year, $480 million Federal Tobacco Control Strategy. This Strategy funds critically important mass media campaigns, education and cessation programs, research, and other initiatives. So far, the government has unjustifiably slashed $26 million in funding from the programme and it intents to chop a further $26 million in the next two years. This diversion of funds must stop.

Power walls in retail outlets are perhaps the most important promotional tool available to the tobacco industry to sell its products, especially to kids. Cigarettes are legitimized by their placement near candies and bubble gum. The Government promised in 1999 to deal with this problem and other aspects of tobacco promotion by way of regulation. Since then, this critical health reform has gone nowhere.

'Light' and 'mild' cigarettes are deceptive to consumers and have led to thousands of deaths in Canada. In 2001, the Health Minister announced the government would regulate an end to the deception. As a first step the federal government’s Notice of Intent to Regulate was published. Since that time, this health initiative has stalled.

In addition, the coalition is asking the government to increase cigarette taxes and close the tax loophole on roll-your-own tobacco, actively enforce the Tobacco Act, take action on fire-safe cigarettes, implement tobacco industry denormalization campaigns, mandate plain packaging, reaffirm provincial ability to control tobacco advertising and promotion, and ratify the WHO Framework Convention of Tobacco Control.

“Quick ratification and subsequent implementation of the WHO Framework Convention of Tobacco Control will reaffirm Canada’s position as a world leader in global tobacco control,” said Neil Collishaw, research director of Physicians for a Smoke-Free Canada.

The list of 10 pressing reforms have been included in an open letter to both Minister of Health Pierre Pettigrew and Minister of State (Public Health) Carolyn Bennett, as well as to all of Canada's MPs.

“Members of our coalition look forward to working in partnership with the Prime Minister's new team to achieve public health goals in tobacco control,” says Ken Kyle, director of public issues, Canadian Cancer Society. “The letter to Mr. Pettigrew and Dr. Bennett is intended to make them aware of the current shortfalls in the tobacco control file, and it is also intended to serve as notice to everyone that we're here to help.”

“At the same time,” adds Fry, “we refuse to wait for action in silence. The impact on public health as a result of the tobacco epidemic dictates a sense of urgency. There is a compelling need for timely and consistent action on tobacco control. In this portfolio, delays can lead directly to increased disease and death. We urge the government to take immediate steps to implement the 10 measures we've called for today. ” 

^{For more information contact:
Lorraine Fry, chair, Canadian Coalition for Action on Tobacco, 416-928-2900
Francis Thompson, policy analyst, the Non-Smokers' Rights Association, 613-230-4211
Neil Collishaw, research director, Physicians for a Smoke-Free Canada, 613-233-4878
Ken Kyle, director of public issues, Canadian Cancer Society, 613-565-2522 ext. 301}

***Open letter***

Monday, January 19, 2004

The Honourable Pierre S. Pettigrew
Minister of Health
House of Commons
Ottawa, Ontario  K1A 0A6

The Honourable Carolyn Bennett
Minister of State (Public Health)
House of Commons
Ottawa, Ontario  K1A 0A6

Dear Ministers:

Congratulations on your recent appointment. The public health community looks forward to working with you and other ministers on tobacco control.

Prime Minister Paul Martin has promised to rally Canadians around a new sense of national purpose and an agenda of change. Given that tobacco use is Canada's number one cause of preventable death, any agenda of change must give priority to curbing the tobacco epidemic.

The government has taken some important steps in tobacco control, such as establishing landmark health warmings, taking a leadership role on the WHO Framework Convention for Tobacco Control, and allocating more resources to its Tobacco Control Programme.

However, many long-standing issues remain. The needed reforms are key elements of any comprehensive tobacco control program. As a consequence, failure to implement these elements may lead directly to increased death and disease. The following is a list of ten pressing reforms which warrant immediate government action:

• Implement fully the Federal Tobacco Control Strategy – In April 2001, to much applause, the Health Minister and the Finance Minister (the Honourable Paul Martin) jointly announced a five-year, $480 million Federal Tobacco Control Strategy. This Strategy funds critically important mass media campaigns, education and cessation programmes, research, and other initiatives. But the Government unjustifiably slashed $13 million in Year 2, followed by a further $39 million over the next three years of the Strategy. These funds must be restored.

• Adopt promotion regulations – The Government has not adopted any promotion regulations under the Tobacco Act, even though the Act was passed in 1997 and a Health Canada consultation paper was published fully five years ago in January 1999.  Power walls in retail outlets are perhaps the most important promotional tool available to the tobacco industry to sell its products, especially to kids. Cigarettes are legitimized by their placement near candies and bubble gum. The Government should ban these visible displays of tobacco products at retail, require health warnings on all permitted advertising and promotion, ban signage at point of sale and in bars, and take other measures such as curbing indirect advertising  (ie. “brand-stretching”: associating non-tobacco products, such as lighters, with cigarette brand names).  

• Ban deceptive and deadly 'light' and 'mild' labeling of cigarettes – 'Light' and 'mild' cigarettes are deceptive and have led to thousands of deaths in Canada. In 2001, the Health Minister announced the government would regulate an end to this deception. As a first step the federal government’s Notice of Intent to Regulate was published. However, more than two years have passed without further regulatory action.  The European Union, Brazil and Israel have all banned these terms, terms which discourage smokers from quitting.  There Government should do likewise in Canada. 

• Close tobacco tax loopholes and increase taxes – The World Bank and World Health Organization both promote increases in tobacco taxes as a highly effective means of reducing smoking, especially among youth. The federal government has not raised taxes since June 2002. There is also a massive tax loophole on roll-your-own tobacco, which is taxed at only one-third the rate of manufactured cigarettes.  This loophole weakens the incentive for price sensitive people to quit. It provides them with a much cheaper alternative to manufactured cigarettes. The Government must close this loophole. It should also apply a general $5.00 tax increase per carton of manufactured cigarettes, and the equivalent on other tobacco products.

•Ratify the FCTC – To its credit, Canada played a leadership role in negotiating the WHO Framework Convention on Tobacco Control (FCTC). This convention sets minimum international tobacco control standards for countries.  Despite taking the initial step of signing the treaty, Canada has not yet ratified the FCTC.  Ratification should proceed quickly.

• Mandate fire-safe cigarettes – Cigarettes are the leading cause of fire-related deaths in this country and are responsible for millions of dollars in property damage. The Government should adopt regulations to require “fire-safe” cigarettes, cigarettes which are less likely to cause fires. Recent developments set the stage for speedy action: the release of a 2003 Health Canada consultation report on fire-safe cigarettes, the unanimous support on Oct. 31, 2003 by the House of Commons for private member’s Bill C-260 (dealing with fire-safe cigarettes), and the recent adoption of “fire-safe” standards by New York State.

•Implement a tobacco industry denormalization campaign – Tobacco industry denormalization campaigns have proven effective at reducing smoking among teenagers and moving entire populations to support stronger tobacco control laws. Over 80 Canadian health organizations have called on the government to implement these campaigns — a demand echoed by the Health Minister’s own Ministerial Advisory Council on Tobacco Control. In 1999, Health Canada committed itself to supporting industry denormalization by endorsing the National Strategy to Reduce Tobacco Use in Canada, of which denormalization was named one of the four main goals to help achieve a smoke-free society. The government has offered us a few isolated tobacco industry denormalization activities, but a large, sustained campaign is needed.

•Actively enforce the Tobacco Act – The Government must vigorously enforce the Tobacco Act.  Without vigilance, the tobacco industry will continue to test the government's resolve. As a start, the Government should eliminate sponsorship advertising that continues illegally and crack down on other prohibited marketing practices. To date, there has been a reluctance to enforce many sections of the act.

• Reaffirm provincial ability to control tobacco advertising and promotion – The Government should table an amendment to reaffirm that provinces can adopt legislation on tobacco advertising and promotion that is more restrictive than federal law. A surprising decision by a Saskatchewan court in October 2003 suspended Saskatchewan’s precedent-setting ban on retail displays on the stated technical ground of being in conflict with the federal Act. With other provinces wanting to follow Saskatchewan’s lead, a short amendment would immediately clear the way for action, avoiding the delays associated with an appeal.

• Implement plain packaging – In 1994, the House of Commons Standing Committee on Health recommended implementation of plain packaging. This reform would help remove the alluring brand images associated with cigarettes. Yet despite more research confirming plain packaging as a measure effective at reducing smoking, a decade has passed without implementation.  The Government should introduce plain packaging with no further delays.

Tobacco kills more than 47,000 people in Canada each year. It accounts for almost one in four deaths, all of which are preventable. In financial terms, tobacco use costs in excess of $4 billion in health care annually. When non-medical costs such as worker absenteeism, residential fires and lost future income from smokers' premature deaths are factored in, the total annual economic burden of tobacco use upon Canadian society rises to more than $15 billion.

Given the toll, Canadians deserve the implementation of these reforms.

We are requesting a meeting with you as soon as possible to discuss our recommendations and look forward to working with you on these issues.

Sincerely,

Lorraine Fry, Chair
Canadian Coalition for Action on Tobacco

On behalf of: Canadian Cancer Society, Canadian Council for Tobacco Control, Canadian Dental Association, Canadian Medical Association, The Lung Association, Heart and Stroke Foundation of Canada, Non-Smokers' Rights Assocation, Physicians for a Smoke-Free Canada, and Coalition Québécoise Pour Le Contrôle Du Tabac