From Tobacco Info No. 6 - July 2011
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Strengthening provincial smoking strategies
Ontario takes steps to improve Smoke-Free initiative
By Joe Strizzi
The government of Ontario has taken new steps to help more people quit smoking, ensure that young people don’t get addicted and eliminate illicit tobacco.
Building on the progress achieved by its Smoke-Free Ontario Strategy, the government will work with educators and young people to keep schools free of smoke and help develop strategies focusing on prevention by introducing Bill 186: An Act to Amend the Tobacco Tax Act, 2011, now in its second reading.
Ontario has also introduced legislation to interrupt the supply of illegal tobacco, focusing on tougher controls over raw leaf products, new fines for possession and stronger seizure powers for police.
“I am pleased that several ministries and stakeholders are engaged in this issue and that the government is increasing its investment in the continued fight against tobacco in Ontario,” said Dr. Arlene King, Ontario’s Chief Medical Officer of Health. “The facts about tobacco use are beyond dispute. It is an epidemic that kills, sickens and burdens health care systems and costs us all money. We cannot win a war we don’t invest in and, like other public health issues, tobacco control is everyone’s business.”
However, many tobacco control specialists argue that these initiatives are just a starting point.
“These are the first steps in the renewal of the Smoke-Free Ontario Strategy,” said Michael Chaiton, Assistant Professor, University of Toronto and scientist at the Ontario Tobacco Research Unit. “As the province says, ‘the Ontario government is renewing and strengthening its commitment to a Smoke-Free Ontario by addressing the recommendations in the October 2010 report of the Tobacco Strategy Advisory Group.’ However, the TSAG report calls for more comprehensive tobacco control measures and this act only addresses the surface so far.”
Preventing youth smoking
The government will provide resources to increase prevention efforts focused on protecting youth, engage young people to develop youth-led tobacco prevention initiatives and conduct research to determine what most impacts decisions by youth to take up smoking and to quit.
Helping people quit smoking
As a second approach to its latest investment in tobacco control, Ontario will help people quit by providing targeted support for smokers with chronic diseases in hospital settings. The province will also provide increased access to nicotine replacement therapies and education in primary care settings, such as family health teams. In addition, it will engage with pharmacists regarding their role in cessation support services; provide support to people ready to quit smoking by enhancing quit lines and online resources; and work with trade associations, employers and unions to provide information and support to employees who wish to quit smoking.
Addressing illegal tobacco
The Ontario government is also set to adopt legislation entitled Supporting Smoke-Free Ontario by Reducing Contraband Act 2011 to further deal with contraband. Quebec has implemented similar measures in recent years.
The proposed legislation would increase control over tobacco supply by expanding licensing of tobacco growers to include all types of raw leaf tobacco grown or imported into Ontario; allow police officers to seize from individuals illegal tobacco products found in plain view; establish new fine levels for individuals caught possessing small amounts of illegal tobacco; create a new marking scheme for fine-cut tobacco to make it easier for police and the Ministry of Revenue’s inspectors and investigators to identify illegal tobacco products; and enable the Minister of Revenue to enter into agreement with First Nations regarding the Tobacco Tax Act on reserves.
The Ministry of Revenue investigators and inspectors seized 150 million illegal cigarettes, 978,000 untaxed cigars and 47 million grams of fine cut tobacco between April 1, 2008, and March 31, 2011. Since 1996, over $18.7 million in penalties were assessed against those violating the Act.
New charges range from $500 to $15,000 or more, with the possibility of serving two-year prison terms.
“Illegal tobacco is a complicated issue, it is an issue that is multi-ministerial, multi-jurisdictional,” said Revenue Minister Sophia Aggelonitis. “We’re working with all our partners and it’s important for us to take this first step.”
Michael Perley of the Ontario Campaign for Action on Tobacco said the fines are a step forward in deterring individuals who wish to buy illegal smokes.
“By buying a $15 bag of cigarettes, you wind up paying $175 for it. That’s a lesson that somebody won’t soon forget. The contraband legislation puts important restrictions in place, particularly on the supply of raw materials,” he said, adding that he thinks the fine won’t outright solve the problem.
Critics say that although these proposed changes are a step in the right direction, the province needs to focus on illegal manufacturers to really curb smuggling.
BC, Nova Scotia and Saskatchewan announce improvements to tobacco strategies
Nicotine replacement therapies will be available to all British Columbian smokers at no cost and smoking cessation prescription drugs will be covered under PharmaCare, Premier Christy Clark announced in early May.
“This program will provide smokers with a new level of direct support to quit, to live smoke-free and to improve their own health as well as the health of their families,” said Clark.
Starting on September 30, 2011, British Columbians will have the choice of either nicotine gum or patches to help quit tobacco with a free supply for up to 12 weeks. Alternatively, they may obtain coverage of prescribed smoking cessation drugs through PharmaCare. The program will cost an estimated $15 million to $25 million per year, based on the number of individuals who use the program.
Over the coming months, the Ministry of Health will work with groups such as the BC Lung Association, the Heart & Stroke Foundation of BC and Yukon, the Canadian Cancer Society, BC and Yukon Division, BC Pharmacy Association, pharmaceutical manufacturers, health authorities and the BC Medical Association to find the best way to implement the program, including how to distribute nicotine gum and patches.
The Nova Scotia Department of Health and Wellness announced improvements to its smoking strategy in April with 57 actions comprising five strategic directions: integration and building collective responsibility; capacity and community action; surveillance, research and evaluation; healthy public policy; and public awareness and social marketing.
Health Minister Maureen MacDonald said the province wants to reduce smoking rates among 20 to 24 year olds from 29% to 20% by 2015-16. Within the same time period, Nova Scotia also wants to reduce smoking among teenagers from 15% to 10%.
“It is troubling to hear that one out of five tobacco vendors is still selling to minors,” MacDonald told reporters. “This is unacceptable.”
Health officials said they also plan to continue efforts to reduce the overall smoking rate, which was 20% in 2008 and was above the national average of 18%.
“It is still the leading preventable cause of illness and death in Nova Scotia,” said Dr. Robert Strang, the province’s Chief Public Health Officer. “How many of us know that more than 1,700 people in our province die each year because of tobacco use?”
Despite the tobacco control strategy’s goals, MacDonald said there is no new funding slated for the program, which has a budget of $3.6 million a year.
Strang also called for stronger enforcement to ensure stores do not sell cigarettes to minors. “Improving our compliance rate will mean making sure that when a tobacco vendor is caught selling to minors, they will face immediate repercussions, such as suspension of their license to sell tobacco,” he said.
The Chief Public Health Officer said the tobacco control strategy will explore taking on the tobacco industry. “Continuing to work with other provinces around potentially suing for the recovery of health-care costs is a multi-jurisdictional effort and discussion that’s been going on for a number of years,” said Strang.
In Saskatchewan, the Ministry of Health has been working in collaboration with stakeholders to advance the goals of Building a Healthier Saskatchewan — a strategy to reduce tobacco use including cessation, prevention and protection.
Key accomplishments of the past year include legislation prohibiting smoking in vehicles with children under the age of 16, around doorways, windows and air intakes of public buildings and on school grounds. Significant effort has been made to support cessation with training provided to professionals from a variety of disciplines to assist people with their efforts to quit using tobacco. Later this year, a series of web-based tobacco related resources for use by school and community educators will be released.