From Dysfonction érectile - Tobacco Info No. 8 - January 2012
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7^th National Conference on Tobacco or Health held in Toronto last November

Federal Tobacco Control Strategy renewal first priority

By Joe Strizzi

With only a few months left until its expiration date, the renewal of the Federal Tobacco Control Strategy (FTCS) was on the minds of most of the 450 tobacco control professionals from across Canada who congregated at the Marriott in downtown Toronto from November 1 to 3 for the 7^th National Conference on Tobacco or Health (NCTH).

“At a time when renewal of the FTCS is in doubt, this gathering gives health advocates nationwide a chance to send a clear signal that federal leadership is needed if the epidemic is to be controlled,” said Michael Perley, director of the Ontario Campaign for Action on Tobacco. “Given the billions of dollars tobacco use costs Canada every year, this critical preventive health care strategy must not fall victim to a narrow focus on one-dimensional across-the-board budget reductions.”

The 10-year, $480 million national strategy expired on March 31, 2011. It had been extended for one year so that Health Canada could conduct a “review,” but its future is, at best, uncertain.

The primary mission of the FTCS was to reduce tobacco-related death and disease among Canadians. The Federal Tobacco Control Strategy established a framework for a comprehensive, fully integrated and multi-faceted approach to tobacco control. It focuses on four mutually reinforcing components: protection, prevention, cessation and harm reduction, supplemented by effective use of public education campaigns, to reach all Canadians. The federal strategy has seen many successes over the past decade, including smoking bans in public spaces, the public awareness of second-hand smoke and the revamping of larger, visual warnings on cigarette packages, but there still remains quite a bit of work to do.

Dr. Andrew Pipe, chief of the Prevention and Rehabilitation Division, University of Ottawa Heart Institute, emphasized the need to avoid indifference on tobacco control. “We shouldn’t sit around and sing Kumbaya, introspectively holding hands,” he said. “There is still a lot of work to do. Healthy, smoke-free living should become an integral part of our Canadian culture.”

Pipe offered many reasons as to why tobacco should continue to be viewed as an epidemic. The first, he said, was that the cigarette is the best designed drug delivery system ever invented. He added that prevention is key. Tobacco represents a 32% chance of addiction after its first use, the highest of all addictive substances, and he also noted that the Canadian medical system will not be able to sustain itself after 2020 as a result of tobacco-related diseases.

He was obviously not the only one who sees the importance of treating the tobacco issue as an epidemic.

“Despite significant progress over the past two decades, tobacco is still the number one cause of preventable disease and death in Canada, exacting a staggering cost on the economy of some $17 billion a year,” said Lorraine Fry, executive director of the Non-Smokers’ Rights Association. “The burden of disease, the annual death toll and the costs imposed on the health care system, employees and families can be substantially reduced through the renewal and implementation of a comprehensive Federal Tobacco Control Strategy, with adequate and sustained funding.”

Furthermore, with nothing but silence from the Conservative government when it comes to renewing the FTCS, public health professionals from all corners of the country echoed the importance of renewing the national strategy at the NCTH, the largest meeting of professionals working in tobacco control in Canada. Initially held every three years, this conference is now convened every two years. It fulfills the Canadian Council for Tobacco Control’s (CCTC) mandate to create and maintain knowledge networks that connect advocates with like-minded individuals and the information they need. These connections and the resulting newly acquired knowledge inform effective action to improve the health of Canadians and the global community. As such, much of the conversation leaned toward the federal strategy as the best way to take action in Canada.

“We believe that the renewal of the Federal Tobacco Control Strategy is an opportunity to further strengthen tobacco control in Canada,” said Cynthia Callard, executive director of Physicians for a Smoke-Free Canada. “A revised approach that learns from the successes and failures of past decades will help the millions of Canadians who wish to quit smoking, and will protect them and others from tobacco industry attempts to undermine public health measures.”

FTCS and the FCTC

Michael DeRosenroll, past president of Smoke-Free Nova Scotia, went even further, noting during his presentation entitled Framework Convention on Tobacco Control (FCTC): The Canadian Shadow Report, that as part of Canada’s ratification of the FCTC, a treaty adopted by the 56th World Health Assembly on May 21, 2003, Canada was legally obligated to ensure a broad national tobacco control strategy. The treaty, ratified by Canada in November 2004, and which came into force on February 27, 2005, states in article 5.1 that each party shall have a federal tobacco control strategy. It was ratified by 173 countries. (For more on the FCTC, please see page 10).

All international trade treaties are legally binding, but according to DeRosenroll, the FCTC doesn’t have the teeth that other treaties do because there are no legal sanctions if it is not followed, as is the case with all non-trade treaties. “With trade treaties, you could have embargoes or economic sanctions, but the only consequence for Canada in this case might be slight shamefulness of not keeping their word. That’s why it’s important that we speak up and remind the government of their promises.” DeRosenroll added that the federal government has signed numerous international declarations promising further implementation and highlighting the importance of the FCTC, including the Political Declaration at the UN’s General Assembly in New York in September. These promises, he said, must continually be pointed out to the government in order to ensure that they are kept.

Tobacco farming subsidies: a major failure of the FTCS

“On at least 11 occasions in 2008 and 2009, the Government proclaimed to the public and to Parliament that the purpose of the $286 million Tobacco Transition Program (TTP) was to help farmers exit the tobacco growing industry. No other purpose was stated. However, some TTP beneficiaries who were subsidized with public money continued to be involved in tobacco growing.” This was how Neil Collishaw, research director, Physicians for a Smoke-Free Canada (PSC), began his presentation entitled, How the Canadian Taxpayers replaced Big Tobacco as Subsidizers of Tobacco Growing in Canada.

Documents recently obtained by PSC under the Access to Information Act have led Collishaw to claim that Agriculture Canada intended to sustain tobacco farming, in keeping with multinational tobacco interests.

In the agreement between Agriculture Canada and the Ontario Flue-Cured Tobacco Growers’ Marketing Board in 2009, the removal of the quota system and improved viability of remaining and future tobacco producers were also identified as purposes behind the federal buyout. Taxpayers were never clearly informed of this, nor of the 50 million of their hard-earned dollars that would go to TTP recipients who continued to be involved in tobacco growing, some by selling their farms to family members, only to continue to work on the land themselves. The FCTC implicitly states that parties should promote economically viable alternatives for tobacco growers, not provide de facto public subsidies for continued tobacco farming.

More work to be done

“This is a crucial time for tobacco control in Canada,” said Les Hagen, executive director of Alberta’s Action on Smoking & Health. “The federal government has played an essential role in reducing tobacco use in Canada and it must continue to support the Federal Tobacco Control Strategy by renewing its ongoing funding commitment. Tobacco use remains the leading avoidable cause of premature death and the federal government’s contribution should not be subject to political debate.”

“It is essential that Health Canada do everything it can to fight the tobacco epidemic,” argued Rob Cunningham, senior policy analyst with the Canadian Cancer Society. “Sustained action by Health Canada is pivotal, given that tobacco products kill 37,000 Canadians each year and that the national smoking rate of 17% remains unacceptably high. We need to drive smoking rates down as fast as possible, by as much as possible. We need to treat the tobacco epidemic like an epidemic.”

Many of the tobacco control experts and researchers suggested that all those concerned with tobacco control write to their MPs or even Prime Minister Harper’s office, to ensure that the federal government understands the importance of renewing the federal strategy.

Dr. Richard Stanwick, chief medical health officer for the Vancouver Island Health Authority and one of the conference’s closing speakers, went as far as to encourage a postcard writing campaign using old cigarette packs folded to look like a postcard, with a simple written request to renew the FTCS.

The NCTH

With some four dozen speakers, three plenary sessions, multiple interactive sessions such as Quit Cafe promoting dialogue on quitlines, 22 conference presentations and roughly 60 abstract reviewers, a national conference of this magnitude took a lot of hard work and dedication from many people to organize and orchestrate. Events like this could not get off the ground without the strong support of the organizing committee, headed by Manuel Arango from the Heart and Stroke Foundation of Canada and Bob Walsh, the executive director of the Canadian Council for Tobacco Control.

Gold category sponsorship was received from McNeil Consumer Healthcare (NicoDerm and Nicorette); silver sponsorship was given by the Ontario government; and bronze sponsors were the Canadian Cancer Society, the Heart and Stroke Foundation of Canada, the Ontario Tobacco Research Unit, Pfizer Canada and Tobacco Info. The Canadian Medical Association funded the networking expo featuring 20 exhibitors. This is the first time in the history of the seven conferences that Health Canada abstained from financing the event because the CCTC had already received the maximum amount that the federal government can give this organization for five consecutive years.