Proceedings of the Standing Senate Committee on
Social Affairs,
Science and Technology
Issue 5 - Evidence
OTTAWA, Wednesday, February 25, 1998
The Standing Senate Committee on Social Affairs, Science and Technology, to which was referred Bill S-8, to amend the Tobacco Act (content regulation), met this day at 3:30 p.m. to give consideration to the bill.
Senator Lowell Murray (Chairman) in the Chair.
[English]
The Chairman: Honourable senators, the committee is meeting to consider Bill S-8.
Our first witness this afternoon is the sponsor of the bill. When he has finished, we will hear from a witness from the Department of Health.
Before beginning, let me take this opportunity to congratulate our colleague, Senator Haidasz, on a very high and well-deserved honour that was bestowed upon him by the Government of Poland. Earlier this month, he was conferred the Order of Merit of Poland, commander's cross with star and sash. This took place at the presidential palace in Warsaw on Tuesday, February 17. Senator Haidasz, you add this to many other distinctions and honours that have been conferred upon you in Canada and elsewhere. All of us warmly congratulate you on this further distinction to your career.
As the sponsor of the bill, you are the opening witness. You know what the protocol is, having been a minister of the Crown. We have several other witnesses to hear from on the bill. I wish to make it clear that when they have been heard, some time later on, some weeks from now, if you wish to be the concluding witness, to come and comment on testimony that has been heard, we will be happy to have you here, although you may have left the Senate by then, sadly. However, we will pay your way here, should you so desire.
The Honourable Stanley Haidasz, P.C.: Members of the committee, it is a great privilege and honour for me to be the first witness to appear for your study of Bill S-8, legislation which seeks to amend the Tobacco Act, which was passed in April of last year, just prior to the general election.
I presented this bill, it received first reading, and then was given second reading in December of last year and referred to this committee. Let me put the bill into perspective.
We all know that tobacco is a lethal substance. It is implicated by medical authorities as the cause or part of the cause of what are called tobacco-related diseases, to which are attributed the premature deaths of 40,000 to 50,000 people in 1994, the latest year that such statistics are available from Statistics Canada.
Furthermore, according to a former employee of the Department of Health who is now in Geneva with the World Health Organization, tobacco is a harmful substance which is blamed for a loss to the Canadian economy, directly and indirectly, of approximately $21 billion, using 1987 figures.
Any responsible government would realize that something should be done about the great physical and economic damage being done to the people of Canada.
As a physician, I have seen many people who are sick with tobacco-related diseases. I have been present at the deaths of people from a tobacco-related disease called pulmonary carcinoma, or lung cancer. It is a terrible death. I was an intern at the Toronto General Hospital in 1950, where I witnessed these diseases and the deaths which end the lives of smokers. This made such an impression on me that I joined forces with one of my teachers, Dr. Norman Delarue, who was a thoracic surgeon at the Toronto General Hospital, and probably the first one in Toronto, if not in all of Canada, to blame lung cancer on the smoking of cigarettes.
These 40,000 to 50,000 premature deaths are all preventable. The 21 clinical diseases attributed to tobacco are also preventable. Therefore, the enormous economic cost to Canada, direct and indirect, estimated to be $21 billion in 1987, is also preventable. Yet, since we first became aware of the dangers of tobacco and the damage it causes, I am sorry to say the government has not been aggressive enough to stop this tragedy.
I have tried several times, as a member of both the House of Commons and the Senate, to have bills passed, and I have sat on various committees studying the tobacco problem. The first in the House of Commons dealt with advertising. In fact, I studied that with old classmates of mine, Drs. Harry Harley and Bruce Halliday. We were in the same class at the Faculty of Medicine in Toronto. We entered the same hospital and were all shocked with what we saw tobacco do to people. Not one of us three ever smoked. I thank God that we never got into that terrible habit which clinicians call a serious addiction. It is equal to the addiction to heroin, according to the clinicians who treat the tobacco addiction syndrome.
I am glad to have this opportunity to speak to my bill before I leave the Senate on March 4, and to appeal to all honourable senators, especially the members of this committee, to do something about this terrible problem.
You probably heard Dr. Wilbert Keon speak in December in support of my bill. You may have also heard Senator Gigantès speak succinctly but eloquently about his experience with the end-stage of tobacco-related diseases. I am grateful for their support.
Canada is further ahead than the U.S.A., and probably every other country, on attacking this problem of preventable diseases. About two years ago, the then Canadian Minister of Health, Ms Marleau, introduced a tobacco strategy paper. However, since that time, we have received only the Tobacco Act, which dealt mainly with advertising and displays of companies that produce this lethal substance.
The remarks I had wanted to make this afternoon have been distributed to you. I do not wish to read the text because time is short. I should, however, like to take this opportunity to say something about those clauses in Bill S-8 which I believe are the crux of it. Clauses 2, 3 and 4 are proposed amendments to the Tobacco Act. I wish to tackle the problem at its heart; that is, to stop the addiction to nicotine which causes people to crave tobacco. Of course, we must attack the levels of nicotine in cigarettes.
I attended a conference on addiction in Washington three years ago. The main topic was tobacco as an addictive substance. We were edified with the zeal and knowledge of some of the researchers in the U.S., who are well ahead of the Food and Drug Administration in Washington.
Our tobacco strategy office in Health Canada has been reorganized with a new chief at its head. I hope that that office will have the resources necessary to carry out the departmental strategy against tobacco as outlined by Minister Marleau almost three years ago.
I wish to go the heart of the problem; that is, the level of nicotine. People become sick and die from tobacco, but nicotine is actually the original cause of the problem. People become addicted to nicotine and then suffer the consequences of the tars, especially the carcinogenic tars, in the smoking cigarette. Of course, other problems are the amount of carbon monoxide that is issued by a smoking cigarette and the harm caused by the additives in tobacco products.
As I mentioned, nicotine is an addictive substance. In my opinion, it is so hazardous that it should be listed in the Hazardous Products Act and outlawed. However, I do not think I will see that happen in my lifetime.
Clause 3 of Bill S-8 proposes an amendment to section 6 of the Tobacco Act. "Reconstituted tobacco" is defined in the bill. Tobacco contains much leaf wastes and even sweepings from the floor of tobacco production plants which can potentially be recombined with other matter to add bulk to tobacco products such as cigarettes.
It has much to do with the weight of a cigarette and it can include substances such as arsenic, sulphides, fibrous material, and cellulose derivatives. These are not healthful products or additives and are therefore very undesirable. They must also be legislated against by prescribing the weight and the ingredients of tobacco.
The test for reconstituted tobacco is actually what is used by chemists in both industry laboratories and in health science laboratories. Just as all the substances are rolled up in a smoking tube of a cigarette, a cigarillo or a whole cigar, it can be placed in an organic solvent no harsher than acetone in order to see what sinks to the bottom. Natural tobacco plant cellulose mainly floats on the surface, but larger segments, and distinct, dark sediments collect at the bottom. This is reconstituted tobacco. The bill I am proposing would limit the amount of reconstituted tobacco to 2 per cent by weight of the actual tobacco product inside the smoking tube.
I also wish to clarify the definition of "tobacco additive," and to make some comments on it. When we talk about a tobacco additive we must also take into consideration the paper that wraps the tobacco product, because manufacturers often lace the tobacco paper with different chemicals. When this paper burns, you get more toxins in the smoke, in addition to the tars. According to reports I have read, there are over 3,000 toxic tars emitted in the smoke of a burning cigarette. Scientists have identified approximately 50 of these toxins or toxic tars that are carcinogenic, which means they can produce cancer in some of the organs of the body.
Some of these additives are called nitrosames, others are pesticides, others are fresheners that are added to a cigarette or a cigar. Some of them are humectants, making the tobacco humid. There is also, as I mentioned before, arsenic, and a host of other noxious substances. I do not have the complete list because the tobacco companies consider the list of their additives to be a trade secret. They say it makes smoking tobacco palatable.
This bill would specify the limits of all of these additives, and that is very important as far as reducing the harm that a tobacco product can produce. My aim is to produce by legislation as harmless a tobacco product as possible. I tried to do that when I was in the House of Commons, by attempting to have tobacco declared a hazardous product, but it was impossible. I was parliamentary secretary to Mr. Basford way back in 1968, when we brought in amendments to the Patent Act to allow generic drugs to be manufactured under licence. Since it was impossible for me to have tobacco declared a hazardous product, I am trying through this bill to cut down the harm that tobacco can cause by reducing the harmful constituents of tobacco products.
For the purposes of Bill S-8, I also include as an additive any substance, such as ammonia, which is included in tobacco in order to increase the effect of nicotine. That is what the tobacco manufacturers want. They want the smoker to be addicted to the nicotine because that is the way they sell tobacco products. The people become addicted to it, they like the aroma of a cigarette. Above all, they want effective nicotine results from this product that they produce because that is why a smoker buys a cigarette: He is addicted to nicotine.
Let us go back to other substances. There are also nitrogenous compounds in tobacco products. Nitrogenous compounds alter the pH, the acidity, of a smoker's saliva when he comes in contact with the fumes of the burning cigarette. The lining of the mouth and the lining of the tongue are also affected by these nitrogenous compounds. They enhance, as I mentioned before, the uptake of nicotine, the substance that the smoker wants, which makes the smoker smoke more often and, indirectly, become sick because of the tars, some of which are potent toxins or even carcinogenic.
Even nicotine by itself can do harmful things. It causes vaso-spasm of the arteries, whether they are to your toes or to your heart. The arteries have a muscular wall, and nicotine causes the muscles of the arteries and veins to go into spasm. The calibre of the inside of the artery is decreased, and therefore less blood flows to the muscle of the heart, to the muscles of your legs, et cetera. When there is less blood flowing, then you can have spasm of your muscles. If you have too much spasm of the muscles of the walls of the coronary artery, you will get angina pectoris, wherein the myocardium will go into spasm. That causes terrific pain right behind the breast bone. If it gets worse, it can cut off the blood flow to the muscle of the heart and then the heart is deprived of oxygen. If that complete deprivation of oxygen lasts for five minutes or more, the heart muscle dies. If too much of the myocardium is affected, then the heart stops beating and you are dead.
I mentioned the nitrogenous compounds. Although they are a small net fraction by weight of a cigarette, they have very harmful effects.
The next thing I want to talk about is a definition which is mentioned in the bill: salt of nicotine. It is necessary in the bill because it occurs in the schedule of the Food and Drugs Act. The Department of Health uses the same terminology as I use in my bill and in my brief to you this afternoon. It is another way of saying "nicotinic substance."
The definition gives us particulars about it, for example, its colour, how fine it is cut up, how humid it is, how long the tobacco was exposed to the air in drying out. The tobacco leaves are dried out after they are picked in the fields.
There is another substance in the human blood called cotinine, which is measured by clinicians who want to measure whether a person was smoking cigarettes or not. They do not have to smell your breath; it can be shielded or hidden. A doctor can take some blood from your vein and measure the amount of cotinine in your blood, and he can tell you how much nicotine you had, even how many cigarettes you have smoked.
Insurance companies do this frequently. Certain insurance companies give you a lower premium if you do not smoke tobacco, but sometimes the insurance companies can demand from you, as their client, a test of cotinine. They want to know whether you are smoking because, first, you are a greater hazard to them if you are a smoker, and, second, they want to ensure that they are not being defrauded. If they gave you a lower premium because you said you were a non-smoker and someone told them, "Hey, this fellow smokes," the insurance company has the right to check whether their client is cheating them or not.
Scientists have determined that cotinine is the bioactive or bioavailable form of nicotine, and that this bioactive form of nicotine latches onto a brain transmitter site. In our brain there are different sites where different medicines attach, and there is a brain transmitter site for cotinine. This brain transmitter can be poisoned by the nicotine or the cotinine that is attached to a site in your brain that satisfies the smoker's addiction. That is what the smoker wants. He wants the feel of nicotine in his brain because it makes him feel euphoric or, as some smokers describe the sensation, relaxed, under the influence of nicotine.
A person addicted to nicotine really needs the cotinine, which is the fine substance that attaches to the site in your brain and makes you addicted and makes you feel euphoric.
I am not going to talk about Eclipse. It is in the notes that were passed on to you. Some companies are trying to develop a product to take the place of a cigarette, and that product is called Eclipse. It works in different ways to trap nicotine, cotinine and the tars.
Clause 2 of Bill S-8 treats the subject of empowerment of a regulatory authority in statutory language, describing a framework within which the authorities will be able to work when regulating tobacco content in smoking products. That is necessary for them because they are supposed to monitor the cigarettes that are sold in Canada, and the department will determine whether what comes out of that smoking cigarette is against the law.
There is another point I should like to raise this afternoon. Many people cannot stand the smell of a cigar or the smell from a smoker's mouth, and this smell is worst in people who regularly use chewing tobacco or snuff. It can also cause cancer, mostly of your gums and your tongue, if you use it too often.
There are also the unsanitary practices where smokers spit their saliva, which can be a further danger to the health of people around them because their spit can also contain a lot of viruses. For example, they can pass on the virus which causes influenza. There are thousands of people that become sick from influenza every year and die. In the great epidemic of 1917, millions of people died from influenza, and it is caused by a virus.
Let me talk about subparagraph (iii) of proposed paragraph 7(a), which relates to additives, such as ammonia. Additives are defined with respect to their addictiveness as well as to their toxic effects, and subparagraph (iii) stands to give the regulatory authorities some kind of power in testing tobacco products, helping them to monitor this lethal substance.
The Chairman: We are getting to the point where there will be no time for questions, senator.
Senator Haidasz: Mr. Chairman, I will stop there.
The Chairman: Colleagues, we have about 10 minutes for questions before we move on to the witness from the Department of Health.
Senator Forest: Mr. Chairman, I would ask the senator to outline very briefly the changes in this bill from Bill S-5, which we reviewed last year.
There had been some concerns about being able to implement that bill if it had passed. My understanding is that the focus of this bill is narrower than that of Bill S-5 and that, therefore, it should get an easier ride in debate.
Senator Haidasz: The Tobacco Act which was passed last April does contain some clauses which say that the minister is empowered to make regulations in the future as to the constituents of a tobacco product. I am outlining these constituents. As a physician, I am trying to bring in regulations to control the amount of nicotine in cigarettes.
Senator Forest: Are you referring to the additives?
Senator Haidasz: First, the nicotine. I wish to limit nicotine to no more than 0.3 milligrams per gram in a cigarette. I also want to limit tars to no more than 0.5 milligrams, and reconstituted tobacco to no more than 2 per cent by weight. That is the crux of the bill. I am going a few steps further than the Tobacco Act that was passed last April.
Tobacco has been killing people as long as cigarettes have been sold in Canada. It is high time we stop these premature deaths and the suffering and loss to our economy.
Mr. Gary Knight, Research Assistant: I understood Senator Forest to be asking a question in regard to the earlier form of Bill S-5, not necessarily a question with respect to Bill C-71, although I think this answer has assisted.
Senator Haidasz: Mr. Chairman, when I mentioned Bill S-5, I meant really Bill C-71, the Tobacco Act that you passed last April.
Senator Forest: I was referring to Bill S-5.
Mr. Knight: In a nutshell, the differences between Bill S-8 and Bill S-5 are quite limited in extent. You will notice that in the central section of this bill, there is no reference to any particular testing method for the smoke on the cigarette. It is left up to the regulating authority to decide what in their view is a satisfactory method.
This is partly because we are aware that there are other methods in the offing. One was developed by a woman who worked at Health Canada and is renowned and well regarded in the research community.
Another change to the bill is that it does not refer to the complicated issue of export and import. That is partly because there was some discussion as to whether we would have to worry about defending the bill against any challenge that might be taken to the World Trade Organization or NAFTA. Frankly, there was an answer to that, which was simply that when you are creating non-tariff barriers motivated by health concerns, you do not have too much to worry about under NAFTA. Nonetheless, Senator Haidasz wanted to go by way of a direct amendment to give guidance to the regulating authority.
Should the regulating authority want to regulate tobacco in other forms, such as chewing tobacco and snuff, there is some guidance, as the senator mentioned, in that subclause, but the main purpose of the bill is not aimed at that issue.
There may, however, be a serious omission. The final rendition of this bill for tabling and introduction at first and second reading went ahead with much haste, and the omission is my fault. It really should refer to selling. Even though the bill would prohibit the manufacture of products that are unsafe because they contain to much nicotine or too many carcinogens, as it is now it would not prohibit their sale. It is somewhat odd to say you cannot manufacture them in Canada but Canadians can buy imported products from other countries. That would introduce a non-tariff barrier of a kind that would actually hurt the Canadian industry. That is not the intention of the bill. I am sure the senator would request that the committee consider an amendment to add the words "or sold" to clause 3 which amends section 6 of the act.
The Chairman: Do work on a draft amendment, please. The committee will consider it.
Thank you very much. We have run out of time.
Colleagues, our next witness is Dr. Murray Kaiserman, from the Department of Health, the Director of the Office of Tobacco Control.
Please proceed if you have some opening remarks. We may have some questions for you.
Dr. Murray Kaiserman, Director, Office of Tobacco Control, Department of Health: Honourable senators, I should like to present Health Canada's position regarding Bill S-8, the proposed amendments to the Tobacco Act.
Senator Haidasz has had a long and distinguished record on tobacco control. He has demonstrate a unique capability to anticipate the direction of tobacco control and to propose measures that have found their way into Canada's tobacco control legislation.
Commencing with Bill S-8, introduced in February of 1986, and Bill S-4, introduced in November of 1986, Senator Haidasz entered the debate on banning smoking in federally regulated workplaces and on placing tobacco products under the Hazardous Products Act.
In May, 1989, with Bill S-6, and in December, 1992, with Bill S-19, Senator Haidasz again placed himself in the forefront of those who would raise the age for purchasing tobacco to 18 from the then current 16 years of age.
With the present Bill S-8, which is the more refined version of Bills S-5 and S-14, Senator Haidasz is again placing himself in the forefront of tobacco control.
Tobacco is the leading cause of preventable death and disease in Canada, killing over 40,000 Canadian men, women and children every year in a variety of ways, accounting for roughly 20 per cent of all deaths that occur annually. It costs the Canadian health care system over $3.5 billion in direct medical expenses. It has also been estimated that smoking costs Canadian businesses about $2,500 per year per smoker, including roughly $2 billion in absenteeism.
It has also been long recognized that the mainstay for the continuation of the tobacco industry is the addition of new smokers and that the vast majority of new smokers are youth under the age of 18 who have become addicted to the product. It has also been long recognized that cigarettes and other tobacco products are addictive and that the drug of addiction is nicotine.
In March 1996, Health Canada convened an expert committee on cigarette modifications, bringing together leading world experts on the issue of cigarette modification, epidemiology, nicotine addiction, cigarette design, and nicotine replacement products. This was a unique committee in that it included not only representatives from anti-tobacco factions -- if I may use that term -- but from the tobacco industry itself.
The expert committee explored a number of issues and made a number of recommendations. Perhaps the most important findings that apply to this legislation are as follows.
First, nicotine is the only tobacco constituent for which administration is well established to produce physiological changes in users that lead the consumer to attempt, even in the face of harm, to sustain its intake. Smokers smoke cigarettes knowing it is harmful because of their addiction to nicotine.
Second, a typical smoker -- that is, a smoker who is nicotine-dependent -- must be able to obtain easily a daily intake of about 20 milligrams of nicotine from about 20 cigarettes, and tends to smoke cigarettes ranging from between 0.7 to 1.4 milligrams per cigarette delivery to the smoker. Cigarettes outside this range have very limited acceptance.
Third, for long-term, filter-cigarette users versus long-term non-filter-cigarette users, there was a reduction in risk for lung cancer of about 20 to 25 per cent. In other words, a simple cigarette modification like a filter actually reduced the harm to the smoker.
Fourth, cigarette modifications which reduce yields of tar and nicotine have been perceived by smokers as being beneficial based on the observation that the risk of smoking-related diseases is less for smokers of filtered cigarettes than for smokers of unfiltered cigarettes. However, yield and risk to health are not directly related. In other words, there is a limit to the benefits of reduction of yield, and some cigarette modifications, like the reduction of the amount of tobacco in a cigarette, have not resulted in the concurrent reduction in risk to the smoker.
The expert committee also concluded that a regulatory environment should foster product modifications which have been identified as having potential health benefits. One of the most important modifications that occurred to cigarettes in the past 20 years, after filters, was the introduction of "light" cigarettes. At the time of their introduction, light cigarettes seemed to offer great hope for public health. What we did not know at the time was how smokers would adjust to these products, how smokers, by changing their smoking patterns and inhaling deeper and longer, or by covering up the tiny ventilation holes used to dilute the smoke, would compensate, thus negating most of the potential health benefits. In addition, at that time we did not fully understand how cigarettes were engineered and how this engineering could confound smoking-machine analysis.
Today, we are much more knowledgeable regarding these factors, and the experience of the past has shown us how not to bring about or introduce changes to cigarettes. One of the most important factors that we must consider is how the consumer is going to respond to the new product.
Smokers have to be willing to use the product. If the product does not deliver what the smoker wants, the smoker will either quit or find a product that does deliver the necessary nicotine. As recent events have shown us, smokers will find alternatives if prices are too high. We must expect them to seek similar alternatives if their favoured products do not deliver what they are seeking. This could involve increased use of contraband.
The bill also presents another difficulty, in that standards which are proposed to be set in the act and the regulations allow for the reduction of these levels. This is very difficult to deal with from a regulatory perspective because the question then becomes: If the product is not safe at the standard established in legislation, why was that standard established in the first place? Another question might be: If the standard is established, it can be considered to be perfect, or as good as you could get, so why change it? The bill potentially removes the option of setting even stricter standards.
There are a number of other technical problems. The bill does address the issue of how the standards are measured, but we must be very careful in developing smoking-machine conditions that will more closely approximate how the smoker smokes, and that may take us a lot longer than the six months available.
Does the proposed level of nicotine actually reduce the addictive potential of the product? The proposal sets a maximum level of 0.3 milligrams of nicotine in the tobacco. It also allows for 100 per cent transfer of this nicotine to the smoker. Therefore, since smokers do not get 100 per cent of the nicotine available in the cigarette anyway, can the industry design a product that actually maximizes efficiency through use of additives which are restricted but still allowed, or through some other measure?
Again, there is a question of potential additives that may actually reduce nicotine and nicotine delivery to the smoker. Cytrel is one such additive currently available. By limiting its use, a potential gain to public health might be lost.
The other issue is limiting the use of reconstituted tobacco. There have been great strides in removal of toxic constituents from whole tobacco. Most notably, there is a product now on the market that has reduced the amount of nitrosamines found in tobacco. This is done through removal by a method similar to that which would be forbidden in the bill. Do we lose potential health benefits because it would be banned?
There is an even more serious consideration. If smokers are unable to get the maximum or needed dose from the cigarettes now on the market, or as proposed under this legislation, will they smoke more cigarettes? There is that potential.
About a year ago, when the Tobacco Act, Bill C-71, was being studied by the House of Commons Standing Committee on Health, representatives of the department stated the following:
We would also want to make sure that any kind of adjustment in the nicotine levels, and how that particular level may work in concert with other substances in the product, could inadvertently create health effects that are equally deleterious.
In other words, if we eliminated the roughly 15,000 to 20,000 cancers that we see at the expense of more heart attacks, heart disease, and respiratory diseases, would we have achieved a real public health gain?
The real problem with modifying the product is that the behaviour of smokers, and the fact that most diseases appear 20 to 40 years after initiation of smoking, severely limit our ability to predict actual outcomes. These considerations apply to any product modification contemplated.
The Tobacco Act, as now written, provides the minister with the authority to regulate product standards. As mentioned by Senator Haidasz, we now have the funds and resources to explore this particular issue fully. Nevertheless, it is our opinion that, before establishing standards, we should undertake an evaluation of available knowledge on tobacco emissions, the health effects of those emissions, and any potential changes in the health effects of those emissions. In that way, we would hope to be able to develop practical standards that will achieve health objectives through reduction of tobacco use and the resultant reduction of health effects to the extent possible.
At this time, we are not in a position to set standards that may not achieve the desired health effects. In addition, we also believe that establishing such standards may be going too far too soon.
Senator LeBreton: That is a lot of information to absorb. You are saying that it may be premature to initiate some of the changes that have been suggested in the bill because we do not know the impact. I personally have knowledge in my own family of people moving to lighter cigarettes and smoking twice as many. You are saying that Health Canada does not have definitive information to prove that this would be of any long-term benefit.
Mr. Kaiserman: I do not think anyone going into the process will have definitive information. The best we can hope for is to be able to say that, in our opinion, we believe that this intervention will work. We are not yet at the position to say that the particular intervention set out in this bill, limiting the amount of nicotine, will achieve the desired health outcome. We just do not know how consumers would react to that product. Traditionally, they have not accepted those kinds of products.
Senator LeBreton: I am particularly concerned about young women because there still seems to be the perception, first, that smoking is glamorous, and, second, that it contributes to keeping their weight down. If we were to introduce a product that had less nicotine, if, in fact, it is the nicotine they seek, they would probably bypass that product. You could not say to someone 18 years old that they have to smoke the lower nicotine cigarettes. They will obtain the product they want.
Mr. Kaiserman: If there is a market for the product, there is a probability that it will become available. If people desire it, there is a potential that the use of smuggled cigarettes, contraband, will reach levels that will negate the health effects of this measure.
Senator Forest: Dr. Kaiserman, did I understand you to say that putting these regulations in now might prevent others from being introduced?
Mr. Kaiserman: I do not think it will prevent it in the long run, but it will make it that much more difficult. Presumably, when you establish standards based upon health measures, you must show that your health measures were not achieved before you can make them stricter.
One of the problems we have with these kinds of health measures is that it takes about 20 to 40 years for the problem to become visible. We are just now seeing the changes in lung cancers brought about by the introduction of light cigarettes. Because people changed their smoking habits after the introduction of light cigarettes, the types of lung cancers have changed. They have gone deeper in the lungs and are manifesting themselves as a different form of lung cancer. There is a danger at this point that that might happen here too, and 20 to 40 years down the road is when we would see it.
Senator Forest: Is that because of the deeper inhalation?
Mr. Kaiserman: That is right. We are advocating doing as much study and work as we can before taking action. The truth of the matter is that the departmental position is that the only safe cigarette is an unlit cigarette.
Senator Maheu: Dr. Kaiserman, you say it takes 40 years for you to see the results of any intervention. How do you justify the hesitance now to the people you will see 40 years from now?
Mr. Kaiserman: We are not hesitant to start. The truth is that there have been a number of interventions over time. The prevalence rates have fallen from around 50 per cent at the time of the first survey to about 30 per cent of the population now. Lung cancers for males, because of tremendous interventions and a lot of work in the past, have levelled off, and there is every expectation that within the next few years the lung cancer rates for men will be declining. Unfortunately, because of changes in smoking habits among females, there is a rise in lung cancer, heart disease and deaths associated with smoking.
Yes, it takes 20 to 40 years to see population effects, but even the saving of one individual life is worthwhile. Do not get me wrong. Light cigarettes may have been beneficial to individual smokers. However, in the aggregate, in the overall population, we may not be seeing the benefits. This is not a process that will result in everyone quitting smoking tomorrow. However, the more we deal with this in a comprehensive manner, with education, public information, legislation, restriction of access, enforcement, product modification, and so on, the fewer people will take up smoking and the fewer people will continue to smoke, and the health effects and costs of smoking will decrease.
The 20-to-40-year time-frame was to indicate that it would take that long for health effects to be seen through the population. We are not willing to wait 20 to 40 years to see benefits. We would like to do the best possible work up-front rather than remove our options.
Senator LeBreton: I believe, just from observation, that cigarette consumption has gone down. Is that not true?
Mr. Kaiserman: The prevalence rate, the percentage of people smoking, has flattened out over the past 10 years, but those that smoke are also smoking less, smoking fewer cigarettes.
Senator LeBreton: Is that starting to show up in the health care system in terms of the amount it costs to treat these people?
Mr. Kaiserman: What is starting to show up in the health care system is the smokers who started smoking in the 1950s and 1960s, not the current smokers. It will take a while for this to work through the system. It is not a short-term effect by any means.
Senator LeBreton: Interestingly enough, then, you will probably see a bump up because there was a whole post-war era population yet to come.
Mr. Kaiserman: They are now working their way through the system. Post-war is the 1950s, and we are now near the end of the 1990s. The early phase of the baby-boom generation is working its way through the system, and that is where the health effects are starting to show up.
The Chairman: You are seeing people in their 60s.
Mr. Kaiserman: Yes.
Senator LeBreton: We still have the whole generation of the 1960s and 1970s to come through, then. That will probably be quite compelling.
Mr. Kaiserman: The leading edge is starting to come through now.
Senator Forest: For those who did move to the lighter brand of cigarettes, is there any indication that that is a step towards kicking the habit, or is that not so?
Mr. Kaiserman: Some studies indicate that some smokers, on the one hand, follow a step-down strategy. They are smoking a cigarette that delivers 14 milligrams of tar and about 1.4 milligrams of nicotine, and they start stepping down towards these low-yield cigarettes. They use that kind of strategy to actually quit.
On the other hand, some people tell themselves that they will smoke a low-yield cigarette and be much safer for it. Yes, if they do not change their smoking habits they would be, but many smokers compensate for that. Some people who should quit or want to quit do not quit because they mislead themselves. It works both ways. It has been a very successful strategy for those who want to quit.
The Chairman: Senator Haidasz has filed with the committee a brief, part of which he read into the record. In the brief he refers to an internal document in your department, which has come to light by way of an Access to Information request, in which, according to him, you take the position that we should go in this direction -- that is, to do something about tobacco content regulation. He states that we did not do so because we were taking our cue on this matter from the FDA in Washington, where he says an expert report along the same lines had been squelched by whomever under whatever influences.
Can you enlighten us at all on this? Do you know what I am talking about?
Mr. Kaiserman: Yes, I am very much aware of the report.
The report itself was in draft stage -- not the first draft but certainly not the last draft. It was more of an option discussion saying that, on one hand, you have nicotine reduction to zero while, on the other hand, you have toxic emission reduction to zero. Each strategy has positive benefits and has potential negative benefits. You have to be aware of both strategies.
It did not provide a final recommendation because it was still a draft and had not really gone out beyond my immediate circle for discussion. However, it did say that any strategy adopted would have to be a North American, continent-wide strategy because smuggling and consumer acceptance were probably the two biggest factors to deal with. It also proposed ways of doing it.
As to the comments about FDA concurrence, I am not aware of any of those. That has never been brought to my attention at any time.
The truth of the matter, senators, is that I am very proud of what we have done in Canada with respect to tobacco control. No jurisdiction in the world has done the things we have done, taken the risks we have taken, and studied the product the way we have, including the Americans. In a way, it is gratifying to see the Americans catching up to us.
The Chairman: Do you know anything about an expert study at the FDA along these lines, the one to which Senator Haidasz referred?
Mr. Kaiserman: No.
The Chairman: How long have you been with the Office of Tobacco Control?
Mr. Kaiserman: I joined the office in 1989 when it was the Tobacco Products Section; then we became the Tobacco Products Unit; and then we became the Office of Tobacco Control in 1994. I have been privileged to lead our research on the product itself.
We, in Canada, are the world leaders in the knowledge of the product. The 50 chemicals that Senator Haidasz mentioned came out of our research. We are acknowledged globally as experts.
The Chairman: I do not have a biography of you. I think this is the first time we have met. Are you a medical doctor?
Mr. Kaiserman: No. I have a doctorate in chemistry and a masters in business administration. I have done a lot of research and have been published in the field of tobacco and tobacco control.
The Chairman: Had you been with Health Canada before going to the Office of Tobacco Control?
Mr. Kaiserman: No, I came from the Department of Consumer and Corporate Affairs.
The Chairman: This is not strictly germane to this bill, but it is relevant to the whole question of tobacco. You have only been at that office since 1989, but do you have an opinion as to the effectiveness, or otherwise, of the various advertising campaigns conducted by the Department of Health and Welfare -- as it was then -- against smoking? In the chronology I have here, I note that in 1982 Health and Welfare Canada launched an anti-smoking campaign. Then in October 1985, Health and Welfare Canada launched a $1.5 million anti-smoking campaign aimed at youth. Do you have a view as to the effectiveness, or otherwise, of those advertising programs?
Mr. Kaiserman: Senator, I am here to talk about the technical issues on the legislation and nothing more. I respectfully cannot and should not talk about my views on that issue.
As the department has pointed out -- and I agree -- this is a comprehensive strategy. Those actions, coupled with the legislation and all other activities, have been very successful in reducing tobacco use in Canada.
The Chairman: You are the director, though, are you not?
Mr. Kaiserman: Yes.
The Chairman: Is there a view in your office on this question?
Mr. Kaiserman: Yes.
The Chairman: We will have an opportunity to go at it again. I do not want to embarrass you. I just wondered whether the department had come to any conclusions on the matter. Is the answer no?
Mr. Kaiserman: It is an integral part of the comprehensive strategy.
The Chairman: I understand that.
I presume the department has done follow-up studies to these advertising campaigns and that they would be available to us through Access to Information. Do you confirm that these studies have been done?
Mr. Kaiserman: I can ensure that they are provided to you. They are available.
The Chairman: We would like to have them.
Senator Haidasz would like to ask a question or two.
Senator Haidasz: Thank you, Dr. Kaiserman, for all the work you have done in Canada as far as controlling the harmful effects of tobacco. I, too, would like to refer to the document that the chairman mentioned. I presume that is the one that was printed on June 13, 1997.
On page 15 of the draft that I have before me, you state that there is a strong possibility that nicotine reduction may not achieve the desired health results. You also state that one way of reducing this possibility is to reduce the toxins in tandem with nicotine, which I think we should do. Let us start by reducing the toxins in tandem with the nicotine. You are not going back on your statement, are you?
Mr. Kaiserman: No. I do apologize. It was an oversight. It was one of my original notes and I skipped it.
One of the strengths of the bill is that there actually is an in-tandem reduction. A major strength of the bill is that you have actually gone that way. No, I am not going back on that statement.
Senator Haidasz: Thank you very much. That encourages me.
I know that my bill is not the solution. There probably is no solution, but I hate to see people continue to smoke and get sick.
Mr. Kaiserman: Yes.
Senator Haidasz: My bill does allow the minister to make changes any time he wishes. That provision is in Bill C-71 as well.
Let us do something; let us start somewhere.
As you say, you are convinced that if we reduce toxins in tandem with nicotine, that is one way of obtaining better health results.
Mr. Kaiserman: Yes.
Senator Haidasz: I am trying to reach a compromise to allow a tobacco product to be manufactured that is as harmless as possible.
As you say, we do not know all the answers, and maybe we never will, but we must start somewhere. More younger people are smoking, and young females are smoking more than the boys. We have to stop that.
The Chairman: Senator Haidasz, do you have a view about the effectiveness of the anti-smoking advertising that the department has done? Do you think it is an effective way to combat smoking?
Senator Haidasz: Mr. Chairman, I have never smoked, although I have treated many smokers and I have family members who smoke. They are addicted to nicotine. If the government does not want to raise taxes as a disincentive to smoking, if it does not want to strengthen controls to bring contraband to a minimum, if not to eliminate it, then let us start reducing the nicotine in tobacco and the toxins. If this is done, perhaps fewer people will smoke. That is my aim. Smoking should be less harmful than it is now under the current regulations.
Senator LeBreton: Are you saying, senator, that since they are addicted, no amount of advertising can break their addiction, that since they are addicted, advertising will not help?
Senator Haidasz: That is right. Advertising does not addict; nicotine addicts, and that is what I am attacking.
The Chairman: The advertising is to some extent a side issue. I followed it a bit. I thought it was intended to be a campaign directed at young people. I thought the idea was to use advertising to persuade young people not to start smoking. Watching the ads, my opinion was that they were very powerful. I just wonder whether they have had the desired effect. I have heard people suggest that they did not.
Dr. Kaiserman will send us copies of the follow-up studies done on behalf of the department.
I thank Dr. Kaiserman very much for his very thorough treatment of this bill. I thank as well Senator Haidasz for appearing today.
The committee adjourned.