Proceedings of the Standing Senate Committee on
Social Affairs,
Science and Technology
Issue 11 - Evidence - May 12, 1998 (5:50 p.m.)
OTTAWA, Tuesday, May 12, 1998
The Standing Senate Committee on Social Affairs, Science and Technology, to which was referred Bill S-13, to incorporate and to establish an industry levy to provide for the Canadian Tobacco Industry Community Responsibility Foundation, met this day at 5:50 p.m. to give consideration to the bill.
Senator Lowell Murray (Chairman) in the Chair.
[English]
The Chairman: Our first witness is Mr. Rod Parker, Chairman and CEO of the Canadian Tobacco Manufacturers' Council.
Mr. Robert Parker, Chairman and Chief Executive Officer, Canadian Tobacco Manufacturers' Council: As we have stated before other committees of the Senate, numerous committees of the other place, and elsewhere, Canada's tobacco manufacturers are opposed to smoking by underage youths. We therefore agree in principle with the aim of this bill. Reasonable criteria for anti-smoking programs, however, would include that they be responsible, effective, economically sensible, and legal. As our brief makes clear, we do not believe that the process, form and substance of the bill meet any of these criteria.
Our criticisms can be grouped under two main headings. The first is that the bill constitutes the direct transfer of government program responsibility, tax authority, tax room, and tax points to unelected and unaccountable private individuals. During the life of this Parliament alone, if passed, it will transfer $500 million from Canadian smokers to anti-smoking lobbyists. That is $125 million a year, with no government strings attached. No oversight could be exercised by Parliament. Even the Auditor General would be unable to examine how that money was spent.
The second group of criticisms are similar to those we have raised frequently in the past. They concern not the objectives of anti-smoking initiatives, but the means. This bill proposes the continuation of the same kinds of programs that have failed in the past, unsupported by credible theory in advance of their implementation, and unmeasured and unassessed during and following their implementation.
The structure of the foundation, in our view, also ensures the continuation of the baseless pretence that the smoking decision is related only to the existence of the industry and its marketing activities. What the critics themselves call "campaigns to demonize the industry" are apparently invented to justify Draconian, and sometimes ultimately illegal, anti-tobacco measures. They bear no relation of which I am aware to thoughtful and effective public policy. In particular, they have no impact on or connection to the decision of any individual to smoke or not to smoke. A reasoned approach to tobacco control will only begin when that sort of hyperbole disappears from the debate, and attention is focused on the objectively measured effectiveness of anti-tobacco programs and policies.
I look forward to your questions. However, before the first of those, I want to correct some erroneous information presented to this committee this morning. Ms Callard, representing Physicians for a Smoke-Free Canada, apparently stated that manufacturers were adding ammonia to tobacco products, particularly to cigarettes. I did not hear that myself, but it was reported to me. I was told that she said that it was not done in the manufacturing process, but during leaf processing, which is done by other companies, so that the tobacco companies could deny that it was done.
I have had an opportunity to check with all three companies. The largest in the industry, which controls approximately two-thirds of the tobacco products sold in Canada, owns its own processing operations, so the accusation does not apply there. In all three cases, there is no ammonia added to tobacco in Canada; not at the growing level, not at the processing level, not at primary or secondary manufacturing, not after the product is in the packages, and not at retail.
This is a complete fiction and fabrication deliberately presented to the committee, under the committee's protections in terms of defamation or other legal action by the manufacturers. I thought that you should have the facts. This illustrates the kind of thing I was just talking about. It also illustrates why we think that these people should not be handed $125 million a year to do with as they please.
The Chairman: In your brief you suggest that this bill might be ultra vires of the federal Parliament, and also possibly in contravention of the Charter, but you have not elaborated on that. I am not necessarily suggesting that you want to deal with that now, but I want to say for the record that you had the opportunity to send one of your legal or constitutional experts here to join a panel on that subject. Indeed, you can still do so if you wish.
Mr. Parker: We appreciate the offer. I will certainly attempt to respond to any questions that you or your colleagues may have about that statement in our brief. The last time that we appeared before a committee of this chamber on the Tobacco Act, we went to considerable effort to bring constitutional experts and to bring a detailed critique of the points in that bill that we believed, and still believe, to be unconstitutional. Virtually none of those aspects of the law were changed. As a result of that, my appearance today is actually a crime under the Tobacco Act. We will indeed deal with that at a later time. I will respond to the best of my ability today if senators have any questions.
Senator Stollery: I must say that I found the testimony this morning to be rather dramatic, to say the least. I ask my question from the perspective of someone who used to be a heavy smoker, but who quit smoking when cigarettes cost 33 cents a pack. I remember very well the arguments in the 1950s before the famous House of Lords report in 1959. I recall reading the report that refuted the argument of the tobacco companies at that time, which was that there was no proof that smoking caused cancer. I remember that so well, because everyone talked about that report. You knew, upon reading it, that at some point you would have to quit smoking if you wanted to stay around.
Your presentation reminds me of the discussions in 1956 and 1957, when it was clear that people were experiencing health problems from smoking. How do you deal with the fact that, according to the testimony this morning, 40,000 people a year die in Canada because of smoking? Do you accept that evidence?
Mr. Park: No, sir, I do not.
Senator Stollery: How many people do you think die as a result of smoking?
Mr. Parker: I do not know.
Senator Stollery: Has the tobacco industry not made any studies of that?
Mr. Parker: Let me start with what we think we know about the health impacts of tobacco. It has been quite clear for a long time that there are significant risks to the health of consumers of tobacco. As a group, smokers materially elevate the risks of contracting a list of diseases and conditions as long as your arm. With reference to that particular number of 40,000, no data collection effort of which I am aware has ever taken place in Canada. It is a statistical construct based originally on a survey of Seventh Day Adventists done in California in about 1970. The number keeps increasing by a couple of thousand people every year, according to the anti-smoker groups, for no reason for which I have ever heard a satisfactory explanation.
Aside from the elevated risk of contracting those diseases, we know that smoker as a group have a shorter life span than non-smokers, on average by between five and seven years. There is still scientific work going on. With regard to the exact causal mechanism, there was a study released last fall which suggested for the first time that there is some evidence of exactly how tobacco smoke might cause a particular disease, I believe a form of lung cancer, but the causal mechanism is still not fully understood. The risk factor is fully understood. It is understood by all of the population, certainly by all smokers, and information to that effect has appeared on the packages for many years.
Senator Stollery: The evidence this morning was quite dramatic. I had no idea that there had been such a resurgence in smoking by young people. My generation, in large part, quit smoking.
Do you accept the figures that show that in California, where they spend $4 per capita on smoking education, only 10 per cent of youths smoke, whereas in Canada, where we spend 33 cents per capita, 33 per cent of youths smoke?
Mr. Parker: I do not know about the California figures, because I have not seen any objective surveys of smoking behaviour. I believe that the committee will hear from someone from California, who may be able to provide some objective information.
In Canada, there is a continuing and fairly sharp disagreement between the manufacturers and the anti-tobacco lobby in general about smoking prevalence, trends, and the implication of those trends in Canada. The information we used, on which we base our statements on this subject, comes from large-scale, public sector surveys done by Statistics Canada, usually on behalf of other federal departments such as Health Canada. Both Statistics Canada and Health Canada have said, in the last couple of years, that there has essentially been no change in smoking behaviour in Canada since the mid-eighties. We believe that to be the case. There is a large scale survey from 1997 coming out, the results of which we have not yet seen. It will be the end of this month, or next month, before that survey is available. There may be a slight decline.
From federal surveys, we have been able to deduce that both youth and adult smoking declined over a period of about 30 years, starting in the early 1960s, and ending in the mid-to-late 1980s. Beginning in 1990 and 1991, it turned around in the very youngest group of smokers. That is the only group where this change happened.
Senator Stollery: There was an increase.
Mr. Parker: Yes. It began in 1990, and persisted until late 1993 or early 1994, when it returned to at or above its previous levels. It then began to plateau, and has declined somewhat. The result is that over the period of 1986 to 1996, the figure at the beginning of the period, and the figure at the end, are identical. There has been no increase in smoking in Canada since the tax rollback in 1994. If anything, there is a slight overall decline.
If every smoker in Canada who smokes a package of cigarettes a day simply smoked one less cigarette a day, 19 rather than 20, that would be a 5 per cent decline. We have had perhaps a 4-per-cent decline, or a little less. Figures are very tricky for a variety of reasons.
There has been no increase in youth smoking. The increase that happened eight years ago happened at a time when advertising was banned, and taxes were high and rising. It not only happened here, but it happened in the U.S. and in the U.K. As well, it did not only happen for tobacco. It happened for cannabis, and for alcohol use by underage youth, and no one knows why. In the case of cannabis, it was clearly not due to packaging or advertising.
Senator Stollery: I live in downtown Toronto. I must be wrong about the number of teenage girls that I have seen smoking -- and the number appears to be increasing. Obviously the tobacco industry does not agree with that.
The Chairman: Just so we can quantify this, I want to know what numbers we are talking about.
In a survey done for the federal Department of Health, I saw a 1996 number that indicated that 11 per cent of teens from 11 to 17 years of age were smokers, and 32 per cent of adults 18 years of age and over were smokers. Are those numbers correct?
Mr. Parker: I would like to check on the 11 per cent figure. The overall number is slightly under 30 per cent. Different numbers done at different times with different methodologies can produce slightly different results.
The Chairman: Are we in the ballpark?
Mr. Parker: At 30 per cent, you certainly are in the ballpark for the population as a whole. Fifteen years of age and above is the division Statistics Canada uses.
The Chairman: We will have to talk to StatsCan when representatives appear before the committee. The surveys done for the Health Canada divided the population into "teens" between the ages of 11 and 17, and "adults," people 18 and over.
Mr. Parker: The StatsCan figures start with 15 to 19 year-olds, and then 20 to 24, and so on.
The Chairman: There is a problem with people smoking under the age of 15.
Mr. Parker: Absolutely. There is smoking by youth at that age.
The Chairman: You do not know the incidence of that, do you?
Mr. Parker: We do not research it, but occasionally Health Canada and other groups do.
Three months ago, we saw a news story that alleged that youth smoking was on the increase. The figure given for Alberta was that it had gone from 22 per cent or 24 per cent to 48 per cent. The industry had heard nothing about such a massive behavioural change in Alberta, so we got the survey data. It was based on a sample of between 30 and 35 people. It was a methodological error, in other words.
The Chairman: The surveys done for Health Canada had a sample of about 2,000 adults, and about 900 teens, which is very good. It was a good-sized sample.
[Translation]
Senator Ferretti Barth: This morning, we heard from some witnesses that the number of smokers had increased considerably. You have just told us however that in percentage terms, the number of smokers has declined. Did I misunderstand you?
[English]
Mr. Parker: To the best of my knowledge, there has been a slight decline over the last three or four years in either the percentage of the population that smokes, and the amount smoked, or both. I know of no significant increase demonstrated by a statistically reliable, objective survey over that same period of time.
A problem arises because of definitions. What is a regular smoker? What is a daily smoker? If you ask someone how much he or she smoked last week, how accurate is that measurement? This is a much more complicated area to measure than generally acknowledged by the media and elsewhere. However, if you ask whether there has been an increase is smoking in Canada since 1994, the answer is absolutely not.
[Translation]
Senator Ferretti Barth: In your opinion, what are the primary reasons why he we have seen an increase in the number of people addicted to smoking? Do you have any idea? Why is tobacco use on the rise? Is it a matter of price and quality or does advertising have something to do with it?
[English]
Mr. Parker: I am not sure I am able to answer the question, because, contrary to the assertions made earlier this morning, I do not believe that the behaviour is happening.
I referred earlier to a continuing and significant disagreement between ourselves and the anti-tobacco organizations. Why would someone claim that the StatsCan information does not exist, or is wrong? One reason, obviously, would be to justify an emergency intervention of some kind. In fact, we believe that smoking behaviour, overall, has been going down. It is an immense problem to measure with great accuracy.
The focus of this bill, and I assume of this committee, and its most pressing concern, is smoking by underage youth -- people below the legal age to purchase and consume cigarettes. That is happening amongst both young men and young women. We agree with the sponsors of the bill that this is a problem and concern that ought to be addressed. However, I cannot tell you why smoking has increased, because I do not believe that it has increased.
[Translation]
Senator Ferretti Barth: Will the 50 cent increase have an impact on tobacco sales?
[English]
Mr. Parker: The 50 cent levy imposed by this bill will be about a dollar a carton by the time the price gets to the retail level, because of wholesale and retail mark-ups on the trade.
In general, we have no disagreement with the theory that there is an inverse relationship between price and consumption. In other words, with cigarettes, as with every other consumer good, as the price goes up, consumption tends to go down.
The smoking rate did not change in Canada during the period from 1988 to 1993. During that period, taxes increased by more than 500 per cent, smuggling established itself and grew to the point where it represented 40 per cent of the national market, and 70 per cent of the market in Quebec was supplied by contraband cigarettes. That is the stunning first available fact from looking at the StatsCan numbers. I hope that the representatives from StatsCan will walk you through it.
What was happening was that a percentage of the population, or all of the population to some extent, bought some of their cigarettes from contraband sources, and at lower prices. The full price impact of the increase brought about by taxes was not present.
It is theoretically possible that, if smuggling had been eliminated or completely prevented -- if Canada were an island and you could not easily import contraband -- the price might have had had a greater impact. It did not have any discernible impact on Canadians during that period. As I indicated, the smoking rate of the very youngest group, which you would expect to be most affected, increased beginning in 1990 and 1991. It levelled off by late 1993 and early 1994. The roll-back was in February of 1994.
There are a number of theoretical calculations about the behavioural impact of a given price change. All we can say is that, based on the past 12 years of experience, the actual performance has been far less than that predicted by the theory.
[Translation]
Senator Ferretti Barth: The 50 cent per carton increase may well hurt tobacco manufacturers, but it will benefit smugglers and smokers will continue to smoke. Persons who are hooked on smoking are not about to quit for the sake of an extra 50 cents. They will continue to find ways of buying cigarettes at a good price and the problems that we have experienced in the Montreal area will continue. At one point, people were buying cigarettes and selling them on the black market. What do you plan to do to address this problem? What provisions are there in the legislation to deal with the smuggling issue?
We seem to be caught in the middle of things. Smokers are like alcoholics. Some manage to stop, while others continue to drink. Rehabilitation works for some people. It is the same thing with cigarettes. Those who cannot afford to pay full prices will look to smugglers for cheap cigarettes. Who is going to suffer as a result of this? Will it be the smokers, those involved in smuggling operations or the governments? What are your thoughts on the subject?
[English]
Mr. Parker: Under this bill, smokers will wind up paying something close to $1 more per carton for the product. A carton currently sells in Ontario and Quebec and the low-tax eastern provinces for something in the range of $28 to $29. I would not regard a dollar per carton as a significant price increase that would affect behaviour. It works out to something in the order of 10 cents to 15 cents per day for a smoker who consumes roughly a package or a little more per day.
The problem is this: We have two tax structures in Canada. We have five provinces with very high taxes where the product costs up to double the figure I just named, and we have a low tax structure. We also have native reserves where something called "black stock product" can be bought. In some cases, natives are able to purchase coloured stock. I am talking about the colour of the tear strips around the packages.
In theory, in buying a product without paying PST, GST or the provincial tobacco tax, you are supposed to buy only black stock. That causes about a $10 carton difference. This is the figure, based on the experience of the late 1980s, that provides enough of a margin to justify criminals importing the product or dealing in the product illegally, because smokers will save $4 or $5 a carton.
If you add to that $10 figure -- and that is the case in Ontario or Quebec -- up to another $25 in Manitoba, Saskatchewan, and Alberta and even more in British Columbia or Newfoundland, there is already a significant margin for criminals. This increase would make it larger, but not by a significant margin.
We are in discussions now with all of the provinces, and with Revenue Canada, about additional measures that might be taken to combat smuggling. It does hurt the manufacturers here, based on the experience in the late 1980s and early 1990s. Smugglers are perfectly capable of bringing in product made anywhere in the world. It does not matter to us whether it is our product in the hands of smugglers or someone else's; we want it stopped. We would prefer to see one tax regime in Canada so these new interprovincial smuggling efforts would be stopped. There is a smuggling problem.
I could not argue whether this bill would significantly address the smuggling situation. I know of nothing that has ever been able to stop smuggling when a product is either banned from availability, or there is a significant price difference that provides an incentive for criminals to deal with a banned substance.
Senator Lavoie-Roux: We know that you support the production of tobacco use and cigarettes. On this subject, we have some hesitation. I understand you also give quite a bit of money to the government. That is the positive part of it.
Mr. Parker: Smokers do.
Senator Lavoie-Roux: You make remarks in your executive summary that we ought to look at more carefully. You underline that there is no requirement that the anti-smoking groups be subject to evaluation. You are perfectly right. If you create such a foundation with a significant amount of money, there should be some measure of evaluation. You then develop this a little bit. They will be unaccountable for the expenditure. The foundation is empowered to duplicate the existing public program, which means that we must have a serious board for the direction of that foundation. The bill contains loopholes that will enable the foundation to spend much more on administration than the 10 per cent unit.
Are you concerned about young people smoking?
Mr. Parker: Yes, indeed, senator.
Senator Lavoie-Roux: You are even concerned with older people smoking. It has been proven that pregnant women who smoke have a higher rate of premature babies.
Mr. Parker: As well as low birth weight.
Senator Lavoie-Roux: What is your suggestion to decrease the amount of younger people who smoke? The things that have been done have not changed much.
Mr. Parker: We are already involved in an approach called Operation I.D., the goal of which is to eliminate access to tobacco. In other words, underage youths should not be able to buy the product. We have been doing this kind of thing for about 10 years. We do it in collaboration with wholesalers, retailers, unions who work in those industries, and others.
One of the problems with that kind of program is that the clerks in convenience stores also tend to be underage youth. They are 14 or 15 years old, and they change jobs all the time. If they go to the same high school as the purchaser, who may be a year or so ahead of them, there is a kind of intimidation factor which makes it difficult for the young clerk to refuse to sell the product. Under the law, however, retailers have a responsibility to ask for identification, and not to sell to underage people.
The last survey from Health Canada that we saw -- and they are doing it now on an annual basis -- said that national compliance against selling to youth was at about 72 per cent. It is up about 22 per cent over the last two years, since this program started. That is good, but it is nowhere near good enough. We have a pilot project about to start in B.C., to see if we cannot get compliance much higher.
Access to tobacco is not the reason kids experiment with it, or decide to smoke. Controlling access makes smoking more difficult, but you will not eliminate youth smoking in that way, even if you were to have 100-per-cent compliance.
Attached to our brief, there is a paper written for the Ontario Tobacco Research Unit, that deals with predictors of youth smoking and cessation. We argued last year that the Tobacco Act, which is all about bans on advertising, limitations on sponsorship, and other matters, does not deal with the real reason youth begin to smoke.
When I was a kid, I heard a story about someone looking for a wallet in the middle of the night. A passer-by offered to help. After four or five minutes, he said, "Exactly where did you lose it." The individual said, "Oh, about half a block down there." The passer-by said, "Well, why are you looking here under the street light?" He said, "Because the light is better." My point is that we have to start looking at where the wallet was actually lost, and what it is that causes kids to smoke. It is rebelliousness, first and foremost. It is parental example. It is peer pressure. It is poor performance at school.
The National Health Forum has come up with a number of recommendations in this area. We think that those are deserving of examination. It does not mean that education programs that have been run in the past should be abandoned, but their tone, I think, ought to be somewhat different. If, as a parent, you are dealing with a rebellious adolescent, and you tell that 16 year old that under no circumstances is he or she to do such and such a thing, it almost guarantees exactly the kind of behaviour that you are attempting to eliminate.
Senator Lavoie-Roux: I know that you put warning labels on your packages, but would you also be willing to give some financial support for further study on the etiology of smoking by young people? Is this completely impossible? I realize that you are selling tobacco.
Mr. Parker: We do manufacture and sell the product.
I raised this problem a year ago before another committee. In order to be effective beyond the area where we are already active, we need partnerships with other groups and organizations. The industry is more than ready to consider measures of the kind that I have just described, as well as others, and to consider financial support for them.
It depends upon the measure. We hear some pretty wild-eyed suggestions from our pals on the other side of this issue, the anti-smoking lobby, about what will cause people to stop smoking. We do not think that this is based on any understanding of why adults or youth smoke. We hear what we regard as misinterpretation.
Senator Stollery: I quit smoking because I did not want to die before my time.
Mr. Parker: That is a good reason to do so.
Senator Cohen: I used to be in the retail business. I know that marketing increases sales, and encourages people to buy. In this case, it encourages people to smoke.
When you appeared before the committee in 1997, you said the one thing that advertising does not do is to persuade people to start smoking, and that manufacturers agree that youth should not smoke, period.
We wonder why kids smoke. When I started to smoke at 13, it was because I sneaked a cigarette, and it was cool. Kids smoked because it was cool. However, do you think that the promotion of sports figures and macho images in sports car racing does not, by association, persuade young kids that smoking is cool? As a kid, that would have moved me. I would have felt that smoking was great, because so and so promoted it.
Mr. Parker: It is very difficult to argue from a specific your reaction to the general.
About 20 countries in the world have banned tobacco advertising and sponsorship in total, in some cases for up to 20 years. We should look to those countries for support for this notion that advertising bans or restrictions would help. People have looked to those countries, and there is no pattern of a reduction in smoking. In fact, in two of the Scandinavian countries, smoking by youth in particular has increased since the ban. Why is that? It does not sound logical. It may be because, when the full weight of the state said that this is such a wonderful, exciting product that it cannot be advertised, 16-year-old kids said "Give me some."
There was a trick brand on the market in Europe, England and the Netherlands for a couple of years called Death Brand cigarettes. It was a black package with a skull and crossbones on it. They also had a brand called Death Lights, which was a white package with a black skull and crossbones on it. It had warning messages that make even the stark Canadian brands look mild by comparison. "Do not buy this product: It is extremely dangerous." For a period of time, it was flying off the shelves. Who was buying it? Teenagers were buying it.
We have had a practical experience in Canada with the banning of advertising over the last ten years. From early 1989 until 1995, product advertising was not present. There was some sponsorship advertising. While our overall smoking rates stayed flat, U.S. smoking rates were declining slightly, with no such controls in place.
All I can tell you is that I cannot agree that the decision to smoke versus the decision to choose a brand is driven by advertising for cigarettes, for cars, or for soap. You pay great attention to advertising once you have decided that you want a car. I do not think an ad will persuade you to buy a car if you do not want one, and that is what we are talking about here.
The Chairman: We will have to pursue these issues with other witnesses, and there will be an opportunity to do so. Thank you very much for appearing today, Mr. Parker.
Our next witness, Mr. David Bonfilio, is here to discuss what works well in other jurisdictions, in terms of public education aimed at reducing the incidence of smoking in the population. At a minimum, he would be able to tell us what works well in California, but he is not limited to that jurisdiction.
Welcome to Canada and to this committee.
Mr. David Bonfilio, Immediate Past Chair, American Cancer Society, California Division, Inc.: I am a volunteer for the American Cancer Society. My career is in banking. I am not a career activist.
When the American Cancer Society helped with the passage of Proposition 99, which is the program that funds our tobacco control in California, we made a promise to the voters of California that we would not accept money from Proposition 99. The American Cancer Society does not benefit in any way, directly or indirectly, from Proposition 99.
I have had an opportunity to scan Bill S-13, and I see several aspects which I like about the bill, and which would improve a tobacco control program in Canada. First, this is a levy, and not a tax. Therefore, it is not subject to the budget process. Second, the funds and the programs will be administered by a foundation separate from the government. I like those two aspects very much. When you hear my comments you will understand why.
In 1988 the California voters, 57.8 per cent of them, voted to pass Proposition 99, which established a 25-cents-per-pack surtax on cigarettes, and an equivalent amount on other tobacco products. Revenues raised were allocated as follows: Health education, 20 per cent. This was to prevent and reduce tobacco use, primarily among young children. Research, 5 per cent, to fund tobacco-related disease research. Hospital services, 35 per cent. Physician services, 10 per cent, which was for health coverage for those people who did not have it. Public resources, 5 per cent, which was an environmental issue -- we form very strange coalitions in California -- and 25 per cent was unallocated, to be used for any of the above five purposes.
Supported by these funds, the California Tobacco Control Program was launched in 1990. The primary goals were to change the social norms of tobacco use, to achieve a smoke-free society, and to reduce tobacco use by 75 per cent before the year 2000.
The California Tobacco Control Program consists of 61 local health departments, hundreds of community based organizations, four ethnic networks, eleven regional community linkage programs, a state of the art, state-wide media campaign, and nearly 1,000 local school districts across the state. These agencies are joined in a coordinated, multi-faceted effort to change the way tobacco and its use are perceived by the communities of California. Since 1988, California's adult smoking rate has dropped 42 per cent, from 26 per cent of the population, to 16 per cent of the population.
While Proposition 99 was fully funded, youth smoking rates levelled, while increases were seen in every other state in the United States. Proposition 99 has saved individuals in California $1 billion U.S. in medical costs. Research has indicated that the anti-smoking campaign, including community and school-based presentation programs, anti-tobacco advertising and quit-smoking programs, has saved the state $211 million U.S. per year in medical and other costs.
Cigarette companies spend approximately $450 million U.S. each year in California. Since 1989, California has spent an average of $84.3 million U.S. per year on tobacco control programs. You can see that the tobacco industry is outweighing us by about five to one.
In order to show the influence of both of these programs, particularly the media program, I have two examples. In 1993, a tobacco industry study -- done to counter another study -- showed that two-thirds of six year olds recognized Joe Camel, and understood that it marketed cigarettes. A study of the California media program in 1992 showed that adults recalled the anti-tobacco ads at a rate from 75 per cent for young adults -- by "young adults" I mean those over 18 -- down to 50 per cent among adults over 45, while adolescents recalled the anti-tobacco campaign at a rate of better than 80 per cent. The kids do see it, and they do hear it.
As I indicated at the beginning of my remarks, Bill S-13 has features that I like. Proposition 99 is subject to the budget process in California, therefore, there have been problems. Proposition 99 was not fully funded until fiscal year 1997. Beginning in 1993, major funds were diverted for other needs because of a budget crisis in California. As a direct result, youth smoking prevalence between 1993 and 1995 in California increased by 30.8 per cent, from 9.1 per cent to 11.9 per cent. With full funding, we are confident we can return to de-normalizing tobacco.
Proposition 99 was, and is, a comprehensive program. A price increase can be countered by the industry, as they did in the mid-1990s in California, but a price increase coupled with a comprehensive plan, including media, workplace and schools, can work.
Senator Kenny: You said that the government had saved $1 billion in health costs, then you went on to quantify the amount of savings that individuals had also incurred in health costs.
Mr. Bonfilio: It was reversed. We estimate it is $1 billion savings by individuals, and $211 million per year by the state.
Senator Kenny: As we look at our bill, we have been trying to calculate how soon there would be a pay-back in terms of health savings, and our assumption has been that it would take some time -- that cancer takes time to catch hold. We estimated that it would perhaps be 15 years before we would start seeing a pay-back with real cost savings. Can you explain why you have experienced savings in California so much sooner than we have anticipated?
Mr. Bonfilio: Firstly, tobacco use does not just affect cancer. It affects the heart, the lungs, and many other organs of the body. Amongst infants, there is Sudden Infant Death Syndrome. We also have colic, and all sorts of different diseases that children pick up. We are seeing saving in tobacco-related illnesses, and not just cancer. Some of those illnesses come on very quickly.
Senator Kenny: Based on your experience, would it be fair to say that we can expect a pay-back far sooner than we have anticipated?
Mr. Bonfilio: Yes.
Senator Kenny: Have you compiled a list of the winners and losers from the projects with which you have gone forward in California?
Mr. Bonfilio: We have a list of some of the winners and losers, which I gave to your office for distribution.
The Department of Health Services, which is part of the administration of the State of California, administers this program, and conducts on-site random sting operations. A DHS employee accompanies a minor to a retail operation, to see if the youth can buy cigarettes.
This program started in December of 1995. By March of 1997, they had conducted over 2,600 checks in 54 counties, which covers pretty much all of California. They found that illegal tobacco sales in the state had dropped from 37 per cent in 1995, to 29.3 per cent in 1996 because of this program. That does work.
Another example came to my attention today. I called Sacramento, because I wanted an example with a little more power. This example has to do with the African-American youth in South Central L.A. For those of you who remember the Rodney King riots, South Central L.A. is where the riots were the worst. It is an extremely poor community.
Under Proposition 99, a community coalition for substance abuse was formed. Young African-American kids decided on their own to monitor billboards in their community. They wanted to know the content of the billboards. Then they went to an affluent, upscale community to look at billboards. They were so angry when they realized that they were being manipulated that they went to the billboard company and said, "We will not stand for this." The billboard company was in a quandary, because these kids brought the press along with them. The company decided to allow the kids to design their own anti-tobacco messages, and to post them on billboards. Not only did we get the message across to the kids that they were being manipulated, we also gave them an outlet to overcome that problem.
Senator Kenny: I would like to turn your attention to Bill S-13. Perhaps you could refer to page 3 under the heading "Objects." We do not expect you to be an expert on our legislation, but we are asking you to give us expert testimony on your legislation. Having had a chance to review the objects we have in this legislation, does this give us sufficient room to have programs of the same nature as yours in California? Are the objects listed in this bill sufficiently comprehensive and inclusive to permit us to have programs of the sort that have resulted in your remarkable reductions in smoking?
Mr. Bonfilio: I believe so, particularly the last one, which states "generally, to do all such things as are conducive to its objects."
Senator Kenny: You believe that there is room in this bill to hit the same targets.
Mr. Bonfilio: Yes.
Senator Kenny: I had an opportunity to meet with the current chair of the American Cancer Society. I gather she has been very involved in Proposition 99.
Mr. Bonfilio: Yes.
Senator Kenny: She indicated that you would be prepared to share with us the results of the successful programs that you have conducted, and also of the programs that were not successful. In the event that this legislation passes, this would help to ensure that we do not have to reinvent the wheel.
Mr. Bonfilio: Definitely. We have turned our media campaign over to the Centers for Disease Control for that very purpose, so that we can share it with all the states, and not just keep it proprietary. We are very concerned about the implications of any legislation that we may pass in the United States on international tobacco sales. We are prepared to do that internationally.
Senator Kenny: During your remarks, you commented in particular about the value of a levy versus a tax, and the fact that a levy required all funds to be spent for the purposes listed in the bill.
Mr. Bonfilio: Yes.
Senator Kenny: Am I correct in saying that what happened in California was that, while the legislators initially accepted Proposition 99, they succumbed to temptation after a period of time, and decided to spend the funds that were intended to go to anti-tobacco programs on other things?
Mr. Bonfilio: Proposition 99 came from the people. It did not go through the legislative process. In California, voters have the ability to pass laws directly. Particularly in a law that affects money, however, we require enabling legislation from our legislature. It becomes part of the budget process. When we wrote up the initial proposition, we made a mistake, because we did have the legislature involved.
If you look at our brief, a chart of the budget summary shows the moneys going to the Department of Health Services, the Department of Education, medical services, and the research account, from year to year. You can see the variations in the dollars going to these various programs. The Department of Health Services probably shows it best. At $100 million per year, it is fully funded. In 1992, 1993, 1994, 1995, 1996, and 1997, it was not fully funded because we had a recession in California in the early nineties. There were other needs with indigent health care, and the legislature and the governor moved the funds to those other programs.
Senator Kenny: You also made the point that you saw a particular value in the fact that the fund would be operated by a foundation that was at arm's length from the government. Would you care to elaborate on that, please?
Mr. Bonfilio: Since the program has been fully funded, we have had problems with the media account. We had some very hard hitting ads, and they made a great impact on the population early on in the program. The current administration is not as willing to be "in your face" as the previous administration was. We do not have the same time of control.
You mentioned that you met Jenny Cook. She was appointed by the governor to chair the committee that produced this particular report. The committee is critical of the administration, of the media account, and of the way that it is been handled. If you can separate it from the government, you are much better off.
Senator Kenny: You are saying that the government was subject to industry pressures somewhere, and for some reason decided to stop those who were producing anti-tobacco ads. In effect, the government censored the effort health groups were making to combat tobacco use amongst youth.
Mr. Bonfilio: Tobacco companies spend $450 million in California a year, which is a tremendous amount of money coming into the economy, and not all of it is in advertising.
Senator Kenny: I am sure that we can all read between the lines there.
The Chairman: What does a package of cigarettes cost in California?
Mr. Bonfilio: That is a good question. I have not smoked in many years, that I could not tell you for certain. I think that is a little more than $1.
The Chairman: Someone will correct me if I am wrong, but I think that a package of cigarettes costs about $4 in Ontario.
Mr. Bonfilio: Yes, Canadian cigarettes are more expensive.
The Chairman: In Ontario, they are $4, and somewhere between $1 and $1.50 in California. That is pretty cheap.
Mr. Bonfilio: Yes.
The Chairman: Yet you have had this very considerable decline.
You tell us that cigarette companies spend approximately $450 million each year in California on advertising, marketing and promotions mainly targeting youth. You also say that, since 1989, California has spent an average of $84.3 million per year on tobacco control programs.
Mr. Bonfilio: Yes.
The Chairman: Is it your evidence that your $84.3 million is more effective than their $450 million?
Mr. Bonfilio: Yes.
The Chairman: Why is that?
Mr. Bonfilio: In the example of the African-American youth in south central L.A., we were able to demonstrate the manipulation to which they had been subjected. We have been able to show that time and again, and the people of California get it. Right now -- and this has been consistent for the last three or four years -- if you ask voters in California if we should have a strong anti-tobacco program, 70 per cent of them say yes. It is consistent.
The Chairman: Is it the media advertising that is most effective on your side?
Mr. Bonfilio: It is everything. We are de-normalizing the use of tobacco on all sides.
The Chairman: Most of the money is spent on media advertising.
Mr. Bonfilio: In dollars, because of placement, yes. However, as far as the number of programs, there are more programs in the communities and in the schools than you would see in the media.
The Chairman: What restrictions are there on the companies in terms of advertising? Can they advertise on television and radio, and in newspapers and magazines?
Mr. Bonfilio: They can only advertise in print media, but they can advertise at sports events and things like that.
Senator LeBreton: In other words, witness, you have achieved all of these excellent results by embarking on major campaign of demystification. You have not brought any kind of law in to restrict tobacco advertising in California, in things other than print or the sponsoring of sports events. Car races held in California or in other parts of the United States are not banned from advertising tobacco products. Your evidence seems to suggest that, with a levy such as yours, and with a very targeted media campaign designed to counter the industry's own advertising, these results are still possible even though the companies are not banned from advertising or sponsoring sports events.
Mr. Bonfilio: Yes, but we are trying to get the ban on sports events. That is a major venue that kids look to. Kids are looking to be cool, they are looking to be sexy, and they are looking to grow up before their time. All those things that we remember from when we were kids are still true of the kids today. We are trying to get these same types of bans.
Senator LeBreton: In California, would you then suggest a similar method to the one that we are suggesting in Bill S-13, which would take the place of tobacco sponsorship at sporting events, and cultural events such as theatre? What is being considered in California? What are the cultural agencies and the sporting people saying about sponsorship? Are they expecting you to come up with replacement dollars?
Mr. Bonfilio: No. In the Del Mar fair, which is down near San Diego, a tobacco company was going to be a major sponsor -- I believe it was Marlboro. The community got up in arms, particularly the Hispanic community, because the attendance is huge, and the audience is largely Hispanic. They did not want a tobacco company being the major sponsor, and the community went to the fair and said that it would not attend if Marlboro were the sponsor. The fair refused Marlboro's sponsorship, and the community said that it would help find an alternate sponsor, but the government did not.
Senator LeBreton: So did the event take place? Did they find alternate sponsors?
Mr. Bonfilio: They can find alternate sponsors.
Senator LeBreton: This is a problem. Many sporting and cultural groups are very worried. The intent of my colleague's bill is to, over time, replace the advertising and sponsorship dollars through this levy. I was curious as to whether California had considered adding this feature Proposition 99.
Mr. Bonfilio: We have something called the First Amendment in the United States. It causes several problems in this area.
Senator LeBreton: It would be against the law?
Mr. Bonfilio: Yes. The tobacco industry would have to agree to it.
Senator LeBreton: For the foreseeable future, then, we will still see sponsored events in California and other parts of the United States, because the First Amendment applies to the whole country.
Mr. Bonfilio: Yes, unless we can have more Minnesota trials.
Senator Stollery: I am looking at the objects of the foundation in the bill. Clause 5(e) provides that one object is to monitor the use of tobacco by gathering and publicizing statistics. You listened to Mr. Parker, the previous witness. It seems a little strange that, 40 years after the problem was clearly understood, the tobacco industry still denies all the statistics that we heard. It is hard to believe that, after 40 years, we do not have some idea of the situation, and know that some of these statistics are correct.
Do you get the same sort of sophistry and blanket denial of statistics in California? Is this the standard method of procedure for the tobacco industry?
Mr. Bonfilio: Yes. On television, some of you may have seen the CEOs of all of the major U.S. tobacco industries standing up before Congress to say that they did not think that tobacco was addictive. We turned that into an effective anti-tobacco ad and said, "Who do they think they are kidding?" That is exactly what the people of California think.
Senator Stollery: I notice that 5(e) mentions gathering and publicizing statistics. Having read this, and having listened to one of the representatives of the tobacco industry, it seems to me that this might be a very good thing. It would, I hope be difficult to deny the legitimacy of statistics gathered using this subclause. It sounds like an excellent idea, particularly in view of the tobacco companies' massive denial of everything.
Mr. Bonfilio: I would agree with you. Even though we have had very reputable researchers doing the studies for us in California, getting large populations, and statistical, relevant information, the tobacco companies will still deny the information or say, "That is not quite true."
Senator Nolin: You mentioned the fact that you have a decrease in your budget because of the budgetary process in California. Could you explain to us the effect of that on the prevalence of adolescent smoking?
Mr. Bonfilio: I will go back to my documents in order to quote them exactly. Among adolescent, the rate went from 9.1 to 11.1, from 1993 to 1995.
Senator Nolin: That coincides with the period when your funding was decreased?
Mr. Bonfilio: It coincides with a major drop in funding, yes.
Senator Nolin: You have researched that, and been convinced that that is the reason for the increase in the prevalence of smoking among adolescents?
Mr. Bonfilio: Yes.
Senator Cools: I was struck by your story about the African American youth and their billboard initiative. Have you any data on use of tobacco by black adolescents in those ghetto areas, in comparison to use by non-black or white youth in other districts? I have an incipient interest in the plight of young people in the ghettos because so many of them are marginalized into concrete jungles. I believe the Americans have coined the term "the underclass."
Could you give us some insights? I do not need that insight to be able to support Senator Kenny's bill, but I should like to have some insight on relative use.
Mr. Bonfilio: Tobacco use among Hispanic youth and African American youth was, for a long time, a beacon of hope. There is a much stronger family structure in those communities. For a long time, it just was not cool for Hispanic kids or African American kids to smoke. I think you are aware that our Surgeon General unveiled a report two weeks ago, which showed that, across the country, there has been about a 70 per cent increase in the rate of smoking among African American youth, and about a 35-per-cent increase among Hispanic youth. We are trying to see if those figures are exactly the same in California. We do know that there is an increase in California in both populations, but we do not know whether it is to the same extent. However, as these kids in South Central L.A. found out, the under-served communities are being targeted.
Senator Cools: Do you have any insights or data on the gender differences between black adolescents males and Hispanic adolescents males, and black and Hispanic adolescent females? I read somewhere that there is a difference.
Mr. Bonfilio: There is a difference in smoking rates between sexes in all races. Smoking rates among teenage girls are higher than among teenage boys. I have not personally seen data by ethnicity, so I cannot answer your question. However, I can tell you that there is a difference between.
Senator Cools: In favour of females?
Mr. Bonfilio: Unfortunately, in favour of girls, yes.
Senator Cools: That is what I was told. I did not want to believe it, so I was looking for confirmation.
The Chairman: Is there a tobacco crop in California?
Mr. Bonfilio: If there is, it is minute.
Senator LeBreton: I believe that there is a higher incidence of smoking among teenage and adolescent girls in Canada as well.
Have you done any studies in California to relate this directly to diet, and their desire to be slim?
Mr. Bonfilio: A study has been done, as part of looking at the whole program. There are about ten aspects to that. Weight and appearance is one of the reasons that kids give for smoking. It is beyond just being cool, being "in", or wanting to emulate someone. It is also body appearance.
Senator LeBreton: There seems to be a belief among young women that, if they smoke, they will eat less -- it will curb their appetite.
Mr. Bonfilio: They have heard of so many people who give up smoking and gain weight. They interpret that to mean that, if they start smoking, the reverse will happen.
Senator LeBreton: That is the Virginia Slims "You've come a long way, baby" type of message.
The Chairman: Thank you very much, Mr. Bonfilio for giving us the benefit of your report.
Senator Kenny: I, too, would like to thank Mr. Bonfilio for coming so far, and for being so helpful. I should like to take advantage of the opportunity, as we are being televised on CPAC, to encourage listeners who were intrigued by what Mr. Bonfilio told us about Proposition 99 to write us, and to write their members of Parliament. They would like to hear from you, if you think that what was done in California would be useful here in Canada.
I should also like to take this opportunity to point out to members of the committee Mr. Roy Cullen, the Member of Parliament for Etobicoke North, is present this evening. He has undertaken to sponsor the bill in the House of Commons.
I would welcome, Mr. Cullen. If you have time to join us, please do.
Mr. Roy Cullen, Member of Parliament: Thank you very much.
The Chairman: We have several very important subjects to address. First, how can adolescents be motivated to avoid smoking, or to stop smoking? How would a youth education fund be used as part of this exercise?
Our next panel is prepared to proceed. One member of that panel is Dr. John C. Luik, an academic who has published and commented on adolescent smoking. Dr. Luik's name was suggested by Mr. Parker of the Tobacco Council. That is not to say that he is a witness for the tobacco industry. He was recommended as someone with academic and other credentials on this subject.
The other four witnesses were suggested by the sponsors of the bill, Senator Kenny and Senator Nolin. That is not to say that Senator Kenny and Senator Nolin are responsible for what these witnesses will say. I thought that you should know how these names came forward.
Dr. John C. Luik, Individual: Honourable senators, thank you for inviting me to speak on this topic. Having said that, let me perhaps tread on your hospitality by suggesting that the question which you have put is not the correct one. The question may not be how adolescents can be motivated to avoid or to cease smoking but, more aptly, whether adolescents can be motivated to avoid or cease smoking. More particularly, we must ask whether adolescents, through any of the mechanisms envisioned in this bill, can be motivated to avoid or cease smoking.
You might ask why I take such a sombre and perhaps downbeat note after what has undoubtedly been an upbeat day of questions about adolescent smoking. Let me suggest several reasons. Unquestionably, the public policy measures which have been instituted by this government and previous governments, and which have been recommended to committees such as yours for the last 20 years in Canada could only be described as singular failures. They are failures when judged by any objective criteria, namely the one you use when looking at any other public policy measure: Have they worked? Have they reduced that stubbornly high statistic of the number of children who continue to smoke in Canada?
Let us look at the evidence, and this is not the tobacco industry's evidence. This is evidence produced by Health Canada, because that is where the statistics come from, or StatsCan, if you want a world-wide and unquestionably objective source. The statistics suggest that, at least in the last six or seven years, there has been no significant decline in smoking prevalence amongst young people in Canada.
When you come back to the question of whether the public policy measures passed by this body and the House of Commons, and instituted over the last 20 years have worked, the answer is qualified: They have worked for some young people. The general rate of smoking over the last 25 years in people under the age of 19 has fallen from about 40 per cent down to -- depending on the source of the statistics -- either 21 or 29 per cent or, in some instances, 30 per cent. There has been some decline in the number of young people who smoke.
What are those measures? They include increased restrictions on access, increasing the age at which it is legal to buy a cigarette, banning cigarette advertising and promotional activities, restricting access to cigarettes in more vigorous sorts of ways, suggesting that all cigarettes be put in plain packages, and significant pricing increases. All of these together have failed to budge that stubborn high number of about one-third of adolescents who still regularly use cigarettes in Canada.
It is interesting that, in most industrialized countries, sometime during adolescence most kids -- 75 to 82 per cent, depending on the country -- will try a cigarette. Only about 30 per cent of them -- or 25 per cent, depending on the source of statistics -- will go on to become regular, daily users of tobacco. When we are talking about how adolescents can be motivated to avoid or cease smoking, we are not talking about the three-quarters who try a cigarette; we are talking about the 25 or 30 per cent who are regular users of the product.
When I started with that somewhat cynical question of whether in fact you have the right question, not "how" but rather "if," what I meant is that the collective emphasis of all of these policies has not really done anything about the hard core continuing smokers.
What might be the reason for that? I suggest that this bill will simply perpetuate the policy mistakes of the last 20 years. It puts the same people who do no understand why adolescents smoke, and who, for 25 years, have been unable to design any effective policy to prevent youth smoking, in charge of smoking policy. To me, it seems a singularly peculiar public policy step. It puts the policy crew which has been unable to address the problem of smoking amongst young people in charge of the reduction of the problem.
Why would I say that they have been unable to address this problem? The answer is fairly obvious. Their policy recommendations, the four or five that I quoted to you at the beginning -- tax increases, restrictions on advertising, restrictions on access, increasing the age of legal accessibility to tobacco -- are, except for one on access, completely disconnected from what the academic literature about smoking uptake amongst juveniles says. Therefore, it is not surprising that none of these public policy measures have worked. They are not theoretically based on what the people who actually study why children begin to smoke say.
For instance, three to four years ago a colleague from Concordia and I presented evidence before a body in the House of Commons, and in this place. This was evidence taken from one of the most comprehensive studies ever assembled on why, in fact, juveniles begin to smoke. It was called "Why Children Begin to Smoke." Two Canadians co-authored the study. It is by Conrad, Flay and Hill. In fact, they are some of the world's best researchers on smoking amongst children. The result over the four years has been what? Not a single one of the predictors of smoking uptake on the part of children has been addressed by the Government of Canada.
What were the most significant predictors of whether in fact children would go on to become smokers? One of the most interesting was that smoking is part of a cluster of adolescent risk-taking behaviours. Notice the words, "adolescent risk-taking behaviours," which include not wearing helmets when riding motorcycles, not wearing seat belts, engaging in risky and unprotected sex, over-indulging in alcohol, using tobacco, and using marijuana. In other words, we are talking about the same 30 per cent of kids who show up on all the statistics who are notorious risk takers, whether with tobacco, alcohol, soft drugs, or seat belts.
The work by Conrad, Flay and Hill, and others, was updated two years ago when Flay and others produced a very comprehensive work on the triadic influence theory of young smokers. Their work consistently shows the three most important risk factors for whether children will, in fact, become smokers are these: Whether they are or have risk-taking personalities, whether in fact they exhibit rebellion against parents or authority figures, government or school, and whether in fact they drop out of school or have poor school performance.
In 20 years of government measures on tobacco control, and of hearing measures proposed by the groups who will come before you, and who would be established as the new mandarins of tobacco control policy by this legislation, not a single one of these predictors has ever been addressed as a matter of public policy in this country. Instead, you have been told repeatedly that it is tobacco advertising that leads young people to smoke; despite the fact that youth smoking did not decline a wit during the almost nine years when there was no tobacco advertising in Canada.
The government's own commissioned study, the National Forum on Health, which reported two years ago to David Dingwall, produced a list of seven or eight policy options on how to deal with the problem of adolescent smoking. Not a single one of those policy options, and I have included them in my brief directly from the report, has been addressed by either Health Canada, or the antismoking movement in this country.
Therefore, when I express some scepticism about whether this bill will do anything to deal with the problem of adolescent smoking, it is on the basis of the record of the people who, under this bill, would preside over tobacco policy in this country. It is a record that can only be called disgraceful; disgraceful when judged on whether it has done anything about adolescent smoking.
I must, in this spirit, put a negative suggestion to you: If in fact you are really interested in dealing with the problem of adolescent smoking, I would suggest that you establish a panel of competent, world famous academics, who know something about why it is that children begin to smoke. I am not including myself. I am referring to people who have published study after study in academic journals. In fact, I would then suggest that you focus measures on school, literacy, risk, and rebellion.
They will not get you the evening headlines, as banning sponsorship, or banning advertising, or increasing the cost of a pack of cigarettes by $2 a pack might. All those things make nice sound bites on the evening news, but I invite you to consider whether they have done anything to stop kids from smoking.
My message, in being cynical about this question, is to say that not "how" but "whether" is the question, if you maintain the same policy paradigm that has been used for years. Regrettably, this bill puts the same tired experts, with their same failed policies in charge. In another ten years, we will be back here, and you will be asking the same question: Why do 30 per cent of Canadian kids still smoke on a regular basis? We need to take solid science about youth smoking and connect it to public policy. There is absolutely no evidence in this bill or from the sponsors that they have a clue about what the solid science says, or that they are, in fact, ready to put it into practice.
[Translation]
Ms Lilianne Bertrand, Director, Health Promotion, Heart and Stroke Foundation: On behalf of the Heart and Stroke Foundation of Quebec, I want to thank you for this opportunity to talk about an initiative that we undertook in 1996-97 involving young Quebeckers between the ages of 12 and 17.
At the outset, our target group was teenagers. Our primary objective was to reduce smoking levels, while focusing on self-esteem and healthy body weight. The foundation felt that given its experience in the field of nutrition, it could help young persons adopt better eating habits and, at the same time, kick the smoking habit.
Our goal was to work within communities. It was important to us that young persons be given an opportunity to shine within their community. These were the objectives behind our project.
Before we got started, we set up an advisory committee and went into the community to meet with young persons and stakeholders, since we wanted to work outside the school setting. The foundation already had a certain amount of expertise conducting programs in a school setting, but this time around, we wanted to focus primarily on youth centers and youth homes to get our message across to youths who may have dropped out of school. It was important for us to reach this segment of the population.
We realized that it was important to include not only teenage girls, but also teenage boys in our feasibility study. Neither group could be excluded.
We issued invitations to tender. I should also mention that this project was made possible through the support of Health Canada. Since our project was designed for young persons to be carried out by young persons, we asked youth homes to submit projects in line with our objectives, namely reducing tobacco use, increasing self-esteem and focusing on the importance of a healthy body weight.
We received in the neighbourhood of 30 project proposals and selected 21 to be carried out across the province. The foundation divided the province into ten regions and projects were carried out in each one. Projects ranged from drawing contests, car rallies, climbing contests, theatrical productions and CD-ROMs. Each project was subsequently evaluated.
Our plans called for putting together a kit to be distributed to youths and youth homes. The 21 projects were conducted in youth homes by young persons with the help of workers and the Heart and Stroke Foundation.
One of our goals was to have young persons work in the community and make their presence felt. To help them do so, we produced promotional material, posters and bookmarks to enhance their profile in the community.
In our subsequent evaluation, we noted that several of these groups had indeed been active in the community, had appeared on community television and had even organized walkathons. They organized dinners attended by parents and adults so that they could share in the experience.
In terms of putting together a kit, we asked the participants in the 21 projects for ideas. For example, if they mounted a theatrical production, we wanted to know how they went about this. What steps did they follow? Where did they find their information on smoking, healthy body weight and self-esteem to include in their initiative? We put together a guide for distribution across the province outlining how each activity was developed. We printed a total of 1,000 copies in French and in English. The only problem we encountered was a shortage of time. Although the program spanned a one-year period, lack of time was the biggest obstacle we encountered. Even the young persons felt they could have used more time to carry out there project. We subjected them to impossible deadlines. We came in under the wire, but since we exhausted all of our funding from Health Canada, we were unable to distribute our kit to as many people as we would have liked.
Although we did manage to distribute our kits throughout the province, we were unable to reach all with the 700 youth groups on our list because of a lack of funds.
Had we had the time and more money, we could have launched a number of educational activities using these kits. Young people need educational activities and support in order to go further. However, we ran out of time and energy.
During the course of the year, the project was evaluated by an outside firm. Representatives met with young persons and stakeholders. We learned that youths greatly appreciated this initiative because they had helped to develop it themselves. Their interest stemmed from the fact that they had been involved in gathering the information needed.
[English]
Ms Dawn Walker, Executive Director, Canadian Institute of Child Health: The Canadian Institute of Child Health is the only national, non-governmental organization in Canada solely committed to developing health promotion and disease prevention programs for children. For over 20 years, the CICH has been working to ensure that the concerns and needs of Canada's children and youth are heard.
Through research, education, child health monitoring, coalition participation, and our many publications and programs, the institute strives to improve children's health and well-being, and to promote physical and emotional health.
I share with my colleague the view that we have known for many years why adolescents start smoking. The common reasons are usually based on expected and normal growth and development. They would include the desire to be part of a peer group, normal rebellion and expected detachment from parents, striving for independence, risk-taking behaviour, self-image such as weight control, and stress release.
During formative years, as early as three years of age, we are all influenced by societal messages, including tobacco advertisements, and promotions that offer an enviable lifestyle and provide real answers and solutions addressing the adolescent growth and development stressors.
If tobacco were not addictive, this habit, often described as a rite of passage, would go the way other rites of passage go. The behaviour of adolescents becomes moderate in all ways as they grow up. However, with tobacco, some become hooked, requiring sustained, comprehensive, multi-sourced cessation initiatives if they want to stop.
Some stop, usually for a reason, such as young men concerned about sports performances. Some stopped or cut down when the price soared. Many young women, unfortunately, do not have a clear reason to quit until child bearing when many, thought to be the majority, do stop. However, the postpartum relapse rate of about 75 per cent is alarming, as the newborn and growing child are now living in an environment with at least one smoking parent, and often two.
We know that children who live with a parent who smokes are at a higher risk of SIDS, of respiratory and ear infections, and of becoming a child or adolescent smoker themselves.
We know that to quit requires motivation, which can come in many ways. Some quit for the benefit of others, for money, for health, et cetera. We also know that there are real psychological and physiological barriers to quitting an addictive habit. Those attempting to quit need access to sustained, comprehensive programs and support in a variety of places; home, school, and the workplace. Help needs to be cheap, and to be available when people want it.
People have unique needs and respond to different approaches. We therefore need different models; peer-led, professional, individual programs, and group sessions. There is no single, simple solution.
We need this dedicated and independent fund. We must provide for sustained and comprehensive programming. For example, we currently have lots of resources, models and information developed during the Tobacco Demand Reduction Strategy, and we have a huge manual of all the youth programs. However, many organizations now have no money to promote or disseminate the material. Others have no money to purchase it. There is no money to reprint, and there is no money to implement.
Our own program, Helping our Kids Breathe Easy, falls into this dilemma. Our program is a community response program to reduce environmental tobacco smoke that affects children. There is no money at the moment to continue the program, to adapt it for adolescent use, or even to address in a comprehensive manner the complex issue of postpartum relapse.
My current position is Executive Director of the Canadian Institute of Child Health. My previous position was as the director of the Tobacco, Alcohol and Other Drug Division of the Health Promotion Directorate of Health Canada. Owing to my experience in that previous role, I should like to recommend that funding must be independent of the government bureaucracy and political system. There, financial support for tobacco demand reduction is sporadic, often stalled due to other priorities, or given up for the other funding demands of the day, and politically dispensed.
In closing, I should like to address a final reason for which adolescents smoke, and to look at why they continue. Sadly, it is a matter of trust. Despite their in-their-face attitude, up-front scepticism, and risk-taking behaviour, they are still child-like in their trust. "If it really were that bad, it just would not be allowed," is often expressed. It defies their reason that, given the facts, society, their parents, and governments would really let them do it. Dispelling the myth that society and government are protecting children and youth is the biggest challenge facing any public tobacco reduction campaign.
I was very pleased to hear my colleague from California talk about the campaign there. My previous experience certainly concurs with what he put forward.
How does government convince young people, if government is responsible for a public campaign that tobacco really causes major disease and kills, when that same government is responsible for it being legal, promoted, and available?
We look to an independent fund that would support more sustained, direct, and hard-hitting campaigns, and prevention and cessation programs that will truly make a difference.
The Chairman: Thank you.
[Translation]
Mr. Mario Bujold, Conseil québécois sur le tabac et la santé: I was surprised and even dismayed to hear the comments made earlier by Mr. Parker, the tobacco industry representative. I got the impression on listening to him that we were living in a different age and on a different planet. Mr. Parker has the temerity to claim that the statistics reporting 40,000 deaths each year in Canada as a result of smoking are not reliable. I have to wonder where he gets his information. I have seen the studies that are regularly produced and I know that the data is reliable. He claims that educational activities are not in the least bit effective. Again, I have to wonder where he is getting his information from because our organization is involved on a daily basis with young persons and has witnessed firsthand the effectiveness of such programs. Studies have demonstrated the impact that anti-smoking programs have on young persons.
That being said, let me reiterate that according to reliable data, tobacco consumption among young people has taken on worrisome proportions in Quebec in particular. Perhaps you know that the percentage of young people who smoke in Quebec has doubled in five years. Between 1991 and 1996, it went from 19 per cent to 38 per cent. Forty-three per cent of young women smoke.
We are talking here about an enormous health problem, a major public health problem and a totally unacceptable situation.
It is curious to note that this increase in smoking over the past five years corresponds to the period during which tobacco taxes were reduced. We are all familiar with the contraband which came to light in 1994 and the decrease in taxes which followed. Statistics show that the tobacco consumption curb increased significantly after 1994 until 1996; a strange phenomenon. We also noted that the tobacco industry increased its publicity and promotion campaigns significantly during those same years in different ways, including sponsorships. That is one way tobacco companies convey their message. They defend themselves by saying that sponsorships are not publicity as such, but they are the only ones to believe that. Advertisers say that sponsorship is publicity.
What can we do to encourage adolescents not to smoke or to stop smoking? That is indeed the current question. Should taxes increased again to pre-1994 levels? Should tobacco publicity and promotion be prohibited? Even if both of those things were done, that would not be sufficient. Those measures would certainly have an effect on tobacco consumption among young people, contrary to what the tobacco industry claims, but they would not be enough. The problem is much broader.
A recent study points to the kind of thing that can be done. There were examples from California and others will be given during the presentation. A recent study carried out in Quebec compares different studies carried out in various parts of the world on the prevention of smoking among young people; it draws conclusions on the most effective approaches, those most likely to reach young people. In the brief I submitted, I chose some features from that study that seem very interesting to me.
First, the authors of that study define the problem of smoking among young people, and its causes. They say among other things that young people begin to smoke because their friends smoke; they are influenced by their peers. They try smoking out of curiosity. They think it is "cool" to smoke. Young people who smoke are more popular, or their mother or father smokes. They see smoking as something positive. They have a positive image of smoking. One might wonder why. They believe that basically tobacco will make them better, will make them superior, more appreciated, will allow them to project a better image, will raise them up a notch. When you look at tobacco publicity, that is what is being presented, the models are heroes, people at the top of a mountain, who have climbed the mountain and reached the summit. When you look at Jacques Villeneuve, the association is clear: Jacques Villeneuve is a model for young people. Not all young people want to become race car drivers, but Jacques Villeneuve becomes a model, a person to emulate. He does not smoke but the image he conveys is that cigarette smoking is an acceptable and desirable phenomenon associated with his success. That is dangerous and there is a problem there.
Earlier, I listed the reasons that lead young people to smoke. We note that there are a number of factors that determine whether young people will smoke or not, and the major one is the social environment. There are indeed several factors that lead young people to smoke. Their perception and attitude to cigarettes can be influenced by the social situations they find themselves in. A study done by the U.S. Surgeon General and the U.S. Department of Health and Human Services points to the most effective means of preventing smoking among young people. They have developed a model that allows us to understand what leads young people to begin to smoke. They have identified five steps in that process; those steps are preparation, which is the point at which young people do not smoke but are beginning to create their mental picture of smoking, their perception of smoking, what they think and perceive cigarettes to be. Another step is experimentation, the time the young person smokes her or his first cigarette. After the experimentation stage, the young person will smoke on a regular basis, repeatedly. This will be done with friends, peers. After that stage comes regular use and an addiction problem the young person cannot get rid of. Those are the five stages identified by those researchers.
In that study, they took into account a series of studies carried out to arrive at that synthesis. I will spare you all the details included in this table. You have all of them in the brief I submitted. Generally speaking, what we must understand from this brief is that intervention has to take place in the young person's social environment.
We must enable him to have better self-esteem in order to develop the skills to resist the cigarette that is offered to him but we must also intervene at the societal level, the family level and the school, in different ways. My colleague will refer more specifically to the type of interventions that can be carried out, their reasons and how they can actually be done. I won't say anymore about that aspect.
There is no single effective approach to reducing smoking among young people but a series of methods, as Mr. Bonfilio said earlier, to make cigarettes socially unacceptable. Young people smoke a great deal because they perceive cigarettes as attractive, normal and almost desirable. Often, parents have an important role to play in that regard but they are not the only ones to be held responsible. Publicity will inevitably have an effect on the perception young people have of tobacco.
Generally speaking, the steps to be taken involve educational programs to raise self-esteem, programs to affect policies and further public health. These could be policies prohibiting smoking in some environments such as the school, for instance. Young people's links with community and family may also be strengthened and people in that environment may be called upon to help young people avoid the first step and not begin to smoke; you can have broader campaigns at the community and media levels, as well as interesting or favourable tax policies.
For instance, contrary to what some claim, the fact that tobacco is or is not available to young people is an important factor that will impact on whether or not they will begin to buy cigarettes and to smoke them. Higher cigarette prices have a deterrent effect.
I referred to restrictions in work places and schools. Prohibiting tobacco promotion and publicity seems absolutely essential to me.
To refer to our own experience, over the past three years we designed a smoking prevention program implemented throughout Quebec and known as the "Youth Coalition Against Smoking," in French "La gang allumée pour une vie sans fumée." The program has been offered in hundreds of schools and youth centres throughout the province. The program's fundamental principle is to make room for young people themselves and allow them to define the type of intervention they see as most effective to encourage other young people to not begin smoking.
Young people have solutions to suggest to urge other young people not to start smoking. They are in the same situation and are in the best position to speak to other young people and have an effective impact on them. This is what we have noted through this program where young people are really models for their peers or for younger groups.
During the last two years of its implementation, the program has allowed us to get in touch directly with more than 81,000 young people throughout the province. We have not measured the impact of the program, i.e. the number of young people who stop smoking because our budget did not allow us to carry out a scientifically valid impact evaluation.
The comments made by those who deal with young people in schools and youth centres, however, concerning the program's effects over the past three years clearly point to the program's effectiveness. It would be interesting to actually measure the impact. Young people and those who deal with them are in favour of the approach and that is a sign that we can do something and that the program gives results.
[English]
Dr. Roy Cameron, Director, Waterloo Smoking Project, Centre for Behavioural Research and Program Evaluation, National Cancer Institute of Canada: Thank you for the invitation to speak at these important hearings. I agree with Dr. Luik that it is important to build on strong science. Unlike him, however, I think that there is a scientific case to be built for taking action now -- strong action. I think that we have a lot to learn, but I want to emphasize the amount that we know.
If we want to be serious about addressing the problem of youth smoking, we must start with the recognition that there is no silver bullet -- no one thing we can do that will make a difference.
If we are serious, we will set in place a set of policies, educational programs, and media interventions that will be coherent, mutually potentiating, and harmonious. The purpose of the policy pieces is to create an environment that reduces the exposure of young people to influences that will lead them to smoke.
The first important piece of policy legislation is to ban promotion. Let me leave you with one image. The Joe Camel campaign in the U.S. is a campaign you may have heard about before. Prior to 1988, Camel cigarettes were an old man's brand. It had one-half of 1 per cent of the youth market. Three years after introducing Joe Camel, Camel had 32.8 per cent of the youth market. To me, that is a very strong indication that tobacco promotion influences the behaviour of young people. When the tobacco industry asks us to believe that they are only competing for market share, think about it. What they are asking us to believe is that they can influence an 18-year-old who smokes, without influencing her friend who does not yet smoke. That is a very highly honed marketing strategy, I submit.
There is good evidence, in my view, that banning promotion is likely to make a difference, in the sense that there is evidence that tobacco promotion does impact on youth behaviour. I have given you one snippet, but if you want to see the tome, there are two reports I would suggest you examine. One is the U.S. Surgeon General's report. The other is a report that our centre prepared for the National Cancer Institute of Canada.
The second policy measure that is important is to increase tax. There is no point in stopping there. Mr. Parker conceded that as price goes up, consumption goes down.
The next measure is limiting access. We heard the California experience that access can be limited, and there is reason to act on that front. I also believe that it is important to restrict smoking in public places, so that smoking does not occur where youth congregate. There is no evidence on that that of which I am aware, but it is a plausible measure, and a sensible thing to do.
With respect to education, if you look at the U.S. Surgeon General's report, 1994, you will see evidence that elementary-school-based programs do reduce smoking among youth.
Our own research at the University of Waterloo has indicated that these programs are very effective in schools where there is a lot of smoking going on. They may not be effective in schools where there is very little smoking going on. We have something to learn about the targeting, but we know a great deal about the effectiveness of these programs.
I would like to mention that, as part of our intervention study, which evaluated our program in a randomized trial supported by the U.S. National Institutes of Health, our group did a lot of the research on rebelliousness and youth onset. It was a large study; we had 5,000 children in 100 schools. We measured rebelliousness, and we found that rebellious kids indeed were at risk of starting to smoke. Our program had a favourable influence on them, however, just as it had a favourable influence on the other kids. In other words, Mr. Parker's concern that we may provoke more smoking by working hard to restrict smoking did not come true in our study.
The next topic is high school programs. Relatively little work has been done in high schools. Our group, as part of the trial I described, developed and evaluated a high school intervention. We found that it resulted in a significant reduction in smoking among young men, but not among young women. On the strength of those findings, the Province of Ontario made that program available to all high schools in the province.
Next is youth cessation. Most youth want to quit. Very few of them plan to be smokers in the long term. We know very little, in my estimation, about how to help them quit. There is a need for development and evaluation work to create programs that are effective in helping young people quit smoking.
We also need to develop community programs that will engage the entire community in the smoking prevention effort. Approximately five studies now show that school-based programs work best when offered in the context of a more comprehensive community program.
I do not want to say anything about media, except that I believe media initiatives should complement policy and educational initiatives. One function of the media agenda should be to advance the policy and educational objectives of the program.
I agree that, to guide our efforts, evaluation is extraordinarily important in this. We have a lot to learn. As the world evolves, it is possible that what works will change, and we need to be on top of that. We need to be consistently monitoring what is and is not working, so that we can make intelligent adjustments to our programming.
In that spirit, to give you a sense what is out there and potentially available, our group at the University of Waterloo has created a school-based smoking profile. We have developed a machine-readable questionnaire that kids and teachers can administer. It comes back to the school. We run it through a computer to get a computer-generated report that tells the school about smoking patterns within the school; how the school norms compare to provincial and national norms, where kids are buying their cigarettes, and how they view smoking. We found this very useful for getting smoking on the agenda at the school, and it has the potential to get it on the agenda of the community.
Finally, it is important to invest in research and development. I would separate out two tasks. One is the task of identifying effective programs, policy and media that have been invented elsewhere. We should not be reinventing the wheel. People around the world are working on this. We should be identifying the things that are working in other places, and importing them.
We also need to develop at home those policies, programs, and media that have not been developed elsewhere, but which are required to fill the gaps. We need not only to develop these, but also to rigorously evaluate them, so that they will make a difference when we disseminate them.
The Chairman: Ms Walker, you are a former federal public servant who has had some experience with the strategy to reduce tobacco use in 1985 and, I suppose, with the social marketing program launched in 1987 -- the anti-smoking advertising and all that. Those were quite powerful television ads, I thought. Do you agree with Dr. Luik that the strategy was a failure?
Ms Walker: No, I do not agree with the overall opinion that the strategy was a failure. It did not reach all young people in terms of making a difference, but we always knew that.
I like this bill because I feel that a sustained marketing strategy would be better if it were independent from the government.
The Chairman: Why is that?
Ms Walker: When we started to focus-test and put together the marketing campaign, we tried to do it in a transparent way, with an advisory committee made up of a number of people from across Canada. As we started to develop the campaign, it became less direct. It became softer, because there was a concern of political liability. It became very difficult. We did have the material from California. We had a number of ideas, and we had marketing firms looking at hard-hitting information. We were trying to debunk or address the issue of manipulation by the tobacco industry. We were trying to talk to young people about manipulation. There was a nervousness about taking on the industry.
I would hope that, if there were an independent fund or foundation which could perhaps be more direct without the same concern for political baggage, it would be more effective.
My frustration came in on a number of the tobacco demand reduction strategies -- because there were a number of them -- on the lack of sustainability, and the lack of comprehensiveness. It is sporadic across the country, and sporadic by institution. Some public health organizations have some money to develop and implement programs; others do not. Some cannot do it in a comprehensive manner. Kids are not getting the sustained message. For those who do decide that they want to quit, there is very little in the area of cessation programs for young people. It was hit and miss. It is quite piecemeal, not comprehensive. That is where I would agree that we failed.
The Chairman: Was there political interference with the program?
Ms Walker: I do not know if the correct phrase is "political interference." There was political concern, as there is in all programs within government.
The Chairman: Those television ads were very powerful. I remember the cocktail, the glass with the poison -- the toxic elements that the fellow was about to drink. The other one was with the smoke and the baby in the crib. Those were not soft. They were very powerful. Is it your testimony that what we needed was more of those, or more frequency to those ads?
Ms Walker: In terms of the breadth of ads, those were the soft ones. There were some harder hitting ads. As our colleague from California mentioned, they addressed some of the issues of tobacco manufacturing advertisements. We were trying to directly debunk the myths of climbing the mountains, riding the horse, and the Virginia Slims image, as opposed to trying to show the negative effects of smoking.
One campaign done quickly over a short period of time just will not do it.
The Chairman: How long did this last?
Ms Walker: We only had a run of about three months.
The Chairman: The social marketing started in 1987. Did the advertising campaign only last three months?
Ms Walker: The air time only lasted a couple of months. There is no way that something like that will have a long-term impact if it is not sustained.
The Chairman: There is no more strategy, is there?
Ms Walker: No, and that is part of the problem, in terms of the sustainability of any sort of media campaign, program, or community response to young people smoking.
Senator Stollery: I was impressed when Dr. Luik said that he opposed turning education over to this group of people. I was just looking at the group of people in clause 11. The advisory panel
may include a representative of the tobacco industry, representatives of provincial ministers of the Crown responsible for health, representatives of health care groups, and such other persons as the Minister considers appropriate.
Do you not agree with that? Does that offend you in some way?
Mr. Luik: Profoundly. I have not seen any evidence of expertise in tobacco reduction strategy from any of those groups, certainly not from the tobacco industry, and certainly not from any of those others. Health Canada confesses that, during the years of its greatest efforts, the youth smoking rate in this country began to climb. How can we say that these groups have the qualifications to bring in an effective strategy, particularly when they have pushed successive governments of Canada to go down a policy course that has not resulted in a decline?
The policies that the government has adopted have largely been brought about and advocated by the very people whom you would enshrine in this legislation, so it strikes me as singularly peculiar.
Senator Stollery: You refer to the provincial ministers of the Crown?
Mr. Luik: Yes.
Senator Stollery: You also refer to representatives of health care groups.
Mr. Luik: Yes.
Senator Stollery: We have had several doctors of various disciplines here, and they clearly do not agree with you. Would you consider yourself a renegade academic?
Mr. Luik: Yes, on this issue, I certainly would. Let me say something about doctors. There are doctors, and then there are doctors. With all due respect, I do not consider that health care physicians, MDs, have any particular competence on the issue of how to prevent young people from smoking. With the medical consequences of smoking, they may have every bit of competence. On issues of adolescent psychology and the tendency of adolescents to engage in risky behaviour -- that is often beyond the competence of the average GP or MD.
Senator Stollery: Perhaps Dr. Stewart, president of the Council for Tobacco Control, is a medical doctor. I did not know that. Apparently, Dr. Cameron is a Ph.D.
Mr. Luik: Ph.D.s are not real doctors, so neither of us is a real doctor.
Senator Stollery: You certainly are a renegade.
Mr. Luik: We are social scientists.
Senator Stollery: Do you have close contacts with the tobacco industry?
Mr. Luik: I have, as the Chairman, said at the beginning, consulted for them, yes.
Senator Johnstone: Thank you for your presentations. I found them impressive. One statement sticks with me. I understand it this way: Children are trusting. Therefore, to them, it defies all reason that society would allow this poison to be sold in the first place. Is that what you are saying? Would you care to elaborate on that?
Ms Walker: I do not know if I can elaborate on that. In focus groups, we have heard it over and over again. Prior to working with Health Canada, I spent eight years at the YM-YWCA working with young people. We heard it over and over again there
In my own family, raising six daughters, I have two who smoke. I run a 30-per-cent smoking rate in my own family. Those two young women are adamantly convinced that, if it were really that bad, it would not be allowed. It is pretty simple.
Senator Kenny: I have two questions which I wish to raise with Dr. Luik. Clause 5(1) says, in part:
(f) to gather, sponsor, commission, conduct and share research on the use of tobacco products throughout Canada and on ways to motivate young persons not to start using tobacco products and to cease using them.
(g) to develop and distribute educational tools, plan and execute communications strategies, run advertising campaigns, use the media and disseminate information through other means to discourage and prevent the use of tobacco products by young persons.
In the course of your testimony before this committee, you indicated a particular preference towards the cluster of risk-takers. You appeared to be of the view that it was worth examining that group in more detail to try to provide strategies to relate to them.
Mr. Luik: That is correct.
Senator Kenny: Do you believe that it would be possible to do that under this piece of legislation, considering clause 5(1)(f)?
Mr. Luik: No, because the people who would be doing this are tied to a paradigm of tobacco control which is the opposite of the risk-taker analysis which I put forward to you. That is demonstrated by the fact that they paid no attention to the academic literature about rebellion and risk-taking.
Senator Kenny: For you, the problem is the people, not the bill. The bill provides the room for it, but you do not believe that the people are competent to do it?
Mr. Luik: If I could be convinced that you would find a group of people who were not from the failed public policy school, as I call it, which has brought us a 30-per-cent adolescent smoking rate in Canada, then I believe that there would be some opportunity. I see this, frankly, as an attempt to set up a self-perpetuating foundation peopled by those who do not, in fact, know anything, or who do not wish to try any novel approaches.
Senator Kenny: You have had some fairly pejorative things to say about some people. Perhaps it would be appropriate to identify some of those groups, and you can correct me if these people do not belong on your list. Amongst the people who have endorsed the bill are the Addiction Research Foundation, the Canadian Cancer Society, the Canadian Medical Association, the Canadian Council of Cardiovascular Nurses, the Canadian Institute of Public Health Inspectors, the Canadian Public Health Association, the Heart and Stroke Foundation of Canada, the Lung Association, the National Cancer Institute of Canada, the Ontario Medical Association, the Registered Nurses' Association, and the University of Ottawa Heart Institute. That is a small selection from a list that is ten times longer. I apologize to those groups that I have not included. Are these the people of whom you speak in such a pejorative manner?
Mr. Luik: Let us take a particular instance to demonstrate the expertise of these people. Almost all of these groups backed the plain packaging proposals which were brought before the Senate and the House of Commons in 1994. Virtually all of these people put their signatures there. Many of them contributed "research" on plain packaging. Let us look at the question of plain packaging, because that tells you much about the academic competence, the research base and the soundness of their thinking about tobacco control.
Without any support in the academic literature, these people produced a lot of research on "a completely novel theory," which was that, if you put cigarettes into plain packaging, you would discourage children from smoking.
It is particularly interesting that the National Cancer Institute of Canada presented a study in which focus groups of children, when presented with this, said that they would, in fact, be more attracted to cigarettes in the proposed packaging than in the current packaging. Here is a group of your own choosing, and it presented evidence which completely contradicted its own proposal to the Senate and the House of Commons.
If this is the calibre of the research produced by these people -- a proposal about plain packaging which their own empirical data did not support when they went out and asked kids whether it would deter them -- then I would say, yes, I would reject the sort of expertise offered by these people.
You have heard a lot of that from this group, although there have been some very positive things. I would agree with many of my colleagues, particularly on self-esteem and risk. Even in this group, you have heard about policy options pursued by the government over the past 20 years, rather than beginning to ask the difficult questions, for instance, suggested by the National Forum on Health.
The National Forum on Health's report on youth substance abuse is one of the few reports which this government has not chosen to publish. There is an executive summary. Why have they chosen not to publish it? I would suggest that it presents, as I summarized in my brief, many unpopular policy options which are difficult to finance, and which take long periods of time to work. They go against the grain of the groups that you have cited.
If that is your list, I would remind you of what they did with plain packaging. If that is the calibre of their research, and of their "new thinking" on this issue, I would decline to use them as experts.
Senator Kenny: Ms Walker, what is the one thing you most need to pursue your objectives vis-à-vis health and children?
Ms Walker: It is difficult to narrow it down to one thing. I agree with my colleague, in that we need to know more about the pivotal time in a young person's life, in terms of risk-taking behaviour and smoking. We did a good job on bicycle helmets. At one time, bicycle helmets were not normally worn, and now it is unheard of to go without one. We have done a fairly good job changing the attitudes of young people on drinking and driving. We have not been as successful changing the attitudes of young people with regard to tobacco use. I continue to maintain that the addictive quality of nicotine makes this habit different from all other risk-taking behaviour. We just do not know enough about how to deal with that.
Therefore, to answer your question, if I had to choose one thing, it would be to have more knowledge on that.
Senator Kenny: You told us earlier that you like this bill. Why do you believe that this bill will help you to get that one thing that you need?
Ms Walker: We need sustained research, sustained programming, and a sustained media community approach to de-normalizing tobacco consumption. I do not think that we can do that within government bureaucracy, where money goes through cycles.
The Chairman: Priorities change.
Ms Walker: Yes, it depends upon how you do it. I like the independence, albeit with evaluation and accountability.
Senator Kenny: Dr. Cameron, if you had to choose only one thing to focus on, what would it be?
Mr. Cameron: I agree with Ms Walker that we need more knowledge. However, my own assessment is that we need money for implementation and training.
Senator Kenny: Does this bill provide the money that you need?
Mr. Cameron: I believe that it would. To give an example, our group did a national survey of schools for Health Canada in 1993, to determine what programming was in place in schools across the country. We found that, although programs that evidence shows make a difference are available, less than one-third of the schools pretended to have such a program in place. In high schools, there was virtually nothing in place.
There are programs which, although imperfect, can make a difference, especially in high-risk schools. I believe that, if we had the money to implement those programs, and an infrastructure for supporting the people who are implementing them, they would have an impact.
Senator Cohen: To follow up on what Ms Walker said, we were also successful when we targeted small children, and taught them to tell their parents not to smoke because it was bad for them. Many parents gave up smoking as a result of that.
Ms Walker: Yes. We also did a good job with pregnant women. However, we have failed with women after they have given birth.
Senator Cohen: In your presentation, you said that many young women do not have a reason to quit until they become pregnant and bear the child, and that, after giving birth, 75 per cent go back to smoking. They suddenly saw the light about the health risk during pregnancy, but they do not realize that second-hand smoke is just as dangerous.
Ms Walker: A great number of them do realize it. However, so many young women who smoke and have young children are dealing with a tremendous amount of societal stress. They say: "Do not take away from me the one thing that makes me feel better. It is cheap. I can carry it in my pocket. It gives me a couple of minutes of peace." Until we can replace that, and help these women to deal with their other stresses, we will not be able to break that cycle. That is where we are stuck, in terms of women with children who are smoking.
The Chairman: I was interested in the evidence of our witness from California, Mr. Bonfilio. In California, they achieved a remarkable reduction in smoking rates amongst adults and teenagers. They accomplished that in a jurisdiction where cigarettes cost something over $1 a package, and where the industry can do just about anything it likes. Indeed, he told us the tobacco companies spend $450 million every year on advertising and promotion. His evidence seemed to support Senator Kenny's bill, in the sense that money spent on anti-smoking education and tobacco control is effective. However, California spends only $84 million a year on that.
If the industry is spending $450 million advocating tobacco use, what are we to conclude from this? If I were Rob Parker from the Canadian Tobacco Manufacturers' Council, I would have taken some comfort in that part of Mr. Bonfilio's evidence.
In this country, we have effectively banned advertising. The price of cigarettes in this province is in excess of $4 per package. We are about to ban sponsorship. One wonders whether the coercive or negative steps that we have taken, or are taking, are at all effective.
[Translation]
My question is addressed to Mr. Bujold who talked about sponsorships.
Mr. Bujold: Yes, I can attempt to answer the question. I think that what was particular about the California study was that the interventions were done at the social environment level. They involved several aspects of the social environment. We know that California, and other American states, are well ahead of us when it comes to prohibiting smoking in workplaces, public places, schools, and various other venues in society. They have done more work on the aspect we referred to earlier, that of making smoking socially unacceptable in society.
That is what I understood from what our witness from California had to say: in spite of tobacco company publicity, many people have noted that they are being manipulated by the tobacco industry because they are not being told the truth; those companies do not deal with reality. The facts are that smoking involves health risks. It is becoming increasingly socially unacceptable, at least I think it is, and that is what we are dealing with here.
It is a good example of efforts that can bring results and change a whole population's perception of smoking.
The Chairman: Are you saying that measures that persuade and encourage are better than coercive methods?
Mr. Bujold: Not necessarily, because they also have coercive measures in California, for instance, laws that apply to public buildings.
The Chairman: Laws that apply to publicity or sponsorships, for instance.
[English]
Anything goes in California.
[Translation]
Mr. Bujold: Yes, we would have to look at the extent to which people can do whatever they like. I am not sufficiently familiar with the studies and research done on that topic. I believe that the population in general has been given a greater understanding of the problem of smoking because certain means were taken to increase that comprehension. Now, in fact, that publicity has much less of an effect on that population.
The Chairman: Do you think the measures taken provincially and municipally in Canada to prohibit smoking in public places are not as effective?
Mr. Bujold: Yes. They are not effective enough, not because of some inherent defect in the laws themselves but because they are not rigorously enforced.
I know the situation in Quebec best, of course, and that is the case in Quebec. We have a law and it was in fact the first such law in Canada, the Loi sur la protection des non-fumeurs dans certains lieux publics, an act to protect non-smokers in public places. However, that law is not respected sufficiently. There are some places in hospitals where people smoke, and that is unacceptable.
Having a law is all well and good, but you must have measures to enforce it. The same thing is true about education. As my colleagues were saying, having an educational program is just one aspect of the situation. You have to be able to disseminate it, to make it accessible to people. You must be able to see to it that young people will come into contact with those messages. It takes more than political will, it takes the right tools to achieve that.
[English]
The Chairman: I take Ms Walker's point that the problem with the anti-tobacco and anti-smoking publicity in the past has not been the quality, but rather the sustainability and the consistency of it.
Mr. Luik: What you are saying is very interesting. One of the paradoxes of this -- and it is a paradox, because I do not know if anyone on the panel can explain it -- is that the United States, during many of the periods to which you refer, has had very loose or non-existent tobacco control policies, and yet has had lower adolescent rates of smoking than Canada. That is a paradox.
I would have to disagree with all this talk of de-normalization. I think tobacco use already is not the norm in Canada. You cannot smoke in public places. You cannot smoke in the workplace. You cannot smoke in federally regulated industries like banks. You cannot smoke on public transportation. Eighty per cent of Canadians say that they do not consider smoking to be a socially acceptable habit. It seems to me that we have already de-normalized.
The interesting thing about de-normalized behaviour is that it hooks up with risk. The kids most at risk are most attracted to those behaviours which adult society tells them are not normal. Therefore, in this strategy of so called de-normalization, you run an enormous risk of attracting those kids to smoking.
This is not solely my opinion. A study was produced by the Royal College of Physicians and Surgeons in 1993 in the U.K. In it, the authors said that the British government should give serious consideration to its constant public campaigns to "de-normalize tobacco," on the assumption that these actually acted as attractors for the very subset of kids with which they were trying to deal. I must ask whether a de-normalization strategy really makes sense.
You must remember that we are not talking about the 80 per cent of kids who smoke as a rite of passage, and then quit. We are talking about kids who find risk and rebellion to be core values.
One of the disconcerting things about this, even though I agree with what my colleagues say about education, is that you are trying to change the core values of an adolescent who is attracted to, and likes, risk-taking. It is very difficult to change anyone's values. It is extraordinarily difficult to change the values of a risk-taking, rebellious youth. In fact, it may be impossible.
One of the politically incorrect things about this debate that needs to be said is that we may never be able to reduce beyond 15 per cent the adolescent prevalence rate in Canada, because that will be the rate of kids who fall into rebellious risk-taking behaviours.
The Chairman: I do not know where you get those numbers. The last figure I saw was 11 per cent for teenagers, and before that it was 8 per cent. We will soon be hearing representatives from Statistics Canada, and I am hopeful that they will set us right.
Mr. Luik: They will reveal all.
Senator Spivak: I do not understand Dr. Luik's comments about de-normalization. Kids go to movies. They watch rock stars. Statistics in the past few years indicate that almost every movie contains cigarette smoking, whereas a few years ago they did not. It is everywhere. It is on television, too, and this is normal. We have not de-normalized it, not for kids.
Mr. Luik: I did not say that we have done so completely, but we have certainly gone a long way.
Senator Spivak: How do you rate movies and television as an influence?
Mr. Luik: The overwhelming majority of adults in this country do not smoke. It is not like growing up in the 1950s. All of my role models smoked, and I have never become been a smoker. When you speak about de normalizing, non-smoking is now the normally accepted behaviour in Canada.
Senator Stollery: I am not sure that I agree with that. People in doorways smoking will greet you with an embarrassed look. As a friend used to say, "when you smoke, all you do is tell people how stupid you are." People give you an embarrassed look when they are standing in the cold with their cigarettes hanging from their mouths.
That is not true with the kids on College Street in Toronto, where I live. I do not need StatsCan to tell me what I see every day, walking along College Street. I see teenage girls, four at a time, smoking. They do not look furtive, and they do not in the least look embarrassed by it all. I see this taking off. There is no question about it. I see it every day where I live.
I find this interesting, because the discussion that we are having is taking place in a different environment than when my generation quit smoking. I started smoking after the war. Surely everyone here remembers what it was like when they started smoking. We were not risk takers. Smoking was just part of what everyone did.
What I find different this evening, is that I believe that the tobacco lobby has weakened. It was not weak in the 1980s. I would be interested if someone could comment. I believe that anyone associated with the tobacco lobby, a director or someone in the business, is running the risk of terrible lawsuits before this is all over. We see it coming in the United States. Huge damages will be paid. There is no question. It has taken them years. They tried the cancer route, and they were shot down.
There are serious legal consequences to the promotion of smoking. Everyone can see it. Five years from now, when the issue becomes worse, those who promote smoking will have opened themselves up to lawsuits, because what they are promoting is killing people. We all know that.
I believe that Senator Kenny's bill will pass, because the country is ready for it. Canadians see what is taking place. The other day we had senior Canadian officers acknowledging that ammonia was put into tobacco, but only as an experiment.
They did not actually put it in the cigarettes. All of that is not lost on the public.
Do you think we have a different atmosphere than we did in the 1980s? As the chairman says, political priorities change. We understand that. Is this not a different atmosphere, where anyone promoting tobacco is facing serious legal consequences?
Ms Walker: The environment today is very different. We know more. We have more facts on tobacco, and on the chemicals constituents of tobacco. We also have had a tremendous shift. Adults now understand the health implications of tobacco use, and the health implications are much clearer now than they were a number of years ago. That has made a major difference.
We recently completed a survey on environmental toxins, and their effects on child health. We anticipated that we would be talking about pesticides and a number of other environmental toxins. Environmental tobacco smoke was number one. This was a survey of 500 health care providers across the country who were asked about environmental toxins and child health. The entire level of knowledge about the effects of tobacco and its health implications is much clearer now than it was 20 years ago.
[Translation]
Mr. Bujold: If tobacco did not exist today and you wanted to market that product, you have to think that it would be completely impossible because of the knowledge 50 years of research has brought us showing that tobacco kills. That is clear. No one questions it. You cannot prohibit the sale of tobacco overnight, as this would create all kinds of contraband problems. There are millions of Canadians who are dependent on a product they cannot stop using from one day to the next.
Now that we know that, what should be done? How can we turn back the clock? We have to give ourselves the means to turn back the tide so that there are fewer and fewer people consuming this product which kills, 50 per cent of the time. That is the question.
[English]
Senator Kenny: We know that 40,000 Canadians died last year, 40,000 died this year, and 40,000 will die next year. One of the bewildering things, going through this exercise, is it that we do not see more of a political reaction. Why is it we that do not see a crowd out in front of the Parliament buildings, shaking their fists at politicians?
I realize that this is off topic a bit for you, but can anyone in the panel tell us why we are not seeing more of a reaction from Canadians? There is not a Canadian family that has not been touched.
Mr. Cameron: I do not have a complete explanation for it. However, one of my guesses is that we have talked about 40,000 people, but we have not put a human face on it. I believe that people are moved by stories and by people, particularly the stories of people that they know -- people who are close to them, people with whom they can identify. I do not believe that we have brought the story out.
Ms Walker: We need to talk about 40,000 lives cut short. People die. We will all die. My own experience in the last year, the short hair, indicates that some of us will die sooner than others. These 40,000 lives are cut short because of tobacco use, and it is both those who smoke directly, and those who suffer from environmental tobacco smoke who die.
I absolutely agree, we have not given it a face, and not a young enough face.
The Chairman: This has been interesting and stimulating.
Our next witnesses will touch upon the question of why cultural groups and sports organizations currently receiving tobacco moneys need a transition fund. To help us discuss that, we have Mr. Marcel Côté, and Dr. Allan Poirier.
[Translation]
Doctor Poirier sent us a document too late in the day to allow for its distribution, but we will do that tomorrow. Do you have an opening statement, Mr. Côté?
Mr. Marcel Côté, author, Tobacco Sponsorship Study (Nov. 1997): I could take about 10 minutes to tell you about a study we carried out last summer at the request of the organizers of the major cultural and sports events in Quebec who benefit from sponsorships.
We published the results in late summer. The example of Quebec, the picture we get of the situation in Quebec might be useful for Canada as a whole. This study was widely disseminated in Quebec, but was little known elsewhere in Canada. Thus, perhaps I will give you the highlights showing the importance of tobacco sponsorships in sports and cultural events and organizations in Canada.
[English]
In 1997, we estimated that $130 million was spent in Quebec, $85 million of which was in sports and cultural events. That sponsorship money has grown tremendously since the mid-1980s, mainly as urban festivities developed; jazz festivals, many kinds of festivals in the summer and winter, all went and tapped sponsorship money. The tobacco moneys were at the forefront at the development of that market.
In 1997, the tobacco companies represented 37 per cent of the $130 million in sponsorship money which we had in Quebec. Out of $130 million, $85 million was in cultural and sporting events.
If you look at a typical event, about 37 per cent of the funds that it receives would be sponsorship money. Sponsorship is the prime source of funds for cultural and sporting events -- more important than ticket sales, more important than grants, more important than gifts, and more important than other revenue from restaurants, and that sort of thing.
We looked at the eight largest events in Quebec, which represent probably 40 per cent of the sponsorship money, to see what role tobacco was playing there. Again, tobacco is about 37 per cent of that whole pie. If you would like to show the pyramid of structure, seven of the eight had a tobacco company as a prime sponsor. These are the Festival de jazz, the Just for Laughs Festival, the fireworks festival, the Grand Prix Trois-Rivières, the Grand Prix de Montréal -- the big ones. The main sponsor for all but one was a tobacco company, which, on average, provided 15 per cent of the revenue for the events, all in cash. The tobacco companies were the only sponsors who provided their money in cash. On top of that, in Quebec they provided $11 million in free advertising of the events. You will probably see advertising for the Montreal Grand Prix. It is announced all in blue colours, and you see a few Player's insignias here and there, but it is all about the Grand Prix. You will see the same thing with the arts, with du Maurier and that sort of thing. This is not accounted for in that figure. In Quebec alone, the advertising was worth about $11 million.
The secondary sponsors, which give about a third of what the primary sponsor gives, are the beer companies, the telephone companies, and companies wishing to reach a large public. You then have the tertiary and the smaller sponsors. The big money comes from the top. Over 55 to 60 per cent of the cash that these organizations receive early in the process, and which helps to pay for the deposits for the artists, for the car drivers, and for the tennis players who want cash, is money that comes from the cigarette makers.
We surveyed 80 smaller events, and they do not have exactly the same pyramid. In fact, they usually do not have a single sponsor. They will get the beer company, the bank and the telephone company. Indeed, sponsors are somewhat less important to them than ticket sales, although grants are more important.
What will happen when we remove the tobacco companies from sponsorship -- when we take away 37 per cent of the money? There is a curve. I am a former economics teacher, and you must understand the law of supply and demand. You will reduce the demand for sponsorship, and the price of sponsorship will fall. This is not a not a non-significant demand. It is a major surgery; 37 per cent of the money will be wiped out. You will then get a lot of adjustment. You cannot take out 37 per cent of the money in the market without creating a series of major adjustments.
The jazz festivals in many major cities in Canada will scrounge, and will go after the beer money, the telephone money, and so on. They will shake and move out. It is just like removing the top pole in a tent: The whole tent will come down. The price will be affected. What you will see is a vicious circle of major readjustment.
We estimate that, in Quebec, three of the eight major events will just fold. We will not name them, but we looked at their data. There is no way that the beer companies, for example, will go there. Contrary to what people think, sponsorship money has not grown for the past three years. It is a flat market now. We went to see beer companies, banks, and lotteries, to ask them whether they would put more money in sponsorship and they said, "No, our budget now is quite optimal. We have so much in advertising, so much in sponsorship."
Sponsorship plays a specific role in communication, and the banks will not put more money in sponsorship because the tobacco companies are not there. It may be a small adjustment, or it may increase because price will decrease, but not by much. The pie will decrease in size. Indeed, we advocated that somehow we should plan a gradual reduction of the sponsorship money, or try to alleviate the impact of that sudden shock, because it will be sudden shock. It will show up when events are not held next year. That is how we will see it.
[Translation]
The Chairman: Doctor Poirier, are you a physician or do you have a doctorate in social sciences?
Dr. Alan Poirier, Spokesperson, Quebec Compensation Fund: I was doing the calculation earlier; I spent 12 years in university. In my own defence, I might add that I only spent seven in the medical faculty. I studied community health and obtained a master's degree in that specialty, as well as in biology. That should give me a little credibility.
Yes, I am a physician. I am the spokesperson for Focus, which is not yet a "compensation fund," but it is a movement that has promoted a Quebec fund in the course of the past six months. Focus is a fund to promote culture, sports and health.
The fact that I am not only a doctor, but also a former television commentator and member of the Union des Artistes, places me at the very center of the ongoing smoking paradox. Major health problems are associated with smoking, but tobacco companies contribute a considerable amount of money to promote events which in turn result in a healthy life style.
The paradox of tobacco is an ongoing problem. If, on the one hand, smoking is bad for young persons, why all of a sudden does it become good when a person reaches nineteen years of age? This type of paradox is not about to go away. From a toxicological and pharmacological standpoint, there is no question that this product should be banned and classified as an illegal substance. Obviously, this is impossible from a sociological or historical standpoint, as others who have come before me have stated.
Under the circumstances, what are we to do? The reality is that we cannot do great deal. Each state must constantly take up the fight. The WHO has a total of 180 member states. The battle is fought at the state level, and at the provincial level in Canada, where debates on the tobacco paradox and the various legislative measures to address this problem are constantly taking place.
Taken separately, legislative measures are not enough. To be effective, they need to be combined with other measures and associated with educational programs. The long-standing strategy of the tobacco industry has been to attack people's credibility. As we saw earlier, the industry argues that its critics are not qualified to speak on the subject. In any event, it is impossible to change people's values, even if someone seemingly more qualified was found.
The tobacco industry always brings up these paradoxes when this issue is discussed. Given that this product contains 43 carcinogenic substances, it should be banned.
The sponsorship issue is no exception. Clearly, given the number of pollutants it contains, the product is legal only by default. Should sponsorship of this product also be deemed legal only by default? To that question, I would answer no.
If the government cannot eliminate this chronic problem, it can at least minimize its harmful effects. One way of doing this is to limit sponsorship.
Almost one year before the bill was passed, I came before the committee to discuss the problems associated with sponsorship. I recommended as a possible solution the creation of a fund. At the time, this was not a popular idea. Subsequently, a number of stakeholders in Quebec said that in their opinion, this suggestion overshadowed the discussion about legislative measures to control tobacco use and that further consideration should be given to the idea of setting up a fund.
We therefore took up the challenge and established a movement composed of some 100 organizations which was unveiled to the public at a press conference on October 14. Our membership was not only comprised of health organizations, as these were already on side. Prior to the adoption of the federal legislation, one of the planks in the Quebec coalition's platform was a ban on sponsorship and the establishment of a compensation fund.
While this recommendation was not retained, fortunately it is once again under consideration. We have decided to promote this idea to the media, Quebec decision-makers and obviously, to sporting and cultural events organizers. They have argued that no interesting solutions have been put on the table and that amendments are needed.
We rallied organizations to our cause, we spoke to people in ministers' offices and to the media, we tried to bring the organizers of eight major sporting and cultural events on side, we made representations to the Minister of Tourism who agreed to speak on our behalf. Now, the organizers of these major events know that solutions do exist.
For inspiration, we looked not only to the funds set up in California, but mainly to the Australian models. In the documentation that I sent along to you, there are three or four examples of Australian funds.
For example, we have the famous Australian fund which was supposed to be dismantled and which has been the source of some criticism. A parliamentary committee recommended that the fund be discontinued but the recommendation was rejected. The goal was not in fact to do away with this fund, but rather to re-introduce it, so to speak, in the departments of health, culture and so forth.
This option was recommended not because the fund did not work, but rather to change the way things were done. This is described quite clearly in the letter signed by the Executive Director of southern Australia. You have also receive copies of letters describing the interesting results that have been achieved in the health field.
These funds differ from those that have been set up in California because they in fact provide financial support to sporting and cultural events. Priority consideration was given on a transitional basis to events that were previously sponsored. The fund remained in place after three or four years. Sporting and cultural events continued to receive financial backing, and money was even available for health education. Initially, these Australian funds have to objectives in mind: to promote health care and to provide sponsorship for various events.
Quebecers support the logical approach taken in Australia. Later on, I will talk to you about the survey that was conducted. Events which are currently not sponsored also endorsed the idea of a compensation fund. These events promote a healthy lifestyle and send a positive message to people.
When we look at all of the advertising on television, we know that someone is trying to sell us something. The same cannot be said in the case of a sporting or cultural event. We attend these events because we enjoy doing so, because it is a pleasant activity. This is the best possible association that we can make. It is even better than direct advertising. Sponsorship experts like Vincent Fisher whom I quoted here one year ago know this to be true. I am only telling you what the experts believe.
Sponsorship works well. For this reason, events must continue to be funded for longer than one or two years with money from the compensation fund in order to continue conveying positive health messages to the public.
This is the main reason why, in my view, this compensation fund should be a permanent arrangement. Tobacco causes permanent health problems and the fund should be associated with events that send out positive messages and have a lasting impact on people. If it fails to convey this kind of message, a compensation fund cannot really be justified in the long term.
In the six months after the movement's founding in October, fund organizers attempted to get their message across to our decision-makers. They met with all or most of Quebec's ministers, including personal meetings with the ministers of Culture, Finance, Health and Tourism. So successful were our efforts that on February 13 last, Quebec's Finance Minister, Mr. Landry, announced that further to the Quebec legislation scheduled to be tabled in two days' time, that is on Thursday, May 14, a $12-million fund would be created from the proceeds generated by the new tax on tobacco products.
FOCUSS and its 220 members were calling for a $60-million fund for Quebec. Why such a large amount? A $60-million fund would exceed current tobacco industry sponsorship levels and would make it possible to reach out to reach out to organizations which are not sponsored by the tobacco industry. It would also provide sufficient funding to send out more messages promoting health. Hence our request for $60 million.
Second, the sports, cultural and theatrical organizations that we contacted and that endorse our position did not tell us that the fund should be managed by the government. In recent years, we have witnessed the creation of numerous funds to assist such fields as tourism and ecology. Obviously, the government is involved in some way because it is the one who collects the money from industry, but management of these funds is assigned to people who know their way around a particular field. People at the local level are usually involved in fund management.
In Australia, provincial funds have been subdivided into various sectors: there is the fund for racing, one for sports, one for culture and so forth.
This approach reflects the two main demands that people have made. Representatives of the eight major events have been silent recently because they know that there is a solution to the problem. They do not wish to state publicly that our idea is a sound one. Why? As one of my good friends would say, they have no desire to shoot themselves in the foot, because that would be painful. They currently receive substantial sums of money from the tobacco industry. They are not about to say: no, we do not want to receive any money from a fund. This would be suicidal for them at this point in time. Judging from the informal talks that we have had with them, we know that they want us to keep up the good work, and if any money is forthcoming as a result of a compensation fund, they would be quite happy to accept it.
Regardless of whether a Canadian fund operates before or after or even in conjunction with a Quebec fund, regardless of the approach Quebec takes, all provinces should be given responsibility for administering a decentralized fund. I am an expert in the field of public health and health promotion and, as mentioned earlier in the case of large national media campaigns, what really works is when efforts are combined with other health and educational initiatives. Health and education, more than any others, are truly areas of provincial jurisdiction. To achieve effective results, community and municipal activities, social marketing and other health promotion strategies must be developed together. All of the measures described by Dr. Cameron must be undertaken at the level where activities are planned.
What you are proposing to do through this bill could be tied in with other provincial educational and health promotion activities.
In the days following February 13, 31,000 young Quebecers signed a petition praising the establishment of this movement. The petition was subsequently presented to Mr. Landry. From the day the idea was launched in October, young students across the province embraced this scheme. A total of 31,000 signatures were collected congratulating Minister Landry on his announcement. Originally, the petition was organized to encourage the Minister to make an announcement, but he in fact did so even before the petition arrived at his office. It therefore took on the tone of a congratulatory message. If in fact the bill does provide for the establishment of a $12-million fund -- that amounts to a tax of two cents per package -- it would not take much to bump the fund up to $24 or $25 million. We are not talking about a major tax increase. It would not be enough to put smugglers back in business. To create a $25-million sponsorship compensation fund in Quebec, we would be looking at the increase of four cents per pack of cigarettes.
As I understand it, if Mr. Landry does not receive any help from the federal government with this compensation fund proposal, he will not hesitate to levy an additional two-cent tax. Taxes increased by more than two cents in February. A total of two cents per pack would go to this compensation fund. If the federal government does not move forward with its own fund, then the minister could possibly increase the new tax from two to four cents per pack to create a more substantial fund. This would still not be enough to satisfy FOCUSS members who are demanding $60 million. A fund of this magnitude would require a tax of 10 cents per pack of cigarettes. I do not think that this would be enough to revitalize the smuggling industry.
The Chairman: We have about 20 minutes remaining.
[English]
Senator Kenny: Mr. Côté, you gave a fascinating presentation, even if it did frighten me a bit, because it reminded me of some of my old economics classes. It certainly made sense.
You said that you approached other groups -- for example, the banks -- and that they expressed some reluctance to step up. Your rationale was that they already had worked out their plan for a period of time. It is probably a fairly reasonable course of action for a corporation to plan out its promotion and donation strategy for a year or two ahead of time.
I am curious about the incredible political leverage that the tobacco companies got with this money. Last year when Bill C-71, the Tobacco Act, was coming through, I must have had 50 lobbyists come through my office. Not one was a tobacco company. Not one was a representative of a tobacco company. They were all recipients of tobacco money. They came, and they had a huge impact on the hill, and they evidenced a great deal of political clout.
Why is it that other industries, such as the banks, which do not enjoy a terrific reputation -- then again they do not annually kill 40,000 of their customers -- have not figured this out, and used it as a tool to impact on the folks around here?
Mr. Côté: That is because you have closed all of the other doors to the tobacco companies. Indeed, the tobacco companies have inflated the price of sponsorship, because that is the only outlet available to them. Fat probably kills many more people than cigarettes.
Senator Kenny: No, it does not.
Mr. Côté: I am thinking of heart attacks. Let us say you gradually ban another substance. Those who are the last to receive sponsorship will get a high concentration of money. That is why the banks will never put as much money into sponsorship as tobacco companies. Indeed, if you would allow tobacco companies to advertise, they would really reduce their amount of sponsorship money. This is a market which was created by regulation.
I live in downtown Montreal. I benefit from this. All summer, thanks to the smokers, we have entertainment; we have a stadium, entertainment in the street. That is the only door left, and all of their money is channelled there.
Senator Kenny: I understand that you are saying that the value of the promotions will go down. If you take out the largest player, supply and demand works. I understand that. Having said that, all you are telling me is that it is a cheap buy for the banks, as an example, and that the banks have an opportunity to pick up this political leverage at a discount. Why are those smart bankers not lining up to do this?
Mr. Côté: That may increase, because the price will go down. We have talked to them, and it will not increase by much. Let us say that the price of prime sponsorship of a major event in Montreal, such as the Craven "A" Just for Laughs Festival, is $1 million, to pick a number. Who will pay for that name? Another company will probably not pay $1 million, because it has other outlets. It can advertise. For it, the value of that prime sponsorship is probably worth half of that figure, because it has many ways of getting its name out there. For the cigarette companies, the only way to get their names in the news every night is to buy their names. They are putting up the big price.
Senator Kenny: I understand that. At the risk of belabouring it, can you give the committee any insight as to why they have not twigged to the political value of these sponsorships? All these people have come here on behalf of the tobacco companies. If the banks had that many people coming here banging on our doors, they would be in terrific shape.
Mr. Côté: Over time, you channel a lot of money to a few people. A significant amount of money is channelled to those who run cultural and sports events. For them, it represents 15 per cent of their total revenue. For any magazine publisher, no single advertiser will represent 15 per cent of revenue. However, because of the concentration effect, the fact that all of the doors are closed, the tobacco companies basically bought these groups. Call it the way you want.
Senator Kenny: I hear what you are saying. I take it that you support a graduated reduction in sponsorship? That aspect of the bill would make sense to you -- to have a phase-out over a period of time, with a slow reduction?
Mr. Côté: Yes.
Senator Kenny: Dr. Poirier, you have an intriguing approach. If I understood you correctly, you are basically saying that transition funds should be tied to a health message.
That is not precluded under this bill. It is conceivable that the foundation or the board could decide that that would be one of the approaches which they would deem to be most effective. I am not saying that they would do that. The bill leaves the decision to the board, but it does not preclude that.
[Translation]
Mr. Poirier: I had understood that the $50 million in compensation for events --
[English]
-- would decrease gradually. Then, after some years, with no compensation for events, everything will go to education. That is fine for health education, but these events are good vehicles for health promotion, and they really need money. I have been the host of a television program which needed $1 million a year in sponsorship. I know that it is difficult to get that money. I am in the middle of the paradox. These groups really need the money. If the bill permits that, then it is fine, but it is not exactly what I understood. I thought that, after five years, there would be no more money for the sports and cultural events.
Senator Kenny: You are correct, sir. What happens is that after five years, the sports and cultural events fund disappears. It is a transitional fund, and it goes down 20 per cent per year, as does the money for tobacco farmers. As that goes down, the money then goes into the educational fund for young people.
The board that manages that has a wide range of options as to where it can put the money. It can put the money into a whole range of things, and test to see whether that works. If your argument is that sponsoring events with a positive health message is an effective way to get to young people, and you could convince the board of that, it could pick up some of this funding. Your suggestion is possible under the bill as currently written.
Mr. Poirier: The cultural and sports communities would be more reassured if it were that this is not a transition fund. It ought not to be up to the famous board to decide everything. If it is managed by the milieu, and if we know that there would still be some money, there would be greater support from the artistic and cultural groups.
[Translation]
All the better if this is part of the proposal, but I feel certain that this would be more readily supported by the artistic, cultural, sporting and tourism community if the plans for the fund were clear at the outset.
[English]
Senator Kenny: I understand what you are saying, sir, and I agree. Thank you.
Senator LeBreton: You used the Australian example, Dr. Poirier. We saw some very positive slides on how they switched over from tobacco manufacturers' advertising to other forms of advertising, and the sports and cultural events survived.
I understand that some countries in Europe have also banned advertising and tobacco sponsorship. How did those countries deal with the transition?
Here, as you know, especially with the Grand Prix in Montreal, and the carts in Toronto, there have been threats to pull the events if we ban sponsorship and advertising. These events are crucial to the economies of Toronto, Vancouver, and other cities.
Which European countries have banned tobacco advertising and sponsorship? In the case of Australia, too, how did they get over this loss of revenue?
Mr. Poirier: I have no information about what they did in countries like France and Germany. I do know that, in Belgium, there is a movement similar to the one in Quebec, asking for a transition fund. That is how I know about the transition approach. I do not have any other information in Europe.
Mr. Coté: We could not find any useful parallel, again, because we created this by closing, the other doors and gradually leaving them only with sports and cultural events. Then, within five years, you had jazz festivals in all of the cities. In Europe, they had various outlets, and they decided to put an overall ban on all kinds of sports advertising and cigarette advertising. Sponsorship was under attack all over.
Only in Canada did we let them create their own lobby, with jazz festivals being the typical event. I think that there are jazz festivals in all of the major cities now.
If we suddenly remove this sponsorship, these creations will be in dire straits. They have sponsorship machines. A large event will typically have four or five people working full time at getting sponsorship. If you do not do anything, they will be grasping at straws, and they will take the funding of all of the smaller events that rely on local sponsorship. That will cause a major disruption. The result will be drastic, because our situation is fairly unique.
Senator LeBreton: You are saying that in France, Belgium and Germany they did not have that dependency. It was more broadly based.
Mr. Côté: There is a lot more alcohol advertising there. It is a different type of sponsorship.
Senator LeBreton: In other words, this is a uniquely Canadian problem?
Mr. Côté: Our case has its own characteristics. We allowed something to be created. That may be an unintended result, but this is what happened in the 1980s and 1990s, when the tobacco companies discovered that new outlet, and built these festivals.
Senator LeBreton: The purpose of Bill S-13, to provide the transitional funding, is crucial because of the spin-off effects?
Mr. Côté: Yes, but it is far from ideal. I do not know whether that group will have the guts to give money to Peter Sampras. Sponsorship is not egalitarian; it is not necessarily politically correct. There are many tough political decisions, if you try to replicate what sponsorships do. Sponsorship is interested only in "hits" -- the number of people who see it on TV or the number of people who see it on the site. That is where the money goes. That is not necessarily always politically correct money. Some of these funds will want to sponsor theatre and dance troupes rather than boxing matches.
That is why it is not the ideal solution, but it is much better than doing nothing.
Senator LeBreton: Do you believe that these events would leave Canada if tobacco sponsorship were pulled?
Mr. Côté: There is no doubt that some of them will leave. There will be rearrangements, and there will be closures. We believe that 40 per cent of the sponsorship money will dry up. That takes into account the drop in price and new money coming in. About 40 per cent of the money will disappear. Do not think that it will not do anything. People will be hurt.
Senator LeBreton: If that money were pulled out of the economy, what would the overall impact be on a city like Montreal?
Mr. Côté: It is not the end of the world. Big cities will survive. Big cities have vibrant economies. There is no doubt that thousands of jobs will be lost, but in a city like Montreal there are over a million jobs. We are talking about a few thousand on an annual basis.
It is probably the face of the summer that will change the most, and the smaller events will be hurt by the rippling effect of all of this if nothing it is done. I am not here to talk about what you could do. I have not studied that. However, there is no doubt that there will be a ripple effect. You cannot remove 40 per cent from the market without affecting it.
[Translation]
Mr. Poirier: What I meant is that we must draw on the experience of the tobacco industry. It pains me to say so, but they are extremely skilful at targeting certain groups. Let me share with you two observations made in the submission.
[English]
This is from the Western Australian Health Promotion Foundation. It says:
Tobacco companies targeted their sponsorships well. Our evaluation shows that current smokers are 1.8 times more likely to attend tobacco replacement sponsorships than other sponsored activities. These sponsorships therefore provide an excellent opportunity to target "at risk" groups with anti-smoking and other messages.
We therefore have to learn from their marketing and their ability to reach different types of people.
It further says:
Spectators and participants particularly at sport events have been shown to have an unfavourable profile of health risk factors, particularly in terms of smoking, unsafe alcohol use and sun protection measures.
That is a particular problem in Australia because of fair skin. It goes on to say:
By judicious targeting of health promotion sponsorship with an appropriate message, the health of sports spectators and participants can be expected to improve in the long term.
[Translation]
Mr. Côté alluded to this foundation's courage in funding sporting events in a perhaps unorthodox fashion. A foundation managed by people at the community level will be taking this kind of risk and will have to rely on the experience of the tobacco industry, even though it claims to know nothing about how young persons behave and to not have conducted any studies.
The Australian model shows that events sponsored by the tobacco industry target people with a certain risk profile, in the sports field in particular. Any future foundation would stand to lose if it did not take into account the tobacco industry's experience with sponsorship and if it were to withdraw from all of the events that the industry formerly sponsored.
We will never know officially, but the industry has done conclusive analyses to determine which particular type of event to support. As Mr. Côté indicated, its objective is to benefit from the sponsorship experience and from media exposure. It focuses on popular events. We must also seek out such events to impart our health messages. Rather than distance ourselves completely from these popular events, we must build on their popularity and find a new way of conveying healthy lifestyle messages to young persons and the public in general in Quebec as well as in the rest of Canada.
The Chairman: Thank you, Dr. Poirier and Mr. Côté. I apologize for making you wait several hours.
[English]
The problem is that the Senate sat several hours longer than we expected it to today, and committees are not permitted to sit while the Senate is sitting.
Thank you both very much for an extremely interesting and valuable contribution to this discussion.
The committee adjourned.