THE STANDING SENATE COMMITTEE ON SOCIAL AFFAIRS, SCIENCE AND TECHNOLOGY
EVIDENCE
OTTAWA, Wednesday, October 22, 2025
The Standing Senate Committee on Social Affairs, Science and Technology met with videoconference this day at 4:13 p.m. [ET] to continue the study of Bill S-202, An Act to amend the Food and Drugs Act (warning label on alcoholic beverages); and to conduct clause-by-clause consideration of Bill S-201, An Act respecting a national framework on sickle cell disease and, in camera, for the consideration of a draft agenda (future business).
Senator Rosemary Moodie (Chair) in the chair.
[English]
The Chair: Good afternoon. My name is Rosemary Moodie. I’m a senator from Ontario and the chair of the Standing Senate Committee on Social Affairs, Science and Technology.
Before we begin, I would like to do a round table and have senators introduce themselves, starting with Senator Osler on my left.
Senator Osler: Senator Flordeliz (Gigi) Osler from Manitoba.
Senator McPhedran: Marilou McPhedran, independent senator representing Manitoba.
[Translation]
Senator Boudreau: Good afternoon. Victor Boudreau from New Brunswick.
[English]
Senator Senior: Hello. Paulette Senior representing Ontario.
[Translation]
Senator Youance: Suze Youance from Quebec.
[English]
Senator Hay: Katherine Hay from Ontario.
Senator Bernard: Wanda Thomas Bernard from Mi’kma’ki, Nova Scotia.
[Translation]
Senator Brazeau: Good afternoon. Patrick Brazeau from the beautiful province of Quebec.
Senator Arnold: Dawn Arnold from New Brunswick.
[English]
Senator Greenwood: Good afternoon, everyone. Margo Greenwood from British Columbia, from the West.
Senator Muggli: Senator Tracy Muggli, Treaty 6 territory, Saskatoon.
The Chair: Today we continue our study of Bill S-202, An Act to amend the Food and Drugs Act (warning label on alcoholic beverages).
Joining us in person for the first panel, we welcome Dr. Margot Burnell, President, Canadian Medical Association, and by video conference, Ian Culbert, Executive Director, Canadian Public Health Association, and Dr. Curtis May, Medical Health Officer, Fraser Health.
Thank you for joining us today. You will each have five minutes for your opening statements followed by questions from committee members.
Dr. Burnell, the floor is yours.
Dr. Margot Burnell, President, Canadian Medical Association: Thank you, Madam Chair.
I acknowledge with gratitude that we gather here today on the traditional and unceded territory of the Anishinabe Algonquin Nation, and I appreciate their stewardship of the land over generations.
My name is Margot Burnell. I am the President of the Canadian Medical Association, and it is an honour to represent physicians and medical learners from every corner of this country and, through them, the people they serve.
I have led hospital departments, contributed to research and advised on national health policy. With nearly four decades of experience as a medical oncologist, I’ve seen firsthand how decisions about health and policy affect the lives of patients and families, including how awareness can shape outcomes long before illness takes hold.
I have had many conversations with patients and their loved ones during their cancer journey where we explore lifestyle issues and the opportunity to modify alcohol consumption to improve health.
Thank you for the invitation to provide the physician’s perspective on Bill S-202, An Act to amend the Food and Drugs Act (warning label on alcoholic beverages). We are pleased to see this bill being considered.
The Canadian Medical Association supports clear health warning labels on all beverage alcohol sold in Canada. As physicians, we witness the effects of alcohol use on our patients every day. We know that alcohol consumption leads to over 800,000 hospital and emergency room visits each year, a strain felt in every community.
While alcohol has been classified as a Group 1 carcinogen for decades, this information has been largely withheld from consumers. Over 40% are unaware that alcohol consumption increases the risk of cancer.
Labels on all alcoholic beverages would empower Canadians to make informed decisions. We’ve seen this work before. Canada already has a clear precedent for health warning labels on tobacco products, warnings that have proven effective in raising awareness and changing behaviour. We view this as a natural extension of that success.
Alcohol remains one of the most widely used drugs of dependence in Canada. It is in the top three of preventable risk factors for developing cancer after cigarettes and obesity, and it continues to contribute a disproportionate share of health harms. Alcohol is linked to more than 200 health conditions and diseases, including liver cirrhosis, alcohol use disorder, cardiovascular disease and complications in newborns. It also increases the risk of at least seven different types of cancer.
But the harm does not stop at physical illness. Alcohol use contributes to motor vehicle accidents, family violence, unemployment and poor mental health. The burden that it places on individuals, families and communities is immense. It is one that physicians would like remedied.
We support measures to inform Canadians about the health impacts of alcohol consumption. We can change the trajectory. We’re not taking alcohol off the shelves. We are seeking to inform Canadians who do not know about the impacts on health. Given our direct experience with patients affected by short- and long-term alcohol-related harm, physicians have an important role to play in shaping public awareness.
Again, chair, I am pleased to be here today to address this matter. Bringing health warnings to the point of sale is a practical step toward prevention. Too often, by the time these patients reach us, intervention comes too late.
The Canadian Medical Association urges the prompt enactment of Bill S-202. Thank you very much.
The Chair: Thank you, Dr. Burnell.
Mr. Culbert, you have the floor.
Ian Culbert, Executive Director, Canadian Public Health Association: Thank you, Madam Chair and honourable senators, for the opportunity to appear before you today.
The Canadian Public Health Association strongly supports Bill S-202, because Canadians have a right to know the health risks associated with the products they consume. This bill would ensure that alcoholic beverages — like other substances known to harm health — carry clear, factual and visible warning labels about their contents and the health risks linked to consumption.
Alcohol is not an ordinary commodity. It is a leading cause of preventable disease and premature death in Canada, as Dr. Burnell has just noted; yet it remains the most widely used harmful substance in this country.
In January 2023, the Canadian Centre on Substance Use and Addiction released Canada’s Guidance on Alcohol and Health. It summarizes decades of scientific evidence and concludes that no level of alcohol use is risk-free. To minimize health risks, Canadians should limit their consumption to no more than two standard drinks per week.
But most people don’t know what a standard drink is or how many they are consuming, because this basic information is not available on product labels. Without it, consumers cannot make informed choices.
This stands in stark contrast to any other food or drink Canadians buy at the grocery store. Every packaged food product in Canada must include a nutrition facts table outlining serving size, calories, fat, sugar and other nutrients. Many will soon be required to display front-of-package symbols for products high in sodium, sugars or saturated fats. Alcoholic beverages, however, are exempt from these basic consumer protections, solely because they are alcoholic in nature.
That exemption is indefensible. It reflects not sound science but the influence of powerful commercial interests. The corporate determinants of health are very much at play here: Industries that profit from consumption have a vested interest in keeping the public uninformed about the risks their products pose.
A 2017 pilot project in Yukon entitled, Northern Territories Alcohol Labels Study, demonstrated how effective labelling can be. Within weeks of introducing labels that included a cancer warning, standard drink information and Canada’s then low-risk drinking guidelines, alcohol sales declined, and public awareness of the link between alcohol and cancer tripled. Yet, despite these early successes, the study was curtailed after alcohol industry associations sent legal threats to the Yukon government, forcing the removal of the cancer warning. The study’s premature end had nothing to do with science or ethics. It was the result of corporate interference.
This episode illustrates clearly how the corporate determinants of health can undermine evidence-based public health policy. It shows that the alcohol industry is determined to keep Canadians drinking in a state of ignorance, and that is not a goal that our laws should enable.
We know from decades of experience with tobacco and, more recently, cannabis that clear, factual and visible labels change behaviour. They increase awareness, shift social norms and, ultimately, save lives.
This is not about restricting choice; it is about ensuring informed consent. Everyone in Canada deserves the same access to health information on an alcoholic beverage as they do on a carton of milk or a box of cereal.
By adopting Bill S-202, Parliament would close a glaring gap in consumer protection, empower individuals to make healthier decisions and help reduce the significant burden of alcohol-related disease and cost to our health and social systems. There is no defensible reason to continue denying Canadians this vital information. Clear labelling is simple, fair and long overdue.
Thank you, and I welcome your questions.
The Chair: Perfect timing, Mr. Culbert.
Dr. Curtis May, Medical Health Officer, Fraser Health: Thank you, Madam Chair and senators, for inviting me to speak.
First, I’d like to acknowledge that the region where I work is on the unceded territories of the Coast Salish and Nlaka’pamux Nations and is home to 32 First Nations within the Fraser Salish Region in the province colonially known as British Columbia.
I am a medical doctor with a specialization in public health and preventive medicine, and I work with the Fraser Health authority as a medical health officer. In this role, I have a responsibility to protect and promote the health of communities, and I would like to exercise this responsibility to help protect the public from alcohol-related harms, both in my region and nationally, by supporting Bill S-202.
Alcohol and its effect on health is a public health issue, so we need to act broadly. We must work with partners and governments at all levels to implement different types of interventions. To give you an idea, in addition to labelling, these may include implementing alcohol policies like restrictions on advertisements or education of the public.
Now, these are two examples out of a comprehensive list of interventions that my colleagues and I support. However, most of the work to help implement these interventions has been at the regional and provincial level. Unlike cannabis and tobacco, federal strategy and legislation around alcohol are minimal. Bill S-202 presents an opportunity for the federal government to make more of a difference, lead by example, build momentum on protecting the public from all harms of alcohol and to go beyond labelling, ideally, as defined in the National Alcohol Strategy.
Focusing back to my role as a medical health officer, my patient is the community. Before I can recommend treatment like health labelling on alcoholic beverages, I need a clear community diagnosis.
As was already stated — and as you have heard many times — firstly, we know that alcohol is carcinogenic to humans. We know that alcohol leads to nearly 100,000 hospitalizations and 18,000 deaths per year in Canada, and 7,000 of those deaths are estimated to be due to cancer.
Despite this danger, alcohol consumption remains high. Among those who drink, an average of 13 standard drinks per week is consumed. People who drink are drinking a lot more than the two drinks per week recommended to be at a low-risk category.
Lastly, there is a lack of awareness of the harms of alcohol, especially for cancer, and especially among youth. It is estimated that around 40 to 50% of Canadians were aware of the link of alcohol to increasing the risk of four out of seven different types of cancers.
My community diagnosis: Not enough people are aware of the risk of disease and cancer by consuming alcohol, and they have a right to know this so they can make an informed choice.
Now that we have this clear diagnosis, we can move on to treatment. One of these treatments is health warning labels. These labels on alcoholic beverages is a targeted and effective intervention to address this diagnosis and to inform consumers to reduce their consumption and harms. This recommendation is supported by me, my colleagues in British Columbia and by many other experts, as you know.
Why labelling? You have heard already that the Yukon study showed an increased awareness of alcohol and cancer risk when labels were applied. It also decreased sales by 6% within a few months after implementation.
Importantly, surveys indicate that health labels are accepted by most Canadians. There are too many details to cover here, but design and implementation choices are key to labelling effectiveness.
In closing, I would also like to share that I have also worked as a family doctor, and most patients know the negative health effects of smoking. We can thank decades of extensive commercial tobacco policies, health education and health labelling for this. In contrast, it is common to see the surprise on patients’ faces when I tell them that one or two glasses of red wine at every dinner increases risk for cancer.
People have a right to know, and I hope we can legislate health labelling on alcoholic beverages to help inform them.
Thank you.
The Chair: Thank you, Dr. May.
Senator Osler: Thank you to all the witnesses for being here today.
My first question is for the Canadian Medical Association, or CMA. I’ll read it out loud. My second question is for the Canadian Public Health Association.
For the CMA: Bill S-202 is about information. The bill aims to inform Canadians about the risks to their health from alcohol consumption so they can make informed decisions. The CMA is actively working to fight health misinformation and disinformation. Given the spread and breadth of health misinformation and disinformation, how can warning labels help people access science-based information on alcohol and health risks?
For the Canadian Public Health Association, my question is about impact. Bill S-202 does not contain metrics to measure any changes in awareness, knowledge, behaviours or health outcomes. From a public health perspective, what indicators from both health and social perspectives could be used to determine whether warning labels are successful? Dr. Burnell?
Dr. Burnell: Thank you, Senator Osler. Misinformation and disinformation are very prevalent now in our medical system and in our discussions with patients and their families. By having standardized labelling on alcoholic beverages, we will be able to reference that as being the correct information. Then we can have a discussion with respect to what their goals and aspirations are in maintaining their health.
So, this clarifies the process. It provides fact, not story, and it standardizes the process so that each company will have to provide standardized labelling that adheres to a standardized template.
It’s critically important. That then fosters the ability to educate our patients and discuss it with them.
Senator Osler: Mr. Culbert, again, my question is about impact and health and social indicators of success.
Mr. Culbert: Thank you very much for the question. There is going to be a range of indicators that could be developed through population-based surveys run by StatCan, awareness and knowledge indicators, risk perception and attitude indicators, behavioural intention and consumption, and the health and social outcomes.
One of the indicators on the social side that I would be interested in is the number of attempted prosecutions related to alcohol, either violence-related or otherwise. Those are some of the indicators that would be important.
Senator Osler: I was wondering about some of the social indicators. Health outcomes would take awhile, because this is a warning label related to cancer. But with regard to alcohol-related emergency room visits, can you speak to some of the social indicators that could be looked at?
Mr. Culbert: Certainly. We could look at the demand on social services and the interventions the police interventions. There is a broad range that we could be looking at. We have quite a bit of experience, and government has a lot of experience looking at these population-level indicators for both tobacco and cannabis, and it would be an extension of them.
Another important part would eventually be the standardization of how we treat psychoactive substances. Right now, they are not regulated based on their actual health harm, but rather our attitude toward them. A future change in that direction would be incredibly important.
Senator Hay: Thank you all for being here. Last time I shared that I was a daughter of an alcoholic — my dad. What I didn’t share is that he suffered cardiac disease and he was diagnosed with colon cancer and died with pancreatic cancer about 20 years ago. He was proudly 12 years sober, but the damage was already done.
To be clear, I fully support this bill. However, I am worried that it’s not a panacea. I don’t think anybody is saying that it is. Perhaps this question is for you, Dr. Burnell. What else must accompany labels to make material impact to change outcomes? I have a follow-up question for Mr. Culbert and Dr. May.
Dr. Burnell: Thank you for the question. What needs to go in tandem with this is education. That needs to be the education of our public and of our physicians, but also education that is shared at every touch point with patients and families. Education needs to start in public schools. It needs to start with the first point of contact with families. That has been shown to be very influential in changing health habits.
Senator Hay: Thank you. I agree. The one thing I’m concerned about, while supporting this fully, is whether this label is perhaps too restrictive. Should it just be related to cancers? I know intimately how alcohol affects someone.
Being “just cancer,” it could add to industry pushback because of the cost of multiple labels, multiple repackaging, et cetera. However, there are many other aspects of harm because of alcohol. Not changing this perhaps, but, by the same token, do you feel this might be too restrictive because of the harm of alcohol for public health?
Mr. Culbert: No, I don’t think it’s too restrictive. Quite honestly, the word “cancer” gets people’s attention. With modern labelling, the addition of a QR code to the warning label could direct consumers to a Government of Canada website that provides them with additional information.
One of the complementary activities that could be undertaken to support this is if Health Canada actually adopted Canada’s health guidance on alcohol and health instead of the outdated low-risk drinking guidelines, and there is significant industry pushback on that right now. So Health Canada has not adopted that new guidance yet.
Dr. May: I would like to add to that. They have done studies and they know that cancer is one of the least known risks from alcohol. It’s actually one of the more accepted labelling. So if we’re going to be strategic, having that as the main label is going to change the most minds, because if people see the same information over and over again, they become numb to it.
I just wanted to add that we need to also look at policy. We need to look at restriction of promotion and sponsorship of alcohol. We need to restrict the availability of where people can obtain alcohol. Those are also very important interventions around education that actually get a good handle reducing alcohol-related harms.
Senator McPhedran: Thank you to each and every one of the witnesses. My question is primarily to you, Mr. Culbert.
First of all, I want to express appreciation for your courage in actually describing some of the behaviour of companies producing alcohol and their lobbyists. It’s a very nice thing to have parliamentary privilege when you’re testifying to a committee like this.
I was very involved in the early days of the tobacco ban, working for the City of Toronto’s Department of Public Health. I saw, of course, the Supreme Court case of RJR-MacDonald Inc. v. Canada (Attorney General), where the corporations claimed legal personhood under the Canadian Charter of Rights and Freedoms, and the Supreme Court agreed with them. Indeed, it does say “person,” and indeed, corporations do have legal personhood.
That’s too bad. I was also involved in drafting the Canadian Charter of Rights and Freedoms, and I wish I had thought about that, but, it’s too late.
My question is to everybody on the panel. It’s from a public health orientation. We know there is going to be major pushback. We know that the money that goes into protecting profit and protecting the industry will be really significant.
My question is to all three of you, beginning with you, Mr. Culbert. This bill may become law. Many private members’ bills never get very far, but this one is doing very well.
Are you thinking beyond being able to get the labels in place? There was a considerable period of time between when the tobacco companies were told they had to do it and that, indeed, they were wrong and that the government could not. What’s happening for those of you that are working now and thinking ahead to the future?
Mr. Culbert: Very briefly, if you work in public health, you have to take a long view. There are no short-term wins. We have much that we have learned from the tobacco wars, and we will approach it in much the same way. Yes, the alcohol industry is putting their shoulder into this. One of the policies is pricing policies, and we had successfully indexed the excise tax on alcohol to the rate of inflation, but that has been stopped twice by this Parliament.
So there is a lot that we could learn from past battles that will apply to this, but we are going to have to be patient; it is going to take time.
Front-of-package labelling is supposed to come into effect in January 2026. That’s been almost a decade, so you have to be patient.
Senator McPhedran: And tenacious.
Mr. Culbert: And tenacious.
Senator McPhedran: Any other responses?
Dr. May: If I can add, when they evaluated people’s responses to the alcohol labels in Yukon, they found that they actually improve their acceptance of other types of alcohol policies. Really, we need to go back to educating the public and increasing their buy-in to the policies, because if they agree that alcohol needs to be labelled and we need to have more of an alarm around that alcohol risk, then industry doesn’t really have as much power.
Senator Brazeau: Welcome to all of you, and thank you for your presentations and for working on this issue.
The question is for all the panellists. Last week we had officials from Health Canada, and when one of my colleagues asked the question, “Since when was Health Canada aware that alcohol was a Group 1 carcinogen,” they mentioned they had only been aware as of four or five years ago, I believe. However, the World Health Organization classified it as a Group 1 carcinogen in 1988.
Part of the research with respect to alcohol policy has also demonstrated that 75%, approximately, of Canadians are not aware of the causal link between alcohol consumption and seven different types of cancers. I would like to hear your thoughts on what your concerns are with respect to very few Canadians knowing about these risks of cancer, but also within your own organizations, what do you believe you can do to raise more awareness, given the fact that the Government of Canada is not fulfilling its responsibility in sharing this information with Canadians?
That’s my question: What could your individual organizations do in lieu of the federal government not doing what it’s supposed to be doing with respect to public health?
Dr. May: I can start if that’s okay.
I opened by saying that we need to take a very broad approach to reducing the harms of alcohol, and I am definitely concerned about use and younger people, because they are less aware of these harms. The thing with carcinogens is that they take a while to start to work, or they take a while to have an effect. Decades later is when we see these cancers start to happen. We really need to make sure that we are educating youth in schools.
Another thing that we’re doing in the province of British Columbia is that we’re working on an alcohol campaign to educate more province-wide in a coordinated manner so people become aware of this. Again, we are also working on minimum unit pricing in the province. We have to work across different levels of policy in order to actually make a change.
I’ll stop there.
The Chair: Mr. Culbert, did you want to respond?
Mr. Culbert: Certainly. We have been advocating against the liberalization of alcohol sales in various provinces across the country. We have a position statement on this where we do recognize alcohol, so it’s getting that information out there.
I think on the ground, public health units such as that of Dr. May, are very active in this work at the ground level, but we need support. When governments are, quite honestly, addicted to alcohol revenue, it is very hard to get them to move the needle.
It is that constant pressure. Even getting Health Canada now to endorse the new guidance should not be as difficult as it is, but there is definite push back at the political level.
Senator Muggli: Thank you for being with us today. I’ll ask Dr. Burnell a question first.
As a previous leader of a hospital in inner city Saskatoon, alcohol presentations outnumbered all other substances’ presentations by probably at least 3 to 1. I’m wondering if you think labelling will make a difference as it relates to presentations to emergency departments for alcohol use.
Dr. Burnell: Yes, I do. I think it will take time for this to bear results, because it’s a long-term process. But the discussions can start immediately, and then we can, hopefully, change the habits of individuals.
They will need to reflect. They will need to make their own personal decisions about their health care journey, but we should see — 10 or 20 years down the road — fewer cancers related to alcohol, and you should see, sort of immediately, hopefully, fewer presentations with respect to violence, domestic abuse and acute alcohol delirium. So those very acute effects should decrease and should be measurable within a couple of years.
The long-term carcinogenic effect, as referenced, we won’t see an impact until much further down the road, but it is an investment in the future.
Senator Muggli: Thank you.
I have a question for Dr. May and Mr. Culbert. Have you seen any evidence of the impact of labelling as it relates to literacy levels, poverty levels or other cross-sections of determinants of health?
Mr. Culbert: What I can say is the warning labels have to be in clear, plain language. There is a science around warning labels to make them effective.
One of the key factors is that they have to change on a regular basis, because people become numb to seeing the same message over and over again. That has been proven with tobacco labelling. We need to take all these lessons into account as we roll out the regulations, because, obviously, changing the law is the first step. Then building the regulations to support that change will take additional time, but there is a huge amount of knowledge that has been developed worldwide about how to do this well.
Senator Muggli: With using appropriate literacy levels for labels and changing them, is there evidence of impact among groups that might have challenges around health determinants? Are the outcomes the same for the people who are wealthy and people who are poor in terms of reducing their usage with labelling?
Mr. Culbert: Unfortunately, there is not enough study of it. There are not enough examples of alcohol labelling around the world — and quality labelling — to be able to do the kind of studies that you’re referring to.
The best study was the Northern Territories Alcohol Labels Study, and it was shut down before it could really show. But even that immediate, almost 6% decline per capita alcohol consumption early in the trial is significant. I would say that there is a broad range of individuals who live in the Yukon who would have been able to see the campaign and see the labelling. You could extrapolate that there would have been positive responses over the longer term.
Senator Bernard: You can see that the social workers on this committee are thinking in the same way. One of my questions was going to be about those who are most negatively impacted, who maybe won’t read the labels or won’t be able to read the labels. How would this bill impact them?
However, before going there, I was quite intrigued, Mr. Culbert, by your comment about corporate determinants of health. I know about social determinants of health; some of us call them “structural determinants of health.”
I want you to tell us more about corporate determinants of health, and how this bill might be positioned to address those realities.
Mr. Culbert: I would start by saying that if you are not already feeling the effects of the corporate determinants of health as senator studying this bill, I would imagine it won’t be long until you are. You will be receiving phone calls, emails and letters from industry telling you what is wrong with this bill and how it will destroy their industry.
There will be much gnashing of teeth and pulling of hair in the industry. The corporate determinants of health are not new, but studying them is a relatively new expansion of our exploration of different determinants of health.
Typically, with most products, the goals of the manufacturers of products and public health goals are typically not aligned. This is the case for a range of products. Tobacco is a legal product, as an example, sold in this country, but it is not good for anyone’s health. Another example is super-processed foods. All of these different products are highly marketed and made to look attractive to the population, but actually have very serious health impacts on people.
When industries promote their products in a way that only enhances their desirability for what is positive about them, and they don’t talk about the negative health impacts, that is the corporate determinants of health.
Senator Bernard: Is there research in this area that you could direct to this committee?
Mr. Culbert: Yes, I will send that information to the clerk.
Senator Bernard: The other term you used this evening that resonated with me was “political determinant of health.” I would like to hear a bit more about your perspective on that, please.
Mr. Culbert: I will simply say that alcohol manufacturers and the alcohol industry are great political supporters, and they are allowed to do that. It is legal, but they support political campaigns in a number of different ways.
Their influence goes beyond the regular lobbying that is registered and legal in this country.
Senator Greenwood: Thanks to all of you for being here today.
I’m going to direct my question to Dr. Hay and then to Dr. Burnell and Mr. Culbert, please respond as well. This is a question that actually relates to us in my office. My question is regarding a letter my office received from a stakeholder who is against this bill. The letter was initially sent to Health Canada and is regarding the low-risk alcohol drinking guidelines report, and this is what they said:
It states that it’s clear that for those involved with these efforts believe that less alcohol is still too much alcohol. This is despite well-established global evidence that exists demonstrating modern alcohol consumption may provide some health benefits, such as reducing risk of developing and dying of heart disease, possibly reducing risk of ischemic stroke, possible reducing your risk of diabetes, improved mental health and socialization.
The letter then cites the Mayo Clinic, but my office has been unable to identify which study they are referring to.
So my question is this: Can you share your thoughts on this stakeholder’s arguments? How would you support or contradict them?
Dr. May: It is a hard truth to swallow, but that study has been debunked. They found that once you control for people who are less healthy they are more likely to stop drinking or were recorded as drinking less, and the people who were healthy were recorded as drinking a bit more.
If you have healthy people drinking more, it looks like they are doing better, but actually they were healthy to begin with.
So when we have new emerging evidence come forth, as was assessed in the guidelines, which, again, was based on the Australian update, which had received a top score in terms of quality, then we start to get new information.
It’s because the measurement was not well done in the past studies, and now we have new information.
Senator Greenwood: Dr. Burnell?
Dr. Burnell: I would agree with that information. I would say that alcohol use probably adversely affects mental health. It is used to help cope with situations, but it contributes to a lot of angst within households, and we see that with presentations to the emergency departments, domestic violence and other harms done. That’s how I would respond to that.
With respect to cardiovascular health, there have been a variety of studies — as alluded to — but for the same amount of consumption, the risk of cancer far outweighs any of those benefits in various studies.
Senator Arnold: Thank you for being here with us today, but a special thanks to Dr. Burnell from my home province of New Brunswick.
We have heard that these things take time before we see the impact and that we need to take the long view and that it will be 10 to 20 years down the road before we are going to see the real impacts from a cancer perspective. Changing the law is the first step. Given all of this, and what feels like a real impetus to get this done, Gowling WLG indicates that the proposed regulatory implementation deadline of one year is unrealistic and deviates from Health Canada’s established practice respecting changes to food labels. Traditionally, food manufacturers are given a transitional period of three to five years before implementation. I’m curious. In all of the challenges you have in health care today, how would you rate this issue? How important is this potential law?
Dr. Burnell: Thank you very much. It’s very important. As the CMA, we want healthy citizens and healthy communities and we need those folks to have a healthy economy, so it fits in very well.
You will see improvement in the acute effects of alcohol misuse or increased alcohol consumption. That is important. It also allows the education to begin now. It allows those discussions and position offices, and it allows consistent messaging around this.
The carcinogenic impact is long-term, but you will see acute improvement. We have been talking about this since 1996, so this came through, and CMA supported a very similar piece of legislation. So this is much overdue.
Senator Arnold: Anyone else on that?
Dr. May: I would just agree that it is very important, and it’s about time. Having this come through is also an opportunity to have more education and other forms of media attention around the health effects of alcohol, which will also have an effect.
They have seen in some of the studies, or they commented in some of the studies, that this could have been why health labelling was also effective, not just by itself, but because it attracted more attention.
Senator Arnold: Dr. May, you said at one point here that you had more on the design and implementation policy. Is there anything specific you would like to share with us that you haven’t already had the chance to?
Dr. May: I was alluding more to what Mr. Culbert brought up, which was around just rotating labels, different types of pictures and making sure that the text was large. There is a systematic review and also a capability statement that lists out all the different ways that those can be designed — and many other people. That is beyond my knowledge.
Senator Senior: Thank you each for being here. A couple of my questions have been asked. I think it’s my social worker-adjacent place, so the determinants of health, corporate and political were already addressed.
Mr. Culbert, you mentioned something about the use of a QR code in terms of labelling. I don’t recall if it was in the context of the need to change labels from time to time, but I believe I heard that a QR code may not be the best approach to labelling in terms of its effectiveness. I don’t know if anyone else heard that, but I think I heard that somewhere.
I wanted you to comment on whether or not a QR code is a good thing to approach this with for labelling, as well as are there other types of labels where QR codes have been effectively used?
Mr. Culbert: To clarify, the QR code would be in addition to the warning label, not instead of. For more information, you can scan the QR code and go to a website.
You can turn to the alcohol industry that uses QR codes extensively to send consumers to their websites for recipes on how to use their products, so I think the link is very closely tied.
Very briefly on the previous point, the industry will always complain that they don’t have enough time to do this. They did with front-of-package labelling, but how often do you go into the grocery store, and your box of Cheerios looks different? It’s a red herring.
If the law says a year, they will push back in regulations, but we have to start the process.
Senator Brazeau: I have a quick question. Obviously, we’re all here discussing Bill S-202, but the federal government is in the business of having public service announcements. Do you think they should do anything on this?
Dr. Burnell: I think it would be a great opportunity to show leadership in this field.
Dr. May: I second that. It’s an opportunity for the federal government to be more prominent in the space of the alcohol talk.
Mr. Culbert: I agree. When you look at who is a trusted information provider, surprisingly, the federal government still ranks in the top five. Public service announcements or inserts into mailings, there are a number of different ways that the federal government — at low cost — can support this initiative.
Senator Bernard: My question follows up on Senator Brazeau’s.
Dr. Burnell, you talked about the need for education as a part of roll-out. How would you see that education for families and communities beyond the idea of the public service announcement? How do we get to education, especially for those communities, many of whom use alcohol as a way of coping with everyday stressors in their lives?
Dr. Burnell: I think the most important is, really, the physician and the health care provider team starting that discussion and exploring with patients and their families what they hope, and when they see such situations to identify good coping strategies and coping strategies that aren’t as beneficial to their health in the long run. It’s really building those trusting relationships to do that.
The other is that we’re also looking at the younger generation. The younger generation is turning to social media. We need to go to those sites and put out factual information as well. The Canadian Medical Association, or the CMA, has done that through Healthcare For Real, putting the facts for various medical scenarios out there. This would be a perfect opportunity to try to reach those individuals, because many of them are seeking their health information from places other than in a physician’s office.
Senator Greenwood: My question is for Mr. Culbert. I’m still following up on misinformation and disinformation.
Can you give us some example of concrete strategies that organizations and governments could use to contradict misinformation and disinformation?
Mr. Culbert: Thank you very much for the question. Certainly, it is actively counteracting those messages. It’s investing in whatever support systems are necessary to be able to identify and then counteract that misinformation, because the longer — what is the saying? A lie travels around the world in a minute, but the truth takes forever.
You have to be proactively doing this, and it takes a lot of resources to be able to do that, especially with the range of topics. If we just focus on health, the CMA does have a great initiative, but it’s not all CMA’s responsibility.
We’re in a society where it’s hard to know who to trust about anything, so having our leadership, our political leadership, telling the truth about these issues is absolutely crucial.
Senator McPhedran: My question is geared, actually, to the federal Minister of Health. I can’t speak for the committee, but I can say for myself that I was respectfully underwhelmed by the witnesses who came to us from the federal department of health, and I think that’s because we actually have not yet heard from anyone holding significant authority.
My question is: Where do you place leadership by the Minister of Health in moving this forward?
Dr. Burnell, if you would?
Dr. Burnell: I think it’s critical that the federal minister supports well-evidenced information on the risk of increasing alcohol consumption.
Senator McPhedran: Does anyone disagree or have anything to add?
Dr. May: I don’t disagree. I don’t think it’s the only thing. I think it’s important, but we can always continue regardless of whether they speak out or not.
Mr. Culbert: I would simply add that when Dr. Gregory Taylor was the Chief Public Health Officer of Canada, his annual report on the status of the health of Canadians focused on alcohol, and it is still a seminal report that I would draw to each senator’s attention.
The Chair: Thank you.
This brings us to the end of the first panel. I would like to thank Dr. Burnell, Mr. Culbert and Dr. May for your testimony today.
In consideration of concluding at an appropriate time, we will now proceed to clause-by-clause consideration of Bill S-201, An Act respecting a national framework on sickle cell disease.
Before we begin, I would like to remind senators of a few points. As chair, I will call each clause successively in the order they appear on the bill. If at any point, a senator is not clear about where we are in the process, please stop us and ask for clarification. I want to ensure that, at all times, we have the same understanding of where we are in the process.
In terms of the mechanics of the process, when more than one amendment is proposed to be moved in a clause, amendments should be proposed in the order of the lines of a clause.
If a senator is opposed to an entire clause, the proper process is not to move a motion to delete the entire clause but rather to vote against the clause as standing as part of the bill.
Some amendments that are moved may have consequential effect on other parts of the bill. It is therefore useful to this process, if a senator moving an amendment would identify to the committee other clauses in this bill where this amendment could have had effect. Otherwise, it will be very difficult for members of the committee to remain consistent in their decision making.
Since no notice is required to move amendments, there can, of course, have been no preliminary analysis of the amendments to establish which ones may be of consequence to others and which may be contradictory.
If committee members ever have questions about the process, or about the priority of anything occurring, they can certainly raise a point of order. As chair, I will listen to the argument, decide when there has been sufficient discussion on a matter of order and make a ruling.
This committee is the ultimate master of its business within the bounds established by our Senate, and a ruling can be appealed to the full committee by asking whether the ruling shall be sustained.
I wish to remind honourable senators that if there is ever any uncertainty as to the results of a voice vote, or a show of hands, the most effective route is to request a roll call vote which, obviously, provides unambiguous results.
Finally, senators are aware that any tied vote negates the motion in question. Are there any questions on any of the above? If not, we can now proceed.
Seeing no questions, senators, is it agreed that the committee proceed to clause-by-clause consideration of Bill S-201, An Act respecting a national framework on sickle cell disease?
Hon. Senators: Agreed.
The Chair: Shall the title stand postponed?
Hon. Senators: Agreed.
The Chair: Shall the preamble stand postponed?
Hon. Senators: Agreed.
The Chair: Shall clause 1, which contains the short title, stand postponed?
Hon. Senators: Agreed.
The Chair: Shall clause 2 carry?
Hon. Senators: Agreed.
The Chair: Shall clause 3 carry?
Hon. Senators: Agreed.
The Chair: Shall clause 4 carry?
Hon. Senators: Agreed.
The Chair: Shall clause 1, which contains the short title, carry?
Hon. Senators: Agreed.
The Chair: Shall the preamble carry?
Hon. Senators: Agreed.
The Chair: Shall the title carry?
Hon. Senators: Agreed.
The Chair: Does the committee wish to consider appending observations to the report? None seen.
Thank you, senators. Is it agreed that I report this bill to the Senate in both official languages, without observation or amendments?
Hon. Senators: Agreed.
The Chair: Thank you, senators. We will now continue in camera to have further discussion on order of business.
(The committee continued in camera.)