Food and Drugs Act
Bill to Amend--Second Reading--Debate Continued
May 16, 2023
Honourable senators, I rise today in support of Bill S-254, introduced by the Honourable Senator Brazeau.
The bill amends Canada’s Food and Drugs Act to ensure that the labelling of alcoholic beverages reflects the most current scientific information. Senators Brazeau, Cordy, Miville-Dechêne and Richards spoke at second reading of this bill. I add my voice to theirs in the hope that we will promptly send this bill to committee for study. Let’s not delay any longer in doing the right thing to improve the lives and the health of Canadians.
Three questions spring to mind upon reading the preamble. What is the link between alcohol and various cancers? Is labelling an effective way to inform the public? How could this bill be improved for the benefit of public health and consumers?
Before establishing the scientifically-proven link between alcohol and cancer, I’d like to share some data on the leading causes of mortality, in order to better understand the relevance of the bill and why urgent action is needed.
You’ll hear the names of many diseases and many types of cancer. I don’t mean to be alarmist, but I’ll be sharing the information that’s being reported in the current medical literature.
In Canada, roughly 300,000 people die each year of all causes. In 2020, malignant tumours were the cause of more than 80,000 of those 300,000 deaths. The numbers compiled by Statistics Canada indicate that cancer is still among the primary causes of death and that alcohol is indirectly responsible for more than one in four deaths — hence the urgency to take action in Canada.
What’s more, we saw notable increases in the rate of deaths associated with alcohol consumption in 2020. Specifically in people under 45, the number of deaths directly caused by alcohol increased by 50%. Many illnesses are caused by the chronic use of alcohol, including alcoholic gastritis, cirrhosis of the liver, pancreatitis, etc.
Note that the illnesses I just cited are responsible for death in the long term. There are other immediate deaths, such as highway accidents, in which alcohol is a determining factor.
What’s more, there’s a proven link between alcohol consumption and acts of aggression and violence.
What concrete action has been taken? The Canadian government tasked the Canadian Centre on Substance Use and Addiction, the CCSA, with conducting studies and submitting reports with science-based recommendations. The CCSA produced a report entitled What We Heard: Refreshing the National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada. It’s a long title, but that’s what it’s called. It’s a synthesis of consultations involving over 170 stakeholders in the context of a process to refresh the national framework.
Our National Framework for Action to Reduce the Harms Associated with Alcohol and Other Drugs and Substances in Canada is almost 20 years old. Its vision is for all people in Canada to live in a society free of the harms associated with these substances.
One of the principles articulated in the framework is that action should be knowledge-based, evidence-informed and evaluated for results. The January 2023 final report on Canada’s guidance on alcohol and health came as a shock to many. It upends conventional thinking. Whereas the approach used to be prescriptive, now it is becoming restrictive.
Rather than suggest a number of drinks per day or per week, the experts are now telling us that the less alcohol one consumes, the better. Contrary to messaging from Éduc’alcool, moderation is no longer in good taste.
No amount of alcohol is considered good for a person’s health. This report is worth taking a closer look at. The guidance is based on the principle of autonomy in harm reduction and the fundamental idea behind it is that people living in Canada have a right to know. In addition to the chronic diseases that I mentioned earlier, alcohol itself is a carcinogen that can cause at least seven types of cancer. People often do not know that. The most recent data show that the use of alcohol causes nearly 7,000 cancer deaths each year in Canada, with most cases being breast cancer, colorectal cancer, liver cancer and oropharyngeal cancer.
According to the Canadian Cancer Society, drinking less alcohol is one of the top behaviours to reduce cancer risk.
The message of Bill S-254 is reiterated in the CCSA report, which states, and I quote:
As a priority, people living in Canada need consistent, easy‑to-use information at the point of pour to track their alcohol use in terms of standard drinks. They also have a right to clear and accessible information about the health and safety of the products they buy.
One of the direct benefits of this bill and a particularly effective policy change could be the mandatory labelling of all alcoholic beverages. We would expect the label to indicate the number of standard drinks per bottle, Canada’s Guidance on Alcohol and Health and the health warnings.
Another study conducted by the CCSA, in collaboration with the Centre for Addiction and Mental Health, reported an association between alcohol use and aggression and violence.
I’m well aware that moving away from our collective addiction to alcohol requires a real paradigm shift. Drinking is deeply rooted in our culture. We call up a friend or colleague to go for a drink. Some even claim it’s their right or duty to drink, as was the case a few years ago with smoking. However, we no longer carry our former convictions about alcohol’s alleged benefits. We must strive to reduce our use of alcohol in all its forms, just as we did with tobacco.
The CCSA produced a separate report entitled Lifetime Risk of Alcohol Attributable Death and Disability. It notes that the lifetime risk of death and disability increases as alcohol consumption increases. This project, titled Canadian Substance Use Costs and Harms, analyzed Canadian data from 2007 to 2020 and lays out the dramatic changes in direct and indirect costs to our society. The CCSA report from March 29, 2023, states that the cost of substance use was estimated to be $49.1 billion in 2020. The cost associated with alcohol is allegedly close to $20 billion, or 40% of that total. The costs associated with the use of alcohol and tobacco have fluctuated over time. The per‑person cost for alcohol has increased by 21%, while the cost for tobacco has decreased by 20%.
These estimates highlight the consequences of substance use, not only on the health care and criminal justice systems, but also on Canadians’ ability to work and contribute to the economy.
To improve health and productivity in Canada, initiatives related to prevention, harm reduction and alcohol treatment must be put in place. Bill S-254 on alcohol labelling is just one of many measures the government should implement to ensure a healthier and safer life experience for all Canadians.
I couldn’t help but wonder whether labelling actually works. A study on the effect of alcohol labelling on consumption, published in 2020 in Journal of Studies of Alcohol and Drugs in an article entitled “The Effects of Alcohol Warning Labels on Population Alcohol Consumption,” compared alcohol consumption in Yukon with its neighbour, Northwest Territories. Approximately 300,000 labels were placed on 98% of alcoholic beverages in Whitehorse. Sales dropped significantly in the capital city for products that carried these warnings, so the labelling made a difference.
My last question is the following: How could we improve this bill to benefit public health and consumers? I believe the only way is to study it in committee. It would give us the opportunity to hear from experts, the industries and other stakeholders on the future implementation of labelling and information to be disclosed. I think it is essential that consumers be able to obtain the information they need to freely make informed decisions.
Given that some consider alcohol a food item, should other information, such as the ingredients and nutritional information, be included?
Those are some of the ideas that I wanted to share with you, esteemed colleagues. Thank you for your attention.
Would Senator Mégie take a question?
Yes.
Ever since we began debating this bill, I’ve been wondering about that fact that there are still some doctors in Quebec, including at the Institut de cardiologie, who say that having two glasses of wine a day is excellent for the heart. As a doctor, what do you think of this debate that seems to pit some doctors against others?
What we realized after the study by the CCSA — and that’s why I said that this surprised more than one person — is that even though the message for some time was that red wine is good for the heart, this new paradigm flies in the face of that. We still don’t know how all this will end. Debates for and against are under way. Maybe there will be other studies or some will believe the studies that were done by the CCSA. I don’t know where this will land, but they worked very hard on the new data to come up with some real standards. I think we need to give more weight to the CCSA data. This shouldn’t stop you from having your glass of wine.
There are some very reputable doctors in Quebec who say that these studies were poorly done and that doctors can continue to advise their patients to drink two glasses of wine. The interesting thing is that between leading experts on these issues, there seems to be a great deal of opposition.
Like all scientific studies, in medicine in particular — we’re talking here about alcohol, but it’s the same thing for other very important topics, such as cancer and other diseases: There are studies that often contradict each other. There would need to be a meta-analysis that takes the articles that are in favour and those that are against. Maybe that will land somewhere in the middle or prove someone or other right, but let’s wait before coming to any conclusions. For now, it’s a broader discussion.
