The Global Tobacco Epidemic Requires Further Canadian Action at Home

Abstract

In 1965 approximately 50% of adult Canadians smoked tobacco. Recent data from 2013 reported that figure at 14.6%.1Reid JL, Hammond D, Rynard VL, Burkhalter R. Tobacco Use in Canada: Patterns and Trends, 2013 Edition. Waterloo, ON: Propel Centre for Population Health Impact, University of Waterloo.Google Scholar This extraordinary accomplishment was the result of aggressive public awareness campaigns and a legal and taxation framework that reduces tobacco consumption.2WHO WHO report on the global tobacco epidemic: Raising taxes on tobacco. World Health Organization, 2015Google Scholar The resulting social inertia has also fostered universal political support and flexibility required to implement an evolving tobacco use reduction strategy. Nonetheless, there is room for improvement. Health Canada reports tobacco use remains the single most preventable cause of premature death in Canada. The World Health Organization reported that 6 million people die annually from tobacco use.3WHO. Tobacco Fact Sheet June 2016. Available at: http://www.who.int/mediacentre/factsheets/fs339/en/. Accessed July 16, 2016.Google Scholar International trends mute any extension of confidence from the Canadian experience: global tobacco consumption has doubled compared to four decades ago,4Proctor R.N. The cigarette catastrophe continues.Lancet. 2015; 385: 938-939Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar and 80% of smokers live in low- and middle-income countries.3WHO. Tobacco Fact Sheet June 2016. Available at: http://www.who.int/mediacentre/factsheets/fs339/en/. Accessed July 16, 2016.Google Scholar The contemporary vigor of Big Tobacco is also evident in stock prices, which are a testament to the industries' ability to adapt and metastasize to emerging and susceptible markets.4Proctor R.N. The cigarette catastrophe continues.Lancet. 2015; 385: 938-939Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar Continued advocacy and leadership are required to confront this formidable global health challenge of the 21st century. All Canadian provinces currently prohibit the display of tobacco for sale. For example, the Smoke-Free Ontario Act states, “No person shall display or permit the display of tobacco… or offer for sale in any manner that permits the purchaser to handle the tobacco product before purchasing it.” However, the Act later states that duty-free retailers are exempt. Similarly, Canadian airplanes on international flights are exempt and covered under The Customs Act. This asymmetric legislation thus permits these enterprises to function as islands that are legally immune to otherwise effective antitobacco legislation. These practices also illustrate conflicting policies to foreign travelers within our country, and simultaneously permits the exportation of backward policies abroad. Canada, along with 167 other countries is a signatory of the legally-binding World Health Organization Framework Convention on Tobacco Control, which stipulates in Article 13 that any form of display constitutes advertising, which should be banned. The notion that this market represents a small proportion of tobacco sales does not shelter the fact that current law dissociates Canada's rigourous domestic tobacco policy from an essential international effort to curb tobacco use in countries that are particularly vulnerable to the pervasive and exploitative actions of tobacco companies. These legal exceptions should be amended to cement the legitimacy of Canada's position to advocate for effective tobacco control policy internationally, and reduce the consumption of tobacco within Canada and beyond. The author has no conflicts of interest to disclose.