Media

The Canadian government has been developing plans to further tighten its already draconian tobacco labelling and packaging rules by issuing a detailed consultation paper that proposes mandating the printing of health warnings on cigarette sticks.

The document was released for consultation on 29 October 2018, giving ‘interested Canadians’ until 4 January, 2019 to submit their feedback.. The relevant federal ministry – Health Canada – will now consider the response as it considers whether cigarette manufacturers and importers in Canada should be required to print such warnings on sticks. The consultation document said that there was recent but limited research showing that health warnings placed directly on tobacco products, notably cigarettes, “could be effective in making the product less appealing to users”. This included studies released in the Nicotine & Tobacco Research journal on adolescents’ perceptions of an on-cigarette health warning, in the Tobacco Control journal on whether ‘dissuasive cigarette sticks’ should be “the next step in standardised (‘plain’) packaging”, and in the Journal of Social Marketing on how young adult female smokers “interpret dissuasive cigarette sticks”.

In its consultation, Health Canada has asked academics, non-governmental organisations, provincial and territorial governments, health care providers and associations, tobacco control experts and the public (it did not mention the tobacco industry) for comments on introducing requirements for stick-based health warnings. It asked if displaying information directly on cigarettes would be effective in informing Canadian smokers about the health hazards and effects of cigarettes. It requested suggestions about the types of messages on cigarettes that could be effective in passing on such messages, including detailed proposals about the size, font or colour of such warnings. And it requested information on any other research into this idea: “All elements of design, such as size, wording, font and colour are being considered,” the paper said. Examples of designs are given – with the words ‘Smoking Causes Cancer’ (and in French, as this is Canada, ‘Fumer Cause le Cancer’) stretching from one end of the tobacco stick to the other; or on the filters. Health Canada plans to summarise the results of the consultation for online publication, with contributors identified only with their express permission.

INDUSTRY IS SCEPTICAL

The tobacco industry has yet to be convinced that this requirement is necessary. In its comments, the Canada branch of Rothmans, Benson & Hedges Inc (RBH) said that while it “supports Health Canada‘s proposal to extend truthful, accurate and non-misleading labelling information to heated tobacco products”, it does not think these warnings should be printed on sticks. The company said it did not believe that this would be “effective in informing Canadians of the health hazards and effects of cigarettes”. In its submission to Health Canada, it said that Canadian smokers were already well aware of the health risks of smoking, given the prominent pack-based warnings. RBH external affairs director Jeff Gaulin added that the company was “not aware of any research […] that would suggest messages displayed directly on cigarettes would provide any benefit” over and above existing warnings. It also highlighted concerns about the fact that “information on the cigarette paper itself […] burns during the use of the product”.

That said, the company is relaxed about differentiated warnings on different kinds of tobacco products, and indeed has a longterm strategy that involves moving away from smoked tobacco products: “RBH is committed to a smoke-free Canada by 2035,” said a company note. RBH has been pushing the Canadian government to regulate tobacco products differently, according to the health risks they pose, noting with displeasure that the country’s Tobacco and Vaping Products Act “currently lumps all tobacco products together and regulates them the same, even if they have different health impacts.

“A bold and more meaningful approach would be for the Canadian government to consider changes that would enable smokers to understand the different levels of risk associated with different tobacco products,” said Gaulin.

JTI IS NOT CONVINCED

Caroline Evans, JTI head of corporate affairs & communications, was also far from convinced health warnings on sticks would be a good idea. “Health Canada has failed to persuade JTI – and Canadians – that this step would carry any added benefit. As such, we have advised against a health labelling requirement for individual cigarettes,” she said. The company also argued that Canadian smokers were already “highly aware of the serious health risks of smoking”, given 75 per cent of legal packs of cigarettes are covered with health warnings. Health Canada has failed to provide evidence that these additional warnings would impact decisions to start, continue or stop smoking, said Evans, claiming the surveys referenced in the consultation document “are woefully inadequate”.

In its formal response to Health Canada’s consultation document, while JTI admitted that respondents in studies cited by the ministry “generally say they find cigarettes with health warnings less attractive (or appealing) than those without”, the company argued that such statements are “only an indication of the respondents’ perceptions” and are “subjective”. Rather, health warnings on sticks would “further stigmatise adults who have made the informed decision to smoke. That is not good public policy. It is government bullying,” said Evans. Of additional concern is that such a rule would be introduced when plain packaging has been mandated in Canada, with new packs likely to be on sale this year (2019), impeding the health ministry from assessing the effectiveness of the new packs in deterring smoking. “Layering new regulations on top of one another will make it impossible for Health Canada to follow its own evidence- based guidelines to determine the effectiveness of individual approaches,” said Evans. “Plain packaging should be given a chance to perform on its own, so that its effect can be accurately measured.”

The company warned that stick labelling might push more smokers to buy more black market products. It added there was no evidence to suggest that stick-based warnings might help customs officials crack down on the illegal tobacco product trade, which already accounts for 20 per cent of Canadian tobacco sales, according to the company.

With the legalisation of cannabis in full swing in Canada, Evans claimed there was “an acute sense of double standards among smokers in Canada today” with the governmen “practically out promoting the cannabis industry, while trying to further stigmatise and bully tobacco smokers.”

Meanwhile, there is evidence that the Canadian government’s tough approach to deter tobacco smoking is not working. Health Canada statistics suggest that smoking is on the increase in the country. It says that in 2017, 15 per cent of Canadians smoked (4.6 million people), up from 13 per cent (3.9 million people) in 2015. The federal government has a policy target of reducing the proportion of Canadians who smoke tobacco to less than 5 per cent by 2035.

Looking ahead, a Health Canada spokesperson said the consultation had been an “important first step for the regulatory project”, stressing that comments received would “inform any changes to the regulations”. He told TJI there was „a lot of work to be done“ by the ministry and, while it would “move as quickly as possible to develop new health labelling regulations”, officials would spend “the next few months analysing the feedback”. They would publish a summary of it later this year, developing and testing potential health warnings using public opinion research, literature reviews and consultation with tobacco control experts. The lack of an immediate response is important, given that Canada faces a federal election by October – so legislative time may run out before a poll in which victory by the governing centre-left liberals is by no means assured.

Keith Nuthall, in Ottawa