Canadian Medical Association Journal 1996; 154: 191-192
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Introduction
For what seemed like the twentieth time during the past few years, the coalition of health groups fighting tobacco use met with the federal Minister of Health,
Diane Marleau, on Nov. 16, 1995, to raise urgent concerns. The most pressing was the legislative vacuum resulting from the September 1995 decision of the Supreme Court of Canada to strike down much of the Tobacco Products Control Act(1) administered by the Health Protection Branch of Health Canada. With this legislation gone, the tobacco-manufacturing industry will undoubtedly challenge limitations on advertising and promotion and could even remove the long-fought-for health warnings from cigarette packages. The Supreme Court decision and the monumental tobacco tax roll-back earlier this year have set back progress on tobacco control in Canada 10 years.
Marleau announced at the meeting that she planned to move "as quickly and as far as possible" to fill the legislative gap and that she would submit to Cabinet proposals to limit the manufacture, sale and marketing of tobacco products. These proposals would include measures dealing with advertising, promotion, sponsorship, access, point of sale, packaging and labelling, reporting and product ingredients. She indicated that she would invite consultation not only with health groups and the tobacco industry but also with the public. She said she feared that the tobacco industry would go to any lengths to counter such proposals, but she hoped that, since the stakes for the health of Canadians are so high, her plan would gain broad support.
The CMA representatives stated that tobacco control has been ranked the number-one health issue at all levels of the organization this year. From General Council and the Board of Directors to the Council on Health Care and Promotion, the provincial and territorial divisions and the rank-and-file members, the CMA is an adamant supporter of comprehensive legislative controls, policies and programs to restrict the promotion and use of tobacco products. Its support is based on widespread recognition that tobacco causes an immediate and long-term addiction and is a terrible hazard to health.
The response of the health groups to Marleau's initiative was unanimous: they demanded and promised to support strong, comprehensive measures. However, the money and power wielded by the tobacco-manufacturing lobby are powerful influences on current members of the federal Cabinet and of the federal Liberal government. The health groups also proposed that interim measures, such as regulation of tobacco under the Hazardous Products Act,(2) may be needed to prevent the industry from quick adoption of new marketing gimmicks and removal of warning labels before legislation is passed.
Perhaps earlier than anyone had hoped, the Minister unveiled, on Dec.11, 1995, the "Blueprint for Tobacco Control," which outlined the intended broad scope of new legislation on tobacco, to be introduced in the spring. This proposal included banning tobacco advertising, restricting event sponsorship, sales and access, and beefing up capabilities for controlling the toxic and addictive ingredients of tobacco products. That the plan was immediately hailed by health organizations and attacked vociferously by the tobacco industry spoke to the importance and potential effect of the plan, if it succeeds in producing regulatory measures with any teeth.
Our agenda for the next year becomes clearer. As physicians, we will need to mobilize efforts at many levels to fight tobacco use, starting with clinical intervention with patients and building to effective political intervention to restore tobacco taxes and tobacco-control legislation. The CMA and its divisions, side by side with Physicians for a Smoke-Free Canada and other influential medical and health organizations, must take concerted action on tobacco in the coming year. The following action plan on tobacco is an example of what physicians can do. By acting on any of the ideas here, or by formulating their own alternative action plans, physicians can contribute to the overall effort needed to gain back the ground lost in 1995.
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Physicians' action plan on tobacco for 1996
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See also:
References
Mobilizing physicians to conduct
clinical intervention in tobacco use
through a medical-association program:
5 years' experience in British Columbia
Doctor, you're in tobacco sales!
Our acceptance of the status quo for smoking
should be a source of national shame
Tough tobacco-control legislation begins
to have an impact in Ontario