Health Savo
Canada Canada
LegislatiowEnforcement
1. Tobacco Sales to Minors: New Legislation
Background:
The August 1994 Survey on Smoking in Canada. a component of Health
Canada7S Tobacco Demand Reduction Strategy. showed that. of the young men
a2ed 15-19 who smoke. 3 1 % be-an to smoke before age 13 and 85% be-an to
smoke before a-e 16. Almost all began to smoke before age 18. Of the young
women a2ed 15-19 who smoke. 26% beaan smoking before aec 13, 83% before
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a2e I h and almost all before aae 1 8.
As well. und.-r-aged smokers buy up to 70% of their cigarettes directly from
retailers.
P-ohibitin the sales of tobacco to youth may be just one part of Canada's
Tobacco Demand Reduction Strategy. but it is an important part. Surveys show
that most smokers become addicted in their teens. Keeping cigarettes out of the
hands of young people is one of the best ways to safeguard their health and
improve the well-beinLy of Canadians.
Actions:
The Tobacco Sales to Young Persons Act. an instrument to further dissuade
children and young teens from becoming smokers, has now become law.
This Act replaces ie outdated Tobacco RestrainrAct.
The Act. for %hich the Minister of Health is responsible. raises the legal age
of purchase from 16 to 18 years, restricts the location of tobacco vending
machines to premises such as bars. taverns or other similar beverage rooms
where minors do not normally have access. and increases the penalties for
selling tobacco to minors from a maximum of $100 to a new maximum of
S50.000 for repeated offences.
Provinces are also contributing legislatively to the National Strategy to
Reduce Tobacco Use. Recendv. Newfoundland, Nova Scotia. New
Brunswick. Prince Edward Island. Ontario and British Columbia have taken
leeislative actions desi-ned to reduce significantly tobacco consumption by
young people. Thcse actions go beyond the minimum standards set by the
federal legislation.
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0 Bi:@'C-li.whichimendstheTS@'PA(banofkiddicpackscontainingfewer
than 20 cigarettes). has passed Third Reading in the House of Commons and
is now before the Senate.
2. Tobacco Le,gislation Enforcement
Back ground:
ft
Health Canada is implementing an expanded enforcement program for the
Tobacco Sales to Young Persons Act (TSYPA) and the Tobacco Products Control
Acr:'TPCA). Sixty-seven new employees will be dedicated to the enforcement of
tobacco epslation. Approximately 20 new inspectors have already been hired
and can investinate public complaints about sales to minors. For the long term.
co-operauve agreements are being discussed with provincial ministries, law
entorccment agencies and other orvanizatons interested in this area, in order to
complement federal enforcement activities while reducing duplication and
overlap. The enforcement component of the Tobacco Demand Reduction Strategy
includes a retailer survey, to provide information on retailer awareness of the
IC @ that will be conducted in collaboration with the provinces and
terniones.
Actions:
Progress to Date
Existins food and drup inspectors have been designated to enforce TSYPA
and TPCA.
Close to twenty additional inspectors have been hired.
The enforcement strategy for the TSYPA is being implemented in a staged
approach. The retail trade has been informed of its obligations under the Act
and Re-ulations. Inspectors have rcspondcd to more than 200 complaints. and
voluntary compliance is being encouraged.
Enforcement activities for violations under the TPCA are under way.
Contacts have been made with provinces and territories regarding the
development of co-operative enforccmcnt agreements.
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1* I Health Santd
Canada Canada
Public Education,
Awareness and Programs
The Tobacco Demand Reduction Stntf-gy (TDRS) includes public education
initiatives aimed at segments of the population which responded mildly to
previous efforts. Highly targeted services and programs will be brought to bear
on preventing smoking, encouraging and helping those who wish to quit smoking
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to do so. and reducine the harmful effects of tobacco smoke on non-smokers,
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expecially infants and children.
'nese services and programs will be implemented which the provinces and
territories and wiEh Canada's health communim They will be complemented by
public awareness campaigns and support for community action uutativcs.
'Me National Clearinghouse on Tobacco and Health, which is supported by the
provincial. territorial and federal oovcmments, as well as non- govemmCDE health
organizations. maintains an extensive collection of materials and provides
customized information to health professionals, researchers and all levels of
government. Through the Tobacco Demand Reduction Strategy, the
Clearinghouse will receive $4.3 million from Health Canada over the next three
years to expand its current mandate and to develop and deliver comprehensive
client services.
1. School Education Program
Background:
The August 1994 Survey on Smoking in Canada, a component of the TDRS,
indicates that. of the young men aged 15- 19 who smoke, 31 % began to smoke
before age 13 and 85% began to smoke before age 16. Almost all began to smoke
before age 18. Of the young women aged 15-19 who smoke, 26% began smoking
before age 13. 83 % before age 16 and almost all before age IS.
Evidence indicates that nearly all first use of tobacco occurs before high-school
graduation. This suggests thar. if adolescents can be kept tobacco-free, many win
never start using tobacco. Because of its addictive nature, there is a strong need
for prevention education through comprehensive school-based programs.
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These programs will pay particular attention to the reasons why young people
smoke and will be appropriate to age and .-rade level. The programs will include
features such as promoting healthy lifestyles. enhancing media literacy, increasing
parental awareness and involvement, and esmblishing school smoking policies
and peer counselling pro-rams.
Actions:
Progress to Date
A National Survey of school programs. directed at grades 6 through 9 and
completed in March 1994 by Health Canada in partner-ship with the Canadian
Cancer Society, identified several gaps in existing prevention programs. TIiis has
led to the planning of an Intermediate Smoking Prevention Resource and Training
Packaze to meet the needs of Aborieinal students, students with motivational
problems. students with low literacy levels and those leaming English or French
as a second Ian quaae.
Next Steps
Evaluation of an emsring preschool prevention program (fall 1994).
Research to address the needs of older youth. specifically those of high-school
aec. in order to design the appropriate resources (spring 1995).
Implementation of Intermediate Smoking Prevention Resource Package
(September 1995).
2. Women and Tobacco Initiative
Background:
Smokinst is the leading cause of premature death among Canadian women. More
than 15@w women die each year in Canada as a result of smoking cigaretms.
The populations most susceptible to smoking include teenagers, women with
low incomes and education levels, women who am single parents, women living
in isolated communities. Francophoacs. Aboriginals and immigrant women.
There are still few women-centred programs and little evaluation of a
female-specific approach in Canada. Tbc goal of the Women and Tobacco
Initiative is to promote a comprehensive approach to increase the number of
women who become and remain tobacco-free.
Research will be conducted to gain additional information on the prevalence and
patterns of wornen's tobacco use in order to develop and implement effective
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tobacco prevention and cessation initiatives to meet the needs of Canadian
women and. in particular, those of women in high-risk populations.
Actions:
Progress to Date
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9 A Situational Analvsis of Adolescent Women's Substance Abuse was
conducted to tobacco. alcohol and other drug use by Canadian
adolescent women aged 13 to 19, as well as prevention pro-rams designed
for them.
0 The Worncri and the Media Project examines the influence of the media
on young women s smokin- behaviours throu-h an analvsis of women's
magazines. newspapers, sponsorships, film. video and television.
0 TbeYWCA Vitality Project supports women living in YWCA housing. in
their decision to re duce or eliminate tobacco use and to choose healthy and
productive alternatives to tobacco use. A pilot program beemining in
September 1994 wil.] focus on holistic I it and promote smoking
cessation, healthy eating, active living, emotional well-being and stress
managemcoL
A review of the smoking patterns and behaviour of high-risk women will
idenmi@, the characteristics of successful tobacco prevention/cessation
programs for biEh-risk women and will analyze successful strategies for
the delivery of effective programming to this target group.
0 Asurvev of workplaces across Canada by the Conference Board of Canada
will produce an inventory of existing workplace health and lifestyle
programming with. a tobacco cessation component
Next Steps
0 DevelcpmenE and implementation of tobacco prevenfion/cessation programs
to met: the needs of at-risk adolescent women.
0 Development of educational materials and resources to educate young women
on media literacy and the encouragement of increased coverage of health and
environmental issues related to women and tobacco.
* Completion of the review of the smoking patterns and behaviour of hig -risk
women (March 1995).
* A Women and Tobacco Workshop will be held in February 1995 to refine
priorities for action in the area of women and tobacco.
0 A Women and Media Workshop also in February 1995 will identify priorities
for action in areas of media bteracv for women and education of media.
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3. Pre- and Postnatal Tobacco Initiative
Background:
Worldwide studies have shown that maternal smoking is the most clearly
established preventable risk factor associated with low birth wei-hL Low birth
weight is a determining
factor in about two thirds of all deaths among newborns.
Ilose who survive are at 2reater risk of developing serious physical and mental
disabilities. The purpose of the Pre- and Postnatal Tobacco Initiative is to reduce
the number of pre- and postnatal women using tobacco. which will have a
significant impact in promoting the birth of healthy babies and the development
of healthy children.
Research will be conducted to *ain additional information on the prevalence and
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pattern of pre- and posmatal women's use of tobacco, in order to develop and
implement effective tobacco cessation programs for women and their families.
Actions:
Progress to Date
The Interim Report of the Prenatal and Postpartum Tobacco Project is now
available. Ile project was designed to determine the extent of the focus on
tobacco in pre- and postnatal programs for socially disadvantaged women and
their families, including those in Aboriginal and multicultural communities.
A series of six booklets on prenatal and postpartum tobacco usage is currently
being developed. The series will provide information to community health
centres' prenatal programs:
- an inventory of resource materials and distributors' list:
- selected program profiles - self-help and group;
- a national survey of programs and discussion of implications:
- a summary of the literature review;
- results of focus groups; and
- the effectiveness of programs and resources with sample evaluation
protocols.
An initiative is currently under way to develop a tobacco cessation program
and to direct resources to prenatal and postpartum women and their partners
in order to reduce the number of women who resume tobacco use after the
birth of their child. Efforts to assist women in maintaining their non-smoking
status after childbirth can improve the health of both mother and child.
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0 Pre- and Postnatal Snwkng: A Review of the Literature is scheduled for
completion in September 1994. The review wUl provide recommendations
for future activities in the area of tobacco control among pre- and postnatal
women and their families.
Next Steps
0 Development of tobacco cessation resources and initiation of pilot testing
directed to postpartum women's relapse of tobacco use (March 1995).
0 Distribut3on of the bookIct series on prenatal and postpartum tobacco usage
(Spring 1995).
4. Priority Groups
Background:
While the overall smoking rate has decreased dramatically over the past 20 years
in Canada. prevalence among a number of groups remains high. This component
of the strategy wiU be aimed at groups who have responded mildly to previous
efforcs. These groups are distinguished for example by age (i.e. youth), ethnicity
and culture, income, hteracy and addiction levels.
Actions:
ne goal of this program is to provide prevention and cessation programs to
prionty groups. A number of activities involving research, program development
and message promotion are being developed as part of the Tobacco Demand
Reduction Strategy CMRS). A literature review is under way to ensure that
groups with high prevalence or limited access to prevention and cessation
programs have been identified.
Youth The primary prevention focus will be on youth. Research will address
whv children and adolescents start to smoke and examine the psycho-social risk
factors that influence smoking behaviour. While school programs are important in
reinforcing decisions not to smoke, a link has been made between ahenadon from
school and smoking. A review of the literature is being conducted on peer-led
groups for street kids in coUaboradon with Canada's Drug Strategy. Behavioural
research is being conducted in coUaboradon with Health Canada's National
Health Research Development Program rZNHRDP).
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Aboriginal A number of inidauves will respond to recommendations made by
Aboriginal oreanizations. -including the need to develop broad-based programs.
In order to ad@rLss the prevention needs of Aboriginal youth, a Child to-Child
approach will be used. This approach has been successfully used among children
and youth in identifying, researching and dealing with issues in relation to the
wider community An inventory of cessation programs dealing with the
non-traditional use of tobacco is also under way.
Low Income The MRS will support research that will examine the factors
which have caused the concentration of tobacco use among low-income groups.
In addition. the impact of smoking on the material well-being of low-income
families will be studied.
Ethno-Cultural Groups These groups are included among the priority groups
primarily because of limited access to culturally appropriate programs and
services. Smokmg rates vary greatly among different cthno-cultural groups.
Additional inf6rmation will be collected through qualitative research in order to
address smoking prevention and cessation needs of diverse groups. Prehminary
discussions have begun with Canadian Heritage in order to develop programs
through partnerships.
Heavily Addicted A research study of those who smoke more than 26* cigarettes
a dav %U provide additional data on which groups arc most heavily addicted to
nicotine. The information will be used to design programs that address the needs
of Lbese aroups. (*26 is the standard measurement to define a heavy smoker.)
5. Environmental Tobacco Smoke
and Famflv Resources
Background:
I There is growing recognition of the health effects posed by environmental
tobacco smoke (ETS). ETS refers to the exposure of non-smokers to tobacco
smoke. The smoke that comes from the burning end of the cigarette contains a
hi Lyher concentration of hazardous substances than the smoke inhaled directly by
a smoker.
It is estimated that at least 330 Canadians die each year from lung cancer as a
result of involuntary exposure to tobacco smoke. ETS increases a child's risk of
developing bronchitis. pneumonia and ear infections, and increases the symptoms
of children with asthma. Evidence also suggests that infants of women who
smoke are at hi-her risk of SMS (Sudden Infant Death Syndrome).
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The coal for the.ETS program is to reduce the proportion of Canadians exposed
to ETS in homes. workplaces and other public places. In order to develop and
evaluate effective programs that will change attitudes and bchaviours about
tobacco use. increased awareness of the cffects of ETS and baseline information
on current attitudes and behaviours are needed.
Actions:
0 A survey on the knowledge, attitudes and practices of parents, children and
child care providers will be used to develop educational programs and
resources to minimize exposure to ETS of families and children in homes.
The information gained from the survey will be shared with health
professionals to educate their clients on the health effects of ETS.
0 A survey will be conducted to determine the nature and extent of smoking
policies in various settin es such as schools, health care facilities, day care
centres, nursery schools and retail and commercial businesses. The
information will be used to support the development of public policies and
programs to minimize exposure to ETS in workplaces and public settings.
6. Communitv Action Initiatives
Background:
Communitv action enables Canadians to take an active role in identifying and
responding to tobacco issues at the local level. The program will mobilize
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voluntary action across Canada to help reduce the harm associated with the use of
tobacco to individuals, families and communities.
Community Action Initiatives will provide time-limited financial support to
non-profit organizations and community groups for prevention, cessation and
protection activities responding to the needs of at-risk populations including
Aboriginals. children and youth, women and hard to reach populations. Funding
priorities reflecting specific regional and national needs wffl be established in
consultation with provincial and territorial governments, community groups,
non-govemment organizations and other key stakeholders.
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Actions:
Progress to Date
Terms and conditions have been developed.
Ile Guide for Applicants has been finalized.
Discussions have begun with provincial and territorial officials as well as
non-covemMent organizations about their involvement in program delivery.
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Next Steps
0 Project proposals will be solicited from community groups and voluntary
organizations by Health Canada offices across the country.
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