A National Strategy

Executive Summary

Tobacco use is the most important cause of preventable illness, disability and premature death in Canada, with the deaths of 45,000 Canadians each year attributable to the use of tobacco products. The latest survey information, from the National Population Health Survey 1996/97 reports that 30% of Canadian men and 25% of women age 12 and over were daily or occasional smokers. However, there are specific populations, particularly First Nations, Metis and Inuit peoples and Francophones for which smoking rates remain significantly higher.

The health risks of smoking, for smokers and non-smokers, are well established and numerous. Other forms of tobacco, such as smokeless tobacco, are also harmful to health. The impact on Canadians reaches beyond health, to societal costs, including direct health care costs, lost productivity and foregone household income. Health Canada estimates that, in Canada, the societal costs attributable to smoking for 1993 were approximately $11 billion.

Tobacco is unlike other legally available consumer products. The nicotine in tobacco products makes the products inherently addictive. Other chemicals, released in tobacco smoke, or released in saliva in the case of chewing tobacco, makes tobacco hazardous. Increases in smoking since 1993, particularly among teens and young adults, are alarming given the fact that young people can develop an addiction with lifelong consequences.

Effective tobacco control requires partners to work together towards common goals and strategic directions. It requires integration, coordination and complementarity of a diverse array of strategies. The federal/provincial/territorial governments have a critical leadership role for achieving national action. A diverse array of strategies including research, policy and programmatic components developed and coordinated at the local, provincial/territorial, national and international levels are needed to successfully reduce tobacco consumption. Canadian governments and major voluntary health agencies have stated a commitment to reduce tobacco use and are engaged in a range of activities in this area. Canadians support such actions. In September 1998, the Provincial/Territorial Conference of Ministers of Health asked the Provincial/Territorial Conference of Deputy Ministers of Health to develop a national tobacco strategy.

This paper provides a framework for action. Building on the longstanding goals of prevention, cessation, and protection, the addition of a goal for denormalization⁽¹⁾ builds on recent evidence of effective interventions. The five strategic directions outlined are: policy and legislation; public education; industry accountability and product control; research; and, building and supporting capacity for action.

The strategic directions provide the basis for planning, implementing and evaluating collaborative action. The priorities for each strategic direction outline a comprehensive, long-term strategy based on practices and interventions known to be effective. It is hoped that all levels of government, organizations, community groups and individuals across Canada will develop plans of action based upon the framework provided in this paper.

When each jurisdiction and organization with an interest in tobacco control contributes to the overall action plan, Canada will be implementing an effective, comprehensive strategy.

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1. Denormilization refers to activities undertaken specifically to reposition tobacco products and the tobacco industry consistent with the addictive and hazadous nature of tobacco products, the health, social and economic burden resulting from the use of tobacco, and practices undertaken by the industry to promote its products and create social goodwill towards the industry. See Appendix C.