|Legislation on Smoking in Canada||To Smoking and Health theme page|
3. Additional Information:
Legislation works proactively, creating a climate that discourages smoking. Tobacco litigation works retroactively, seeking to divert the burden of tobacco use onto the tobacco industry. Litigation has three objectives:
- To recover compensation for economic damages, medical expenses and perhaps pain and suffering, due to the defendant’s wrongdoing;
- Deterrence: to avert future wrongdoing of the defendant, here in terms of producing and marketing harmful products;
- To establish accountability, so that wrongdoers can be held accountable by society.
Litigation and legislation can work together, in that successful litigation can then fund legislated smoking cessation or health promotion programs. Tobacco litigation in the USA has included class action lawsuits, ranging from a group of people to coordinated efforts of several States against tobacco companies. The Engle case, for example, was a class-action begun in 1994 on behalf of all individuals suffering from tobacco-related diseases along with their surviving relatives in Florida. A verdict of US$145 billion was awarded by a jury in punitive damages against tobacco companies, but this was reversed in 2006 by the Florida Supreme Court, although this ruling allowed for individual cases to be brought. The Tobacco Products Liability Project (TPLP) in April of 2010 caused tobacco companies to pay over US$230 million for a smoking cessation program to help thousands of smokers in Louisiana. As of 2010, at least eighty tobacco cases are pending in eleven countries.
Ontario. Progress in tobacco legislation has been rapid in Ontario.
- The Ontario Ministry of Health published a report entitled "Smoking Cessation in Ontario 1998/99, Current Trends, Interventions and Initiatives". This called for a province-wide quit-smoking strategy, an increase in taxation, and for federal regulation of the amount of nicotine in cigarettes. The provincial government gave $9 million annually to the Ontario Tobacco Strategy.
- The Tobacco Youth Protection Act (before the Senate as of May, 2000) aims to direct 3/4 of a cent per cigarette (or 19 cents per pack, roughly $360 million per year) to fund efforts to reduce smoking among young people.
- Banning smoking entirely in restaurants, etc., required considerable political will. The Toronto ban of 1998 failed after restaurant owners protested fearing loss of clientele. The point was debated: a similar ban in 1998 in California (more information below) did not appear to lead to economic losses.
- By May, 2000, Ottawa, Kanata and Nepean agreed to strengthen bylaws on smoking in public places. This was implemented in May, 2001, and prohibited smoking in restaurants, bars, billiard and bingo halls (wow!), etc. Smoking was, however, permitted in enclosed and separately ventilated smoking rooms. Subsequently, in 2004, these were also closed down.
- In January, 2009, Ontario passed a law banning smoking in cars when a passenger under 16 is present. Fines range up to $250.
- Research is beginning to assess the impact of these changes on smoking. One indication is the growing acceptance of smoke-free places. This may begin at work and in public places, but it has also extended to private spaces: many fathers of small children not smoke outside their front doors. This chart shows the growing numbers of smokers who have chosen to no longer smoke in their homes:
It is possible, however, that bans polarize people's attitudes. While half of all Ontarians who smoked at some time during their life have now quit, half of all current smokers are not considering quitting. 1998 survey data quoted in the Ontario Drug Monitor suggest that 46% of Ontario smokers were in pre-contemplation, 38% were contemplating quitting, 14% were in preparation, and 2% were in the action stage of quitting.
The Health Department runs a Tobacco Information line at 724-4256
A Success Story? The California Tobacco Control Program.
- In 1989, the California Tobacco Control Program (Proposition 99) was implemented based on the hypothesis that a decline in tobacco use would reduce deaths from heart disease. (The excess risk of heart disease falls rapidly after cessation of smoking.)
- Proposition 99 increased the tax on cigarettes by 25 cents per package, of which 5 cents supported an anti-tobacco education campaign, resulting in the creation of the largest tobacco-control campaign ever undertaken.
- The tax increase was combined with an aggressive media and community campaigns which attacked the tobacco industry and stressed clean indoor air, and policies designed to foster a smoke-free society.
- The main hypothesis was correct – The California Tobacco Control Program has substantially reduced the prevalence of smoking and the level of cigarette consumption among smokers.
- Mortality from heart disease decreased significantly more in California than in the rest of the United States after the introduction of Proposition 99. By 1997, per capita cigarette consumption in California was 21 percent lower then in other states.
- Between 1989 and 1997 there were 33,300 fewer deaths from heart disease than would have been expected if the earlier trend in mortality from heart disease in California relative to the rest of the US had continued.
- This would suggest that well-designed, aggressive tobacco-control programs can quickly achieve major reductions in heart disease mortality quite. The study also shows that scaling back or weakening such programs by limiting them to children, as the tobacco industry and representatives of the public health community advocate, is associated with an increase in deaths.
- Public Health advocates should redouble their efforts to confront the tobacco industry and its allies in legislatures and everywhere else and insist that similar steps to Proposition 99 be implemented to ensure the reduction the number of tobacco-related deaths.
Source: Fichtenberg, C and Glantz, S. Association of the California Tobacco Control Program with decline in cigarette consumption and mortality from heart disease. New England Journal of Medicine, 2000; 343:1772-7.
The difficulties in encouraging governments to act is described in a review of Sir Richard Doll's contributions to research on smoking and health