31 May marks the annual celebration of World No Tobacco Day. Created in 1987, the Member States of the World Health Organization (WHO) wanted to draw attention to the preventable death, diseases and disorders caused by what they deemed to be a growing epidemic.
The WHO’s 2022 global campaign for World No Tobacco Day is based on the theme “Tobacco: Threat to our environment”, which focuses on the detrimental environmental impact of tobacco. The campaign also brings to light the tobacco industry’s attempt to re-brand itself as environmentally friendly, despite the lack of both objective data and concrete and consistent local and international regulatory legislation.
The WHO considers the tobacco epidemic as “one of the biggest public health threats the world has ever faced”. Tobacco consumption kills more than eight million people every year, and up to half of the people who use tobacco-consuming products. Over one million of those deaths are related to second-hand smoke inhalation.
In Canada, tobacco is the number one cause of preventable death and disease. Cigarette smoking decreased from 21% of the population in 2003 to 15% in 2017, according to the Ontario Tobacco Monitoring Report, 2018. However, hundreds of thousands of residents across Toronto and Ontario are still current smokers. The report focused on the rapidly changing dynamics presented by both the legalization of cannabis and the use of alternative forms of nicotine consumption in the form of, for example, e-cigarettes.
Increasingly, both the federal government and local governments across Canada have focused on tobacco control in recent years. Some of the means through which Canada has focused on tobacco control include restrictions on where smoking can occur, the prohibition of tobacco advertising, laws regulating the content of cigarettes, and restrictions on where tobacco products can be sold. As of February 2020, tobacco products across Canada are required to have plain packaging.
Canada became a signatory to the WHO’s Framework Convention on Tobacco Control in 2005. Since 2017, Canada has focused on two measures for tobacco control. First, in 2018, the federal government enacted the Tobacco and Vaping Products Act, with the intended purpose of providing a “legal framework to respond to the national public health problem of… tobacco consumption”. Second, the federal government implemented Canada’s Tobacco Strategy, which aims to decrease tobacco use to less than five per cent by 2035 through programmes designed to help current smokers quit and discourage others from starting in the first place.
In Ontario, the Smoke-Free Ontario Act, 2017 was enacted to regulate the sale, supply, display and promotion of tobacco and vapour products. The laws currently in place at the provincial level aim to (a) mitigate second-hand smoke inhalation, (b) help current smokers quit, and (c) discourage children and youth from starting to smoke.
Despite these important tobacco control developments, the tobacco industry continues to profit from cigarette sales across Canada. In 2019, tobacco companies made more than CAD 4 billion in gross revenue from cigarette sales alone. J. Robert Branston, a researcher at the University of Bath, argues that the massive profitability of tobacco companies has been a clear hindrance to tobacco control efforts. Branston claims that “Changing this profit story would, therefore, represent a game-changing possibility for tobacco control as the companies will lose interest in selling products like cigarettes if they cannot profit from doing so”.
Phillip Morris International (PMI), a leading tobacco company, has begun sharing its vision of a ‘smoke-free future’, whereby its stated goal is to focus on developing smoke-free products to offer a viable alternative to cigarettes. PMI’s aspiration is to become a majority smoke-free business by 2025. A Canadian PMI subsidiary, Rothmans, Benson & Hedges Inc., claims it “wants to stop selling cigarettes” altogether by 2035 because of the harmful chemicals released by cigarettes and the illnesses caused by cigarette consumption.
The WHO has questioned PMI’s commitment to the goal of tobacco control, declaring in 2017 that it would not engage with PMI’s Foundation for a Smoke-Free World. The WHO pointed specifically to the inherent disconnect between PMI’s smoke-free initiative and its vocal opposition to policies aimed at reducing tobacco consumption. Dr. Vinayak Prasad, head of the WHO’s tobacco control division, stated that if PMI’s goals were genuine, the focus would be less on a smoke-free world and more on a tobacco-free society.
In 2021, the Canadian Public Health Association (CPHA) called for special attention to the use of smoke-free products, such as vaping devices. Rather than attempting to expand and apply tobacco control initiatives to include vaping, more independent research needs to be conducted to determine vaping’s potential as a gateway to using tobacco. The CPHA believes that much more needs to be done at the local and federal level to reach the ‘five per cent by 2035 goal’ cited in Canada’s Tobacco Strategy.
The number of people consuming tobacco products has declined over the last few decades. However, Canada’s goal of reducing tobacco consumption to five per cent in the next decade or so remains very ambitious. The impact of tobacco use, whether on the environment or people, cannot be separated from the industries that profit massively from its consumption. PMI’s ‘vision’ for a smoke-free future makes it sound like a company that has accepted that its biggest selling product has detrimental impacts, and that it wishes to shift gears. However, the perpetrator of the problem cannot possibly be part of the solution due to an obvious and irreconcilable conflict of interest. Furthermore, the focus on a smoke-free future sounds like no more than a pivot towards the potential of a whole new health crisis, especially as we continue to learn about the detrimental health impacts of smoke-free alternatives like vaping. Until the tobacco industry stops favouring profit over policies aimed at genuinely addressing tobacco control, these ‘visions’ are nothing more than a mirage.
Edited by Ali Shahrukh Pracha