Wednesday 9 February 1994

Tobacco Control Act, 1993, Bill 119, Mrs Grier / Loi de 1993 sur la réglementation de l'usage du tabac, projet de loi 119, Mme Grier

Glen McDonald

YMCA Youth Employment Services

Jody-Lyn Joki, youth representative, Sudbury region

Canadian Cancer Society, Ontario northeast region

Helen Ghent, past president, Ontario division

Langley Neal Robertson

Sudbury General Hospital Auxiliary

Lois Nault, president

William Wilson

Lyla Burnett

Brian Baggs

Ontario Lung Association, Sudbury-Nipissing region

Dorothy Klein, executive director

Dr Douglas Marr, volunteer

Pat Madden

Sudbury Heart Health Coalition

Dr Tom Crichton, member, physician team

Porcupine Health Unit

Erica Webb, tobacco program coordinator

Sudbury Board of Education

John Stroyan, health and safety officer

Angela Desjardin, secondary school student

Steven Price, secondary school student

Steven Levesque, secondary school student

Tom Bertrim, secondary school principal

Sudbury and District Health Unit

Laurie Fraser, public health nurse

Vic Sahai, epidemiologist, teaching health unit

Noella Piquette, heart and lung patient

FRESH (For Reduced Environmental Smoke Hazards)

Gil Gasparini, representative

Katie Gasparini, representative

Sabih Uddin

Sudbury and District Council on Tobacco or Health

Claire McChesney, chair

Marjorie Shaw, registered nurse

David Webster

Cathy Dashper

Michael Borkovich; Terry Bristow; Ricco Berardi

Phyllis Palangio

North Bay and District Health Unit

Dr Catherine Whiting, medical officer of health

Allergy/Asthma Information Association, Sudbury branch

Barbara Gregoris, member


Chair / Président: Beer, Charles (York-Mackenzie L)

*Vice-Chair / Vice-Président: Eddy, Ron (Brant-Haldimand L)

Carter, Jenny (Peterborough ND)

*Cunningham, Dianne (London North/-Nord PC)

Hope, Randy R. (Chatham-Kent ND)

Martin, Tony (Sault Ste Marie ND)

*McGuinty, Dalton (Ottawa South/-Sud L)

*O'Connor, Larry (Durham-York ND)

*O'Neill, Yvonne (Ottawa-Rideau L)

Owens, Stephen (Scarborough Centre ND)

*Rizzo, Tony (Oakwood ND)

*Wilson, Jim (Simcoe West/-Ouest PC)

*In attendance / présents

Substitutions present / Membres remplaçants présents:

Murdock, Sharon (Sudbury ND) for Ms Carter

Perruzza, Anthony (Downsview ND) for Mr Hope

Wiseman, Jim (Durham West/-Ouest ND) for Mr Owens

Also taking part / Autres participants et participantes:

Ministry of Health:

O'Connor, Larry, parliamentary assistant to the minister

Brenda Mitchell, manager, tobacco strategy unit

Clerk / Greffier: Arnott, Doug

Staff / Personnel: Gardner, Dr Bob, assistant director, Legislative Research Service



The committee met at 1003 in the Travelway Inn, Sudbury.


Consideration of Bill 119, An Act to prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others / Projet de loi 119, Loi visant à empêcher la fourniture de tabac aux jeunes et à en réglementer la vente et l'usage par les autres.


The Vice-Chair (Mr Ron Eddy): Welcome, ladies and gentlemen. Good morning. We'll commence with the first presentation, to be made by a representative of the Pharma Plus Drugmart in Sudbury. Mr McDonald, you are allotted 15 minutes, and we hope that there will be time for a few questions following your presentation.

Mr Glen McDonald: On behalf of Sudburians, I'd like to welcome the committee to Sudbury on this cold morning. I'd accuse you of bringing this weather with you from southern Ontario, but I'm sure you all know better.

Thank you for the opportunity to present to you this morning. My name is Glen McDonald. I've been a pharmacist for 23 years and work at the Pharma Plus Drugmart in the New Sudbury Centre. I was born and raised in the Sudbury area and have lived here all my life, other than the four years that I went to university in Toronto.

I think that the stated intent of Bill 119 is good and I support it in the main, especially the raising of the legal age from 18 to 19 and the reduction in the number of vending machines.

I don't approve of smoking. My mother, who was a heavy smoker, died of lung cancer at the age of 41, and my father died last November from pneumonia complicated by emphysema which was also the result of many years of smoking. I know 13,000 Ontarians die annually as the result of smoking.

I'm here before you because I oppose paragraph 4(2)8, which prohibits the sale of tobacco products in pharmacies. I have two reasons for this opposition: first of all, the impact on jobs in pharmacy, and secondly, because I don't think it will be effective.

First, the jobs issue. Our pharmacy employs 21 people and is open for business 74 hours per week. We have 5,000 square feet of retail space, so we can't rely solely on prescription and over-the-counter sales. We therefore sell a wide variety of items, including cosmetics, health and beauty aids and magazines. In fact, we have even installed a post office.

The Ontario government recently cut our dispensing fee and we are under pressure from third-party carriers and mail-order pharmacy. Add to this the possible loss of tobacco sales and companion sales and some jobs will be lost.

Two of our Pharma Plus Drugmarts have closed here in Sudbury in the last few years, including our downtown location, which closed just last fall. Every pharmacy cannot be a health care facility only. There are only so many patient aids that can be sold.

My second reason for opposing section 4(2)8 was because I don't think this ban will work. Banning tobacco sales in pharmacies makes no sense if the spirit of the bill is to deter people under 19 from buying cigarettes. A study by the Lindquist Avey group showed that pharmacies were the most diligent at enforcing the ban on tobacco sales to minors. This was corroborated by one of the young smokers who appeared before you yesterday.

It is difficult to understand how redirecting the sale of tobacco from pharmacies to corner stores will resolve anything. It seems to be a cosmetic approach. If all of us are truly serious about addressing this costly health care crisis, then we would make tobacco a controlled or a restricted sale item, even with the inherent loss of government revenues.

There are ethical issues involved as well. There is the question of whether we can justify having products for health care at one end of the pharmacy and tobacco products at the other. I don't think customers have a problem with this. As a pharmacist, I am not directly involved in the sale of the tobacco products. The customers seem able to separate the professional area of the pharmacy from the front shop where the tobacco products are sold.

Many customers are not shy. They are quick to point out things that upset them: a price that's too high, a sale item that's out of stock or a product that they feel is inferior. But in my 23 years in pharmacy, I've not had one person say that they don't think we should be selling tobacco products.

The ethical dilemma is real but it has to be weighed against the practical reality. Last week, three students from this year's graduating class in pharmacy appeared before the committee. The high ideals they showed are commendable. When one of the three was asked how pharmacists should replace the revenues lost by elimination of tobacco, she said they shouldn't worry about recovering the lost sales, but rather continue counselling people on their medications. Idealistic, yes, but the reality is that these graduates may not have jobs to go to.

A local MPP was quoted last week saying pharmacists can't have their cake and eat it too, meaning that they can't expect to be considered health care professionals and sell tobacco. Also last week, a doctor from British Columbia told the committee that if pharmacists want to be considered as health care professionals, they should not sell tobacco products. He also said that young people associate tobacco in pharmacies with it being okay to smoke. This has not been borne out by any young people who I've spoken to or by those who appeared before the committee.

Maybe to be considered a health care professional, a doctor or pharmacist should rather not smoke himself; that is, lead by example. I think this would be more likely to influence any young person we come in contact with.


Finally, after 23 years as a retail pharmacist, I find it hard to feel like a scoundrel for working in a pharmacy that sells tobacco. Governments are elected to serve the people. Perhaps this government needs to ask itself if by banning tobacco sales in pharmacies it is doing what the public wants, or if it is even in their best interests.

Mr Jim Wilson (Simcoe West): Thank you, sir, for your presentation. Much of what you've said has been reiterated by a number of your colleagues who appeared before the committee. You did say something, though, that disturbs me.

This is the first time we've been outside of Toronto so it's important to get the --

Mrs Dianne Cunningham (London North): Other than London.

Mr Jim Wilson: Other than London, Ontario.

Mr McDonald: It's part of Toronto.

Mr Jim Wilson: To me it's all the same.

Mrs Cunningham: No, don't tell me that.

Mr Jim Wilson: I come from Toronto, so it all appears to be the same, but none the less, I guess we've just lost all the votes in southwestern Ontario.

None the less, I think in my part of the province -- I'm north of Toronto, more of a small-town, rural area. Many of the pharmacists there, even the ones who have voluntarily removed cigarettes or tobacco products from their shelves, still oppose the ban on a business principle and they tell me they're retailers, and you've made that point. But you did say it might be difficult to replace the sales lost to tobacco products and the companion sales, which is the main point.

Do you want to expand on that? Because I think you said not everybody can get into prostheses or whatever other health care lines. I have the same problem. The town of Alliston has three or four pharmacies. They all can't just move into video sales or something like that to replace the tobacco products.

Mr McDonald: I think when I spoke about the high ideals of the graduating students and when I watched that part of the proceedings, I could put myself in the same position when I was graduating. I probably would have felt exactly the same way. Everybody would like to come out and work in an environment where all you do is dispense prescriptions, counsel people, maybe help them a little bit with cough and cold needs, vitamins, that kind of thing, and not even have to bother with the rest of the cosmetics and magazines and things that I mentioned.

But when you have a retail area, like I said, of 5,000 square feet, it just doesn't work. We have rents to pay. I'm just talking about my particular situation. We're in a mall and there's a high fixed cost, so you have to diversify. Historically, we've sold tobacco and it's brought in a fair amount of revenue. Those sales would be hard to replace. What I meant by not everybody can sell is there are so many bedpans that can be sold, so if every single pharmacy all of a sudden brings all these items in, walkers and bedpans and things, there's not going to be any more sold in the city, so it's not going to be really be that much of a boon to your business to replace the lost sales.

Mr Dalton McGuinty (Ottawa South): Thank you for your presentation, Mr McDonald. I happen to agree that the provision in the bill which bans tobacco sales in pharmacies is unfair and I don't think it will help achieve the stated objective of the bill, which is primarily to reduce smoking in kids.

I think when you weigh that against the broader message that we're sending -- you can now smoke when you're 19, right? So when you're an adult, when you're grown up, then you can smoke and it's still a legal product. So I think in the face of that, it's really not going to make much of a difference whether we ban it in pharmacies or not. I guess if we wanted to be really dramatic, we'd ban it everywhere. That would be a powerful message, but obviously for a number of reasons we can't do that.

But you talked about, and somebody else has mentioned this as well -- I think a number of presenters have -- making tobacco products controlled or restricted. What does that mean and what would the practical implications be?

Mr McDonald: When you really think about it, when products become more controlled, they tend to go into pharmacies rather than out. And the more controlled they become, the closer they get to my area or even in behind the counter with us, because they count on us then to counsel people on the pros and cons of taking particular products. Schedule C is what comes to mind. We're expected to participate in the sale of every schedule C item.

Mr McGuinty: Give me an example, something that I would know about that's a schedule C item.

Mr McDonald: Ibuprofen.

Mr McGuinty: Is that the pain reliever?

Mr McDonald: Motrin. I'm giving you the chemical name. Nicorette gum is another, seeing we're talking about smoking. The other thought -- I think it's been mentioned a few times -- having instead of an LCBO, a TCBO outlet maybe makes sense if you really want to control it.

Mr Jim Wiseman (Durham West): I guess, from my perspective, I look at what should be the ultimate goal, which really is to eliminate cigarettes from everywhere. Eventually, that would mean they would be eliminated from drugstores and so on. The goal of this legislation is to get the message out to young people that smoking cigarettes is going to really do harm to their lives and to their lifestyle.

Since you're a thoughtful man and I found your presentation thoughtful, I'd like to ask you if you could give the committee some idea of what we could really put into this bill that would be different, that would really have some meaning in terms of making it more difficult for young people to get cigarettes?

Mr McDonald: I think one of the key things is, when you think of illegal drugs -- like marijuana was a big drug years ago and it was illegal, but I don't think kids had any trouble getting it in the school system. With all you hear about contraband cigarettes coming in, I'm sure they're all over in the school system. Whether you ban it from all legal retail outlets, I think you still have to get tough at the other end, the illegal aspect of it.

The Vice-Chair: Thank you for your presentation.


Ms Jody-Lyn Joki: Good morning. On behalf of the YMCA Youth Employment Services, I'd like to welcome this committee to Sudbury. My name is Jody-Lyn Joki. I am a youth representative for the Sudbury region at the YMCA employment services. This service provides unemployed youth with training to successfully complete their job search independently. We also provide on-the-job training for those who need it and we help youth attain their grade 12 diploma.

I am currently working on a project called youth policy directions, which is a provincial project that provides youth with a voice when it comes to policy-making decisions that affect them. Because Bill 119 is a policy that affects youth, I appreciate this opportunity to express my thoughts regarding this proposal.

Promotion, peer pressure and accessibility are the main reasons why so many young persons start up smoking and continue. On any given day, our exposure to the promotion of cigarettes is almost continuous. For example, while I was on my way to work the other day, I stopped to fuel my car. When I walked in to pay the clerk, there on the counter was a variety of different brands of cigarettes. Next, I stopped at a convenience store to pick up a juice and an issue of Cosmopolitan. As I searched my wallet for change, I looked up and once again I was confronted with racks of cigarettes.

Later on, during my midmorning break, I was leafing through my Cosmo and I came across an appealing ad for Virginia Slims cigarettes. The ad portrayed a tall and slender young lady with a clear complexion and perfect white teeth. She sat there with a red leather jacket on, her legs wrapped around a street bike, caressing a smoke between her fingers. The message is: If you smoke Virginia Slims, you just might look and feel as beautiful as her. How misleading, I thought.

However, in the corner of the ad in black and white was a Surgeon General's warning: "Quitting smoking now reduces serious risks to your health." But what could this warning mean to young people who are feeling healthy and think they are fitting the image of the beautiful people portrayed in the cigarette ads? Judging by how many of them start and continue smoking, the warning does not mean much to them.


Finally, on my way home from work, I stopped to pick up a few items at the grocery store. As I walked in -- you guessed it -- more cigarettes. Cigarettes are effectively advertised and they are also strategically located in stores so that they are being well promoted. Not only does their location in the store serve as promotion, it also increases their accessibility. At this point, cigarettes are accessible to high-school-age youth. Bill 119 would restrict smoking to people aged 19 and over. That would require that people must produce identification in order to purchase cigarettes, just like alcohol purchases.

Some people may argue that photo ID will not prevent all minors from obtaining cigarettes. This is true; there will be irresponsible people who will put cigarettes into the hands of youth. Also, some people under 19 may look older than they appear and may not be asked to produce ID when purchasing cigarettes. This situation occurs sometimes with alcohol purchases, but most youth under 19 are refused because they cannot produce the proper ID.

Having to produce a driver's licence or photo identification would only be a problem for those not old enough to obtain the proper ID. The penalties provided by Bill 119 for those establishments that sell cigarettes to minors serve as a deterrent, just like speeding limits on highways. Not everyone follows them, but most people drive at reasonable speeds. Therefore, laws are enforced and they serve as a deterrent.

The accessibility to cigarettes that vending machines provide for youth can hardly be argued. A vending machine cannot ask for ID. Cigarette vending machines practically put the smokes into the hands of youth. The removal of cigarette vending machines is addressed in Bill 119.

At this point, cigarettes are easily accessible to high-school-age youth. When I was entering high school, I was 13 years old and I looked up to the 18-year-old seniors as to how I should dress and how I should act. It is no different for smoking. To decide whether or not to smoke, a 13-year-old freshman looks up to seniors as role models. Although 18-year-olds are entering into adulthood, they are still intermingling with people who are essentially still children.

Being at age 20, I still have clear memories of the pressure of trying to be like the seniors. Freshmen look up to them. They are cool. Freshmen are still growing and developing and they are not as mature as their senior counterparts. One way they can become like them and join them that is within their grasp is to smoke with them.

Adolescence is a very difficult and confusing time for young people. Appearing or feeling older has the effect of releasing the youth from feelings of awkwardness. The youth may reason that having a cigarette hanging out of their mouth will accomplish this. This occurs daily within the smoking compounds of our high schools today. Bill 119 will not only restrict smoking to people beyond high school years, but it will also keep smoking off high school property.

All of us are aware of the huge effect that peer pressure has on people today, but peer pressure is even worse for teenagers who are trying to conform to an image of what is cool and acceptable. Most of my decisions as to my direction in life were made during my high school years. This is a time when most high school youth decide on what career they want to pursue, where they want to work or whether they want to go on to post-secondary education.

These are very important decisions for a person who has so little experience, but they are ones that will dramatically affect the rest of their lives. It is also at this time that people make the decision of whether or not to smoke. If the young person decides to smoke, he or she is being initiated into what may result in a lifetime of addiction, poor health and certain financial strains due to this decision.

Everyone begins to smoke because of peer pressure. No one ever takes a first drag of a cigarette and says, "Oh, boy, doesn't this taste good," because at first cigarette smoking is noxious to anyone. Cigarette smoke is something a person must train their body to accept and to crave. Keeping cigarettes out of the schools will help alleviate some of the peer pressure that results in young people starting to smoke.

Smoking is an addiction and no addiction has positive results for the short term or long term for the addict. It is commendable that the government is putting forth an initiative that would result in fewer people becoming addicted to cigarettes. It would accomplish this by reducing accessibility of cigarettes to the ages where this addiction usually begins. By passing Bill 119 it would accomplish those objectives and for those who do not take up smoking because of Bill 119 there is a better chance that they will live a healthier life, free from the addiction of cigarettes.

Mr McGuinty: Jody-Lyn Joki, thank you very much for a very articulate presentation, I think, of some of the special influences to which young people are susceptible. I thought you presented that very well.

We had an interesting presentation yesterday from a group of committed young people, smokers, who described for us some of the difficulties they had in kicking the habit and why they started and their great reluctance to give up the habit, notwithstanding what happens in terms of us passing new laws.

There's an idea that has been kicked around here and if it is met with great approval, I'll lay claim to property ownership; if it flops, then I'll give the benefit here to my Conservative colleagues. That's this idea -- I think it's a good idea, in fact -- that deals with assigning some responsibility to our young people when it comes to cigarettes. By that, I mean imposing some kind of a penalty in the same way we do for young people if they're caught buying liquor underage or if they're caught in possession of liquor underage.

If I'm a young person, I'm out in the field and I'm having a drink, there's a law against that, but if I'm smoking, there's no law against that. I think the law sends a powerful message to young people and maybe we're missing the opportunity by not including such a provision in this bill. What do you think?

Ms Joki: It is something I have considered and I have discussed with other people and I do think it would deter a lot of youth from starting to smoke. It won't prevent all youth from smoking. As I mentioned in my presentation, they'll always find a way. There will always be people who start to drink, but it is something that deters a lot of youth from going ahead and drinking alcohol and I think it would be effective. If this bill is passed and those under 19 aren't to purchase cigarettes, then some of the responsibility should be put on the one who attempts to buy the cigarettes and who is smoking.

Mr Jim Wilson: Thank you very much for your presentation. I thought it was excellent. As you know, all three political parties agree on this legislation and voted for it on second reading in the House. I think where we bog down from time to time is the clause that deals with the banning of sale of tobacco products in pharmacies. There are some differences among the government and the opposition with respect to that issue, and vending machines, because I just wanted to take the opportunity at the beginning of these hearings to clear that up. Certainly, my party agrees we should ban it in vending machines for the most part, but we should also compensate those vending machine owners whom we might be putting out of business.

You did mention in your remarks -- and I want to make sure, just following what Mr McGuinty was saying, that we not leave the impression out there that this bill is anything dramatically different than what the current law is. It simply increases the age to 19, puts heavier penalties on retailers or people who sell cigarettes or furnish cigarettes to people below the age of 19. That's not any different than the current model we've been looking at, which is 18, with penalties on retailers.

I think the big thing is an addition to putting some onus on the young people themselves, that is, in one state where they've brought in a licensing model, they also fined the young people $25 and you have to go down to the police station and pay the $25. You've answered that question.

It was interesting yesterday when we had a group of smokers. I got the impression from most of them, I think four out of five of them basically told us nothing would deter them from smoking, that it was just something young people have to go through and it's a trial-and-error thing. Do you have friends who smoke and, if so, what's their attitude towards what we should be doing? What would make them stop smoking, do you think?


Ms Joki: Yes, I do have friends who smoke. I'm not quite sure. I can't give you an exact answer what would deter them. As I mentioned in my presentation, there's a high level of accessibility to cigarettes for youth. Everywhere they go they're bumping into cigarettes. It's practically embedded into their lives. It's promoted on television, it's promoted in magazines when it comes to advertising, any store they walk into, and even certain department stores now have little refreshment areas where they sell cigarettes. So if the government decided to go further with Bill 119, it probably would be a good idea to think of decreasing accessibility in retail establishments when it comes to cigarettes. Otherwise, like those youth you mentioned yesterday, if they want to smoke, they will find a way to smoke, and if it is accessible, they will get to it.

Mr Jim Wilson: Good answer.

Mr Anthony Perruzza (Downsview): First of all, thank you very much for appearing before the committee. It's tough enough to appear before groups like this and I think it's even more courageous when you don't necessarily have a financial interest or a personal stake in what we're dealing with. It's not often you find people who don't have a personal stake in what we're dealing with who'll come and appear before the committee. It's really easy when there's a financial interest to motivate yourself and say, "I've got to get out there and give those people a piece of my mind, because it's going to impact on my livelihood." You obviously can make the lifestyle decisions that are good for you and you can choose to smoke or not to smoke. I suspect you'll choose not to smoke and I think that's the wise way to go.

I just want to get your feedback, because I think you're going to hear a lot of bantering that goes around the table on how everybody agrees and doesn't agree, but we obviously all make decisions on how to pursue this particular issue in different ways. I don't necessarily agree that cutting taxes on cigarettes or bringing down the price of cigarettes is a good thing, in that if you make them more affordable, I think more young people are apt to reach for a pack.

We had an expert appear before this committee the other day who suggested that in a person's lifetime we give over three million viewings of cigarettes and cigarette packages, green ones, red ones, white ones, blue ones, striped ones, all these really colourful, really appealing, really sexy packages of cigarettes. If you place them in places where you have it in your own mind, and especially in a pharmacy where you go in and you say, "This is a place where I can get medication to get healthy and be well," and at the same time you find this sexy, chic pack of cigarettes which you've viewed a million times already in your life and you associate it with a particular lifestyle that's very appealing, I don't think that's necessarily a good thing.

I just basically wanted to get some feedback from you, because the Conservatives don't believe that we should take cigarettes out of drug stores and that kind of thing, and the Liberals obviously now believe that cigarette taxes should be reduced.

The Vice-Chair: Mr Perruzza, your question please.

Mr Perruzza: That's my question. I just wanted to get some feedback on these two things.

Ms Joki: Regarding cigarette packaging?

Mr Perruzza: Cigarette packaging and how taxes would impact on young people's ability to purchase them, and whether that's a good thing or not.

Ms Joki: First I'd like to address the cigarette packaging. You did mention it earlier on in your question. I have read quite a bit of information regarding it and I do agree that is something that makes it more attractive to young people, the packaging. Like I mentioned, regarding the Cosmopolitan advertising and smoking, when a youth sees something like that and they're young and they don't have the maturity of an adult, that is very attractive to them. Some of the cigarette packages, and I'm sure you've heard this before and you'll probably hear it again, do look similar to perfume bottle boxes. When they are portrayed in that sort of fashion, it is almost encouraging the youth to take up smoking.

When it comes to taxes, I'm really not sure. I've never gone ahead and purchased a package of cigarettes before.

The Vice-Chair: Congratulations.

Ms Joki: Thank you. But I do think by decreasing taxes, it will make it more accessible to youth to purchase them.

The Vice-Chair: Thank you for your response and for your presentation.


Mrs Helen Ghent: My name is Helen Ghent. For the last two years I have been president of the Ontario division of the Canadian Cancer Society, an organization of volunteers who have no vested interest other than the health and welfare of Canadians with regard to prevention and cure of a disease that is taking hundreds of thousands of lives, many of which are directly related to tobacco.

I appreciate the opportunity to speak to you, particularly because I think it's important that you listen to the public as well as recognize the fact that you should be listening to research.

We're particularly delighted with the present government's stand. We congratulate Ruth Grier on her continued commitment to her targeted tobacco-reduction figures, because we believe that those should be the issue, and also Floyd Laughren, who under tremendous fiscal constraint, is really trying hard to hold the line. The issue of roll-back of tobacco taxes is devastating frankly to the whole issue of prevention.

The tragedy is, we're already behind the eight ball, because the damage from tobacco consumption is cumulative. So we already know that for the next 20 years, we've got big, big problems in terms of health care. If we don't do something pretty quickly to stop the addiction of 3,000 victims every month, we're going to be in a position that's horrendous. Therefore the Ontario tobacco act is critical, frankly.

I think the important thing is, I look around the table here and realize that we're talking about a group of people who have the potential to become addicts who think 30 is old. They don't care about the messages, because they're invulnerable. They're young. Don't you remember? I remember the first cigarette at eight, and I forced my four-year-old brother to have one so he wouldn't tell my parents. I think we have to understand the psychology behind this.

We feel it's particularly important for the government and all parties, because this is an opportunity to make a very strong statement to those people who have elected you to take responsibility for the health of this province and to follow the pursuit of health, not at the expense of personal or corporate profit.

I think it's important for you to recognize how we as an organization work. I am today representing the northeast region. That's a horrendously large area. It covers Cochrane, Timiskaming, Sudbury, Algoma, Parry Sound and Nipissing. There are hundreds of volunteers who every year bring services and programs to 5,000 cancer patients: supplementary services, transportation to treatment and emotional support. Apart from that, we have a lot of volunteers who are bringing health messages about how to reduce your cancer risk. What good is it when we have no backing, we have no legislative clout? I think it's critical that you understand that.

This disease affects not just the victim himself, but it affects families, friends and communities. It's at tremendous public and private cost in pain and agony and suffering. These volunteers who sit with these patients, who drive them, they know that pain and agony, and they know that with the information we have today about tobacco, a lot of this could be prevented.


I think it's important also to realize that the Canadian Cancer Society, in the time it has been raising funds for cancer research, has provided $1 billion to the National Cancer Institute of Canada. Not one penny has come from the government. Every single cent has come from knocking on doors and asking the public for money. That money has been entrusted to us to find the answer to this disease. The interesting this is, the answers have been forthcoming, but they haven't been the answers that people necessarily want to hear. The most significant of all is that tobacco products cause cancer.

What is really significant here is that this product kills when used as intended. It has no other use. If it were discovered today, it wouldn't be allowed to exist. It would be in the hazardous substances act. Even the United States, which is behind in taxation, has classified environmental tobacco smoke as a carcinogen. Canada better wake up and do the same thing.

Putting a human face on statistics is important. Three things have happened in statistics that I think are relevant. Last year 10% of grade 7s in Ontario were smokers, a 50% increase since 1991. That's pretty significant. While we're sitting here today and you're deliberating, every 40 minutes a person will die from tobacco-related disease, five times the number of AIDS, suicide and traffic accidents combined. We get all the press and all the ads about AIDS. It's insignificant compared to something that we can do something about. Tobacco is the cause of 30% of all cancers and 85% of lung cancers; pretty significant.

As it stands, I think Bill 119 makes a clear health message. It reinforces the scientific evidence that tobacco products cause disease. It allows for personal choice at the age of consent. It restricts access to children through controlled outlets. By the pharmacy ban, and I think this one's absolutely critical, it underscores the difference between tobacco and other legal products. It provides for measures that will deter and penalize offenders.

It's really important that, at the same time, we want to ensure that the intent of the legislation is actually met in interpretation and enforcement, because that's been the weak link with anything that exists today. There is no enforcement and there's really no regard for the law. We want to make sure that there's no question about the government's very honest effort to prevent illness and premature death.

If I were to look at the specifics of the recommendations, to sell tobacco in pharmacies is in opposition to what a pharmacist stands for in terms of public trust and in terms of selling products that enhance one's health. There is absolutely no use for tobacco in the healthy life of a person in any way, shape or form.

I think the other thing that Jody-Lyn very definitely talked about was the vulnerability of young people to peer pressure, advertising and logos. Frankly, a tobacco package is an accessory, and therefore plain packaging is really an issue that needs to be addressed. It has nothing to do with adults. It just makes it unattractive to children. For your information, the cancer society in Ontario invested in some research this year with regard to plain packs. The results of that have just been released and will be available to you if you wish.

The other issue of course is vending machines. A child doesn't even have to be tall enough to reach a counter to have access to a vending machine, so it obviously has to go.

With regard to the kiddie packs, I find that reprehensible, because it just shows the targeting methods of an unscrupulous industry that knows that adults are either addicted or will have enough sense not to smoke, where children are the targeted audience and they don't have the maturity to deal with the issue.

I'd like to conclude my remarks with a personal statement. I've been involved with this organization a long time and my particular area of interest is education. I was a smoker when I started doing education for the cancer society in -- well, it was years ago, but it was in 1971 that I stopped. The reason I stopped was that I read an article in Progress magazine, which is the magazine of the National Cancer Institute of Canada. Dr Tony Miller, who you probably know is a well-known cancer epidemiologist, wrote a scathing attack in which he said that any Canadian Cancer Society volunteer who was involved with education and who smoked had a choice: They either stopped smoking or they got out of education, because they were doing more harm than good.

Children, for a number of years, look to their peers, their parents, their teachers, role models on television and in their community, and they believe everything that's told to them. What those people say is, "Don't smoke, don't drink, don't take drugs." One day they wake up and they look at these very people who smoke and drink and take drugs. So obviously the message is, "It's okay."

With the help of this legislation, our elected representatives can make a strong statement. They can end the hypocrisy of pharmacies selling a product that has only a deleterious effect on health. They can remove the control that tobacco manufacturers try to exert over vulnerable consumers through sponsorship advertising and package design. They can ensure that people who circumvent the current law see no opportunity to do so with the new legislation.

Then, with the help of this legislation, the things that the other health charities, including the cancer society, do which are bringing health promotion and cessation programs to the public can be done with more meaningful results.

I really pray that you, as a group, bring back the right messages to the House and that you have the stamina and the guts, frankly, to deal with this in a very proactive way to protect the health of the children in this province. Down the line, we'll have a healthy place in which to live. I do believe the bill needs to be strengthened and that there have to be real teeth in it, but thank God we live in this province, because it's nice to see the effort that you're putting into it. I really believe you're trying to come up with the right results.

Mr Wiseman: I have just one very short question. The one thing you said that really concerns me is that there is this 50% increase in the number of grade 7 kids who are smoking, the 10% of them. This really concerns me, because there are no more smoking ads on TV. There's a real culture out there. Even my 4 1/2-year-old is telling the neighbour to stop smoking. So what's going on? Why do we have this increase in smoking among grade 7 kids?

Mrs Ghent: I believe that when you look, there are single-cigarette sales, there are kiddie packs. There are no laws being obeyed about the age at which somebody can buy, there's no enforcement of anything, and peer pressure is still the issue. So if we don't close those loopholes, I don't think it's possible.

Mrs Yvonne O'Neill (Ottawa-Rideau): Thank you so much for a very enlightening presentation. You've been in the field long enough to really underline your credibility.

There are a couple of things I'd like to ask you, one of them being that you think the bill should be strengthened and I would like you to be a little more specific, because I don't think you've put any of that on record. Secondly, have you got any ideas for us about how it could be better enforced? I'm thinking of other possibilities, of fines or whatever. Maybe you would like to say a little bit about both those things.

Mrs Ghent: With regard to the enforcement, and I'm speaking on behalf of the cancer society, we didn't know what format that would take in terms of regulating outlets, because I think that licensing of vendors is a really key point. I think they have to understand that this is not just a candy bar or a Lotto ticket. To be able to sell tobacco, there are rules and regulations and they have to be abided by. I think that is the first thing.

The fine has to be appropriate. It has to be significant, that you revoke their licence after a first offence or second offence and put in severe monetary penalty.

Mrs O'Neill: So you think the municipalities should have the onus, all of them, of putting it on, or do you think it should be part of this bill?

Mrs Ghent: I really can't give you the answer, but I could get back to you with a position statement from the organization.

Mrs O'Neill: Okay. That would be very helpful.

I like that you say, "Pharmacists are persons of trust in the community." That's a very important statement.

Mrs Ghent: Yes, and I find it very hard to believe that anybody's income -- I know it will be affected, but I don't believe that anybody who runs any business has a right to sell everything.


Mrs O'Neill: Can you say anything more about strengthening the bill?

Mrs Ghent: Again, I'd like to see vending machines abolished altogether, or else they're going to have to be behind the bar, literally, and somebody there is going to have to dispense them. Nobody gets direct access to it.

I think the vendor must have proof of identity, not assume that the person looks their age. That has to be legally strengthened.

Mrs O'Neill: You say something about cigarette cases.

Ms Ghent: Paraphernalia, yes. That goes along with advertising and accessorizing, and I do believe that has no place. I think that is exactly the avenue and the strategy that tobacco companies will use. They are using the corporate opportunity for culture and sport, so they're getting around the advertising that way. I think it's wrong.

The Vice-Chair: Thank you for your presentation. It's very helpful.


Mr Langley Neal Robertson: I'm Langley Neal Robertson. I'm an independent pharmacist from Harris Guardian Drugs in North Bay. I'm speaking for myself basically, not for any group, just as a pharmacist, one who doesn't sell tobacco any more and who, 21 years ago, smoked. So there we are.

The Vice-Chair: We're pleased to hear from you.

Mr Robertson: As a preface to this presentation, I have to state that I view the introduction of selective prohibiting legislation with great reservation. My feelings have always been that the less legislation, the better. Keep it simple.

I bring this up only to emphasize that, to me, the use of legislation is the last resort and should always be invoked with extreme reluctance. This point has been reached. Please view what I'm going to present through this light and please realize that in my mind this is a necessary step towards what must be done to prevent the spread of this menace. I don't feel the word "menace" overstates the problem, but in fact understates it.

Tobacco use is the largest preventable cause of death and therefore Ontario's most important health problem. The extent of this devastation is difficult to imagine -- in fact, it sounds like fiction -- but consider that in the time allotted to me for this presentation possibly one Canadian has died from a smoking-related disorder. I think anything that kills a Canadian every 15 minutes is a menace. This figure is a little different from what I heard a few minutes ago, but I got it from another source.

My suspicion is that by now you will have heard almost everything I have to contribute, because I've either seen what I'm going to say in print or I've been watching some of the proceedings and have heard, often, what I was going to say. Bear with me, please.

With that in mind, I speak in favour of Bill 119. Restriction of access to all tobacco products should be the emphasis, and to this end, the discontinuance of sales through health providers is a must: No sales in pharmacies or hospitals. The health provider selling tobacco products is the ultimate contradiction.

I should note at this point that the initiative to ban tobacco sales in pharmacies originated with the Ontario College of Pharmacists, the regulating body of the self-governing profession of pharmacy, not the government. At this point I'd like to commend the government and the opposition parties for getting it to this point; second reading, I understand.

The Canadian Pharmaceutical Association states that a pharmacist should not participate in an advertising or promotional program which might encourage misuse or abuse of drugs. So tobacco products, which in fact kill, have no place in a pharmacy.

The legal age to purchase tobacco should be increased to 19 from 18. Of course, this is beneficial since after the age of 19 it's been found that people are less likely to smoke if they haven't started. As an interesting anecdote, it has been illegal to sell tobacco products to persons under the age of 16 since 1908; however, the median age for becoming a daily smoker is 15. Overall, teenage smoking has declined, but a disturbing trend has shown up since 1991: the increasing tobacco use of grade 7s, which we just heard about a few minutes ago. I say 9.4%, but who cares? It's too much.

A universal truth is that prevention is more effective than treatment; that is to say, it is easier to deal with those who do not smoke than it is to stop them after they have started. I'd introduce at this point that the prohibition of sales through unattended vending machines is a must.

I've heard the argument that pharmacists are better able to counsel patients for smoking cessation if they're selling the product. No, I don't think so. Sorry, but this just doesn't wash. I do not believe that selling tobacco products will enhance our ability in counselling a smoker on how to quit. This is ridiculous in fact. To think, on the one hand, we'd place a four-by-six sign saying, "We have the lowest price on tobacco, come in and buy some," and in the next breath counsel a purchaser to stop smoking -- no, hardly.

Then there's the level-playing-field theory where pharmacies, as retailers, should be allowed to sell any legal product if any other retailer can sell it. Does this mean that a tobacco store should be able to fill prescriptions, or are they already? No, of course not. Some retailers can sell one thing and others are allowed exclusive rights to sell others, and thus it has been for a long time.

The hue and cry from tobacco sellers who wish to continue selling tobacco products is that pharmacies may be forced to close. My answer is, yes, some pharmacies will close. It is, however, unlikely that the prohibiting of tobacco sales is the only cause for their closing.

A study by the CPhA in 1992 showed that of 56 pharmacies that voluntarily eliminated tobacco sales, 59% either had no income loss or an increase in overall sales; 13 had marginal losses and 7 had moderate losses. However, all 20 of the latter had recouped in the next two years.

The handwriting for sales of tobacco products in pharmacies has long been on the wall; you just had to read it. If one has not tried to make plans to overcome the lost revenues from tobacco sales, then I'm very much afraid they have made a business error. Plainly and simply, they have shaken the dice and they have come up snake eyes.

We discontinued tobacco sales in our two North Bay stores in April 1991. Although our sales for the two stores in tobacco in 1990 were about $800,000, we did discontinue the sales. Through positive efforts, these losses have been regained and surpassed, without reducing staff, I might add.

One of the most bizarre arguments for retaining the right to sell tobacco in pharmacies is the scenario where if pharmacies don't sell tobacco, then kids will buy from smugglers. I find it hard to take this seriously, and in any event, this would be dealt with as a matter for the police. Although pharmacists may be concerned as citizens, that should be about it.

The message must be clear: Tobacco products kill and pharmacies sell health items, so pharmacies should not sell tobacco products, period.

Speaking from personal experience, I must say that we were quite surprised at the public's reaction to our discontinuation of tobacco sales. Many people sent us letters of support and commendations. One went so far as to send North Bay Guardian a plaque which we display with pride in the back of the store. In other words, our experience was consistent with CPhA study results. The medical community was also very supportive.

Initially, there was a considerable dollar loss in revenues per month, but sales volume did come back and our sales surpassed those we had in the tobacco-selling days. No one wants to take losses, but there is a time to take a stand on what is right. This is that time. Both government and pharmacy must seek either economies or new sources to replace revenues given up by the reduction in sales of this product.

Pharmacy is an old profession which has long been an honourable and trusted one. Let us not confuse the issue. It's a health-providing profession. Let us be that.


Mr Jim Wilson: Thank you for your presentation. We've been told by other independent pharmacists that actually it's a bit of a myth that pharmacists have a real monopoly, and it's been pointed out to the committee that anyone can set up a pharmacy, that you simply have to meet the requirements and get college certification, and that's quite true. Pharmacies are popping up everywhere: in the back of A&P stores, in Eaton's and Loblaws. We were told all you need is running water and you have to meet the physical criteria of setting up a dispensary in your store and a few other fairly simple -- and hire a pharmacist, of course. Any retailer can get into the business. You posed the question, could a tobacco shop under today's laws set up a pharmacy? Of course they could.

I want your comment on that because it's been suggested to us that perhaps we wouldn't be receiving such negative reaction from those pharmacists who don't want to see a ban on tobacco products if there was more of a monopoly on selling prescription drugs, if there weren't so many pharmacists in the business. A lot of people tell us that because there are so many pharmacists in town they really had to expand their retail trade at the front of the store and part of that is that they sell tobacco products, often as loss leaders, to bring customers into the store so they can make money and be in business.

What are your thoughts with respect to perhaps we should be looking at the regulations of the college and its criteria for setting up pharmacies and tightening those?

Mr Robertson: I'm not sure altogether how to address that. It's been, up till now, very difficult for a tobacco shop to set up.


Mr Robertson: It could be a hardware store. I don't care. It doesn't matter. You can buy a pre-1953 charter from somebody, I suppose, and set up a pharmacy.

Mr Jim Wilson: No, you don't even need that.

Mr Robertson: You don't? You don't need that?

Mr Jim Wilson: No. Anybody can set up a pharmacy, yes. That's their point.

Mr Robertson: I wasn't aware of that, actually. It's never come up.

Mr Jim Wilson: They think it's too easy. The law is very clear. There's a certain set of criteria you have to meet and as long as you meet that -- this is the evidence they're giving us -- there aren't too many people turned down.

Mr Robertson: I'm not aware that that's the case. If it is, then possibly they should be looking at something like that.

Mr Larry O'Connor (Durham-York): Thank you for your presentation and for coming here this morning. As you know, this legislation is just a part of the strategy, and the strategy's been laid out pretty clearly since the Premier's Council report, the strategy laid out in 1992, a discussion paper in January 1993 and then hearing from people.

The draft legislation was circulated and over 240 people made written presentations and 34 oral presentations to the Ministry of Health officials in drafting this legislation. In doing so, we heard from people saying that the licensing could impact negatively on small business, add an additional drain on it. Then we've heard from people saying that we should go to a licensing system because that little licence up in the corner is something that the retailer would be proud of. Of course, the licensing then goes to some pretty strict enforcement. I think the enforcement is in the legislation --

The Vice-Chair: Question.

Mr O'Connor: Thank you -- and the key here I think is getting the message out to the people we're targeting, the young people. It is not the licence up in the corner but the sign before the people when they go in to purchase it, then of course the statutory prohibition if they're caught selling to minors and then some signage saying this store has committed the offence of selling to minors.

How would you, as a pharmacy owner, feel if a pharmacy wasn't included in this but was then subject to -- and we've been hearing nothing but wonderful things about how pharmacists would never sell to a minor -- all of a sudden pharmacists are being charged under the legislation and have signs put up there saying that this pharmacy and then of course your colleagues have been selling to minors? How would you feel if that was the situation, because clearly it would happen?

Mr Robertson: Obviously I don't think they should be selling in a pharmacy, so that wouldn't be a case as far as that goes.

Mr O'Connor: I agree with you. Thank you.

Mr McGuinty: Thank you very much, sir, for your presentation. First of all I want to commend you for taking tobacco products out of your drugstore and I think we should all be endorsing patronizing drugstores, pharmacies, which don't sell tobacco products.

Obviously this issue is the subject of some controversy. We're going back and forth here with pharmacists bringing opposing positions to the committee. I personally don't feel that the removal of tobacco products is a step which is going to have any measurable effect in the war against tobacco. I think there are some 1,400 pharmacies in the province which sell tobacco products and there are 120,000 cigarette retailers, and I just don't see the symbolic value when you juxtapose that with a greater symbolism, which is: "Well, Mummy can still smoke. Daddy can still smoke. Uncle So-and-so can still smoke. When you're 19 you can smoke." I just don't see how that's going to make any significant dent in that.

What I really appreciated though was the way you prefaced your comments as seeing the law as kind of a last resort. In that context I want to ask this question. This bill also addresses vending machines, again the primary purpose being to make it tougher for kids to get hooked. Do you think it's fair that we ban vending machines from bars?

Mr Robertson: I don't see what difference -- if it's in a bar then you're not going to get children. I suppose you can make a case, much like a health facility. I saw somebody mentioning something about some advocate for mental patients --

Mr McGuinty: Right.

Mr Robertson: -- and they seemed to make sense. I guess nothing is carved in stone.

Mr McGuinty: Right. I might add, just on a point of personal interest to you, my relations in North Bay are very disappointed that you banned tobacco. They run McGuinty Funeral Homes.

Mr Robertson: Ah, yes.

The Vice-Chair: Thank you for your presentation, Mr Robertson.


The Vice-Chair: The next presentation will be by a representative of the Sudbury General Hospital Auxiliary. Would you please come forward, introduce yourself and proceed with the presentation. Welcome.

Mrs Lois Nault: My name is Lois Nault, president of the auxiliary of Sudbury General Hospital and chairman of region 10 of the Hospital Auxiliary Association of Ontario, also known as HAAO.

Our auxiliary was founded in 1949, before our hospital was officially opened in 1950. As a supplementary source of revenue, besides our bake sales, teas, raffles etc, we started a tuck shop in a corner of our front lobby. We sold chocolate bars, chips, gum and tobacco products. A few years later we were given a permanent location on the front main floor near the switchboard. We increased our sundries with pop, infants' wear, magazines and more tobacco products. Our revenue kept rising as a result, so we expanded the size of the shop to accommodate our growing volume.

Twenty years ago our board of directors suggested we consider eliminating tobacco products from our shop for health reasons. We discussed the matter with our members and, although we knew it would definitely cause a drop in our revenue, we all agreed, as a health care facility, we should not be selling tobacco products that are a threat to one's health.

The first few years after eliminating them, our revenue did decline, but we have always been very innovative and determined ladies. What we did was to diversify by expanding our shop again to make it big enough to sell coffee, tea, hot chocolate, more hand-knit items, fresh and artificial flowers and a larger gift line etc. Our revenue increased significantly from then on, and so much so that a few walls were torn down to make it even bigger.

Currently, we provide sandwiches, several kinds of pastries, a hot chocolate machine was installed, fresh cookies and butter tarts, parking tokens, stamps, bus tickets and Nevada lottery tickets. Our motto is, "If we don't carry it, we will do our utmost to accommodate your request." Hospital staff, doctors, volunteers, visitors and patients are our very best customers.

In conclusion, we still firmly believe that we made the right decision 20 years ago to eliminate all tobacco products from our shops. As we all know very well, heart disease, strokes and heart attacks, lung cancer, bone cancer and other health-related problems are definitely linked to the use of, and abuse of, any tobacco products.

As an added note to this, our revenue has gone up every year since and our donation to our hospital in 1993 was $182,000, and we are sure we will surpass that amount again this year. Thank you.

The Vice-Chair: Thank you for your success story.

Mrs Nault: That's short and sweet.

Mr Jim Wilson: Thank you, ma'am, for being right to the point. I guess the way I look at this is, and I certainly agree with your decision not to sell tobacco products in the tuck shop of a hospital or in that case any major health care facility. That's where, with respect to the pharmacy thing, we differ with the government in terms of when I go into a Zellers store that has a pharmacy at the back, I don't think of the Zellers store as a health care facility. Yet, under this law, it will be considered a health care facility because it has one department out of, we've been told, over 30 departments that happen to be a drugstore.


I have no problem and I don't think the public has any problem realizing a hospital is a health care facility. In fact, I would think it abhorrent to be selling tobacco products in a hospital tuck shop and I've always thought that. I used to always think, because I did volunteer work in a hospital when I was in university, it was pretty bad that people were huddled in smoking areas in hospitals, although I have some sympathy -- it's been pointed out that we have to look at the veterans' case, in the case of Sunnybrook hospital in Toronto, where they have a veterans' wing, that perhaps we'll have to make an exception there.

But do you have any thoughts on the non-traditional pharmacies that are going to be hit by this ban and do you think consumers can't tell the difference between a retail store and the pharmacy at the back of the store?

Mrs Nault: The stores that sell sundries and food and have the pharmacy at the back, I think that they're separate, actually, in some ways because it is in a different area of the store or whatever. But I'm in agreement that they shouldn't be selling them; I don't think it's wise. But where else are they going to sell them? People are going to be buying them. Definitely their revenue will go down, they have a point there, but as we were saying, it is a store or a shop where they sell drugs for health reasons, so one is counteracting the other. If you're going to be selling tobacco and you're selling other things besides, they don't seem to go together.

Mrs O'Neill: Thank you so much, Ms Nault. Is there a provincial association of the auxiliaries of the hospitals?

Mrs Nault: Yes.

Mrs O'Neill: I really think you should send this brief to them. I had a little more experience than I wanted in hospitals in 1993, with very close relatives being involved, and I'm not sure that every hospital is where you're at with their tuck shops. I do know that for one of my relatives, trying to give up smoking in the hospital, a fresh cookie would have been very helpful to have when he wanted a cigarette.

I really think that you have in your brief -- and I was just saying to my colleague that we can say quite a bit in 432 words -- said a lot. I think you've shown and I hope those who are here this morning and those who will read the Hansard will find that you have shown there are other ways to serve customers, there are options to be offered and I think you've done a very good service to this committee, so thank you so much for coming.

Mrs Nault: Thank you.

Mr Perruzza: More a comment and a reflection than really a question: I come from a country where when someone becomes a doctor or a pharmacist they occupy a very privileged and responsible place in society. They have pharmacies there and I don't think anybody would get into that area if their aim was to sell or promote cigarettes or promote anything other than their craft, which is dispensing medication and providing a health care service. So it's quite interesting. That's not necessarily to say that they have a lower ratio of people to smoking but I think it has to do with what that office essentially carries with it, and with it, it carries a high degree of responsibility, and to promote cigarette sales or to sell cigarettes by a highly respected, responsible person is, I think, irresponsible. I just make that observation.

The Vice-Chair: Did you wish to comment?

Mrs Nault: Yes, I'd like to make a comment. As I mentioned in my introduction, I am chairman of region 10 of the Hospital Auxiliary Association of Ontario. My area extends to Wawa, down as far as Parry Sound, down as far as Mattawa and all points in between. None of the tuck shops in my region sell tobacco products and have not sold them for quite some time.

Mrs O'Neill: Wow. That's quite a record.

The Vice-Chair: Thank you very much for that information and your presentation.


Mr William Wilson: I'd like to thank you for coming to Sudbury and giving us the opportunity to speak to you. My name is Bill Wilson. I'm a pharmacist from Sudbury. I'd like to speak to you from three perspectives, first as an ex-smoker. I'm a reformed sinner and I suppose we all tend to be quite strident in our views about our former vices. I'm no exception. I quit smoking about 20 years ago and my views, rather than mellowing with time, have become more rigid. I just have no tolerance for the use or sale of tobacco products.

Second, I speak to you as the council member for the Ontario College of Pharmacists for district 14, which includes a great area of northeastern Ontario. I support the position of the college of pharmacists in this matter and I would like to thank the current government for bringing forth the legislation that will enable the implementation of the college's recommendations regarding the sale of tobacco products in pharmacies.

Third, and I think most important, I speak to you as a pharmacist and pharmacy owner. My partner, who is also my wife, and I own two pharmacies. One is South End Apothecary, and "apothecary" is just a funny way of saying pharmacy for those of you who don't know that. It's located in a medical building here in Sudbury. We opened it about three years ago and we've never sold tobacco products at this location. The second pharmacy, Wilson Pharmacy, is located in Copper Cliff, which is just underneath the smoke stack over there to the west. Copper Cliff is now part of the city of Sudbury. The pharmacy has been in my family since 1911, when my grandfather came to Copper Cliff and purchased it. My father owned it and now I own it. It's more of a traditional pharmacy, selling a mix of products. We did sell tobacco products there at one time.

I stopped selling the tobacco products in the mid-1980s. I can't give you an exact date because at the time I didn't think it was such an important step; it was something that I felt very strongly about. I was prepared to take that step regardless of public opinion. This move was made before it became fashionable to stop selling tobacco products in pharmacies and it was met with some objection and ridicule by the public. Nevertheless, we proceeded and most people were supportive of the move and respected my forgoing financial gain in favour of upholding an ethical principle. As it turned out, we did not suffer financially because of that decision and we did gain a measure of respect in the community.

I don't think I have to revisit all the financial issues involved here, as a previous presenter mentioned the Canadian Pharmaceutical Association survey which showed that most pharmacies did not suffer major financial consequences when they stopped selling tobacco products. Heart Health Sudbury did a survey locally here this past summer and it found that 19 of 38 local pharmacies no longer sell tobacco products. As far as I know, no pharmacies have gone out of business due to stopping the sale of tobacco products.

I've heard some pharmacists argue that tobacco products should be sold in pharmacies because as health care professionals we're better qualified to monitor their use and counsel customers regarding the possible side effects. I submit that if their tobacco products are located in the dispensary, then perhaps they can monitor their use. Otherwise, I just can't follow this line of reasoning, and I can't see that anyone, any pharmacist, is going to have cigarettes in their dispensary and sell them through their dispensary.


The decision of council: It's really that we're sending out a message here. It's a symbolic gesture that we as health care professionals do not support or condone the use of tobacco products. We're telling the public that smoking is harmful. This is a very laudable message and I support it. I'm trying to sell it within the profession. I think a lot of pharmacists have bought into that message. It's becoming increasingly difficult to get that message across, though, when various levels of government are cutting taxes and caving in to groups that threaten to break the law or that are breaking the law. We're getting mixed messages here, and I think it's important that all levels of government send out the consistent message that smoking is unacceptable. In any event, I'm sure you've heard a lot about that, as well.

I guess I just have to express, on a personal note, a very strong sense of frustration as a pharmacist that we are trying to send out this message and we are giving up financial gain and the government cuts taxes, which will increase the use of tobacco. It's a very frustrating feeling and I'm trying to search for the appropriate words to express that. I suppose "outrage" is one that is overused now. I guess "disgust" would be a better term to sum up my feeling about the whole thing.

Anyway, there will always be someone who will cry wolf when any action is taken that may financially affect some segment of society, but in business there are always financial adjustments to be made, whether it's a result of changing markets, new competition or the result of changes in government regulations. We as a society cannot condone something that is wrong purely for financial considerations. After all, is it right to continue shelling the women and children in the markets of Sarajevo because the soldier on the hill might lose his job or some arms manufacturer may have to close down his factory? Is it right for a profession that is charged with protecting the public health to continue selling a product that kills thousands of people each year? The answer is clearly evident.

In closing, I would just like to share with you something that happened in one of my stores recently. I have an elderly couple who are clients of one of my pharmacies. The wife has chronic obstructive pulmonary disease. We dispense inhalers and other medication that enable her to breathe, and she continues to smoke. Her husband, a non-smoker, or perhaps an ex-smoker, has recently developed cancer of the larynx. If I was sending cigarettes along with her prescriptions used to treat the cancer and the lung disease, I could not look in the mirror in the morning. Thank you.

Mr Jim Wilson: Thank you for your presentation. I think you make a couple of very good points.

Mr William Wilson: Could I just correct one thing that you said earlier? Not anyone can set up a pharmacy. The shares of a pharmacy have to be 51% owned by a pharmacist, unless someone goes and buys a pre-1954 charter which contains a grandfather clause and allows them to set up a pharmacy. But otherwise, you do have to have 51% ownership by a pharmacist. Sorry for interrupting.

Mr Jim Wilson: No, I understand that. In fact, it's a good point. Could the research people please provide all members of the committee with the criteria required to set up a pharmacy? I was reiterating evidence that had been given by pharmacists, telling us that they felt part of the problem and pressure on them was that anyone can set up a pharmacy. I'd be happy to send you the Hansard in that regard.

Mr William Wilson: Okay.

Mr Jim Wilson: Secondly, I thought you made a couple of god points, though. Government, particularly all governments, this government and previous governments in Ontario, are addicted to the $800-million worth of revenue we get from cigarette sales. It used to be $1.2 billion, and it's actually declined now because of the underground economy. I think that no matter what government does, it will always be sending out mixed messages. Mr Laughren's first response, some two weeks ago, to the possibility that the feds would eventually lower the taxes was, "I can't give up the revenue." It was not a health response, interestingly enough.

The question, though, I want to ask you is with respect -- I don't think we'd be in this position if more pressure had been on pharmacists with respect to the voluntary ban that was in place. I've asked groups why we didn't see the big press conferences and all of the groups really hitting pharmacists hard so that government wouldn't be put in the position of having to impose this ban. Now, you mentioned you've made personal efforts to try and convince colleagues. Did you feel enough was done? Because frankly, I was Health critic and I didn't even know for quite a while that there was a voluntary ban in place. That's how well publicized it was.

Mr William Wilson: It may not have been publicized outside the profession, but it certainly has been publicized within the profession. The college is the one that passed the resolution and asked the government to bring forth the legislation enabling the ban of the sale of tobacco products in pharmacies. It was a resolution made by the Ontario College of Pharmacists, and this resolution was reinforced last June; the college did vote again last June and reaffirmed its decision at that time. So it is an internal --

Mr Jim Wilson: Well, it's external now.

Mr William Wilson: That's because the Ontario College of Pharmacists cannot pass the legislation, as is my understanding. They pass a resolution and then, as a self-governing body, they have to send that recommendation to the government, which brings forth the legislation and passes it, which then becomes the law of the land.

Mr O'Connor: In fact, that's why they came to the committee.

The Vice-Chair: Thank you. Mr Wiseman.

Mr Wiseman: Thank you. I understand --

Mr Jim Wilson: I'm not finished; I just want to make a point on that. That's my point. I know the college can't do it and that this is the process. They weren't given the power to do that under the Regulated Health Professions Act. My point is, if it's such a good idea, why couldn't the college convince its own members and why throw it in the government's lap?

Mr William Wilson: I guess the college felt that it was an issue that shouldn't be left as a voluntary decision. After all, there are other areas of practice that are mandated, that are part of the legislation. If they were left up to the discretion of each individual pharmacist, then there would be quite a discrepancy in the levels of practice by various pharmacists. Some things have to be enshrined in law. I guess the college at the time -- I was not a member of the college at that time -- felt that this was such an issue and that it was important to have a standard level of practice throughout the profession in regard to this issue.

Mr Wiseman: I would like to quote from Floyd Laughren and what he said about lowering the price of tobacco. He said, "The smuggling of tobacco products is a very complex issue, and this quick-fix solution can only have serious long-term health effects." He also said: "There are no winners in this situation. Non-smokers will obviously be affected by the revenue loss and smokers will lose as well, since cheaper cigarettes will almost certainly lead to an increase in smoking and all the health problems that go with it." I think the Finance minister is clearly communicating that there is a huge concern about the increase of costs due to cigarette smoking. It's interesting that --

The Vice-Chair: Do you have a question, Mr Wiseman?

Mr Wiseman: Yes, I'm getting to that question right now.


It's interesting that the Ontario Hospital Association has indicated that there has been an increase of over two million visits to hospitals from last year to this year, so you have this huge increase in terms of costs.

My question is that when you were talking about example, I believe that really the only way we're going to slow down this cigarette smoking is by example, and I agree with you that if all of the pharmacies and all of the health people were sending the same message to young people, they would see it as well, that smoking is not something they should start or get involved with.

Mr William Wilson: I agree with you. We've been sending out this message for a long time and this is just one more reinforcement of that message. I think the biggest stick has been the financial one so far, and that has been the biggest deterrent to smoking. But it's important that we keep hitting home with this, whether it's setting aside smoke-free floors in hotels or smoke-free areas in restaurants or pharmacists standing up and saying: "This is wrong. We cannot sell tobacco products because it's detrimental to your health." All these things are important. No one message is going to stop people from smoking, but it's a cumulative message and it's important that we're consistent and keep going in the right direction. We don't want to have backward steps, and reducing the taxes is a step backwards. If the Minister of Finance provincially is reluctant to lower taxes or is against it, I applaud him for that. Unfortunately, I think there's been a lot of harm done already by moves by other levels of government, but that's not the concern here.

Mr McGuinty: Mr Wilson, thanks for your presentation. One of the statements you made in your presentation here is: "Is it right for a profession that is charged with protecting the public health to continue selling a product that kills thousands of people each year? The answer is clearly evident." Who could disagree?

Mr William Wilson: That's right. I can't.

Mr McGuinty: But I have to ask you, is it right for us as political representatives to allow an industry to continue to reap profits in the province at the expense of the health of our citizens? I think the answer there again is the answer is evident. No, I don't think it's right either.

Mr Perruzza: I don't understand the question.

Interjection: It's not addressed to you.

The Vice-Chair: Proceed, please.

Mr McGuinty: The distinction we have to draw is between what's right and what's legal. If we wanted to do what was right, we'd ban tobacco today in the province. That's the difficulty that I think you can see that we all face. I just don't see how doing what is right in connection with pharmacists will have a significant effect in the big picture.

Mr William Wilson: I'm not saying it will have a significant effect in the big picture. I'm saying it's one more message. It's one more little message that's getting out. By banning the sale of tobacco products in pharmacies, it's not going to stop people from smoking, but it will send out that message. If you can't see that, then I don't think there's anything I'm going to say that's going to convince you, but it's an important message. It's important as a profession that we are consistent in this message and I think it's important that people realize that there are professions that are interested in the public health that are willing to stand up and say, "We will forgo this income in the better interest of society, in the better interest of public health."

Will the government do anything? Will the government stoop to anything to make money? There are times --

The Vice-Chair: Would you like to answer that question?

Mr Jim Wilson: Casinos.

Mr William Wilson: Well, I don't think I had better. No, really, I don't mean to be here to run down anything else. I'm trying to speak in support of this measure. I realize that politicians have a great many things to consider when they're making decisions and you can't just say that tobacco's going to be illegal today and have society accept that. It has to be a continual educational process, much the same as educating people about diet in regard to heart disease, just public health and all aspects of it. It's an educational process. But the symbols are important and this is a symbol, and I think that is the message that has to get out.

Personally, I can't sell tobacco products. I'm just violently opposed to it. But I think it's important that that message get out to the public, and perhaps someone will listen and realize that tobacco products are harmful, because in spite of all the messages that are getting out today, there are people who still don't realize it. If we took someone in and showed them a smoker's lung and it was full of tar and you had to scrape the guck off it, that might get the message across. But we can't do that, so we're using this symbol.

Mr Perruzza: Mr Chairman, I'd just simply like to take off my hat to this gentleman and hope that Mr Bill Wilson continues to do well.

The Vice-Chair: I'm sure we all join you in that comment. Thank you very much. We appreciate your presentation.


Ms Lyla Burnett: Ladies and gentlemen, thank you for allowing me time to speak today. My name is Lyla Burnett and I am from North Bay, where I've been employed for the last 13 years as a pharmacy manager at Pharma Plus Drugmart, a retail pharmacy.

As a pharmacist and retailer, I am concerned with Bill 119 and its impact on my store and the community. Presently, tobacco sales are approximately 14% of total store sales. This figure converts to a customer count of about 1,000 people per week. By eliminating tobacco sales in this pharmacy, there would be a decrease in both sales and customers to the store. The net result would be at least a 10% profit loss, which would result in at least a 10% reduction in employee hours. This translates to about 40 hours, or at least one full-time job in our store.

This figure could in fact be higher, because a decrease in customer traffic will affect other sales as well. Sales of confectionery and sundry items will drop with less store traffic. As well as the effect on the store sales and staffing, and perhaps more importantly, it's unrealistic to think fewer people will smoke because they cannot buy their cigarettes at a retail pharmacy.

Bill 119 may actually increase contraband cigarette sales because fewer retail outlets would be selling cigarettes legally. As for minors purchasing tobacco, our pharmacy, at least, has been diligent in enforcing laws concerning tobacco sales to minors. If laws governing tobacco sales are to become tighter, are pharmacies the ones to pick on? Why should one type of retailer be singled out as a culprit? If tobacco sales are to be effectively limited, then perhaps a designated licensed dealer for these products, similar to alcohol sales, would be a better choice. If this were the case, pharmacies already handle items with restricted access, such as schedule C products.

In conclusion, the intention of Bill 119 may be honourable, but I feel its results will be negative in its effect on pharmacy retail business, negative in its effect on employees of this business and, most importantly, will not have the positive effect on tobacco sales, or specifically sales to minors, that was intended. Retail pharmacy businesses should be allowed to decide for themselves whether to sell this legal product.

Mrs Cunningham: Thank you for appearing today. There are many parts of this legislation where we're not clear what the regulations will be. We're hoping to get that during the clause-by-clause or before that, I would hope, from the government.

There are other parts that some of us would like to see strengthened, where we would make amendments. For example, we talk about the school building. Many of us would expand that to say the school property if you are going to say young people shouldn't smoke. We would make it more clear in the legislation. That's just an example.


You interested me because I feel very strongly that retailers should be licensed. That would be an amendment that I would hope we would put forth for the consideration of the government. We're heard it from many groups. Some have gone so far as to say that these cigarettes, if sold at all, should be sold in the liquor stores so that you're really prohibiting young people under age.

I'm wondering how you feel about making the young people who are under age responsible, because personally -- if they're breaking the law, I wonder what you think the penalty should be, if at all.

Ms Burnett: If they're caught smoking? I'm not sure I understand your question exactly.

Mrs Cunningham: Smoking or purchasing cigarettes in public is not unlike drinking alcohol, and that's illegal. So, really, this is so far a legal product, isn't it?

Ms Burnett: Yes.

Mrs Cunningham: How far would you go? That's my point.

Ms Burnett: I certainly don't disagree that the age should be raised for selling tobacco. I'm not a smoker and I'm not here to advocate that smoking is good for your health. It's not. Certainly I agree that we have to try to both educate minors and somehow enforce more strongly, get that message across to minors.

As far as what we could do to enforce it, maybe, if caught, some kind of volunteer service with a cancer society or lung association or something like that to make them more aware of the hazards of smoking.

The point I was trying to make is I really don't think that by eliminating tobacco sales from pharmacy, you're going to stop any young person from smoking.

Mrs Cunningham: I personally agree with that. Given the intent of the bill, it's my personal opinion. "The bill is intended to prevent the provision of tobacco to young persons and to regulate its sale and use by others." It's that simple. It's one line. So if we in fact are introducing pieces of legislation that will not prevent the provision of tobacco to young persons, I don't agree with it, so I obviously share your view in spite of all of the ideology. I certainly question some people who are in the health professions who want to sell it, but I don't think making laws is going to fulfil the purpose of the bill. Therefore I agree with you.

But if you would give it some thought, I think your idea of community service is most commendable. That's the kind of thing we want to make recommendations on to the ministry with regard to how we feel the regulations should fall in place.

Mr Wiseman: I'd like to ask Ms Mitchell if she could perhaps clarify the difference between the statutory prohibition in the bill and the whole concept of licensing, and why the bill has statutory prohibition instead of licensing.

Interjection: That's a trick question.

Mr Wiseman: That's actually from the parliamentary assistant, and he's transferred it to you so you can answer.

Ms Brenda Mitchell: We looked at the options of licensing systems which we'd had recommended to us by groups and the option of an automatic prohibition. I'll try to explain how the two different systems work, and that may clarify why we made the choice that the government did. I'd also like to help clarify that a licensing system for all tobacco retailers is different from the option of selling through liquor control stores.

If a licensing system were to be established, it would require that all tobacco retailers obtain a licence. In order for that licence to be issued, a bureaucracy would have to be set up to review the applications. If someone demonstrated knowledge of the law and there was no reason for past conduct to not give them a licence, they would be issued a licence.

Once a tobacco retailer had a licence, if it was thought that they had contravened the law, they would then have to be notified of the contravention and given a time period in which to come into compliance with the law.

If they didn't come into compliance with the law or had a second contravention, then there would be an administrative tribunal in place. So, once again, another organization would have to be formed to review whether or not there should be a suspension or revocation of the licence. Once the tribunal had made its decision, if the retailer chose to take issue with it, they could appeal it to the court before a final decision would be made.

What we have heard from many groups is that they are looking for a fairly efficient way to have a strict penalty put in place for contravention of the act, and what we are proposing is an automatic statutory prohibition so that, once there was a second conviction, an automatic prohibition would come in place for a defined period of time prohibiting the sale of tobacco from that premise during the period.

Mr O'Connor: The statutory prohibition is located right underneath that table in your act.

Mr Perruzza: I just have a five-minute question.

The Vice-Chair: Just a moment, please. I must go on to the next speaker. I'll come back to you.

Mr McGuinty: Ms Burnett, watching the various pharmacists come before us here is somewhat akin to watching a ping-pong match in terms of the difference of positions that you bring. It's obviously a source of a great deal of controversy. We heard from a Mr Wilson earlier, who was a member of the council, who's very much in favour of the legislation. Yesterday at Queen's Park we heard from another member of the council who expressed the opposing opinion. Why is it that you're not going along with what your college decided?

Ms Burnett: Pharmacy is both a profession and in many cases it's a retail business as well. Unfortunately, in a retail store we're faced with the dilemma on one side where we're operating the actual professional pharmacy but we're trying to operate a front shop as well. Now, there have been government cutbacks in fees and what not and we've been told, "Well, you have to make that up in your front shop business." If you run a small professional pharmacy, that may be possible. If you run a large retail pharmacy, it becomes less possible if you're being told that you can't sell some kind of legal product. I think that's where the dissension comes within the profession itself. We're all professionals, but some of us are retailers as well.

Mr Perruzza: You may want to answer this; you may not. If everyone were to get well tomorrow and required no more medication, what would you do?

Ms Burnett: It would be wonderful.

Mr Perruzza: What would you do?

Ms Burnett: I don't know what I would do.

Mrs Cunningham: We wouldn't need a government.

Mr Wiseman: That sounds good to me too.

Mr O'Connor: At least we have a government focusing on wellness.

The Vice-Chair: Thank you for your presentation and answering questions. We appreciate it.


Mr Brian Baggs: My name is Brian Baggs. I'm a volunteer with the Heart and Stroke Foundation of Ontario and I'm honoured to represent the Heart and Stroke Foundation here at these hearings.

You have the brief before you and I'm not going to go through in intimate detail or line for line. I'm a volunteer, as I said, with the Heart and Stroke Foundation, Sudbury branch, and I'm very honoured to represent the views of the Heart and Stroke Foundation but as well my own views.

Although our brief covers many aspects of the Tobacco Control Act, I would like to concentrate on our youth. That's the emphasis I'd like to place today, if I could, the concerns, problems, education and prevention, especially in the area of packaging and retail licensing, which I think have a great effect on our youth.


I'm a father of three, two still teenagers. I'm a former smoker who had a heart attack and open-heart surgery, so I speak from a little bit of personal experience along those lines as well. I'm also a high school teacher, and I know full well the great impact cigarettes and smoking have on our youth, I know the impact peer pressure has on our youth and I also know a great deal of the influence role models have on our youth, either as a teacher or as a parent or in the media or as the sports heroes and rock heroes indicate in their actions to our youth. So I know there are many life decisions that young people have to make, either in a positive or a negative nature.

But to me personally and to the young people I'm associated with, it's imperative that such a life-threatening social addiction as smoking be addressed very seriously and taken seriously and that strong measures be enforced to help and protect our youth of today for their future.

Every day, I discuss for a few moments, whether it's with the hockey team that I coach, my own children or the students who come in contact with me, the seriousness and consequences of smoking. But I feel, and I sincerely believe this, that it's not near enough. A lot more has to be done to protect our youth from the diseases of cigarette smoking that can occur.

I'd like to address the position on packaging. I think it's vital that we interpret your intent that enforcing plain packaging regulations be enforced with a positive imagery. Also, I would like to stress that young people are influenced by what they see. They're influenced by who models them, and if an adult or an educator or one of your or their peers pulls out a package of cigarettes, they identify it and immediately make social contact with it.

Also, the fact that they can buy kiddie packs allows them to buy cigarettes at a lower price. The events of yesterday indicate that they will also have access -- I had a hockey practice last night. Five of my players smoke, despite the fact that we do everything possible to stop them from smoking. We discussed the implications of getting cigarettes at a cheaper rate, and they were very happy about it. Hurray, they can get them at a cheaper rate, despite all the health warnings we advocate.

I'd like to point out that brand image often appeals to the socially insecure and the cigarette is used as a part of a wardrobe. It follows that when these crutches are removed, the appeal and sale of cigarettes could be expected to decline. They look for heroes; they look for identification; they look for belonging; they look for a social group; and cigarettes offer them those crutches that, if taken away, they may look for other sources and other ways of identifying through things and improving themselves.

On the business of retailing, and I'll be brief here as well, control of sales to minors will not stop all kids from smoking -- that's known -- especially those who are already addicted. Therefore, although this may not be within the mandate of this committee, I would like you to consider the fact that maybe money and emphasis should be put into education, methods that will help them stop smoking and methods that will help them get better if they have problems with their smoking addiction. I believe the government can do something along that line, either through resources in money, education or whatever materials can be used.

However, some will continue to obtain tobacco from older friends and even from their parents. However, retail stores, in my opinion, are by far the largest supplier of tobacco to minors, accounting for up to 80% of the total youth market in purchasing cigarettes.

Along those lines, I think now that youths can easily purchase cigarettes 24 hours a day, in packages or individually -- and these stores unfortunately are very often located where students and teenagers hang out, be it either the school or the arenas -- I think any change in availability or proximity will help reduce the sale to minors. It's been proven that children who are turned down on their first purchase attempts are likely to be discouraged from taking up smoking in the first place, if there are prohibitions prohibiting them from doing so.

On a final note that's rather personal, I guess, as an educator, if we came out with a very strong proactive campaign and enforced legislation, I believe it would make it even easier for school boards -- this is a personal opinion -- and I also believe it would make it easier for schools themselves to eliminate the smoking compounds within our facilities that I personally find very hypocritical. As an educator and health advocate, I find it difficult to educate teenagers about smoking when it's perceived as okay to light up, and legally at the moment not much is done to prevent them from doing so.

I entreat you to read our brief and the other aspects of what we have to say through the Heart and Stroke Foundation.

Mrs Cunningham: Thank you, Mr Baggs, for your work with the Heart and Stroke Foundation and for all the other things you do with young people. I think everything you've said today is something that we have been made aware of, but it's nice to see a teacher come forward with your concerns.

I've got a question for you.

Mr Baggs: No problem.

Mrs Cunningham: On school boards, for the past 20 years in this province, they've always had to deal with the education of young people around the use of tobacco and heart and lung disease, and I think they do a pretty good job. I think most of us would agree that seven-year-olds would point at people and say, "You shouldn't be smoking."

Mr Baggs: Correct.

Mrs Cunningham: We had someone come before our committee in London who I wasn't proud of, but if we had had the opportunity, we would have told him that teachers do a great job. Where I think teachers haven't been as successful is that when school boards are trying to make non-smoking policies, they haven't always shown the leadership. But you're aware of that.

Given this legislation, we're probably going to ban smoking from school buildings, perhaps expand it to school property, and you know what that means. That means the lady around the corner from the school is going to call your school.

Mr Baggs: Exactly.

Mrs Cunningham: What do you think the penalty should be for the young people who are smoking on the neighbours' property?

Mr Baggs: Off school property, then I think the penalty's inherent within the school system itself. Each school has its own method of handling discipline, but I feel that yes, they are violating -- they're off school property illegally. They're AWOL from school. They're skippers, if you want to call them that.

Mrs Cunningham: What if they're doing it at 4:30?

Mr Baggs: If they're doing it at 4:30, that's it.

Mrs Cunningham: You see, we have an opportunity now to do something to help you.

Mr Baggs: Right. At 4:30, school is out. They smoke at home, they smoke on the street corners, wherever they may be. It's pretty hard for the school to mandate any kind of legislation once the school hours are over. I think that has to become a provincial-municipal position there. But during the school hours when we are responsible for those students, from 8 o'clock till 4:30, with the support of the government and legislation to give us some teeth, then I think we as educators -- and I'm speaking personally here, because I'm not in a position of complete authority in my school; I have superiors.

Mrs Cunningham: Whom you influence, I expect.

Mr Baggs: I have some influence, yes. I hope to have a great deal of influence.

Mrs Cunningham: I hope so too.

Mr Baggs: If they would take it seriously enough that this is an infraction, it would be written in the school rules. Just like missing classes, or part of them, just like being absent for a day without excuses, whatever the case may be, whatever discipline problems we do within the school, that could be written right into the school rules, that smoking during the school time, on or off school property, including school trips, including my hockey team -- they do not smoke before a game, they do not smoke in the change room, they don't smoke after the game, but once they leave the arena, like every other teenager, they do what they do.

Mrs Cunningham: You should know that some of us are seriously thinking of treating this like alcohol and saying it ought to be illegal and there should be some sanctions. One of the pharmacists earlier today suggested that it could be community work. Others have suggested it should be fines. I wonder what you think about that.

Mr Baggs: Yes, I think a first offender, like anybody else, deserves a second chance, and however we deal with first offenders and the seriousness of these crimes -- although smoking is a serious thing and I don't want to demean it -- they should be approached, "You have violated the rules here now." The next time, yes, a fine would be perfectly acceptable to me.

Mr Wiseman: I'd like to try this from a different tack. I think if the committee does decide to go with banning smoking on school property, it's going to have to pick a couple of hundred yards on public property around there so they just don't go across the road or stand on the public sidewalk and smoke.


Mr Baggs: I recognize that, but in my estimation it's very simple. Maybe I'm simplifying it. If you're off school property and you're having a cigarette on the neighbour's lawn now, you are violating the rules of the school; therefore consequences are accordingly.

Mr Wiseman: The question I am going to pose to you is that I would say that of the kids you deal with, and it was the same when I was teaching, about 95% of the kids would buy into the rules; they'd buy into the whole game. They would say: "Yes, we understand that. We're not going to do it." There's 5%, though, who have always traditionally been the problem. Is that where you see the need to have this real heavy hand or this real heavy punishment being given out?

I know some of those kids are just going to say: "Drop dead. You can do whatever you want to me. You can give me detentions, you can get me kicked out of school, but I'm not going to buy into this."

Mr Baggs: You're right, but it doesn't matter whether it's smoking or whether it's adhering to the rules of the school. Those are students that don't buy into anything. I guess we'd have to work very hard at those -- I wouldn't want to write them off -- maybe through education, maybe through talking and so on gradually you might. It has happened in my experience and maybe yours that from that 5% one of them has come around.

Mr Wiseman: It's a great moment but it's not often.

Mr Baggs: That's a great moment, but I don't think we should give up on them. I sincerely think that not allowing them the opportunity is the primary source of preventing things; the second one is if they do avail themselves, by whatever means they do, and it's illegal, then there are consequences for it. Along with the consequences, I believe that reinforcement in education and all the other things that go along with it might change. We're not going to cure everybody.

Mr Wiseman: Do you think if Doug Gilmour told your hockey players that they couldn't become great hockey players if they continued to smoke, that would have an effect?

Mr Baggs: To some; not necessarily all of them, but to some.

Mr McGuinty: I particularly appreciated your comments about this idea of a penalty, given that you're an educator. It just strikes me that there's something perverse about us talking about the problems associated with smoking and the difficulties healthwise that it will bring and yet if I'm 14 I can sit on the curb and smoke my cigarette while the police drive by.

Mr Baggs: Right at the moment.

Mr McGuinty: Right at the moment, exactly. I want to talk to you a bit about those kids who are in the fiend's grip, so to speak.

Mrs Cunningham: The what?

Mr Baggs: Who are addicted? Is that what you mean?

Mr McGuinty: Addicted right now, yes. Is there anything at your school, and if there isn't could there be something at your school, where we could do something about it, unhook them?

Mr Baggs: The agencies, the cancer society, the lung society, the Heart and Stroke Foundation, have reams of materials, educational devices, videos and so on that are available to the students. More could be done in the schools. Because I have a personal bias, it occurs in my classroom almost on a daily basis. I can't say that happens in every classroom; of course not. But through their health courses and so on students are made available to that. More could be done. More speakers could be brought in. More material can be made available. Certainly the schools can do a lot more than they're doing right now.

But I think you need the two edges of the sword. You need the flat side of the sword, the stroking side, the education side of the sword, the health side of the sword, but I think you have to flip it over and have that edge to it. When you have both going and working in conjunction with each other, I think an awful lot can be done for our youth today in schools, in clubs, with hockey teams and so on. It's a real education process, and it has to come from everywhere. It has to come from the grass roots, which I think I'm part of, but it certainly has to come from you people who are at the top. If we can come together like this, we're going to hit the middle. There are going to be fringes, that's life, but hopefully we can get as many people and youth as we can coming together rather than coming against each other. That's my personal opinion about it all.

Mr McGuinty: I was thinking in terms of something to be offered at school. I know there's all kinds of literature, and there are videos. Things are kind of told to kids, young people, but I've never heard of a program saying, for instance, "Listen, those who want to quit" --

Mr Baggs: Yes, okay.

Mr McGuinty: Okay, here's the program. It starts. It's offered during school hours. "This is the positive reinforcement you will get; this is what you're going to get out of this." It has to be apart from, "Stop smoking and you'll get healthier." I don't think that's enough for kids.

Mr Baggs: Right, you're absolutely correct. Those programs are quite available through the health agencies and I agree with you that schools should be doing that. That's quite true. I don't know if the department of education is represented here in any stretch or form, but certainly I would like you to take that back to the minister and have him put that right in the legislation for schools and have it as a school policy. You're very correct in what you're saying. Help is out there. Get it in the schools. Get it to our youth from grades 1 on to 13 and even into the universities, if it's possible, but certainly our adolescents and young people.

There are very active programs from our agencies going into the schools and doing exactly what you're discussing, but it's on a personal basis or an individual basis as a school or teacher. Legislation of that kind from the Minister of Education would be ideal.

The Vice-Chair: Thank you for your presentation.


Ms Dorothy Klein: This is Dr Douglas Marr, a volunteer with the Ontario Lung Association and he's also a child psychiatrist.

My name is Dorothy Klein and I am the executive director of the Lung Association, Sudbury-Nipissing region. I represent over 250 active volunteers in the region and over 10,000 regular contributors who generously support this organization through voluntary contributions. Our volunteers are actively involved in promoting respiratory health and preventing lung disease. Our supporters recognize the importance of eliminating respiratory health hazards and products that contribute to disease. Tobacco is a major concern of the many people who support our organization.

Many of our supporters suffer from asthma, bronchitis or emphysema. Exposure to tobacco smoke can be life-threatening to these people and can cause a sudden restriction of the air passages, resulting in acute pain and anxiety. We are not talking about a dainty cough; we're talking about choking and death. Acute asthma is the most common medical emergency in children and is responsible for increasing hospitalization and death rates in our country. Tobacco smoke caused many of these asthmatic attacks.

Annually, 150,000 to 300,000 cases of bronchitis and pneumonia in infants and young children up to the age of 18 months of age are attributable to environmental tobacco smoke. Environmental tobacco smoke can only be removed from our indoor air by removing the source: smoking. Research shows that the removal of tobacco smoke through air cleaning or ventilation is both technically and economically impractical. Quality of life for persons with asthma, bronchitis or emphysema is severely restricted by the fear of exposure to environmental tobacco smoke. This isn't a mere fantasy. Exposure to secondary smoke could threaten their lives. Dr Marr, who has three children with asthma, can certainly vouch for that. It affects where they live, where they go, the school they attend, where they work and with whom they associate.

The Lung Association offers smoking cessation materials and support to smokers who want to stop smoking. We are convinced that tobacco is an addictive and lethal product. The number of students of all age groups that come to us for information about smoking is increasing daily. Our volunteers work with students to prepare presentations to their peers and we promote the Quit 4 Life program designed by youth for youth. Some of you are aware of the Quit 4 Life program, which is designed for teens 15 years of age to 19 years of age. Students as young as eight and nine years of age tell us how easy it is to buy cigarettes for 25 cents and 50 cents each, and how easy it is to buy a pack at the corner store, gas bar and our health pharmacies.


I am a mother of four teenagers. They're 14, 16, 18 and 20 years of age. I know that my 14- and 16-year-old can purchase cigarettes at any neighbourhood tobacco retailer with no questions asked.

Vending machines have been found in public games rooms in our city. Many of our youth congregate in the public games rooms which are located near their schools. Our youth do not have to depend on contraband cigarettes as their source. They know that cigarettes are blatantly sold everywhere and that present restrictions are not enforced.

I spoke to a grade 9 physical education class of 13 girls. Six of those girls, at 14 years of age, smoked over a pack of cigarettes a day. They get most of their cigarettes from home, where cigarettes are bought as a staple with the apples and the oranges and are on the kitchen table. When they go out of the house to go to school, they grab a pack of cigarettes instead of a lunch. They say this keeps them slim. Any money they get buys extra cigarettes. One 14-year-old girl could not remember when she started to smoke.

At almost every school presentation, we hear students confess that they would like to stop smoking but can't. Many admit to having seriously tried to stop smoking at least three times before they're 17 years of age. One 17-year-old told me that he had a choice of renewing his driver's licence or buying cigarettes. He chose cigarettes. He admits to feeling irritable and out of control when he can't get cigarettes. When he doesn't have enough money, he pays five cents a drag.

These youths are addicted before they can really make informed decisions. They are already into addictive behaviour with the irrational logic supporting their addiction. The depression caused by the realization of the power of this addiction is overwhelming to them. We must protect our youth.

We are pleased that the provincial government is taking steps to control the tobacco epidemic that is sweeping our society. Bill 119 is a critical piece of legislation and demonstrates the commitment of both the government and the opposition parties to long-term health and quality of life for Ontario residents. Bill 119 will affect the ability of young people to gain access to tobacco-industry products. It will protect our youth from exposure to the lures of tobacco products before they can fully understand the rights of an informed decision and the profound and long-term effects smoking will have on their health and their future.

Our youth do not realize how fragile and vital our respiratory system is, and that it is essential to our existence. I have here a real set of lungs -- and we made some comment earlier that we should have a real set of lungs here. Well, this is a real set of lungs. They've been fully inflated. That's the size of an adult man's lungs. I use these lungs to show the students the size and the texture of the lungs. They can see the proximity of the lungs to the heart, where the heart sits. We discuss the seriousness of lung surgery and how lung transplants are performed. The lung is the first organ to deteriorate at the time of death, and transplants must be done within a very restricted time frame. The students are awed by this visual demonstration.

This convinces me that they are totally unaware of the implications of the decision to smoke and to expose themselves to secondary smoke. They are attracted by the glitter of the cigarette package and the promotion advertisement. They are attracted by the promises of friendship and social acceptance offered by the lure of the cigarette. The government must not allow our youth to be victims of the destructive ploy of the tobacco industry to lure these young, innocent people into using tobacco products and facing a future of addictive behaviour, ill health, economic hardship and early death. A government with integrity does not allow a lethal, highly addictive product to be marketed to kids before the age of responsibility in attractive, confidence-building packages. The government, non-smokers and smokers alike, must give our kids a chance.

The supporters of the Lung Association are counting on this bill being passed. They applaud the proposal to license all tobacco retailers and to introduce stiff, consistent and enforceable penalties for violation. They applaud the elimination of tobacco vending machines in public and unsupervised locations. They applaud the plain packaging with provincial health warnings. They appeal to the government to address the environmental tobacco smoke issue, especially in public places and in the workplace. We are convinced that smuggling is a legal problem and that the Tobacco Control Act will help to reduce smuggling in Ontario.

Parents and persons concerned about our kids applaud the proposed licensing, control over access of tobacco products and control over the exploitation of the young, the innocent and the naïve. This is the year of the family. This proposed legislation will support the role of parents as they guide their youth.

In closing, I cannot stress enough that the Tobacco Control Act is an essential piece of legislation. It's imperative that Ontario continue to tackle the tobacco issue aggressively, especially in light of the recent announcement to lower the cost of tobacco products in Canada.

On behalf of the Sudbury and District Council on Tobacco or Health, of which the Lung Association is an active member, I would like to invite all the members of the standing committee to a press conference which will be held here in this room at 12:30 today. Your presence will be appreciated, and I thank you for your consideration.

The Vice-Chair: Thank you for your presentation. Did Dr Marr wish to comment at this time?

Dr Douglas Marr: Just to endorse everything that Dorothy has said and to applaud the House, the government, for this proactive initiative which I think is very much in the spirit of the family, the child and the protection of vulnerable youth before they can make the informed choice. In the same way that alcohol, driving fast and many other dangerous things are contained, I think we have to look at the much more insidious but equally pervasive problem of tobacco.

The Vice-Chair: Thank you. The parliamentary assistant wishes to make a comment.

Mr O'Connor: I don't have a question, just a clarification for you. On page 4 of your brief, you've mentioned that you applaud the government for the licensing. The licensing isn't part of the legislation. All the important parts that it has been pointed out to us they'd like to see on licensing are actually in place, and it's very stringent and very tight, but licensing itself isn't. Actually, there was a briefing. My assistant here had mentioned it just before, but I just wanted to clarify that for you.

Ms Klein: Thank you.

Mr Perruzza: I know this may sound silly, but I'm going to ask it anyway. How would you feel about a picture of that on a cigarette package?

Ms Klein: Well, it's certainly very impressive. I'll tell you, if you touch it, it feels like styrofoam. You really, really realize how very fragile the lung tissue is.

Mr Wiseman: How many packs a day is that?

Ms Klein: This was a non-smoker, actually.

Dr Marr: These are very healthy lungs.

Ms Klein: These are healthy lungs. It's just that they don't have the blood supply in them any more. That's why they're not pink.

Mr Perruzza: Every lung that I've seen is that colour from heavy smokers. When they're not heavy smokers, they're bright red.

Ms Klein: That's right, because of being able to see the blood supply. But the blood has been removed from this. The black stuff is really --

Mr Jim Wilson: Dried blood.

Ms Klein: Dried blood, yes.

Mr Perruzza: It's a real shame that we would take up smoking and really damage that.

Ms Klein: Most teens don't realize that in a lung transplant you have to have exactly the same size of lung to go in. If you're not going to do a lung-heart transplant, it has to then go right in there, and you have to get the ribcage to go back around this. So you can't take somebody's lung that might be smaller than yours and transplant it, or larger, because it just will not fit in. It's very difficult. So when the kids say, "Oh, well, I'll get a transplant from somebody else," it's not that easy.


Mr Jim Wilson: I want to follow up on the point that was made by the parliamentary assistant.

On page 4 you do a lot of applauding. The parliamentary assistant did clear up that this act doesn't do licensing. There are a couple of other things I just wanted to talk about too. Vending machines are being banned totally, here it's mentioned, "in public and unsupervised locations." Plain packaging, that's not in the act either. There's regulatory authority to deal with packaging and health warnings, but it's not spelled out. You do mention that you're encouraging the government to deal with environmental tobacco smoke, but there's nothing about the workplace in this act.

Do you think, as we obviously feel in opposition, that life would be going a lot easier on these committees if the government would just come forward with its regulations? For instance, we've had a number of groups, and we don't bother correcting them every time, telling us that the government's going ahead to ban kiddie packs. I don't know where people get this blind faith that the government's going to go ahead and do that. It seems to me if the government wanted to do it, it would be in the act rather than this tippy-toeing around. I think the cancer society makes this point actually quite well from time to time. I've actually read in the media that the government's banning kiddie packs and the government's bringing in plain packaging and a number of other things. I don't know what act they're talking about, but it's not this one. I wanted to ask you whether you'd like to see the regulations too, because I think it's time we saw them.

Ms Klein: Yes. From a professional point of view, but also as a parent, it's very difficult when it's broad and it can be misinterpreted. You can take it and get all these loopholes, all these other areas.

As a parent of four teenagers, I see that as very important, because teens are at a time when they're challenging, when they're really looking, and that's when it comes out whether we really mean what we say, what we really mean when we put legislation in. Is it going to stick? They're going to check the parameters to see whether or not there are loopholes, and if there are loopholes, it's a heyday, and that's what's happening.

Mr Jim Wilson: I appreciate that, because we need your help and other people's to keep the pressure on the government. We're not done in this process yet. Clause-by-clause will be back in Toronto. It tends to be a fairly closed and quick process. If the bill is passed the way it is, we're going to be into an election and you can't depend on anything being done. So we need your help to pressure the government and say: "Do you mean all this stuff? You've been getting great press but it isn't in this act. Let's put your words where your mouth is."

Ms Klein: So you're advocating that we really continue with the pressure?

Mr Jim Wilson: Keep the heat up. That's what opposition parties do. We get accused of being partisan if we do it, but I think in this act it's just fair.


The Vice-Chair: Please, shall we take turns? It's helpful.

Mr Perruzza: I don't understand them any more.

The Vice-Chair: Please. The parliamentary assistant has requested permission to make a comment regarding this matter.

Mr O'Connor: The plain packaging I think is an important issue. It's something that was talked about in the early discussion paper. In fact, at that time the federal government looked like it was going to move in that direction. In the press release put out by the present federal government, they said that they're going to look into it.

We put in the ability, in case the federal government doesn't move on it, that we can do it here in Ontario, because we think that it's important that we move forward, that this is an important issue. We are going to make sure that we have the ability in case the federal government doesn't do it.

The Vice-Chair: Thank you for that clarification.

Mr Jim Wilson: There's nothing to stop the government from putting it in and then saying if there's a federal act that overrides, the federal act will supersede. It's normal.

The Vice-Chair: Thank you for your comment.

Ms Klein: I just wanted to comment on the importance of the plain packaging. Last night I stopped at a corner store here in Sudbury. Behind the counter where you get the cash, the whole wall was cigarette packages with the glitter. There was duMaurier, there was Player's, there was Export, all of it. Anybody coming in, they didn't see the Hostess potato chips. They were in the back. That was what was the most attractive decor for this store, and this was across the road from a high school.

The Vice-Chair: Thank you for pointing that out. The final question by Mr McGuinty.

Mr McGuinty: I particularly appreciated your comments about how young people simply cannot fathom what it is they're getting into when they take up smoking. There have been a number of studies done on this. There was one in the States where high school kids were asked how long they anticipated they would continue to smoke and would they stop smoking by a certain age. This was a long-term study and they followed them through. They discovered that almost all of the kids said they would quit by I think it was 25, but when they followed them through, over 80% were still smoking.

I think it's okay to make the comparison with a young child. "Don't touch the hot burner," right? You don't attempt to reason with the child until he reaches a certain age. What the child knows is that if he moves to touch the burner, something the child doesn't like is going to happen. Probably the parent's going to get angry. You prefer that you set up that kind of mechanism where the kid knows, "If I do this, I'm going to get in trouble."

What you're telling me reinforces this idea that there should be a penalty for kids so that they know they're going to get into trouble, not because we can reason with them, but because it's one more thing that'll make it harder for them to get hooked. What do you think about that?

Ms Klein: You're advocating a penalty for possession, in other words.

Mr McGuinty: Exactly, like we do for alcohol. The doctor made reference to speeding as well. Those things cause damage to you. I think we're underestimating kids' ability to assume a little bit of responsibility in this regard.

Ms Klein: When I speak to young people on smoking, they're very honest. They're very straightforward and very honest. They will say very openly, "I'm not worried about 20 years from now, because it's the here and now." When I'm talking to them about dying of problems or tobacco-related diseases, I'm talking about something way off. Also, they really do believe that we'll come up with something, as they've said, lung transplants, anything. They really take no responsibility for 20 years down the road.

I'm not saying that we don't continue to educate, but there have to be some immediate things that do come to them, and they have to recognize that it is not tolerable. I'm a mother of four teenagers and I know that they do look for restrictions.

Mr McGuinty: You have our sympathy.


Ms Klein: Actually it's an enjoyable time because they really make you stand up there and say what you really believe in and then you have to act that way as well. This is where it is with you. What we're showing as a whole society, we're saying one thing and we're allowing and doing something altogether different. The hypocrisy and the mockery that are there are ridiculous. We've really got to stand up there and put our actions where our mouth is.

The Vice-Chair: A good note to end on. Thank you very much for your presentation. We appreciate it.


Mr Pat Madden: My name is Pat Madden and I'm the merchandising manager for two Pharma Plus drugstores in North Bay.

I would like to thank the committee for allowing me this time to present my views on the proposed legislation known as Bill 119, and in particular the section of this bill that would prohibit retail pharmacies from selling tobacco products.

Overall, Bill 119 may represent a proper step by government to aid in the creation of a smoke-free society. However, it falls short of proposing a total ban on the sale of tobacco products, and for this reason I would ask this committee to support a change to the section of this bill in which retail pharmacies would be prohibited from such sales. I would ask that it be changed to allow retail pharmacies to decide for themselves whether to trade in a product that would still remain a legal retail product.

While tobacco products are allowed to remain legal, prohibiting their sales at retail pharmacies does not seem to be the proper way to achieve the stronger control or restrictions wanted over them. In the retail sector, the retail pharmacy would be one of the more experienced retail outlets that could exercise such restrictions and controls. After all, our retail pharmacy business has long been equipped with such restrictions and controls of particular or specific items.

Also, given the retail pharmacies' history of following restrictions already in place, such as the sale of tobacco products to minors, I think they have shown an awareness and an ability to deal with such controls in regard to tobacco.

If this section of the legislation as it is now proposed is to become law, the sales loss to retail pharmacies will unfortunately be significant. In our two stores in North Bay the tobacco sales are approximately 18% of the total retail business. I fear that the loss of these sales will not only hurt our stores' total business by this amount but also have a negative effect on the other areas of our retail business.

Tobacco customers for the most part do not purchase tobacco products as an extra item to their normal drugstore purchases but rather as their primary reason for being a drugstore customer at all. Therefore, extra purchases that they may have made as a result of this will also be lost to our retail business.

I also fear that this loss of business will have a negative effect on the amount of man-hours that retail pharmacies can properly use to be viable in their retail endeavours. At present tobacco sales levels, I would estimate that our stores in North Bay could be affected by a loss of over 100 man-hours per week, or what could translate into the equivalent of two or three full-time positions.

If tobacco products were made illegal in our province, I believe that retail pharmacies would be a strong advocate in aiding the removal of this considered health hazard. However, as long as the tobacco products remain legal, prohibiting their sales in retail pharmacies creates not only an unfairness to a specific sector of the retail industry but also an unfairness that will have no impact on the amount of smoking done in our province, and therefore will not show any health benefit to our public.

The banning from retail pharmacies of products which can be legally purchased within a block of that specific location or even within the same mall, under the same roof, will simply make the tobacco purchasers move their business elsewhere. For us, this can often be more than just their tobacco business.

Finally, I would like to ask this committee to consider this issue apart from the product involved. While there may be good argument for a net gain to society through specific restrictions of products, such restrictions can often infringe on other areas of that society's rights. In this case, the net gain of restricting a specific area of the retail sector from trading in a specific product should be considered in relation to the unfairness of banning a legitimate business from trading in what will remain a legal product. Again I thank you for this time.

Mr Jim Wilson: I'm just looking at the only economic study that's been done to date. It was done independently of government, although using the same techniques as those applied by the various ministries in terms of economic studies and forecasts. It was a study done by Coopers and Lybrand presented to the committee last week. You mention job losses. It talks about the total effect on job losses, part-time and full-time, in the province of Ontario. Province-wide they could be 2,746. In northern Ontario -- it's the smallest region hit but I assume that's because of the number of pharmacies in the area involved -- it amounts to a total job loss of 196. The government has never come forward with its own economic statement or study, and I think if you're going to tell one section of the retail sector that it can't sell a product, you should at least, in fairness to them, do a study. I want you to comment on that.

Second is something that's in my head from the previous presentation. This study also shows that in fact it'll probably increase the contraband sales. It doesn't go into a great deal of detail on that, other than giving us some indication that contraband or illegal sales of products could very well go up because people don't have access to legitimate retailers in some communities, is the point that's made. Do you want to comment on either of those? Are you familiar with the study?

Mr Madden: I am familiar with the study, yes. Your second point, speaking of northern Ontario, may reflect just the number of locations. If you do find yourself in more rural areas, then due to a drugstore not being there, maybe that was Coopers and Lybrand's idea of where to get them at that point. But that's only my opinion. I'm not sure what you meant in the first part of the considerations to comment on.

Mr Jim Wilson: I was just following up on your comments about the job losses.

Mr Madden: The government study? Yes, I think in all fairness there are a few studies, pro and con, that are circulating around these days if you're within this industry, and they are pro and con. I think it would be probably only fair if the government would try objectively to have one done that would not be pro or con but just faced those economic facts.


Mr Jim Wilson: What about the other side of the coin? The government says, "Well, okay, there might be a few job losses." I think there's been acceptance that if you close down the sale of tobacco in the pharmacy sector, there won't be an increase in jobs in the other -- how many stores are there? -- 120,000 retailers that will continue to sell cigarettes because it will be spread over too far a base to actually increase any of the jobs that will be lost in the pharmacy sector.

The government says: "Fine. That's the price to pay for keeping the community of Ontario healthy." At the same time, the determinants of health care tell us that employment is probably one of the best things you can possibly do to keep and have a healthy economy: the infamous Fraser Mustard study that talks about determinants of health care, the most important thing being a healthy economy, a healthy export economy, the second one being to keep people employed. None the less, the government says that doesn't matter in this case even though we spend tons of legislative time dealing with those matters. Any comments on that?

Mr Madden: If we believed that it would decrease smoking in the province by eliminating us, I think you'd certainly have more advocates within our industry saying, "Okay, then we'll swallow that loss." But I for one don't see where there is any evidence that smoking will decrease by eliminating us from these sales. Therefore, the issue of the reduction of smoking in our province doesn't seem to be aided in our restriction.

Mr O'Connor: I agree with you that studies can quite often be somewhat biased in how they're presented, and I guess I would question the sample size of the 13.

Mr Jim Wilson: It's 13 plus 459.

Mr O'Connor: Anyway, I think we have heard from the Addiction Research Foundation that limiting the amount of retailers would have an impact. My question would be, as a retailer, pharmacist --

Mr Madden: Retailer.

Mr O'Connor: You're a retailer, okay. With Pharma Plus.

Mr Madden: Pharma Plus Drugmart.

Mr O'Connor: The college of pharmacy has suggested that there be voluntary compliance with some reduction and elimination of the sale of tobacco products. We've certainly heard a varying amount of views on this issue, of course. We've heard from retailers, drugstores, who have said that the way they went about breaking themselves free from the habit of selling tobacco or retailing it was they actually started by taking it from the wall that somebody pointed out to us, that big, fancy wall there displaying it, and put it underneath the counter to start with. They found that the sales, because it wasn't there standing out, dropped off, and then they actually made the move and went away from the sale of tobacco within their retail drugstore.

You're in a retail drugstore and I wondered if you have tried to comply with the college's suggestion that you should eliminate tobacco products from retail drugstores. Did you make any attempts to try to eliminate those sales from your store?

Mr Madden: I'm not sure what you want me to answer, but in the reduction of viewing, I think the drugstore industry has --

Mr O'Connor: Your store, though. I don't want you to comment on the whole industry.

Mr Madden: Because we are part of a corporate chain, we're restricted to what we've been told to do. But as a company and specific stores, I think we have already gone under the counter and reduced the signage and the spectacular wall that you speak of, although if you were a retail store manager, you would know that it's the ugliest area of your store, certainly not the most appealing. Over my career working in drugstores, I've seen its presence decrease at least by half as far as that kind of logo advertising.

Mr O'Connor: We heard this morning here in Sudbury of course that 19 out of 38, half of them, don't sell tobacco products. Some of them have made that decision, some never did, and they felt there was no economic impact on that decision from those that had eliminated it.

Mr Madden: I think each store is specific, whatever their location was, the time of business and their cigarette business. I don't think you can judge that --

Mr O'Connor: Yes. That's why I said here in Sudbury too, knowing you're from North Bay.

Mrs O'Neill: Mr Madden, we've been here all morning listening to various presenters, and the contraband word or even the presence of contraband cigarettes hasn't come up nearly as much, if at all. You've just said something that made me think about it when you said you don't think that your not selling cigarettes will change matters. So that was a hint. But there haven't even been many hints. When we were in southwestern Ontario and certainly in Toronto, this subject came up in almost every presentation. Do you feel there is a strong presence of contraband in North Bay, Sudbury, and the surrounding area?

There seems to be, for instance, a comment made that the lowering of the tax federally yesterday is going to make a big difference here. We didn't hear that as much in the south because people are already getting their cigarettes for $18 and $20 a carton. So I just wondered if you could give us an insight since you're from the area.

Mr Madden: I do say there is a fairly big part of contraband going on in our city, in North Bay. I saw in Mr Chrétien's talk yesterday in Parliament that 35% was the point mentioned in Ontario for the level of contraband cigarette sales.

Mrs O'Neill: That might be an average.

Mr Madden: Yes, but I would think that North Bay is not far behind the provincial average in that respect: 35% would seem like it if I look at certain cigarette loss of sales over the last two years. It's just that we in the north usually are a few months behind. The truck takes a little longer to get here.

Mrs O'Neill: So you've noticed in your own store a drop in sales that would directly relate.

Mr Madden: Yes, that would directly relate to contraband as opposed to they've stopped smoking, yes.

The Vice-Chair: Thank you very much for your presentation.

I've tried to equalize the time between the caucuses, and the last speaker did not take as much as time.

Mr Perruzza: Given that I hear you stumbling and fumbling, it's okay.

The Vice-Chair: There's no problem with that. I've been known to work right through without -- thank you for your presentation.

It's been pointed out to me that I must be much more diligent this afternoon in watching my stopwatch. That's necessitated by the fact that a plane leaves Sudbury at a certain time, and those who wish to return should be on that one or stay over. So thank you. We'll try to reconvene at 1:30 sharp if we could, please.

The committee recessed from 1248 to 1335.


The Vice-Chair: Welcome, ladies and gentlemen. We have many presentations this afternoon, the first being a presentation by representatives of the Sudbury Heart Health Coalition. Welcome.

Dr Tom Crichton: I'd like to begin by thanking you and the committee for allowing us the opportunity to speak to you this afternoon. My name is Dr Tom Crichton. I'm a family physician working here in Sudbury. I am a member of the Heart Health physician team. My colleague with me today, David Courtemanche, is a community development coordinator with Heart Health. We have worked together to co-author this presentation and would both be available to answer questions, should there be any.

To start, just a summary about what Heart Health is, for those of you who don't know. The Sudbury Heart Health project is one of five demonstration sites in Ontario that's been mandated by the Ministry of Health to try to demonstrate to the rest of the province how a community can mobilize itself around the issue of heart disease. We carry a three-pronged approach to this, based on trying to modify three of the modifiable risk factors for cardiovascular disease, namely, better nutrition, increased physical activity and reduced tobacco use and tobacco use prevention. These are the cornerstones of our community mobilization process here in Sudbury.

As a member of the physician team, I focused much of my activity in the last 18 months or so on the tobacco use prevention end of things. We've played an active advocacy role locally on behalf of the coalition in advocating for a stronger local smoking bylaw.

Also, as a representative of the physician team, I have received special training, through a national initiative endorsed by the college of family physicians and the Canadian Medical Association, called Guide Your Patients to a Smoke-Free Future, by which I was trained as a trainer to come back and teach other family doctors to be a more effective advocate in helping their patients stop smoking.

The larger coalition's been involved in a number of other community efforts that we don't have time to go into this afternoon, but there are a couple that are important and I'd like to draw your attention to a few of them. Locally, there is in place a program called This Business Loves Kids. This has been coordinated by Heart Health, the Sudbury and District Health Unit and the regional police department, aimed at tobacco retailers. The purpose of this program was designed to make retailers aware of laws surrounding tobacco and encourage them to comply with these laws.

Heart Health has been involved in an ongoing media campaign attempting to raise public awareness around the health consequences of smoking. Our major focus this year has been a campaign called Code Blue, which involved the production of an action guide available to community leaders to help them organize themselves to take action against tobacco use and heart disease. In this guide are a number of different ideas that have been used in other locales successfully to help teach community leaders what to do around tobacco use prevention.

I mention these programs because I feel they are important, specifically in relation to Bill 119, a bill that I think will have a direct impact on our efforts to help young people stop smoking and prevent them from starting smoking.

In terms of the bill directly, on behalf of Heart Health I'd like to offer our congratulations to the province on your leadership in this area. Bill 119 represents a strong piece of legislation that could have a tremendous impact on tobacco use in this province. I can't offer any technical expertise on the bill; that's not my field. I would like to give you the perspective of a family physician, though -- I do know something about that -- and I feel this kind of legislation will impact on my ability as a member of a medical community to deal with this problem.

I think it's important, when we look at the bill, to try to see what is its intent. As I understand it, the intent of the bill is to prevent young people from accessing tobacco products by regulating the way the tobacco products are sold. I think the strength of Bill 119 is found in a few of its major components.

I believe strongly that raising the legal age of purchase of tobacco to 19 is important, because it allows retailers to ask for photo identification, much the way that the Liquor Control Board of Ontario asks for photo identification for the purchase of alcohol.

Furthermore, eliminating vending machines in all public areas is paramount to this strategy. In Sudbury alone, we see vending machines strategically placed in video arcades, bowling alleys, motel lobbies -- if you noticed on the way in -- anywhere where young people can congregate. Even in the vending machine in this motel, right beside the cigarettes, in the same row, are the Macaroon chocolate bars and the Cadbury Caramilk on the other end. The vending machines being in places where young people congregate gives them easy access to cigarettes.


Banning tobacco sales in pharmacies also is fundamental to an effective strategy here. I gather there was an announcement made easier today that an local pharmacy has been caught selling tobacco to a minor. I think this demonstrates a real need to understand what's going on and who's selling these products. We've heard so much in the last weeks about the black market and how important the black market is. It's not the black market that's the real problem: It's a huge distribution network of legitimate business people who are taking an irresponsible approach, at times, to tobacco sales.

It's incomprehensible to me that we can allow tobacco to be sold in a health care facility such as a pharmacy. It's sending a very poor and powerful message to children that tobacco is associated with health products. It's a mixed message. I've heard people who study this issue and our teenagers say, "Really, if tobacco was all that bad, the government wouldn't allow it to be sold in pharmacies."

Furthermore, I think Bill 119 is an attempt to make health warnings more effective, and packaging in retail stores is important from a public education perspective. I'm impressed that the bill attempts to implement an automatic prohibition against retailers who demonstrate that they'll continually sell tobacco to children. As a community, we recognize that retailers have been given an important trust to sell this product, and if they're not prepared to take that responsibility seriously, we feel it should be the responsibility of public policy to restrict their ability to sell cigarettes.

As I say, I certainly applaud a lot of Bill 119's attempts to address this tobacco issue, but there are a few components that I think have been omitted, and I'd like to just touch on a couple of those.

First, I think a comprehensive regulatory licensing system is important. With a system like this in place and properly enforced, tobacco retailers would immediately get the message that they can lose their licence to sell tobacco if they're caught breaking the law. I don't know of any other regulatory measure that would be nearly as effective as this one system.

I'd like to see consideration given to plain packaging as a strategy to deal with the tremendous amount of advertising that goes on in the tobacco industry. I have with me today an advertisement from Life magazine in 1946, part of a series that ran. I'll pass it around, and you can all have a look at it. The focus of the article was the number of studies in the 1940s that showed more doctors smoked Camels than any other cigarettes. Camel ran a series of advertisements showing the doctor in a number of different poses and then a statement at the bottom that, "If your doctor smokes Camels, they must indeed be the cigarettes for you." Hopefully, as physicians, we've come a long way since 1946.

Interjection: We have.

Dr Crichton: Of course it's changed, but advertising is still the same, and that's the whole point of the tobacco industry, to get out there and beat the bushes for more customers.

Patrick O'Sullivan, the executive director of Heart Health, took these photographs locally at a pharmacy to show you just how and where advertising is in place today in this community. I draw your attention to the tobacco advertisements in this particular picture. One is very low, at eye level for kids, and one is up high, close to the sign, and says, "Prescriptions," as if to associate du Maurier with the prescription. This is what's really what's going on in the community.

There was an article about a year and a half ago from the Canadian Medical Association that reported on the success of a huge advertising initiative in the United States. In 1988, Camel had 1% of the teenage smoking market in the United States. It introduced an advertising campaign that included an animated figure named Joe Camel, a cartoon camel who smokes. Within three years, by 1991, Camel's share of the teenage market had increased from less than 1% to 33%. In 1991 a study looked at five- and six-year-old children in California, and the animated character of Joe Camel was recognized by as many of the five- and six-year-olds as recognized Mickey Mouse as an animated character. It's very powerful advertising machinery at work here. But I digress a bit.

The important thing to remember about advertising -- you've heard this, I'm sure, before from other people -- is that every day in Canada probably around 100 people die from tobacco-related illnesses, so the whole point about the marketing and advertising is that every day the tobacco industry has to recruit at least 100, because they've lost 100 of their best customers in any given day.

We have with us as well a five-pack, a so-called toddler pack of cigarettes, that Dave had purchased here in Sudbury a couple of months ago. Dave went in to buy this. We wanted to buy 30 packages to give to local politicians at an information night we had. When he asked the clerk behind the counter for 30 packages, she laughed and said, and this is a direct quote: "Why do you want 30 packages? Do you know a lot of kids?" Dave responded with a question: "Why? Do you sell these cigarettes to kids?" Her response was simply to laugh. As the conversation moved on, she was asked where she got the five-packs from, and she said that the same guy who delivers the chocolate bars brought in the kiddie packs of cigarettes. This is really what's happening in the stores: Tobacco is being treated like confectionery candy.

One large area that hasn't been addressed in this bill, one I can bring some personal expertise to, is the area of smoking cessation. We've all heard that Canada has made great strides as a nation in the last 10 years in reducing the numbers of people who smoke. That's great. Unfortunately, what that's left us with is a very hard-core group of committed, addicted smokers. These are people who have tried to quit smoking before or, if they haven't, have really thought about it. They really do want to stop smoking, a good number of them.

The problem then becomes how you can help this committed group of addicted smokers. We're dealing with nicotine addiction, and nicotine has been compared to heroin in terms of its addictive properties. There are people who've been cross-addicted to nicotine and heroin who say it was easier to get off heroin than nicotine.

Studies that have been done in the area of smoking cessation show that if a doctor is interested and expresses interest to his patients, then a higher percentage of his patients will be successful in stopping smoking. It's more than just that, though. The more layers you can add to the smoking cessation effort -- the doctor counselling, a nurse counselling, public education, support groups, hotlines -- the higher and higher your success rate goes.

Two years ago, when nicotine patches were released, there was a great flurry of interest and activity here about this issue. I did some reading on it. Even with nicotine replacement therapies and good counselling, a good success rate for smoking cessation in a year is 10% -- that's good. If I can get 10% of my patients to quit in a year, then I'm doing better than average, which really goes to show you how difficult this addiction is to deal with and break. That is one area that, in a broader sense, we as physicians could use some more help in, in better implementing public education or better policies or community support groups for committed nicotine-addicted smokers who want to quit.

Finally, one other concern about Bill 119 stems from the history of the tobacco industry's dissection of new legislation and its ability to find loopholes in new legislation. It's important, if you can, to try to develop some sort of implementation strategy for this bill such that there can be an ongoing review of the effectiveness of the bill and whether it's continuing to meet what its intent was, and then deal with any attempts by the tobacco industry to move around through the loopholes. I'm not a legal expert, but I would leave that in your hands.

We hear a lot of talk about tobacco being a legal product in Canada now. It is. It concerns me because it really is a legal product only if it's sold legally, and we know that a great deal of time it isn't; not just the black market, but we've heard today that children do buy this product. It's a dangerous legal product as well that I feel has to be regulated.

I think Bill 119 is attempting to do this, and I hope that when you go back to Queen's Park to deliberate over what you've heard here you will remember what the intent of the bill is and ask yourself the question of whether you feel it really will fulfil that intent.

Given our statements, I hope you give further consideration to a comprehensive licensing system, plain packaging, advertising restrictions, and consideration of further help on the issues of smoking cessation.

Thanks very much for your time, and if I or Dave can answer any of your questions, we'd be more than happy.


Mr McGuinty: I'm especially interested in any suggestions you might have that would help you as somebody on the front line, or a teacher or parents, help people we have over the course of history tacitly allowed and approved of getting addicted to cigarettes in this province. How do we unhook them? What is it we're not doing now that we could be doing?

Dr Crichton: That's a big question, because there are a lot of different reasons different people smoke and are addicted to smoking. You can dissect your population at risk into different groups.

If you begin by addressing those consumers coming into the market at the beginning, if you can somehow restrict their access to tobacco, fewer and fewer of them will start smoking and fewer and fewer of them will be addicted to smoking. Restrictions on selling cigarettes are not going to help adult addicted smokers. They're going to be able to buy this product as long as the product continues to be a legal product in Canada.

If you're asking for my opinion about how to help those people, it's making them ever more aware of the negative health consequences of smoking. It's not that they're not aware; everybody has heard that smoking is bad for you. But people have to hear time and time again, not just from their doctor but from their coworkers and from advertising and from the community at large, that smoking is dangerous to your health, and if you want help, please turn to someplace for help. Whether that's their doctor, a community-sponsored clinic, a support group at their health unit or a hotline they can call, all of these measures would be effective in one degree or another in any different community in this province.

Mr McGuinty: Just so I understand, do smokers go through an ongoing process of denial that it's a problem? I assume they all have to do the same thing internally to quit. What is it they have to do before they can quit?

Dr Crichton: The first step is wanting to quit. They have to move from what they call the pre-contemplative stage of smoking cessation to the contemplative stage. There are smokers who are in denial, you know: "I won't get lung cancer, I won't have a heart attack. My Uncle Louis smoked till he was 85, eight packs a day and he's still" -- everybody knows somebody like that. A lot of times they will deny, and that's how they put it off and don't even think about smoking. But then one day something happens and they move from never having thought about it to starting to think about it, and that's when you can begin to help them along through making an attempt and staying off.

The Vice-Chair: Thank you for your presentation. We're very pleased to have it.


Ms Erica Webb: My name is Erica Webb. I'm the tobacco program coordinator at the Porcupine Health Unit. The Porcupine Health Unit is actually north of here in Timmins. We don't have a large population, but we cover a wide area, up to Moosonee on the coast.

This presentation was put together by the health unit and also by Tobacco Free Timmins Sans Tabac, which is our local Interagency Council on Smoking and Health. They focus their efforts in Timmins, and then the health unit focuses its efforts in the other communities north of us.

We're really concerned about the issue of smoking. The Cochrane district has had significantly higher smoking rates for some time now. In the 1990 health survey, we were 10% higher than the provincial average, and in some age groups we were higher than that.

We don't have data for individual communities, but I can speak from experience, for example in Moosonee, that the smoking rates are very high in the young population. We've done some presentations to grade 8 students up there, and in that class of 20 there was one who didn't smoke. That also might speak to the issue of cost of smoking. For example, there's a native community across the river, and the cost of cigarettes is lower there.

We also have higher rates of lung cancer, bronchitis, emphysema and heart disease within our district. With the increased number of smokers, I feel that secondhand smoke is also a bigger issue: If there are more people smoking, you have more secondhand smoke.

This evidence underscores the fact that for our tobacco use prevention program to achieve our overall objectives in improving community health, we have to have things such as Bill 119. We have lobbied hard in our area. It's probably our first experience with having to lobby on something like this, and it's because we feel we need this bill to back up any educational efforts we have been doing over the past years.

Our local member of Parliament was very supportive in this. He himself is an ex-smoker. It's Mr Gilles Bisson, and he's an NDP member. He's been smoke-free for over a year now, and we've really been able to use him for a role model in the community.

Mr Wiseman: He's crankier.

Ms Webb: I think he's gained a little weight too.

We're concerned about some of these health issues. One I'd like to focus on is smoke-free spaces. I'm sure you've had some evidence about the dangers of secondhand smoke. It's been classified as a class A cancer-causing substance. We must consider the rights and health of non-smokers. We've been putting a lot of attention to educating our public about the health hazards of secondhand smoke and trying to make the group that does not smoke more vocal about its rights.

We feel this bill is a good place to start with setting a minimum standard of protection for these non-smokers, especially in communities where the smoking rates are high. Nevertheless, you have people who don't smoke, and you need a minimum standard for those people to be protected from the secondhand smoke.

The issue of smoke-free spaces can also be looked at through youths' eyes. If you have a larger percentage of youths who are not smoking, you can almost look upon the enhancement of smoke-free spaces as a way to reinforce the fact that they are not smoking. If you see a school with a group of students outside it who are smoking and you ask in a class, "What percentage of teenagers do you think smokes?" they will usually give you a figure very much over what the true percentage is. I think the enhancement of smoke-free spaces would be one way to emphasize the positive for students who are not smoking so that you will see groups sitting in smoke-free spaces and setting a positive example.

We've also had some contact from heart patients, asthmatics and the elderly. We have a very active elderly woman who in fact belongs to a non-smokers' rights group in Toronto, and I would suspect she's probably one of the very few northern people who does. She's very active, and her quality of life is definitely affected by the lack of smoke-free spaces.

We have a lot of phone calls from students now who are increasing the number of projects they're doing on secondhand smoke, so there's definitely some interest there from the students.

We have a lot of students who have asthma. They may not smoke, but they are concerned about their asthma and how they can be protected from it.

I also see smoke-free spaces as being important to the process of quitting smoking. When we offer smoking-cessation counselling, one thing we advise people is, for example, "If you're going to go into a restaurant, challenge yourself and sit in the non-smoking area." Well, if they go to a restaurant in Iroquois Falls, there is no non-smoking area, and therefore they don't have any positive reinforcement to do that.

I've also had several calls from a woman who's interested in smoke-free laundromats, which initially may not seem like a real priority, but if you look at the groups of people who are smoking at higher rates they are those who are perhaps less advantaged economically, and these are the people who may be using the laundromats. To emphasize the positive again, if she's in a high-risk group for smoking and she's not smoking, and she's requesting some quality space here, she's right. The only answer I had for her is: "We're working on that bill and we're trying to get that passed for you. I'll have some news for you in a few months."

There's been quite a bit said about access to cigarettes by minors. We feel immediate attention must be paid to teenagers who smoke. I'm a public health nurse, and we also have other nurses who have counselled those who are trying to quit, adults and youth. It is very difficult, energy-consuming and very overwhelming for some to beat the habit, so prevention is very important. I've counselled some 15- and 16-year-olds who've tried to quit and can't, who fail. I really feel a vicious cycle can begin for these youths when they have such a failure. In addition, today they may be labelled as addicts. These negative experiences are definitely going to cause trouble for them in the future.

One example of that is presentations we've done to such groups as -- there's a program called Futures, which is to try to get students who had dropped out of school back into the educational system to upgrade themselves. In those groups, 60% and 70% of them are smoking. Now they're trying to get back into the workplace and they smoke heavily. They've got another problem to overcome.


I met a woman on Monday who had lost her husband, who was a heavy smoker, to kidney and lung cancer when he was 35 years old. She said he had started smoking at 12 years old. Just to put it in perspective, by 35 he had already smoked for 23 years. That's a long time. She had written to our local Lung Association to talk about her experience in the hopes that it would prevent somebody else from starting or from going through what they had. She herself quit cold turkey the day her husband was diagnosed with lung cancer. She was also a heavy smoker.

She said to me that she feels cigarettes should be banned. She stated, "You never think it's going to happen to you." I think we all know that that's where teens are coming from. This scenario is not unique and it's repeated all too often. A strong Bill 119 could assist in preventing the same thing for another 12-year-old. It was interesting that his mother had also died of lung cancer related to smoking, so you're looking at generations. I think licensing would be one way to do that.

The addictive nature of cigarettes is another big health concern which I'm sure you've heard a lot about. We feel this requires serious action. Speaking from my own experience and from other health workers' experience, when we counselled people about the hazards of smoking 10 years ago, we would not very often have been mentioning the word "addiction." Now the words "deadly habit" and "addict" surface very frequently.

The social norms are changing around tobacco use, and I think a process such as this is helping that. If we are to deal with a serious addiction, then we need some serious action. We cannot, for example, compare nicotine addiction to heroin and cocaine addiction in a class in a school and then sit and watch youth continue to smoke where they please.

Even for teenagers who have chosen not to smoke, this is a really big inconsistency, and they'll question you about it when you're doing classes with them. We feel that the regulations around Bill 119 should be very strong and very unconflicting about the social norms for tobacco use.

Some of our recommendations are included in the bill already, and some we would like to see strengthened.

We would like to see the proof of identification raised to 19 years old, and a photo ID is very important. We admit it will not solve all the problems, but it will definitely deter some youths and it will set a system in place. For example, if you deter a 13-year-old who was going to try it, it gives you a couple more years to continue with your educational program.

We feel strongly that a licensing system is very important. It would allow for better monitoring of sales and a method for dealing with infractions, such as the loss of the permit. It sends a strong message to those who sell tobacco. With the example before, the kiddie pack of five, many people who sell tobacco are not aware of the serious nature of this product. I was really disturbed by some of the recent coverage of the debate around lowering taxes on cigarettes. Some people were very excited, as if they were talking about a sale. This is something we should wonder about.

I did hear some talk yesterday when I was listening to the coverage about the administrative load for businesses if there are more forms to fill in and such. Personally, I think that would be well worth it. At the very least, this section should be written in such a way as to enable and encourage municipalities to pursue this channel themselves. I know our local MPP supports that.

Smoke-free spaces: I've already talked about those. We have a small committee in Timmins to look at some changes in our community, and we need the support of the provincial law to back up anything we do there. This should be spelled out specifically to include all areas where teenagers congregate, such as arcades and theatres -- someone said to me when we were discussing this that arcade operators may very well support this, as the smoke damages their machines -- all sports facilities, arenas and other locations associated with youth and physical activity, again to remove any inconsistencies.

Enclosed shopping malls: We have to remember that a lot of essential services are now located in shopping malls, such as banks, post offices and pharmacies. Elderly people, asthmatics, do have to go into those malls, so it's not a luxury-type thing.

Laundromats I've already talked about.

Reception areas, taxis and restaurants: In our area we're under discussion for 50-50 percentage, not unreasonable when you look at the rates of smokers versus non-smokers. Again, it would give a chance to highlight the non-smoking population in an area for non-smokers.

Plain packaging and countertop displays: It's already been discussed that packaging is a major tool to encourage youths to smoke. We also endorse plain packaging with strong health warnings, and we feel countertop displays should be removed. I think it's been mentioned that the wall of cigarettes with all this nice packaging is very appealing to use.

They should also be located under the counter. There are a lot of other products located under the counter that you have to ask for that are far less damaging than cigarettes. One I can think of, for example, is videos. They'll leave the package up there for you to choose your video, which is very nicely coloured, but because they don't want the videos shoplifted they put them behind the counter and you have to ask for the actual film. There are other items that the shop owners themselves may feel are in danger of being shoplifting that they'll put behind the counter. I don't think it's unreasonable to ask for a similar approach for cigarettes.

Removal of tobacco sales from pharmacies: We feel this should be implemented as soon as possible. There has been a lot of discussion around this. It's definitely an inconsistency and therefore should not continue. There's a lot of money spent by the pharmacy chains marketing themselves as health educators and health providers in order to attract business. Some pharmacies are now marketing themselves as tobacco-free pharmacies. I think that debate should end and they should be removed.

I was struck by the fact that these inconsistencies are picked up by teenagers and younger. I was teaching a grade 6 class on smoking. The topic was not pharmacies and smoking at all, it was just general prevention. A grade 6 child asked me, "If it's so bad, why are pharmacists selling it?" I was totally shocked, totally surprised. Whether he'd been discussing this issue with his parents, I'm not sure, but at grade 6 they are aware of these things. That was an unprompted comment.

In conclusion, the Porcupine Health Unit and Tobacco Free Timmins congratulate the government and members of Parliament for bringing forward this bill. We hope that with the strong input from such things as these hearings, all communities and health professionals, it will assist in achieving the overall health objectives for the people of the Cochrane district and Ontario in tobacco use prevention.

Ms Sharon Murdock (Sudbury): I'm very upset with what's happening federally, and I think there's a lot more that can be done.

As to licensing, which is not part of Bill 119 at present but is to be discussed, I gather from your comments that you would have it municipally administered?

Ms Webb: That would be a compromise. There are some municipalities that have a licensing system. From what I understand -- I'm not totally up on the way the laws can be written -- there can be enabling legislation which would encourage municipalities to do that. We have discussed that with our local municipality, and they feel it should be done at the provincial level.

Ms Murdock: In Sudbury we have smoke-free arenas and so on, and I gather it isn't the same in Cochrane, if you have restaurants where you can't go --

Ms Webb: In the Cochrane district every community is very different. For example, one of our communities in Hearst is largely French-speaking and there's a high rate of smoking up there. Their situation is quite different from, say, Timmins, where I would operate out of. A provincial standard is necessary for such communities even to begin a process.

Ms Murdock: Northern Ontario has a higher incidence of smoking rates anyway, compared to the average, and on top of that you have mining, which affects lungs and so on. If you have communities that don't have no-smoking policies, then you wonder how stringent they would be in terms of enforcement of licences.

Ms Webb: I think I said that at the very least it be a municipal licensing system. We feel that a provincial licensing system would be much better. Municipalities like that are very unlikely to undertake a licensing system themselves to begin with, so if you have a provincial system, at some point they would have to do this.

The Vice-Chair: Thank you for your presentation.

Mr O'Connor: I'd just like to clarify the licensing element. The municipalities do have the ability to license. In fact, many municipalities have it. In the legislation, as far as the municipal bylaws are concerned, where a municipal bylaw is more restrictive than the provincial legislation, the municipal bylaw will have precedence over the provincial legislation.

Ms Murdock: So municipalities can have a licensing system now.

Mr O'Connor: In fact, some have. I think the city of Vaughan just went to a system.

Mr Jim Wilson: Just to clarify that, this act doesn't introduce a licensing system either, so every municipal licensing bylaw would supersede this act, I assume.

Mr O'Connor: Yes.



Mr John Stroyan: Thank you for allowing us to present before the committee. My name is John Stroyan and I'm the health and safety officer with the Sudbury Board of Education, a board with 56 schools and more than 20,000 students that covers a geographical area more than twice the size of Metropolitan Toronto.

With me today are Tom Bertrim, principal of Lively District Secondary School; Steven Levesque, vice-president of the student council for Lively District Secondary School; Steven Price, a member of our smoking cessation committee for Lively District Secondary School, a smoker himself; and Angela Desjardin, also a member of our smoking cessation committee for Lively District Secondary School and also a smoker.

The Sudbury Board of Education applauds the provincial government for the introduction of Bill 119 and we are anxiously awaiting its passing to assist us in our efforts to reduce smoking among the youth in our communities.

The Sudbury Board of Education has already implemented a plan to eliminate smoking from our school properties. Our plan involves phasing secondary schools into our smoke-free policy. Since the rollout of this plan in January, one school in particular, Lively District Secondary School, has become smoke-free and two other area schools have signed up for the program.

We begin our program with consultation with the students, setting target dates, providing signage, literature and, most importantly, smoking cessation programs for those students. A little aside from my brief: That was done through experience. We experienced student walkouts prior to consultation with the students, so there was some experience gained in that process.

At the elementary level, through pilot programs offered through the Canadian Heart and Stroke Foundation, Heart Health and public health officials, we will be adopting a Healthy Schools-Healthy Kids program targeted at improving health education for our youth, particularly focusing on heart-healthy issues like smoking.

Unfortunately, in order to make this program a success, we need the support of Bill 119. In particular, there are two areas within the bill that need to be mentioned.

First, under paragraph 2 of section 9, the definition of a school should include the school grounds as per the Education Act, paragraph 1(1)49, which says a "`school'...includes the teachers and other staff members associated with such unit or institution and the lands and premises used in connection therewith."

Second, we are concerned the enforcement of this act will be a low priority for police services. We hope we are wrong in that aspect.

The Sudbury Board of Education is also concerned about the smokers already addicted. We hope this committee will consider provisions for smoking cessation programs for the youth who need the help. It has been our experience that without this offer of help, those students already smoking would just be forced further underground.

In closing, we endorse Bill 119 as a progressive step forward in protecting our children but also encourage the committee to review the few points we have brought forward.

I'd now call upon each of the representatives of the board who are here to make a few comments, and then open up for questions.

Ms Angela Desjardin: I feel that this program is needed. The students who are addicted, are addicted. That won't change just by saying, "You can't smoke any more because you're not old enough." I don't think that'll do anything for them. That's basically all I have to say.

Mr Steven Price: I think smoking cessation programs would be beneficial, because I feel the same way Angela does. People can't just quit smoking because the law says they have to. They need something to help them out. These cessation programs should be able to help them out if they choose.

Mr Steven Levesque: I just have a few quick comments from the student council. I agree with you, sir: Education must begin in the elementary years. Children must be told repeatedly about statistics on health-related problems as a result of smoking.

If you survey the students in our smoking area at Lively high school, you'll find that some, if not all, started because it was a rebellious stage and they started because of their peers. Education can stop the smoking "fad." If this is done, you will not have student walkouts at high schools like ours because students are aware it is wrong. Having schools smoke-free for the new arriving students in grade 9 each year will not be a problem.

Mr Tom Bertrim: As the principal of Lively District Secondary School and as a principal with the Sudbury Board of Education, I have some extremely strong feelings about smoking in schools.

First, I can't understand how educational situations in elementary or secondary school can allow students to smoke on the property or the premises of the building. Smoking is an addiction. We don't allow students to do heroin or to do drugs. It's treated quite seriously.

Second, I have some strong concerns about the model that's shown when we allow students to smoke on the property of the school.

Third, I have some concerns about community ownership for the smoking problem. You can't expect schools to hide the problem and to have designated smoking areas on our property or even the premises. That's not right, as far as I'm concerned, but the public has to share that. If kids leave our school and go and stand in front of a store off the property, I have no control over that. But I feel the community has to have a say in this too. We've had good support involved in that way too.

The last point I feel very strongly about is the fact that students are learners. Also, as the employers of the Sudbury Board of Education, we have to help students and staff members who are addicted to go through a cessation program. We can't just eliminate it; we have to give some support. That's what we're trying to pilot at Lively District Secondary School this year.


Mr O'Connor: Terrific presentation. I hope you don't mind if I share this with some high schools in my riding. Just one correction to item (f): Under the law it's 18, not 16.

Mr Stroyan: I'm sorry, that's an error.

Mr O'Connor: I'll correct that when I share this. The other thing is: Under section 9, paragraph 2, you talked about the "school" definition. Actually, the intent is to have the legislation -- though it doesn't say that; I guess we'll have to clarify it -- use "school" as it is written in the Education Act. That's what we had planned, but we need to clarify that and get legislative counsel to draft it so the intent reads the way you put forward.

Mr McGuinty: I'm going to touch on two areas. I'm very interested that you said you had a school walkout because the program was, I gather, put into place overnight. The other thing I wanted to get a bit more information on was the cessation program that's offered at the school. Would you suggest that we phase this in, or what's going to happen in our high schools if we say, "Look, folks, tomorrow, bingo, that's it: no smoking"?

Mr Bertrim: The first part of the question centres on learning how to do something. This is a complex issue. We had a non-smoking policy on the property and premises at our school for two years before, but it was a farce because we didn't supervise it. It became even more farcical when our students who are smokers became very casual about how they were smoking in designated areas. I asked my teaching staff to come on board and we did supervise it and we asked people to leave the property if they wanted to smoke. We had a walkout one day, but as far as I'm concerned, it was probably the best thing that ever happened. Because of that, we had a committee form in the school and we started to do things the right way. We've engaged a committee that has smokers on it, student council representatives, staff members, and we're back on the right track.

With regard to the smoking cessation programs, we feel that without offering that assistance to the students, they wouldn't participate in the program. One of the things I was very disappointed about as we started to explore smoking cessation programs was, first and foremost, that there are no programs within our community geared to youth. That was a real challenge, to get smoking cessation programs for them. We have been able to work with one organization that itself is running it as a pilot within its organization, the Seventh-Day Adventists' program, but the services were not available for the youth.

We feel it should be included in the bill for those who are already addicted, because it is an addiction, and that it should be phased into the schools -- that is the learning we have gained -- over a period of time, whether it be the grace period of the act or whatever, when it does pass, and that the services be offered to the existing students, and not just cutting them down cold turkey.

Mr Bertrim: As an addendum to what was just said by I believe Angela, several of our students have mentioned the power of peer pressure. What we are trying to do in Lively is offer a program which will begin the Monday after the March break, and it has the same basis some industries have offered. We are offering to our students, as a part of the regular school day, a 10-hour program where, when they are onsite in school, they can go and take the cessation program. It's kind of like it has a credit base or a monetary base. Our board is even allowing any teachers or support staff who wish to take this course during the course of the school day; they won't lose money or anything like that.

The other thing we've done is that as we've formed our committee -- and this is from some of the research we gained from British Columbia; I researched Canada when it comes to how these programs go. We're taking a senior student approach to this and we're starting off with the seniors in the school who are smokers and want to quit. We hope then to get a peer basis and move from that as models to the rest of the school over the course of the next several years.

Mr Wiseman: Are you going to extend it to the elementary schools too?

Mr Bertrim: In our area of Walden that's probably an even more important area. It's my dream that all elementary and secondary schools will have a completely smoke-free philosophy.

Mr Stroyan: We currently enforce a smoke-free property in all of our elementary schools, so the secondary schools were our primary focus because that's where we had designated smoking areas. The elementary schools are already smoke-free property.

The Vice-Chair: Thank you very much for your presentation and for bringing the students with you. We deeply appreciate that. The best of luck in your program. We hope it'll bring results.


Ms Laurie Fraser: My name is Laurie Fraser. I'm a public health nurse at the Sudbury and District Health Unit. I'd like to introduce Vic Sahai, our epidemiologist in our teaching health unit, and Noella Piquette, a senior citizen in Sudbury.

The Sudbury and District Health Unit would like to commend the NDP government for its leadership in bringing in Bill 119. This law could set national and international precedents. I'm sure the world is watching.

The Tobacco Control Act could lead to major breakthroughs for the regulation of environmental tobacco smoke, or ETS. This could mean protection from ETS for all non-smokers. We must remember that the majority of Canadians are not smokers. Sometimes it seems to get lost in the shuffle.

Bill 119 would also prevent the tobacco industry from accessing our children as it focuses on hooking a new generation of smokers. This bill as it is, is a good start, but we could do more. Areas like workplace environmental tobacco smoke, banning the sale of chewing tobacco, which is becoming a popular habit with our youngsters as they look at their favourite ball players and other hockey heroes, a licensing scheme for the regulation of tobacco retailers, and the investigation of the tobacco industry's role in the smuggling issue indeed require closer investigation.

I'd ask Vic Sahai to highlight tobacco issues in light of the Sudbury experience.

Mr Vic Sahai: I would like to ask one question. If tobacco were a germ, or if we were dealing with handguns that were killing 39,000 Canadians a year, this wouldn't go on. You would do something about it immediately. I know you've seen the stats. I think you've seen them so many times that they just go right over your head and you say, "Yes, we have heard the stats." But I would like to put these stats into context. If tobacco were a germ, as Canadians, as citizens of the world, we would be in crisis.

Look at the third page, where it says "If Tobacco Was a Germ." The third point is that tobacco kills 45 times more people than AIDS, yet as a government in Canada we spent $100 million last year on AIDS research alone.

Also, in terms of secondhand smoke, if I were to go to a pharmacy and buy a handgun and then take it to a restaurant, I would be locked up. Tobacco smoke, especially secondary smoke, kills a lot more people in Canada than handguns. So please don't tell me that we do not have a crisis in Ontario, in Canada, in the world.

This isn't my show. I would like to introduce Noella.


Ms Noella Piquette: Ladies and gentlemen, members of the committee, I thank you for hearing me. I'm a senior citizen and I live in a senior citizens' building. I would call that a public place that deserves to have eliminated the smoking in the lobby on the first floor. The smokers are in the minority, but they spend all their time downstairs. They don't have too much to do, so the cigarette takes the place.

I've been in four buildings in 13 years and I had no problems in my lungs and my heart. Now I'm on oxygen until the day I die and I bleed from the lungs. I was hospitalized last February, a year ago. I spent 29 days in the hospital, bleeding constantly. Two weeks ago I had a nosebleed like a haemorrhage; all of a sudden I was just splashed. My throat has been itchy, because I had a tumour and they took half my throat, and paralysed, so if I cough, it's hard, and something breaks.

There's a small lobby and a small laundry room and there's only a wall between the two, so they do their washing and then they come and sit in the lobby, five chairs and they get some from the rec rooms, and they smoke in the rec room, so the smokers have the run of the house. So we, the non-smokers, who are the majority, don't dare say anything, because the smokers are on their guard and they're not going to give up easily.

They told one gentleman of Ontario Housing, the first meeting we've had at Towers, "I'm not going to go outside and smoke." The gentleman asked, "What could we do to make the senior citizens live better and longer and be satisfied?" I told the gentleman -- I forget his name -- "Smoking would be the first one." I'm having oxygen 24 hours a day, as soon as I get home. I don't go out with it, because it's a nuisance to go out. I haven't washed my clothes in the laundromat for two years since I've been there, because the smoke's there and I just choke. The others are afraid to say anything, but they're behind me.

I've said I'm on oxygen, and I'm on nitroglycerine, three patches a day, for my heart. I've got a cardiac heart and one lung that gives me a lot of trouble. I'd like to see the smoke disappear from the first floor and the halls to the top of the building, with signs and posters put up, because they won't listen to anything else but strength or orders, so I don't say anything to them.

But I mentioned it in church. The priest came in and said the mass on Sunday, and he was looking at the poster on the wall: "Did you walk a block today?" The priest said: "Yes. Did you walk a block? That's good for you." I said: "Well, they forgot one thing. What about the smoke down here? It's so thick you can cut it with a knife. I don't know how long I can take it without them putting me six feet under." He said, "Yes, the smoke."

I'd like to have that disappear. There are a lot of them who don't say anything and just whisper. I've got 27 names gathered already just since I read about the health unit in the paper, Northern Life, and I phoned Laurie. I didn't know her, but we got to know each other. We pay the same rent, but we are in jail. There's one woman who smokes night and day, just chain-smokes; she lights them all almost with one match, and then she opens her door and here the smoke comes out. I have to open my patio door. They've also got a patio door and windows, so they could smoke in their apartments; I don't mean to cut them off. But the rest of the building is all ours, not just for them.

That's about all. Thank you for hearing me, and I hope something can be done to erase that smoke once and for all.

Ms Fraser: The health unit aim is to improve the health of the total population, specifically in the area of tobacco, to improve the health of the population by eliminating tobacco use. It is through this kind of legislation that this goal will happen.

We have run two successful Quit and Win campaigns for smokers in the Sudbury area, in 1992 and 1993, and have just completed a telephone information line for Sudburians who wanted help to quit during National Non-Smoking Week. We have talked to hundreds of smokers who are battling to break free. They're asking for supportive environments to aid them in their struggle to break free. They want support from the people in their families, support from the people in their workplaces, and support from their communities. Other people have a role to play, and I think this is an area that is often not considered by other people.

It's easy to forget that these issues do not refer to faceless statistics but to people struggling out there with tobacco issues, people like Noella. We want to thank Noella so much for sharing her personal experiences with us. The government has pledged to cut cigarette consumption in half by the year 2000 and to reduce the annual toll of 13,000 people who die prematurely because of tobacco use. For Noella and all the others like Noella, let's get on with making it happen.

Mr Jim Wilson: Noella, you make a very compelling case with respect to the building you live in. I'm going to give the government the opportunity to clarify this issue. While I agree with the health unit's comments that this bill will help with some of the secondhand smoke, environmental smoke, I'm not sure we're doing anything for your case, Noella. I'll let the parliamentary assistant explain the government's position on that.

Mr O'Connor: Thank you, Jim, for the opportunity. I appreciate you coming. Part of the overall government strategy you've talked about. It works out to about 5% a year reduction. I think that, with all the work from all the communities, is achievable.

The issue you pointed out, that's why we're having the public hearings. In the bill we've stated "and other public places" to allow us the opportunity to spell out places in the regulations, so it's important that we do hear from people. We've heard suggestions that there be a total ban in all public places and we've heard from people saying places like laundromats, arcades and what not, and from yourself about the public places in apartment buildings. It's important that we hear from people like you, and that's why we're having the public hearings. It's possible for us to do that, because we have the ability through this legislation.

It's important that people like you do come forward. I appreciate you taking the time to come here. I'm sure on a cold day it's probably awkward for you to get out as well.

Ms Piquette: It's tough, yes.

The Vice-Chair: Thank you very much for your presentation. We were very pleased to have you today.

Mr Jim Wilson: I just want to know from ministry staff, under this act, what is the legal status of an apartment building like the one Noella lives in? Is it possible to incorporate it under this act, or is there some other act we have to look at? Is it considered a public place?

Ms Mitchell: Are you talking about apartment buildings or public housing? I'd want to look into it and get back to you.

Mr McGuinty: Are they covered under Bill 119?

Ms Mitchell: No, because it's not one of the premises specified within the act.

Mr Jim Wilson: Is it possible under a health act? I don't want to mislead the witnesses that we can do it as an amendment under this act if we can't do it under this act.

Ms Mitchell: Could we have the opportunity to consult legal counsel and get back to you later?

The Vice-Chair: Absolutely.



Mr Gil Gasparini: Hello. My name's Gil Gasparini, and this is my daughter Katie. We're here representing FRESH, which stands for For Reduced Environmental Smoke Hazards.

It's great that the government and you people in general would take the time and the effort to tackle this very important issue. I'd like to do a little background on myself, just to show you where I came from in the smoking issue.

I've never been a smoker. I probably tried it when I was very young, but I always disliked it from as far back as I can remember. Right now, I'm a parent with four pre-teen children. I've looked at this issue and I've said we've got to do something so that my kids aren't affected, dragged into the whole spirit of smoking and thinking it's cool and thinking it's sexy.

My wife and I have both taken a stand. We've made our home smoke-free, and I don't make any exceptions for anybody. My mother's a smoker, and I won't let her in my house to smoke. When we go to restaurants we insist on non-smoking sections. It irked me to no end when you used to go into a restaurant and they would tell you, "We've got something in non-smoking if you want to wait." I've walked out of restaurants when they say that. That was a stand I took.

We joined FRESH, which was established when the city was making its bylaw. We wanted to have some input to make sure it was strong legislation. We've worked with Katie's school to make posters so it would have an effect on her and would also have an effect on the community. We write letters to the newspaper when someone says something in the paper that I feel is stupid. My wife is sitting now on the Sudbury and District Council on Tobacco or Health. We take every opportunity to talk to our kids about the dangers of smoking.

What really bugs me the most is that even after doing all this, there is still no guarantee that my children will not be dragged into the smoking issue. What I'm looking for from the government and in legislation is, to use a phrase of the 1990s, a paradigm shift, where the attitudes are changed so that people will not go into laundromats, will not go into restaurants, will not even go into hotels and think they have a right to smoke.

I watched a movie the other night where a lawyer was asking questions of someone on the stand and he was smoking while he was doing it. A lawyer would not do that. He wouldn't even think of doing that. People coming into the courthouse would not even think that was allowable. I want that same attitude to be prevalent in society, where they don't think they have the right to go into a restaurant or a hotel and light up a cigarette.

Getting involved with FRESH, I found out even more of the dangers of secondhand smoke. I'm not going to list all the things I've heard; you've got all the material in front of you and you know what it's all about.

We'd like to see this legislation strong. We like to think of it as the pointed end of a wedge. This is only the beginning. We'll just keep going until we're a smoke-free society.

We would like to see plain packaging with much stronger warnings on it so that it sends a signal. These are dangerous chemicals you're inhaling, and we would like to see that warning. The packages are acting as the advertising for tobacco right now. I was at a coffee shop, and this young person took out one of these little tin packs that flipped up that were sold by the tobacco industry, bringing back that sexy image, something different. I hear they couldn't keep them on the shelves at Christmastime; they were sold out like crazy. That has got to stop. The whole packaging issue has got to stop so that the cool and the sexy image is gone.

I've got written down here banning the kiddie packs. I hope the federal government has now addressed that and they'll be gone.

Mr Wiseman: They're looking at it.

Mr Gasparini: Not yet?

Mr O'Connor: All they said is that they're looking at it.

Mr Gasparini: I hope this legislation will have something in it.

I'd like to see the age raised to 19, as a lot of people have mentioned before. I'd like to see a strong licensing of retailers, that when they don't comply they get a big fine and if they keep non-complying they lose their licence.

I was just watching -- I don't know if it was these proceedings last night on TV. The thought came to me that we have liquor stores that are already licensed establishments. I know there would be an outcry of many confectioneries and many stores, but if a confectionery store is dealing with one product to handle its whole load of making an income, its's in trouble to begin with.

I don't know about this last point. We put down that vending machines should be banned. Sudbury I believe has banned them. I don't know if it's across the province, but --

Interjection: They're banned in the bill.

Mr Gasparini: It's banned in the bill? That's great.

The last thing is the change in attitude. I'm hoping that this change of attitude is pushed by the government. I don't think it's going to happen on its own. It's got to have a driving force. I think Bill 119 is a starting edge. Hopefully, it will be, and my children, as they become teenagers, will not be in that predicament of having to fall under the pressure to start smoking. Thank you.

I'd like to present my daughter. She wants to say a few words.

Ms Katie Gasparini: Hello. My name is Katie Gasparini. I'm an 11-year-old who's concerned about smoking in my generation. I live in a non-smoking house and have great influence from my parents, and I hope never to smoke. But normal children have that opportunity. For instance, one girl I know whose mother smokes told me, "It's no big deal; we're all going to try smoking once or twice," and what that girl says, lots of other girls listen to. That's what I want to stop, things like kiddie packs. No heavily addicted smoker is going to buy a pack of 15 cigarettes. A 12- or 13-year-old will, something they can afford.

We made drugs like crack illegal. Why can't we do that for cigarettes? Then thousands of people don't have to die; for instance, my friend's grandmother, who died, or my grandmother, whom I worry a lot about.

But do you know what really won't stop smoking? All those movies that had a hero smoking, and it's not usually an ugly person. It's usually a pretty blonde girl or a handsome muscular boy whom everybody likes. I agree with thousands of people. Those movies and shows have to be banned. And you know the commercials supported by the government? I know it's for a good cause, but if you have a body like that -- skinny, blonde and pretty, or tall, handsome and muscular -- maybe it's worth jumping into a pool of harmful chemicals.

If you reduce the taxes, children will be able to buy cheap cigarettes. Canada will have half the children smoking. We, my generation, need your help. You could help us by educating children, getting rid of kiddie packs, making cigarettes illegal, banning those shows and movies with the pretty girl who smokes, and looking at all situations before putting them on the air.

Do you care about me, my friends and my generation? If you do, you know you need to help. Thank you.

Mr O'Connor: You talk about this being a wedge. There might be a few things the committee disagrees over -- that's part of partisan politics -- but we agree we're just part of that wedge; that the other parts of the wedge are people like yourselves who are actually out there in the community supporting the associations that have been around for quite a while working on these issues, like Heart and Stroke, and the lung and cancer societies, and people like you coming forward in the next generation of supporters trying to change this attitude.

When you talk about this being part of the wedge, you're right: It's only part of it, and there's been other legislation in the past. Legislators can't do it alone. We'll try to do our part, and we appreciate your coming forward and being the other part of the wedge.

Mr Wiseman: Katie, you saw the presentation by the previous group from the Lively high school. If those young people were to come into your school and make a presentation, or talk to you and your friends, what kind of impact do you think that would have? Would that be important? Would that help? Would that have an impact on that girlfriend of yours who sees smoking in her house on a regular basis, or is she already too far influenced by her parents?

Ms Gasparini: We're not really friends, she doesn't listen to much I say, but I think it would make a big impact on most of my friends who do like me.

Mr Wiseman: So if these two young people from the Lively high school who were here, who smoke but want to quit, came around to your school and said they smoke but that they want to quit and why, and that they shouldn't start, that would have an impact?

Ms Gasparini: Yes, probably.

Mr Wiseman: Good luck.

The Vice-Chair: Thank you very much for your presentation. It was very helpful.



The Vice-Chair: The next presentation is from a representative of Dean's Pharmacy. Welcome.

Mr Sabih Uddin: Good thing the roads were great for coming from North Bay.

Mr O'Connor: I could have seen my grandmother if we did.

Mr Uddin: Mr Chairman, members of the standing committee on social development, it's my privilege to be here from North Bay to present my views in support of the Tobacco Control Act, Bill 119, and make suggestions for improvement of this bill.

My name is Sabih Uddin. I'm a community pharmacist. I have owned and operated an independent pharmacy in North Bay since 1974. I'm proud to say that I voluntarily never sold cigarettes in my pharmacy and I still have survived.

I am an active member of the Ontario Pharmacists' Association and the Canadian Pharmaceutical Association. I was a member of the council of the Ontario College of Pharmacists from district 14. I served on the council for about five years. I was a member of the council of the Ontario College of Pharmacists, which passed a resolution in 1990 to eliminate the sale of tobacco from pharmacies. So I've been involved with this issue for quite some time.

I would like to congratulate this government for acting responsibly by introducing Bill 119. I also applaud the opposition parties for their support of this bill.

There is no doubt or controversy that tobacco use is the most important public health problem in Ontario. It not only is directly responsible for about 13,000 deaths per year in Ontario but is also a major contributor in producing a number of diseases, including ill effects on the foetus of the parents who smoke, both mother and father. At this time I will not elaborate on the adverse effects of tobacco on the human body. I am sure members of this committee are all well aware of the health problems caused by tobacco use.

Tobacco is highly addictive and is also a lethal product. Ironically, most children start smoking between the ages of 12 and 14 years of age. Health and Welfare Canada surveys show that over 90% of young smokers started before the age of 17. I'm quite pleased with the provisions of Bill 119 which directly affect young people's ability to gain access to tobacco products, in particular the provisions which: tighten control on the sale to minors; raise the minimum age to 19 years for a person to buy tobacco products; reduce tobacco outlets for young and old alike by imposing a ban on vending machines; ban tobacco sales by health care professionals and establishments, especially pharmacies; impose tougher guidelines for packaging and restrict advertising of tobacco; prohibit smoking in designated places, including schools; and set mechanisms and penalties for non-compliance.

Bill 119 can be improved in several important ways.

The Tobacco Control Act should have a clear definition of a pharmacy. It should specify limitation of the signs at the point of a retail sale. It should also define school grounds and require a usage report from tobacco wholesalers and retailers, just to keep track of where the things are moving.

The term "pharmacy" is not well defined in Bill 119. Compounding this problem, the definition of the term "retail establishment" does not unambiguously and clearly prevent direct, exclusive access between pharmacies and areas devoted to tobacco sales. To resolve this problem, I propose the following definition of the term "pharmacy":

"Premises in or in part of which prescriptions are compounded and dispensed for the public or drugs are sold by retail, as well as all contiguous retail space, whether under common ownership or otherwise, within the premises and whether used for sale of health products or otherwise."

I feel a clear definition of pharmacy is extremely important. Only then will all pharmacies, large or small, in supermarkets or department stores be on the same level playing field.

I also feel that cigarette packs of less than 20 cigarettes should be banned, which has been previously mentioned. As I speak, they sell kiddie packs.

The time exemption for implementation of the pharmacy ban should be reduced. Had the government acted when the college passed the resolution in 1990, no pharmacy would be selling tobacco by now. The time has been given to all the pharmacies already.

Under section 15, a 12-month sale prohibition for a third or subsequent conviction should be specified.

Section 9 should be amended so as to prohibit smoking in all public places unless specifically exempted by the act or its regulations, and we need to ban spitting tobacco.

There are two other important issues which are not directly addressed in this bill but which need attention by the Legislature. The first and most urgent is the need for further controls on smoking in the workplace. The second is the issue of retailer licensing.

I would like to see licensed establishments which handle tobacco products, whether retailer, wholesaler or manufacturer, bear all the cost of implementation of this act. The fee for the licence should be specified and periodically revised to meet the increased cost of implementation.

I believe the incorporation of the above amendments into the Tobacco Control Act will create a world precedent. Passage of this bill will be in line with the government's commitment to preventive health care as a reality. Strong support for an amended bill will indicate to the Legislature that the political leadership of this province is serious in its desire to keep our young people away from tobacco industry products and ultimately have a smoke-free generation, which is the desire of all parties who are in support of this bill.

I also feel the elimination of tobacco sale from the pharmacy would not have an adverse effect on the economics of the pharmacies. It has been tried. I've never sold it. I know how it can be done. Many of the pharmacies have done it without a great deal of hardship.


Ms Murdock: We had a couple of presentations made in Toronto last week from pharmacists who claimed that the retail side of their business was going to be dramatically affected by taking cigarettes out of their sales. Our point is that if you're a health care professional, you can't be talking out of both sides of your mouth; you either are a health care professional and you don't serve noxious poisons to all and sundry who come in. I'll fight to the death on that one.

But your definition, at least as I'm reading it -- and maybe you didn't intend this; I don't know -- for example, in Sudbury here, K mart up at the Four Corners has cigarettes at the cashier as you go out. So under "all contiguous retail space," that would be affected. You said, "whether under common ownership or otherwise," which would also mean the mall hall. Am I correct in understanding that?

Mr Uddin: It wouldn't be contiguous as long as it was in the same framework of the store. If that particular store, K mart, decided to have a pharmacy, they have to meet certain standards of keeping the pharmacy. They can keep the tobacco outside, like a kiosk, not within the same premises of the four walls of the store. That would be my answer to that. And supermarkets have an option: They can sell tobacco, they can sell whatever they want, but if they want to sell tobacco and have a pharmacy, that's no good.

Ms Murdock: I agree.

Mr Jim Wilson: Given that Ms Murdock made the point that pharmacists can't talk out of both side of their mouth, using the same logic, can the government talk out of both sides of its mouth? It makes a huge profit out of tobacco, some $800 million a year, and Mr Laughren's made it very clear he does not want to give up the revenue. In his first week of discussions about lowering the tax, it was not health reasons he was citing. He can't afford to give up $800 million to $1 billion worth of revenue. So this is the first government in history to say, "Health professionals can't make money off tobacco, even if they are retailers, but we can, because we're the government and we have a monopoly on this sort of thing."

Ms Murdock: Because we're paying $17 billion in health care. That's why.

Mr Jim Wilson: Either you apply logic or you don't, in my view, and that's why no other government has singled out pharmacists, because we're more guilty than the pharmacists could ever possibly be. We didn't do that, because we apply logic.

Mr Uddin: I agree with you that there are two sides of the coin, that it is very difficult for the government to lose the control of the $800 million or so it collects in terms of the revenues. But as the honourable Sharon Murdock mentioned, there is a lot more money spent on treating those than the tax revenues they're responsible for.

I'm in favour of even higher taxes, but I can't seem to get anywhere. I think it should be such an expensive item. The people who smoke are the ones who should pay for it. On the other side of the health issue, those who smoke should have to pay an OHIP premium maybe 10 times higher, whatever it may be. If the government reduces the taxes: "I'm going to reduce $5 of tax. If you smoke, next time your OHIP bill is going to be so much more. I'm going to charge you more for the OHIP."

Mr Jim Wilson: That's a good idea. That's what private insurance companies do.

Mr Uddin: Private insurance companies do it. I think the government should look at it at this point. You're starting to hear talk about the federal government reducing the taxes because we are all wondering about smuggling and what not. "All right, fine, we'll reduce the tax by $5, $10," whatever it may be, "but if you smoke, we're going to have to charge you for your health bill." That's something to look at. Maybe I've strayed out of my main frame.

Ms Murdock: Do the pharmacies in the country you came from sell tobacco?

Mr Uddin: Some did, some did not. But I never sold it, and "voluntarily" was the word I used. When I bought that store, that store did sell tobacco. The very first thing I did is eliminate it, and in the space it was in I concentrated on other health products, diabetic and what not, and I had more people coming to me ultimately. Basically, if the pharmacists want to, they can concentrate on providing health services in other areas, not just the filling of the prescriptions alone. That's the way I feel.

The Vice-Chair: Thank you for the presentation and answering the questions we had.


Ms Claire McChesney: My name's Claire McChesney. I'm the chairperson for the Sudbury and District Council on Tobacco or Health. I make that distinction, because we feel those two words are mutually exclusive, that you can't have them both; you have one or the other. I would also like to introduce Marjorie Shaw, who's a registered nurse at the Northeastern Ontario Regional Cancer Centre and a colleague of mine.

You have some printed material before you. I have to preface my remarks with the fact that this has changed at least four times over the last 24 hours and I reserve the right to say it's my cheat sheet. That's really all it is.

I'd like to start by congratulating the NDP government particularly for resisting the stampede right now to lower the tax. That's the most catastrophic thing that could have happened to us in health care in relation to the tobacco question. I would like to change what I said following that, that I hoped the opposition parties would join the present government in supporting Bill 119, because it's obvious from what's going on here today that there certainly is support, because it is a non-partisan issue. Health, as far as I'm concerned --


Ms McChesney: No yelling across the table.

The Vice-Chair: Thank you. I need the help.

Mrs Cunningham: It's been one of those days. We got up early.

Ms McChesney: They tell me that travelling up north, the air is a little more rarefied.

In light of what has happened at the federal level, it makes the passage of this bill so important. I can't underscore that enough. Not only is it important that it be passed, but it's important that it be passed now, not five, six, seven, eight months down the road. We need it now because the floodgates are open. Whether we like it or not, they're there.

One of the reasons you haven't heard a whole lot about the whole issue of contraband, our feeling is, is that that's a red herring. The tobacco companies have done it beautifully. They're laughing all the way to the bank. You won't hear anything more from me on that subject.

Our objective, really, is that the whole thing is about kids. We've got to keep them from starting. You heard young people coming here today and telling you just that. How are we going to do that? There are a number of avenues we can take, not the least of which is plain packaging. The feds have said, "We're going to look at it." That's not good enough. You don't have time to look at it. Get off your duffs and do something and do something now. If you've got children, you know they don't buy generic jeans. Mine didn't, and I don't think any of yours do. That's a no-no; it's got to be the brand name. So put them in the plain brown wrapper. It's a help. Everything is a help.

Mr Wiseman: With dirty lungs on the front.

Ms McChesney: Exactly, the dirty lungs on the front. I like the idea of them being just plain white with a big black bordered thing that says, "Tobacco kills." It says it all very simply.

Ms Murdock: Hard to smuggle, too.

Ms McChesney: Yes. We have to be careful in our deliberations. As I mentioned before, don't get swung by the red herrings. Watch the loopholes, and there are loopholes. This is where I'm talking about it being a non-partisan issue. Don't get caught up in the loopholes; close them. The one that comes to mind most readily -- I think it's under 3.2 -- is where they're talking about selling or giving to persons under 19. The Liquor Control Act covers it very nicely. Don't reinvent the wheel. Just take that. It's there for you. Just follow the same logic. It covers it very nicely. We talk about the legislation. You're quite right when you say government is trying to do its part. It's about time, I'm glad you are, but I agree it is multifocal. It's not just government. Government plays, though, a very important part, there's no doubt about that. Our communities, with our municipal bylaws -- and we're extremely active in this community in relation to municipal bylaws -- have our role to play. I as an individual have a role to play as well. It's when you put all three of those in synchrony that you're going to get the results you want. But we've got to work together, we can't be pulling in two different directions. I agree we've all got a role to play. You do yours and, by God, I'll do mine. There's no doubt about that.

We could sit here and you could come up with the most fantastic Bill 119 that would even please me, but if nobody enforces it, we might as well all pack our bags and go home because it ain't worth the paper it's written on.

Just to prove a point to you, we had our little session at noon because, as a council, we decided before we started our presentation that we wanted to know what was happening right here in our community, because none of us smoked and you can really get out of it. So we counselled a 16-year-old to go into a Shoppers Drug Mart -- this was with parental consent, by the way -- to buy a pack of cigarettes. First try, boom, got his cigarettes and walked out. Now, this is not somebody who looked 18; he was 16. He's two years below age. Wasn't asked for ID, nothing: first crack. Somebody said, "Did you try anything more?" We didn't need to. That said it all.


To get back to the issue of the red herrings, forget the contraband. They don't need to get contraband cigarettes. They can get all they want in the local store, at the pharmacies, the gas bars, wherever. Contraband in terms of our youth really is not an issue.

Going back to enforcement, it's been proven in the States that you can educate till the cows come home, you can go to them and say, "This is bad for our children. Don't do it. You must be civic-minded" etc, and they will say, "Yes, yes, yes," and they will continue to sell to the minor. You need a sting operation and then you need somebody to walk in afterwards and say, "This is the first time. The second time, you lose your licence" or "You can't sell your products" for whatever length of time. That is far more difficult. I spoke to a retailer about that, and it's much more difficult for them to have their customers come in and have to say to them, "Sorry, I can't sell you cigarettes today because I broke the law and I'm not allowed to." Not only is that an embarrassment for them; the other thing that happens is that the customer who came in for cigarettes is going to go to the place across the way: "I can get my cigarettes. I can do the one-stop shopping." We have to enforce it. It's no good if you don't enforce it.

In terms of the pharmacies, because I'm in the health care field is why I feel so strongly about it. They can't say, "I'm a health care professional, but I'm going to continue to sell cigarettes." You get cigarettes at this end and you've got the nicotine patches under lock and key at the other. It just does not compute. We're sending the wrong message, and that's the difficulty I have with the pharmacies selling cigarettes. It has nothing to do with retailing, who's going to have a job and who isn't. I'm here to protect the kids, and that's the message you're sending them. We can't do that. We can't afford to do it.

I don't think it's any more correct for those cigarettes to be sold in that pharmacy than in a tuck shop in the hospital. I feel that very strongly. I happened to be a board member of the Sudbury General at the time, and believe me, that one was debated. That was at least eight or 10 years ago, and we debated that one till midnight and it won by one vote. So it was not easy.

This brings me to my closing remarks, and that's about addiction. We've discussed today that maybe we should penalize the youngsters who are caught smoking. I'm not taking issue with that, but the one thing we really didn't talk about was the real culprits: It's the tobacco industry, and the buggers are getting away with it. Who the heck is penalizing them? They're protected. They're protected every which way and back again. One of the things they have just done magnificently well is to conceal the fact of addiction. We know that nicotine is as addictive as heroin or cocaine, but you can walk out and speak to young people and they won't believe you. They will not believe you that it is that addictive, but we know in fact that it is.

It goes back to the issue of the pharmacists. They have controlled substances, codeine, morphine, and these come under very stringent federal regulation. They would have us believe, "We can keep that locked up in the dispensary, but I can display nicotine products, tobacco products," where everybody's going to have to see it because it's right behind the cash register. I have difficulty with that.

At this point, I'd like to introduce Marjorie so Marjorie can tell you what she's here about.

Ms Marjorie Shaw: I'm here because I am a smoker, a very confirmed smoker. As far as I'm concerned, that means I'm addicted to nicotine. I have certainly tried to stop smoking. I've used all the crutches out there that are available. I tried the Nicorette gum but it didn't work, probably because I don't like chewing gum. I tried a couple of the behaviour change programs that are available. One consisted of collecting all your old cigarette butts and saving them for an eternity. That's pretty disgusting even for a smoker, I can tell you, so that went out the window. The other one I tried, the behavioural changes were just so unnatural: One day you were eating dinner at 5 o'clock in the afternoon and another day you were eating it at 10 o'clock at night. It just turned your whole life upside down and was totally impossible.

The last time that I tried to quit was about a year ago. The patches were out at that time, and I thought, "Now, this may work." My family doctor agreed to write me a prescription for eight weeks of patches. I spent two solid weeks of about two or two and a half hours every evening planning my own personal behaviour changes so I would get out of this trap I was caught in, but behaviour changes that I felt were tailored to my life that I could live with and still carry on. I did the best on that program that I did on any I had tried, till I got down to about five cigarettes a day. I couldn't get it any lower. Those are five essential cigarettes; at least to me they are, at the moment.

I should know what smoking is all about and why I should stop smoking. If it all happened up here in your head, there'd be no problem. I'm a nurse. I work at the cancer clinic. I work primarily with palliative patients, patients who are dying with their disease. Daily I'm helping these patients and their families cope with the disease and with the dying process. Many, many of these patients were heavy smokers. I know that statistically cigarette smoking is a high-risk contributing factor to cancer. If it were just logic and knowledge and so-called intelligence, I should be able to quit.

So why don't I stop smoking? There are many reasons, and I'm very good at rationalizing; that's a very good defence mechanism which works well for me. Some are:

I started smoking when I was 16, so the damage is already done, it's too late. I don't have any major lung problems: I don't cough, I don't wheeze, I don't have frequent infections or anything like that, no signs of problems with it. I get lots of exercise outdoors. I live in this clear, rarefied air of Sudbury -- at least I do now; I didn't always. I walk a lot. I have a dog. We get lots of exercise together. I do cross-country skiing in the wintertime, gardening in the summertime.

I also can say to myself, "If I weren't smoking I could be doing other things, probably worse, to deal with the stresses in my life, so maybe smoking isn't so bad after all." And although many of the patients have smoked, regularly we see patients who have never smoked and are still dying with their cancer.

There are lots of contaminants I'm exposed to that I have absolutely no control over. I lived in the Golden Horseshoe for umpteen years. Now it's amazing when I drive down. I can see this pall of smoke and fog over it as I'm going down Highway 400. I think, "I used to live in that stuff."

Mr Wiseman: You just want to turn around, right?

Ms Shaw: Well, I don't do it any more often than I have to.

And I tell myself I might as well do something I enjoy, that I get some satisfaction from, so I smoke. But really the bottom line is that I don't quit because I can't, because I'm addicted to it, and nothing so far has come along in my life to say, "You must stop smoking."

I do console myself also with my accomplishments, and I have made a few; this all hasn't been totally in vain. I used to smoke Buckingham cigarettes.

Ms Murdock: Pretty strong.

Ms Shaw: I don't any more; they'd probably kill me now, actually. I'm down to the extra-light, so I've certainly reduced the nicotine by a fair amount. On bad days I do smoke 15 to 20 cigarettes, if I'm having a really stressful day or for some reason it's a heavy smoking day, but on good days, and I have many of those too, I smoke five, so it's a fluctuating number. But until something happens in my life that scares the hell out of me or really convinces me, I will never stop smoking. I'll smoke for the rest of my life. That's all I have to say.

Ms McChesney: On that note, I thank you all for allowing us to present to you.


Mr McGuinty: I just want to comment on your sting operation. I thought it was very resourceful on your part. One of the things I recognize since being elected in 1990 is the severe limitations of what government can do. I was very impressed by a gentleman who was here earlier with his daughter, telling what he's doing as a father and as a responsible member of a community.

This is just an idea, and you'd want to check with a lawyer first on this. The Ottawa Citizen once a year goes to a number of auto garages. There's a particular problem associated with a car and they know what it is. They take it to eight shops and get a price for the work that needs to be done, and then they print it. They tell people who the less-than-honest workers are and who the more honest ones are.

You may want to conduct your sting on a biannual basis, without telling people, of course, and you just keep everybody on their toes. That's a way you can assist and maintain the profile at a press conference, and all the retailers are out there on their toes.

Ms McChesney: That's not a bad idea.

Mrs Cunningham: I just wondered what you think about these fines. I found it appalling when you pointed out to us that there are fines now but nobody is enforcing the existing legislation. I suppose that's why some individuals have come before the committee and said: "They should be licensed. They'll lose their licence and can never sell them again." The fines are going up, but the enforcement might be the difficulty. There certainly would be less to enforce, wouldn't there, if you just took their licence away?

Second, others have said, and you might have said, "Put it in with the beer and the wine in the LCBO."

Ms McChesney: That's certainly one option: Grab a corner of the liquor store and put the cigarettes in. Why not?

Mrs Cunningham: Maybe that would be a deterrent for you. If you kept running into the liquor store every day, people wouldn't think you did such a good job. I don't mean that, you know.

It's going to take tough stuff. I think your point was, don't let them get started.

Ms Shaw: That's right. I started when I was 16. The answer is "Don't start," not "Stop." The answer is just not to start.

Mr Wiseman: I believe you are referring to what is called an emotionally significant event that will be necessary.

Ms Shaw: Am I? Okay.

Mr Wiseman: This hasn't been raised before,and I'll probably get shot by the ministry for even raising it. What if something was built into the legislation that would allow for a civil suit to be lodged against the seller of cigarettes if he's caught selling them in contravention of the law, that if somebody sold my daughter cigarettes and she was under the age, you as a group or I as a parent could take them to court and sue them for doing it?

Ms McChesney: I like the idea. The only difficulty with that is the cost involved. That is always a deterrent for people. When I was looking at what the feds have been doing, I swear if I had a young child -- mine are all grown up now -- I would seriously contemplate a class action against the government for recklessly endangering the health of my child.

Mr Wiseman: That's along the lines of what I'm thinking about. I know in the Environmental Bill of Rights we put into it that any two people can challenge the ministry, that if there's damage to the environment, there's an immediate move where you can go to sue and launch a civil action. This just occurred to me while you were making your presentation. If we don't have the resources in terms of being able to enforce by having police and everybody doing it, maybe we need to empower citizens to be able to do it themselves.

Ms McChesney: Anything we can do that will help in the area of enforcement, the sting operations, allowing people to launch suits, may well be a part of it.

The Vice-Chair: Thank you very much.



Dr David Webster: My name is Dr David Webster. I'm a nuclear medicine physician in the city. I did general practice for about seven or eight years before I came here, so I have had some personal experience in dealing with the tobacco issue.

I'd like to thank the committee, first of all, for allowing me to come here and do a presentation on behalf of Bill 119. This issue is very dear to my heart. I'm actually one of the people in the front line who has to deal with the casualties from this tobacco industry.

The most clear message I want to give here is that you've got our full support in introducing this bill, and I would encourage you not only to pass it but to strengthen it.

At the same time, I've got to be honest with you, I have a lot of anger and resentment inside me. You people have been aware of the very same information that we have over the past couple of decades. To say we could offer this up as an example of where politicians have reacted to a major public health concern -- it's not a very ideal model, particularly given the announcement yesterday from Mr Chrétien. He shamelessly sold the Liberals to the tobacco industry. He set philosophy back to the pre-Socratic level for the criminals; that is, might is clearly right currently in this country.

Our own local Diane Marleau I would like to call our new minister of disease. Where were her concerns? Not particularly with the health issues. She was concerned that "one of the members of the Canadian family," ie Quebec, was losing out on some profits. That was her major concern.

Mr Rae doesn't know me, but we've had some definite differences on philosophy. I'm a physician, after all. But I have the most profound respect for Mr Rae's stance on this issue. As Ontarians we can be very proud, if we cannot offer this up as a model, of him taking a very honourable stand for us.

To get back to the issue of Bill 119, this is a public health issue. The information is absolutely overwhelming in favour of not only passing this bill, but one could effectively argue to increase it. What I have trouble with is reconciling that with, for example, the NDP's response to, say, the asbestos industry. When the NDP was in opposition a number of years ago, you may recall that, over about a dozen or so worker deaths, these people were prepared to go to the wall on that. They shut the Legislature of Ontario down for probably 10 days. They played a pivotal role in shutting down the asbestos industry and removing the stuff from our offices and our public places. I'm having a little trouble reconciling that with this issue.

We as the public, I as the public, need an explanation about why, now that the NDP is in power, in spite of all the promises that were given to us -- the fact that this bill was even introduced is a bit of a miracle. If it hadn't been for rather profound and aggressive lobbying by the anti-tobacco groups and public humiliation of the government, we wouldn't be here talking today. We all know that in September the caucus officially recommended that this bill not be introduced, that it somehow wasn't important enough for their consideration.

Not important enough for their consideration? By their own figures, there is one death every 40 minutes. We know we've got several thousand kids per month getting addicted to this. This comes from a government, by the way, as it restructures health care, that keeps harping the line, "We're concerned about preventive health care." This is the single most important preventable health care issue in the province. To be kind, clearly people have been dragging their feet a bit. I, as just a plain, ordinary person on the street, would like to be able to reconcile that in my own mind.

Quite clearly, the issues of rights and freedom of choice do not hold water on this one. I don't have a choice to wear my seatbelt or put saccharine in my coffee or asbestos wallpaper on my room. Is there a person in this room who doesn't believe, a person in Canada who doesn't acknowledge, that the issue here is solely profit?

Don't get me wrong. If you knew me personally you'd realize that I'm all for free enterprise, but -- call me crazy -- I have a little problem with an industry and a tax-revenue base that is somehow based on the fact that it requires 2,000 or 3,000 kids per month to come into this market. Unfortunately, it results in one death every 40 minutes, not to mention the secondhand smoke effects, the disability, the chronic care hospitals, the effects on unborn foetuses and so on. I have a problem with that. I'm having trouble understanding why we're not seeing a more aggressive response if people are really, truly concerned about health issues.

I've heard these concerns from business, and they really are real. One of the concerns I heard raised was the paperwork because this now would become a regulated product. Can anybody possibly offer me an explanation? If there was ever an example of a product that required regulation about who could sell this stuff and who could buy it, surely this has got to be the granddaddy example of them all, but we're concerned about the paperwork.

I'll tell you about some real paperwork. As a physician, I have actually sat with patients who were dying from smoking-related illnesses, and after they die and the body is cooling, I have to go fill out some paperwork: their death certificate. There I sit pondering in my mind that here is this person who's part of this sacrifice on the altar in the name of profits. Their life is summed up to a cigarette.

The bottom-line argument to date has been that this at least has been a source of profit and we can put the profits to good use for social programs and so on. I'm hearing things about business wanting compensation. I couldn't agree more. The government has turned a blind eye to this issue for so long that you've created a whole mass of industries and stores for which a large part of their business actually depends on making profits off this stuff. They are really going to be in trouble. I think you owe it to them to come up with some sort of compensation package if what we hope happens: that tobacco usage and income and revenue profits go down.

I'm speaking now directly to politicians who oppose this, who are embarrassed by this, who wish this bill had never got here or would like to dilute it. I wish they could tell me how it is that the numbers, for example 13,000 deaths per year in the province, aren't enough to impress them. I would like to know from you people today just what kind of death figures, what kind of addiction figures would it take to move you to actually switch your arguments over clearly to the health side? Yes, work on compensating business, but nevertheless put your major efforts towards strengthening this bill and taking some definitive action here.

Moving to pharmacy, in the health profession, as you might appreciate, this is surely one of the most embarrassing issues for public health professionals that I can possibly think of. I cannot believe that intelligent people are actually willing to hide behind the "legally available product" argument. I would love to have been here when they were thinking about banning thalidomide to see whether these people would have been upset because they were going to remove one of their products.

These statements are totally devoid of any moral or ethical principle, and that's what it comes down to, quite clearly. The public needs to know that the issue of whether sales in pharmacies should be banned, which is so obvious, was actually brought forward by the College of Pharmacy, as I understand. They want this to be produced. It is the professional regulating body of the profession of pharmacy that wants to establish a principle, a code of ethics, which everybody else in the health care profession has to stand by.

Could we have a better example of a conflict of interest, of professional misconduct -- as used against physicians all the time -- of behaviour that is not in keeping with the honour of a health care profession? Yet we have people who will actually say: "We want to be able to sell out the front of our stores the leading cause of death in this country and we want to sell the products to treat it from the back of the store. At the same time, we want to be considered respected members of the health care community."

We keep hearing about education from the pharmacists. If you want to send a message loud and clear about just how deeply in the back pocket of the tobacco industry you are, go against the college on this one. The college is asking for the power to do this. Stand up against them and be willing to say, "We don't care. We've got profits at stake here, we've got bottom-line ledger figures at stake here."

What an incredible precedent. In the past, the members of the opposition, for example on asbestos, have been the ones who have been hounding the government to take some action and behave responsibly about the information it had available -- I remind you of ethyl carbonate contamination in wine a few years ago in South African wines -- demanding responsible behaviour and resignations. Now we see members of the opposition wanting to water down or eliminate a bill that -- with the health care issues on this one, the other ones combined don't even get on the same planet of scale of the implications of this. Quite clearly, this is just an embarrassment for the profession.

What I like to do here now, and what I would like you to take away most, is that we keep hearing these numbers bantered around glibly about deaths and about addiction and about the profit motive for all of this thing; this is what justifies this. By their own figures, it's one death every 40 minutes: Each one of those deaths represents a real person with a real name, with family and relatives.

This is a case example. When I was in practice there was a man in his early 50s. He spent his life building up a thriving business in the local community. His family is all grown up, they've got their education, they're bringing the grandkids over to see grandma and grandpa. This man comes in with a spot on his X-ray and a little bit of a cough. The man had inoperable lung cancer and eight months later he was dead. I was a family practitioner in a rural setting actually doing house calls, and I sat and shared some of the grief of that family as that man slowly died. You should have been there when he had the spread of cancer to his brain and was completely delirious and uncontrollable.

The point I want to make is that these are the real faces behind those numbers. These scenarios are being played out as we sit here and speak. This is blood money we're talking about that we're living off here. Am I being melodramatic? I don't think so.

I can give you a more personal example of my own father. My father was a faithful supporter of the profits of the tobacco industry and tax revenues for the government for many years until he developed -- sorry, I'm on a roll.

The Vice-Chair: I am listening to every word you're saying.

Dr Webster: He developed a cancer of his throat which wrapped around his carotid artery, that major artery supplying his brain. You remember in the horror movies, they slit their throat and these people bleed all over the place. He was told, and we as a family were told, that how we could expect he would die is that the cancer would erode through his carotid artery and he would simply bleed out his blood volume on the floor in front of us. You can imagine the terror of that man and our family sitting there trying to have polite conversation as he's dying, wondering if in the next moment he's going to erode through and simply bleed out in front of us. He didn't. He suffocated to death. It might be argued medically that he'd have been a lot better off to simply bleed out. It would have been a little traumatic for a while, but he would have died much quicker than he did.

The point I want to make is that you can sit around in all of your philosophical discussions and talk about balanced figures and profits and incomes and expenses, as we constantly hear about. This is what it translates to at the street level. That's what we deal with. That's what the families are dealing with. To borrow a term from The Sports Network, we've got real life, real drama here; real death, real human suffering.


I would like to close by saying -- I've probably gone over -- that we need to send a message to the kids of this province that governments are not impotent, like the federal Liberals, that we can actually take a stand on an issue which -- who could argue? -- is the most profound and important issue in public health that has confronted us in the last 40 or 50 years. You need to take strong measures to make sure, absolutely, that you keep this stuff out of the hands of kids. Give an unequivocal message to them. I know most of you politicians support that. I'm really aiming this at the people who do not.

We obviously need to make the point that this product is clearly different from any other consumer product we can possibly imagine. If that means putting the stuff in plain packages with strong warnings on it, yes, we may need to, as governments have in the past on issues of public health, infringe slightly on the freedom of expression and so on of various companies and businesses.

I haven't talked about secondhand smoke in the environment, but even the government here introduced workplace environment legislation. If the levels of pollution in an industry got as high as they do in any bingo hall in the city, the NDP government, the unions and so on, would have the power now to shut that place down. But somehow we see this going on every day around us.

We need to remove this poison from the pharmacies and get on with life here. This is an embarrassment.

You have a rare opportunity. I've obviously been carrying on in a bit of a tirade on this whole thing. You can see I have a lot of passion and anger about this, for lots of reasons. But I would like to do anything I could to encourage you. You've got the support of the health care community, that's for sure, to go with this, and I would encourage you to go even farther, particularly in light of what's happened. The Liberals have simply eliminated most of the gains that have been made by the health community of this country in one foul swoop, if that actually passes through.

You have a unique opportunity as politicians to stand up, like Mr Rae. How many people are going to stand up and rave about Diane Marleau's response on this issue? How many people will stand up and rave about how proud we can be of Mr Rae, that somebody has finally stood up against the juggernaut of the tobacco industry, been willing to accept its wrath and actually go forward on an issue of public health, clearly and finally give a message to society that we can deal with these issues, that we can move on?

I'll end there, and I will be happy to entertain any questions, if I can answer them.

The Vice-Chair: We're very short of time for questions, however.

Mr McGuinty: Dr Webster, thank you. You certainly didn't allow us time to dose off.

In fairness, we all have to assume some responsibility for this problem. I don't blame the tobacco industry. I blame us. We allow them to exist.

Dr Webster: We agree on that.

Mr McGuinty: But I want to focus on the medical profession for a minute. My perception as a layperson not overly acquainted with medical problems is that the greatest problem facing us in terms of medicine is AIDS.

Dr Webster: No, not at all.

Mr McGuinty: But that's the impression I get from medical people or what I read in the newspaper.

Dr Webster: Well, they're very selective in that. It's certainly far more dramatic, but if you look at the number of deaths per year of AIDS victims, they don't even get on the same charts. AIDS is a major issue because it also is preventable.

Mr McGuinty: I agree with you.

Dr Webster: Here's a figure: 45 times more deaths from tobacco than AIDS. You've probably heard that.

Mr McGuinty: We've heard that several times, and I agree with you completely.

Dr Webster: If we were duping you into believing those figures, you should have been there to point out to us that in fact we were wrong, because you had those numbers.

Mr McGuinty: Why doesn't the medical profession get together, whether it's the World Health Organization, the medical officers of health for Ontario, and declare, "This is an epidemic"?

Dr Webster: Lots of individuals have said that. In fact, in the Ottawa-Carleton area you may be aware that there's a group of physicians who make statements, who've tried to say that smokers themselves have responsibility on this issue. They want to be able to take smokers off the coronary bypass list, for example. Physicians have made statements as individuals.

Mr McGuinty: I support those doctors entirely, but my perception is that they really constitute -- not a renegade group, that's not the right word, but they just don't seem to fall within mainstream medicine.

Dr Webster: The problem at the moment is that physicians -- and I'm not trying to make apologies for them. I am doing my bit up here on their behalf, and to be quite honest, I'm a little ashamed that we're not seeing more response from them myself. But at the moment, as you might appreciate, there are a lot more issues on their plate. As these issues have been finally, for once, brought to the attention of the government and the media, there are a lot of other things doctors have on their mind.

I'm telling you, we're a little busy up here to try, for example in Sudbury, to have the time and make the effort it requires. I took the day off work. I'm the only nuclear medicine physician between the Sault and North Bay, and in fact the only qualified one up to Thunder Bay here. I took the day to sit and think about this and worry, and as you might imagine, I'm not used to speaking.

Mr McGuinty: Don't practise. You're already good.

The Vice-Chair: Thank you for a very stirring presentation. It's appreciated.

The parliamentary assistant would like to make a clarification.

Mr O'Connor: Mr McGuinty asked why the medical officers of health don't say something. In fact, the chief medical officer of health on page 2 of his report, which we all have, says: "Tobacco-related diseases are this province's number one public health problem. The cost in human lives and quality of life and health care dollars is colossal. The circumstances call for nothing less than thorough and relentless action by all Ontarians." The chief medical officer of health, and I think we'll probably hear from another medical officer of health today, has stated quite clearly that it is the major problem we face in the province.

Dr Webster: I would like to ask the politicians who have spoken against the measures in this bill, if we turn the clocks back just a little --

Mrs Cunningham: Nobody's speaking against it.

Dr Webster: Nobody here? Well, what about the pharmacies? Who's speaking on it?

The Vice-Chair: There are questions about it.

Dr Webster: We talk about educating the kids of this province. What do you think the message is to the kids of this province? We're talking about education here.

Mr Jim Wilson: I'll tell you what I think. We've gone to great lengths to ask kids. They think poison products are kept in pharmacies, and if you ask them, they say that cigarettes, if you're really worried about it, should go behind the counter. So if you try and apply some logic to this, it should go out of all retailers and into where all the other poisons are put in our society, behind the counter.

Dr Webster: But you argued against that. I would have to agree with that.

Mr Jim Wilson: No, I wouldn't argue against that. That's what I'm arguing.

Dr Webster: You're arguing that it should be taken out of the retailers --

Mrs Cunningham: We're saying they should be licensed.

Mr Jim Wilson: You can't pick on one retailer. It makes no logical sense to pick on one retailer.

The Vice-Chair: We have degenerated into a general discussion on this matter.

Mr Jim Wilson: When I was a kid, pharmacies were a place where poisons were kept. If you ask kids that now, they agree with that.

The Vice-Chair: If I, as Chair, had the opportunity, I would have asked you, "But why aren't you asking for a ban on tobacco for ever?" However, I'm the Chair, and I can't get into that.

Can somebody phone the airport and tell them the plane has to be held an extra hour? We can't make it.


The Vice-Chair: I'd love to stay in Sudbury tonight.



Ms Cathy Dashper: My name is Cathy Dashper, the pharmacy manager at the regional cancer centre here in Sudbury.

I strongly support Bill 119 and its aim to decrease smoking among young people as well as banning tobacco sales in pharmacies. My support stems from being a health care professional at the cancer centre as well as being a pharmacist concerned with the integrity of the profession of pharmacy.

At the cancer centre we see hundreds of patients every year diagnosed with cancer related to tobacco use. We know that tobacco use kills. It follows that cutting tobacco sales means savings lives. It's a start for tobacco sales to be banned in health care facilities. Ideally, this will lead to the restricted sale of tobacco by a controlled vendor, like the Liquor Control Board of Ontario. This ban should send a message to our young people that a package of cigarettes is a hazardous product, not to be considered another casual purchase like a candy bar in a pharmacy.

Unfortunately, our federal government has decided to decrease the price of cigarettes and thus make them more accessible to our young people. This is one more reason to support Bill 119 and to support the Ontario government's resistance to reduce the tax.

Speaking as a pharmacist, I have been encouraged by the Ontario College of Pharmacists' initiative in trying to remove tobacco from drugstores. It does not make sense for a health care profession to be selling the country's leading cause of preventable death. In 1989 OCP adopted a policy of disapproval of tobacco sales in pharmacies and asked for voluntary removal of tobacco from pharmacies. As this voluntary approach was discredited by Shoppers Drug Mart and other chains, the Ontario College of Pharmacists petitioned the government to legislate the separation of tobacco sales from the practise of pharmacy.

With the introduction of Bill 119, the Minister of Health is complying with the request of our college. When pharmacies such as Shoppers Drug Mart oppose our college's request for legislation it really undermines pharmacy as a self-regulating profession.

In summary, Bill 119 is a definite step in the right direction. It sends a clear message to the general public and particularly to young people. This message is that tobacco products are hazardous and not to be used casually. It also sends the message that pharmacy is a health care profession and the sale of tobacco is incompatible with a pharmacist's code of ethics.

Mr Wiseman: It's starting to bother me in the back of my mind, and I'd like to ask the researcher if somebody could comment on what we would have to do to this bill to give parents and to give groups the right to sue retailers or pharmacies that have sold cigarettes to minors, thus addicting them to this drug. If somebody could help me with that later on, at some other time, I'd appreciate that.

The Vice-Chair: Would you like to record it? We'll have it reported at a later date.

Mrs Cunningham: It's sad that we've got a law right now and it's not being enforced. I'm on your side.

Do you think if the liquor control board were in charge of the sale of cigarettes we wouldn't have to listen to this argument any more about who sells them? It gets to be a real problem and I think we have to take it beyond what the legislation says right now.

Ms Dashper: If it was sold in the liquor control board, it would decrease the use. The young people would know for sure that it was a hazardous product and not, as I said, a candy bar they can just go into a drugstore and pick up whenever they want, especially the kiddie packs they're selling. We think it's atrocious.

Mrs Cunningham: By the way, some of the examples that have been used today are not in legislation or in regulations, but we don't know what the regulations look like. It won't be difficult to put the list together; in fact, Mr Gardner already has done that as the researcher to the committee to let us know what positions are being taken by the public. They're under certain headings, and we'll be looking at them and offering amendments or recommendations to the government for their inclusion as part of the regulations.

I think you have come on rather strong, and I support you in this regard. It was in London just on Monday that we heard from a medical officer of health for the first time who said there should be some responsibility on the young person who of course is smoking underage. Of course some of the school representatives have told us what a difficult time they're going to have, and they've tried themselves over the years and need this kind of legislation to ban smoking of cigarettes from schools. We're going to strengthen it, hopefully -- the parliamentary assistant said we will -- to include school property. Now we've got these young people who will continue to smoke because they will be able still to get these cigarettes, in my view, if we don't strengthen the legislation. Would you fine them? What would you do as a penalty? If we're teaching responsibility in today's society, which I don't think we do enough of, what would you do?

Ms Dashper: That's a difficult question. I suppose if they're going against the law, they should be fined. The trouble is that these kids have barely enough money to buy this package of cigarettes. How are they going to pay the fine?

Mrs Cunningham: It's true. A lot of people have come before and said community service, so that's another alternative we're thinking about, that they would be required to do some hours of community service, which of course is a sanction the courts use sometimes for young people.

Ms Murdock: In the cancer care treatment centre.

Ms Dashper: Yes, to see all our patients.

Mrs Cunningham: Would you think about it? We would love to hear from you subsequently, because it is a question that has come up as a result of presentations. It's fine to tell legislators and governments to do things, but we like to get the support too, and when I ask a question like that, there are a lot of people who think and say, "Ah, not my kid" or "not the kid down the street" or something. I think it's time we take those kinds of stands.

Ms Dashper: They really have to be warned of the hazards, though. So many kids just think it's not going to happen to them, that cancer of the lung is something that happens to somebody else.

Mrs Cunningham: Public health officials in schools and teachers are telling us that they've been doing this kind of education for 30 years.

Ms Dashper: But the rate of smoking in women is increasing at an alarming rate.

Mrs Cunningham: It was amazing, wasn't it?

Mr O'Connor: Thank you for your presentation and for the strong points and the way you delivered them. We're trying to focus on the young people, and that's really where I want to try to focus a lot of my attention and energy, and I try to get into as many schools within my riding as I can to talk to young people about this. I just wondered, are schools brought into the regional cancer centre you're part of, or are there problems of confidentiality? Is that used as a tool to drive home the message to kids that it kills?

Ms Dashper: We've had our paediatric oncology nurse go into schools to talk about cancer. I don't think we've had school children into the centre. We've had them paint pictures for us about sun awareness week, that sort of thing, and different hazards within the community, but I don't think we've ever had children come in and I don't know that it would be appropriate to see the radiation. No, I don't think it would be appropriate.

Mr O'Connor: That's why I wondered, the confidentiality kind of problem.

Mrs Cunningham: Just for your information, at the risk of dating myself, in the 1950s in Toronto we went to Toronto General Hospital and saw pickled lungs of smokers. I'm sure you wouldn't call them that, but that's what we called them, and it wasn't offensive and it just taught you not to smoke.

The Vice-Chair: Would it ever.

Ms Dashper: I think there are many exhibits to that effect.

Mr Wiseman: I remember as a three-year-old going to that office.

The Vice-Chair: Thank you very much for your presentation. It aroused a great deal of interest.


Mr Michael Borkovich: Good afternoon, Mr Chairman, members of the committee. Thank you for the opportunity to be here today. My name is Michael Borkovich, and I'm the pharmacist-owner of the Shoppers Drug Mart in the Sudbury Super Mall on Lasalle Boulevard. With me today is Terry Bristow, the pharmacist-owner of the Shoppers Drug Mart on Long Lake Road in the Four Corners Plaza. Also with me is Enrico Berardi, a store accountant and part owner of the Nickel Centre Pharmacy in Garson. Nickel Centre Pharmacy happens to be an independent pharmacy.

First of all, let me say that we strongly support the intentions of Bill 119, to work towards making Ontario a smoke-free society. The controls you propose to curtail the sale of tobacco to minors are commendable. Anything that discourages people, especially young people, from smoking will help you achieve this goal.

However, we cannot support the pharmacy ban included in Bill 119, and we want to explain to you why we believe you should remove subsection 4(2) from the bill. There are three key messages we want to leave with you:

(1) The sale of tobacco should be the voluntary decision of the pharmacy owner, depending on their economic format, and not something that is determined by the government.

(2) Pharmacists are very diligent in ensuring that we do not sell tobacco to minors. If you take it out of pharmacies, you will essentially be making it easier for young people to buy tobacco from retailers who are less concerned.

(3) There will be no health care benefits from this legislation. Nothing will be achieved and no one will stop smoking as a result of the pharmacy ban.

I presently employ 40 people, 23 full-time and 17 part-time. Tobacco constitutes about 10% of my sales, so if I have to remove tobacco I will likely have to reduce my wage hours by an equivalent amount, which means I will have to cut back my staff by about four people. This will result in job losses. That does not take into account the impact this will have on additional sales that are generated when a tobacco purchaser comes into my store.

There is no other product I can add that will generate 10% of sales. Presently I sell tobacco, cosmetics, confectionery, over-the-counter goods, health and beauty aids. I sell these products because it is an economic decision. I am not endorsing the purchase of any of these products. I sell these products because my customers want to buy these products in my store. If other pharmacists decide not to sell tobacco, or any other product, that is certainly their right and their privilege to do so. But it should not be the decision of the government to tell me as a retailer what I can and what I cannot sell.

The profession of pharmacy is clearly split on this issue. Therefore, it should be left up to the individual whether to sell the tobacco. When I am in the dispensary, I am a pharmacist. I counsel patients, check drug profiles, call physicians and use my professional judgement in every prescription I fill. But when I leave the dispensary I am a retailer in a very competitive environment. I have to make sure I provide even better prices, better service, better selection to be a successful retailer. I am both a retailer and a pharmacist.


According to a new study by Coopers and Lybrand, over 2,700 full-time and part-time jobs in the province will be lost and from 120 to 140 pharmacies will close if they prohibit the sale of tobacco. In northern Ontario, this translates to 196 jobs that will be lost and 10 community pharmacies that will be closed. There definitely will be whole communities that will no longer have pharmacy service, especially in the north, as a result of this legislation.

Before I pass this on to my colleagues, I have to say that I cannot understand the logic that was used by the college and now by the Ministry of Health. I really cannot see how removing tobacco from pharmacies will have any impact on the amount that is smoked. There will be lots of retailers who will fill the void, both legal and illegal. In my mall alone there is an Inclination smoke shop, a K mart and an independent grocer, all of which sell tobacco. I do not believe that any smokers will stop smoking because they can't buy tobacco from my store, and in the end, the only impact will be on my staff, and it won't be a positive impact.

Mr Terry Bristow: Good afternoon, members of the committee. You'll have to excuse me; I'm just getting over the flu.

You have heard a number of presenters claim that pharmacies are the most responsible vendors of tobacco, and there have even been proposals that pharmacies should be the only place where you can buy tobacco.

Let me tell you about how I ensure that my employees never sell tobacco to minors. When I hire new employees they undergo a fairly lengthy orientation process. They must view a video about the sale of tobacco to minors which was produced by the Retail Council of Canada. Every new employee spends several hours working directly with a supervisor. The supervisor would demonstrate to the new employee how to ask for identification from tobacco purchasers if they suspect they are underage. Often this is quite forbidding for a new employee, but we have made it an accepted practice in our store and that makes it a lot easier for the novice employee.

We also have decals on our cash registers showing that tobacco will not be sold to anybody under the age of 18 as a constant reminder to our staff. Every new employee also reads and signs a declaration that they will never knowingly sell tobacco to minors and that it is grounds for dismissal if they do. Nobody is saying there will never be mistakes, but I can assure you that no other type of retailer is going to the same lengths as we are to curtail this activity.

The stated intent of this legislation is, and I quote from the Minister of Health, "Effective, far-reaching legislation that discourages people, and especially young people, from becoming addicted to a deadly habit." I can tell you that pharmacy is your friend in all this. We are the most responsible vendors of tobacco. We can assure you that all necessary steps are taken in a pharmacy environment so minors cannot buy tobacco. Without pharmacy, as Michael pointed out, the sales will very quickly shift to another type of retailer, and they may not be as diligent about the sale of tobacco to minors. How does a corner store operator train their staff? Do they use videos and sign declarations? Often there is only one sales clerk in the store at any given time, so how can they possibly ensure that their employees are never knowingly selling tobacco to minors? The same applies to gas bars. They rarely have more than one sales clerk at a time.

In my store I employ more than 50 people, and my pharmacy's open until 10 pm every day to offer extended-hour pharmacy service. Tobacco is only one of many categories that I sell in my store. In my case, tobacco makes up 10% of my sales. There is no doubt about it; I will have to reduce my wage expenses by a proportionate amount. I will have two choices: Either I cut staff or I cut my hours of operation, which means that my customers will not have a pharmacy service late at night. I urge you to reconsider this legislation so that I will not have to take either of these dramatic steps.

Mr Ricco Berardi: My name is Ricco. I and my brother co-own Nickel Centre Pharmacy, which is just on the way to the airport where you're going to catch your late plane.

I wish to thank you, first of all, for allowing us to make a presentation to hear what I have to say. What I have to say is unique to me. It's not unique to Shoppers or Pharma Plus or any other group; it's us.

As a family-owned business, I ask you, when you go back to Toronto or at the end of these presentations, to seriously consider exactly what's going to happen. The objectives of Bill 119, as I understand them, are first of all to decrease the amount of smoking, to decrease the number of smokers, and especially and above all, to reduce the chances that young people will start smoking. We are in complete agreement with that, but I'm not sure how the ban on the sale of tobacco in pharmacies is going to help achieve that. Pharmacies do not cause people to smoke, and that should be clear. We are also probably one of the most diligent in ensuring that those under 18 do not purchase tobacco.

In our pharmacy, we have cut back on the visibility of tobacco to the point where it occupies a small section behind the counter and is no more than three feet high. What was once cigarettes has now been replaced by Duracell batteries and Eveready batteries. We have noticed that our tobacco sales got slashed to just over half. We also noticed that sales of lottery tickets, for example, dropped. We also noticed that sales of some confectionery items dropped.

If you take away certain revenues from us, as a business person I have to tell you we're going to have to re-examine the expense side of the equation. The biggest expense is wages. I don't know what's going to happen. You might argue: "Well, replace them with something else." I don't think we're that atypical. Our lease, for example, restricts us to what we can sell. We can only devote a certain portion of our store to foodstuffs because there's a major food store and it has an exclusive. We can't rent or sell videos because there's a video store in the mall. You say, "Be creative." We've looked at all those options, and because of our circumstances they're not available. If you drop tobacco from ours, we don't have a product to replace it. That's a fact of life.

I seriously question the fairness of the law that prohibits us from selling a legal product when in our mall there are three other places where you can buy tobacco, the furthest being about 130 feet away. If you don't like the price you can go to the arenas and place your order for cigarettes and liquor. I guess I'm just confused. I'm not quite sure myself sometimes.

Our retail format is very different from the format of a medical centre pharmacy. We don't have 25 general physicians above us sending prescriptions our way, or have an elevator that happens to open to the door of a pharmacy. We're not a big community, and the front-shop items complement or allow the dispensary; the dispensary allows the front shop. They go hand in hand almost, but they do allow each other to exist.

Wal-Mart, for example, is coming to our town, and 80% of the Wal-Mart stores have pharmacies. We don't want a situation where some of these large retailers can simply fence off a new area or put a wall and have their own little door and circumvent both the spirit and the intent of the law, because then the field is not level.

It's just fairness. I just want you to understand where we're coming from. These others are going to have a competitive advantage over us, and it will impact upon us. This is the fourth year of a major recession, and every little bit helps. I don't know when it's going to turn around.

I want to also refer to a letter from a pharmacist who did voluntarily stop selling tobacco approximately four years ago. This letter was addressed to Mr Charles Beer.

The Vice-Chair: Mr Charles Beer is the Chair of the committee, who is absent today, so I have the privilege of filling in.

Mr Berardi: It was written by Luke Michaud. He and his dad own Health Care Pharmacy. This appeared in the Sudbury Star on February 3. The last paragraph reads: "Even though I am 100% in favour of Bill 119, I do believe the timing could not be at a worse time. Pharmacies have had to survive the recession on top of government cutbacks. I'm certain that some pharmacies will have to close if this bill becomes law." This is from a pharmacist who has voluntarily cut out tobacco. We've cut back on tobacco and we've noticed that there have been other repercussions.

In terms of the goals, yes, smoking is bad. I'm going to pass it back to Terry. I just wanted you to hear my side.


Mr Borkovich: In preparing for this presentation, I took a look at the list of presenters. There were 21 presenters listed on the agenda. Of these, 13 were from health care groups and social service agencies. I could guess quite easily the position these groups would take on the pharmacy ban. I'm sure they all wholeheartedly support the pharmacy ban.

With all due respect, these individuals who represent health care professionals are not retailers, nor do they understand the realities of retail. Unlike pharmacists, who are both retailers and professionals, they can easily embrace the symbolism of a pharmacy ban because it would have absolutely no consequences to them. They do not have to employ cashiers, stock clerks, receivers, merchandisers. They do not have to worry about the competitor who's next door.

As legislators, you must weigh benefits of a particular policy against the costs. If you do so in this case, you will clearly see that there will be nothing gained by the pharmacy ban but that the costs are substantial. Thank you very much for your attention.

Mr Jim Wilson: It's clear that a lot of health groups and physicians don't agree with your position opposing the ban on tobacco products. As Health critic for the Ontario PC Party for three years, I've watched the government's treatment of pharmacists. I don't think they like pharmacists very much. The government has hinged this section of the legislation on two things.

They have told us time and time again, "You have to decide whether you're a retailer or a pharmacist," and time and time again the pharmacists have said, "We're both." They've hinged it also on the college's position, its June 1991 request to the government indicating that it wanted a ban on tobacco products and indicating that you are a health care facility.

That's very interesting, because I sat on this committee on November 29 when that same college came forward and said: "When it comes to the issue of sexual abuse, for God's sake don't consider us a health facility from one end of the store to the other. We want to know from this committee and from you legislators when the patient-pharmacist relationship begins, and we don't think it begins at the front cashier where the cigarettes and chocolate bars are sold; it only begins when that customer talks to the pharmacist, becomes a patient under that act."

It was clear to me at that time that your same college was trying to tell me that it recognizes you're both a retailer and a pharmacist and wanted a clear definition of when that pharmacist-patient relationship began. They didn't want to be responsible for some clerk at the retail end of the store who might make a joke of an inappropriate sexual nature; they didn't want to be responsible for those actions.

Call me stupid, but at least call me consistent. I've always considered them both a pharmacist and a retailer. I got mixed messages from your own college, and I don't appreciate being put in this position. I've told them that.

Second, when the government negotiates with your profession for your ODB fee, the BAP plus 10%, it tells you, "We give you a monopoly on drugs at the back of the store; therefore, we expect you to make money at the retail end of your store and your retail end should subsidize your back end." Particularly with the expenditure control plan and the social contract, this government is talking out of both sides of its mouth when it comes to this legislation, saying, "You have to decide whether you're a health facility or a retailer," because in its own negotiations it tells you you're both and it counts on you being both. Now it's saying, "As a retailer, we want to single you out for health reasons and we've got the whole health community behind us."

I call it cheap politics. It's cheap politics because the tough decision is to move it out of retail totally and move it into the LCBO or Brewers Retail. They're not going to do that because all hell would break out with every Becker store and Mac's milk and everything in this province, so they've picked on you.

I'm being consistent. I'll go to my grave being consistent on this issue, and my party's been consistent. When people accuse us of being friends of Imasco and that, my immediate response is, thank God Shoppers Drug Mart has come around to the business principles the Ontario PC Party has always stood for. If we happen to be allies on this particular issue, fine, but it's not because of any special relationship with Imasco or Shoppers Drug Mart or anything else. In fact, I would ask where the hell all those companies have been over the last decade while my party's been --

Interjection: Floundering.

Mr Jim Wilson: -- rounding up debts and trying to get back into first place. Let's clear the air on this. Some of us have some principles and don't speak out of both sides of our mouths, behind closed doors in negotiations --

The Vice-Chair: The question, please.

Mr Jim Wilson: -- when it comes to Bill 100, and now you nail them in this thing. I'd like to hear your comments on all of that.

Mr Borkovich: Well, that was a 10-minute preamble. I agree pretty wholeheartedly with you. We are pharmacists, we are retailers. There are a lot of different kinds of pharmacies out there. There are medical clinic pharmacies, like Enrico just mentioned, which have four floors of doctors above them and no front store and don't need a front store.

We are not in a medical building; we are not in a medical clinic. We are out in the community and we are a community pharmacy. We have a front store. The front store is very important to our existence. The front store is one of the main reasons we're open until 10 every night and why we're open on Sundays and holidays, which a lot of these medical clinics are not. That's what I wanted to say.

Also, as to the college's decision to present this to the Legislature back in 1991, this was something the council members voted on -- there are 10 or 12 council members from the various parts of Ontario -- and there wasn't a lot of consultation back then with the grass-roots pharmacists.

If you took a survey, I think it's not overwhelmingly that all pharmacists want tobacco out. Those who are in medical clinics are sitting on the high moral ground. It's easy to say we're professionals. We are. But for those who are in retail and community with front stores that are open extended hours, open on Sundays and holidays, it's very important to us. By taking it out of pharmacies, I don't think it's going to decrease consumption. I think the downside is much more catastrophic than the upside of taking it out. We're looking at more job losses across Ontario, and I don't think there's any upside. I don't think anybody's going to quit because of taking it out of pharmacies.

The Vice-Chair: Thank you for your presentation.

Mr Wiseman: I wanted to ask a question, but you gave him all the time. He made a speech.

The Vice-Chair: He was the first on the list.


Ms Phyllis Palangio: I want to thank you all very much for the opportunity to address this committee. I've just come in from North Bay. It was rather a harrowing trip, so if I'm a little out of breath, that's why.

I'm going to represent five people here today; I'm wearing five different hats. I'm going to be as brief as I can introducing them all.

My name is Phyllis Palangio. The first person I am representing is the ex-consumer of the product we're talking about today. My history of addiction with nicotine falls directly into the parameters of most of the people who have been addicted in this province: Starting age around 17, 17 years' worth of addiction, one to two packages of cigarettes smoked per day, and a very difficult time quitting, five tries. I can still remember sitting downstairs at 2 o'clock in the morning blowing cigarette smoke up the chimney so my husband wouldn't know that my third attempt to quit had failed.

The second hat I am wearing today is that of a mother who has three teenage children. As infants, my children suffered from the usual effects of sidestream smoke including lung infections, back-to-back cases of bronchitis, ruptured eardrums. When we quit smoking at home, the children got well.

The third hat I'm wearing today is that of an RN. I have 25 years in the health care field. During that time I have helped people come to terms with the long-term effects of smoking, and I have witnessed their deaths from the terminal illnesses of cancer, lung disease and heart disease.


For the last two years, I have been the director of the Nipissing detoxification unit for drug and alcohol abuse. That has been a very enlightening experience, even after all those years in the health care field. Our mandate is to allow admission to 16 years of age and older for people who are currently intoxicated, in withdrawal or at risk of relapse from chemical abuse. We are seeing more and more 16- and 17-year-olds coming through our door, and every one of them has a cigarette hanging out of his or her mouth.

If you look at the alcoholics we treat in our unit today, more than 90% of them are also addicted to nicotine. Nicotine is a drug of entry into the drug world. It is also a transfer drug. We have a saying in our unit: "Sugar leads to caffeine." If you have something sweet, you think of a cup of coffee. "Caffeine leads to nicotine." You have a cup of coffee, you want a cigarette. "Nicotine leads to alcohol and other drugs."

We know from experience as well that the clients we're treating are dying from the effects of tobacco use. They're not dying, the majority of them, from the long-term effects of the alcohol or the other drugs they're using. We also know from experience that the effect of nicotine is the same on the body as if a person is using cocaine or heroin. Now, the effect is not as dramatic, you don't get the sudden upsurges and the sudden downhills, but you do get the same roller-coaster ride. The same pattern of addiction is there, and the issues associated with withdrawal are the same for nicotine as they are for alcohol, the same as they are for cocaine, the same as they are for heroin.

Nicotine is one of the most addictive drugs in the world, and if you ask someone who is in our unit for another addiction, what they would like to get off most, they will list nicotine. And they can't; they're still smoking.

Back in January and February 1992, we ran a residential smoking cessation project at the Nipissing centre. This project was a pilot project. We were only able to admit 49 clients. We did not advertise that we were having a smoking cessation program. We called the newspaper and told one reporter what we were doing. The story went local within a day, provincial within two days and national within three. Within three weeks we had 300 people applying for admission to that program and we had to turn down the majority of them.

Some of them were pregnant. We had calls from obstetricians begging us to take their clients. We had some clients who were being threatened with portable oxygen therapy if they did not get off the nicotine right away. We had people going for major surgery within a week.

We took the most serious cases. The success rate for that type of detoxification was over 98%, but because the program could not continue, they relapsed. There was no support group for them to go back to. If the program had continued, it may have been successful.

The average number of attempts to quit before they came to us was five. These people were seriously addicted and seriously in need of help. But one thing that was very evident from that trial we did is that the issue is not to get people off cigarettes. That's not where it's at. The issue is to prevent them from being on cigarettes in the first place.

The last hat I'm wearing today is that of the chairperson of the North Bay and District Council on Smoking and Health. I think everybody on that committee must be from Missouri, because we read all the statistics that were available provincially for smoking and we wanted to prove to ourselves that the North Bay area fell into the parameters that were being outlined for the province. So we got some money together and we conducted a major survey, and I think you may have an executive summary there.

This is the project we did. We surveyed 500 students in our community in grades 7 and 9. To our astonishment, we found that yes, we did fall into the provincial statistical average. It was to our horror as well. The average age of starts for students in our area is 12. The majority of cigarettes are being purchased through vending machines and retailers. It was a rather disappointing find, I must say, the results of this survey. Anyway, we'll go over some of those results in more detail later on.

But what I wanted to say today was that the council, as it stands, is an interagency council and also encompasses volunteers from the community. We're all on a volunteer basis, actually. Our goal is to achieve a tobacco-free community to protect the health of the community, to reduce tobacco use and to prevent tobacco use. To follow through on that goal, we have developed some resolutions at the end of our survey. I will read those later as we go through my report, but I'd like to make some specific comments on Bill 119.

Other than to say we are definitely as a council in support of what you are trying to do, this is definitely where it is at. Children consider themselves to be 10 feet tall and flameproof. They cannot understand the long-term implications of this addictive drug that they're getting involved with right now. Kids are going to experiment with drugs no matter how much you try to prevent it. They're going to try alcohol; they're going to try nicotine; they may try other drugs as well. But if they can't get it on a regular basis, the chances are they're not going to become heavily addicted before the age of 19. If you can keep them away from it that long, you can probably prevent them from becoming addicted for the rest of their lives. It's paramount. It's the only solution to this long-term problem. Thirteen thousand of our people are dying every year in Ontario, 38,000 in Canada. We have to stop it somewhere. This is the most cost-effective and the best way to do it.

We would like to see Bill 119 strengthened as well. I've outlined some sections on page 2.

Section 3, prohibiting the sale of tobacco to persons under 19: Provincial and local surveys confirm that smoking starts for youth concentrate in the 12-to-17-year range, with the average age in North Bay being 12. Pushing the legal age for tobacco consumption to 19 sends a clear message to our youth that tobacco ranks with alcohol as a substance which needs to be controlled, and that as a community we are taking responsibility to protect our youth from the adverse effects of this addictive drug. I can't stress enough the addiction portion of this drug.

Section 4, prohibiting the sale of tobacco in designated places such as hospitals and pharmacies: The voice in opposition to the banning of cigarette sales in pharmacies is strong. The voice of physicians, pharmacists and other health care professionals warning us of the danger of tobacco consumption is stronger. Pharmacies which no longer carry tobacco products are still in business, and their message to the public is clear: Tobacco kills and is not an appropriate sale item in a retail outlet associated with health and wellness. A clearer definition of the term "pharmacies" would prevent loophole selling in borderline situations where pharmacies are linked to adjacent areas selling tobacco such as those seen in malls.

Plain packaging, section 5: Plain packaging with bold black health warnings is a deterrent to cigarette sales to teens. The current colourful packaging with product logos is eye-catching to the young and often associated with endorsement by authority figures in a young person's life when parents, relatives, peers etc are seen using them. This is the tobacco industry's most powerful advertising technique. Regulations surrounding the packaging of tobacco should be specifically defined to stipulate generic white or yellow colour with bold black health warnings encompassing no less than 25% of the package surface area. In addition, kiddie packages of less than 20 cigarettes should be banned in an effort to keep this product out of the price range of most youth. It was only recently that I found out that one of my children was supplementing their allowance by buying cigarettes and selling them individually at school, $1 a cigarette. It's a real good way to make money.

Generic packaging with health warnings gives more credence to the serious risks associated with its use. The generic strategy's greatest impact would be on the youth not yet addicted, although some reduction in tobacco consumption by regular smokers in all age groups could be anticipated.

In addition, generic packaging identifies contraband cigarettes by sight, as cigarettes packaged for export would retain their original colour and logos. Kids don't want to be generic; kids want to be bright and different. Having this kind of packaging would definitely have an impact on tobacco sales.

Banning the sale of tobacco from vending machines: As I indicated in our youth survey, 21.4% of our youth are smoking regularly by grade 9, and 76% of those ranked vending machines as the easiest target for buying cigarettes. Although we support the federal government's Tobacco Sales to Young Persons Act, which would restrict the sale of tobacco to vending machines located in licensed establishments, we would prefer to see the provincial legislation, which is to ban cigarettes from vending machines entirely if possible.

We believe that all reports that are made available on the distribution of tobacco products should be available to the public.


Section 9, prohibition of smoking in certain places: The restriction of smoking in designated places such as secondary schools and financial institutions supports the public's demand for protection against environmental tobacco smoke but does not go far enough to define the parameters of the establishments listed. Schools, for example, should be defined as in the Ontario Education Act.

We, as adults, have a responsibility to create a healthy environment for our children. The tighter the controls imposed on the use of this drug in the areas where people congregate, the stronger the message about the negative consequences of smoking. Education itself just isn't going to do it with the youth. They have to be shown. They have to see an example. They have to know that it's not socially acceptable to smoke. If possible, we would prefer to see them having to go right off school property parameters. The existing legislation could have a big impact on the number of youth who are starting to smoke if it could be enforced. But, unfortunately, there does not appear to be any enforcement -- no money, no human power -- to enforce what is currently there. If possible, we would like to see the provincial government have some kind of plan which would ensure that enforcement of these new regulations will take place.

In conclusion, Canada is already a world leader in tobacco control legislation. Bill 119, with the amendments suggested here, will support the provincial government's commitment to preventive health care and take the lead in provincial legislation. We are definitely in support of the strong leadership role of the NDP government, and we appreciate and strongly support its stand on not reducing the provincial tax on cigarettes. I understand we are still holding firm on that, although two provinces have caved in already.

Ms Murdock: Alberta and BC?

Ms Palangio: There's four now? No, I knew Quebec did, and I heard New Brunswick this morning. I'm sure the reduction in tax will have the desired impact. It will probably be a non-violent way to a short-term solution, but the long-term effect will be devastating.

Mr Wiseman: I'd like to get this on the record. From your experience at the addiction centre, how soon does a young person become addicted to cigarettes and how frequently do they have to smoke in order to become addicted and at what level?

Ms Palangio: Some of the histories we have done indicate that as few as four cigarettes can create an occasional smoker, and the occasional smoker usually at that age will go on to become a regular smoker. It is the same pattern of addiction that you see with any other drug: It is used as a coping mechanism, used to get rid of the pain of social embarrassment or inadequacies the person may feel. Once it becomes successful in that capacity, the addiction starts to develop.

Mr Wiseman: So you're saying there has to be a psychological dependency at the same time as the smoking?

Ms Palangio: With all addictions there is some kind of psychological component involved as well.

Mr Wiseman: So for somebody just trying it for a lark, what would they have to do if they didn't have the psychological component?

Ms Palangio: If they were trying it for a lark, the chances are they would not become addicted, if it was a one-time deal and they didn't have a need to use it again: the social pressure or an internal need for it.

Mr Wiseman: So peer pressure is enough of a psychological impact?

Ms Palangio: Peer pressure can be enough to create the physical addiction. Once the physical addiction has taken hold, it's possible that person may have an easier time getting off cigarettes, but if the psychological component is there as well they will have a much more difficult time.

You have people who can quit an addiction immediately. My husband was like that. "Okay, I'm going to quit tomorrow." Bang, done. Me? It took me two and half years of smoking outside and cheating; like I said, smoking up the chimney. Two and a half years and I finally made it.

Mr Wiseman: That's interesting, because I've read a historical thing on veterans returning from South Vietnam. A lot of them had been doing crack and cocaine and marijuana in South Vietnam and some of them came back and off it just like that --

Ms Palangio: Because the psychological need was gone.

Mr Wiseman: -- and others just were trapped. That's interesting to know.

Ms Palangio: But the ones we're seeing at the detox are basically the hard-core smokers who are going to have a very difficult time getting off. They are not the majority of the population of smokers, but they're out there.

The Vice-Chair: Thank you for your presentation. We're pleased to have it.


The Vice-Chair: The next presentation is from the North Bay and District Health Unit. Is Dr Catherine Whiting in the house? Welcome. We used to travel together.

Dr Catherine Whiting: Thank you, Ron. I see other familiar faces and some new faces, and certainly a lot of interesting, differing views around the table so I welcome some interesting questions at the end of my presentation.

I recognize too that you've had a long day. I understand I'm second-last on the list and I will try not to put you into slumber, because I don't think this is an issue we should go to sleep about.

The board of health of the North Bay and District Health Unit has a community mandate, as do other health units across the province, to protect and promote the health of its residents. One of the goals of the mandatory health programs and services guidelines is to improve the health of the population by eliminating tobacco use, so I take up Ron's challenge about suggesting that our goal, and this is just the first step, is to actually look at the banning of tobacco.

A three-pronged approach including prevention, protection and cessation is being used to achieve this goal. We must work together to increase the number of the population who have never smoked. In that instance, we're referring to our youth. If they don't start when they're young, the chances are they will not take up smoking when they're older. We must protect the majority of our population who choose not to smoke from the negative health effects of environmental tobacco smoke.

As a mother, my children do not smoke, and hopefully will not smoke if we continue to create an environment that allows them to make that healthy choice. I would be extremely upset as a parent, having given my children the opportunity to live in an environment that is smoke-free, at least at home, to have them exposed in their young life and in their future life to cigarette smoke in other environments.

We must help those who choose to smoke, because the medical interventions for smoking-related illness are either totally ineffective or they're too late.

The board of health for the North Bay and District Health Unit congratulates the government on the introduction of this legislation. This legislation is introduced to reduce the number of young people who become addicted to tobacco and to protect both non-smokers and smokers from environmental tobacco smoke.

I'm going to hold up this report, because we have been trying to get this message across. People just choose not to listen.

As Ontario's chief medical officer of health stated in his Tobacco and Your Health report, reinforced it in his adolescent youth report and reinforced it again in his heart health report, tobacco use is the most important health problem in Ontario and, surprise, surprise, it's the most important health problem in North Bay and district and it's probably the most important health problem in Sudbury.

As the medical officer of health for the board of health for North Bay and district, I'm particularly concerned about the impact of smoking in my area. Nipissing district is lagging behind the province and so is the rest of northern Ontario, particularly in the fight against tobacco. There are fewer non-smokers in Nipissing district compared to Ontario, and I've put the numbers in the report. Correspondingly, Nipissing district therefore has more adult smokers than the province. We have smoking-related standardized morbidity rates and standardized mortality rates that are significantly higher than the province. As a medical officer of health who wants to improve the health of my community, this is not good news.

So what will help us achieve our goal? When I say "us", it's not just people in North Bay; we need the whole province. In fact, I'm sorry to say we need the support of the whole country, but I think we're losing that. What will help us achieve our goal to eliminate tobacco use? Legislation is an important part of a comprehensive strategy. We all know that knowledge does not lead, by itself, to a change in attitude or behaviour. It doesn't matter how many times you take the young person to show them the picture of the lung; it will not necessarily change their attitude about smoking or wanting to experiment and it may not change their behaviour. So legislation is important.


What's another part of the comprehensive strategy? Enforcement of that legislation. What's the point in having legislation if you're not going to do something about it? It's like municipalities having property standards bylaws and not enforcing them. Sorry, I won't get off on another issue.

We need a multipronged approach to ensure success of this legislation. It's an excellent piece of legislation but it doesn't go far enough.

The board of health of North Bay and District Health Unit is very pleased with several provisions in Bill 119. In particular, we're extremely pleased, the whole board, about tightening the controls on the sales to minors. Why? The majority of people who start smoking start as teenagers. Do you know, if you ask teenagers what they think, they're in a state of denial. Our teenagers are not only invincible; they're infertile, they're immune and they're immortal. How are you going to change that attitude, ladies and gentlemen? With knowledge, with information. We need to have a comprehensive, multipronged approach to this issue. I know this, because I talk to my daughter who is almost a teenager and all of this stuff comes out. If we remember back when we were teenagers, sometimes it still carries on as adults.

The city of North Bay in 1993 -- you already heard about this survey we did, but it's an important piece of information and I want to reinforce it. Our local council on tobacco and health did a survey of grade 7 and 9 students which revealed that 16.3% of our youth reported smoking regularly or occasionally. More importantly, this number of regular or occasional smokers doubled from grade 7 to grade 9. This is just the tip of the iceberg, because as the teens get older the rate of smoking increases with age.

How can we help our youth? And it's our responsibility; we're not going to blame the victim here. How can we help control access to tobacco for our youth? We can do that by tightening up on tobacco retailer licensing. It's very important. Again, the city of North Bay survey by our council on tobacco and health showed that 86.1% of underage smokers found it easy to obtain cigarettes; 48.8% said stores or retailers and gas stations were very easy sources. Another interesting piece of information is that another easy source is that the parents who smoke give cigarettes to their kids who smoke, so we can't forget about the adults in this situation either.

Measures in the act are good, but they don't go far enough to tighten controls on sales to minors. We need to give our youth a clear, consistent message. We try to teach our youth about decision-making tools. Part of that decision-making tool is that they have to have clear, consistent messages and information given to them. We're not doing that as a society, just the fact that we allow cigarettes to be sold in pharmacies. We need to move towards handling tobacco like other restricted and addictive substances. This is a legally addicting drug; it's not M&Ms.

LLBOs and beer stores handle alcohol, our other legally restricted drug. Why not require tobacco to be sold in these same restrictive, controlled settings? Why not give our youth and our adults a clear, consistent message.

Banning cigarettes from vending machines makes sense. No other product that is illegal for minors to purchase is sold through unsupervised vending machines. Again, our survey showed that 18.7% of smokers reported their source as vending machines often, and a further 10.6% reported using them sometimes, and the ones who used them to have cigarettes sometimes go on to be the ones who have them regularly.

Plain packaging would be less attractive to young people, and this has been shown in studies. A recent Canadian Cancer Society study found that more than two thirds of young people 12 to 15 years said fewer youth would smoke if cigarettes were sold in plain packages.

Another item in Bill 119 that would help deal with access by youth is prohibiting smoking in designated places, including schools and strengthening non-compliance penalties. We were moving forward in our area with banning cigarettes from school property. We have recently had one of our high schools decide they want to change their mind and allow kids to smoke on school property. Please ban smoking from school property. We need this legislation.

These measures will help decrease exposure to environmental tobacco smoke, a known human carcinogen, for both non-smokers and smokers. Sometimes we forget about that. We want to say: "Oh, these smokers, let's stick them all up in a room and make them pay for their health care. Let's just get really angry at them." Well, listen, guys, this is an addictive substance, and we as a society have not done a great job on keeping people away from this addictive substance or giving them a clear message. It was in fact for a long time a very cool thing to do and rather sexy for women too to have a cigarette hanging out of their mouth.

Ontario's Smoking in the Workplace Act of 1990 offers no protection to an employee from an employer who wishes to allow smoking in the workplace. The Ontario tobacco strategy has a goal to eliminate environmental tobacco smoke from all public places and workplaces by 1995. To achieve this goal, the Tobacco Control Act must prohibit smoking in workplaces and public places.

Another good measure which I've alluded to is banning cigarette sales by licensed health care professionals and by putting provincial health warnings on the packaging. I'm not so sure that's going to help our youth because they think they're invincible and immune and immortal. I'm not sure putting the health warning on will help them, but it might help adults who might think, as they get older, that maybe they're not immortal.

We must act now to protect our youth and prevent unnecessary deaths. Believe me, we have more restrictions on alcohol, which causes half the number of deaths in our province, than tobacco. We especially need to move quickly. This government is to be congratulated on this very progressive piece of legislation.

As Canadians, we tend to be unaccepting of what we do well, what we can be noted for. I hope that Ontarians will not follow suit. Ontario has a progressive piece of legislation here to help improve the health of Ontarians. Let's not be traditional Canadians and not carry this forward and cave in to people and lobby groups that don't want us to be particularly forward-thinking and truly have healthy public policy for our people. Of course I'm referring to the recent events around lowering the federal tax on tobacco.

I won't take any more of your time with my formal presentation. There is more in the longer version for you to peruse at your leisure, if you have any spare time, but I will take any questions.

Mr McGuinty: Dr Whiting, thank you very much. There's something that's happening at this time -- it's funny how the thinking is evolving, in terms of the general population, about smoking. It's achieved such a level now, it's become so prominent in the media that there may be an opportunity here for this government that it doesn't sense yet and that may not have existed before: that is, to move even further than Bill 119 provides for. It may very well be that our general public feels, probably as a reaction to what has happened at the federal level, we have to so something dramatic to counter that.


It seems to me that a couple of ways the government should be seriously considering to tighten this up is that instead of getting into this issue with the pharmacies, which is just nibbling away at the problem, it should be considering putting tobacco in the equivalent of an LCBO. They should be seriously considering fining kids, as we do with alcohol. We restrict its sale and we send a message to kids, so I can tell my 12-year-old: "It's against the law. We feel, as a society, it's so important to protect you from this that it's against the law."

Dr Whiting -- as a medical officer of health, I know you'll be concerned about this -- right now, two 14-year-olds can sit side by side on a curb, one drinking and one smoking. Which one is subject to arrest if a police officer comes by? Which one has to hide? Who has to be furtive? And which one causes the greater health problems? We're talking about mixed messages here. Those are two ways we could seriously beef up Bill 119.

Dr Whiting: The only concern I would have is that we don't just put in blaming-the-victim pieces of prohibitive legislation, that we also move ahead, accepting our responsibility for this problem and not just blame the youth.

Mr McGuinty: No. It has to be comprehensive.

Dr Whiting: To a 12-year-old who has been given access to messages on television, messages in books that it's okay for adults to smoke, seeing that they're lowering the price of them now, "It mustn't be too bad." We're giving them all these messages. Then they get started on something that's addictive. We have to recognize that this is an addictive drug, just like alcohol. With alcohol, when a youth drinks, gets behind the wheel of a car and harms -- both of these drugs have primary and secondary effects, primary effects on the person and secondary effects on others. We need to have a balanced approach to what we do about that. Drinking and driving, yes: If that youth were behind the wheel of a car and drinking, the Young Offenders Act would take over, I believe.

It might be worth looking at something like that, but then you have to decide, at what age is a youth making a truly informed decision about getting hooked on a drug that we're promoting as a society in various ways, and that the tobacco lobby and big tobacco companies are promoting? We're giving such contradictory messages. We do the same thing with alcohol. would hope the next piece of legislation that comes down is something that even looks further at our next big problem, which is alcohol, but let's tackle cigarettes first.

The Vice-Chair: Thank you for your presentation.


The Vice-Chair: The next presentation is from the Allergy/Asthma Information Association, Sudbury branch, Ms Gregoris. Welcome to the committee.

Ms Barbara Gregoris: I should be welcoming you guys.

The Vice-Chair: You mean to Sudbury? It is warmer up here.

Mr O'Connor: Sharon arranged that for us.

Ms Gregoris: So you brought the warm weather up.

Mr O'Connor: What happened to your snow? There's more in Toronto.

Ms Gregoris: Really? I haven't been down that way in over a month. There's plenty up here for us.

I won't be following the copy of the draft. That's come out of our national office. I present my own bit to offer to you guys. If I get a bit wheezy throughout this, excuse me. I was exposed to smoke twice today and there are still lingering effects. I'm Barbara Gregoris, a member of, and presenting on behalf of, the Allergy/Asthma Information Association.

Bill 119 possesses good qualities. Both the government and the opposition are to be commended for their effort to protect the health of Canadians. However, AAIA, which is the Allergy/Asthma Information Association, believes that the issue of exposure to environmental tobacco smoke has not been thoroughly addressed.

These are the facts: Tobacco smoke kills approximately 40,000 Canadians yearly. Tobacco smoke is a very severe irritant and as such will cause bronchial constriction of the lungs. Therefore, everyone will experience a degree of chest tightness, and those who suffer allergic diseases like asthma or rhinitis are most severely affected. Secondhand smoke exposure is responsible for an estimated 15,000 to 30,000 infections annually in children under the age of two. One in six Canadians suffers from respiratory allergic conditions like asthma or rhinitis. Over 80% of asthma develops prior to a child's third birthday. Secondhand exposure to cigarette smoke is an extremely common trigger of asthma regardless of age, and half a million asthmatic children are made sicker by exposure to tobacco smoke.

Just as a personal perspective for me, I became involved with the association and became interested in this bill because both myself and my 23-month-old son are asthmatics. He's been recently diagnosed, as of September. My husband and I and my son all react adversely to smoke. As a result, before the city of Sudbury placed a smoke-free order on all public places, my family and I would avoid places like shopping malls, restaurants and community events.

Sudbury has a number of great community events throughout the year, but we would have to avoid these places because of the effects on my family's health and on my own health, not only because of the adverse reaction to smoke and our health but out of concern for our young son's safety and wellbeing. For an infant in a stroller or a toddler learning to walk or run, as I'm sure everyone's well familiar with, cigarettes dangling from a smoker's hand pose too great a risk of an accidental burn to his face. When my son was a newborn, and it was the coldest summer in history around here I think, I was on maternity leave. On two occasions I went into the mall with the stroller. He would be sleeping in the stroller; I'd be moving along. Twice cigarette ashes were accidentally dropped on to where he was sleeping, on to his cover. After those incidents, it just wasn't worth the risk.

It was something I wasn't even aware of until it happened. I guess you don't think at that height level until you have little ones you're concerned about. As a result of that, we've since moved from a stroller to a large backpack. Whenever we go into public situations, even outdoor events, my husband will carry our son on his back where he's well out of the reach of any cigarettes.

For example, just to expand some more on how tobacco smoke affects our lives, when exposed to smoke I begin to wheeze and I lose my voice quite quickly. As a case worker I rely on my voice to communicate to my clients. If I don't have a voice, I don't communicate so hot. My husband's eyes begin to run so badly he cannot see clearly enough to drive, and his sinuses become stuffed up. My son's asthma begins to flare up. Usually we have a three-day bout afterwards trying to just bring things down again. It's not that we want to avoid shopping malls, it's not that we want to avoid restaurants or especially community events -- some of the community events around here are great -- but the cost to our family has been too great.


Presently, municipalities designate smoke-free areas, but there's no consistency between municipalities on common smoke-free areas. There may be a smoke-free area in one municipality, but in another municipality that same area would be an area where smoking is allowed. AAIA was instrumental in bringing about legislation regarding ingredient listing on food products. Because of that legislation, Canadians know what they are eating. Likewise, we have the right to know whether there will be secondhand smoke before we go, and not when we arrive at a building or at an event.

People have the right to choose the air they breathe, just as they have the right to choose the products they eat. Consistency in smoking regulations would give us the knowledge to make a choice. Adults can make a conscious decision about whether they will be in an area which has smoking. That's a choice they would be able to make.

Children have limited ability to make those decisions. Kids, regardless of age, don't understand that in this spot, in this town, there's smoking, that if we go for a sporting event or a social event we wouldn't be able to go to that same type of area, be it a hockey arena, a sports facility, a shopping mall. How do you explain that to a child of five, that "We're going to have to pass on that this time around"?

We need to ensure that there are smoke-free areas for our children, and that's the main reason I'm here. I hope to have the option, as my son grows older, of teaching him, "These are the places you can go and you know you won't have to worry about smoke" or "If you go into these types of buildings, these are the areas you're going to have to avoid. But these are the choices of what you can do as a compromise."

To strengthen Bill 119, the association would favour a smoking ban in all public places. This way, it would give people the right to choose.

We would also call for further controls on the issue of smoking in the workplace through amendments to the Smoking in the Workplace Act. There have been several incidents reported to AAIA which indicate that the support to ban smoking at work is becoming more lax.

In conclusion, proactive legislation can save future health care dollars by preventing and minimizing respiratory diseases in all ages. Proactive legislation would also reduce the burden of workers' sick time, school absenteeism and the financial burden of medication costs which families bear. It is hoped that a proactive stand will be taken with the passing of Bill 119, a stand which will protect our children and the rights of those with respiratory allergies to be symptom-free and to prevent the development of the life-threatening chronic disease of asthma. AAIA would request the guarantee of a smoke-free environment in all public places.

Ms Murdock: Earlier this afternoon, I think it was someone from Cochrane who made a presentation about having it municipally administered, because every municipality is different. The parliamentary assistant reminded me that under the existing legislation the municipalities have the right to do that right now, if they wish, but your point that it's different everywhere is being made very effectively.

I read somewhere in the full draft you presented, "smoking in public places...unless there is some specific reason for an exemption," but basically, your whole presentation is that there shouldn't be really any exemptions. What kind of exemption would you be suggesting?

Ms Gregoris: With regard to exemptions, that would be a compromise, in essence, of a number of places having a smoking area where the ventilation is to the outside area, an area that is separate. Cambrian College here in town would be an example. Their smoking area is a building set way back, vented to the outside, so it's not circulated within.

Ms Murdock: So it's not exemptions per se under the legislation, but construction exemptions. Cambrian has that building, but if Timmins didn't have the same kind of facility, it would not get an exemption. That's what you're saying.

Ms Gregoris: The concern with a lot of the buildings that have the closed-in -- Civic Square is a good example. Civic Square is where our municipal hall and provincial buildings are.

Mr Wiseman: Do they recycle the air?

Ms Gregoris: Yes.

Mr Wiseman: So what you're saying is where they recycle the air there should be no smoking.

Ms Gregoris: Yes, because you can't separate that air. Civic Square is a non-smoking building, but there is smoking in the restaurant. There are two restaurants within the complex, and there is smoking there. Eventually, that smoking filters out into the rest of the common area.

Mrs Cunningham: I admire people like you who get involved and try to change things. In terms of the legislation we're talking about today, with regard to preventing the provision of tobacco to young persons and regulating its sale and use by others, we've got all kinds of good information and recommendations to strengthen it. But the legislation you're concerned about is the labour legislation with regard to workplace smoking. I think one of the recommendations of this committee to the government ought to be that this ought to be looked at.

I sat through the hearings and heard from medical officers of health, lung associations, people like yourself who got involved in your community. There wasn't anybody who said the 25% unventilated area would work. We've had it in place now for what, four years? Something like that. Maybe five?

Mr O'Connor: A little bit longer.

Mrs Cunningham: Whatever. I wasn't the government. The point is that it's got to be changed, and I think a simple way of changing this is just to say, "No smoking in public places." The public is fed up with sitting beside people who smoke, and I think most smokers are now embarrassed. I really believe there's been a difference in the last five or six years and it's time to bring that one to the forefront. Sharon, you could do that. We've heard it here in your constituency. You probably agree with me.

Ms Murdock: Oh, yes, I do.

Mrs Cunningham: We've heard it a number of times today, we heard it a number of times in London, and I know the rest of the committee members have heard it all over the province. It's time to bring it back. It goes hand in hand with this one, and that would certainly be one of our recommendations.

Ms Murdock: That's my ministry.

Mrs Cunningham: Sharon's ministry. There you go, we're all set.

The Vice-Chair: Thank you for your presentation. We appreciate it.

Ms Murdock: Before everyone leaves my lovely riding of Sudbury, I want to thank everyone for coming. It's unfortunate, when we sit on committee, that you never get the chance to see it.

The Vice-Chair: Let's face it, we may have further discussion and stay overnight.

Ms Murdock: That's true, if something happens at the airport.

Ms Gregoris: Which is easy enough.

Mr Wiseman: I would like them to invite us back in the summertime so I can enjoy paddling just over the hill here at the canoe club where I used to paddle.

Ms Murdock: In a downtown lake that is non-polluted, I might add. I'm very proud of my riding and I'm very happy that all of you have been able to at least appreciate it through the windows. Thank you. Thanks to the staff too.

The Vice-Chair: This concludes the hearings on Bill 119, An Act to prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others for today.

Mr McGuinty has a question for the committee, apparently.

Mr McGuinty: Just a question to the parliamentary assistant or counsel, to clarify something. Would this have application on reserves?

Mr O'Connor: In the legislation, you'll note that there are exemption provisions for cultural use. That's how it would apply.

Mr McGuinty: But apart from that, it would apply fully on the reserves?

Mr Jim Wilson: So all that applies to retail outlets on reserves.

Mr O'Connor: As far as I know at this point, yes. We could stand to be corrected.

The Vice-Chair: That question will be pursued and a response rendered as soon as humanly possible. The committee is adjourned.

The committee adjourned at 1711.