Tuesday 8 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

Halton regional health department

Sandra Murphy, public health nurse

Kian Higgins, high school student

Jenny Kang, high school student

Daryll Gordon, high school student

Annie Stokan, high school student

Bobbi MacNeil, high school student

Katherine Verge, high school student

Halton Council on Smoking and Health

Joyce See, chairperson

Edith Telford, volunteer

James Gay

Simcoe-Matic Canteen Ltd

Jim Dykes, owner and president

Cathy Jaynes; Salem Khamis

Canadian Cancer Society, Ontario Georgian Lakelands region

Gretta Gill, president

Ontario Federation of Home and School Associations

Norma McGuire, immediate past president

Ruth Woodcock, first executive vice-president

Peterborough County-City Health Unit

Christine Finlan, health promoter, tobacco use prevention program

Leslie Braden

Canadian Cancer Society, Ontario central west region

Bonnie Hauser, chair, health promotion

Howard Lackie

Meri Bukowskyj

Council for a Tobacco-Free Ontario

Alwyn Robertson, executive director

Dr Michael Goodyear, vice-president, public affairs

George Phillips

Haliburton, Kawartha, Pine Ridge District Health Unit

Bill Wensley, board vice-chair

Psychiatric Patient Advocate Office

David Giuffrida, acting director

Duff Waring, systemic policy adviser and acting legal counsel

Kohl and Frisch Ltd

Ronald Frisch, chief executive officer

Jane Chamberlin

Simcoe County District Health Unit

Dr David Butler-Jones, medical officer of health

Cathryn Rees, public health, healthy child and adolescent program

Shelly Howe, high school student

Simcoe County Interagency Council on Smoking and Health

Shawn Fendley, member

Vito Chiefari, member

Mark Borutskie


*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:

Haslam, Karen (Perth ND) for Ms Carter

Huget, Bob (Sarnia ND) for Mr Hope

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

Also taking part / Autres participants et participantes:

O'Connor, Larry, parliamentary assistant to the Minister of Health

Clerk / Greffier: Arnott, Doug

Staff / Personnel: Boucher, Joanne, research officer, Legislative Research Service



The committee met at 1005 in room 151.


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 Chair (Mr Charles Beer): Good morning. It's Tuesday and we're back in Toronto, I think. Our first witnesses this morning are the representatives from Halton regional health department. Welcome. We understand the roads are not that great, so our 11:15 deputation will not be coming from around St Catharines; evidently the road has been closed south of Hamilton.

Ms Sandra Murphy: Everyone on the agenda in front of you is here today, and they include Yvonne Everard-Parr, tobacco use prevention officer, and Peter Willmott, director of health protection. They won't be presenting, however.

The Halton regional health department appreciates the opportunity to address the committee in support of Bill 119. I've brought with me today six students from Milton. They are smokers, and I will be asking them to speak to you shortly.

I'm a public health nurse. My name is Sandra Murphy and I'm assigned to three high schools in the town of Milton. I'm here to talk to you today about the youth of Halton and the problem of tobacco use.

According to the chief medical officer of health in his report on youth, Opportunities for Health, 22% of youths 12 to 19 years of age now smoke regularly. Male and female rates in the province are virtually the same. While there are no comprehensive statistics for the region of Halton, the Ontario Health Survey did compile statistics for the central west region of the province, and those statistics are similar to provincial statistics.

Several surveys of students attending Halton high schools have been done, and the findings from the Halton surveys reflect the provincial and regional statistics. Young people under the age of 18 are smoking and they are purchasing their own tobacco.

You have in front of you the brief that we presented. Some of the regional surveys are in that brief. I'd like to speak to the one that was done in Milton in January of this year. It was a particular Milton high school and we surveyed 634 Milton high school students. It showed a smoking rate of 26.1%, and that is four percentage points higher than the regional or provincial average.

The majority of the young smokers in this survey told us that they are able to buy their own cigarettes. Some 60.3% of 14-year-olds, 67% of 15-year-olds, 86.4% of the 16-year-olds and 100% of the 17-year-olds surveyed were able to purchase their own cigarettes. Youth in Halton are clearly beginning to smoke and have access to cigarettes at an early age.

The Halton regional health department would like to suggest three amendments to Bill 119. I would like to read those recommendations to you after you have had an opportunity to listen and talk to the group of young smokers.

These students attend E.C. Drury High School and Bishop Paul Francis Reding Secondary School in the town of Milton. They will introduce themselves, present their experiences with tobacco and allow for questions.

The Chair: Would you mind just putting those recommendations on the record now, just in terms of time? That way we won't have to keep worrying, "Are we running out of time? We still need to get that in."

Ms Sandra Murphy: Certainly. The Halton regional health department fully endorses the provisions of the proposed Bill 119 and would like to suggest the following amendments: in section 3, that the type of identification required by youth to prove age of majority be specified; in section 9, that "amusement arcade" be included as a place where smoking should not be permitted; and in section 13, that the wording in subsection (1) be changed to read "will appoint" from "may appoint."

Thank you again for allowing us this opportunity to speak in support of Bill 119. We congratulate the government on introducing this important piece of public health legislation and congratulate also the opposition parties for their support of it.

Mr Kian Higgins: My name is Kian Higgins. I'm 19 years old. I've been smoking since I was 14. I was buying cigarettes for myself at that time. I'd buy them from retail stores, and when I was 16 I could go to pretty much any store. I've been asked for ID once or twice since I've been smoking.

Ms Jenny Kang: My name is Jenny Kang. I am 16 years old. I have been smoking since I was 14. I attend Bishop Reding high school and I find that there's no trouble in obtaining cigarettes. I'm rarely asked for ID.

Mr Daryll Gordon: My name is Daryll Gordon. I'm 18 years old. I've been smoking since I was 17 and I have had no problems at all getting cigarettes. They don't ask for ID or anything, anywhere.

Ms Annie Stokan: My name is Annie Stokan. I attend Bishop Reding high school. I'm in grade 11. I'm 16 years old right now. I've been smoking for about a year and I find buying tobacco products is no problem. We have smugglers that are able to bring them in to us and it's no problem at all to go to retail stores.

Ms Bobbi MacNeil: Hi, my name is Bobbi MacNeil. I am 17 years old. I've been smoking since I was 13 years old and I've been asked for ID maybe once since I've started. I don't find that there are problems going to stores at all. I never get ID-ed for it.

Ms Katherine Verge: Hi, my name is Katherine Verge and I attend E.C. Drury High School in Milton. I'm 18 and I've been smoking since I was 14. When I first started smoking, I noticed that I could go anywhere and I wouldn't get ID-ed. I find that the easiest places to get it are convenience stores, whereas the hardest places are grocery stores and Shoppers Drug Mart.

I especially notice that the smuggling -- I know even at our town, it's a very small town and it's very easy to get. Whether it's the schools or it's on the street, it's extremely easy to get it.

I've noticed, at least through my experience, that in the past year I've gotten ID-ed more than I had when I first started smoking, when I was 14 and 15. Now that I'm 18, I find that more people are more aware and that I've been getting ID-ed more than I had been when I first started.

The Chair: I think we'll have a good number of questions here. We'll begin with Mr Wilson.

Mr Jim Wilson (Simcoe West): A big thanks to all of you for appearing before the committee. This is the first time we've had a string of smokers appear before the committee, and it's a very interesting presentation as a result. In fact I don't think we've had any smokers appear before the committee.

The Chair: At least not who have admitted it.

Mr Jim Wilson: Not that they've made a point of telling us about anyway.

I'd be interested to know your thoughts on the following, and that is that we've been floating around the idea that perhaps we should make the possession and smoking of cigarettes under the age of 19 or 18 illegal, much like alcohol.

The reason we've been floating that idea around from opposition parties is that clearly, and your own testimony here today shows us, the current model really isn't working. The current model is that the onus and the responsibility is on the retailer, the Becker's store clerk who sells you these things. There are heavy fines under this legislation. There are fines now in existence, and they don't seem to be working.

Perhaps we should put some responsibility on young people and make it an illegal product under a certain age. We would have to sort of phase it in, say five years from now, because we know there are a number of young people under the age of 18 now who are addicted and you just can't stop them cold turkey -- it would be cruel and unusual punishment I think in our society -- but at some point the government announce that in five or 10 years it will be illegal to smoke under a certain age. What do you think of that idea, anybody?

Mr Gordon: I feel that there are more important things to worry about than catching kids smoking. There's nothing you can do. No matter what you do to stop them from smoking, they'll always get it. Whether they steal it from their parents, whether they get someone to go in and buy it for them, they're always going to obtain it somehow. There are more important things to worry about in our society than catching young kids smoking. You have drugs running through society like a fire, you know. Pay more attention to more important things than smoking.

Mr Jim Wilson: Does it bother you at all that when you go and purchase cigarettes under the age of 18, under current law, you're putting that store in jeopardy? Under this law, they could lose their right to sell cigarettes for up to six months and there are heavy fines. Does that cross your mind at all? I'm not sure it would've crossed my mind when I was 18 or under, but --

Ms MacNeil: I think it's their responsibility. It's up to us too. I mean, it's our decision whether or not we're going to smoke. If we go to the store, it's up to them to refuse us.

Mr Jim Wilson: Okay. You don't think you should take any responsibility for that?

Ms MacNeil: No.

Mr Jim Wilson: Do you agree that retailers should be punished because you're demanding cigarettes?

Ms MacNeil: Yes, because they can refuse us if they wanted to.

Mr Jim Wilson: But you'll just go somewhere else.

Ms MacNeil: Yes.

Mr Higgins: I think we should be punished, the person; also the retailer. I used to go in and when I got cigarettes, I'd feel like a big man. I'd go in and get a pack of cigarettes: "I look old. I got a pack of cigarettes."

Mr Dalton McGuinty (Ottawa South): I gather that all of you are still smoking, notwithstanding these piles of evidence that it causes you harm. One of the things we have to consider is the practical implications of the legislation. If we're going to prohibit smoking on all school grounds, what's going to happen to you? What will kids who are smoking now do?

Ms MacNeil: I don't think it'll stop; I don't think it'll stop at all. You're going to do it whether or not they say you can.

Ms Verge: Whether people are smoking in their cars or whatever, it's not going to stop. At our school, since the grounds are so large, there are designated areas where you can smoke. There's one designated area, but no one listens to that; people smoke anyway. Whether people are smoking in their cars or they're hidden behind a tree or whatever, people are still going to smoke. They're not going to listen to that, because they believe you're outside, you have the choice to smoke, especially if it's after school. People don't listen even more when it's that time of the day.

Mr McGuinty: What you've got here of course, you've got a bunch of adults sitting around who've dreamed up an idea on how to make it harder for kids to stop smoking. Maybe we should ask you. I shouldn't call you kids; I guess young people. If you wanted to make sure your younger brothers or sisters or people coming up through the ranks don't start smoking, what would you do?

Ms Verge: It really upsets me in many ways that a lot of publicity that gets people smoking is aimed at young people. I've noticed because I'm a female, and I know there are more female smokers, that a lot of the things are aimed at young females. At that time, when you're 14 and you're getting into high school, you want to fit in so badly, and I think a lot of it is aimed towards people around that age. What they first have to do is stop that right there, because I don't think when you're 13, you're like, "Oh well, maybe I'm not going to smoke because it's 19." I don't think that will have an effect on people starting to smoke at that age.

Mr Higgins: I think it will; I agree with you. I'm trying to quit. I've been smoking for five years, and I think you've got to impose all the legislation you can, because when you're a young kid and you're not allowed to smoke at school, you know, you're not going to smoke at home. You've got to start somewhere. You can't start with the older people, so you've got to start young.


Ms Kang: I think it's more of a challenge. The more you put up rules, the more rebellious teenaged people will get. When you're young you want to fit in and you're going to do the most outrageous thing to get attention, so you might just go walk around the school property and you'll see a group of teenagers smoking.

Mr McGuinty: Just one final question, please: Have any of you bought cigarettes from vending machines, particularly inside a bar?

Mr Higgins: Yes.

Ms Kang: Yes.

Mr McGuinty: You've been in bars underage too? Where's the parliamentary constable, Mr Chairman?

The Chair: Sorry, this is all being taped. The parliamentary assistant.

Mr Larry O'Connor (Durham-York): I appreciate your coming before the committee. I suppose when I was your age I was one of the ones standing in the designated smoking corner, and at that time it wasn't unfamiliar to see teachers join us there. It took a long time for me to quit, I think probably about six attempts.

As you know, the government isn't trying to legislate that there be a cessation right across the province for people to quit smoking, because we can't do it alone. The strategy involves working with the public health units, working with the community groups out there like the Lung Association, the Canadian Cancer Society, the Heart and Stroke Foundation of Ontario and a number of other people out there working on it.

Especially during National Non-Smoking Week I've gone into a lot of classrooms and talked to kids younger than yourselves, probably around the age when some of you said you started smoking. If you had something to say that could be directed to the Minister of Health, who will be watching this no doubt with keen interest, that would help us in our strategy to keep young people from becoming addicted to a habit that kills 13,000 Ontarians every year, what would you say? Would it be plain packaging, would it be restricting, would it have helped if someone had asked you for identification every time you tried to buy cigarettes? What would be the key? I'd ask if you could all have a quick response for that I'd appreciate that.

Ms Kang: I'd say it's advertisement. It's mainly focused on young people anyway.

Mr O'Connor: Plain packages?

Ms Kang: No, it doesn't make a difference. All the brand names are known anyway.

Mr Higgins: No.

Ms Kang: I would say so.

Mr Higgins: I think it's a matter of style, you know, the brand you smoke. It kind of defines your persona.

Mr Gordon: Stand by your brand.

Ms Kang: Yes, but that's a brand, not the packaging. It's the brand name.

Mr Gordon: Then it wouldn't matter.

Mr Higgins: If they're all the same packaging --

Ms Kang: But that's even more of a reason to say, "Look, I smoke Player's." It doesn't matter what it looks like; you just say that you do.

The Chair: Sounds like the Legislature.

Mrs Karen Haslam (Perth): I was enjoying it. Could you let them go on a little longer?

Ms Verge: I also believe it's not just the age that will make people stop smoking. I think what's going on right now with all the publicity, yes, that's going to also help people to stop smoking, but I think that it won't make a difference whether it's 18 or 19 unless in the store you're forced to show not even a birth certificate, because anyone can show a birth certificate, whether it's photocopied or not; it has to be even stricter than that, whether it's photo ID or three pieces of identification. It has to be something along the lines of that rather than just having to show a birth certificate, because if it's just a birth certificate, just because it's 19, people can still show identification and it still won't make a difference.

Mr O'Connor: What would you say, as a smoker, to your younger brother or sister, if you have one -- I have six of them under me still -- that would convince them not to take up smoking?

Ms Verge: I don't think there is really anything that you can say. I think it's just one of those things that they have to learn on their own. I know through past experience I was taught, you know, "Don't try it, don't try it; it's wrong, it's wrong." That's why I did it. What is so wrong about this? Why is it so bad? Why should I not try this? So then I was like, "I've got to try this," and that's how it started, with just wanting to know what it's all about. Then it started socially and then one morning I woke up and I was shaking, and I'm like, "Whoa, I'm hooked." I think that's a lot of it. It does start that way, that you're just interested and want to know what it's all about.

Ms Stokan: I have a younger sister and she knows I've been smoking for a while now and she sees how it's affecting my health. I've been more easily catching colds and stuff like that and she'll give me lectures, even though she's younger. She realized for herself that it's not the thing to do. She's 14 years old. I just think you have to come up with it yourself. Nothing anyone says to you will really change your mind. If you want to do it, you're going to do it. If not, you won't.

Mr O'Connor: I wish you all well when you get to the point where you decide that you want to quit, because it's very hard to quit. It took me six attempts. I hope it doesn't take you that many attempts. The longer you smoke, the harder it's going to be, believe me. Thanks for coming.

The Chair: All of you, as it was said at the beginning, are smokers and I assume you have been working with the Halton regional health department and its programs around getting people to stop smoking. The gentleman at the end said he was trying to stop. Knowing what you know now, going through this sort of program and working with the regional health department, are you all trying to stop?

Mr Gordon: No.

Ms Verge: No.

Mr Gordon: I have no desire to stop, personally.

Mr McGuinty: You must be a rich man.

Mr O'Connor: It takes a while.

The Chair: I just think those are things we need to know and I just wondered where you were in terms of what you plan to do.

Mr Gordon: I agree with what Annie said because both my parents smoked and I was totally against it when I was younger because I was into sports and I did all athletic, and it just happens. One day it just happens and it's just like a chain. It starts small and then you're in before you even know it. So there's nothing anyone says that can make you not want to try it or not do it. It just happens.

The Chair: I'm sure we wish we had more time this morning but I'm afraid we have to draw this to a close. Did you wish to just add any final thought?

Ms Sandra Murphy: I was just going to comment on what is happening in some of the schools. We are working with smokers, we've invited them to be a part of organizing the school environmentally and looking at policies within the school that help smokers to cut back or to quit. So smokers are coming on board. There are some kids who are ready to stop and some kids who aren't yet. Thank you very much for having us.

The Chair: Thank you for coming. We appreciate it.


The Chair: I then call on our next presenter, the Halton Council on Smoking and Health. Welcome to the committee.

Can I just note again, for those members who arrived a bit late, that the 11:15 appointment will not be here because the roads are closed out in Hamilton.

Ms Joyce See: Thank you. We almost had the same problem. My co-presenter was a little caught up in traffic

My name is Joyce See. I'm the chairperson of the Halton Council on Smoking and Health. This is Edith Telford. She's a volunteer with the Halton council and has been with the Halton council since it started 10 years ago.

The Halton Council on Smoking and Health is an interagency council made up of community organizations and volunteers like Mrs Telford. Our member organizations are the Addiction Research Foundation; both of the boards of education in Halton, the Halton public and separate school boards; the Halton regional health department; the Heart and Stroke Foundation of Ontario; the Lung Association, Halton region; and the Canadian Cancer Society, Oakville, Burlington, Halton Hills and Milton branches.

The Halton council got together initially to plan activities for National Non-Smoking Week and World No Tobacco Day. Our council, because it has been around for about 11 years, has had other projects where we've tried to address tobacco issues. The primary one I think was that the council worked for about two years developing Project Smokefree, which was a consolidation of resources for teaching tobacco prevention in the schools. It's a package that's been used throughout Halton and it's been used by other organizations as well. We're fairly proud of that. We're at the point of evaluating that project. It's about five years old.

I'd like to introduce you to Edie Telford. She's been a volunteer. She's a retired kindergarten teacher. She's going to hopefully give the committee some of her experiences with tobacco use and talk about one of her kindergarten classes. Hopefully that will reflect some of the statistics that you've probably been hearing about the tobacco problem itself.


Mrs Edith Telford: My name is Edith Telford. Joyce has said this all before but I've been a volunteer for the cancer society for 12 years and a member of the Halton Council on Smoking and Health for 10 years.

I taught kindergarten in Oakville from 1960 to 1981. During that time, I guided about 1,000 children through their kindergarten year. The children in those first classes would now be about 39 or 40 years old. This is a picture of one of the first classes that I taught kindergarten, and I'll talk more about it later. First, I must tell about my own experiences with the problems of smoking which encouraged me to become a volunteer health educator.

I started smoking as a teenager. I followed the example of my best friend, who thought that if she smoked she'd be a big shot. I thought, well, if she smokes, I'll smoke. Anyway, after a while I went to normal school and taught school for two years and then married. My husband went overseas in the Second World War and when he came home we thought we'd like to have a family.

After two miscarriages I decided that I might have better luck if I stopped smoking, which I did, cold turkey. In two months my weight jumped from 92 pounds to 107 pounds. That's because instead of smoking, I ate. I remember one evening eating chocolates --

Interjection: And drinking beer.

Mrs Telford: Drinking beer? If you can imagine how that would taste. Anyway, 15 months after that our son was born and he weighed eight pounds, and 20 months after that another son came along and he weighed seven and a half, so I must have done something right. They were healthy little guys with lots of energy. But no one had ever told me about the relationship between smoking and miscarriages, so I had to find out for myself.

When the children were both in school I went back to teaching, this time as a kindergarten teacher. A year later my husband died of a heart attack. His doctor had never told him that smoking was a danger to his health.

I felt very sorry for myself and foolishly started smoking again. By the time my elder son was in his teens I realized that he was smoking, so of course I thought what a horrible example I'd been setting and I quit again. Now, it took a little longer that time, but cold turkey again. It didn't help my son, he was hooked, but my younger son and my new husband were glad that I had chosen that route. Neither of them has ever smoked.

Now, back to the picture. The students in this picture would have graduated in 1974. According to the national statistics of that year, 55% of the boys and 38% of the girls between the ages of 12 and 19 years would have been smokers. These are represented by the faces with the red dots. They don't have a dot on me. I wonder what I was.

Further statistics tell us that 18% to 20% of smokers will die from related causes like lung cancer, heart disease and emphysema before they reach the age of 70 years. These are represented by the faces with the blue dots. Actually, there's blue on the red dots. Those are the ones who will die by the age of 70.

It saddens me to think that so many of our young people have started a habit which will be so difficult to stop. It is my hope that Bill 119 will go a long way to discourage tobacco use by our young people.

Ms See: The Halton Council on Smoking and Health, in our submission to you, has made a number of recommendations for amendments to the law, the first reiterating what the health department has mentioned about proof of age, so some kind of a photo ID. We think that's essential to be able to tell at what age kids are smoking.

In section 4, talking about the retail establishments, some kind of stipulation about licensed establishments: Three of our communities have it in municipal bylaws that licences are required to sell tobacco. The fourth doesn't. So virtually any place in the town of Halton Hills can sell tobacco because there are no restrictions.

Also in subsection 4(3), there's mention of the restriction of pharmacies etc coming in one year after the law is passed. That seems to be much too long a time. In the vending machines section, they've talked about three months as being the time. Three months seems to be a reasonable time to allow for stock to clear out etc and to make an adjustment. That would be a recommendation.

On the packaging and health warnings section, the Canadian Cancer Society study that talked about the impact of packaging on youth, the identification with a brand etc, we support the findings of that study and would recommend that if there is a change to packaging, that perhaps the change should be to the buffer-white packaging.

Under the controls relating to smoking, section 9, we would recommend that "a prescribed place" perhaps be a place that's ventilated to the outdoors, so that smoking only be allowed in places that are ventilated.

Subsection 9(2) talks about smoking in school property. If it could be extended to on school property, in Halton we're fairly lucky that both of our boards of education have chosen that there is no smoking -- they have policies that says there's no smoking on school property -- but I understand that there aren't many boards that have that policy. That should be extended.

Again in section 9, if there could be an addition of amusement arcades, and I think the health department talked about this a bit, we would concur with its recommendation and its definition for amusement arcades, the rationale for that being that youth are the target of arcades and youth are mostly the people who frequent arcades. If we support the legislation and have 19 as the age when smoking's permitted, then 19 is probably about the age that the kids are going to arcades. They shouldn't be allowed to smoke there.

Then the final recommendation we have pertains to the inspection, and a request that the wording be changed from "the Minister of Health may appoint inspectors for the purposes of this act" to the "the minister will."

I think from what you've heard from the youths who preceded us here today, enforcement is the key. If we can make it so that the laws that we have in place are enforced, then I think that we'll go a long way to stopping children from starting to smoke.

I have a 20-year-old son who's been smoking since he was 14, and it distresses me that so many of the health implications are going to affect him. I know they're going to affect him and, as a parent, it's a difficult thing to see. I thank the committee for their time.

The Chair: Thank you. The parliamentary assistant just had one point of clarification.

Mr O'Connor: You stated, on subsection 9(2), you want to expand it to include the school property?

Ms See: Yes.

Mr O'Connor: We're using, from the Education Act, the description of school, which includes the property. I would hope that maybe legislative counsel will note the concern that's being raised here, and we can take a look at that, but the intent was to include the school property as well.

Mr Jim Wilson: Thank you for your presentation. You mentioned that some municipalities in your area have a licensing system in effect. I'm just wondering, what is the result of the retailer compliance in those areas?

Ms See: My understanding is that all that's required is that annually a licence renewal is sent out from the municipality to the retailers, and I think it's $10 or $15 that they have to pay for a licence. If there's a complaint, then we've negotiated with one of our municipalities that this complaint about selling tobacco to minors could impact on the subsequent year's renewal of that licence. That's all there is so far.

Mr Jim Wilson: To the best of your knowledge, have licences been revoked?

Ms See: Not to my knowledge.

The Chair: I'm sorry that time is going to mean we have to end, because with all the students I allowed a little more time there. I think your position was very similar. We want to thank you, and particularly for the personal experiences. Thank you again.



Mr James Gay: Mr Chairman and honourable members, thank you for meeting with me this morning. I'll be brief with my comments on Bill 119, the proposed Ontario Tobacco Control Act.

My name is James Gay, manager of long-term care pharmacy services with Pharma Plus Drugmart, working out of our head office in Mississauga. I've been registered as a pharmacist in Ontario since 1983 and came into the office in 1988 after five years as a retail pharmacy manager with our company.

In the next few minutes, I will outline my position on Bill 119, especially section 4(2)8, the proposed ban on tobacco sales from drugstores.

First, I would like to applaud the government's efforts to reduce the tobacco use in our province. I've been quite impressed with your public messages on the subject. My wife and I were at a theatre on Sunday taking in a movie and one of your messages appeared before the movie started. It was concise and extremely effective in getting the message across. Again, I was quite impressed.

The strategic objective of discouraging children and adolescents from starting smoking, reducing overall tobacco use and decreasing public exposure to secondhand smoke is admirable and, I feel, obtainable with suitable public education. However, I do oppose section 4(2)8 since it is excessively punitive and inflicts unfair hardship on our segment of the retail industry without having any effect on the government's objectives I've just outlined.

Shifting distribution out of drugstores will actually diminish the control government has over the sale of tobacco to minors, which is one of the main intentions of the legislation. I was quite surprised at some of the remarks I heard this morning. It was very educational.

Under section 4(2)8, sales will be removed from an area which is highly regulated, secure and responsible. Taking tobacco out of drugstores will move sales of this legal product into outlets which are not as regulated, secure and responsible. A report by Lindquist Avey Macdonald Baskerville, which was presented to you last week, demonstrated that if people can't buy cigarettes in drugstores, they will simply buy them elsewhere, thus supporting my previous comment on shifting distribution. Again, it was reinforced by some of the comments made by the students this morning.

If the government wants to ban the sale of tobacco, it should do so, although you and I all know that this would be next to impossible. The fact of the matter is, stopping selling tobacco in all retail outlets altogether -- place it into government-controlled outlets like an LCBO or a TCBO, if you will, but don't simply prevent one kind of retail outlet from selling this product and not the others.

It has been stated by proponents of this bill that it is unethical for a pharmacist who is a health professional to sell tobacco products, that sale of these products is contradictory to our role as a member of the health care team. I feel that as long as tobacco is a legal product, then it should be up to individuals to make that decision as to whether they purchase tobacco products. All anyone can do is try and educate the people as to the dangers of their decision to smoke.

Pharmacists who decide not to sell tobacco are making a decision to be a corporate censor. That is their decision. A pharmacist who decides not to be a corporate censor is no less ethical. He or she is just allowing the consumers to make their own choice.

Furthermore, I do not think it is the government's role to legislate ethics. I feel the whole ethical argument gives rise to the question, is it ethical for the government to rely on revenues from the sale of a product that is harmful to a person's health?

One of the dilemmas pharmacists have always faced is, are we health professionals or are we retailers? In my opinion, pharmacists are both. We cannot lose sight of the fact that today's retail drugstore is made up of a front shop and a dispensary. In order for a pharmacist to be in a position to provide proper pharmaceutical care to his or her patients, both must be viable, unless the dispensary is located in a medical building where the pharmacy can survive on its own.

In the most recent Ontario College of Pharmacists newsletter, the college outlines the Regulated Health Professions Act, which was proclaimed in force effective January 1, 1994. I found it interesting that the act, which has jurisdiction over the dispensary only, recognizes the front shop as distinct from the professional area while at the same time the college is stating that in the case of tobacco it feels compelled to dictate which products are sold outside of the dispensary area.

As you can see, the issue is not black or white as to whether we are retailers or health professionals at the same time. Our own college can be inconsistent as to how it applies its regulations to drugstores, sometimes including the front shop and sometimes excluding it.

We must look at the retail drugstore as a whole to get the proper picture. Pharmaceutical care is the direction the pharmacist and the profession are taking with respect to the way the modern pharmacist should be practising. The concept places the patient as the focus, whereas the drug was the focus historically. This method of practice takes much more of the pharmacist's time and thus is more costly to the drugstore operator. Over the past few years we have seen our professional fees cut back, increasing pressures on our fees by third-party carriers and mail-order pharmacy, which is posing a new threat to our livelihood.

Removing tobacco from our stores while allowing other retailers to continue selling tobacco products is yet another blow to our bottom line, and I can only state that at some point there will just not be enough profit available to finance the extra services that pharmacists truly wish to provide to their patients under the pharmaceutical care model.

Within my practice I consult with long-term care facility staff regarding the medications taken by the residents. I spend a great deal of my time in the facilities reviewing medication profiles for the purposes of simplifying patients' medication needs. Frequently this results in lowering the number of medications each resident takes.

This effort saves the provincial government valuable dollars while at the same time decreasing the revenue of the particular pharmacy location that is servicing the facility. Please allow me to emphasize that we are not paid a cent for these consulting services that we provide, beyond a professional fee.

I'm not going to propose to you that we need tobacco revenue to remain suppliers of long-term care, but as I mentioned before, continual erosion of the total store profits does put pressure on each of the components of our business to justify its existence.

In summary, please allow me to state again my opposition of section 4(2)8 of Bill 119, as in my opinion it will not result in the government's noble objective being fulfilled. At the same time it unfairly discriminates against one segment of the retail market and places undue financial hardship on a segment already hit by other pressures, including the provincial government, which recently cut our fees after a three-year freeze on them.

I thank you very much for your time and I will be glad to entertain any questions.

The Chair: Thank you. We're a little tight on time, but we'll try to work in a couple of questions.

Mrs Haslam: In July the pharmacists college asked for a phased-in removal and put an implementation strategy in place. Have you complied with this proposed voluntary phase-out in any way?

Mr Gay: I believe our president commented on behalf of the company on the corporation's objectives. What I can say is that we are in favour of voluntary cessation of smoking products and ultimately I think you will see pharmacies remove tobacco from their product mix, but I think we have to be given the time.

Mrs Haslam: That's another point. You mentioned your bottom line, which seems to be business-oriented and profit-oriented. We are here dealing with a health issue, and I think we have to keep that in context. You talk about allowing others to sell and not allowing pharmacies to sell, when in truth it's the pharmacists who come before us and say they're asking for a more level playing field. They're saying that unfortunately there are some who are not complying with the college's asking an implementation strategy. It's unfortunate that the government has to step in, but they are asking that the government step in to level the playing field for them, just as you are indicating that it would be a level playing field if nobody sold tobacco.

You're a pharmacist. Do you agree that smoking does have significant negative health effects on our population?

Mr Gay: Of course. I think I'd be foolish to say that I don't, and I have presented a Butting Out For Life program sponsored by Merrell Dow to over 150 pharmacists on five or six separate occasions. I agree we should be involved in trying to counsel people on stopping smoking. But, going back to your issue on the bottom line, without a profit we won't be there to counsel people.


Mrs Haslam: Do you feel that the financial benefit of tobacco sales should supersede the health goals in the future of a tobacco-free society?

Mr Gay: No, but I also feel that a person's right to purchase a legal product in a retail outlet shouldn't be superseded by the government as well.

The Chair: Time for one short final question.

Mr McGuinty: Not so much a question, Mr Chair, as a comment. I just wanted to thank Mr Gay for presenting a fair analysis of this issue. It would be nice if it was purely a legal issue or a moral issue or a business issue or a health issue. I think the fact of the matter is it's all of those.

If it was purely a health issue, we would have the nerve here today to ban smoking everywhere in this province immediately. But it's not. There are obviously other considerations. We squeeze about $1 billion out of smoking Ontarians on an annual basis. We profit from that to some extent. Canada-wide we take about $8 billion out of our smokers. It's not a simple issue. I think people do a disservice to the debate, an injustice, to treat it purely as a health issue or purely as a business issue. Thank you.

The Chair: Thank you very much for coming before the committee today.


The Chair: If I could then call on Simcoe-Matic Canteen, Mr Jim Dykes, president and owner. Mr Dykes, welcome to the committee. We have a copy of your submission so once you're settled, please go ahead.

Mr Jim Dykes: I bring you greetings from sunny Orillia this morning. I came down here under the mistaken impression that you have warm, sunny weather in Toronto all the time.

The Chair: Did you have warm, sunny weather in Orillia this morning?

Mr Dykes: Yes, we had a beautiful morning in Orillia. I trust it still is when I get back.

I'm here to speak to you regarding Bill 119, specifically section 7, as it relates to the vending industry and the vending of cigarette products.

A very quick background on our company is that we're an independent, family-owned company operating out of our head office in Orillia, servicing all of the small communities from Barrie to Huntsville to Collingwood and all points in between. We employ 16 people in those communities. Over half of our staff have in excess of 20 years' service to our company and to our many customers.

We provide a wide range of vending services, of which tobacco is just one. Tobacco does represent 25% of our annual turnover and it also represents 25% of our staffing. The assets that we purchased when we bought this business represent $125,000 to our company and we're a small company. That's a significant investment.

Our concerns are fairly brief. We're very sympathetic to the spirit and the intent of both provincial legislation and the federal guidelines specifically as they relate to the discouragement of young people from smoking.

We do not believe that a ban on cigarette vending machines, however, will have any effect on youth and smoking, nor will it have any effect on reducing overall cigarette consumption. Our locations and pricing are not typically available nor are they attractive to youths. Our vending machines are the most expensive source of cigarettes in the marketplace.

Vending machines account for three quarters of 1% of the cigarettes sold in Canada. Our vending machines do not offer kiddie packs. We have had in place for over three years now a proactive program that we did on our own accord to ensure to the very best of our ability that children don't have access to tobacco, nor are they allowed to purchase tobacco products from our machines.

Two years ago we sold our family home and with my partner borrowed a further $500,000 to buy this business, a business that we understood to be a legal business and one that we pinned all of our future hopes and dreams on. A loss of 25% of our employees, which this legislation would immediately impact us by, 25% of sales and 25% of our assets would be a full-blown disaster and possibly a fatal blow to our growing company.

Specifically, our company would immediately be forced to lay off four people and incur the cost of retrieving and disposing of the $125,000 worth of assets which are still sitting on my balance sheet. They cannot be used for any other purpose. While this is going on, we would be trying to keep the wolves from our door. I'm sure all of you can appreciate that banks don't get real excited about a business that loses 25% of its revenue virtually overnight.

In brief summary, we do not condone smoking. We do not think children should be allowed to buy cigarettes.

Section 7 of Bill 119 will not, in our opinion, accomplish the goals it is intended to. We operate our machines exclusively in adult environments, as a service to adults only. Without exception, I have canvassed every one of our customers and they appreciate our service and feel that if we do not offer the service we offer to them in an adult environment, the business will go entirely into the black market.

The reason our industry exists in adult environments is because people who operate those establishments cannot control the sale of cigarettes nor can they cover the inventory costs of carrying these products in their establishments.

We support the federal Tobacco Sales to Young Persons Act with regard to the sale of cigarettes through vending machines. The federal plan allows cigarette machines to be placed in bars, taverns or other similar beverage rooms; in other words, places where access is restricted to people who are 19 years of age or older.

We also happen to believe that the federal plan should be expanded to include all adult environments. I don't believe cigarette machines should go anywhere where they cannot be controlled and that children could have access to them. I too have children and don't want them exposed to opportunities to purchase cigarettes. But I do believe that in a free society and with a legal product we should all have a right to exercise our rights.

If cigarette vendors are banned, cigarette sales will not cease. They will just be sourced elsewhere. We would like to ask, why then should our distribution channel, or one single distribution channel, be singled out and destroyed?

If our cries are not heard we would like to ask you for some things to help us through a transition. We would need time to depreciate those assets. We would need time to seek other revenue sources, and by seeking other revenue sources we can protect the jobs of the honest, hardworking, taxpaying Ontarians who built our company over the last 30 years and who will be innocent victims of this legislation.

On behalf of the Simcoe-Matic Canteen family, thank you for the opportunity to give our views. We urge you to ask our industry for help towards accomplishing your goals. We will help you, but please don't take away our dreams.

The Chair: Thank you.

Mr Dykes: If I could, on just one personal note, I've tried to remain unemotional but this is a very personal issue to my family, to the 16 employees who we help pay their mortgages every month. All of them will be watching this tonight on their television sets in communities from Collingwood to Midland to Orillia. These are real people with real children and dreams of their own.

When you make your decision about this legislation, it's not just a business. As Mr McGuinty pointed out, it's not just a health issue. There are real lives are stake. We'd appreciate if you'd think about that when you're making your decisions about changes to this legislation.

Mr Jim Wilson: Thank you, Mr Dykes. I think you make a very persuasive argument. The position of my party, the Ontario PC Party, has been to push the government for some sort of compensation and, secondly, a longer phase-out period. The only reason we've even taken that position is because I believe it's inevitable the government will pass this legislation. We're trying to be realistic about what we expect the government will do.

Having said all that, our preference would have been to simply leave vending machines in bars, along with the federal act, because I remember very well the federal discussions. I used to be EA to the Health minister there and it made perfect sense to me. In fact, a number of States have followed that route where, as long as the vending machine's near the actual bar so the bartender can give some supervision to it, it seems to be fine. It's my view that this government wanted to go further. They wanted a bigger headline than the federal act so they're going to ban you totally.

Having said that, you raise in your summary and recommendations on page 3 -- you talk about time, the necessary time to depreciate your assets etc. What type of a time frame would you require to do that?

Mr Dykes: For every operator, of course, it would be different, depending on when they purchased their assets. Traditional depreciation period on an asset like that would be five years. I believe, though, that if we were given three years, that would give us the time that we could deploy our resources to go out and seek other businesses that we could put ourselves into, perhaps even seek out other products that we could retrofit these machines to serve.

To throw millions of pounds of junk metal into landfill sites or wherever they would go, to me seems an awful waste from an environmental point of view and from a practicality point of view. If we had three years, that would give us enough lead time to preserve the jobs in our company and allow us to get on with new businesses.


Mr Jim Wilson: If the government were not to give you three years -- the bill of course speaks to three months, which is a very, very short time frame -- you mentioned that your physical asset in terms of cigarette vending machines is $125,000?

Mr Dykes: That's a fact.

Mr Jim Wilson: Would that be the total compensation that you would require?

Mr Dykes: Exactly.

Mrs Haslam: I just love it when Mr Wilson is non-partisan. When we look at the federal legislation, and I agree we support the federal legislation --

Mr Jim Wilson: I take it as a compliment.

Mrs Haslam: No, it wasn't.

Mr Jim Wilson: I wouldn't expect it.

Mrs Haslam: Please don't.

The Chair: Order, please. Mrs Haslam, if you could just direct your question to the witness, please.

Mrs Haslam: The problem is that in the federal legislation and Ontario there is no age restriction to access, only in consumption. One of the concerns about this legislation was that it still left access to vending machines to young people. As a matter of fact, when we were in London yesterday they had a survey done in Lambton county that showed that out of 216 people who were questioned, 78 of those young people, which is more than 26% of those questioned, had access to vending machines. So it is a concern, it is a proven concern and it's something that when we're looking at this particular legislation and young people we, as legislators, have to be cognizant of.

Actually, my question was around the time lines. There was another organization of vending machine people who came in, who visited us. One of the questions I asked was, "Could you retool your machines?" I understand that in tobacco vending machines it's impossible or financially not conducive to retool the tobacco machines. I'd ask if you agree with that.

Also, they said three months was not enough time. They're going to be rushed just to take it out to comply with the federal legislation. They feel that if the provincial legislation comes in and extends it to those licensed premises, whether they're adult or not, because of where the machines are located and the access for young people -- they asked for an additional year; you asked for three. I wondered if you'd comment on that.

Mr Dykes: Sure. Let me take your points one at a time. I share all the concerns you have. I wasn't paying lipservice to the issue of children and smoking. We have no desire to ever sell a package of cigarettes to children.

I've never seen a single shred of evidence yet in all of the reports I've seen that indicates that children buy their cigarettes out of a vending machine. Typically, they're not available to them by their locations. Children are the ones with the least amount of money to spend. Therefore, we're their last choice to put their money into to get cigarettes and that suits us just fine. We carry very large stickers on there. We educate all of our customers who have our machines what the stickers mean on there, explaining the law as it relates to children buying cigarettes.

I have not yet ever seen, as recently as recent radio surveys done here in Toronto, any evidence that any children are using our particular machines for their source of cigarettes. But I still believe we should take every possible precaution to make sure that doesn't change in the future. Especially in light of possible tax cuts and all kinds of things, cigarettes could become more affordable out of machines.

Mrs Haslam: They're addictive. I think that's the problem when we look at it. When we do have a survey from a school that says they do have access, that's a concern for us.

Mr Dykes: I don't know the Toronto market, but I can take you to high schools in central Ontario where every day at lunch-hour the trunks are opened up and the black-market cigarettes are sold in open view to anyone who wants to drive in. They run drive-through services.

Mrs Haslam: I think we agree that enforcement is the problem.

Mr Ron Eddy (Brant-Haldimand): Totally ignored.

Mr Dykes: Totally ignored.

Mrs Haslam: Enforcement is one of the main things we're going to have to look at.

Mr Dykes: I agree. Getting to your other two points, the likelihood of retooling our equipment is remote. I don't rule it out, because I would like to seek out every possible opportunity, but that's one of the reasons that I've asked for a longer period of time. That's an awful lot of money I borrowed to buy those assets. I would like to depreciate them as much as possible. If I can get any other use out of them at all subsequent to that, that would help our cause and, of course, we can maintain the jobs.

The timing of the changeover would be a disaster to us, not just from the job-loss point of view but from a functional point of view. It's a big job moving vending machines around and we happen to be spread across all of central Ontario. Anything you could do to help us from any of the vantage points I have addressed this morning would be very much appreciated.

The Chair: Mr Dykes, we want to thank you for coming down from Orillia this morning and for your presentation and your personal views.


The Chair: If I could then call on the representatives of the York Region Public Health Department. I just draw to the attention of members that the parliamentary assistant and I are again proud to see representatives from York region before the committee. Welcome. Please go ahead. We have a copy of your submission.

Ms Cathy Jaynes: Thank you. My name is Cathy Jaynes and I work as a health educator at York region public health department. I have brought a co-presenter with me today, Mr Salem Khamis, who is the pharmacist-owner of Hillcroft Pharmacy. I'm going to talk first. His talk is more interesting and he's going to go last.

Just to talk about York region, we are primarily a residential community. The majority of our population is under 19 years of age, and certainly any legislation that's going to impact positively on the health of children and adolescents we are going to be very interested in. We are really pleased with the whole bill and we congratulate members of the government and members of the opposition on bringing the bill this far.

We're very happy with tightening control on sales to minors. Again, the majority of our population is under 19 years of age, so we don't want to see those youth have easy access to tobacco.

We are in favour of banning vending machines and we had to agree, from our point of view, with some of the youth who spoke this morning. As a former health counsellor at a high school, I used to know for a fact that many of my clients and many of the kids I saw when I was teaching birth control classes in grade 9, the same kids, were in the bars buying cigarettes from vending machines. The whole point is they are unmanned and anybody can put a coin in those machines. We are pleased to say that the city of Vaughan, which is in York region, has now banned tobacco vending machines.

Banning cigarettes by pharmacies is a crucial point. Tobacco should not in any way be construed as a therapeutic substance. It should not in any way be associated with health care or health care services. I know that people will say: "Well, they're just going to go across to the mini-mart or they're just going to go around the corner. Do you really think it's going to have an effect on consumption?"

In the short term that may be true but, as you know, tobacco use prevention is a long-term issue. We have to start educating the public that you can't go into a pharmacy and buy goods for your health and then see cigarettes there, because indirectly the public will see: "They're in pharmacies. Surely cigarettes can't be that bad." This likens back to commercials in the 1950s where cigarettes were advertised as helping coughs etc. We have to start calling an issue an issue and stand behind it.

We did a random telephone survey to just 40 pharmacies. It was very small, just every third pharmacy in a municipal phone book. Thirty-nine per cent of our pharmacies do not sell tobacco products, and they reported many positive comments, as Mr Khamis will talk about. A further 40% supported withdrawal, and of the percentage that still sold tobacco products, 15% were going to withdraw tobacco products in the near future.

Some of the pharmacies that were still selling cited different reasons for why they still had tobacco products, some of these being the parent companies. They could not voluntarily withdraw tobacco products without facing a legal action. There was resistance to having a legal substance legislated off the shelf, which we've heard again this morning. Some of the pharmacists talked about, "Well, that's fine, do that, but then let's call tobacco a controlled substance and sell it in outlets such as the LCBO," and they felt fine with that.

The packaging regulations: We are in favour of generic packaging and recommendations on this. We would further like to see a complete list of the ingredients on the tobacco package. Consumers have the right to know what's in the product they're consuming. If there's any room after that on the package, we would like some health warnings.

Prohibiting smoking in schools and on school properties: Again, we have differing policies in York region. The public board has one policy, the separate board has another. We were quite shocked in 1993 to find that there were some schools contemplating using school funds to build shelters on their properties for smokers. This was a staff-generated committee. We have of course responded to our concerns, talked to them about it, but comprehensive legislation would put an end to this.

Again, effective compliance strategies such as fines and inspection are very important.


What I would like to talk about are some amendments that we feel should be included in Bill 119. I work in policy analysis in healthy public policy and I receive calls from people in the workplace who live or work in York region and who are very concerned about working in environments with secondhand smoke.

In the last six months I've received 53 calls, which may sound like a small number, but these people are very afraid to talk. They won't give me their names, they won't give me their places, I can't call them back. I'm just getting these calls while I'm sitting in the office for the most part.

The majority of calls were people who had a workforce of less than 20, so we're talking about small businesses, with typically no management or union support for their concerns. In many cases the employers or managers themselves smoked. Again, they're very afraid to complain for fear of losing their jobs. A majority of these people stated that they had just been hired at this job for less than six months after being laid off somewhere else, so for them, keeping their present job was a priority to the exclusion of their physical wellbeing.

They complained of things like nausea and headaches and watery eyes. One caller described working in a small office area, four workers around her with desks who would chain-smoke from 9 o'clock in the morning till 5 o'clock in the evening. Their friends would come in and often smoke at the desks as well. Clients and customers would come in. She would go home, take her clothes and hang them in the garage. She would actually feel physically ill.

Unfortunately there was no municipal support for the work site. There is of course the Ontario labour board. In calling the labour board she was told, "Yes, the inspector will come, but it could be weeks or months and we can't really tell you when it's going to be." Her solution was to try and find another job and, when she got the other job, go to her present employer and say, "I'd really like to stay here but I can't." People feel they have to have something to fall back on.

There have been more educated people than I who have been talking about the dangers of environmental tobacco smoke. Since people in the work site spend about 90% of their time indoors, we really have to protect them from high-hazard environments.

Smoking in restaurants: These should be designated as smoke-free spaces not only for the patrons, but also recognizing that restaurants are workplaces for many people in York region and Ontario. Recent literature talks about levels of ETS as being up to two times higher than in offices and one and a half times higher than for residences. If you are a non-smoker, you have more of a risk from going to your workplace from environmental tobacco smoke than you do from living with a smoker.

In bars it's horrendous. It's up to six times higher than offices and 4.5 times higher than living with a smoker. These are really hazardous environments. The literature also shows a 50% increase in lung cancer risk among foodservice workers, and this can in part be causally related to tobacco smoke exposure in the workplace. That's pretty shocking.

It seems like those working in public service, and that includes myself, are protected from smoky environments. Many municipal, federal and provincial buildings are legislated as smoke-free. Surely we're not saying that we protect the health of the core of our public workers more than we do our private sector.

Smoking in public places: I receive a lot of calls especially from seniors who would just dearly love to go to a bingo parlour and they really miss this, but because of predisposing health conditions or they're afraid of having an asthma attack while they're there, they can't go. We would really like to see some more comprehensive legislation for arcades, bowling alleys and bingo parlours.

We as the health units and our many community partners will pledge our full support for the provisions in Bill 119. We are currently distributing free bylaw signs to municipalities. We are working with municipalities to strengthen their smoking bylaws. Two municipalities are currently strengthening, and I'm proud to say in Georgina we are starting to enact a bylaw by looking at smoking in the restaurants. I've seen the legislation, the bylaw, and it looks pretty good.

In conclusion, I would just like to again congratulate government members and opposition members. It's an excellent piece of legislation. We are concerned that perhaps some opposition members may not support the vending machine ban or sales in pharmacies. We would like to see government work together. This is an opportunity for the members of the provincial government to send a message to all municipalities, to send a message across that this legislation can have a positive impact.

I'd like to also make special mention of Larry O'Connor, who has given a lot of leadership in this. We thank you for it.

Mr Salem Khamis: I just want to present an alternative viewpoint. We are an independent pharmacy. We have been in operation since 1986. As a matter of policy, we decided not to sell tobacco from the onset. It did hurt us economically obviously, but I decided that, as a health professional, I could not justify selling tobacco for my customers.

It didn't make sense to me to be selling tobacco at the front of the shop, and at the back of the shop selling prescriptions for smoking addiction and trying to help people prevent addiction to smoking. So as a matter of policy, we decided in 1986 not to sell tobacco. We've been in operation for eight years. We have survived, fortunately. Maybe we would have made a little bit more money had we been selling tobacco, but as a health professional I feel proud of myself in having taken a decision before it was legislated.

It's unfortunate that we have to come to a stage where we have to legislate tobacco in pharmacies. I would have preferred voluntary cessation. It seems to me it has not worked. The OCP has being trying for years; the Canadian Pharmaceutical Association has been trying for years. You've heard a lot of presentations from big stores that say how desperately they need the revenue from tobacco. I just want to let you know that there are two viewpoints. I'm an independent pharmacist. I don't have any axes to grind and whatever I do in my store affects me directly.

Another point that I wanted to bring across was that our customers have been very happy with our decision. We've had a lot of customer loyalty because of the fact that we don't sell tobacco. I feel we should bring pharmacies into a position where, when you walk into a pharmacy, you know you're in a health field.

When you walk into a hospital or a doctor's office, you don't expect to see vending machines for tobacco. The same way, when you walk into a pharmacy, you should not expect to see tobacco. Unfortunately, it has to be legislated. I don't agree with the government legislating what a drugstore can or cannot sell, but I feel in this issue we're on the right track. That's all I wanted to say.

The Chair: Thank you. We have a few minutes for questions.

Mr McGuinty: Thank you both for your presentation. Something I wanted to mention is that I was surprised myself to learn yesterday, when we had an owner from Shoppers Drug Mart, I guess a franchisee, that he was not required to sell tobacco products within his store; rather that was a matter of his choice. I thought I should share that with you.

The other thing, Ms Jaynes, is you've raised something which a lot of people feel. They come here to see us and they have a sincere desire to see us do whatever we can to curtail smoking. That's a very legitimate position to take. But just so that you can understand and anybody who might be watching us today on TV can understand, in opposition our obligation is to ensure that all perspectives are brought forward. It is rarely our obligation to join hands with the government and to not bring forward those positions which might not otherwise be heard.

I think one of the serious difficulties with the legislation is connected with the ban of sales in pharmacies, for a variety of reasons, one of which is that it will not reduce smoking overall, and it strikes me as a patent unfairness. It would be fairer, for me, to ban it everywhere. It would be fairer to restrict it to an LCBO equivalent, for instance. Anyway, I just wanted to leave you with that. If you want to comment, please do.

Ms Jaynes: Again, I agree that in the short term it may not reduce consumption. The point I was trying to make was that we are trying to change people's health attitudes in tobacco use prevention. In changing health attitudes, I think it's just vital that we don't associate tobacco with health care products and services. That's the first step. There are no quick fixes, I agree with you, and there may not be small or immediate effects on consumption, but I feel this is the way to go for the long term.


Mr O'Connor: Thank you for your presentation and your kind words. Looking at page 3 on your brief, you talk about your survey. I appreciate the comments. In noting those who had not voluntarily removed them, you cited the first one as saying selling the products as a policy of their head office. Of course they had some concerns there. I wondered if you'd like to add to that comment.

Ms Jaynes: It was just a telephone survey. I think it was Big V and Shoppers Drug Mart. Please excuse me if I'm wrong, but I believe that those were the pharmacies. They were saying, "Well, the pharmacist-owner said, `Yes, I would be pleased to, I would love to,' but this is policy." Now, we did not go into whether she wanted to go into an independent pharmacy and we did not explore the legal issue, but these were the comments made to us.

Mr O'Connor: So there was a real fear that --

Ms Jaynes: There was a fear. She said, "This is a policy of our head office, and I cannot voluntarily withdraw these products."

The Chair: Thank you both again for coming before the committee. We appreciate it.


The Chair: I call on the representative from the Canadian Cancer Society, Ontario Georgian Lakelands region. It's Ms Gretta Gill. Welcome to the committee. We have a copy of your submission. Please go ahead.

Ms Gretta Gill: Thank you. Mr Chair, honourable members of the committee on social development, the Canadian Cancer Society provides its services through nine regions across the province. You will have heard in our initial submission about the mission of the society and about its volunteer base. I am one of those volunteers, working in the Georgian Lakelands region as one of more than 1,700 volunteers there. I am president of the region, overseeing its numerous programs and committees.

The region encompasses the counties of Bruce, Grey, Simcoe and the Muskoka area. In these counties, the society estimates that 6,400 people died of tobacco-related disease from 1976 to 1985. These were unnecessary deaths.

To help eradicate cancer, we believe that the reduction of smoking as an addiction is a vital step. We are pleased to see Bill 119 as part of the government's tobacco strategy and, in particular, as supporting the strategy's intent to make all schools, public places and workplaces smoke-free by 1995 and, throughout the 1990s, to reduce the percentages of the population who smoke. We will see a payback in the improved health of the population in the years to come.

The Georgian Lakelands region subscribes to the views presented in the Ontario division's brief presented on February 1. We're here to present some additional factual information and our reasons for believing in the need for the legislation. We are also here to comment on relevant experience.

As a health agency, we are concerned about saving people's lives and improving the conditions of those lives. Bill 119 is important to help reduce the considerable number of illnesses and deaths caused by tobacco's impact on the human body. While our mandate is to eradicate cancer and to support those affected by cancer, we are part of the network of health agencies with a shared vision of an Ontario society unburdened by the consequences of tobacco-related diseases.

As a volunteer with the society, I believe this legislation is crucial. As a citizen and a member of the community, I also believe this.

You have already been given a lot of facts. I've read these too and I'd just like to reiterate some of the ones I find particularly disturbing.

Tobacco is a major contributor to death in Canada. One Health and Welfare study estimated that for every 100 smokers now 15 years of age, 36 will die of tobacco-related diseases before age 70. Other studies suggest the number is higher, about 50%. This represents eight times as many deaths as those due to car accidents, suicide, murder, AIDS and drug abuse together.

The average age of beginning smoking has dropped from 16 to 12. In a 1986 survey, 88% of young people who smoked had considered quitting; 72% had already tried but been unsuccessful.

Some consider tobacco to be a gateway drug leading to abuse of other drugs.

In 1989, regular smokers aged 12 to 19 consumed some 576,056 cigarettes a day, or 12 each.

As a municipal councillor, I can provide a personal perspective on the tobacco-related activities in the town of Collingwood. We have a town bylaw prohibiting smoking in public places in the town. In addition, some of our retailers have voluntarily deemed their retail stores to be non-smoking.

I'm also a member of the board of directors for our hospital board at the Collingwood General and Marine Hospital, and it too is a smoke-free facility.

We endorse the Ontario division submission to this committee and fully support all the suggested amendments and additions contained therein. We believe that the following essential components should remain:

Designated age of 19 for purchasers of tobacco products: This will be consistent with the legal age for purchasing alcohol and will allow the use of the same identification. Hopefully, an increase in the legal age for purchase will postpone and in fact avoid the decision by young people to smoke.

In talking with a local pharmacist in Collingwood, he felt that tobacco purchases should be only at LCBOs and at Brewers Retail. I happened to hear, just as I came in, in the last submission they were mentioning that as well. That's what his thought was and that it would not affect his business or his pharmacy not to have cigarettes.

Ban on vending machines and the sale in prescribed places: These provisions will make it more difficult for young people under 19 to buy cigarettes and impossible for anyone to purchase them in health care institutions.

Prohibition of the sale of tobacco products in pharmacies: It's important that pharmacies be recognized as health care establishments, not just ordinary retail stores, and that they not sell items which destroy people's health.

Restrictions on places where smoking is permitted: It's important that smoking be disallowed in public places, school properties, day nurseries, stores and their grounds. Some of the smokers we assist tell us that restrictions on smoking in these places and in their workplaces have helped them to stop smoking.

In particular, it's vital that smoking not be permitted on school grounds. If it's prohibited, children will not see teachers, who tend to be children's role models, and teenagers who already smoke will find it more difficult to smoke during the day. In our area, Simcoe county, the schools already prohibit smoking on the school grounds.

We would like to see plain packaging adopted as well as warnings in clear, simple English.

Strong penalties for non-compliance: Enforcement must accompany progressive laws.

We endorse the strengthening of the legislation recommended as follows:

The legislation must place a ban on the sale of chewing tobacco, again often used by children's role models, baseball players.

The legislation must prohibit the sale of kiddie packs.

As mentioned above, the legislation must broaden section 9 regarding places where smoking is prohibited to include the grounds of the places cited.

The legislation must add a section to ensure that advertising and promotion of tobacco products is prohibited.

The legislation must provide for licensing of tobacco retailers.

We must collectively focus on the objective of improving public health. If there is one value we should all hold in common, it is the value of human life. We should do everything possible not only to preserve life but also to ensure a high quality of health for everyone. There may well be no other piece of legislation you are able to influence which has had such direct known benefit to the people in this province.

I congratulate you for your stand in promoting this type of legislation.

Mr Jim Wilson: Gretta, thank you very much for making your way down from Collingwood this morning and appearing before our committee. I understand the weather wasn't so great.

Ms Gill: Actually, it was lovely all the way until I got to Toronto. The sun was shining back home and everything was great.


Mr Jim Wilson: You know, Gretta, I've always believed that.

Thank you for your presentation. I think it's one of the most succinct and direct that we've had. I would agree with about 98% of it. We have a bit of a disagreement with respect to pharmacies. My party has taken the position that we see it as a freedom-of-business issue and that we do see pharmacies as a section of the retail sector out there. None the less, we agree with just about everything else in the legislation, and your suggestions for tightening up the legislation are quite good.

I want to go one further. It's an idea I've been floating around for a couple of weeks. It seems to me that the current model doesn't work very well, that we have a punitive system on retailers. We fine retailers but we put no responsibility on the young person currently under the age of 18. They can go and buy cigarettes. If one retailer won't sell it to them, then they just go down the street to another. They just keep trying or they buy them out of the trunks of cars.

We've been floating around the idea that perhaps, like alcohol, we should make the consumption and possession of cigarettes under the age of 19 illegal, with a phase-in period, recognizing that there are a number of young people today who are addicted. What are your thoughts on that?

Ms Gill: It sounds like a great idea, the problem being enforcement of course. I do know that the property owners around the schools where there isn't any smoking on the school property have mentioned to me that they don't appreciate the cigarette butts they find on their grass, and so on. It's because they're not allowed to smoke; there isn't a designated area for them to smoke any longer. I'm sure they would be in favour of community service or something of that nature as a penalty for students who are smoking under the age of 19.

Mr Jim Wilson: We asked some young people this morning who are smokers who appeared before our committee, which is the first time, I think, we've had a string of admitted smokers appear before the committee, and generally they didn't feel it would matter one way or the other.

We couldn't seem to get out of them how in the world to get them either to stop or not take up the habit. They basically said it's trial and error. Some people will smoke and some people won't, and there's nothing you can do about it. In fact, if you tell them they can't, it's just more of an enticement to start smoking. There was one young gentleman, though, who agreed that anything you could do to crack down -- and he did agree that young people should take some responsibility.

It strikes me when I drive by Collingwood Collegiate and there's the Becker store at the corner that, even though they can't smoke on the grounds of Collingwood Collegiate, it doesn't matter. A few yards away they huddle around the Becker store.

Ms Gill: The property behind Becker is where the lady was complaining about the butts to me.

Mr Jim Wilson: I feel sorry for the Becker store owner because suddenly employers in this province have become cradle-to-grave caretakers of the people of this province. I appreciate your comments with respect to sharing the responsibility for the problem.

Ms Gill: I work in an elementary school as well in Collingwood and we try to educate the grade 6, 7 and 8 students about the dangers of smoking and how they'll be addicted for life, and so on. We have great posters about how your clothes smell and it's like kissing an ashtray, and all of the rest of it. You still end up with a couple of grade 8s who try to start smoking as, I guess, a rebellion against parents and so on.

Mrs Haslam: One of your recommendations was providing for licensing of tobacco retailers. Why do you feel that would be more effective than what is already proposed as a ticketing model within the legislation?

Ms Gill: To have them licensed, they will hopefully be more diligent at checking ages of 19 years of age, showing an age of majority card or a driver's licence, or something. I feel, as Mr Wilson has mentioned, that they will continue to go on. If one place won't sell them cigarettes, then others will. If it's licensed and legislated properly and there are penalties for non-compliance, then I'm sure that would assist.

Mrs Haslam: Are you aware of the model that I'm talking about that's being proposed, where you're ticketed and on a second offence you lose the right to sell or have tobacco?

Ms Gill: Yes, I am.

Mrs Haslam: Okay. That's fine. Thank you.

The Chair: Thank you again very much for coming down and making a presentation to the committee.


Mrs Norma McGuire: Mr Chairman, I'd like to introduce us. On my right is Ruth Woodcock, the first executive vice-president of the Ontario Federation of Home and School Associations, from Etobicoke. On my left is Betty Turner, the president of the Ontario Federation of Home and School Associations, from Windsor. I am Norma McGuire and I'm the immediate past president. I'm from Etobicoke as well.

First of all, I'd like to really give you some praise for having seen the bill get this far. I think it's great that we have been able to do that. The minister has put a lot of effort into this and I know the ministry staff have also put forth great efforts. I really appreciate what you're doing for the young people of Ontario.

I'm not going to go through the paper you have in front of you in any way, shape or form. The first page is an overview, and I would like to highlight a couple of things from that. We are over 18,000 identifiable volunteer parents in the elementary and secondary public school system across the province. The back page shows our board of directors' list so that you know that we do represent a very broad spectrum of this province.

We were formed in 1916 in Ontario to put forth an advocacy role on behalf of children and youth. In 1985, the Canadian Home and School and Parent-Teacher Federation was formed for health issue reasons.

The mission statement you will see is on page 2 and in there is our motto, "The best for each student." Following that are the belief statements, and I don't plan to read those to you. We want the best for a child or a youth in every aspect of their life.

We're typical parents. We're typical citizens of this province. We don't come with a wealth of research background or that type of thing. We aren't going to give you a lot of data. You've received that from a lot of other people, so we're going to go on to other things rather than repeat.

We are advocates for youth. We're concerned about their health and wellbeing now and into their adult years as well. Yes, we do have a vested interest in this hearing: it is the health of our children. No one's paying us to be here either. We cared enough to come on our own. We spent our time, our energies and our own dollars to be here. We definitely don't have a vested interest in that way.

We support the OCAT submission that you heard on February 1 and the Council for a Tobacco-Free Ontario presentation that you will hear later this afternoon. I don't want to go into the details of those.

As early as 1965 parents across this country were asking for legislation about tobacco. We asked at that time for the curtailment of cigarette advertising and for promotion of anti-tobacco campaigns. Almost 30 years ago we were asking for this legislation. We're still waiting. Even last year at our annual meeting in April we asked again for zero tolerance towards smoking in the buildings and on the property of all Ontario elementary and secondary public schools. It has been a long wait and we're still in there trying to get this to happen.

When used as intended, tobacco is lethal, addictive and illegal for those under 18, and you know that. It's legal, but it's lethal and addictive for those over 18. We're asking you to raise the age to 19, to prevent the onset of tobacco use for as long as possible.

Please stand also on the tobacco tax. I understand something was to have happened with that this morning. I missed it. I ask you not to follow the example of the federal government or the government of Quebec. Be strong.

We ask you to eliminate kiddie packs. It's easy for young people to buy a pack of five cigarettes. Eliminate the sale of individual cigarettes. They're easier to get than ever. A minimum pack size of 20 is the norm and should stay that way.


We also would like you to remove the purchase opportunities for buying tobacco. License the retailers. I heard someone say strict penalties. I'm asking for severe penalties for those who sell to underaged people. The proof-of-age card with a picture is successful in the alcohol focus, and I would like to see that happen with the tobacco issue as well.

We heard a few minutes ago about smokeless tobacco, and through our brief you will read our opinion about the issue of spitting tobacco.

It's our duty, but it's also your duty, to ensure that access is limited, onset is delayed and use is prevented. Parents want long, healthy, tobacco-disease-free lives for their children. There's nothing worse than seeing a parent struggling with the death of a child, whatever the reason.

We ask you to continue to support young people. Regardless of your party affiliation, our children's lives depend on you and on the passing of Bill 119. Please encourage your colleagues to vote with you in favour of Bill 119.

Mrs Haslam: On one of your pages you talk about the number of mixed messages. It's a concern to us, looking at the pharmacies in particular and the fact that they are in the health care profession. Pharmacists are health care professionals governed by a body, a college of pharmacists. How important are mixed messages to young people?

Mrs McGuire: They are very important. I think I could pass that question on to Ruth, who sits on the Alliance for Children and Television, about mixed messages, media literacy and that type of thing.

Mrs Ruth Woodcock: I think basically the only thing I want to say is that as far as it goes with television, children are a captive audience when it comes to television, and you see them going from one place to the next. Violent acts are increasing in schools. This is off cigarettes, but I think it has a bearing. It's increasing all over the place because of what the children are seeing on television, and I think smoking goes the same way. They're influenced greatly.

Mrs Dianne Cunningham (London North): You're not alone in your presentation, but I'd like to congratulate you on your stamina. Thirty years is a long time and some of us have been there with you.

These kinds of things happen to us, if you know what I mean. We get ourselves elected to do some of these things too. It's long overdue and it's been a goal I think of parents that we see this strict legislation. I can tell you that we're certainly going to be supporting this, but we'd like to see it strengthened.

We think the regulations or the legislation itself must include the licensing of the retail outlets. You've already stated that. We'd like your opinion, because we've heard from two other presenters, a public health unit and the cancer society, with regard to banning it from school properties.

With that, I'd like you to think about a very strong position that one of the health units from Windsor took yesterday. They thought that the responsibility should be on the young people themselves, and if in fact there were fines with regard to drinking underage, there ought to be with smoking. So they were talking about some kind of sanctions against young people.

I personally would agree with that. I think we've tried the education route for 30 years and I've become quite cynical about trying any harder. These young people are on the properties of other private citizens, as we heard in Collingwood today, and smoking next door to the schools. That's one of the problems the school boards have, although I like your strong position.

I wondered what you would say about going further with young people and their responsibility and any suggestions you might have for the committee with regard to school property, because we know what a challenge that will be if it appears in the legislation, but I think some of us are seriously considering it.

Mrs McGuire: I guess at the school where my children attended, there was the typical cancer corner -- and that's what they called it in elementary school, "cancer corner." They knew, but it didn't prevent them going on someone else's property. I don't know how one does prevent that, other than constantly complaining to the students. Then they become very negative towards that person, and who knows what might happen.

I think you would need to have an age restriction at which you start it. To expect a 10-year-old to pay a fine would be difficult. It's going to be parents who would pay that fine. There are children who do have part-time jobs as they get older and that might be a deterrent if they knew they could be fined. Does that answer your question sufficiently?

Mrs Cunningham: Yes. I think you have taken a strong position, and I guess what we're looking for in the committee is that kind of support, because we know how contentious it is to say, "You can't smoke on school property," and then have you smoking on all the neighbours' properties. So maybe there ought to be some penalty involved with this. The enforcement would be something that I think young people would think about.

Mrs McGuire: The penalty may not be monetary; it may be doing some community work, which may be better.

Mrs Cunningham: I think that was mentioned by the cancer society earlier, that it might be a good idea.

Mr McGuinty: I too am concerned about a mixed message. My colleague Ms Haslam raised this issue of a mixed message with respect to pharmacies and, as you know, that's subject to considerable debate here. But I'm concerned about another mixed message we're still going to be sending at the end of the day here after we pass Bill 119, which, by the way, is by and large a very good bill.

Mrs McGuire: Definitely.

Mr McGuinty: That is, I'm a kid, I'm 13 let's say. Now, the message I'm getting is: "When I'm 19, then I can get at those darned cigarettes, then I can make myself sick. So all I've got to do is wait, and then when I'm an adult I can do stupid kinds of things." I think that's still a mixed message.

What I'm hoping is that some day a presenter will come before us and say: "Listen, we've got a plan. It's a long-term plan to phase tobacco out of this province." Maybe something like, first, we're going restrict the sale to the equivalent of an LCBO, and then later on you can't get the darned things without a prescription, something along those lines. But I just am frustrated that we're nibbling away constantly at the edges and we're still sending out a mixed message, we're still endorsing it implicitly in the province. It's a legal product. What do you think?

Mrs McGuire: First of all, the later a person starts to smoke, the more likely they are not to, and I think that will continue regardless. I don't see it as being, "I'm going to be 19 and I can do it." I think if they know, if they've had that education, they've had that pressure, there won't be as much peer pressure from their friends to smoke. They will be able at that time to see some of their parents, their relatives who have smoked and are then suffering in some way, if they have not been denied that relative or a friend. I think it will take them some time to realize, but by the time they're 19, they should be able to make the proper decisions.

Mrs Woodcock: I'd just like to add that at that time they've also probably had the further advantage of more education on the disadvantages and the problems with smoking and tobacco because they've had a chance to finish their education.

The Chair: I want to thank you on behalf of all the members of the committee for coming before us this morning. We appreciate it.

The committee recessed from 1150 to 1331.

The Chair: Good afternoon. We begin our afternoon hearings in the standing committee on social development. We are reviewing Bill 119, An Act to prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others.

Before calling the first witness, members of the committee, I'd just like to note that we've received two documents from research: One is the summary of recommendations to date in the hearings we've had, as well as a fairly copious compendium of recent press clippings, but this issue being what it is, I suspect the clippings will continue to grow. Members have a copy for their information.


The Chair: With that, we will begin our afternoon's hearings and I would invite the representative from the Peterborough County-City Health Unit. We welcome you. I hope your drive down was not too difficult.

Mrs Christine Finlan: I took the bus.

The Chair: I guess I should say I hope it won't be worse going home. It doesn't look too nice out there. But in any event, we welcome you to the committee. If you'd please identify yourself, we have a copy of your submission, so please go ahead.

Mrs Finlan: I am here today representing the Peterborough County-City Health Unit and the Coalition for a Tobacco-Free Peterborough. I'm Christine Finlan, a health promoter with the health unit's tobacco use prevention program.

We would like to take this opportunity first off to commend the Health minister and the NDP government for bringing forth this legislation. Bill 119 is an excellent step towards comprehensive tobacco legislation in our province.

In Peterborough we are very concerned about the effects of tobacco use on our population. We see more than 200 deaths a year attributable to tobacco use and that's clearly unacceptable. We cannot continue to tolerate the human and financial costs.

Clearly the focus of any tobacco control legislation needs to be on your youth. We need to ensure that they do not start smoking. Once children have been lured into that tobacco market, they are trapped in a lifetime of addiction, and sadly, all too often, in a lifetime that's shortened.

Effective public health measures are required to limit both the access and exposure to tobacco use. Licensing of retailers must be part of Bill 119. Most minors purchase their tobacco in retail stores, and we know that enforcing restrictions on the sales to minors results in reduced smoking rates among youth. We know what works; let's do it.

Currently the legislation is confusing and does not provide an effective deterrent for retailers not to sell tobacco to children. Store owners have been left virtually to interpret the law on their own. A recent survey in Peterborough of our grade 9 students indicated that half of those underaged smokers were able to buy their own cigarettes and only 20% were ever asked for identification.

In Peterborough an education campaign to inform retailers of their moral and legal obligations not to sell to minors revealed that retailers basically wanted to do the right thing but they were unsure about what the law required of them. In one particularly interesting example a gentleman had saved all of the notes he had ever received from parents stating that it was okay for their kids to buy cigarettes. He put them all in a plastic shopping bag and toted them out very proudly, yet the fact remained that he was still selling cigarettes to underaged children.

Cleaning up the current requirements is a positive first step, but the law needs to be clear and it has to be enforced. The threat of losing a licence to sell tobacco would facilitate that enforcement.

We need to ensure that we do not produce another generation of tobacco users, but we also have a responsibility to protect those who cannot protect themselves from exposure to secondhand smoke. Unborn children, children and seniors are particularly vulnerable to the effects of environmental tobacco smoke, or ETS. They're powerless to control their environment or to leave it.

There is no debate about the health hazards associated with exposure to ETS. We've all heard it. The US Environmental Protection Agency has classified it as a group A carcinogen, meaning it causes cancer in humans. Any level, then, of exposure is clearly unacceptable and it's irresponsible.

We recommend to the committee that Bill 119 then be amended to prohibit smoking in all public places. It stands to reason that if a substance is hazardous in one area, it's a hazard in another.

Exposure to ETS in public places has an immediate effect on the health of our population but it also affects the smoking rates of our youth. Our children do not acquire their attitudes and beliefs in a vacuum. Adolescents have a need to belong and they are influenced by the overall rules and values of our society. By eliminating smoking in public places we send a clear message to our youth that smoking is not a socially acceptable behaviour.

Right now, we're sending very confusing messages to our youth. On one hand, they hear a lot of information about all the health hazards of smoking, both to the smoker and to those around them. Yet there appears to be a reluctance to take the necessary steps to remedy the situation. Children can be exposed to ETS in all public places, and by eliminating smoking in all public places, we would be helping to protect the health of our more valuable resource, our children.

In Peterborough we've been doing a lot of work in this area in particular and we've come a long way. We've had a bylaw in existence since 1988 and a total ban on smoking in public places has been introduced. A number of places have gone smoke-free on their own: Our shopping malls, hospitals, schools, our community college, memorial arena, municipal buildings, some restaurants and most recently a doughnut shop are all smoke-free.

Despite how far we've come, we can't go any further without your help. There are 17 different municipalities within the county, each with its own guidelines and regulations. Achieving a level playing field, you can imagine, is almost impossible. Municipalities are reluctant to take responsibility for controlling a substance that remains legal in Ontario. Though there's virtually no debate over the health issue, there is a feeling that this problem is of a greater magnitude. It's not unique to Peterborough; all of Ontario is affected by tobacco use.

At the health unit we receive a great many calls from people in the community who are concerned about exposure to secondhand smoke and they want to know what to do. The problem is that, sadly, all too often the current laws are being upheld; it's just they're not sufficient to control exposure. We urge you to remain committed to health promotion and illness prevention in order to achieve a higher level of wellbeing in our province.

In closing, I would like to address the committee as a mother of two, soon to be three, and as a health care professional. Let's not forget what the issue is really about: It's about the lives that are at stake. It's not about the taxes and jobs and freedom of choice or enterprise; it's about the lives. I often wonder how many tax dollars it takes to equal one human life.

I urge you to act responsibly in the face of the evidence. Clearly the lives of the people of Ontario depend on you for today and tomorrow. Let's continue to work together and make tobacco use something our children will learn about only in their history lessons. Thank you.


Mr McGuinty: You, like many other presenters, have raised this idea of putting into place a licensing system, and the government I gather had heard this prior to drafting the bill and decided not to go ahead with it.

I just had a question. I look at the fines that the government has come up with in Bill 119 and they seem to me to be pretty darned stiff. If you sell to somebody who's under 19 the maximum fine if the defendant's an individual is $50,000, and then there's a prohibition period I think of six months. That seems to me pretty tough. If I'm somebody out there operating a small store, that's going to scare me and hopefully it will have the desired effect, which is to ensure that I won't sell and I'll be very, very careful.

I'm just wondering why you don't think that will be effective, and of course the thing that we have to balance on the other side of this is to impose a further burden on our small business operators in the province with government paperwork.

Mrs Finlan: I think the key to anything that's proposed is the enforcement issue. We could have a very stiff fine, but unless there's a real threat of being caught, it doesn't have any teeth to it, does it?

I think any enforcement of the act has to begin with a knowledge of who the retailers are to begin with. That's a clear place to start. I think by a licensing system that means that the retailers have a bit of a vested interest as well in upholding the law. I think just having a stiff fine on its own is not enough. There has to be clearly some enforcement of that, and I think that licensing would help to provide some of that.

Mr O'Connor: Thank you for your presentation. I just listened with interest to what you've said here and have to agree with my colleague Mr McGuinty here. I thought that it was pretty clear: "No person shall sell or give tobacco to a person who is less than 19 years old."

It goes on further in the next subsection and we've heard, "It is a defence to a charge under this section that the defendant believed the person receiving the tobacco to be at least 19 years old, because the person produced a prescribed form of identification." So we're asking for identification. Now we've asked that that be changed so that it includes a picture on the identification so that we're not leaving it kind of wishy-washy out there.

I think as well that the fines and the penalties are pretty stiff, as my colleague has pointed out. Would you go so far then as to recommend that not only do we include what we've laid out in the statutory measures but if, for example, you've been caught once, twice or earlier convictions, would you go so far then to say that those prior convictions will be convictions not only under this act but under federal acts as well? Then when we talk about being charged, the person is not just being charged under this act but also being charged on tobacco-related charges under federal legislation.

Mrs Finlan: I'd have to say honestly that I haven't thought necessarily about provincial versus federal charges that way. Again, I think the key is the enforcement of whatever is put in place, that there has to be a true threat to the retailers in order for whatever happens to be put in place to work.

Mr O'Connor: I guess then a key would be that not only at the hearings do we have a chance to talk about it and the public is being made aware of it, but also follow up public awareness by the government to let retailers know that this act is in force.

Mrs Finlan: I think awareness and again enforcement. There has to be enforcement.

The Chair: Thank you very much for coming before the committee today. We wish you all the best.


The Chair: If I could then call on Leslie Braden, Pharma Plus Drugmart, Barrie. Ms Braden, help yourself to some water and welcome to the committee. Please go ahead.

Ms Leslie Braden: Members of the committee, I am Leslie Braden, a pharmacist and a pharmacy manager for a Pharma Plus Drugmart, which is a community pharmacy in the Bayfield Mall in Barrie, Ontario.

I would like the members of this committee to consider the impact and the implications of Bill 119 in my local marketplace. As a health care professional I support the intent of Bill 119 to further restrict the sale of tobacco to minors by increasing the legal age for tobacco purchase.

However, I cannot support section 4(2)8 of this bill, which would prohibit the sale of tobacco in pharmacies. This discriminatory legislation would not serve the goal of protecting our youth and is an abhorrent restriction of freedom in the marketplace to sell a legal substance.

As you may know, the 61,000-and-some residents of Barrie have been devastated over the last several years by the downsizing and closure of major employers like General Tire, Tambrands and Hill Refrigeration.

The pharmacy in which I work is 7,000 square feet of retail space located in a residential mall. We are open every day of the year, except for Christmas and New Year's Day. We are conveniently accessible to our patients evenings and Sundays. The store employs nine full-time and 10 part-time staff within our various departments, including our dispensary, our over-the-counter medication department, cosmetics, infant care, confection, tobacco and sundry departments.

Under the same roof, within the same shopping mall, are four other general retail stores which sell tobacco. Traditionally in a drug store located in a mall the selling of a blend of merchandise, sometimes referred to as "front store," has subsidized supervision of extended hours of pharmaceutical care services.

This subsidization has become increasingly important as the rising unemployment in our community has swollen the numbers of general welfare and family benefit recipients. As those utilizing the Ontario drug benefit program have increased, profitability in the dispensing area has dropped drastically. Due to the restrictions in the number of items reimbursed, the freezing of the dispensing fee and the social contract clawback, I have seen my dispensary's gross margin drop by 10%. This is not healthy in business.

Tobacco in 1993 represented 23% of the front-store sales and 15% of the total sales for the store. In terms of total dollars of sales generated, tobacco was the third-largest category after prescriptions and over-the-counter medications. Tobacco sales in 1993 contributed 23% of the dollars to total store net profit, or to the bottom line. If tobacco was removed from the store, we would have to cut our wage dollars proportionately. Considering 1993 figures, this would mean two full-time positions would be cut or reclassified to part-time and additional part-time hours would be reduced.

These figures do not include the loss of revenue to my store due to the loss of companion sales should the legislation be passed. Those additional items now sold at the time of the tobacco sale have been estimated by the Coopers and Lybrand consulting group to be 25 cents to 37.5 cents of additional sales on every dollar of tobacco sales, so we stand to lose more. Those companion losses could result in further staff cuts in my store.

Across the province Coopers and Lybrand concluded that banning the sale of tobacco from pharmacies could result in 133 potential pharmacy closures and the loss of 700 full-time and up to 2,000 part-time jobs. This is no small matter. When there are already other tobacco vendors under the same roof in my mall, do you really suppose there will be any less cigarettes sold because their sale is banned in my pharmacy? A vendor could even set up a tobacco kiosk less than 10 feet from the entrance of my pharmacy to take advantage of the recently diverted traffic.

I believe Bill 119 will not change the volume of tobacco sales, but only their location. Bill 119 will unfairly discriminate against pharmacies by prohibiting the sale of a legal product from a closely controlled environment. Those sales will be driven to other retail outlets and to the contraband tobacco market. The intent of Bill 119 to decrease sales of tobacco to young people is worthwhile, but shifting distribution from pharmacies and leaving its sale in other retail outlets will only be creating an unfair playing field and will not have an impact on the number of cigarettes smoked by minors.

The Lindquist Avey study on tobacco distribution found that retail pharmacies are the most diligent in enforcing the ban of tobacco sale to minors. Removing tobacco sales from pharmacies will increase sales in other retail outlets where the same study says the laws are much less stringently enforced. The fewer number of legal outlets for tobacco, the more likely smokers will be to participate in the contraband tobacco market, an arena where the government has then absolutely no control.


The size, location, rent and staffing of my pharmacy have been predicated on the existing sales mix, which includes tobacco. I'm not sure if you're aware that many drugstores, particularly in mall locations, have their rents tied up in long-term leases with a percentage rent component. The percentage of tobacco sales paid as rent is about one quarter of our other products. So the bottom line is, if tobacco sales are removed from pharmacies, our rent would increase.

To restrict sales in the front store will impair the stability of the interdependent structure of dispensary and front store. This will be a more damaging blow because the current government has already restricted dispensary profit by reducing our fees after a three-year freeze. If the front shop fails, the hours of operation will likely be restricted and the patients in my community will have restricted access to their pharmacist, the one front-line health care provider they can rely on to be available to them without an appointment.

Bill 119 will not achieve its goals by banning tobacco sales in retail pharmacies. This section, section 4(2)8 of the bill, will instead result in lost jobs, reduction in hours of operation of pharmacies and consequently in families losing access to a valuable member of a health care team in their local community.

I hope that my comments and views will be of assistance to this committee in its deliberations over Bill 119 and I would be happy to answer your questions at this point.

Mrs Haslam: We've been on this committee for a couple of weeks and I think we've heard this argument from some of the chain drugstores before. It always amazes me that this committee's going to have to come to a decision and now, given that the federal government has just lowered the taxes on cigarettes which will increase possibly the number of people who smoke, I think it's incumbent on us to be very strong in this legislation because we have to be.

I'm always referring back to other presentations that we've had made to us. The Lung Association in London and Middlesex did a presentation where it said that in the Canadian economy lost productivity and wages due to smoking-related illnesses and premature deaths account for an estimated $5.4 billion yearly, as a loss and as an additional $1.5 billion yearly spent on hospital care and physicians' services for these illnesses.

When I have chain companies come and say, "Bottom line to us it is a cost item," bottom line maybe to the government, we have to look at it as a cost item too, only our costs are $5.4 billion yearly to the economy and $1.5 billion yearly on a budget out of $17 billion, a third of our budget going into the health care costs. We have to look at 13,000 premature deaths a year.

When we have presentations come here, I'm concerned that we hear that there's a loss of some jobs and it's not easy, that there'll be a loss of profitability for some druggists, and then on the other hand we have pharmacists come in and say: "I did it. It used to be 10% of my business and I didn't go under. I was able to maintain my integrity as a health practitioner without losing the business and by replacing it with other products."

Ms Braden: Different stores may be able to do that.

Mrs Haslam: I agree. I hear chains come in and say: "You're not going to reduce the volume when you take it out of only our store. We would like a level playing field." I have other pharmacists come in and say: "That's why the college of pharmacists wanted you to bring this in, because we do need a level playing field. Voluntarily, it's not working out there. Voluntarily, our pharmacists are not following what their own college has put in place, for various reasons, depending on the chain store you're located in, depending on whether you are hired by a store or whether you are an owner of that store and look at the front line as a profitability."

I must tell you that the one thing that did bring it more to my attention was when Lambton county came in, because up until now we've heard pharmacists say, "We're the ones who are more precise in how we control the tobacco." In Lambton county 36% of the questionnaires that went out to their own local high school -- 36% of the students said they had access through pharmacists. To me that says we have to come to grips with this and maybe it's time we did play a very hard line in this situation and come to terms with that. As pharmacists, don't you feel it's time you took a hard line and said, "Bottom line maybe isn't profit this time"?

Ms Braden: I appreciate your concerns and I have no argument that it isn't a major health risk and a major concern for all of us. I don't agree that Bill 119 is a method of effectively dealing with it and I maintain that tobacco is a legal substance and we are responsible in our manner of selling it. Over time the marketplace will gradually diminish in its sales in pharmacies and that will be accomplished in a voluntary manner as we reintroduce different product mixes, but we cannot be legislated --

Mrs Haslam: It hasn't happened since 1990, when the college introduced it. It was supposed to have worked in four years. What kind of time lines do you think the chain drugstore or your drugstore is going to need if it's not done in four years?

Ms Braden: I can't speak for the chain I am employed for; I can speak as an independent pharmacist. I believe change does take time and I believe we will need to reassess our position in the community as far as what we sell as retailers but that it cannot be legislated. It is a process of education, of educating particularly our young people and being out in the community.

Mrs Haslam: Which, as Mrs Cunningham has said, is not exactly working and we have to --

Ms Braden: If I'm allowed to maintain my store in my community, I can maintain my influence on the young people I come in contact with. If I'm closed, I cannot do that.

Mrs Cunningham: I'm going to remind my colleague that the main focus of the Middlesex-London Lung Association was on the workplace and the need for more legislation.

Mrs Haslam: But the facts are there.

Mrs Cunningham: Yes, but they never made any comment on the point of sale. They did make a lot of comments on the workplace.

The Chair: We'll keep questions and answers to the witness, please.

Mrs Cunningham: Yes, it's hard though, isn't it, when somebody else has spoken. I'm just correcting that.

Ms Braden: The Lambton study is perhaps an unfortunate anecdote. The Lindquist Avey study does define that tobacco is sold most responsibly from pharmacy retail outlets rather than other retail outlets and that's quite clear.

Mrs Cunningham: I think this morning the students who were before the committee also said that, which is quite interesting. From our point of view, where we're looking at this issue, we certainly support your position because we feel that the emphasis has to be on licensing the person, in fact the retailer, that's selling the cigarettes. I wonder what your opinion would be on that. Also, the health unit in Essex-Windsor also stated that it was important that the young people take responsibility and that perhaps there ought to be some fine or some deterrent to young people who are indulging in illegal activity.

Ms Braden: I agree.

Mrs Cunningham: I wondered what you would say about having to be licensed as a drugstore in spite of the fact that I think basically you people are asking for identification more than anybody else. What would you think about the young people who are smoking off the school grounds -- we hope, if they have to smoke, we wanted this thing to be a school grounds thing. What would you say about going after young people with fines and what would you recommend?

Ms Braden: I believe they should be called to account for their behaviour and certainly waiting until they're 19 years of age -- they should be able to account for their decisions prior to that. I believe in the licensing of establishments to sell tobacco. That would create a sense of educating of retailers. It would bring everyone on line with the enforcing of the age restriction.

If we were to establish an identification similar to several years ago, back in my university days, the age of majority card -- perhaps something like that could be established that could be used as an effective photo identification for students or minors who are coming of age, so they could be identified by all retailers. By educating retailers I think you would obtain cooperation from those who right now are perhaps a little lax.

The Chair: Thank you very much. I'm sorry that our time is going to have to end the questions, but we also wish you a safe trip back to Barrie.



Ms Bonnie Hauser: Thank you for allowing me to stand before the committee. I'm Bonnie Hauser and I'm a representative of the Canadian Cancer Society. I'm the health promotion chairperson for the central west region. The central west region is the Golden Horseshoe, Niagara, Kitchener-Waterloo, Brantford, Halton and Haldimand-Norfolk.

The Canadian Cancer Society is a volunteer-driven, non-profit organization whose mission is the elimination of cancer and to enhance the quality of life of people living with cancer. My voluntary position as health promotion chairperson is to enable people to take the responsibility for cancer control by adopting lifestyles that will promote prevention, early detection and early treatment of cancer. The cancer society feels that Bill 119 is a crucial legislative framework which will enhance our efforts to improve the health of the people in our province.

The reduction of tobacco use will greatly reduce the incidence of tobacco-related cancers. Tobacco contributes to 30% of cancers and 85% of lung cancers. Over 90% of the people who smoke start smoking before the age of 17. The initiation of tobacco use and becoming addicted -- people become addicted between 12 and 15. If we can stop them from smoking before that age, we will prevent them from becoming addicted to tobacco use. I feel that Bill 119 will help this by increasing the legal age to 19, eliminating the kiddie packs by imposing proper packaging restrictions and eliminating vending machines, which are easily accessible to minors.

Bill 119 promises to help reduce the availability of tobacco products to minors. By increasing the age to 19, they can use the age of majority cards to identify people, which would make it a lot easier to regulate the sale.

Vending machines must be removed so that the sale of cigarettes can be monitored. If we reduce the access of cigarettes for minors, we will reduce the amount of teens who will begin smoking. Some 3,000 teens per month join the tobacco market, and 36% of these teens will die of tobacco-related deaths before they reach the age of 70. The health costs of this are phenomenal.

I've included in my report some statistics for the central west region. As I was writing these numbers down, it became very upsetting. It just seems like statistics, but 21,000 people in the central west region died of tobacco-related diseases in a 10-year period. That's scary, and it seems to be increasing. That was a total cost of close to $66 million in health care. We should address this. I think that Bill 119 is going to help restrict the amount of people who start smoking younger and therefore restrict the amount of people who die of tobacco-related diseases.

It's really surprising in the area that I live in that the Haldimand-Norfolk separate school board and the Norfolk public school board still allow smoking on their premises. I really feel that Bill 119 will help eliminate smoking on school properties. We all know that if teachers are found smoking, it's a role model for children, Mr Eddy, and this should not be allowed.

In a public opinion poll that the cancer society was involved in, done in September and November 1992, they found very strong support for tobacco control measures which would keep children and teens from buying tobacco. One third of the people who were polled were smokers themselves, yet 81% of these people supported legislation to restrict access of minors to tobacco products and 75% of them wanted a ban on vending machines to allow cigarettes to be sold only at licensed retailers who will require the showing of proof of age cards.

I have several statistics in my pamphlet, but I'll just highlight some of them.

Seventy per cent of the people who were polled felt there should be a ban on cigarette smoking in indoor public places. This is really interesting because 33% of these people are smokers themselves, so it sounds like 6% of the smokers actually want a ban in public places also.

Sixty-four per cent of them cite that lung cancer is the primary danger of tobacco smoking. The general public realizes that tobacco use is not healthy, and I think the general public really wants them to do something about it. The introduction of Bill 119 will help address some of these concerns and will help give the public the legislation they require.

One of the areas that I am personally involved with is I am also a pharmacist. As a pharmacist, my husband and I own Hauser's IDA drugstore in Dunnville, Ontario. There are two drugstores in our town, and we made the decision in 1982 to eliminate tobacco products from our drugstore. This decision was very difficult because, as you know, there is a financial implication to reducing the sale of a product that you have in your store. Ethically we felt that we could not be true health care professionals and continue to sell a product that we knew causes severe health problems.

Surprisingly enough, this was a very positive decision to make as far as retail went. We became the professional pharmacy in town. The other pharmacy was known for selling the cheapest cigarettes. People came to us because they wanted to receive professional information from a professional store. We had a patient who went to the other store to buy his cigarettes and came to our store to get his prescriptions because he felt he was getting professional service at our store. We got a lot of positive feedback as far as customers praising our decision, and I think we even had new customers come in to our business.

Some of the pharmacists think their business will collapse if they're not selling cigarettes. Last year in the summer our competitor took out his cigarette products, and even though his claim to fame was selling cheap cigarettes, he's still in business and doing quite well. My brother also owns two drugstores in Port Colborne, and he eliminated tobacco products. His competition was Shoppers Drug Mart. He picked up many new customers. People were very supportive of his decision. In the Hamilton area, the Dell Pharmacy chain has removed tobacco products voluntarily from its stores too, and they are still in business. If a drugstore is going to go out of business from removing tobacco products, maybe they should be opening a smoke shop, not a health care establishment.

These opinions are strongly backed by our governing body. The Ontario College of Pharmacists strongly recommends that pharmacists remove tobacco products, and Bill 119 is the legislation that will make it a universal decision. The Ontario Pharmacists' Association also encourages voluntary cessation of the sale of tobacco products. In a survey vote in the fall of 1992, 62.1% of pharmacists supported the voluntary withdrawal of tobacco products.

A lot of pharmacists are afraid of this act, and I think it's because they feel the decision is being taken away from them. But when you explain to them that it's the Ontario College of Pharmacists that has tried to encourage this committee to introduce the withdrawal of tobacco products from pharmacies, I think they understand that it is a really positive decision. Pharmacists must make their business the business of health, and tobacco products have no place in a pharmacy. Bill 119 reflects this position and enforces the pharmacist to uphold the recommendation of the college of pharmacists.

In conclusion, I think the cancer society believes the government will receive strong support for Bill 119. As a volunteer of the society, I know that my fellow volunteers and the people who donate to our society are concerned about tobacco sales to minors and wish that tobacco use could be reduced or eliminated. As a pharmacist, I know the majority of pharmacists are willing to remove or have already removed tobacco products from their stores. I feel Bill 119 will help to reduce tobacco use and in turn reduce the incidence of cancer.

Thank you very much for your time.


Mr Eddy: Thank you for your presentation and indeed your own story of how you've eliminated the sale of tobacco in your pharmacy. I think that's good in your connection with the Canadian Cancer Society.

Realizing the concern that most people have about youngsters starting to smoke and realizing your support of Bill 119 as it stands, are there any other things that you think should be included that would help this situation? I know a great deal of it is through the contraband tobacco situation, of course, but are there other things that you think should be included in Bill 119 to strengthen it in regard to the point of youngsters starting to smoke?

Ms Hauser: I guess education is the main thing, if we educate people to the deterrent factors of tobacco use. I guess if people aren't allowed to smoke in public places, it won't be seen as a glorious image of smoking, and if it's kind of put to the back rooms or the outside, it won't be as convenient. I think that may help youngsters decide not to smoke. I think they start because they think it's a defiance of authority, but if you make it an uncool thing to do by kind of making it a backroom thing and not allowing smoking in any public places -- there are a lot of communities that still don't have that bylaw.

Mr Eddy: Yes. Unfortunately, that's true. Thank you for your response.

The Chair: Thank you very much. I'm afraid we have a very tight agenda this afternoon so I'm going to have to close it off there, but thank you again for coming. Safe trip home.

Mr O'Connor: If I might, Mr Chair?

The Chair: Oh, yes. Sorry. The parliamentary assistant just had a couple of documents.

Mr O'Connor: As a result of this morning's announcement by the Prime Minister of Canada, I've got a copy of the press release and the fact sheet related to it, and I also have a press release from the Treasurer of the province, Floyd Laughren, who has been deeply disturbed by the federal move. I would like to table that and circulate it to the members of the committee.


Mr Howard Lackie: Mr Chairman, ladies and gentlemen of the standing committee, I'd like to take this opportunity to thank you for allowing me to make this presentation today. My name is Howard Lackie, as was stated. I'm a pharmacist, a fellow of the American Society of Consultant Pharmacists and also the American College of Apothecaries. I'm very much committed to community health care, as are my wife, who is a physiotherapist, and my daughter, currently a resident in obstetrics and gynaecology in this city. I own two pharmacies in St Catharines.

I apologize, as I indicated to the clerk earlier, that I do not have copies right at the moment, but I will provide them. In fact I had prepared the 25 copies as was required to make my original submission to you, but after reviewing and watching what has been going on here during the last week and hearing what has happened this morning, I wanted to say something a little different. So, please, with your indulgence, I want to bring a little different perspective to the issues. I am prepared to hand in this presentation as I've finished it earlier today and will provide you with more copies.

Forgive me: I am not a lobbyist. I'm a simple pharmacist. I'm there on the front lines. I deliver health care. I counsel with my patients. I fill their prescriptions seven days a week, trying to make a living for myself and providing employment for 65 people in my two pharmacies. I own and operate two Shoppers Drug Mart stores in St Catharines. One is located at Port Plaza near the infamous Port Dalhousie, and the other at North End Plaza on Lakeshore Road, also in St Catharines.

Now, please, I'm not one of the bad guys, because to the casual observer watching this scenario and witnessing these proceedings, that is what this debate has turned into: the good guys who don't sell tobacco and the bad guys from Shoppers Drug Mart. Because our parentage and our relationship are associated with Imperial Tobacco, the bad-guy image of Shoppers is of course taken for granted.

For the record, Imperial Tobacco cares as much about me as I care about them, and that's not very much. There's absolutely no love lost in our business relationship. Again for the record, you might refer to the two sales representatives who just called on me this past week or two. We are two separate and distinct corporations in a holding company known as Imasco. I don't even think that the Imperial Tobacco workers in Guelph shop in Shoppers Drug Mart stores. They certainly don't shop at my Shoppers Drug Mart. I'm not my brother's keeper in this regard, and they're not concerned about me either.

As you have heard, there are about 1,400 pharmacies in this province who could be classified as the bad guys, and the balance of the 800 are the good guys. But as you know, the problem is not that simplistic. I only wish this issue was as black and white as it seems to appear. As you are well aware, it is a very, very complex problem. In fact there are over 2,200 pharmacies and over 7,000 pharmacists in this province who abhor tobacco. I don't believe there is one single member of our profession who condones its use or truly approves of its sale. If there is, then he or she is from a completely different planet.

Your proposed legislation is a good piece of legislation. I believe if I asked all of you, those who are here right now anyway, members of the standing committee, if this legislation did not contain the provision that's referred to as section 4(2)8, would you vote right now at this very minute for its implementation, I think there would be a unanimity in this room without any question. The Liberals, the Conservatives, the NDP government members, all of your hands would go up. Shoot them high. You would vote a unanimous yes, almost a historic, unanimous yes, and tomorrow morning it would be passed.

The quicker we get the 19-year-old provision in and the sooner we get serious about finding vendors who break the law the better. Every day lost in that regard is another day wasted. But obviously, this section 4(2)8 is the clause that has slowed down the implementation of this act. This is what's making us sit here for these long weeks.

It was while I was watching the proceedings on the parliamentary channel -- I never, ever thought I would watch that thing -- that I decided to discard my original presentation. It was because of the nature of the questions that had been asked by all party members to the pharmacist presenters particularly. I see Mrs Haslam has vacated the room, but I know she's been asking the same question, and please believe me, I believe that question is right on. It goes to the heart of the matter and it addresses the fundamentals of this issue.

She's asking, "How can you be a pharmacist and a health care professional and operate a health care facility while at the same time you're selling a product which negates that very purpose?" That question is absolutely the right question for all of you; not just Mrs Haslam, but all of us. We present that question. It is absolutely the issue and the question.

I have to tell you personally that as a health care professional operating a health care facility, it is incongruous that I sell tobacco. It's a paradox; it's a conflict. There's no doubt about it. Absolutely. But all of you members on this standing committee, all of you honourable members, I presume, have to realize that a pharmacist is not only a health care professional.

In the same way that the government of Ontario is made up of different portfolios and there are different ministries in the government, so is pharmacy made up of different portfolios, and there are different ministries and disciplines within a drugstore. In the universality of a drugstore, we're composed of different parts. In the same way that the Ministry of Health obviously finds tobacco reprehensible, while I am wearing my white coat and I am serving in my dispensary and I am like the Minister of Health, tobacco is likewise unacceptable.


However, the Ministry of Finance and the Ontario government need revenue from all sources to pay their bills. The Ministry of Finance needs taxes from liquor, from beer and wine sales, from gambling, yes, even from Pro-Line -- we'll find out what the basketball situation is -- and even from tobacco.

The Ministry of Finance takes that money to pay the bills of the Ministry of Health, and while I am proverbially wearing the Minister of Finance's hat in my drugstore, my responsibility goes beyond the dispensary. I have to create enough revenue to pay the bills at my pharmacies, to pay the salaries, wages and other expenses incurred in the operation of both of my drugstores. The pharmacy itself is not self-liquidating and does not cover the costs for the balance of my store. Maybe that's an issue for a whole different committee meeting. We'll leave that one at this point.

When I am acting as the Minister of Labour, I have to create employment opportunities for the 65 people who work in my two stores. Remember, as some of the earlier speakers said, I also come from a community that has been very, very hard hit in the labour force. General Motors is the major employer in the St Catharines-Niagara community.

Please forgive me for my analogy to this series of Politics 101, but that's exactly how a pharmacy and a drugstore operate. In the same way that the government wears many different hats in different ministries, in different portfolios, and in the same way that some departments raise revenue that may be incongruous or in conflict with other departments, your ministries are inexplicably bound together by virtue of the fact that you are a composite body. You are a cabinet. The pharmacy is one part of our business; the drugstore is another part of our business.

As I might term myself in this context, as the Premier of two Shoppers Drug Marts -- I've lost some of my notes. Just one moment.

The Chair: Take your time. These things happen.

Mr Lackie: These things do happen, yes. I normally like to talk off the cuff, but because you did ask for 25 copies, I'll see if I have some of my original notes when I redid them on the computer. No, I don't, so we'll use a little bit of cuff work here.

The Chair: It's all right. You can take a moment to sort your thoughts out. We have time.

Mr Lackie: I'm referring to the differential and the comparative nature of the government and its different ministries and their responsibilities and my responsibilities. I have to emphasize that I wear those same hats that the government wears. I have to look after all of these same different ministries. There is a conflict there, but I still must be able to make that balance. That balance is one that I have a lot of difficulty with, as I indicated before, because there is a conflict in terms of the health care issue and in terms of being able to maintain my pharmacy in a viable fashion.

In this particular situation, I think there are some other issues that may be of concern. I'd like to refer to another point and that is with regard to the Ontario College of Pharmacists. They had asked this government to bring this legislation into place and put it into place, and this government is merely reacting to that particular request.

In June 1991, the district representative for the St Catharines-Niagara Peninsula was Donna Sutherland. In subsequent elections, which were held a couple of months after that in August 1991, Donna, who had voted for tobacco removal, was herself removed in that election by a 63% majority. Our profession was clearly unhappy with Donna's position and we expressed it in our vote, just as what happens to each and every one of you when you're out there and you speak to your constituents. The vote is the final thing.

A new representative in that particular jurisdiction took a different opinion and I believe that opinion represented the majority of the pharmacists on this particular issue. I also think, and I'm sure you've heard this before, that in a survey done by the Ontario Pharmacists' Association, 62% of the members of that association indicated that they are in favour of the legislation but without section 4(2)8.

The profession is clearly divided. Even in just this past three quarters of an hour you have heard pharmacists who have stated both pro and con. That is an issue which I feel should be recognized. We are not unanimous on this particular legislation as it stands right now. We are unanimous I believe on the fact that we honestly feel that tobacco should be controlled and restricted, but on the actual way of doing it we are not unanimous. I believe you have to take that into account in your deliberations as well.

I apologize for messing up the last couple of moments of my presentation for you and I will try to get you a full copy of it for your records. At this point I'd be happy to answer any questions you might have.

Mr Jim Wilson: Thank you, sir, for your presentation. With respect to your latter comments about the feelings of pharmacists, I did my own survey, mailed to all of the pharmacists in the province of Ontario, and had 560 responses. Of those, 77% believe that the government should not impose this ban. Of that 77%, a significant portion of those were pharmacists who didn't sell cigarettes but still believed, on a business principle, that the government should not impose this ban.

I'm getting the feeling during these hearings that we're hearing from two types of pharmacies -- the large pharmacies, with perhaps 7,000 square feet or more, and the smaller pharmacies, where the banning of tobacco products won't have as large an effect. I also suspect at the same time that those smaller pharmacies don't provide the same services that a Shoppers Drug Mart does, for example. Some stores have 24-hour service, Mr Bloom told us, in some cases home delivery, and a number of other actually quite unique things that Shoppers and some of the larger chains provide to their customers in terms of service.

I'm just wondering, if you're not able to keep tobacco products and the spinoff business that comes from the sale of tobacco products, will those customer services suffer? Secondly, can you give us a feel for what I think we're seeing as the two types of pharmacies, the smaller versus the larger merchandising pharmacies?

Mr Lackie: Let me answer your first question first. I'll pose it to those of you who are familiar with the Minister of Finance in the government. If the Minister of Finance is without the resources, without the money to do all the things that everybody else in all of his other ministries would like -- I've heard the words "social contract" and "cutbacks" and all kinds of other things -- what is the natural result? The natural result is that you cannot afford to do some of the niceties.

Has anybody ever tried to call a ministry office and instead of a person, because persons are expensive, you get a telephone and a telephone answering machine? At some point way down the way, because it's not high on the priority list, our service from the government has decreased.

There is absolutely no difference in my own ministries. If I have the Ministry of Tobacco without financing to provide for the Ministry of Health in my pharmacy, then absolutely there is going to be a decrease in services, and not because I want to decrease the services. If anybody knows me, my prime concern is service: service to the consumer, service to the patient. They are the only things that drive me.


Your other question is with regard to the size of stores. If I understand it correctly, I believe, from my knowledge of the independents, the smaller independent stores, that their focus in terms of financial merchandising and overall focus is very, very different and very much away from anything other than a personal business that they conduct maybe 9 to 5 or 9 to 6. It's a one-person or two-person operation. Certainly their services are not there. They don't have the resources.

I noticed that somewhere later on today you're going to be hearing from a tobacco supplier who services these small people. You might ask him what kind of business they do and how much of an effect it really would have on them. I would venture to say, from my own personal knowledge, that it would have a minimal, if any, effect on them at all, but it certainly would have an effect on the way I operate my business today.

Mr O'Connor: Thank you for coming to the committee today and bringing across, again, another view from a pharmacist.

Earlier today we had a presentation from the York region public health department. They did a telephone survey quite similar to, I guess, Mr Wilson's survey. They surveyed 40 pharmacies from across York region and they found that 90% of the pharmacist employees supported the ban and 39% of the pharmacies already do not sell tobacco products. Those that didn't had positive comments from customers and people from the health community. Some 40% supported the withdrawal of tobacco and 15% of the pharmacies actually had planned to eliminate tobacco in the near future. That's 15%, so that puts it over 50%, I guess. Those that had tobacco products said it was marginal losses. I guess it's all in the marketing, and that's the retail end of your business.

One of the disturbing things that was pointed out to us, though, was that some of the owners who had not voluntarily withdrawn tobacco products said that they could not legally do so without legal action being taken by the parent corporation. I just wondered if you had been confronted with that type of a situation where the parent corporation for the chain -- and they didn't identify themselves, for obvious reasons -- felt that there would be legal action taken against them. I wondered if you had been confronted by that type of situation.

Mr Lackie: I have never been confronted by that. If you're referring to Shoppers Drug Mart, I know that there are a number of Shoppers Drug Marts that do not sell tobacco products. They are smaller stores. They are in medical facilities or health care units and they do not sell cigarettes. I can talk only for myself.

Mr O'Connor: And that's why I pointed out that they didn't name one. Of course, I wouldn't want to name this as just being Shoppers --

Mr Lackie: I can't speak for anyone else.

Mr O'Connor: -- because it doesn't point to just Shoppers.

Mr Lackie: Right, there are other people in this marketplace.

The Chair: Thank you very much again for coming before the committee. We appreciate it.


The Chair: I next ask Dr Meri Bukowskyj. Welcome to the committee. We have a copy of your brief and attachment. Please go ahead.

Dr Meri Bukowskyj: Thank you. I won't be reading directly from my submission. I had actually presented this with overheads, but I'll just sort of flip through my overheads so I'm not reading directly.

I'm coming here to this committee today not as a member of the Non-Smokers' Rights Association, not as a member of the Ontario Medical Association, not as a member of Physicians for a Smoke-Free Canada. I support all those people. I know they've done submissions and I support everything they say. Why I am here today is because I wanted to present my views as a physician and as a respirologist, because I see the end results of tobacco every single day in my workplace.

I am one of the physicians who has to tell people that they have lung cancer. I am one of the physicians who has to tell people they have emphysema. I am one of the people who has to tell people that they're going to die. I have to tell people that they're inoperable and I have to tell people that they're going to be on oxygen for the rest of their lives. This piece of legislation is very important to me and I think it has to be very important to you as legislators.

In your list of things, I want you, at the beginning, just to keep in mind that smoking kills more people than alcohol, cocaine, crack, heroin, homicides, suicides, car accidents, fire and AIDS combined. We have to put it in the perspective of a mortality rate that is really extensive, and I'd like you to keep that in mind. Similarly, I'd like you to recall that the majority of smokers want to quit smoking, and five out of six wish they had never started, and that's an important fact.

Next, what I'm going to do is read to you a letter that is addressed to Mr Beer from one of my patients. This is a lady with very severe emphysema who is now relegated to staying in her bed, or walking a few steps to a chair, and is on oxygen 24 hours a day. She feels this issue fairly significantly now.

"I am a 72-year-old woman. Worked hard all my life" -- this is her letter which I have Xeroxed for you -- "and should be enjoying my retirement. I had my first cigarette when I was about 16. As years went by, my smoking increased to a pack a day for the past 40 years.

"I was advised by my doctor a few years ago to put out my cigarettes before I would ruin my health. Putting a deaf ear to this I carried on smoking until it was too late. I now have emphysema and was diagnosed for this in 1988.

"I would gladly give 10 years of my life to be able to breathe normally. It is no life to be hooked up to a tank of oxygen for the rest of your days.

"I would like to say, if you are a smoker now, quit. If not, don't start. Take this advice from one who is living a life of hell."

I think you should put that into perspective. She's not alone. There are a lot of other people who are living a life of hell that they had no idea that they were going to have to live through because they started to smoke.

You have to understand that smokers deny, as she did, their personal risk of ever developing illness. You ask kids who start to smoke, "Do you know the risks of smoke?" "Yes." "Is it going to happen to you?" "No." They deny. Smokers deny their addiction. There is no way that they understand the level of addiction that is induced by nicotine. They have no comprehension. You ask kids, are they going to be able to quit smoking in the next year? "No problem." Come back to them five years later, most of them are still smoking.

They don't understand the level of their addiction, nor do people who have never smoked understand the addiction to nicotine. I don't understand it. I'm a never-smoker, but I can certainly have a great deal more empathy with the patients whom I've seen, their level of difficulty in trying to quit smoking and all the extensive reading I've done on addiction. But I think one of the problems is that people who have never smoked don't understand, and that's part of the problem for smokers.

One of the things you have to understand is that nicotine from an inhaled cigarette reaches the brain in seven seconds. There is nothing else that gets that fast to your brain, not even intravenous drugs. That gives you virtually immediate reinforcement of your addiction. Nicotine, as I said earlier, is as addictive as heroin and cocaine. Appreciate that. These people are drug addicts. They could be in New York City in the ghetto. But they don't like that analogy, they don't like that comparison.

You also have to understand that there's an incredibly high rate of failure for people who try to quit smoking. At the end of a year, only 8% of smokers, as a total group, have stayed off cigarettes, a 92% failure rate. It's unbelievable. It's a lot more difficult to quit than it is to prevent, and if we can prevent our children from starting to smoke, they won't get into this difficulty of trying to quit an incredibly severe addiction.

Most children, as you're aware, start to smoke between the ages of 10 to 14. Unbelievable. Think about alcohol. You're not supposed to drink before age 19. You don't vote, you don't drink before you're 19, but you're allowed to smoke. There's a very interesting statistic: Alcohol is responsible for about 2% of all deaths in Ontario in 1992. How many deaths were caused by tobacco? It was 20%. But we don't regulate tobacco. No, no, we regulate alcohol. I think we have to do something a lot stronger.

I think Bill 119 is a really good start. I think this government deserves a lot of credit for introducing this bill. I find it incomprehensible that any member of the opposition would not support this bill. It's just untenable that we would not do something to prevent our children from becoming sick.

I, in general, support the provisions of the bill as they stand. What I'd like to do is just go through several of them that I would like to see improvements on.

First of all, I think that restricting access is very important. I think now that the federal government has gone ahead and made this horrendous mistake in lowering taxes, we have to make this bill a lot stronger to protect people in Ontario. I think we should do a lot, lot more.

Licensing: Fine, you can start, but I think that all tobacco should be sold in LCBOs. Get the age of majority. You don't have to do any extra amount of licensing involved. They're already in place. They just have to put up a couple of extra shelves with their packets of poison and they can sell them in places that are already restricted. That will not only limit teenagers; it will also limit where adults can get cigarettes and it will make it harder for them, especially now that the federal government has made it easier for them in terms of costs.


The pharmacy ban: I'm sorry, I very much support having a pharmacy ban. I don't see how you can call yourself a health professional and sell, at the other end of your store, a tobacco product which ultimately results in death. It's not acceptable.

I think, once again, that the federal government has not done enough in terms of packaging and the health warnings. As you know, the Tobacco Products Control Act has a statement in it that allows the provinces to do more. I think that in fact this government should do more in terms of putting warnings on the packages and introducing plain packaging. If the federal government's going to pull the rug out from under us, then I think we should do something more.

I think in fact that smoking should be prohibited in designated areas. In my community we can still smoke in malls. You can die walking through some of the malls in Kingston. You can go into the hospitals. Their designated area is an area that's outside of an elevator where patients are transported. The smoke is thick and yet this is a hospital, a designated smoking area? I think this provincial government should do something that will actually protect not only the patients but the people who go into the hospital. I think that kind of legislation would make it fair to everybody throughout the province.

I think kiddie packs are an abomination. I think there should be a minimum size. I would make it larger than it is now, so that it becomes incredibly more expensive, especially now that the federal government has done what it has. Make the smallest size of the pack 40. That'll make it more expensive to buy. Children can't afford it. Nor will some of the adults who are on the borderline.

I think the other thing that needs to be addressed, although I realize it's not part of Bill 119, is smoking in the workplace. It is something that needs further legislation because it does not adequately protect workers. I think that's something that you should consider revamping.

In closing, what I would like to say is that the tobacco industry did not elect you or any part of this government; the people did. I think it's your responsibility to protect us and our children. Thank you.

Mr Tony Martin (Sault Ste Marie): I want to thank you for coming forward and for your very clear-cut, decisive way of presenting. Certainly there was no doubt in anybody's mind about where you stood on all of these issues. I don't think, from listening over the last couple of weeks to the discussion that's gone on here and from the presenters, there's any doubt in anybody's mind that smoking is not, in any way, a habit that we should be supporting. It is in fact dangerous to one's health and is a cost to society as a whole that is preventable, at minimum.

The debate or the issue at this table seems to be around how much we should still allow smoking or the sale of cigarettes to be available and one of freedom to market and those kinds of things. Certainly the provisions in this act that are under some contention are the sale of cigarettes in pharmacies and the removing of vending machines. In your mind, is there any debate at all around the question of whether we should be selling cigarettes at all?

Dr Bukowskyj: Oh, if I could do it, I'd have a decree and you couldn't sell cigarettes at all. But I think you have to understand that a large portion of the population is now addicted. A large portion of the population that is now ill from their smoking started smoking during the Second World War and earlier when there was nothing known about tobacco. The Red Cross used to give out cigarette packages to the armed forces.

I think it's very difficult to remove a product that we now know is so dangerous, even though it's not legislated or controlled as much as it should be. I think all we can do is control it more and more and ultimately remove it. But I think a hundred years from now people are going to look back at us and say: "How in heaven's name could you have allowed this to happen? You knew all these bad things and yet you allowed people to continue to buy it and to smoke it and to die. How could you do it?"

Mr Martin: Just another little piece -- Jim wanted a question, if he has time -- is the onus of responsibility. Right now, we're certainly putting the onus on the adults in the community who sell these products to make sure that they don't sell to children. There's some suggestion that maybe the onus should be more on the children who buy the products. What's your sense of the fairness of that?

Dr Bukowskyj: I think it's your responsibility as adults. You have to remember that kids are kids. How many stupid things did you do when you were a child? I think we have to protect our children. That's why we have an age of majority.

Mr Jim Wiseman (Durham West): I was a Tory when I was a youngster.

Mr Jim Wilson: Thank God you switched.

Mr Wiseman: I saw the light.

Dr Bukowskyj: Anyway, I think it's important. Yes, I agree actually and I had never thought of that, but I think putting a fine on children for smoking is important. But I think it's also important for adults to protect them because you don't know enough. You don't know until you're older what the hazards are, nor do you internalize them. So I think I agree with both.

Mr McGuinty: Obviously you are a very committed advocate and you make a compelling case.

I want to refer to the words of a presenter who appeared before you, "You know, it would be nice if this was all black and white." I guess it's like so many of the issues that we have to deal with here in government, if we could be pro one side and anti the other, depending on which particular interest group we're dealing with. But of course this is a complicated issue as a result of the history that has developed over the tobacco industry in this province.

Even today, in the press release put out by the Minister of Finance for the government that is sponsoring this bill, which is a good bill -- by the way, I'm not aware of any single member of the opposition who's voting against this bill, just so we're clear about that. That Minister of Finance said, "Ontario stands to lose hundreds of millions of dollars a year from lower revenues if we cut our taxes." I'm not criticizing him for that whatsoever. That's a very legitimate expression of concern on his behalf as the Minister of Finance.

The Health minister of Canada expressed some very serious concerns about reducing the tax.

Dr Bukowskyj: When? I didn't hear her say a word.

Mr McGuinty: Well, she did. Again, I think that's a very legitimate expression of her concerns about that issue. It's a broad issue, it's complicated and this piece of legislation, like any piece of legislation that's ever been put out by any government anywhere at any time, has some imperfections, so we're trying to address those here.

I want to come back to this issue of youth responsibility. How is it that, if we're dealing with something like alcohol, it only accounts for 2% of all deaths but we're distributing the darned thing through a tight network of regulated stores and we're telling kids it's illegal for them to drink when it only causes 2% of the deaths? Why aren't we doing the same thing with cigarettes?

Dr Bukowskyj: Exactly.

Mr McGuinty: Just so I'm specific, you're prepared to impose some kind of sanction against kids if they buy cigarettes below the age of 19?

Dr Bukowskyj: Sure.

The Chair: Dr Bukowskyj, I'm sorry that we don't have more time but we thank you very much for coming.

Mr Wiseman: Mr Chairman, since I didn't get a chance to ask my question of the doctor and since this is only my first day on this committee, I would like to see a breakdown of the frequency of visits to a doctor of a person who smokes, the cost per visit and see the fee breakdown that a doctor would be able to charge on these cigarette-related visits such as cancer, emphysema, the asthmas or whatever, just so I can have some idea of the magnitude we're talking about. I think that the public really doesn't understand what it's costing the system and I would like to see those numbers so I can talk about it in a more precise way.

The Chair: Just because of our time problem this afternoon, if we could take that under advisement and just work on out --

Mr Wiseman: Oh, I don't want it now.

The Chair: We'll see what we can get together.

Mr O'Connor: I appreciate the time because it may take a wee bit of time to compile that information.

Mr Wiseman: That's fine. Eventually.



Ms Alwyn Robertson: Good afternoon and thank you, Mr Chairman, members of the committee. My name is Alwyn Robertson. I'm the executive director of the Council for a Tobacco-Free Ontario and I'm very pleased to be here and to be joined, to my right, by Mrs Norma McGuire, who is our vice-president of administration for the council and who has also made an earlier presentation. She sits on our council as a representative for the Ontario Federation of Home and School Associations. To my left is Dr Michael Goodyear, who is our vice-president of public affairs and is also the representative for Physicians for a Smoke-Free Canada -- Ontario on the council.

What I'd like to do is just to briefly describe to you the nature of the council and its membership and then I will turn the microphone over to Dr Goodyear, who can talk to some of the substantive concerns that we have at the council about Bill 119.

First of all, I would like to offer the council's congratulations to the government for introducing Bill 119 and also our thanks to members of all parties for supporting this piece of legislation. I hope that you're finding this hearing a very interesting process as you're listening to all of us come before you.

The Council for a Tobacco-Free Ontario began its life about 20 years ago as the Ontario Interagency Council on Smoking and Health, and we were set up with representatives from some of the major societies: the Canadian Cancer Society in Ontario, the Heart and Stroke Foundation of Ontario and the Lung Association, along with approximately 30 health and professional associations.

I'm pleased to report that almost 20 years one of the things that the interagency council was to do was to encourage joint action with agencies in promoting legislation and education. Today the Council for a Tobacco-Free Ontario is still very much alive and kicking with very much the same mandate and membership of those original organizations for 20 years.

The council is a resource centre. It is part of the Ontario tobacco strategy. We have a total of 38 local councils on smoking and health in communities all across the province. The council represents the grass-roots component of Ontario's efforts to promote smoking cessation messages across the province.

We have linkages with major health care and professional organizations. You will see a list of some of those organizations at the back appendix to our report to the committee. We also do a number of things to educate people about tobacco issues, this being an example of one of the things that our committee has put together towards the smoke-free class of 2000.

This is being distributed to all grade 6 classes across Ontario and represents a way to help teachers teach young students about tobacco and the messages. We're trying to work with the community and get people together about a very common issue that's of great concern to people and we represent a lot of volunteers and individuals within the community.

I would just like to close by saying that the council supports this piece of legislation. Ontario needs it. It's very encouraging to think that we've been around, on the one hand, for 20 years and unfortunately we're still here because the problem still exists. Thank you. I'd like to turn the microphone over to Dr Goodyear.

Dr Michael Goodyear: Good afternoon. Your timing is certainly impeccable in terms of when you chose to have these committee proceedings in terms of the public interest. I'm sure you engineered it all.

I want to make a strong statement now, in view of the news today, that I wish to congratulate the very strong stand that the government of Ontario has made, and I hope with the support of the opposition parties, against the federal government's insane activities earlier today. It makes, obviously, the activities that you are designing in this bill even more essential, that it must make a major impact in reducing demand.

I would urge you as individual citizens of Canada and as parliamentarians and whatever links you have to bring every pressure you can to bear on your federal counterparts to reverse their policies. They can reverse their policies. Remember, it only took them eight weeks to reverse their policies in 1992, so public pressure does have an effect.

Our time is very limited. I would like to make time available for answering questions on any aspect of issues that have come up in the last couple of weeks that concern you and I would like to touch on a few things that I've heard.

First, and maybe a little technicality: This is a Tobacco Control Act and not, as in the federal legislation, a Tobacco Products Control Act. I would like to remind you that you need to make your definition of tobacco rather broad. This is a packet of cigarette papers. Interestingly enough, it actually is in violation of the federal Tobacco Products Control Act. But since there are so few people in the country, I think about three, who actually enforce that act, provincial legislation that covers all tobacco paraphernalia is important. You may also be aware that most tobacco paraphernalia of course is used for other purposes than smoking tobacco. For instance, you can roll up and smoke all sorts of things which I won't mention on the public record.

This is a packet of cigarettes. Well, it's not actually; it's a packet of candy but, as you see, it's packaged to look very much like a package of cigarettes, Chicago. I haven't opened them. I don't have a sweet tooth. I think, as with a number of other jurisdictions, you should seriously consider including things that pretend to be cigarettes or tobacco products.

We have touched on the plain or generic packaging, which is an even more stringent regulation, in the past. This is a packet of smuggled cigarettes, which is very topical today. I'd just like to draw your attention to the fact that the label is written in French because, as you know, all Americans speak French and therefore we need to export French labels to the Americans. This is another reason why absolute control over the packaging and labelling I think is required, and that rather shoots the smuggling story in the foot.

But I do urge you to incorporate those sections of the federal legislation, as I mentioned to you the other day, into the Ontario legislation to make sure that it at least has the powers of the federal government in terms of concurrent jurisdiction.

I heard the other day people asking questions about licensing. Without surrendering our bottom line, which I think you've heard by now even from members of this committee, that we think the ideal solution would be to restrict tobacco sales to the liquor control board, somebody asked the other day -- I forget which of you -- what does licensing have to offer as opposed to the statutory prohibition?

Well, it's tangible. It's something you can hold in your hand. You've got a licence, it's something you hang on your wall and indeed usually you have to hang it on your wall. It's an exchange for money. When people actually pay for something they have a lot more respect for it, as most people can tell you. It can have built-in conditions. It has to be renewed, which means that it has to be applied for as well, that objections from the community can be applied just as in alcohol licensing.

Already we have British Columbia, Manitoba, New Brunswick, Prince Edward Island and probably Alberta that have licensing schemes, so you're not exactly going to be atypical if you have your licensing schemes. I'd also remind people here that the youth wings of all three provincial parties submitted a brief in 1989 requesting the then Attorney General to introduce licensing. So this is not something that is alien to the political philosophy of the politicians in Ontario.

We've heard a lot about pharmacies. I don't want to really discuss that because I think that's a perfectly straightforward issue, as I said the other day, except of course that is only part of a limitation. Your licensing conditions could restrict the outlets to not only health facilities and pharmacies; obviously you meant to put in educational facilities. I think that was a slight oversight.

I'd also draw your attention to the national fire code, the fire code of Ontario and the Gasoline Handling Act of Ontario, that there are many places under the current legislation where tobacco consumption is illegal. It doesn't make a lot of sense to allow tobacco to be sold where tobacco consumption is illegal and presumably people could start a fire.

On the back page of our brief you will find an advertisement for pizza. If you look at a bit more carefully you will see that pizza now comes with cigarettes. We'd like to ask just how many adolescents who are great fans of pizza phoned for a pizza and were asked for proof of age when they asked for cigarettes to be thrown in there. We would like you to look very carefully at the list of designated places in terms of sales. This would certainly help some of those people who have been complaining about being picked on.

This morning I heard the question of possession raised, and I know I have touched on it before. The question was raised about whether children should be taken to court and fined for smoking or possessing tobacco. I would again remind you that the federal legislation does include forfeiture as a penalty for possession, and that legislation is due to be repealed some time.

In fact, may I ask the Chairman or the clerk to consider -- I did actually have compiled at some stage a complete dossier of pertinent federal and other provincial legislation -- whether making copies of those available to the committee would be useful or whether they already have that from their research officer. I can make that available, to see what's going on in other jurisdictions.


I was interested in the suggestion earlier about community service. I think community service that is oriented to the field, that is to say, where children could learn more about tobacco smoking and smoking and health would be, could be, an appropriate penalty. So could cleaning up the litter. That might bring the message home.

Any of you who have stood at a bus stop or at any other spot and have watched somebody who smokes and seen what they do with their packaging and the cigarette that they've finished with when the bus comes along will realize the large quantity -- and I can give you some actual estimates -- of packaging and litter that's deposited on our planet by the smoking community, which is certainly notoriously careless in its habits. So something along those lines could be an appropriate penalty for possession and for smoking underage.

Again, I have heard questions over the last few days in the area of sales to minors, about how you define the regulations there. I think I heard concern earlier about the current wording of the defence and I would strongly urge you that you use the current regulations governing the sale of alcohol in terms of controlling that.

I also draw your attention, since we've talked about concurrent jurisdiction a bit, to a clause in the act that applies to conflict such that the legislation, be it municipal or federal, that has the greater penalty or is more restrictive of smoking to apply. I think there's some ambiguity there because obviously there is some legislation that may be more restrictive and have a lower penalty, so clearly it should be "and" rather than "or". Also, of course, a tobacco sales offence as defined in this act is something contravening regulations of this act. Let me give you an example.

Many parents and teachers have complained in my community of vendors who are selling single cigarettes to children for 25 to 50 cents. This is of course a violation of both the Excise Act and the Excise Tax Act, federal jurisdiction, which is only enforceable by the RCMP now, although I hear the Quebec Provincial Police now want the powers to enforce that. A tobacco sales offence should be an offence against all pertinent legislation, not just against this act, to bring that under control.

Another small point: commencement. There is no commencement date in this act. You may not think that's important unless you study the jurisdictional history of other provinces and even federal legislation in this area and realize, for instance Manitoba has had an act sitting on its books now for two, I think, almost three years and is still writing the regulations. I know it's a lot of work for Brenda Mitchell over there in the corner, but I strongly recommend that you put a definite date on it and this will concentrate the mind, as I think that judges say when they pass the death sentence.

You've obviously heard that the other major area we're concerned about is environmental tobacco smoke. The other day I received a letter from the International Agency for Research on Cancer, a body you may not be very familiar with but it's a United Nations agency that sets standards for carcinogens and their regulation internationally. They stated in that letter to me, in response to an inquiry, that they now consider environmental tobacco smoke to be a carcinogen within the meaning of their regulations that they draft internationally.

I would reiterate to you that we now consider environmental tobacco smoke to be the commonest cause of death in non-smokers, which is a pretty major problem. I would again urge you to consider amending the Smoking in the Workplace Act. You are amending a number of other acts under this legislation so that you can consolidate the powers to bring that under control.

I recall that when the city of Toronto first introduced its city workplace legislation, I spoke to the people who manned the hotline several weeks later and asked them what sort of calls they were getting. It's rather interesting that the majority of calls they were getting were from people who thought they lived or worked within the city of Toronto, because you don't have to go through Customs to get out of the city of Toronto, who weren't. In other words, they got far more calls from people who wanted to be protected in their workplace than from people who objected to the legislation.

Finally, before we switch to questions, I have included a signal page, a cartoon taken from the Globe and Mail on Thursday. When you set your final seal on this legislation, let you not be accused as the people who put a smiling face to death.

Mr Wiseman: You've certainly presented us with a lot of information. My question earlier had been with respect to total costs of delivering the health care that is necessary to take up the impact of tobacco smoking. We've talked a lot about negative things and about a lot of ways of trying to make a negative impact on smoking. Are there some things that should be done in a positive sense that could negate smoking?

We know, for example, that young women between the ages of 10 and 16 are the group who are the fastest-growing group of smokers. What could be done in order to turn them away from cigarettes in a positive way, as opposed to saying, "If you do this, we're going to do that to you," that kind of thing?

Dr Goodyear: As Larry well knows, because he was there at the time I actually asked a group of young teenagers of mixed gender this a few weeks ago, and we had reviewed the videotapes being used as commercials now, basically we said to them: "If you were given all the money in the world and you were allowed to make videos or commercials, what would you put in them? What would be the message you would want to give either to yourselves a few years ago, before it was too late, or to your younger brothers and sisters?"

They said, "We would want to make videos about the people who make a lot of money about peddling these drugs to kids and getting very rich while we get sicker." That's something they would really respond to, instead of being into necessarily scaring them with stories of lung cancer, which of course they don't really respond to very well. Is that something positive? It's something that appeals to their sense of autonomy, their sense of control. This is a drug which basically takes away their control over themselves.

Obviously we want to show them maybe what they could achieve. You could feature a lot of athletes who are non-smokers and show what they achieve, compared to a lot of puffing and panting people who will never make it to Lillehammer because they smoked. Is that the sort of thing you had in mind when you say you want positive images rather than negative images? I would agree with you. Sometimes we're referred to as the anti-smoking lobby, something that always upsets me.

Mr Wiseman: I guess what I'm giving you here is an opportunity on TV to give some messages to the parents out there, who could possibly do something in a positive way to prevent their kids from starting smoking. In that respect I'm even asking for myself, since mine are still young.

Dr Goodyear: As you know, the Ontario government has been distributing materials to parents and placing advertisements in the papers suggesting that they write in or phone in for that information.

Curiously, one of the things that came up in the meeting that Larry and I had with these teenagers is that actually we need information for the children to give to their parents just as much. Parents are exemplars and the chances of you becoming a smoker if your parents smoke is much greater than if they don't, and if both smoke, even more so.

In fact, one of the problems that seems to be emerging at the moment, according to some teachers, is that children are taking home all these materials about tobacco and health from their schools and the parents who smoke are getting really upset about this and complaining to the schools that they're bringing materials home that are upsetting their parents. So this is a two-way dialogue. This is a very complex problem, with no simple solutions, or we wouldn't still be discussing it here all these years ahead.

The Chair: I'm sorry, I'm going to have to break it off, but thank you very much for coming before the committee today.

Mr O'Connor: Mr Chair, if I might, did committee members receive a copy of this booklet?

Mrs Yvonne O'Neill (Ottawa-Rideau): Yes, we did.

Mr O'Connor: This is just the parents' guide to lead to a discussion between children and parents.

Mr Wiseman: Show it so the camera can see it.

The Chair: If somebody's looking at it, where would they get that?

Mr O'Connor: They can get it from the Ministry of Health. In fact, there were over 7,300 requests within the first 48 hours of the ads that were placed on the radio for this. I'll give this to the clerk, because he may get a few calls as well.


The Chair: Our next witness then is Mr George Phillips. If I understand correctly, Mr Phillips, you have a Pharma Plus Drugmart here in Toronto. Welcome to the committee. Please go ahead.

Mr George Phillips: Thank you for having me here. I kind of feel overwhelmed by all of this, especially the people who have gone before me. I am just a simple community pharmacist. I'm fortunate to have 22 years' experience in this profession.

I got concerned when I read that the government's Bill 119 would effectively bar the sale of tobacco products from pharmacies. At first I thought the bill was a noble gesture with regard to its general theme, but the provision that bans the sale from pharmacies definitely threatens my livelihood, and that's why I'm here today.


From the outset, though, I realized that the person or persons sponsoring this bill have been given incorrect information about my profession and that pharmacies and indeed the profession of pharmacy was being singled out for unfair and unusual punishment again because lawmakers do not seem to know how pharmacies operate in this society. Time and again you have attacked our profession, not caring about the hardships your actions will cause. For instance, do you realize that for corporate pharmacy to exist, we need to do more than fill prescriptions? We need to offer the public services and goods they want and expect.

I'm sure you've heard several submissions here about the contribution to our bottom line that tobacco sales are responsible for in this society. The sale of tobacco products is a small portion of our overall profitability, but because a customer is in our store, he may purchase several other items which will contribute greatly to our bottom line.

Removing tobacco from our sales will only remove the opportunity for us to survive. You must agree that our overall profitability will be severely affected, and many drugstores will either close or reduce staff and hours. In fact jobs will be lost, and I have been advised that you already have the statistics on how many jobs could be lost in Ontario.

When drugstores close, not only will working people lose their jobs; the entire health care delivery system will suffer. Pharmacists are the number one community health resource. We counsel and advise the public on minor and major health-related problems -- may I add, for free. We save the health care system a lot of money in this province by preventing the public from going to a hospital emergency department to seek help for minor ailments.

I am sure you recognize the dual role of the pharmacist. We are professionals and we are also retailers. You pay us a fee for our professionalism, and the government allows us a markup on our drugs simply because of our role as retailers. But it seems unfair to me that you are going to deny us our dual role when it seems to suit the government.

Tobacco is still a legal product in Ontario. People will smoke if they choose to. It seems to me that your efforts will be better served if you ban the product from other businesses also. Make tobacco illegal.

Today I appeal to you to help me to keep my job and maintain my family. Allow me to provide to your public the excellent standard of pharmaceutical care that all pharmacists provide. Think about the availability of pharmacies in rural areas of Ontario. These pharmacies depend more on allied sales in the stores than the ones located in well-populated areas.

In closing, I would like to say, would it not be ironic that in your quest towards a smoke-free society, you find it necessary to put so many restrictions on tobacco products that you make it a prescription item and put it in pharmacies, where we sell it to the public and control it because of the regulations that are inherent in my profession? I thank you very much.

Mr Jim Wilson: Thank you, sir, for your presentation. I think most, if not all, of what you've said makes perfect sense to me and my party. In fact, your latter comments about moving it into a pharmacy -- it seems to me if you were taking a logical approach to this issue, that's where you would be heading. Unfortunately, we can't seem to -- so far, anyway -- budge the government on this issue, and it leads me to think that perhaps there's more at play here than what the government is trying to tell the public.

The government, as you know, has a couple of arguments. One is that it's inconsistent for pharmacists to be selling cigarettes at the front of the store and health products at the back of the store. Second, perhaps -- they're not sure; they have no proof -- it will reduce consumption by young people if we can restrict the number of access points to purchase cigarettes, ie, get rid of the sales in pharmacies.

I don't buy either argument. As a young person I didn't see pharmacies as a health thing. I saw it as a place where I got supplies for my science project or I picked up the odd prescription for my parents. That was the only time I went to a pharmacy, probably, until I was in my latter teens. The young people we've had before this committee, many of them don't buy their cigarettes at pharmacies. In fact, one this morning said actually the only place that ever checked for ID was Shoppers Drug Mart.

Do you think there's something else at play here? Do you have any thoughts as to why the government's trying to put you out of business?

Mr George Phillips: Like I said in my presentation here, I don't think the government is well informed. I think they've been misinformed. To begin with, the government calls this a health care facility. A pharmacy is in no way a health care facility. A pharmacy is a retail operation. We retail drugs. Your prescription drugs we sell to you on retail.

Mr Jim Wilson: Exactly. The formulary dictates that.

Mr George Phillips: I am a professional, because to work in a pharmacy or to be a pharmacist I need a degree. That makes me a professional. But a pharmacy is not a health care facility. A hospital is a health care facility. A health clinic is a health care facility. I believe that the government is thinking, in its contracted view, that any pharmacy is a health care facility. It made them come up with this kind of argument. A pharmacy is a retail operation. We can't exist on just selling prescriptions, which is what our major function is.

Some pharmacies, on the other hand, that are located in huge medical buildings do not need to do that to have a reasonable bottom line. They don't need to sell other things. I sell panty hose, I sell hair products, hair colour, everything. I sell condoms.

If the government were well informed, it would have known, the people who are sponsoring this bill would have known, that we counsel people against cigarette smoking. We are the only place where you can come in and the pharmacist can sit with you and counsel you about the ills of cigarette smoking.

At the beginning, I thought it was a conspiracy against pharmacies. The timing is so bad, coming at the heels of the social contract and a reduction in our fee. I figured it was a double whammy and somebody really hates us up there. I see no reason whatsoever. Look at how unfair this is, Mr Wilson.

Mr Jim Wilson: I agree with you. I've been putting forward the conspiracy theory, but you're the only one confirming it to date. I appreciate your comments because we used to have a deputy minister who said there were too many pharmacists.

The Chair: Mr Wilson, we're tight on time. Mr McGuinty, a short final question, please.

Mr McGuinty: Mr Phillips, I want to thank you and, in fact, since time didn't permit, I'll profit from the occasion to thank Ms Braden and Mr Lackie for what I thought were thoughtful and moderate statements regarding the implication that this bill will have on your businesses.

I'm not sure if I can accept that pharmacists can both counsel against the use of tobacco and sell it at the same time. I'm not sure that I can accept that because we just haven't had enough conclusive evidence that pharmacists are more responsible in terms of how they sell tobacco and that they're more careful in terms of not selling it to people under 19.

One thing I do agree with you completely on, and with your colleagues who spoke earlier this afternoon, is that I find it unfair to impose a tobacco ban on pharmacies alone. It's my understanding that your total sales for the industry average are from 7% to 8% for tobacco sales, and the argument is made that you could make this up elsewhere if there was a ban put into effect. I also understand that you wouldn't make it up through additional prescriptions; you're not going to have more people getting more sick as a result of a tobacco ban.


My question to you is, if the government is sure that you won't suffer any losses, or if you do, that you'll be able to make them up elsewhere, why don't we ban tobacco sales by any retailer who's selling tobacco in the range of 7% to 8%, because surely they could make it up elsewhere in the store?

Mr George Phillips: No, no, tobacco sales are 7%. You buy tobacco; the profit margin is very low. It's a convenience item. I've been a pharmacist for 22 years. I know of people who would come to my pharmacy to buy their prescription -- which is my livelihood, by the way -- when tobacco is on sale, when cigarettes are on sale. When the person is in the pharmacy to pick up their tobacco, he would go around and pick up some hair gel. My bottom line there is 30%. He might pick up some pop. He might pick up some aspirin. He might come to the pharmacist for a question. Anything like that. Seven per cent is nothing, but the sales that are generated by the person's presence in my pharmacy are what's important to me, not the tobacco.

You talk about unfairness. Yes, it's unfair for the government of Ontario to ban cigarettes only in pharmacies. What are you going to achieve?

Mr McGuinty: Good question.

Mr George Phillips: They were going to buy it. Take a grocery store with a deli, a bakery, groceries, a pharmacy in the corner, a place where they sell sandwiches. What are you going to tell these people? Are you going to tell these people, "You're a health care facility"? Are you going to tell a grocer: "You're a health care facility. You can't sell cigarettes here"? The public will be greatly inconvenienced. They come to buy their groceries. Convenience is the order of the day.

You've been told that the three principles in business are location, location, location. Add to that convenience, convenience, convenience. I don't want to go to two places if I go out in today's weather, for instance. I want to go buy my cigarettes and get my other allied purchases at the same place. It's very unfair, not only to pharmacists but also to the general public.

The Chair: Thank you very much, Mr Phillips, for coming before the committee today.


Mr Bill Wensley: I'm Bill Wensley, the vice-chair of the board of the Haliburton, Kawartha, Pine Ridge District Health Unit. We provide public health services in home care to the people of Haliburton, Victoria and Northumberland counties. Our medical officer of health, Dr Hukowich, isn't able to be here today. Actually, we flipped a coin. One of us was going to come on the train and the other was going to drive, and Via Rail won out.

I think it would be important for me to state my bias at the outset. I'm a former smoker, I'm the retired registrar of the Ontario College of Pharmacists and I'm a strong advocate of wellness promotion and illness prevention, as I'm sure everyone else here is.

I also want to congratulate the committee and yourself, Mr Chairman, for your remarkable perseverance and patience over the past couple of weeks. I too have watched these proceedings on cable television, the first time I've ever done it. It's at times a painful process but I'm sure it's worthwhile.

Our board and the staff of our health unit wish to indicate our strong support for Bill 119. We endorse the intent to further restrict access to tobacco by youngsters and support efforts to create a more coherent public message as to the place that tobacco should occupy in our society.

The detrimental effects of tobacco use have been clearly demonstrated. There is no argument as to the significant level of harmful effect from tobacco use except from those few having a monetary interest in being able to profit through the continued unrestricted sale of tobacco. Their voices, no matter how loud, must not be allowed to prevail over the clear and coherent message from the health care community.

Tobacco is a unique product in that it kills and sickens such a high proportion of its users when used specifically as intended. I think this is the main theme of our presentation. It is a product where initiation occurs during childhood and adolescence, and continued use during adulthood is more a function of the addictive nature of nicotine rather than a personal and informed choice.

Its continued availability is an accident of history. As we know, it was introduced into society at a time when its harmful effects were unknown. We know of no other slowly acting addictive poison, yet is it available openly on every street corner. While it remains a legal product because of society's general acceptance of the argument that prohibition would not succeed in its elimination, is tobacco a truly legitimate product?

Is there anyone, apart from those who directly profit from the production and sale of tobacco, who wants to see a higher proportion of smokers? Do smokers themselves want to see their children or grandchildren start smoking? Would we allow physicians and nurses to promote tobacco use? Would the College of Physicians and Surgeons or the government not intervene if physicians began selling tobacco from their waiting rooms?

Yet some would still argue the right of pharmacists to sell tobacco products. They claim that pharmacists are retail business persons who have a right to sell a legal product. This argument totally ignores the fact that pharmacists are not simply retail business persons but are health care professionals. They are granted a monopoly for the sale of non-prescription drugs and the dispensing of medications as prescribed by physicians. Their ability to sell tobacco adds a needless legitimacy to what is otherwise a uniquely harmful substance. It serves to confuse our children. It fosters a belief that tobacco is not as harmful as is claimed, since we freely allow its sale from facilities whose primary purpose relates to health care.

I can remember when I was a 13-year-old starting to smoke. Some people would tell me: "It's not good for you. Don't do it." I would use the argument, "Well, it's got to be okay because doctors smoke." Now we realize, of course, that very few physicians do smoke. I think we've come a long way since that day. The point I want to make here is that every possible step should be taken to eliminate public images that tobacco use is safe.

We go on to pose some perhaps rhetorical questions. I'll cite these. Failure to act on this proposed legislation would only be explainable on the basis that the Legislature collectively, and you its members individually, believed that (1) there was no problem or only a minimal problem associated with tobacco use; (2) the benefit to society and to individual members of continued tobacco use outweighed the level of harm; (3) sufficient steps had already been taken that would, in time, eliminate the tobacco problem; (4) the steps proposed in this legislation would not achieve the desired effect; or (5) the problem of tobacco use was an individual problem or choice and not one for the government to solve.

I'm going to briefly develop each of these points. First, we know the committee has been provided with scientific evidence that has conclusively shown the causal relationship between tobacco use and such health problems as chronic bronchitis, emphysema, lung cancer and heart disease.

What could be the claimed benefits from children starting to smoke? Most adults would like to quit but find it difficult, if not impossible. The benefit for most smokers is solely the avoidance of the signs and symptoms of nicotine withdrawal rather than any positive effect from tobacco use. Does the revenue to government through taxation outweigh the added health care and other costs created by tobacco use? I think not.

Twenty per cent of our adolescents still become smokers. How many generations are we prepared to wait to see a further reduction in tobacco use?


What about the effect of this legislation? Clearly the tobacco industry sees the potential of these measures curtailing their sales or they would not be concerned by the passage of this legislation. They are certainly the most expert at understanding the role of tobacco and its merchandising. Their fear that these measures will have an impact on their profits is a good sign of the efficacy of this legislation if passed.

Objection to tobacco use by health professionals is not an issue of morality; it is an issue of causing ill health and premature death. Tobacco use is not a personal, informed choice made by adults. Tobacco initiation is a deliberate addiction of our children, a vulnerable group in society who have the right to expect protection. In what other way does a free and democratic society allow a group of adults to prey on children? Is it not the responsibility of all of us, including government, to protect children?

During the course of your deliberations, you have already seen and will continue to see delegations of two particular types. On the one side will be individuals who wish to put an end to this unnecessary epidemic of ill health and premature death caused by tobacco use. On the other side are those from the tobacco industry with dollar signs in their eyes whose bank account size is directly related to their continued ability to ensure a market with each coming generation of unsuspecting children.

While this piece of legislation is undoubtedly not the final answer to the problem of tobacco use, it is a necessary and important step on the road leading to a healthier society. Your support should be, and I am convinced will be, with those whose vested interests lie with the health of our citizens.

We strongly endorse this bill, recognizing that it is one more step in a long journey.

Mrs Haslam: I get so angry when I hear people paint the government as if we have this grudge to bear on small business people or on the pharmacists, as if we're picking on the pharmacists because we're asking them to be a health practitioner, because we're doing what the Ontario College of Pharmacists has asked us to do. It just makes my blood boil.

I look at the costs involved in the health budget, I look at the costs involved with tobacco and the loss of job time, I look at the number of people who die, and I ask myself, if I were a health practitioner, if I were a pharmacist and I took an oath to promote the health of people in Ontario, I think those standards that I should be operating under and the responsibility that I would have as a health practitioner would be something I would hold very dear to me. I believe in principles.

It really angers me when I think that we're being painted as if it's all our fault. We're asking them to do something that they've been asked to do for years voluntarily by the Ontario College of Pharmacists. Excuse me for venting. I don't vent too often, Mr Chair. I just wanted to vent this time.

I'm glad you support this. To tell you the truth, a majority of the people who come in do support what we're trying to do in this legislation. It's interesting to see that they want us to go further, and I keep asking, is this the time? Can we now bring in a tobacco control board? Is this the time to put a whole process of licensing in place instead of going with what has already been suggested? I'm sure that the people in the ministry will say, "Oh, no, no, no, Karen, please don't ask about licensing," but I've never been known to follow bureaucrats' advice in the first place.

When I was associate minister of Health, we had presentations come in and a lot of people said, "We would like the licensing." The concern seemed to be that we didn't want to set up a whole new process, a whole new layer. Do you feel that we should go that extra step, that we should look at licensing, if what we're seeing in the model that is in the legislation is saying, "We can do the same thing by bringing it in in this model as a statutory ticketing," where they do lose it, they can't even have it on their premises.

Most people come in and say, "If they lose their licence, they'll really be worried," but on the other hand, if they lose the right to sell tobacco, they can't even have it on their premises. It must be removed. We send a letter to the manufacturers.

The Chair: Mrs Haslam, are you going to ask a question?

Mrs Haslam: Is that not as effective as licensing?

Mr Wensley: Just to answer your question about the efficacy of a licensed-vendor approach, I think that's probably a very effective way to do it. It's been said here before that the licensed vendor would have a very strong interest in seeing that his or her licence was not revoked for cause. It would tend to be somewhat self-policing. So I think down the road the idea of licensing vendors is a very good one.

I wonder, however, if we're quite ready for that or if we can handle it. I'm not arguing against it, but I'm a firm believer in a course of limited objectives. As I said, we believe that this bill is one step forward towards that end. I believe that if we can reduce the number of retail outlets, somehow control them and have them licensed and have a very strong reason for them not to stray from the conditions of that licence, we will also be further down that road.

The Chair: Thank you. I regret that time is our enemy this afternoon, but I want to thank you very much for coming before the committee.


Mr David Giuffrida: Good afternoon. My name is David Giuffrida. I'm the acting director of the Psychiatric Patient Advocate Office. Joining me today is Duff Waring. Mr Waring has served as the systemic policy adviser to our program for several years and is currently our acting legal counsel. We'd both like to present our submission to you today.

Mr Duff Waring: The Psychiatric Patient Advocate Office works for the rights of patients in Ontario's 10 provincial psychiatric hospitals. We are a quasiindependent program of the Ministry of Health, but we do not speak on behalf of the ministry. We speak on behalf of the patients who are often our clients.

I'd like to point out before we get into our submission that we are not promoting an outright opposition to this bill. We are challenging its unintended disparate impact on patients in psychiatric facilities.

I'm sure you're aware that people with psychiatric labels are often denied the right to make decisions about their lives that other Ontarians take for granted. In fact the Ontario Mental Health Act reflects the reality that even patients who are involuntarily detained in psychiatric facilities can be as competent as any other Ontarian to make decisions about their treatment, finances or lifestyle.

We uphold the right of psychiatric patients to make the same choices that other Ontarians are entitled to make. Consequently, we promote the right of psychiatric patients to choose whether to smoke where they live. We also assert that psychiatric patients should be able to buy tobacco near where they live. Bill 119 could deny vulnerable Ontarians in care facilities the right to make these choices.

The fact is that the majority of inpatients or outpatients smoke. They have identified smoking as one of their few pleasures and would not choose to reside in or attend a facility in which they could not smoke. The two petitions from patients at the St Thomas and Penetanguishene psychiatric hospitals that we have included in our submission illustrate this point. These patients oppose further restrictions on the use and sale of tobacco in psychiatric facilities, and we support them.

Bill 119 designates places in which smoking would be prohibited and refers to psychiatric facilities and other residential settings in which care is provided, such as nursing homes and homes for special care. We are pleased that section 9, paragraph 1, of this bill would allow exceptions for designated smoking areas that are exempted by regulation. This section would allow the maintenance of the designated smoking areas currently in place in psychiatric facilities.

We note also that the Ontario public service policy for a smoke-free workplace in psychiatric hospitals also allows for designated smoking areas. The rationale behind this aspect of the OPS policy is that the hospital is, however temporarily, the patient's place of residence and that denying tobacco to patients who smoke can exacerbate their clinical condition.


We observe that many clinicians have complained about outpatients who are asked to attend hospital on a daily basis but who are non-compliant with medication and other therapeutic programs. These clinicians are currently trying to improve upon and expand such community-based day programs for patients who have been discharged from the hospital. We suggest that further restrictions on smoking would frustrate this effort. They would make psychiatric facilities inhospitable to the majority of outpatients who smoke. This would obviously interfere with their willingness to attend the hospital and comply with treatment.

Apparently the initial opposition to smoking restrictions in care facilities has not faded. The Clarke Institute of Psychiatry, for instance, initially banned smoking altogether. It now maintains designated smoking areas on inpatient wards. This reversal in hospital policy was apparently in response to strong protests by the patients, and staff concerns about the fire hazard from surreptitious smoking.

We do not dispute the negative health effects attributed to smoking. We recognize the enormous health care costs and lost productivity resulting from smoking.

We also recognize that adult Ontarians are still allowed to smoke in their own homes and legally purchase tobacco near their homes. Bill 119 will not affect these Ontarians the same way it will affect or could affect our clients. We feel that our laws should apply equally to Ontarians who live in psychiatric hospitals.

Bill 119 disproportionately affects people who call an institution a home because it prohibits the sale of tobacco in these facilities. If we wish to allow residents in these facilities the same right to smoke where they live that other Ontarians have, is it not cynical to make tobacco inaccessible to them?

Mr Giuffrida: I'd like to underscore the point Mr Waring has made about the risk of making psychiatric facilities less hospitable to their intended beneficiaries. Clinicians tell us that it can be difficult to motivate people with major mental illnesses to come to day treatment programs and to take medication.

I have in front of me a draft document that one psychiatric hospital is considering using if it's obliged to enforce current and proposed laws restricting smoking. It would be handed to a patient caught smoking in the wrong place. It says: "If you are observed smoking in a non-smoking area, security is authorized to ask you to put it out. If you refuse to put it out, security has the authority to escort you from the area to the outside." Then in bold face, "If you receive three of these notices, you will be banned from the hospital for one week." So we find health care facilities driven to a point where they may consider having to drive the patients they're trying to serve off the grounds in order to enforce restrictive smoking laws.

One of the ways of measuring whether a system is fair is whether it treats like cases alike. There is a purity to Bill 119 in that, if the paradigm you use is that everyone in a health facility will be equally exposed to this law and no one in a health facility will be able to smoke, that seems consistent, but I'm going to invite you to categorize things differently.

As Mr Waring pointed out, most Ontarians continue to be permitted to smoke in their homes. The state of evolution of our thinking in this social policy area has not yet extended to the point where we have outright banned the use of tobacco. So to extend a consistent right to psychiatric patients, they should be allowed to smoke where they reside as well.

Another way to categorize it is situations in which the state detains people and provides their housing. This happens in health care facilities when people may be detained under the Mental Health Act and under the Criminal Code. It also happens in correctional facilities, and there is not the same application of the bill to correctional facilities. There are about 7,800 inmates at any one time in Ontario's correctional facilities, and nothing in Bill 119 is going to restrict their ability to purchase tobacco in those settings. So we're concerned about the disparate impact.

What we'd recommend is that a power be placed in the legislation that would permit the making of regulations which would permit the limited sale of tobacco products to adults who are residing in care facilities.

Our other recommendation deals with the section of the legislation that allows other legislation, in particular municipal bylaws that are more restrictive of smoking, to override Bill 119.

Our concern is that if the Legislature on the provincial level decides to honour the right of Ontarians to smoke where they live, it would be unfair to oblige them to make this argument at over 800 municipalities, if you will, across Ontario. If the policy is established in this legislation, then it would be unfortunate if municipal bylaws, for example, could be more restrictive and could ban smoking on the psych ward of a hospital where the hospital has succeeded in getting a regulation under Bill 119 permitting smoking.

Those are our two concerns. The sale of tobacco should be allowed in places where people live, particularly where they are detained. Where the state has said, "You can't leave these premises," you have a right to smoke. It's not fair to say, "But you can't purchase tobacco." Human ingenuity being what it is, in places where the sale of tobacco is restricted now, it has been our understanding that health care staff are often obliging in helping patients procure tobacco from outside the hospital grounds, and I don't know if they're particularly dedicated to buying retail. At least if it were in the hospital you'd be collecting taxes on it. We'll pause there for questions.

The Chair: Thank you. This is the first time we've really had this issue raised, so I'm going to give each caucus an opportunity to raise a question and I'd just ask a little cooperation in perhaps not too long.

Mr Jim Wilson: David, good to see you again, and Duff. As usual, you bring a thoughtful presentation before the standing committee. The issue was kind of raised before with respect to veterans in Sunnybrook. The suggestion, and I thought it was rather astonishing, is apparently that when their tuck shop is closed now on weekends, people come in and sell the veterans contraband cigarettes at premium prices. Is that going on or could that go on in psychiatric institutions? You're more of a restrictive institution, but you just mentioned that staff sometimes help patients procure cigarettes. If you can't buy them legally, what will happen?

Mr Giuffrida: It has never been suggested to me that the staff are making any profit when they assist patients --

Mr Jim Wilson: No, I assume the staff are doing it as a favour.

Mr Giuffrida: Yes. But yes, it is our understanding that staff are accommodating patients in that way.

Mr Jim Wilson: The legion told us that in the case of veterans, it's not the staff but other people coming in off the street and selling the veterans contraband cigarettes.

Mr Giuffrida: I haven't been informed of that happening, but tobacco may still be sold in a number of the provincial psychiatric hospitals. We don't perhaps have a wide enough sample to see if that would happen.

Mr Jim Wilson: The bottom line is, you'd just like the status quo with respect to psychiatric hospitals?

Mr Giuffrida: Well, the status quo permits the sale of tobacco products to anyone of appropriate age; currently visitors, staff as well as patients. To be consistent with the policy objectives of this legislation, you might want to restrict the sale of tobacco products in psychiatric hospitals so it's not available to staff and visitors. They have the ability to leave the grounds and buy it elsewhere. But it should be made available to people who cannot leave the grounds.

Mr McGuinty: Thank you very much, gentlemen, for highlighting what I think is quite rightly categorized as a discriminatory provision in Bill 119.

Somebody visited my constituency office in Ottawa recently and described for me the importance of maintaining a routine for some of the inpatients at a psychiatric facility. In effect, I interpret this as meaning that we could make a very good argument to the effect that it is in a person's overall health picture to be able to continue to smoke at a facility. Would you agree with that?

Mr Giuffrida: I'm sorry, could you say that once more, please?

Mr McGuinty: It is in that person's interests, I guess from a global health perspective, that they be able to continue to smoke.

Mr Giuffrida: I think we ground it in rights rather than health. They have the same right as other Ontarians have to make decisions, whether that includes overeating, whether that includes smoking.

Mr Waring: I think it's fair to say that some of our clients have said to us that they're better able to maintain their own psychological wellbeing if they can smoke. That's, I think, as far as we could take that.

Mr McGuinty: I was thinking of stress management.

Mr Giuffrida: The point is particularly applicable within the first couple of days after admission, when a person may be in psychiatric crisis. If, as a consequence of admission, they are totally denied access to tobacco, that is arguably the worst time to oblige somebody to go through nicotine withdrawal.

Mr Waring: I'd suggest to you that you could find many staff people in the provincial psychiatric hospitals who would agree with Mr Giuffrida on that.

Mr O'Connor: I guess at this point I'd just like to thank you for coming. You certainly put a different light into an area that we have had limited discussion on.

Maybe you could enlighten me a wee bit: Given that, of course, you're advocating for the rights of the patients, I guess that puts you in a bit of a predicament when you would then have to find protection for the same non-smokers in respect to the accommodation of their wishes as well. I can see there are some dilemmas in even being an advocate for two sides of an issue.

If you want to comment on that, I'd appreciate it. I thank you for coming before the committee and sharing the thoughts of those you advocate for.

Mr Waring: I think over the years we've been consistent in our position here. We respect, as much as possible, the rights of non-smokers and we try and respect the rights of our clients who do smoke, which is why we have always supported designated smoking areas in the psychiatric hospitals.

Mr Giuffrida: The hospitals have already invested some money in ensuring that these smoking areas are separately ventilated so the status quo substantially accommodates the rights of smokers and non-smokers.

The Chair: Thank you very much for coming before the committee today and for your written presentation. We appreciate it.



Mr Ronald Frisch: Thank you for the opportunity to present my company's views with respect to Bill 119.

My name is Ronald Frisch and I am chief executive officer of Kohl and Frisch Ltd, a privately held family business that has operated as a wholesale distributor in the province of Ontario for over 75 years. Since 1916 we have serviced a customer base that includes drugstores, both chains and independents, convenience stores, discount chains and department stores.

The bulk of our business is with drugstores and in that regard we service stores throughout the province with anything they may choose from our product line which includes pharmaceuticals, health and beauty aids, tobacco, confectionery, general sundries and any other items that our customers may sell at any particular point in time. Our business is service and if our customers, and therefore the consumers, create a demand for a product, we will distribute it for them as part of our commitment to handle all of their product needs.

I have read Bill 119 and am fully supportive of some of the measures that have been proposed. I do, however, have some concerns that I would like to address, as follows:

First, the requirement for wholesale reports: Section 8 indicates the requirement on the part of wholesale distributors to provide reports to the Ministry of Health in accordance with the regulations. Bill 119 does not give any indication of what these regulations are. As wholesale distributors who do not sell to the public, our company and most other wholesale distributors in Ontario only sell to retailers who have provided us with their Ontario retail sales tax vendor permit. The Ministry of Revenue already receives reports from us on the tobacco portion of our business. In the current economic environment, we are not looking to increase expenses by producing more reports that don't help us run our business. If there is a justifiable need, would the wholesale distributors of Ontario be compensated for the administrative function that seems to be asked of us?

Conversely, I do note that subsection 14(4) mentions that a fine could be levied against a distributor for failing to comply with the reporting requirement in its prescribed format, a format which is not identified in the bill. This fine could be as much as $100,000. This seems to indicate that an error on a backup administrative function, where no physical product is involved, could result in a fine of immense proportions and threaten the very foundation of a business. Surely this cannot be the intent. I can assure you that no fine is needed to ensure that wholesale distributors comply with the law and I would respectfully request that this entire area be rethought.

Second, the change in age to purchase tobacco from 18 to 19: I wholeheartedly applaud this change but I would suggest that teenagers be required to show proof of age when making a purchase. The onus should not fall solely on the retailer. A retailer can be enticed into selling to those under the legal age, or an employee of a retailer can simply make a mistake. It's harder if the teenager produces his proof of age as a matter of course. Teenagers know that they have to produce cash or a credit card to make a purchase. They also know that they have to have their birth certificate or passport in order to travel outside the country. They should share the responsibility of ensuring that tobacco is only purchased by those of legal age.

My interest here is not completely an unselfish one. I don't wish to hear a customer of mine tell me that he can't pay for the merchandise he bought on credit because he has to pay his fine for selling tobacco to someone underage and he has no further funds. This can and will happen.

As an aside, we should all realize that this age restriction only applies to purchases in legal retail outlets. The illegal black market in smuggled cigarettes has no legal age. This is where the greatest risk lies. While I'm aware that the Lindquist Avey report that has been presented to you indicates that just over 25% of the Ontario market is illegal, I believe they are being conservative.

I can tell you that our sales of tobacco products have declined by almost 50% in the last two years alone. It's no wonder; the illegal cigarettes are being sold at prices that equate to the legal prices in 1987. Until the illegal market is stamped out, tobacco will be readily accessible to anyone of any age within the province.

The third area of concern is the ban on selling tobacco in drugstores. I believe that such a ban will have a major economic impact on drugstores and, by translation, on companies like mine who supply them. Please consider the following areas of concern:

First, cash flow for the store: Since the drugstores do not sell on credit but they do make their purchases on credit, the stores use the cash flow generated -- which is roughly over $40 per carton and this is substantial -- to supplement their banking positions by thousands of dollars.

I can tell you that today many independent drugstores have trouble paying their bills on time. In almost every case they complain about the long delay in getting paid by the provincial government for Ontario drug benefit claims. These delays range from between two and six months.

With this as a starting point, if the cash flow from tobacco sales disappears, these stores will find it even tougher to operate and many won't survive. I don't think the banks will be extending more credit to single-location retail stores who are already strapped financially.

After all, their government revenues have been cut back, their product line will have been reduced and all the while with the bank's security reduced as a result of the new bankruptcy laws of December 1992, which allocate the inventory on hand back to the creditor instead of to the secured bank.

Second, impulse sales: Despite the reduction in the number of smokers over the years, we must realize that a substantial number of people still smoke. When people wishing to purchase tobacco walk into a retail store, the retailer is hoping to sell them more than just tobacco. For over 75 years, for example, we have observed the strong link between our customers' purchases of confectionery and tobacco.

Internally, we have been mindful of efficiencies tailored to delivering tobacco and confectionery at the same time. It is our belief that if tobacco were to be unavailable in drugstores, the confectionery and some other product sales would plummet in these stores as well and would be purchased in many cases wherever the tobacco is purchased.

As many of these items generate good profits, the drugstore operator would again have to find a way to overcome this issue. I am not surprised that the Coopers and Lybrand report that has been presented to you confirms my personal observation in this regard.

How does this proposed ban impact on my company? First, wholesalers will be faced with more difficult credit and collection tasks than exist today and there will be inevitable losses to be covered. As well, bearing in mind that as a wholesale distributor we deliver a mixed bag of products to the drugstore, we have certain other costs that must be covered, including the cost of running our building and getting the truck to the store.

The object for us as business people, of course, is to generate more profit on each delivery than the cost incurred. While the profit margin on tobacco is quite small, it still contributes to the overall funds needed to service the customer. If, for example, it costs us $100 to make that delivery, and currently $20 is covered through the profit on the tobacco portion of the order, we will have to cover that extra $20 either by raising prices or by cutting costs or services.

As our current services include delivering pharmaceuticals, even one single bottle, to drugstores within three to five hours of receiving the order within the Golden Horseshoe and within 18 hours for the rest of Ontario, such services play an unsung but essential part in the delivery of health care in Ontario. It would be a step backward to tamper with such services, yet the alternative would be to raise prices which would increase the cost of health care in Ontario. Neither of these alternatives would be desirable, yet they may be unavoidable.


What must be recognized is that while certain drugstores are prescription dispensaries only, others are full-service retail stores that include a dispensary. We have recognized this factor in the way we deal with the stores.

First, we send out two separate catalogues, one for the front shop, which is like this one and lists thousands of products from shampoos to batteries and all kinds of front-shop merchandise within the store. Typically, the front-store manager receives this catalogue. The other catalogue lists pharmaceuticals only, and this catalogue is sent to the professional pharmacist in the store, who uses it in terms of maintaining his inventory and placing his orders.

Then we receive the store's orders separately by phone. The pharmacist phones the pharmaceutical orders to one of our dedicated sales personnel who only take pharmaceutical orders. The front-shop order is placed by different store personnel, calling different sales people within our office. It really is like there are two stores within the same four walls at the retail location. We have recognized this in our business, and I believe that you should recognize it in the proposed legislation by allowing the continued sale of tobacco in these retail environments.

I am aware that certain drugstores in Ontario have voluntarily stopped selling tobacco and have been able to continue along in business. Of our customers, only a few have taken this approach, and in each case it was to their economic advantage to do so. Each retail drugstore should similarly be able to evaluate its own business and decide if it can survive the change to its economic position that would result.

Let's not forget that we're talking about a legal product and that the retailer must compete with other stores for the consumer's dollar. Let's also remember that the retailer has to pay the rent and the bank. If he can't, there won't be any ethics or messages to even talk about.

I have to tell you that I find it interesting that on the way here I heard the Treasurer being interviewed on the radio about today's federal tobacco initiative. He said he could not afford to do without his revenue from tobacco. I think the drugstores' position, in many cases, is very similar.

A drugstore today is more than just a dispensary of prescriptions. It is a marketplace for health and beauty aids, household products, groceries, confectionery and tobacco as well. In fact, the term "drugstore" may be a misnomer. It is more like a general store with a dispensary, and the pharmacist has very little or nothing to do with some of the products that may be available in the store, because his or her domain seems to be the dispensary only. At the very least, I would recommend that the government conduct an economic impact study to determine the effect of a ban on the sale of tobacco in drugstores.

I sincerely hope that you will consider these various issues I have raised. I thank you again for the opportunity to present my company's views on these matters.

Mrs Haslam: Actually, I liked your comment on page 5: "The term `drugstore' may be a misnomer." I think you're right. I think we should call it a "supercosmetic mart" or just "supermart" and leave the drug out of it, and maybe we wouldn't have the arguments we seem to be having over the sale of tobacco in a drugstore.

You mentioned the Coopers and Lybrand report. Have you read the Coopers and Lybrand report?

Mr Frisch: I have not read it. I'm aware of some of the information.

Mrs Haslam: Are you aware that out of 1,400 pharmacists, they interviewed 13?

Mr Frisch: No.

Mrs Haslam: You sell to pharmacies that don't sell tobacco?

Mr Frisch: Yes.

Mrs Haslam: What products replaced the tobacco then? You do sell to pharmacies that don't sell tobacco. It's not a major percentage of your business?

Mr Frisch: No. Within the drugstore market that we service, some of them are dispensaries only that have never sold tobacco, and therefore it's not an issue. The few that I know of that did stop selling tobacco, they were not purchasing, at least not from us. They may have purchased from other wholesalers, I don't know, but their purchases from us were very minimal, and I think that probably economically they did not suffer and possibly replaced it with another line of product that countered it.

Mrs Haslam: Do you offer discounts for other products based on the amount of tobacco you market?

Mr Frisch: No, we don't.

Mr Jim Wilson: I think you make a very good argument, and it would be an argument that would hold water if you were talking to legislators who all understood retail and all understood business.

It seems to me that there are a lot of people out there who have a lot of nerve coming before this committee wanting to put somebody out of business and have never run a business in their lives.

I think the government misses the point, and you've made it again, and Mr Phillips, who's a Pharma Plus pharmacist and was in just within the hour, saying, "Look, it's not, in the case of the pharmacist, the profit necessarily on tobacco products; it's the traffic flow of the customers coming in and picking up all the other products they may pick up while they're in the store." That's the point, and that's the point that I think is missed.

Secondly, it seems to me that the government talks out of both sides of its mouth. It is very clear in the Ministry of Health -- I've been Health critic for almost three years now -- that during negotiations with the ODB pricing, the government makes it very clear that they expect pharmacists to make money at the retail end of the store.

In essence, because the government gives pharmacists a monopoly on selling drugs, they don't expect the pharmacist to make money at the back of the store. Therefore, you have to make your profit to pay all of the expenses you mentioned at the front of the store, and part of that retailing and marketing is the customer flow that comes with the sale of tobacco products.

It's pretty simple to me. I don't know why it's so convoluted for people, but we've been through this before. It's déjà vu all over again. We did the same thing on labour laws, and we will repeal those.

You mentioned as your very first point whether you're going to be compensated for yet another report that has to be filled out. The small business people at lunch told me, for example, with -- and I just did some off the top of my head: PST, GST, EHT, employer health tax, T4 preps, WCB, UI, Statistics Canada. The list goes on to almost 24 that I could think of, because my family was in retail for a number of years.

I added up the reporting dates that we would go through. We would have 35 reporting dates for all of those things during the year; you know, GST quarterly, WCB quarterly. We used to just put all the cheques in one envelope, send it in and hope to God the bureaucrats didn't lose the cheques -- and huge fines if we missed any of those bloody reporting dates. Now here's another one.

But I think the problem is, and I want you to comment on this, the Ministry of Health doesn't talk to the treasury, other than the treasury says: "We need the $800 million from tobacco sales, so don't take it out of all retailers. But if you want to pick on pharmacists, we know that'll have no effect on our revenues because it won't reduce consumption of cigarettes. So go ahead and do that." The Treasurer again today is confirming that, but yet again another cost of doing business with another report.

There is precedent in the reporting system to rebate retailers for some of the forms they fill out. What are your thoughts on this? I don't know how you explain any better than you did in your presentation, but we'll give you another opportunity to try and explain to people what the net effect of all these rules and regulations is on business.

Mr Frisch: Well, we're trying to be efficient, and the more efficient we can be, the lower we can keep our prices. That translates all through the economy. The more overhead that's put on it at the business level, the more reports, especially with stiff fines, you have to create the internal administrative function to make sure that you're not susceptible to these.

Any cost that's incurred, a fine has to be passed on or absorbed in some way. In a low-margin business like the wholesale business, and I think you've heard that from other presenters, I can't imagine that wholesalers can absorb hefty fines when we're working so close to the line and trying to provide the kind of services.

As I indicated, we can get pharmaceuticals ordered by a store at noon delivered to a store at 3 o'clock. That's what we want to focus on, not the back end of reporting, when we don't even know what the report is going to be used for and we're already giving certain reports.

Mr Jim Wilson: The Ministry of Revenue already gets reports from you.

Mr Frisch: Yes, monthly.

Mr Jim Wilson: Should it be your problem that this report isn't sufficient for the Ministry of Health?

Mr Frisch: No, I don't think it should be. We're already complying.

Mr Jim Wilson: So you just have another ministry in isolation asking you for another report, and I'll bet not one bureaucrat in the Ministry of Health who's asking for this has ever run a small business. I'll bet that's where it's coming from. It's just completely out of isolation.

Mr Frisch: Have they asked the Ministry of Revenue if their reports would satisfy the need?

Mr Jim Wilson: Apparently they have, and they don't, so they've decided on the new one. It's not like they're going to harmonize reports or anything. Maybe we can help you on that so you don't have to fill out two where the one would suffice.

The Chair: The parliamentary assistant would just like to make a clarification with respect to this issue of forms.


Mr O'Connor: I appreciate your coming before us and talking about the wholesale reports and what not. As you may or may not know, there was a discussion document that was put out a year ago in January which was the draft or the proposed legislation that we're talking about here. The whole thing hinges on an overall strategy of how we're going to approach this. This is a comprehensive strategy to reduce tobacco use in the province of Ontario.

The forms that you've talked about that you fill out regarding the taxation -- I appreciate that, and my colleague has talked about them -- don't say where you've sold those cigarettes. It's a form and remission of the money; you're remitting the money. What it doesn't do for the Ministry of Health is say who's buying them and who's selling them, where they're sold, the type of product.

For us to deal with this in an overall strategy -- because this is a health care strategy that the Ministry of Health is dealing with. That's why they pointed out a year ago in their document that this type of reporting is going to be very important, so that we can take a look at the end results that we want to achieve through the legislation.

I just wanted to explain that and hopefully give you an idea of why we want the reports. I guess you're going to be a partner in the health care of the future of the province of Ontario. Just as we've been applauded, you too can be applauded for the work that you do.

The Chair: Do you have any comment?

Mr Frisch: Yes, just to comment, we are already a partner in health care in Ontario through the work we do in delivering pharmaceuticals to drugstores throughout the province. I'm not aware of what the forms are, what information is required on the forms. I didn't see in Bill 119 that it would itemize it. But are you suggesting that we'll be submitting to you the names of our customers and who we sold to, invoice by invoice, date by date?

Mr O'Connor: No. It would be broader than that, and it will be dealt with in the regulations. The committee members are aware of this because we've tried to, where possible, indicate some of the regulations that would be affected. They're in their binder actually. If they take a look in their binder, the section dealing with the reporting, they'll note where we've tried to spell out why we have to put this reporting mechanism in there and the purpose of it. Of course, it's part of the overall tobacco strategy that the province is trying to put forward.

Mr Frisch: When they have a retail sales tax vendor permit number and the government has a record of that, they know, or can know, that the store is going to be selling the product tobacco, for example.

Mr O'Connor: Could.

Mr Frisch: Could know that they're going to be selling the product. If they already know, and you're not going to ask what they bought on a given day or how much they bought, what I'm saying is, if you have the information already, please don't ask us to increase our administrative burden to give you information that's already within the system.

The Chair: I think there is obviously going to be a lot more discussion around forms if this goes forward. I just think we've heard the views expressed, and at this point I'm going to have to bring it to a close. I'm sorry. But thank you very much for coming today before the committee.


Ms Jane Chamberlin: I thank you for the opportunity to appear before you today. I'm here as a private citizen. I speak only for myself, but I think I should tell you that I served as a public member of the Ontario College of Pharmacists for six years and was the chairman of the college's task force on the sale of tobacco in pharmacies.

As you will know, the report of that committee adopted by the college in June 1991 asked that the government support the college in its request to remove tobacco sales from pharmacies in Ontario. Obviously I wholeheartedly support the intention of Bill 119, and specifically its initiative to remove the sale of tobacco from pharmacies.

In addition, I want to personally thank this government for introducing Bill 119, the opposition for supporting it and all parties for facilitating its progress in this committee.

As you have heard and are hearing at some length, the college task force heard from all sides every imaginable argument for and against restricting pharmacists from selling tobacco. I have some sympathy with the process that you're undergoing and, probably at 4:15, the fact that you're only barely awake, but I appreciate the opportunity to appear here.

The Chair: It's deceptive. We're really wide awake.

Ms Chamberlin: The response of the Ontario College of Pharmacists is on the record. Essentially, the college of pharmacists endorsed the need to "do the right thing." It recommended that health care professionals -- and Ms Haslam brought this point up earlier, to my considerable gratification -- should act in the best interests of their patients, even when that best interest could mean financial hardship to the professionals themselves. I think that's probably a fairly key point here. It's the crux of a number of the arguments that are being brought before you.

It was probably the most difficult decision ever made by the college. I felt the work of the Ontario College of Pharmacists showed courage and professional leadership. I'm proud of our efforts. But the college could not implement its recommendations. To do so, we needed your help. Naturally, I am very grateful that you have endorsed our work and delighted that you have taken the next essential step. Believe me, when you put in that amount of effort, you're delighted to see some follow-through.

Also on the record are the very cogent and detailed arguments by the Ontario Campaign for Action on Tobacco about a number of proposed changes to various components of this bill. While I support these recommendations in general, I will use my brief time here to speak to one issue only, and that is what I see as the very essential provision to remove tobacco from pharmacies.

Please bear with me as I address some rather global issues. I think my points may add a new dimension to this debate.

Ontario's health system is publicly funded and comes with a very high pricetag. That's no news to anyone in this room. The public and its government in these tough economic times are quite rightly questioning whether they are receiving sufficient value for the money spent. I would suggest that when it comes to the cost of pharmacy services, we can get much better value.

A large percentage of the cost of educating pharmacists and of the cost of dispensing prescription drugs in Ontario is borne by the taxpayers of this province. These highly educated professionals, experts in the use of drugs and other health aids, are located on the main streets of virtually every town in this province. They are accessible to the public without appointment on every workday, all day, and often on Sundays and evenings as well. We have here a wonderful health care information resource. We pay for it. But we -- and by "we" I mean the system and the public -- badly underutilize this resource.

So what does it matter? You've only to look at hospitalization statistics and drug utilization studies to understand that this province is paying not only for the use of drugs, but for their misuse. For the elderly particularly, we incur high costs for hospital stays which are caused, not prevented, by the inappropriate use of drugs. A high percentage of misuse is based on misunderstanding.

There are enormous cost savings and huge benefits in quality of life to be gained from optimizing the use of the pharmacist as a public information resource, as a full contributor of the expertise we pay for for the health of Ontario citizens, to ensure the public's understanding of the correct use of drug products.

Now, tell me. If you were an average member of the public, would you seek and rely on health care advice from professionals who sold you a deadly product at the front of their establishments and then proffered a few elements of short-term symptom relief at the back? How would you respect a health care professional who was willing to profit from selling you tobacco?

Then again, if you were a teenager or perhaps someone who really did believe in the professional credibility of the pharmacist, would you not delude yourself, as Bill Wensley mentioned earlier, that perhaps if the product is endorsed for sale in a pharmacy, maybe it's really not all that bad?

The citizens of this province deserve better: both better service and better value for their money. The pharmacists of this province deserve better. They deserve the opportunity to contribute the full benefit of their professional expertise. Believe me, in many cases they are not. In many cases they are frustrated professionals because they have been very well trained and they in many cases sit at the back of the store and count, pour, lick and stick, which is hardly what we're paying for. They deserve the opportunity to fulfil their essential role as important members of the health care team.


In closing, I ask you to endorse Bill 119. I would ask, indeed, particularly in the light of current federal initiatives -- I wear black today -- that you strengthen it. As the Ontario College of Pharmacists did in the report of its task force, I would suggest that you restrict the sale of tobacco to licensed outlets, as with the sale of liquor. This is the strongest approach and probably the only truly effective way to achieve the stated intentions of this bill, particularly to prevent the provision of tobacco to young persons. I believe the benefits of this approach will be clarified by others.

Bill 119 is a very important step on the road to a sane tobacco policy for this province. As Mr Wensley mentioned earlier, it is just one step but it is a very important one, hopefully an important step also to a healthier, tobacco-free society.

I welcome your questions and I offer my support. I'd be happy, if the opportunity arises, to help further on this very important health issue. Thank you for having me here today.

Mrs Haslam: On page 3, you mentioned the college could not implement the recommendations. I understand in chain drugstores sometimes pharmacists are hired to be in the back of the store, and that's their place within a chain store or in an A&P in particular. I understand that in a Shoppers Drug Mart, when the policy of their parent company, Imasco, is to sell tobacco, it's difficult for pharmacists to effectively have a voice in what products they sell. Is that some of the reasoning why it was difficult for the college to implement its recommendations, that you tried to do it in a volunteer way?

Ms Chamberlin: No. It was a difficult decision for the college to make. The college, on the best legal advice available, did not believe it had the power to implement the decisions. It needed the act to do that.

Mrs Haslam: Okay, that clarifies that for me. I always forget to thank people. I'd like to say thank you. This presentation needs to be framed. I am very impressed with the concise way you've come to the crux of the problem. I think you've been very straightforward and very, very clear on the situation as it now stands. I thank you for this presentation.

Ms Chamberlin: Thank you for your compliments.

Mr Jim Wilson: Ms Chamberlin, playing devil's advocate as I am over here, the sole devil sometimes on this side --

Mrs Haslam: Big devil.

Mr Jim Wilson: -- I went through the RHPA with pharmacists and everyone else in this room and very much, I think, understand the profession. It strikes me, as a legislator, that one of the reasons the college is not given the authority to make such a ban is that we never intended for the college to ban a legal product or to regulate it, and the RHPA did not extend any new powers to any of the colleges to do exactly what this college has asked the government to do. That was, I would say, very much on purpose, because the debate was around the RHPA. Now, if the government then wanted you to have the regulatory authority to start deciding what products your members could sell and not sell, we'd have given it to you then.

Ms Chamberlin: I'd like to clarify for you that I am no longer on the college and I do not speak for them.

Mr Jim Wilson: You're not on the college. Sorry, and I don't mean to say this in any derogatory way either, but it just strikes me that what we're going through now is the proper course. It strikes me that by not giving the regulatory authority to the regulatory college, it was a recognition by the Legislature that pharmacists are also retailers and that there's another thing that they do out there. Do you have any comments on that?

Ms Chamberlin: Probably not the comments that you're looking for. I think it's quite clear that pharmacy is a different kind of profession; the Regulated Health Professions Act covers a number. Pharmacy is not only a professional activity; it also regulates places and things, drugs and drugstores, as well as professional activities. That makes it quite different from a number of the other health care professions.

I do want to clarify that I don't speak for the college. I think your point's an interesting one. I think you are undergoing the correct process. I think, however, that the college, in recognizing the professional responsibility of its members, took the right step in recommending to you that you proceed on this.

Mr Jim Wilson: On page 5 of your submission, I guess I have a problem with the fact that we're told time and time again that the public see all pharmacies as health care facilities.

Ms Chamberlin: We'd like them to see them as health care facilities. I'm making the point that there is an enormous health care resource available to the public that you're already paying for. If they don't see them as health care facilities and they don't appreciate the quality of information that's available to them there, the public and the system are missing out on an enormous professional health care value that's right there on the street.

Mr Jim Wilson: What about these non-traditional pharmacies like Zellers? Surely to goodness people don't see Zellers as a health care facility. They see it as a large department store that happens to have a drug counter.

Ms Chamberlin: Under this act I suspect they will no longer have a drug counter at the back.

Mr O'Connor: It will place some retailers and pharmacists in a position where they will have to chose between the two. I just wanted to ask for your comment in that we have heard from the college. They had suggested that there be a phase-out, that pharmacists voluntarily phase out the sales of tobacco. In fact, we did have an opportunity to hear from some students of pharmacy who were very supportive of the legislation because they wanted to see themselves as health care professionals.

I tend to agree with you that pharmacists are terrific health care professionals who are there and who quite often are underutilized. People don't always go and talk to their pharmacist and perhaps listen to a suggestion or two that they may have to offer that would undoubtedly save us as taxpayers some money.

The students never said that anywhere in their learning, going through school, they should be looking at just pure marketing of everything. They went through school to be health care professionals. Could you comment on that element further? I appreciate what you have said.

Ms Chamberlin: I think you've said it very well. That's absolutely the case. Students are trained to be health care professionals. The fact that pharmacy is a mixed scenario with a business element involved, I think we have to be very careful that the professionalism comes first and, quite frankly, that this province accepts its responsibilities to fund the professional aspects and doesn't leave pharmacists out there swinging in the wind to make a profit or some other way of earning their living than through their profession. I think there is that element of responsibility on the part of the province.

Mr O'Connor: An unfortunate incident that did happen was when we had the college and the pharmacists' association before a committee that was looking at reform to the Ontario drug benefit plan and they left the table. That was an unfortunate situation because I was interested in how we could utilize all the elements of the health care training that pharmacists had received. At that point I was disappointed because I truly believe they are health care professionals that have been underutilized and would look forward to expanding discussions with them.

Ms Chamberlin: This is a complex issue. This is only one part of it, but it is a significant part of it.

The Chair: Thank you very much for coming before the committee today. We appreciate it.



The Chair: I call on the Simcoe County District Health Unit. Mr Wilson, we're about to get into some good Simcoe county presentations. Welcome. Please introduce your delegation and then go ahead.

Dr David Butler-Jones: Certainly. I'm David Butler-Jones. I'm the medical officer in Simcoe county. The committee had the opportunity to hear from me last week, presenting on behalf of ALOHA. I have no intention to repeat that and you'll be thankful for that, I think.

I would like to introduce and we felt that it might be of interest to the committee to hear from Cathryn Rees, who is a public health nurse working in the healthy child and adolescent program of the health unit; also Shelly Howe, who is a grade 11 student at Innisdale Secondary School in Barrie. I'll turn it over to them now.

Ms Cathryn Rees: I've been working for 10 years with children and adolescents in Barrie and I'm sensing and hearing a change in the attitude young people have towards tobacco. The timing is really right for this bill. The majority of the teenagers are in favour. I've prepared a poster here. I thought I would try to speak to all of the points on that poster. Here we've got the "Break Free" and Lung Association poster that many of you have seen, effectively showing the image of the smoking female teen.

The first point over here -- we're accumulating more negatives now rather than positives -- it's not cool to be poor. Cigarettes are so expensive, teens can't afford to offer them around any more. They often have reduced allowances and many part-time jobs have been eliminated. Buying cigarettes has become a financial hardship. There's very little spending money left for anything else. Keeping the price of cigarettes high has been proven to deter young people from smoking. I'm sure you've heard a lot about that. I'm proud that you're standing firm against the federal government tax reduction.

The next point: It's not cool to be addicted. The high cost of cigarettes is making teen smokers cut down and encouraging many to quit. Students are thus being confronted with the shocking fact that they are addicted much earlier in their smoking careers. Teens are appalled by their addiction to cigarettes. Teens are telling their non-smoking peers and younger students not to smoke. There actually is a cessation group at Innisdale, where I am the nurse, and the students in that group want to go to the elementary schools and talk to the grade 8 classes and tell these students not to start smoking.

Smoking teens have come face to face with the power that addiction holds over them. Teens are no longer feeling they're making their own decisions for themselves; now they're being controlled by cigarettes. Teens who quit state they are proud. Other smoking teens who know they have quit respect them very much for that achievement.

It's too much of a hassle to find somewhere to smoke, the next point. In Simcoe county tobacco use anywhere on school property has been prohibited. Off-school property at Shelly's high school means a significant walk. There is no time for a smoke between classes and snow piles have created further barriers.

There is a momentum towards increasing regulations in our society. It's becoming accepted that a caring community and a caring government would make such laws for the common good and take steps to enforce them. Some examples you'll be very aware of: seatbelt legislation, graduated licensing for teen drivers, RIDE programs, bicycle helmet legislation, planned improvement of enforcement of regulations prohibiting the sale of alcohol to minors, school board prohibitions of tobacco use on school property, municipal bylaws for smoke-free spaces, and now the Ontario Tobacco Control Act.

In Shelly's class I was asking how many of the students were smokers, and 68% in that class were currently smokers; four had been and had quit. I was also asking that class about the bill and asked how many were in favour of raising the age of purchase to 19: 59% were in favour. When Shelly and I were talking she made the very good point that, if the teenagers have to be 19 to purchase cigarettes, you have fewer of the 16-year-olds or kids who might look 16 who aren't who would be quite likely to buy cigarettes or sell cigarettes to the children who are 11 and 12 years old.

When I asked Shelly's class about the licensing of vendors, 68% were in favour. When I asked them about having stiff penalties for vendors, 68% were in favour. So you can realize that smokers were voting for these controls.

The next point: It might be true that tobacco destroys your health and appearance. This wonderful TV spot from the Ministry of Health has caught many teens' attention. I hear about that when I walk around the high school.

So to conclude my remarks, I say passing this bill is a job for all members of all parties. The bill is needed by the children of the people who elected you. To pass this bill with the full intent takes courage. Be courageous.

Are there any questions you would like to ask Shelly or myself?

The Chair: Yes, I'm sure there are, and thank you for that specific information that you've included.

Mr Jim Wilson: Dr Butler-Jones, it's good to see you again. Cathryn and Shelly, welcome to the committee. As I'm sure you know quite well, I'm not aware of any members of the Legislature intending on voting against the legislation. In fact, it passed second reading quite easily in the Legislature. We're just trying to fine-tune a bit of it.

Your comments with respect to 68% of Shelly's class who claim they were smokers are most disturbing. It kind of goes in line with a group of young people who appeared before the committee this morning. There were five or six of them who were all smokers and the message I got from them was, nothing seems to be working. The more negative message we send to them, the more rebellious they get and they just want to start because people tell them no.

Back in my days, not too many years ago, the health unit used to come in with a black lung. Was that the health unit, Dr Butler-Jones?

Dr Butler-Jones: It would have been the health department then.

Mr Jim Wilson: The health department. They used to show us how to brush our teeth back in those days too but that sort of thing didn't seem to have much effect on my generation. I guess it had some effect. The trend has been good but it's sort of bottoming out right at the moment or plateauing, I guess I should say.

We also had the opportunity to ask them whether they thought it would be a good idea if we made the consumption and possession of cigarettes under the age of 19 illegal, much like alcohol. You know, put some responsibility on their shoulders. They made it clear that they just go from retailer to retailer or the black market and eventually they're going to get their cigarettes somewhere. There's no way we could stop them.

I think, Shelly, it's probably your experience and I'd like you to comment on that. Secondly, do you think we should make it illegal and put some responsibility on their shoulders?

Ms Shelly Howe: I know that I've talked to my friends and they said that no matter what they do, they're going to get their smokes from somewhere. It's not going to stop them. There's always someone they can get to buy the smokes for them. But to make it illegal?

Mr Jim Wilson: There's one state that I can think of where, in addition to being fairly tough on the sellers of cigarettes, they also have a $25 fine for the young people, and you have to go down to the police station and pay that $25 fine. You don't get a criminal record or anything, but it's just a recognition that you have to have to responsibility for what you do. You're not supposed to be buying cigarettes now under the age of 18 or 19. Would that have any effect on your friends, do you think?

Ms Howe: I don't think so. I've been talking to them and they said that no matter what you do, they're going to get them. That's just going to make them want to get them more.

Mr Jim Wilson: It kind of leaves us in a bit of a predicament.

Ms Rees: That is a group of teens and that is their smoking behaviour; it's part of their total lifestyle and it's not just smoking that is part of the lifestyle they have generated. There are other teens who are not following that specific subculture of teens. There are many, many different groups of teens. We have other subcultures of teens who would be intimidated by having to ask someone to buy the cigarettes for them, who would be intimidated by the law as it is stated.


We also really are trying to focus on people who haven't started. We want to increase the hassle and increase the barriers for the people who didn't start. So at the bottom of the poster, it's time to quit for some students if they can manage, and that is awfully hard, but the bottom line is: Better yet, don't start.

This legislation is really going to do a lot for the young people who are not smoking at this point in time. Sure, some of them will enjoy the challenge and will chase after it, but that group will be getting smaller and smaller if we do have this legislation with the intent that is within it.

Mr Jim Wilson: I appreciate your comments very much but this legislation doesn't do a heck of a lot, in my opinion, to alter the current model. It raises it one year and teens have told us, "Whoopee ding-dong"; it puts heavier fines on retailers, so maybe they will smarten up, though teens tell us it won't matter; and it has some other provision like vending machines. Less than 1% of cigarettes are sold through vending machines anyway, but I agree we should ban them. We should also compensate the people who own those vending machines.

Pharmacies, okay, if you accept the argument that it will restrict. It's only going to restrict the sale of cigarettes in a small part of a huge retail sector. So I'm in favour of the legislation but I'm missing the boat. I think we need more teeth in it. All we're doing is propagating an old model and putting new clothes on it.

Dr Butler-Jones: I think that goes back to the position that you would hear from health units generally that relate to price and availability: the fewer places you can get it, whether it's only in licensed establishments like we talked about last week, the issues that relate to maintaining the price of the cigarettes.

The notion of having a simple fining system, for a 12-year-old that would be a barrier. It may not be for somebody who's already addicted at 15 or 17, but for a 12-year-old looking at the prospect of just having a pack of cigarettes and somebody saying, "That's $25," then it might be a barrier. Those kinds of things I think are important considerations, and the point is to get them to stop before they even start.

Mr O'Connor: I appreciate what you've added to this debate. It's always nice to see young people come forward because it lets us know that we're reaching some of the target that we're trying to reach, and that's our young people. We don't want them to become addicted.

One of the things the bill has in place is an automatic prohibition, and we've also heard there should be a licensing system. Someone today suggested that the licence that hangs up in the corner in the retailer's, that allows that person to have that licence, is kind of an important thing. They thought maybe that's what we should be going to.

I'm not convinced of that. I like the model we've got before us because when you get into the stage of the automatic prohibition, you put a sign in there that says, "This retailer has been selling cigarettes to children under the legal age to sell them." To me, it sends a stronger message out there. Would you not think that we should be trying to send out the strongest message, and would you support that element? You've read the automatic prohibition section. Do you think that's strong enough? I think it's pretty tough.

Dr Butler-Jones: I think in that context it's useful. Personally, I think that cigarettes should only be available through LCBOs and beer stores and wine stores so that you overcome the issues of the under-19s, because they have a system in place to deal with that. It is an access issue. As long as you've got corner stores selling cigarettes, you're still going to face that dilemma. I agree. If that's where it's going to stay, then those kinds of prohibitions are important.

The Chair: Thank you all for coming before the committee today. We appreciate it.

Members, we have distributed a copy of Bill C-111, which is the bill that was passed in the House of Commons today, just for your information.


The Chair: Representatives from the Simcoe County Interagency Council on Smoking and Health, welcome. Please introduce yourselves and go ahead.

Ms Shawn Fendley: Thank you very much. It may have been confusing to try and figure out who was who, but I am Shawn Fendley and my colleague is Vito Chiefari. We both come representing the Simcoe County Interagency Council on Smoking and Health, which is a group that I'm proud to say has been in existence since 1979 and represents people from the Lung Association, the Heart and Stroke Foundation, the Cancer Society, the Addiction Research Foundation, the health unit, both our boards of education, Best Start Barrie, which is a low-birth- weight prevention project initiative in Barrie, the community health centre, some local physicians and some community members at large.

We've worked long and hard over many, many years in the areas of education, cessation support and environmental protection, but our major focus, particularly in the last couple of years, has been on youth and the prevention of smoking starting in the first place.

We truly believe that it's not one initiative alone but our collective efforts of governments, local bodies like ourselves, educators, parents, young people and the community at large that can really make a difference and help our future generations be smoke-free. We really must do all we can to keep our young people from tobacco addiction, which we know is a leading preventable cause of death.

I'm sure you've had many people say to you that with any efforts we can make to keep young people from smoking up into the age of 20, the likelihood of their ever becoming addicted to tobacco is very, very slim. We feel that Bill 119 is a most important piece of legislation that could be considered in Ontario respective to our health. It will complement and strengthen many of the actions that are already under way in communities. We really do need the support of a strong tobacco act to show people and our young people that we really are serious about protecting people's health.

We really do applaud this government for bringing forth and introducing Bill 119 and for the government and the opposition parties to see it passed through second reading and referred to this committee for hearings. Thank you very much for the opportunity today to present our position to you.

Needless to say, with a great focus on youth and prevention of tobacco use, we are very pleased to see the provisions that are looking at reducing young people's access to tobacco, such as increasing the legal age, banning the sale of tobacco in pharmacies and other health facilities, banning vending machines, controlling the illegal sale of tobacco to minors and prohibiting smoking in designated places, including schools.

We are very fortunate. As of September 1993, both our school boards have made it a policy that there's no smoking on any school properties, but we know that there many other communities across this province that don't have such policies in place. As important are the health warnings and the health information that need to be part of packaging and posting where tobacco is sold.

There are some other thoughts that we'd like you to consider in terms of provisions that would be even more helpful in keeping our young people smoke-free, such things as banning countertop, self-service and other point-of-purchase displays and looking at banning any packaging of cigarettes with less than 20 cigarettes.

We just heard from the delegation from the health unit that one of the critical factors for young people today is the cost. I think the tobacco industry has been creative in looking at ways of trying to beat the increasing cost and the taxes by putting them in smaller portions, which helps when somebody may be thinking of trying out a new habit, may not want to buy a whole pack but a few might be quite interesting, or if you've an established habit and money is low, it might be something that you could continue.

We truly believe that strengthening the designation of smoke-free places in our community in such things as recreational facilities, theatres and shopping malls will also help contribute to our goal to keep our youth smoke-free.

We'd also like you to consider incorporating a minimum of 50% smoke-free seating in banquet halls, food establishments and bingo parlours as a step forward to making more and more community places smoke-free.

I'd like to follow with some arguments for those suggestions and my colleague will carry on as well.

I think one of the things we've talked about is the frustration in realizing that there have been many, many efforts that have been successful in reducing the numbers of adolescents who are smoking in the community, but we seem to have hit a stalemate. I think one of the main reasons we have to look at is the inconsistency of our messages.

We talk about the health hazards and yet it's something that's readily available, easily accessed, marketed very, very attractively and allowed in so many public places. We still know there are a fair number of adults who smoke. It leaves you with that question, if it's so bad for us, then why is this all still happening? I think a point we really need to take into serious consideration is, are we sending consistent messages to our young people?


It's something we battle with every day. I have a nine-year-old daughter and at this point in time it's really not too difficult to talk to her about the hazards of smoking. If you see something or you talk about a neighbour who smokes, it's very easy to rationalize with her some of the hazards and, yes, some people still choose to smoke. But I know as she gets older and the outside messages become stronger, that rationale is going to be much harder to argue. I think the messages need to be far more consistent, because I know my input won't have nearly as much weight in the future. We really need to prove that our talk is not cheap and we must do everything we can to remove the incongruencies.

When we talk about the ease of getting cigarettes, I think you've probably well heard about situations where we know that you're not supposed to be selling tobacco to people under the age of 18 and yet it's very easily accessed. I cited an example in our brief. It was very challenging. We had three headlines on three different pages of the paper. This exercise was done in May of last year. We've got front headlines: "Buying Cigarettes Easy for Teens." The article carries on and says, "Underage Smokers Finding it Easy to Spark Up." The last one says, "Teenagers Treat It as a Game."

I think the frustration was that here was somebody who was only 16 years of age, sent to six locations in our community and had no problem at all in buying cigarettes from any one of those locations. There was a major supermarket, local corner stores and two pharmacies included, and not once did she get questioned or asked to show identification. I think that situation could pretty much be replicated across this province.

We really need to seriously look at it. If we think it's a hazard for young people to access cigarettes, then we need to follow through with that and make sure that the measures that we put into place are enforced.

I know you've also heard lots of arguments about the relationship between tobacco and pharmacies and that message we're sending to people related to tobacco and health. I think it's just another example of the importance of not talking out of both sides of our mouth. If it really is a hazard to our health, then why is it so readily available in what I consider very much a health care facility?

Just to draw it to your attention, we were asked on behalf of an IDA pharmacy, the Piercys in Orillia, to forward a letter to the committee from them about their recent experience of deciding to open a pharmacy in Orillia in 1991, very tough economic times, and deciding not to sell cigarettes and what their experience has been. I'd like to just draw that to your attention.

Then there's the piece about the not-so-subtle marketing. We know that there are things, as mentioned, like kiddie packs and point-of-purchase displays that are very conveniently positioned so that anyone going to the front of the store to make their purchase is going to pass by these displays, and very much at the eye level where many, many young people will see it. Again, they're just things that tend to undermine our messages that tobacco products are a health hazard.

My colleague will talk about smokefree spaces.

Mr Vito Chiefari: Thank you to the committee for letting me speak. I think that the bill itself is an excellent piece of legislation. My focus is going to be on environmental tobacco smoke, focusing a lot on section 9 of the act.

I think that, following through with what Shawn's saying about the positive message that we give our kids, the more smoke-free places we create in our society, the better examples we're providing for our youth. I don't have the empirical evidence to show that, but that to me just makes sense.

I'm not here as a medical doctor to talk about the consequences of secondhand smoke. I've read studies talking about secondhand smoke and environmental tobacco smoke linked to lung cancer and respiratory complications and allergies.

The only example I have is my grandmother. This sticks in my mind. In 1976 my grandmother went to the doctor complaining about coughs and sneezing and all kinds of respiratory problems. Her doctor did the routine stuff on her and she said, "Mrs Carnovale, do you smoke?" My grandmother goes, "No, I don't smoke." "No, no, you can tell me the truth. I'm your doctor." My grandmother says, "No, I don't smoke, but my husband smokes." Of course, my grandfather smoked a pack and a half of Export A a day back in the 1970s.

She came home in tears and really upset about the fact that she was going die on behalf of the fact that he smoked, so he gave up the habit. I never forgot that, and that to me is enough evidence of the consequences of secondhand smoke. My grandfather, of course, died of lung cancer in 1989, and that's another story.

In respect to section 9 of the act, I think it's a great step when we talk about banning smoking in our schools, in our nurseries, our financial institutions, retail outlets, laundries, hairdressers etc. I think we have to add a few to that list, to include recreational facilities such as arenas, theatres and shopping malls. If we're going to make a positive statement out there, let's go the full spectrum.

I think an additional section should be added on to incorporate at least 50% smoke-free sections in places such as banquet halls, food establishments, including restaurants, and bingo parlours. I'll make some arguments around that. Even though you may have heard a lot of arguments around the fact that we should go completely smoke-free in restaurants and places like that -- I agree totally -- this to me is at least a good first step for us, if we go segregation.

In Simcoe county, just to give you a flavour of the area that I work in, we have a population of roughly 275,000 people. Only 60,000 live in communities where we have bylaws that have any smoke-free requirements in places that people commonly frequent. I can go into any parts of Alliston or Collingwood or parts of Midland and you may have a smoke-free section in a restaurant one day and nothing the next. Those bylaws just aren't there. The province could do great things in that area if it created a province-wide benchmark.

In respect of the people affected by these places, thousands of people go to restaurants on a weekly basis. The kids in Simcoe county pretty well live in our arenas. Whether they're hockey players, figure skaters or just spectators, it's like a second home to many people. If we made them all smoke-free, it'd be a fantastic thing.

Provincial legislation would create a living playing field for everyone. It would tell the rest of the province that this is how we're going to work. It sets a minimum benchmark that everybody has to follow. It creates a great opportunity for the business person to implement this thing because the government says we have to do it and makes that step a lot easier.

In terms of municipalities, a lot of municipalities will probably never see smoking issues as being a priority. If it's not done at the province, it probably won't be done. It's a good step that we're taking here.

In terms of implementation, as a past public health inspector, I worked under smoking bylaws. I think it's something that could be implemented by public health inspectors or bylaw enforcement officers quite easily. I say that with a grain of salt because resources aren't always there. But we deal with the promotion piece of legislation, we deal with the enforcement piece of it. It's not something where we'd have to set up a new framework of people to implement this act. I think one of the biggest points for creating a strong smoke-free environment piece in the legislation is the fact that society is ready for it. This isn't something that I think this society is going to be up in arms over, because the majority of the population does not smoke. Even smokers, in most cases, don't mind the idea of having a smoke-free place.

In conclusion, I think this is an excellent piece of legislation. Shawn and I, in our work in Simcoe county, talk to hundreds of people during the week. When we bring up Bill 119, they think it's a good thing, no matter who we talk to. There are exceptions, but the majority of people think it's a good thing, smokers and non-smokers.

The other thing is that Bill 119 provides a much-needed piece of legislation to go with everything else that has been done in this province to try to curtail smoking. It complements the promotional piece, all our ads and all the things we're doing in our schools that Cathryn talked about. I think it's a good, complementary piece.

The other thing is that this sends a very clear message. Bill 119 sends a very clear message to the province that we're serious. It sends a very clear message to some of our federal people that we're serious and we're playing ball here with tobacco. Anyway, we're open to any questions.

Mr McGuinty: Thank you both very much for your presentation. One thing comes to mind, listening to you, Ms Fendley, with respect to your little account there of the difficulties, the fears that you may feel with respect to your daughter. After having listened to those young people who were here earlier today, particularly if their parents were non-smokers -- and I've got some kids of my own, my daughter is now 12 and she is going through, I think, what is a classical transitional phase where the influences outside the home become greater than those inside the home. You're concerned about whether they're going to pick up the habit and I think, in some ways, I guess what I'm really afraid of is Hollywood may start showing kids' heroes smoking. Bogey and Bacall did more for butts than the industry ever did for itself, I think, in some ways.


It would be nice if I could go home and tell my kids, and maybe you could go home and tell your child: "It's against the law. You're under 19, honey, and it's against the law for you to smoke." That means something to my kids. It's very meaningful for them to know that something is contrary to the law. I'm just wondering how you would react to that.

Ms Fendley: I think we can all argue, as probably being teenagers once ourselves, that there's that element of intrigue with being against the law. But I think for most of us, that still bears a pretty heavy weight on our shoulders, when we think about doing something or not doing something. For me what it does is send a strong message that it's against the law because we really are concerned about your health and the health of the people of Ontario. It's not because we just don't want you to do something.

Mr McGuinty: Right.

Ms Fendley: It really again puts the weight behind how committed we are to the health of people in Ontario and to young people.

Mr Chiefari: Yes, it sends a clear message that we're serious about what we're doing. Usually, in my estimation, you have to tie some consequence to lawbreaking, whether that be a nasty letter that goes home with parents or whether that be a dollar-figure fine. I think it's something that should be there.

The Chair: Thank you. I should offer some hope, as a parent of kids who have passed 9 and 12 that in fact some do reach the point where they're not smoking and they're past that danger zone. I just want to give you both encouragement.

Mrs Haslam: No, the danger zone goes to 20, because I'm in the same situation. In your brief you had easy-to-get cigarettes, and they actually got into pharmacies and got cigarettes. Do you know how many or what pharmacies they were?

Ms Fendley: I know that from the piece of information that was in the article. One was a Shoppers Drug Mart and one was a Guardian Drug.

Mrs Haslam: Shoppers Drug Mart. I can't believe it.

Mr Wiseman: No, not Shoppers Drug Mart.

Mrs Haslam: Not Shoppers Drug Mart. Okay.

The Chair: Thank you very much for coming to the committee today. We appreciate it.


The Chair: I then call our final witness for today who has been, I know, sitting back there waiting very patiently. Mr Borutskie, if you would come forward, we want to welcome you as well to the committee. Once you're settled, please go ahead with your presentation.

Mr Mark Borutskie: Thank you for this opportunity of allowing me to make this presentation. My name is Mark Borutskie and I am a practising pharmacist and co-owner of McGregor IDA Drugs in Bowmanville.

Originally, I was not going to make a presentation to this committee. However, because of a series of events, I've changed my decision and I feel compelled to give you a balanced opinion on this issue.

In October 1990 members of the Non-Smokers' Rights Association made a passionate presentation to the council members of the Ontario College of Pharmacists. After much debate, the Ontario College of Pharmacists passed a resolution in June 1991 to remove tobacco products from pharmacies. The college council based its decision on a section of the Health Disciplines Act which states that the college's mandate is to serve and protect the public interest.

I was very concerned with the college's decision, particularly that the council was making decisions about the removal of a legal product because that product may not serve and protect the public interest. My concern was that, if the college made a decision on tobacco in June 1991, what contentious product would it take issue with tomorrow?

I felt that the college had made the wrong decision. I decided to join together with the Committee of Independent Pharmacists. In August 1991, the elections for the Ontario College of Pharmacists were being held and I decided to stand against the sitting member from my district. I did so because he was one of the council members who voted in favour of the removal of tobacco.

My feelings then, as they still do now, remain the same. If the ultimate purpose of the proposed legislation is to decrease the number of smokers in the province, then I truly believe it will not be achieved. The sales of tobacco products will simply move to the corner store or down to the large grocery store. To simply close one type of tobacco retail outlet and have those sales reappear at another type of outlet appears to be only a lateral move towards combating tobacco use.

My district extends from around Kingston and Gananoque and moves west to include Durham region. There are over 600 pharmacists in district 2. Many pharmacists were upset about the unfair way the council had dealt with this matter. There was no prior canvassing of our membership regarding their feelings on this issue.

My support in the district was reasonably strong. The incumbent member decided not to stand and I was elected unopposed. I've been a council member since October 1991. In fact, you should know that of the nine college council members who voted for the removal of tobacco in June 1991, eight of those councillors were out of office after the August 1991 elections. When I got to college, together with my colleagues, we tried to set in motion the process to overrule the tobacco vote. However, we discovered this was not as simple as it sounded.

The council of the Ontario College of Pharmacists is made up of elected members representing 16 districts. They are voted in by the approximately 8,000 pharmacists registered with the college. If a vote were taken today with the 16 elected members, I believe the tobacco decision would be overturned. In addition to the elected members, the college includes seven non-elected members.

Time and time again this matter has been discussed and debated at college council meetings. In each case the motion to reverse the decision has been defeated. However, I feel these defeated motions do not truly represent the wishes of the majority of pharmacists in Ontario.

I spoke earlier about a change in the council members. Most of the votes cast in the August 1991 elections were made in favour of those candidates who wanted to leave tobacco in drugstores. The Ontario Pharmacists' Association held a referendum in the fall of 1993 on this issue and 62% voted in favour of voluntary removal of tobacco as opposed to legislated removal.

There are about 1,400 pharmacies in the province out of 2,200 which sell tobacco. That's 64% of the profession selling the product. Actually, when you consider that about 250 of these 2,200 pharmacies are located in hospitals, the percentage selling tobacco rises to about 75%.

This is a very divisive issue with many groups. One thing I know we all agree with is that we, as health care professionals, would like to work with everyone towards reduction in tobacco consumption. As pharmacists, we want to play our part to ensure that minors do not start smoking. Raising the age to 19 is a good start. If there only was a way to make it an offence to smoke under 19, that would make government's endeavours more effective, but obviously that could never be enforced.

Ladies and gentlemen, I'm telling you that this is not what our profession or today's elected college members want you to do. We are a house divided. The majority of pharmacists in this province do not want you to proceed with the pharmacy provision.


I'm aware of a report prepared by Coopers and Lybrand detailing the economic impact of the legislation on pharmacies. They predict that about 110 drugstores in the province will close and between 1,300 and 1,500 jobs will be lost. Some of those positions will be pharmacists. Pharmacies closing down and pharmacists and other full-time employed people losing their jobs is not necessary.

Will it reduce smoking? You know it won't. I think I'm well regarded and respected by my colleagues, as evidenced by the fact that elections again were held in August 1993 and this time I was opposed by a pharmacist who advocated tobacco removal, yet I won a convincing majority. I really do stand before you as a representative of the Ontario College of Pharmacists who has been put to the test of his peers and who does represent their views. Their vote is not to proceed with your legislation as it relates to tobacco in pharmacies.

Section 4(2)8 should be taken out, but the rest of your legislation should go forward. Once again, I would like to thank you all for the opportunity of making this presentation today. I only hope I have brought some balance to your committee and that you make a decision which is fair and truly represents our profession.

Mr McGuinty: Thank you very much, Mr Borutskie. I think you were helping to lend some insight into an area which I certainly find confusing. That is, we're told that in 1990 or 1991 the college council requested that the government ban, through legislation, the sale of tobacco products in pharmacies, yet we've been besieged by a number of presenters who are obviously against that, so it's obviously a source of controversy within the profession.

There have been informal surveys done by members, people sitting on the committee, and they frankly admitted that they weren't scientific, so I'm not sure how much weight we can put on them. So it's good, I guess, to get some information from somebody on the inside at this particular stage. How many council members that are sitting are appointed?

Mr Borutskie: According to the Health Disciplines Act, right now there are six, but of course that's going to change come the fall, I believe.

Mr McGuinty: Just now, I mean.

Mr Borutskie: There are six sitting right now.

Mr McGuinty: Are any of those pharmacists?

Mr Borutskie: No. Six public members with 16 elected pharmacists.

Mr McGuinty: All right, well, let's just talk the pharmacists for now. You're telling me if we had a vote just among the pharmacists, you're convinced that --

Mr Borutskie: Nothing's guaranteed, but I think it would pass.

Mr McGuinty: But what's your district?

Mr Borutskie: I think they would be in favour. When I read the survey by the Ontario Pharmacists' Association, where they arrived at about 64%, or whatever I said, in favour of voluntary withdrawal of tobacco products, I think that's pretty close to the mark.

Certainly I've had members who called me, knowing I was going to be here, telling me their concerns too, and certainly there were a number who disagreed, who agreed with the government's position of taking tobacco out of pharmacies completely. I see both sides and I'm trying to represent the majority of the pharmacists in my district.

Mr McGuinty: That survey you referred to, when was that done?

Mr Borutskie: September, I think.

Mr McGuinty: That's the most recent one?

Mr Borutskie: I think it is. I'm pretty sure it was September 1993.

Mr McGuinty: That was conducted by the college?

Mr Borutskie: No, by the Ontario Pharmacists' Association. It wasn't done by the college.

Mr O'Connor: Thank you for coming before us today. Does the area you represent cover York region as well?

Mr Borutskie: No, it doesn't.

Mr O'Connor: We had a presentation earlier today by the public health department from York region. They did their own survey and it was a random telephone survey. They phoned 40 pharmacies across York region. Some 90% of the pharmacists' employees supported the ban. A sample of the 39 pharmacies did not sell tobacco products. These pharmacies reported positive comments from their customers and other health care professionals.

A further 40% supported the withdrawal of tobacco products and in fact 15% had already started the plan to remove it before the legislation has been enacted. Some of them even stated that they did so in fear of perhaps losing profits, but of course the lost tobacco sales were not great enough to cause any true economic hardship for those that had reported.

A question I've got for you is, we're trying to deal with this here. We've heard from other people from the college, but we've also heard from the students of pharmacy. It was tremendous. You know, I always get enthused when young people come to the committee, because often we're talking about legislation that's going to be in the books for many years and we're talking about young people.

Maybe you've done this survey. Have you gone to the students of pharmacy and suggested, "Should we continue the sale of this lethal product?" Did you survey them as well in the survey that you did? I know that the students, until they become pharmacists, don't actually become regulated by the college of pharmacy and don't have representation there, but I just wondered about your thoughts on that.

Mr Borutskie: The survey that I mentioned was done by the pharmacists' association. I don't know whether they did survey students. I don't have that information. For what it's worth, certainly I got some feedback from my own kids. They knew I was coming down here and --

Mr O'Connor: Are they students of pharmacy?

Mr Borutskie: No.

Mr O'Connor: Not following in dad's footsteps.

Mr Borutskie: One's in high school and one's in college. But I ran it by them, what I was doing. Neither of them smokes. They're dead against smoking for sure, but they agreed with the main thrust of why I'm here, the removal of a legal product. The sales part is an issue. I mentioned it. It's not as important to me; I see tobacco sales shrinking. I don't think in our store we're going to be selling any tobacco in five years anyway because the sales are just diminishing. To give you an idea, sales of tobacco in my store are 3%, and they're going to be less than 1%.

Mr O'Connor: The students of pharmacy that we had here were clearly in support of the ban of the sale of this lethal product in pharmacies because they see it as a contradiction. They fully support the legislation because they see themselves, as students, as young people now studying and wanting to become health care professionals, in an ethical dilemma. They definitely supported wholeheartedly the ban on pharmacies, so perhaps you may want to go and talk to them as well. We have heard from them as well, so I appreciate that.

Mr Borutskie: Just one extra thing to mention. There are many drugs that come out on the market that people might find offensive. There's a new drug which certainly hasn't been released in Canada, but it's been out in Europe. I don't know if you're aware of it. It's called RU486. It's an abortion pill. When that's released, if it ever is, in Canada, there are going to be a number of pharmacists who because of their views on this, again a very contentious issue -- everybody has their own feelings about abortion, of what to do. That will be another dilemma.

Would the government give you any support, any guidelines, as far as, you know, "If you don't believe in the drug, how can you hand it out?" Again, I don't know. It's a lethal product, but if a doctor orders it, it's an issue that a lot of pharmacists, and the students when they get out, will have to deal with, because it will probably be available when they're out in the workforce.

Mrs Cunningham: Since this bill is intended to prevent the provision of tobacco to young persons -- we personally don't think that saying that pharmacies can't sell them would help us in that regard, because we think people would go down in another part of the mall or whatever, but that's just our position. Have you thought about licensing retailers in order to sell tobacco?

Mr Borutskie: As a liquor control board type outlet?

Mrs Cunningham: Yes.

Mr Borutskie: I've thought of it. I see nothing wrong with it at all. If it was going to be a level playing field, certainly, where it was sold in outlets, I'm in agreement.

Mrs Cunningham: Have you thought about young people being responsible, who would come into your store or anywhere else, to the extent that if indeed they were able to purchase or were found with cigarettes on their person and they were under the age of 19, there would be possible sanctions against people who are smoking and have purchased underage?

Mr Borutskie: I've thought of that. I don't know how you'd enforce it. It would be very difficult to enforce, just like the suggestion was made to me to ban smoking in all public places. You could only smoke in your car and in your house; you couldn't smoke outside on the street. That would eliminate a lot of smoking.

Mrs Cunningham: You'd have to carefully define "public places." But the reason we're putting this to you is that there have been arguments on both sides, and I think the one is that if you really believe a pharmacy is a health care centre, then you wouldn't sell cigarettes, but pharmacists have come forward and told us they don't believe that's what a pharmacy is in their instance.

To me, that argument's irrelevant. I'm talking about who should be selling, and I don't think any retailers should be told by the government of Ontario that they can't sell certain products. In this instance we're thinking about licensing certain places, and you've answered that question. But I think you also have to think about the young people who purchased the cigarettes regardless, and what their responsibility is.

I think we have to take those kinds of tough stands if we're going to ban the sale of cigarettes to people under the age of 19. It has to be both sides and there have to be some sanctions. When you go back to your professional organization, I would hope that you would look at those two questions and help us out and give us some recommendations. There have to be responsibilities on both sides.

Mr Borutskie: I agree with you.

The Chair: Thank you very much for coming before the committee. We hope whatever the weather's doing out there, you have a safe trip home.

Mr Borutskie: Thank you very much.

Mr Wiseman: It's not doing much.

The Chair: Somebody has reported it's not doing much. That's good news. Just before we adjourn then, the committee will be in Sudbury tomorrow and we will reconvene here Thursday morning at 10 o'clock.

The committee adjourned at 1722.