Canada reverses warnings decision

03 Feb 2011

A detrimental decision

This decision was taken despite:

  • international research proving that warnings lose their effectiveness over time;
  • six years of work by Health Canada;
  • public opinion and other research commissioned by the department at a cost of some $4 million;
  • negotiations with provincial governments over the printing of a national toll-free quit line number and website address on packs;
  • various consultations with stakeholders; and
  • ongoing pressure from health groups.

Tobacco control NGOs lead the fight against this decision

To reverse this ill-conceived decision, health groups undertook a multi-pronged and relentless advocacy campaign. Media advocacy played a critical role in the campaign and its ultimate success; in fact, there were four waves of media coverage of the warnings issue between late September and mid-December:

  • The first wave addressed the Minister’s decision not to proceed with new warnings, which was leaked to health interests, and the reaction of the provinces to the fact that there would be no increased promotion of their provincial/territorial quit line by having the phone number printed on cigarette packs.
  • The second salvo began on 8 November, with an editorial in the Canadian Medical Association Journal expressing outrage over the government’s “senseless policy change” on the warnings. Two days later, following public release of possible new U.S. warnings, a spate of newspaper articles appeared criticising the federal government’s inaction. Health groups had been quick to inform reporters that the U.S. warnings included one of the hard-hitting warnings shelved by Canada—a deathbed photo of 42-year-old Canadian Barb Tarbox and her heart-wrenching testimonial: “This is what dying of cancer looks like”.
  • A third wave of media coverage in early December dealt with the hearing by the parliamentary health committee into the warnings cancellation. This time health officials and the Minister insisted that the warnings were not cancelled but rather were undergoing further review.
  • On 16 December several more newspaper articles covered the open letter to the Health Minister sent by 10 health groups.

The end result was that on 30 December the Health Minister, in a complete reversal of her earlier position, announced that Canada would be proceeding with new tobacco package warnings “as soon as possible”, and proclaimed that Canada intended to remain a world leader in tobacco control. What Health Minister Leona Aglukkaq announced was in fact merely the outline of what the new tobacco package warnings system will include:

  • a set of 16 new warnings, some of which will address health risks not covered in previous warning rotations, including bladder cancer and macular degeneration;
  • an increase in the size of the warnings from 50 per cent to 75 per cent of both major surfaces of packs of cigarettes and, for the first time, little cigars;
  • the addition of a toll-free quit line telephone number and website address to each warning; and
  • the inclusion of at least one testimonial from a real person who had suffered from a tobacco-caused disease (the Barb Tarbox warning).

While the government’s about-face is reason to rejoice, health groups in Canada must remain vigilant. The announcement left out many details, and as the saying goes “the devil is in the details” such as:

  • only four of the 16 warnings were revealed;
  • other than the Barb Tarbox warning, none of the hard-hitting graphics previously tested appeared in the warnings announced;
  • the two warnings that the industry has feared the most—of addiction and of death from second-hand smoke—were not announced and the final 16 selected warnings may not include hard-hitting warnings for either;
  • a breast cancer warning was not among the new warnings showcased, despite being highly recommended by many who participated in the consultations; and
  • no details were given to substantiate the promise of “improved” health information messages inside packages (which now include both cessation and risk messages) and toxic emission statements.

Once the remaining details are finalised, draft regulations must be published, official consultations undertaken, and the final (possibly revised) set of new warnings printed in the Canada Gazette. Only then will we know whether Canada’s new tobacco package warning system puts the country once again in a position of world leadership for tobacco control.

Lessons learned

•    An initiative that is deemed “dead” could merely be “shelved,” could actually be “under consideration” and could ultimately be fully resuscitated. Translation: never give up.
•    The media is a critical tool in an advocacy campaign. We used many different tactics to get repeated coverage of the warnings cancellation: we issued media advisories to inform media of important events, such as the Health Committee hearing; we issued news releases; we telephoned individual reporters and briefed them on a possible story, such as the Canadian angle on the release of the US warnings candidates.
•    We worked closely with Opposition parties to encourage the government to reverse its decision.
•    To paraphrase an old adage: two birds in the bush are worth a lot less than one bird in the hand. In other words, while cause to rejoice, an announcement is just an announcement. Advocacy must continue until a reform is fully implemented.

This opinion piece is by Melodie Tilson – Director of Policy at the Non-Smokers’ Rights Association in Canada

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