Monday, 26 May 2025

Health Groups call on Federal Health Minister Marjorie Michel to ban vape flavours within her first 100 days.

 PRESS RELEASE

(Ottawa – May 26, 2025) – Deeply concerned with the impact of the previous government’s permissive approach to nicotine vaping products, tobacco control organizations are calling on the new government to quickly align controls on this market with those used for tobacco.

As part of these important reforms, they are asking for regulations to ban flavours in vaping products to be finalized within the Health Minister’s first 100 days in office. Restricting flavours in vaping products was a commitment made by the Liberal Party in the recent federal election.

“Minister Michel has inherited the youth vaping crisis, and her intervention is urgently needed to clean up the mess her predecessors left behind,” said Les Hagen, Executive Director of Action on Smoking & Health. “This will require her to stand up to the tobacco industry and its front groups, and to protect youth from their attempts to undermine health policies.”

“The youth vaping crisis has gone on far too long,” he added. “The past government’s decision to liberalize the sale of vaping products has negatively impacted one-half of Canadian youth without producing any measurable benefit in overall smoking cessation among adults.

Vaping products became legal for sale and promotion in Canada in May 2018, and were exempted from the marketing restrictions that have been proven to help protect young people from starting to use tobacco products. These measures include large graphic health warnings, plain and standardized products and packaging, bans on flavourings and sweeteners, and controls on accessibility including a ban on interprovincial sales.

“Over the past seven years, parents, teachers and health professionals have struggled to protect kids from the predatory commercial activities which followed,” said Flory Doucas, co-director of the Quebec Coalition for Tobacco Control. “They have waited for meaningful federal government action while hundreds of thousands of children were being recruited to nicotine addiction by an industry sugar-coating a harmful drug with exotic flavours and playful devices.”

Health Canada’s 2023 Canadian Substance Use Survey found that over one million Canadian teenagers aged 15-19 (48%) had tried vaping products, 681,000 (31%) had used them in the past month and that 400,600 (17%) were vaping on a daily basis.

“We cannot afford for this government to sit on its hands or take the same laissez-faire approach to the tobacco and nicotine industry as its predecessor,” said Cynthia Callard, Executive Director of Physicians for a Smoke-Free Canada. “The need for stronger regulations has been recognized by government for years, as the cost of its inaction continues to climb.”

Health Canada proposed several measures to address the youth vaping crisis in the spring of 2019. Only one of these measures has been approved (limiting nicotine concentration), despite ongoing appeals by health organizations and federal and provincial Medical Officers of Health. Four years after draft regulations to restrict flavourings were published, they have still not been finalized despite Ministerial promises to do so.

“The legalization of vaping products has not produced a net public health benefit in Canada,” said Ms. Callard. “Since 2018 there has been no increase in quit attempts or in successful quitting among smokers, and the number of former smokers has actually dropped. Smoking rates are going down at a slower rate than in years prior to the legalization of nicotine vaping products. 

Opening the vaping market allowed corporate interests to halt the reduction in nicotine addiction. The widespread use of nicotine products among young people means there are as many or more nicotine users in Canada as there were before these products were legalized. Only a minority of Canadian vapers (28%) are former smokers. 

“The previous government’s preference for a poorly regulated vaping market has facilitated the tobacco industry pivoting to other harmful products and launching a new epidemic of nicotine addiction,” said Mr. Hagen.

Health Canada’s Canadian Substance Use Survey found that one in every three young Canadians who had tried vaping even once were using these products on a daily basis. Independent studies of nicotine use among youth report that young vapers find themselves more addicted than do young cigarette smokers. Many studies report that youth who use vaping products are much more likely to start using tobacco products.

In addition to being highly addictive, vaping products present significant risks for cardiovascular disease, lung injury and exposure to toxins, especially given some of the additives used to flavour liquids.

“We are not calling for a ban on vaping products,” said Flory Doucas. “We are calling for the use of proven regulatory controls to prevent industry from enticing young people to experiment with and become addicted to nicotine.”

“At the current rate of initiation, the nicotine industry is set to recruit more than 15,000 school-aged children to vaping during Minister Michel’s first 100 days in office. She is the Canadian with the greatest power and responsibility to bring that number down before the start of the school year this September.”

Backgrounder can be downloaded Here

Friday, 11 April 2025

Canada's conservatives give the floor to the tobacco industry

This post reports on the presence this week of tobacco and nicotine interests at the Canada Strong & Free Network (CSFN) Conference held in Ottawa. 

The CSFN is a political advocacy group established twenty years ago by Preston Manning as the Manning Centre for Building Democracy, but was given a new name in 2025.  Its relationship with Canada's Conservative Party is described as "interlocking", with board members including former federal cabinet ministers (Joe Oliver) and political advisors (Ray Novak, Kate Harrison).

The CSFN hosts two networking conferences each year --  billing them as "exchanges of ideas and best practices and fulfilling our mission of facilitating exchanges and stronger relationships amongst the conservative movement’s various components."

This year's conference features presentations by tobacco industry agencies (Frank Silva, Imperial Tobacco), industry-sponsored agencies (Consumer Choice, Maria Papaionnou, Rights4Vapers) and individuals (Ian Irvine) and nicotine apologist (David Sweanor).

On yesterday's agenda, Imperial Tobacco's CEO was scheduled to introduce a talk on "Why Liberalism Failed" shortly after a panel discussion with vaping advocates: "Common Sense Policies that Let Adults Be Adults."

The presence of tobacco-nicotine industry spokespeople and strategists in this spring's conference is noteworthy in the context of the federal election in which the event falls. In previous meetings Imperial Tobacco has sponsored refreshments (October 2024; April 2024) and Rights4Vapers has also sponsored previous meetings,  as has the Vaping Industry Trade Association. This year's agenda appears to be the first in which this industry has been promoted to the front of the room.

The Framework Convention on Tobacco Control imposes requirements on governments to protect public health measures from tobacco industry interference, and offers guidance on how to implement this obligation. Health Canada recently published guidance for federal employees, but has refrained from offering recommendations to political agencies (or other levels of government). 

The Article 5.3 guidelines are based on the principle that there is a fundamental and irreconcilable conflict between the tobacco industry's interests and public health interests.  They call for accountability and transparency on the part of government and the industry. Health Canada has failed to impose on the industry any reporting requirements on political sponsorships or related expenditures. 

The cozying up between nicotine manufacturers and politicians and political advocacy groups that took place this week in Ottawa is not illegal. But it is a discouraging sign for those who have previously relied on pan-partisan support for tobacco control. 

The CFSN has proposed an answer to Canada's Conservative Party on the fundamental political question of  "whose side are you on?" There are 17 days left for this and other parties to provide a clear answer to this question.  

Wednesday, 26 March 2025

Regulations to implement a regulatory charge are published today

 Today's edition of the Canada Gazette (Part II) included the first public release of the regulations that will require tobacco companies to pay some of the federal governments' costs to manage the industry. These regulations are the Tobacco Charges Regulations SOR/2025-80. The regulations were announced two weeks ago by Ya'ara Saks before the change in prime minister and cabinet. 

Under this new regulation Health Canada, the Public Health Agency and Indigenous Services Canada are required to calculate the amount that it spends in its tobacco regulation and then apportions this cost on manufacturers in proportion to their revenues. Companies are required to provide net sales revenues for each category of tobacco products (e.g. cigarettes, little cigars, heated tobacco, etc.). The charge is not applied to vaping products, nicotine pouches or other nicotine products which do not contain tobacco leaf.

The date that the regulation comes into force is not established. The text provides it to come into force no earlier than May 1, 2025, but leaves an option for the incoming government to cancel the approach merely by not completing the registration process. "11 (1) These Regulations, except section 9, come into force on May 1, 2025, but if they are registered after that day, they come into force on the day on which they are registered."

This charge was a key demand of leading health charities during the last federal election, and was the only tobacco- or nicotine- related measure identified in the mandate letter issued to the Minister of Addictions in 2021. The regulation was adopted by cabinet on March 6 - eight days before the change in government.  (The 2021 mandate letter has been removed from the Prime Ministers website, but is available on the Internet Archive.) 

The Tobacco and Vaping Products Act was amended as part of the 2024 budget bill to authorize the government to recoup certain costs provided that they were related to "the carrying out of the purpose of this Act."  

The TVPA purpose with respect to tobacco is narrowly cast. Other than the generalized intent "to protect the health of Canadians", it identifies the protection of young persons and others from inducements to use tobacco products, to restrict the access of young persons to tobacco products, and to enhance public awareness (and avoid misinformation) about the risks of tobacco use.

Nonetheless, the intent of the department at this time is to use this charge to recoup costs associated with activities that are not clearly embraced by the TVPA purpose. The activities listed in the (non-binding) regulatory impact statement (RIAS) are: "compliance and enforcement activities, laboratory analysis, development and implementation of regulations, public education and awareness on the health hazards of tobacco use, supporting improved services and resources to help people quit smoking, and providing funding to First Nations, Inuit and Métis Nation to develop and implement approaches to reducing commercial tobacco use. The costs to administer the tobacco cost recovery framework will also be included. Activities undertaken in relation to vaping are not included at this time, except if they are for the purpose of helping Canadians quit tobacco."

The weakness of the link between these activities and the legislated purpose of the act were the focus of the concerns we expressed about the proposed fee last summer, and our subsequent recommendations for a revised purpose to the law.  These concerns were not identified in the RIAS published today. 

To date Health Canada has not predicted how much it would recover as a result of this new charge. The RIAS identifies that the regulation will cost the industry $42.54 million per year, including their own reporting and administrative costs. The administrative costs for the federal government to administer the program are estimated at $1.3 million per year.   

The RIAS states that the three departments which will participate in this process currently receive 85% of the $66.2 million annual budget for tobacco control (including vaping and other forms of nicotine use). Information from other sources on federal expenditures on tobacco control can be found on our 2024 fact sheet 

Tuesday, 25 March 2025

PMI boasts that heated tobacco, vaping and pouches increase nicotine use and profits

Last month Philip Morris International (PMI) talked to investors at the CAGNY conference - an annual event held in Florida to connect manufacturers with investors. PMI used the occasion to report on its experience over the past 10 years on smoke-free products

This post identifies some take-away facts from this presentation. The slide deck can be viewed here, and the transcript is available courtesy of Seeking Alpha here

Little more than a decade has passed since PMI became the first multinational tobacco company to re-invent its business and to expand its product line to include new nicotine technologies. It's initial focus was on heated tobacco (IQOS was launched in Italy and Japan in 2014 and introduced to Canada in 2017). In 2022 it began selling vaping products (for which Canada was its first market) and in the same year it acquired Swedish Match and began marketing Zyn pouches.

New nicotine products have allowed PMI's profits to grow

Over the past 10 years, PMI's revenues from cigarette sales have fallen somewhat - from $26.6 billion in 2015 to $23.2 billion in 2024. This loss in revenue has been more than made up for by increased revenues from non-combustible products: from a mere $199 million in 2015 to $14.7 billion in 2024.

Last year the company made 38 cents of every dollar of earnings from "smoke-free" products - heated tobacco, vaping or pouches. (slide 37)



New products have allowed PMI to sell more nicotine.

Overo the past 10 years, the number of cigarettes sold by Philip Morris have fallen steadily (because they increased prices, the drop in revenues was not as acute). This loss in volume sales has been largely made up for by an increase in the number of other nicotine products sold. Using "stick equivalent units" to compare sales with traditional cigarettes, the company reports that after 2020 newer product sales allowed them to turn an annual 2% decrease in units of nicotine sole to a 2% annual increase. (Slide 9)


New Nicotine Products are more profitable than traditional cigarettes.

It costs PMI much less to manufacture cigarettes than IQOS (at a global level, an average of $13 per 1,000 cigarettes vs. $26 per 1,000 IQOS devices and sticks), but they nonetheless make much more money from IQOS sales ($54 for 1,000 IQOS vs $23 for cigarettes). 

For Zyn, the profit difference is even more dramatic. In the United States, the company makes $185 on 1000 Zyn pouches, which costs them $30 to manufacture. (Slide 16). 


The global nicotine market is not shrinking as alternative product sales grow. 

As the world observes the 20th anniversary of the Framework Convention on Tobacco Control it is disheartening to hear that PMI estimates that global nicotine sales (86% of which are cigarettes) are not falling and that the "Total nicotine market [is] close to stable". (slide 24)

Ignoring other tobacco products (like bidis, hookah, etc), the company estimates that the for every 6 cigarettes sold world wide, there is one equivalent dose of nicotine sold in the form of heated tobacco, vaping liquids or nicotine pouch. 

The proportion of the nicotine market taken up by traditional cigarettes varies greatly by country. PMI presented separate data only for the United States, where slightly less than half of nicotine products sold are cigarettes. (Slide 25)


Smokers who also use vaping or pouches use nicotine more often than those who only smoke or vape.

PMI reported the results of its consumer research into the volume of use by individuals who use one or more product category. They found that those who used more than two non-combustible products (HNB, vaping and oral) "have substantial higher daily consumption" than do those who use only one product. 

Those who use both cigarettes and non-combustible nicotine also increase the volume of product they use. Individuals who use only heated tobacco use about the same quantity of product as do smokers, but those who only vape use less. (Slide 28


In his comments, PMI CEO Jacek Olczak alluded to the role that these products have in overcoming regulatory and social restrictions on smoking. "...We start looking into the nicotine, new nicotine market, the smoke-free market more from the multi-category perspective versus the one because we also see this in the marketplace, then the consumers are not really focused on one product category. They're looking at the smoke-free products from the perspective of the repertoire which satisfies or responds to the different needs or moments or situations they might have during the day."

PMI's new products appeal more to wealthier people.

Included in this investor presentation was information on the age and income brackets of individuals who used PMI's brands of cigarettes, heated tobacco, vaping and nicotine pouches. Globally, most of their customers are in middle or higher income brackets, and this is even more true for the non-cigarette categories. Its vaping products are more likely to be purchased by younger people.





Monday, 3 March 2025

Newly-released data on cigarette sales suggests pockets of increased illicit trade

Last week Health Canada updated the information it provides on tobacco sales in Canada, and transferred this information to the department's consolidated data platform (HealthInfobase.canada.ca). Provincial level information is presented for cigarettes; national level data is shown for other forms of tobacco, but provincial level information is downloadable

Tobacco manufacturers are required to report to Health Canada the number of each brand of cigarettes and the number of kilograms of fine-cut tobacco they sell in each province each month. 

This information, together with national estimates of the number of smokers in each province, allows the calculation of the average number of cigarettes legally sold per smoker in each province. 

Differences in these estimates over time or between provinces could suggest:

* changing patterns of nicotine use (if smokers are changing how many cigarettes a day they smoke, and/or substituting cigarettes with vaping products on some occasions).

* changes in survey methods which affect the estimates of smoking behaviour (the survey mode for the Canadian Community Health Survey was modified in 2015, 2020 and 2022).

* changes in purchasing behaviour (if smokers increase or decrease the number of cigarettes they buy which are not included in the manufacturers' reports, such as illicit supply, interprovincial sales and duty-free purchases related to travel).

A data sheet showing cigarette sales per smoker is available here

As shown in the figures below (and on the data sheet) this information reveals that:

* Over the last 10 years, the number of reported smokers has decreased by about one-third (37%), but the number of cigarettes legally sold has decreased by half (48%).

* In some provinces, the difference between the drop in sales and smokers is very dramatic. The fall in the number of cigarettes sold was twice as large in Newfoundland and New Brunswick than the drop in the number of smokers (19% vs 69% in Newfoundland; 28% vs 61% in New Brunswick.

* The number of cigarettes legally sold per smoker varies considerably across Canada: from 16 cigarettes per day in Saskatchewan to 9 cigarettes per day in British Columbia and Newfoundland.




Wednesday, 26 February 2025

Twenty years later, the FCTC needs help

This week marks 20 years since the Framework Convention on Tobacco Control came into force.

You have to have a long memory to recall how extraordinarily ambitious it was dream that countries would agree on an international law on tobacco and to devote your efforts to working on this treaty. And perhaps you have to have been there to fully appreciate the visionary leadership and strategic acumen that was shown by those individuals working within government and non-government systems who made it happen. 

The architects and stonemasons of the FCTC have now largely moved on to new challenges, have moved out to retirement or are sadly no longer with us. Those who have replaced them are facing tobacco control challenges which are no less daunting and require no less skill and commitment to overcome. Nor are the stakes any lower. 

Just as before, the treaty faces the headwinds of tobacco industry interference and the lack of funding. Added to these familiar challenges is the industry's ability to use new nicotine products to sidestep tobacco control measures and to inveigle themselves into tobacco control discussions. 

A commentary published in the Lancet this week reflects on the FCTC at the 20-year mark and offers some advice on how Parties can better meet old and new challenges [Gilmore AB et al. 20th anniversary of the WHO Framework Convention on Tobacco Control coming into force: Gilmore AB et al. 20th anniversary of the WHO Framework Convention on Tobacco Control coming into force: time for a step change in ambition.

The recommendations in this commentary include:

* Ensuring stable financing by moving towards a polluter pay approach in which the industry pays for the harm it causes

* Accelerating implementation among those countries which are behind and adopting forward looking measures (such as those under review by the Article 2.1 Expert Group) among countries which have met the basic implementation objectives

* Responding to new nicotine/tobacco products and tobacco industry disinformation by accepting there is unlikely to be a single approach that fits all countries, but that the FCTC offers regulations that can be applied to all new products and stronger measures are also consistent with the treaty.

* Taking steps to prevent industry interference by developing measures to prevent their involvement in COP delegations, by establishing a legal defence fund, by providing the funding to ensure that independent science is available and by better holding the industry accountable for the harms it causes.

* Increasing data sharing and scientific and other exchanges among governments. 

The aspirations, enthusiasm, stamina and cooperation that were engaged in building the FCTC are badly needed again.

 

Sunday, 9 February 2025

Health Canada's 2023 drug survey shows very high rates of youth vaping and smoking. Why is no one talking about it?

On December 27th, during the lull between Christmas and New Year, Health Canada quietly released the results of the Canadian Substance Use Survey. The material produced for this release includes a data sheet summary, a description of the methodology, and a very useful interactive data tool

Notably missing from these communications products was a press release or any official statement about the context or impact of these results in the department's view. Also absent over the intervening 6 weeks is any comment or reaction from the federal Minister responsible for addressing the harms of substance use, the Hon. Ya'ara Saks.

This silence is all the more concerning, given the picture this survey provides of harmful substance use among young Canadians, with indicators of early dependence. Among teenagers aged 15-19, 17% vape daily, 12% use cannabis every day or nearly every day and one-in-twenty (5%) already meets the criteria for alcohol dependence. 

This post reports on the findings of this survey with respect to tobacco and nicotine use.


Canadian Substance Use Survey (CSUS) 2023 estimates for cigarette and vaping prevalence

As shown in the figures above, the CSUS estimates that almost as many Canadians were using vaping products as smoking cigarettes:  10% were past month vapers and vs 13% were past-month smokers. They found 1 in 20 Canadians vapes daily (5%), compared with 1 in 12 who smokes cigarettes daily (8%).

When it comes to young Canadians (aged 15 to 24), past month cigarette smoking rates are similar to those in the general population (14% vs 13%). However, vaping rates are significantly higher: in the past month 1 in 3 teenagers (31%) and 1 in 4 young adults (26%) used a vaping device, compared with 1 in 14 adults over 25 (7%).

With respect to daily use of these products, CSUS found that in comparison with adults over 25, young people are much less likely to smoke daily  (3% for 15-19 year olds, 4% for 20 to 24 year olds and 9% for those over 25), but much more likely to vape on a daily basis. About 1 in 6 (17%) teenagers aged 15-19 vapes daily, as do 1 in 7 (15%) young adults,  compared with 1 in 25 adults over 25.

The figures shown above were extracted from the CSUS data tables. It should be noted that, unlike many other government surveys, CSUS includes in their estimate of daily cigarette use those who have smoked fewer than 100 cigarettes in their lifetime.  

The CSUS estimates for overall smoking rates use are aligned with those from other government surveys .... but....

When comparing the estimates of overall population prevalence of cigarette smoking from this survey with those produced by other government surveys, the rates of cigarette use are largely consistent. The wave of the Canadian Community Health Survey (CCHS) conducted in 2023 identified 11.4% Canadians as "current smokers". The CSUS identified 11.8% who met the same criteria.  

The results for other smoking variables were also aligned. CSUS estimates of those who had ever smoked 1 cigarette or who had smoked 100 cigarettes or more, or who had smoked in the past 30 days were very close to those produced by the CCHS (50% vs 52%; 37% vs 41%, 13% vs 12%). CCHS has historically covered the population of people over 12 years of age, but in 2023 was changed to cover only those 18 years and older.

The trend-line produced by CCHS, CSUS and two other Health Canada surveys of smoking are shown below. They do not suggest that there has been a substantial decrease in the rates of cigarette use over the past 4 years.  

...CSUS estimates for smoking rates among youth and young adults are higher than indicated by previous surveys.

For young people, the CSUS produces higher estimates of current and daily smoking than did Health Canada's previous surveys (the Canadian Tobacco Alcohol and Drug Survey, CTADS, and the Canadian Tobacco and Nicotine Survey, CTNS).

The CTNS in 2022 estimated that 4% of youth aged 15-19 were current smokers, and 1% were daily smokers. The CSUS estimates in the following year were 8% and 3% respectively. For young adults aged 20 to 24 the 2022 CTNS estimates were  8% (current) and 3% (daily), which contrasts with the 2023 CSUS estimates of 10% and 4%. Estimates for those aged over 25 were substantially the same.  

The CSUS estimates for vaping in Canada are the highest recorded to date.

Health Canada surveys which monitor vaping began in 2013 (the Canadian Tobacco Alcohol and Drug Survey), and were redesigned in 2019 (The Canadian Tobacco and Nicotine Survey) and then subsumed into other surveys in 2023, including CSUS (15+), the CCHS (18+) and the Canadian Health Survey on Children and Youth (CHSCY, not yet released).  

The rates for ever use, past-month use and daily use of vaping products from available federal government surveys are shown below. Of theses, the CSUS has produced the highest estimates of  youth use:

  • half of youth (47%) and young adults (52%) have used an e-cigarette at least once
  • one-third of youth (31%) and one-quarter of young adults (26%) have used them in the past month
  • one-sixth of youth (17%) and one-seventh of young adults (15%) use them daily. 
  • for every three young Canadians who experiment with vaping devices, one has become a daily user.


Differences among surveys:  CSUS vs. CCHS vs. CTNS vs CTADS vs .....

The methods used by the CSUS are not identical to those used in the previous surveys commissioned by Health Canada to assess substance use. 

Because of these differences, the results from one instrument is not not intended to be used to evaluate changes over time in the behaviour. In the information attached to the CSUS release, Health Canada makes this clear:  "The changes to the sampling methodology in 2023 may have impacted estimates of substance use. ... cell phone recruitment and oversampling of youth and young adults with the knowledge that the survey would be asking about substance use, may have resulted in an overestimation of substance use ... we recommend using CSUS 2023 data without comparison to previous iterations."

On this basis, we cannot infer that vaping rates have risen dramatically between 2022 and 2023. But can we infer that are problems with one or other survey sampling methods? 

Of the four surveys identified above, CSUS is the only one which was not conducted by Statistics Canada. The work was contracted to Advanis, the public opinion firm which also manages the Health Canada's cannabis survey (The Canadian Cannabis Survey). This private sector research firm appears to have followed similar recruitment and selection methods in both surveys. 

In the technical notes which accompany these Advanis surveys, a rationale is provided for the decision to supplement traditional telephone recruitment with outreach to young people who participate in on-line panels and also for providing some financial incentives for certain youth respondents. This approach has not been included in the surveys conducted for Health Canada by Statistics Canada.

It seems evident that these sampling methods produced very different results for measuring youth substance use. What is less clear is how to interpret the results.

Implications for public health

Such dramatic differences in the measurements commissioned by Health Canada warrant reflection and action.

If the problem of youth vaping and other substance use is greater than previously thought, there is even more reason for the department to (finally!) step off the brakes and implement measures to stop manufacturers from inducing young people to use harmful and addictive products.

If the Minister and the department do not wish adjust their policies and programs in response to this new information, then they should explain this decision. 

At the very least, there should be greater transparency and openness about how the federal government views the results and methods of its own surveys.