Canadian views on acceptability and risks of use of alcohol, tobacco, e-cigarettes and cannabis (and links to other consumer research commissioned by Health Canada: 2006-2021)

Which do Canadians think is more harmful? - Vaping cannabis or vaping nicotine? And which is more acceptable? Tobacco or e-cigarettes?

Answers to these questions are provided in the Canadian Cannabis Survey, which is conducted annually by Advanis on behalf of Health Canada. Since 2018, this survey has included questions related to the social acceptability and likelihood of harm associated with the use of alcohol, tobacco, cannabis and nicotine.

This post presents results for these questions over the past 4 years. Tables and figures are available on a downloadable fact sheet. (Breakdown by age and region was not provided in the survey reports)

The full survey reports and data files are available on the website of Library and Archives Canada:

• 2017: POR 006-18
• 2019: POR 130 - 18
• 2020: POR 114-19
• 2021: POR 102-20

Social acceptability

Fewer than 2 in 3 Canadians think that the occasional use of cannabis or tobacco is socially acceptable, although more than 9 in 10 think occasional alcohol use is. With respect to regular use, the acceptance is predictably lower. Nonetheless, around one-third of Canadians consider it socially acceptable to use tobacco and e-cigarettes on a regular basis - with slightly more favourable views of regular cannabis use and a majority thinking that regular drinking is acceptable.

Question: How socially acceptable do you think it is for a person to use the following substances?

Risks of use

The views on the risks of harm associated with the use of these legal drugs reflects the same pattern, with more positive views towards alcohol use, and most negative views of tobacco and e-cigarettes, with cannabis falling in the middle.

Fewer than 1 in 5 Canadians thought that occasional alcohol use presented a great or moderate risk to the user, compared with almost 2 in 3 for tobacco and e-cigarettes, and around 4 in 10 for cannabis. Regular use for all products was seen as having greater risks: 9 in 10 Canadians perceive regular tobacco use as risky, 8 in 10 have that view of e-cigarettes, and around 7 in 10 perceive regular use of alcohol and cannabis as risky.

Question: How much do you think people risk harming themselves when they do each of the following activities?

Perceptions of users and non-users

Those who have used any of these substances in the past year are more likely to consider regular use acceptable, and with the potential exception of tobacco are less likely to consider it risky.

Data for the highest level of acceptability ("completely) and risk ("great") are shown below. Those who use tobacco or e-cigarettes are more than twice as likely to think they are completely accepted. The difference in perception of great risk is only slighlty different between users and non users for tobacco and e-cigarettes, compared with cannabis, where non-users are much more likely to perceive great risk in use.

-----------------------------------------------

Since 2006, all consumer research commissioned by the federal government is deposited in the Library and Archives of Canada. These documents can be searched through an index maintained at the following web-address: https://www.bac-lac.gc.ca/eng/porr/Pages/search.aspx

Listed below, and hyperlinked, are the research reports commissioned by Health Canada which focused on vaping or tobacco use.

Number	Prepared by	Title
POR 113-20	Environics Research	Vapers online survey to measure attitudes and behaviours regarding vaping over time (2019 to 2021)[i]
POR 103-20	Earnscliffe Strategy Group	Smoking lived experience study[ii]
POR 061-20.	Earnscliffe Strategy Group.	Qualitative Research on Adult Smoking Cessation[iii]
POR 026-20.	Quorus Consulting Group	Qualitative Research Exploring Options for Warnings on Cigarettes – 2020[iv]
POR 024-20.	Strategic Council.	Understanding Youth and Young Adults’ Interest in, and Usage of, Flavoured Cannabis Vaping Products[v]
POR 020-20.	Earnscliffe Strategy Group	Youth and young adult vaping cessation research [vi]
POR 098-19	Environics Research Group	Vapers online survey to measure attitudes and behaviours regarding vaping over time (2019 to 2020)   [vii]
POR-069-19	Quorus Consulting Group.	Exploratory Research on Youth Vaping [viii]
POR 048-19	Earnscliffe Strategy Group	Social values and psychographic segmentation of tobacco and nicotine users and non-users.  [ix]
POR 026-19	Narrative Research	Online qualitative testing of draft health warnings for cigars, pipe tobacco, smokeless tobacco and toxic statements for smokeless product packaging – 2019.[x]
POR 025-19	Quorus Consulting Group	Qualitative testing of new health information messages, including placement options, as well as the thematic linking of labelling elements – 2019 [xi]
POR 019-19	Phoenix SPI	Health Care Providers' Views and Experiences with Smoking Cessation and Alternative Nicotine Products [xii]
POR 014-19	Leger	Advertising evaluation of Youth Vaping Prevention Campaign - post ACET : methodological report.[xiii]
POR 141-18	Environics Research	Vapers’ Panel Survey to Measure Attitudes and Behaviours Regarding Vaping Products.[xiv]
POR 139-18	Phoenix Strategic Perspesctives	Spring 2019 Focus Groups (Third Cycle)[xv]
POR 126-18.	Corporate Research Associates Inc.	Qualitative Testing of Revised Health Warnings for Cigarette Packages and on Cigarettes: 2019 [xvi]
POR 119-18	Environics Research Group Limited	Smoking Behaviour Journey Map[xvii]
POR 093-18	Phoenix SPI	Smokers and Recent Quitters’ Awareness and Perceptions of Options to Minimize Harms from Tobacco Products[xviii]
POR 083-18	Environics	Vapers panel survey to measure attitudes and behaviours regarding vaping products [xix]
POR 067-18	Earnscliffe Strategy Group.	Qualitative and quantitative research on perceptions of nicotine [xx]
POR 058-18.	Environics Research Group	Public Opinion Research on Noticeability of Health Information Messages and Effectiveness of Health Warnings for Tobacco Labelling [xxi]
POR 054-18.	Phoenix SPI.	Exploratory research on smoking cessation   [xxii]
POR 037-18	Corporate Research Associates.	Vaping Prevention Concepts Testing [xxiii]
POR 014-18	Corporate Research Associates	Testing of relative risk statements for vaping products [xxiv]
POR 013-18	Phoenix SPI	Break It Off: Tobacco Cessation Creative Concepts Testing [xxv]
POR 099-17	Corporate Research Associates	Evaluation of possible labelling elements for vaping products - phase 1 and phase II   [xxvi]
POR 096-17	Phoenix Strategic Perspectives	Qualitative public opinion research of draft health information messages and toxic statements for cigarette packaging  [xxvii]
POR 074-17	Phoenix Strategic Perspectives Inc	Peer crowd analysis and segmentation for vaping and tobacco  [xxviii]
POR 047-17	Environics Research Group	Longitudinal vaper panel survey to measure attitudes and behaviours regarding vaping products[xxix]
POR 028-17	Phoenix Strategic Perspectives Inc	Qualitative testing of new health warnings and contact information taglines for cigarette packages - 2017  [xxx]
POR 088-16	Phoenix Strategic Perspectives Inc	Qualitative/quantiative research on E-cigarette flavours and risk perception  [xxxi]
POR 041-16	Environics Research Group	Qualitative and quantitative research on standardized cigarette design elements and cigarette packages  [xxxii]
POR 095-15.	Environics Research Associates	Youth Vaping Prevention Campaign – Testing New Messages[xxxiii]
POR 046-12	Harris/Decima	Evaluation of Canadian tobacco product health-related labels (cigarettes and little cigars) [xxxiv]
POR 041-12	Phoenix Strategic Perspectives Inc.	Tobacco cessation exploratory research with young adults (aged 20-24)   [xxxv]
POR 075-11	Environics Research Group.	2012 baseline evaluation of Canadian graphic health warning messages [xxxvi]
POR 118-08	Phoenix Strategic Perspectives Inc.	Testing the size, colour, and impact of contact information on tobacco product packaging  [xxxvii]
POR 109-08	Strategic Counsel	Health Canada performance survey 2009  [xxxviii]
POR 288-07	Ipsos Reid	Examining spillover and recall of tobacco industry advertising among Canadian youth[xxxix]
POR 254-07a	Les Études de Marché Créatec +	Quantitative study of Canadian youth smokers and vulnerable non-smokers effects of modified packaging through increasing the size of warnings on cigarette packages[xl]
POR 254-07b	Les Études de Marché Créatec +	Quantitative study of Canadian adult smokers : effects of modified packaging through increasing the size of warnings on cigarette packages[xli]
POR 245-07	Environics Research Group.	Consumer research on the size of health warning messages : quantitative study of Canadian youth : Adults[xlii] and Youth.[xliii]
POR 201-07	Environics Research Group	The health effects of tobacco and health warning messages on cigarette packages : survey of adults and adult smokers   [xliv]
POR 185-07	Phoenix Strategic Perspectives Inc	Qualitative testing of toxic emissions statements   [xlv]
POR 154-07	Decima Research	Testing of bilingual health warning notices for tobacco industry print advertising  [xlvi]
POR 111-07	Decima Research	Canadians' recall of tobacco industry advertising 2007-2009[xlvii]
POR 064-07	Decima Research	Testing of health warning messages and health information messages for tobacco products[xlviii]
POR 038-07	The Antima Group	Health Canada survey of priorities for children and youth  [xlix]
POR 487-06	Western Opinion Research	Canadians and indoor air quality [l]
POR 408-06	The Strategic Counsel	Health directors' perceptions of current tobacco control activities in First Nations communities  [li]
POR 392-06	Decima	Second hand smoke in multiple unit residential buildings [lii]
POR 373-06	Millward Brown	The persistent smoker in Canada  [liii]
POR 365-06	Environics Research Group.	Occasional smokers in Canada : a qualitative and quantitative study,  [liv]
POR 364-06	Phoenix Strategic Perspectives Inc.	Discount smokers in Ontario and Quebec : exploratory analysis,  [lv]
POR 328-06	Environics Research Group	Qualitative exploration of Canadian youth and tobacco retailer's views regarding the prohibition of tobacco sales to youth   [lvi]
POR 283-06	CRÉATEC +	Pre and post evaluation of the 2006/07 second-hand smoke advertising campaign among smoking parents  [lvii]
POR 272-06	Decima Research	Canadians' recall of tobacco industry advertising and purchase patterns of cigarettes [lviii]
POR 259-06	Environics Research Group.	Testing of mock-ups of health warning messages and warning notices on tobacco product advertisements for smokeless tobacco   [lix]
POR 189-06	Études de marché CRÉATEC +	Survey of public health practitioners on the core competencies for public health   [lx]
POR 156-06	Decima Research	Second-hand smoke : testing of TV and print concepts[lxi]
POR 154-07	Decima Research	Testing of bilingual health warning notices for tobacco industry print advertising  [lxii]
POR 122-06	Corporate Research Associates Inc.	Manitoba follow-up survey on the tobacco retail environment, 2006 : report[lxiii]
POR 26-07	Strategic Counsel	Health and wellness priorities findings from qualitative research  [lxiv]

---

• [i]          https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/113-20-e/index.html
• [ii]         https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/103-20-e/index.html
• [iii]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/061-20-e/report.pdf
• [iv]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/026-20-f/index.html
• [v]         https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/024-20-e/index.html
• [vi]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/020-20-e/index.html
• [vii]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/098-19-e/index.html
• [viii]      https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/069-19-e/report.pdf
• [ix]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/048-19-e/index.html
• [x]         http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/026-19-e/index.html
• [xi]        http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/025-19-e/index.html
• [xii]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2020/019-19-e/index.html
• [xiii]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/014-19-e/index.html
• [xiv]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/141-18-e/index.html
• [xv]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/privy_council/2019/139-18-e/index-3-eng.pdf
• [xvi]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/126-18-f/index.html
• [xvii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/119-18-e/index.html
• [xviii]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/093-18-e/index.html
• [xix]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/083-18-e/index.html
• [xx]       http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/067-18-e/index.html
• [xxi]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/058-18-e/index.html
• [xxii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/054-18-e/index.html
• [xxiii]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/037-18-e/index.html
• [xxiv]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/014-18-e/index.html
• [xxv]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2019/013-18-e/report.pdf
• [xxvi]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/099-17-e/index.html
• [xxvii]   https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/096-17-e/report.pdf
• [xxviii] https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/074-17-e/index.html
• [xxix]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/047-17-e/index.html
• [xxx]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2018/028-17-e/index.html
• [xxxi]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2017/088-16-e/index.html
• [xxxii]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2017/041-16-e/index.html
• [xxxiii]   https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2021/095-15-f/index.html
• [xxxiv]   https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2013/046-12/index.html
• [xxxv]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2013/041-12/report.pdf
• [xxxvi]   http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2012/075-11/report.pdf
• [xxxvii] http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2009/118-08/report.pdf
• [xxxviii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2010/109-08/report.pdf
• [xxxix]   http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/288-07/report.pdf
• [xl]        http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/254-07-e/report.pdf
• [xli]       http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/254-07a-e/report.pdf
• [xlii]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/245-07-a-e/index.html%7Chttp://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/245-07-a-e/report.pdf
• [xliii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/245-07-y-e/index.html%7Chttp://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/245-07-y-e/report.pdf
• [xliv]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/201-07-e/report.pdf
• [xlv]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/185-07-e/report.pdf
• [xlvi]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/154-07/report.pdf
• [xlvii]    http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2009/111-07/report.pdf
• [xlviii]   http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2009/064-07/index.html
• [xlix]     https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/038-07/report.pdf
• [l]          https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/487-06-e/report.pdf
• [li]         https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2008/408-06-e/report.pdf
• [lii]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/392-06/report.pdf
• [liii]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/373-06/report.pdf
• [liv]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/365-06/report.pdf
• [lv]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/364-06/report.pdf
• [lvi]       http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/328-06/report.pdf
• [lvii]      https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/283-06a/report.pdf
• [lviii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/272-06/report.pdf
• [lix]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/259-06/report.pdf
• [lx]        https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/public_health_agency_canada/2007/189-06/report.pdf
• [lxi]       https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2006/156-06/report.pdf
• [lxii]      http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/154-07/report.pdf
• [lxiii]     http://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/122-06/report.pdf
• [lxiv]     https://epe.lac-bac.gc.ca/100/200/301/pwgsc-tpsgc/por-ef/health/2007/124-07/report.pdf

'Clear the Smoke': Imperial Tobacco launches an illegal health-reassurance ad campaign

 Last week Imperial Tobacco Canada Ltd. launched a new campaign using the industry's decades' old strategy of invoking medical experts as pitch-men for their products. This post documents how this campaign (a) is consistent with the industry's historic marketing practices, (b) is inconsistent with federal law and (c) is nonetheless likely to be permitted to continue. 

DEJA VU ALL OVER AGAIN

A century ago, governments were not overly worried about the long-term consequences of smoking cigarettes. But there were concerns that throat irritation and coughing were signs that cigarettes might be harmful. To allay these concerns (and sideline critics), the companies displayed medical endorsement for their brands such as "More Doctors Smoke Camels". "Physicians say LUCKIES are less irritating". "L&M Filters are just what the doctor ordered".  

Health Reassurance in the 1930s.

Today, our government is not overly worried about the long-term consequences of vaping, although short-term adverse effects on blood vessels and airways are likely to lead to serious disease, just like they do for tobacco. To allay these concerns (and sideline critics), the companies are using the same playbook: undermine science linking their products to harm, mobilize third-party validators, create phony grass roots organizations, manipulate health regulators. 

ITL's "Clear the smoke"

Imperial Tobacco's Clear the Smoke is the newest marketing arm of this approach in Canada (RBH's UNSMOKE campaign is another). The communications objective is for the public to see vaping products as a relatively benign product, and to foster an environment where they are regulated as low to medium-risk consumer goods. The company's strategy is to be seen as aligned with government and as 'part of the solution'. The main tactic in this campaign is the use of credible health authorities as third party validators.

Health Reassurance in the 2020s

The advertising copy is direct quotes from researchers, governments and public health agencies. Health Canada's views are given high profile: "Switching from tobacco cigarettes to vaping will reduce your exposure to many toxic and cancer causing chemicals." "Vaping products and e-cigarettes deliver nicotine in a less harmful way that smoking cigarettes." "Vaping is less harmful than smoking." Other Canadian health voices are also present, including the Heart and Stroke Foundation, and researchers at the University of Waterloo. 

The views of some organizations appear to be fairly represented, while in other cases the ads leave the impression that the organizations are more favourable towards e-cigarettes than they are.  

Most viewers of the campaign are unlikely to notice the discrepancy. Those who read the billboards, tweets and newspaper ads that appeared last week are unlikely to look up the source documents, or note that the take-away message is different or less nuanced than the source documents.

AN ILLEGAL PROMOTION 

Federal law prohibits promotions with endorsements and health claims 

Although Imperial's campaign does not display trademarks or other brand elements used in selling its VUSE brand vaping devices and liquids, there is little doubt that Clear the Smoke meets the definition of a promotion under the federal Tobacco and Vaping Products Act (TVPA): "a representation about a product or service by any means, whether directly or indirectly, including any communication of information about a product or service and its price and distribution, that is likely to influence and shape attitudes, beliefs and behaviours about the product or service." (s. 18 (1)) 

This law also makes clear that suppliers are not allowed to promote vaping products by using testimonials or endorsements (s. 30.21(1)); or by creating erroneous impressions about health impacts (s. 30.42(1); or by causing people to believe that "health benefits may be derived" from vaping (s. 30.43(1)); or by suggesting that vaping is safer than smoking (s. 30.43(2)). 

This law applies to all forms of promotion for vaping products, and not just promotions which mention brands or contain specific brand elements (s. 2). It defines a promotion to include both direct and indirect communications that are "likely to influence and shape attitudes, beliefs and behaviours". (s. 18 (1)). The penalty for breaking these sections of the law is fines of up to $500,000 or up to 2 years in prison (s. 47). 

In addition to the provisions of the law, there are additional restrictions in the Vaping Products Promotion Regulations  which prohibit ads for vaping products or brand elements which can be seen or heard to young persons.

The TVPA includes some freedom-of-expression exemptions. For example,  individuals not involved in the production or sale of vaping products and who are not paid by manufacturers or retailers can promote vaping products when doing so as part of an artistic work (a book or film, for example), or as part of a commentary, report or opinion. These exemptions do not apply when the promotions are accompanied by payment from a manufacturer or retailer. (S. 18(3)). As a manufacturer, Imperial Tobacco does not qualify for these exemptions.

The Clear the Smoke campaign is an obvious infringement of the TVPA, and it may also run afoul of other federal laws. The Competition Act (s. 52(1)), for example, prohibits false or misleading advertising. Many years ago, the government agency charged with administering those provisions intervened to stop tobacco companies from marketing "light" cigarettes. In this case they could well find that this campaign is misleading both with respect to the health consequences of vaping and also misleads the consumer with respect to the endorsement of many agencies.  

This bus-shelter ad seen in Ottawa this week contravenes
the TVPA and its regulations because it is a representation about vaping products which seeks to influence attitudes and beliefs and: 

1) can be seen by young people

2) displays third-party endorsement

3) is likely to cause people to think that vaping is safer than smoking.

Provincial prohibitions

Provincial governments had adopted legislation governing general advertising, and many have adopted specific restrictions on vaping products. 

Under the Quebec Tobacco Control Act, for example, advertising for vaping products is under the same restrictions as tobacco products. This law bans all direct and indirect advertising  that contains testimonials or endorsements, uses a slogan, contains a text that refers to real or fictional persons, or is likely to create an erroneous impression about the health effects. (s. 24). The Quebec Consumer Protection Act prohibits manufacturers from omitting important facts in any promotions (s. 228) - important facts would include the documented health harms associated with e-cigarettes.

IMPERIAL TOBACCO ROLLS THE DICE (again)

With the potential of a half-million-dollar fine or jail time, one might think Imperial Tobacco is taking a risk in launching this new campaign. In the current environment, however, they may well calculate that they will be able to run an illegal campaign without incurring penalties.

Enforcement history is on their side. Despite hundreds of observed infractions, Health Canada has not yet laid any charges for illegal vaping promotions.  The department's enforcement approach relies on warnings and "negotiated compliance" before any legal action is taken, and it often takes weeks before a compliance requeste is officially made. This 'yellow card' system, coupled with the time that it takes for the department to issue a warning, will allow the company to run its campaign for a typical month before allowing it to disappear quietly.

Imperial Tobacco has run illegal campaigns without penalty before. In September 2018 the company launched its ePen3 device using widespread television advertising. The lifestyle imagery in the ad was illegal, but it took Health Canada almost two months (from Labour Day weekend to November 1st) before the company was asked to take down the campaign. Even though the ad was broadcast more than 1,000 times after the company was told to "immediately cease", no charges were laid and no penalties incurred. (The ad can still be viewed on YouTube). 

In 2020, this company initiated a "Facts not Fear" campaign (the website is still active), which similarly offered a health reassurance message on vaping. Although Health Canada and the government of Quebec were reported as investigating this campaign, no compliance action was ever made public.  (In 2020 we notified the Competition Bureau about the campaign,  but have not yet received a reply.) 

Federal policies on vaping will complicate enforcement. Health Canada's harm reduction approach to tobacco is only briefly described. Nonetheless, the department has put much on the record that could make it difficult (or at least embarrassing) to prosecute the company for quoting the department. In 2018 the department initiated a fast-track process to give the companies the right to make 7 relative risk statements, very similar to those Imperial Tobacco is using in its campaign. During the public consultation in the fall of 2018, concerns were raised about the public health impact of these statements, the department's Vaping Advisory Board did not concur with the proposed wording, the government received contrary advice from other scientists and the government's public opinion research revealed significant discomfort to some of the statements. Although the department subsequently dropped the idea of allowing relative risk statements, its earlier exploration of the idea could complicate efforts to discipline Imperial Tobacco for assuming that right.

LEARNING FROM HISTORY

The Clear the Smoke campaign is a reinvention of the "scientific controversy" efforts by the industry to cast doubt on the causal relationship between smoking or second-hand smoke and disease. Although the financial relationship was not disclosed for decades, they engaged prominent Canadian scientists - like Hans Selye - to encourage law-makers to see cigarettes as a necessary product for some smokers. These actions, Canadian courts have ruled, were wrongful as they "impeded and delayed" Canadians from learning about the harms of smoking. 

Today's tolerance of vaping product promotions by Health Canada echoes the departmental view in the 1970s that restrictions on tobacco advertising should be avoided because this would "reduce the oportunity to encourage smokers to switch brands." and make it more difficult to keep "using industry marketing process to promote low tar cigarettes and achieve other health objectives".  

Last week, American historian Robert Jackler released his analysis of efforts by some tobacco companies to create a climate friendly to their newer products.  He links these new campaigns to historic efforts by tobacco companies to portray themselves as reformed and to obfuscate the health harms of their products. Such ads "gaslight" the public through "copious repetition of untruths, into doubting well-established scientific truths." He calls on newspapers and other media to reject these ads.

Newspapers and billboard owners have the right to reject these ads - but Canada's government has the duty to do so. Our letter calling on them to enforce the TVPA can be downloaded here.

What investors are being told: slides from CAGNY presentations by BAT, PMI and Altria

An important annual event for investor analysts is the Consumer Analyst Group of New York (CAGNY) conference, which takes place every February. Over the past week this conference has received presentations from 3 large tobacco companies -  British American Tobacco, Philip Morris International and Altria. 

Analysts are often given information that is helpful to regulators too. This post spotlights a handful of slides that give us a peek under the hood of these companies.

Age verification systems are a marketing tool (Altria, Slide 11)

Government-issuesd ID may help establish whether a customer has reached the minimum age for legal sale, but it does not help tobacco companies keep track of their customers or gain insights into purchasing patterns. ALTRIA is incentivizing retailers to implement digital age verification systems which the company can then use to direct promotions to customers. (PMI has piloted a system in New Zealand for VEEV vaping products). 

Billy Gifford, Altria's new CEO, described this system to investors this week as a "unified and real-time consumer identity that ties their purchase data and interactions with our brands to our marketing communications."

Smokers are not much more successful at switching than they are at quitting.  (Altria, Slide 5)

Altria has used its consumer tracking systems to follow the purchasing behaviour of smokers. Although almost one-third have tried a reduced risk/smoke-free product, most who try such products stop buying them after a few weeks. Altria did not identify whether they relapse back to cigarettes or stop tobacco use altogether. Either way, the company wants to ensure these products are sold with government support ("clear, authorized information about the benefits of switching)" and that they provide "enjoyable sensory experiences and nicotine satisfaction".

Altria's depiction of the trajectory of switchers is a reminder of the effort that is required to "convert" smokers to alternative nicotine use.

Reducing risk is not the main reason people start vaping  (BAT, Slide 22)

Although it is its VUSE vaping product that BAT focuses on in Canada, in other parts of the world it also sells nicotine pouches (modern oral) and heated tobacco (HTP). This week investors were told that consumers are drawn to use these products by differing factors. 

BAT's consumer research found that reducing risk was less important in recruiting vapers that product imagery (identity), nicotine (satisfaction) and taste (flavour exploration) can be encouraged to use these  in eastern Europe and Asia. 

Nicotine use  in the USA has dropped very little over the pat 5 years (Altria, slide 25)

Although sales of combustible tobacco have fallen by 14% over the 5 years period 2016 to 2021, the U.S.  tobacco industry has been able to recoup most of those losses by increasing the markets for smokeless tobacco and vapour products. The overall fall in nicotine sales is about 4% (from 16.3 to 15.7 billion units) 

Cigarettes will remain the bedrock of profits (and the problem) for the foreseeable future. (PMI, Slide 15)

Under Philip Morris' enthusiasm for "smoke-free success" are numbers which show that conventional tobacco products remains the foundation of their business. Last year, for every dollar spent in the global nicotine market,  92 cents was spent on combustible tobacco, with two cents spent on vaping products and NRT combined.

Over the next four years, the company expects that alternative nicotine products will replace 7/8ths of lost combustible tobacco sales. The result? the total nicotine market is here for the long run: "declining at an underlying rate of around -1%". 

New drug products are key to "growing" sales and profit (BAT, Slide 50 )

This week BAT repeated its assurance to investors that it could overcome the loss of cigarette customers by providing alternative nicotine and other drug products. The drugs they are interested in are thoses that cause "boost", "focus" and "calm" (slide 15).  Cannabis-based products are one of their first areas of investment, and the CAGNY audience was reminded of BAT's investment in Canada's Organigram 

"Lifestyle drugs" will provide PMI with long-term growth. (PMI, slide 25)

PMI is also seeking to become a diversified consumer drug manufacturer. Its controversial acquisition last year of companies with expertise in inhalation drug delivery (Vectura) and oral drug delivery (Fertin) are just the beginning, CEO Jacek Olczak told investors this week. 

PMI is also exploring providing approved medical treatments for heart attacks, migraine and pain management, and OTC products that provide psychotropic effects ("focus, sleep, energy, pain and calm.") (slide 26).  Although they are interested in CBD and medical marijuana, the company says it is not at this time intending to sell recreational cannabis.

Links to CAGNY presentations:

• Altria: February 22, 2022
• Philip Morris: February 23, 2022
• British American Tobacco: February 23, 2022

2022: A time to focus on tobacco and vaping waste.

Globally and nationally, new opportunities have been presented for civil society and governments to focus their attention on ways to  reduce the environmental damage caused by tobacco products. This post (and an accompanying briefing note) provides some background on (1) opportunities to advance controls, (2) notable developments in some jurisdictions, and (3) some vulnerabilities for public health. 

1 Opportunities to "drive action" on cigarette filters

Comment on draft federal regulations which ban certain single-use plastics (but not cigarette filters)

On Christmas Day (really!) Environment and Climate Change Canada (ECCC) published draft regulations ("Single-Use Plastics Prohibition Regulations") in the Canada Gazette, Part I. These regulations would ban the manufacture or sale of single-use plastic checkout bags, cutlery, stir sticks, straws and some foodservice ware. Last May, plastics were added to the official list of toxic substances in Canada's Environmental Protection Act. 

Despite the toxicity of cigarette and e-cigarette waste, and despite calls for cigarette filters to be included in the ban, the federal government has not yet made any detailed plans to manage post consumer waste from tobacco industry products. 

The consultation on draft regulations is an opportunity to encourage this department to give priority to cigarette waste and to ensure that this is done in ways that support reductions in tobacco use. 

Health authorities, organizations and individuals can participate in this consultation to encourage the federal government to develop a plan to manage tobacco and e-cigarette waste which contributes to achieving environmental and public health goals. The consultation closes on March 5, 2022. Information on how to submit comments is available on ECCC's web-site. 

Engage in the UNEP-WHO/FCTC social media campaign.

In late January, the UN agencies responsible for tobacco regulation (World Health Organization - Framework Convention on Tobacco Control) and the environment (United Nations Environmental Program) launched a partnership to "drive action" on the human and environmental harms caused by plastics in cigarette filters. One of the aims of this campaign is to "encourage citizens to advocate" for measures like the EU directive requiring all filtered cigarette packages to have a warning label.

Observe World No Tobacco Day with this year's theme "Tobacco: Threat to our environment"

Since the mid 1980s, the World Health Organization has encouraged governments to observe May 31st as World No Tobacco Day.  The theme set for this year by WHO is "Tobacco: Threat to our environment."  WHO hopes this will accelerate action: "The campaign calls on governments and policy makers to step up legislation, including implementing and strengthening existing schemes to make producers responsible for the environmental and economic costs of tobacco product waste."

2 International developments.

Mandatory labelling (European Union). Since July 2021, EU Directive 2019/904 has required packages of filtered cigarettes to be labelled with an alert regarding the plastic content (and from July 2022 the notice must be printed on the package). EU member states are also required to ensure that producers pay for awareness-raising, litter clean-up, dadta gathering and reporting and waste collection. 

Packages of filtered cigarettes sold in the EU
must now display this caution sign. 

Expanded Producer Responsibility (France).  France plans to reduce the number of discarded cigarette butts in the environment by 40 percent within six years. In 2020 it passed an anti-waste (Antigaspillage) law which required industries to assume responsibility for managing such waste and in 2021 an industry-managed organization, ALCOME, was established by government authority to direct these activities, and to contribute 80 million euro in funding.

Filter ban (California). Legislative proposals have been introduced (but not yet passed) to ban filtered cigarettes and single-use e-cigarettes. The most recent of these, Assembly Bill 1690, was presented in January 2022.

Waste charge (San Francisco and Korea). For over a decade, San Francisco has collected a cigarette litter abatement fee from retailers. They now collect $1.05 per package. Korea. The Republic of Korea has imposed a waste charge on a package of 20 cigarettes at 24.4 won (about $0.03). A similar tax is also applied to e-cigarette cartridges or heat-not-burn sticks in 2015.

Deposit-return. Proposals for a deposit-return system for cigarette filters - similar to that required for pop-bottles - have been made by health and environmental groups in Germany, Canada, considered by some U.S. State legislatures, and endorsed by some Canadian municipalities. 

Evidence gathering (United Kingdom). In November 2021, the U.K. Department for Environmental and Rural Affairs launched a public process to gather evidence on how to manage "problematic plastic items" including with a focus on wet wipes, tobacco filters and sachets. The call for evidence closed on February 12, 2022.

3 Risks and Vulnerabilities

"Principle 1: There is a fundamental and irreconcilable conflict between the tobacco industry’s interests and public health policy interests."  Canada and 180 other countries have adopted this principle to guide their relationships with the tobacco industry and to protect public health measures from industry interference. 

Permitting tobacco companies to lead the management of tobacco waste, as France is doing, is one way to apply Extended Producer Responsibility (EPR), but it also creates opportunities for the companies to use these activities in ways which undermine public health measures. 

Tobacco and e-cigarette companies will use their influence to defeat measures that encourage smokers to quit or discourage young people from starting (filter bans, waste fees, smoking prohibitions on beaches or other environmentally-sensitive areas).  Their intention is to frame the issue as one of "smokers' responsibilities" and not "commercial waste". They will promote measures which renormalize smoking (like plentiful public ashtrays) or which externalize the costs of waste management (community clean-ups). They will create economic allies by creating or funding environmental groups, as they did in previous decades with sports and arts associations.

These efforts are already underway in Canada. With some fanfare, the Canadian branch of Philip Morris, for example, brands its waste initiatives under the #UNSMOKE harm reduction banner and funds community groups to recruit volunteers to clean up its post-consumer waste. Last year the company donated $75,000 to 19 community groups to clean up tobacco and other waste, leveraging 10 million volunteer hours. 754,000 cigarette butts were collected -- less than the number Vancouver city estimates are dropped there in a single day. It also partners with Terracycle to incentivize cigarette clean-ups as fundraisers for community groups. 

Philip Morris/RBH #UNSMOKE
clean-up of downtown Toronto, 2019. 

Governments and communities can protect themselves from these vulnerabilities by:

• ensuring transparency in any discussions between tobacco companies and governments on all issues.
• rejecting measures which externalize the costs of tobacco waste management
• countering tobacco industry public relations activities
• protecting public measures from tobacco industry influence by discouraging partnerships with tobacco companies (including withholding public funding from groups which partner with tobacco companies).

Selected Resources

Briefing notes

Physicians for a Smoke-Free Canada. Plastic waste from tobacco and vaping products. 
http://smoke-free.ca/SUAP/2020/Single-Use-Plastics-and-Tobacco-Waste.pdf

Public Health Law  Center. Policy Tools for Minimizing Public Health and Environmental Effects of Cigarette Waste. https://publichealthlawcenter.org/sites/default/files/tclc-guide-cigarette-waste-2013.pdf

Selected research articles

Research synthesis. Public Health Ontario. Smoke Free Series: Post-Consumer Waste
https://cm.publichealthontario.ca/-/media/documents/s/2021/synthesis-post-consumer-waste.pdf

Recent publication. Karen Evans-Reeves et al. The ‘filter fraud’ persists: the tobacco industry is still using filters to suggest lower health risks while destroying the environment. Tobacco Control, 2021. 

https://tobaccocontrol.bmj.com/content/tobaccocontrol/early/2021/04/26/tobaccocontrol-2020-056245.full.pdf

Video

Tom Novotny talks about removing cigarette filters. Youtube. https://youtu.be/RjA4dPckfn0