Penny Priddy

Tuesday, October 5, 1999

Thank you Minister Priddy for accepting our "rendez-vous". May I ask you to introduce yourself?

Hello. I'm Penny Priddy, Minister of Health and Minister Responsible for Seniors in the Government of British Columbia, Canada. I've held the Health Minister portfolio since February, 1998, and before that served as Minister of Labour, and Minister of Women's Equality. My background is in health. I was educated as a nurse and have worked with children, families, and people with disabilities in a variety of programs over the past thirty years. I am a mother and grandmother to a delightful boy named Liam.

My interest in tobacco prevention comes from my interest in working with children. Every day in British Columbia 20 more children start smoking.

Half of those who continue to smoke and become addicted will eventually die of a tobacco-related illness. Protecting children from tobacco is the reason British Columbia has a Tobacco Strategy. Our tobacco strategy has a range of programs and initiatives including legal action against the tobacco companies, protection and prevention programs, and public education. But they all focus on the same goal: protecting children from the dangers of tobacco. We are determined to hold the tobacco industry accountable for the damage its products inflict on our young people.

Although my first job is to protect British Columbia's children from the tobacco industry, I recognize that the industry's reach is worldwide and its pockets are deep. In the interests of children around the world, we all have an obligation to share our experience with approaches that work.

1. British Columbia is presented as a world leader in tobacco control. Your strategy is explained on your site www.tobaccofacts.org. It combines legislation, litigation and public education. Can you tell us about the funding and how it compares with the taxes collected from tobacco products and eventually with the promotional budgets of the industry? Could you also explain the mechanism of the Tobacco Fee Act?

One of the first actions of the BC Tobacco Strategy was to increase funding for tobacco programs. Last year the British Columbia government more than doubled its funding and allocated C$5 million for a range of tobacco prevention, protection, cessation and public education programs. This year, funding has been increased again to C$6.5 million.

This funding comes from the province's general revenues and is provided regardless of the amount collected from taxes on tobacco products. Taxes on tobacco products in British Columbia are approximately C$483 million, which, incidentally, are paid entirely by smokers and consumers of tobacco products.
In British Columbia, like all of Canada, the government provides universal health insurance which covers health care and hospital costs for all Canadians. This is funded in part through affordable premiums, but the majority of those costs are funded through the province's general revenues -
or, more specifically, all of BC's taxpayers. It is estimated that the cost each year resulting from tobacco related illness in British Columbia exceeds C$1 billion, and tax revenue from tobacco products comes nowhere near covering all the costs associated with tobacco related illness.
 
How does this compare with the promotional budgets of the industry?

Our tobacco prevention and control budget includes C$1.5 million on public education and promotion. This, of course, is miniscule compared with the amount that is estimated to be spent by tobacco companies on promotion.

Tobacco companies in Canada do not advertise their products directly through television, magazines and billboards. Promotional costs are incurred in ways such as event sponsorship (which includes print, transit and billboard advertising) and retail promotions (such as product placement). It is difficult to pinpoint the amount spent on promotion by Canadian tobacco companies -- they are not required to report their marketing and sponsorship expenditures to government and they do not do so voluntarily. We have access to data on some expenditures in 1996:
- Health Canada reports that the tobacco companies volunteered that they spent $60 million on sponsorship in 1996;
- Correspondence from the tobacco companies to Canadian retailers in 1999 indicated that $70 million was spent on retail promotion.

As British Columbia has about 12 per cent of the population of Canada, we would estimate the amount spent in B.C. that year by dividing the national amount by 12 - at least $10.8 million - but we don't have access to the exact amount.

The tobacco industry engages in other promotional activity, but we don't have access to the costs. An example of this is the opening of an office in British Columbia by the Canadian Tobacco Manufacturers Council last year -
the first outside of Ottawa. The work of the office is part government relations and part promotion, but we have no idea what the expenses, including travel, salaries and hospitality, of this office would be.

Could you also explain the mechanism of the Tobacco Fee Act?

Part of the British Columbia Tobacco Strategy is to hold tobacco companies accountable for the damage they have done. To accomplish this, British Columbia launched its lawsuit against the major Canadian tobacco companies in November, 1998.

British Columbia has also introduced the Tobacco Fee Act to have tobacco companies pay their fair share of costs of tobacco reduction programs. This legislation has not yet been proclaimed, but it is a clear signal to the tobacco industry that it is time they helped to pay for programs to prevent children from becoming addicted and to help smokers quit.

2. In a recent article published in the American Journal of Public Health there is a comparative study of the taxes collected from illegal sales of tobacco to minors. Do you have any similar information about British Columbia and Canada?

First, I'll outline British Columbia's legislation and tobacco protection programs to prevent the sale of tobacco to minors under age 19. Two years ago we increased tobacco enforcement funding by 70 per cent. British Columbia has the largest tobacco enforcement program in Canada, both in terms of dollars invested (C$1.2 million) and in terms of the number of officers enforcing sales to minors legislation. Tobacco Enforcement Program funding is cost shared between the federal and provincial governments.

In January 1999, tougher regulations to the Tobacco Sales Act came into effect, increasing fines and lengths of suspensions for retailers convicted of selling tobacco products to minors. Retailers who have multiple convictions for selling tobacco to minors can have their authority to sell tobacco suspended for up to 24 months and suspended retailers are required to post suspension signs.

In July, 1999, the legislation was amended to require the Ministry of Health to publicize information about retailers who receive suspensions for tobacco sales violations.

Not all tobacco consumption by minors in British Columbia represents illegal sales to minors. Some consumption may be a result of third-party furnishment of tobacco (an older individual giving it to a minor rather than selling it), which is only illegal under the federal Tobacco Act if done in a public place involving a minor under the age of 18.

I am not aware of any studies on this topic that relate to other Canadian jurisdictions, but we do have data here in British Columbia. Ministry staff estimate that in 1997, tobacco consumed by minors aged 12-18 represented more than $42.8 million in retail sales, of which $12.7 million was collected in federal taxes and $20.0 million was collected in provincial taxes. These figures are soft and based on a number of assumptions, such as that proper duties and taxes were paid on all tobacco consumed by minors.

3. You are taking action to promote smokefree environments and it still looks like a hotly debated issue. Could you tell us how you assess the situation now? For the workplace, for the other public places? Do you have any data about people smoking at home? California did monitor this trend and it was very interesting to see the evolution (especially in households with children).

In British Columbia, the Workers' Compensation Board (WCB) regulates protection of workers. In April, 1998, the WCB Occupational Health and Safety Regulation came into effect to protect workers from exposure to second-hand smoke in all workplaces in British Columbia. Some workplaces were exempted. The exemptions of all remaining workplaces - including bars, restaurants, prisons and longterm care facilities - will be removed as of January 1, 2000.

In a Memorandum of Understanding signed with WCB and the Union of British Columbia Municipalities, the Ministry of Health is working to support the WCB. The Ministry of Health and health authorities have an important educational role in advance of the Regulation coming into effect on January 1, 2000.

The Ministry of Health also encourages smoke-free environments through local municipal bylaws. More than 50 per cent of the municipalities in the province have smoking control bylaws. Through these efforts more than 90 per cent of the population in BC have protection from second-hand smoke in public places.

Can you tell us how you have assessed the situation now?

In June of 1999, a recent province wide survey conducted by the Angus Reid Group on behalf of the WCB and Clean Air Coalition reported that:
- more than 90 per cent of BC adults believe non-smokers should be provided with a smoke-free environment at work.
- 70 per cent of adults in BC are aware that WCB has established health and safety standards to protect all workers from second-hand smoke and
- 73 per cent of this group are aware that the standards include all public facilities.

Do you have any data about people smoking at home?

The latest statistics available on smoking rates in British Columbia and Canada are from 1997 - this was a major study that examined all kinds of smoking attitudes and patterns and the results are available at
http://www.hlth.gov.bc.ca/tobacrs/index.html. That's the year the British Columbia government began its much more aggressive and comprehensive approach to tobacco prevention. We expect to undertake another similar major study to measure progress in 2000 and we hope to begin to see some change. Here are some of the findings regarding smoking in the home from the 1997 Tobacco Use in BC survey:
- Among all non-smokers in the province, 83 per cent report no ETS
- exposure at home.
- Daily or nearly daily exposure to ETS occurs in 18 per cent of households
- with children aged 11 and under in BC.
- This translates into 15 per cent in the Lower Mainland (the most highly urbanized area of the province) and nearly 25 per cent in the Northern Regions.

The question asks about the ETS exposure in the home in California. I can only assume they are referring to the trend in 1992 where 75 per cent of homes where children lived were smoke-free. In 1997 it was reported that this rose to 85 per cent. In BC we do not have information to document a similar trend however, in 1997 we had a similar rate of 83 per cent .

Q4: Can you give us some details about the new youth cessation program delivered in high schools?

Kick the Nic 2000 is a new youth group tobacco cessation program designed to provide teens with a quit smoking program that addresses their needs. About two-thirds of young people who smoke in British Columbia want to quit but can't. This program has been designed to help teens quit smoking and to provide resources for health and education professionals to support teens during this challenging process.

The new program is unique in many ways. It celebrates success, accentuates the positive, focuses on skill-building activities, and emphasizes peer support. The materials are eye-catching, youth focused and easy to use and incorporate strategies to successfully involve teens.

Kick the Nic 2000 includes:
- A step-by-step facilitators guide that consists of ten 40-minute sessions, that teens and facilitators schedule in a way that best meets the participants needs. The materials are designed to build awareness, motivation, and the skills that teens will need to quit.
- A participant handbook that is colorful, teen friendly, and compact. It has engaging activities and practical suggestions to help teens in their effort to quit.
- A large, distinctive recruitment poster that is designed to attract teens.
- Innovative items such as "buddy support" cards which teens can use to encourage their family and peers to support them during the quitting process.

All the materials for the new program have been developed with input from youth. Teens were involved in the design of the program prototype and piloting of the program.

British Columbia's Teen Tobacco Team - a group of youth from across the province who advise me in matters relating to tobacco -- have also helped review the materials and have been active in creating a design that was appealing and accessible to their peers. The Teen Tobacco Team recommended the implementation of a youth tobacco cessation program as an important component of British Columbia's Tobacco Strategy.

The new youth tobacco cessation program has just been launched and is being distributed in schools throughout the province.

This program will also be distributed as part of a tobacco prevention kit, bc.tobaccofacts to all British Columbia schools with grades 8 to 12 in March 2000.

5. You hosted a World Health Organisation meeting of public health experts in Vancouver in December 1998. Is British Columbia considering taking new initiatives at the international level? On a more regional level, do you have any type of cooperation with other Pacific Northwest states trying to develop tobacco control programs, like Washington State, Oregon, California?
What about the cooperation with the Canadian federal government?  Do you have any advice for countries with a federal structure?

British Columbia was asked by the World Health Organisation to host its meeting of public experts in Vancouver because of the leadership British Columbia had shown in tobacco prevention and control. This meeting led to an accelerated process by the WHO in developing its Framework Convention on Tobacco Control. As a provincial jurisdiction in a federal state, it is beyond British Columbia's jurisdiction to initiate international programs, but we are continuing to work with the federal government on these important issues. Our role internationally has been to showcase our programs and initiatives as a model to other jurisdictions.

In May, 1999, it was my pleasure and honor to address the session on the Framework Convention on Tobacco Control at the World Health Assembly in Geneva. And in August, 1999, British Columbia's tobacco programs were featured as the cover essay for the Tobacco Control journal (http://tc.bmjjournals.com/).

At the same time, we have benefited from the experiences and programs of other jurisdictions. We have been in touch with the State of California and have aired television messages produced there. In both California and Australia they are adapting the British Columbia developed "Critics Choice" program for use in their schools. (Critics Choice is a program whereby high school students view a reel of several tobacco-awareness television ads and vote for the one they believe is the most effective. The government then airs the ad that received the most votes.) Our Attorney General has had discussions with the Washington State Attorney and we'll be contacting the States of Washington and Florida to learn more about their programs. We've worked with Massachusetts on the issue of testing and disclosure of tobacco ingredients and smoke chemicals.

We continue to work together with our federal counterpart Health Canada on the issue of tobacco control. Last September I urged our Federal/Provincial/Territorial Health ministers to take stronger action nationally on tobacco. This led to the development of a paper outlining new directions for a national strategy on tobacco.

I believe that while a great deal can be done within our individual jurisdictions, tobacco addiction is an international problem requiring international co-operation and solutions. The framework convention is an integral part of WHO's Tobacco Free Initiative, and will provide an international legal instrument to discourage the spread of the tobacco epidemic. It will complement and support our individual efforts.

At the framework convention meeting in Vancouver, there was general agreement that protecting youth and children, strengthening the leadership role of women in tobacco control, and controlling smuggling across borders were priorities.

Perhaps most importantly, there was recognition that working co-operatively with each other - sharing ideas and strategies - makes it easier for all of us to develop affordable and effective tobacco reduction initiatives tailored to our own jurisdictions' needs.

The importance of international initiatives such as the WHO framework convention cannot be overstated. They send a clear message to the tobacco industry that we are united in our efforts to discourage the global spread of tobacco and tobacco products among our young people.

Tobacco is an issue that has no boundaries. Tobacco company advertising and promotion crosses borders as does smuggling. The same techniques are used to influence children in Mexico and Indonesia as they are in Canada and the European Community. Effectively protecting children from tobacco requires cooperation by all governments in a federal state, as well as at the international level. Each jurisdiction has its responsibilities and obligations and I encourage any and all governments to take the strongest action they can within their jurisdictional powers.

Do you have anything else you would like to add?

First, I thank you and your audience for this opportunity to share some of our experiences and initiatives with respect to tobacco prevention and control.

It is important to remember that even in those jurisdictions that are taking strong action on tobacco, there is still a great deal to be done. Far too many of our young people are still falling prey to the glamorous images of smokers portrayed in advertising, movies and television.

There is also the Catch 22 situation where jurisdictions that take that strongest action find they are also faced with increased activity on the part of the tobacco industry. We've certainly seen that in British Columbia and would benefit from the support of other jurisdictions. We don't have any intention of scaling back, however. We intend to forge ahead - facing the challenges along the way -- confident of the support and grateful for the co-operation of health leaders around the world.

Thank you very much Minister Priddy for taking the time to be with us today.