Neil Collishaw

RENDEZ-VOUS 67
Wednesday, May 10 2000

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

During the 1970s, I worked on Long Range Health Planning in the Canadian Health Department. We analyzed all the public health problems that Canada faced. No matter how we did the calculations, tobacco always came up as the most serious public health problem in the country.

With this knowledge firmly in my mind, when a chance came up in 1981 for me to work on tobacco full-time in the Health Department, I jumped at it. I spent the next ten years working on tobacco in the Health Protection Branch of the Health Department. When I started in 1981, Canada had no tobacco control legislation and the highest rate of tobacco consumption per adult in the world. By the end of my time at Health Canada in 1991, Canada has adopted a comprehensive tobacco control policy including high prices, controls on smoking in public places and workplaces, and the Tobacco Products Control Act that banned most advertising and required strong warnings on packages.

In 1991, I moved to WHO and worked in the Tobacco or Health Programme until 1999. At WHO I was involved in initiating work on the Framework Convention on Tobacco Control, and in helping countries all over the world to strengthen their tobacco control programmes. I was also involved in documenting the scale of the tobacco epidemic, and in preparing publications including Guidelines on controlling and monitoring the tobacco epidemic and Tobacco or health: A global status report. We did all this on a shoestring budget, but I never tired of presenting arguments to WHO management that tobacco needed to become a high priority in WHO. Finally, the message got through. The new Director-General, Dr Gro Harlem Brundtland, has made tobacco a high priority in WHO.

Q1. First question : Can you tell us about your recent appointment with PSC, what you are going to do with them and what type of group they are. Have you met other groups like them in other countries? It looks like a good idea to mobilize physicians for tobacco control.

Physicians for a Smoke-Free Canada is a charitable organization, with about 1500 members. Its Board of Directors, presided over by Dr Mark Taylor of Winnipeg, consists entirely of physicians and all volunteer their time to the Board of Directors. Its members are totally committed to strengthening tobacco control, just as is our long-term staff. Our long-term staff numbers precisely two, myself and Cynthia Callard, the Executive Director.

I am familiar with other physician-oriented tobacco control groups like Doctors Ought to Care (DOC), European Medical Action on Smoking and Health (EMASH) and International Doctors Against Tobacco (IDAT). We would like to see all doctors, in Canada, and all around the world, become effective tobacco control advocates.

Q2. I just received in the mail an excellent document about the new health warnings proposals for Canada. It makes very convincingly the case for very significant changes in the design and labeling of the packs. Still in many countries the interest for such radical changes remain minimal. Look for instance at the very timid proposals for the new EU Directive or in the last congressional proposals in the US.

How do you explain this type of restraint? Is it the fear to fight with the industry? What do you think should be now the minimal/maximal -worldwide?- requirements for labeling (short of generic packaging)?

Each country will need to come up with its own labeling requirements that are appropriate to its language and culture, but they might like to look to Canada for what is possible for warning form, content and size. The proposals for warnings in Canada was subject to extensive market research. The message from the research focus groups was loud and clear. Stop pussyfooting! Tell it like it is - in strong words, big warnings, and scary color pictures. I am proud to say that the government is determinedly following through to make full-color warnings that take up 50% of the front and back of packages the law of the land.

The EU directive certainly does not go as far as the current Canadian draft warnings. However, the EU directive will ban the use of terms like light and mild, something not yet achieved in Canada.

Q3. You have mined the industry documents. Can you tell us about this experience? Some of us are not familiar with them and are sort of overwhelmed by the perspective of millions of pages to read. Any advice for the average lay tobacco control advocate on how to approach those mines?

There are now over forty million pages of tobacco industry documents in the public domain, thanks largely to the efforts of the legal team in Minnesota that extracted the agreement to make the documents public from the tobacco industry. A good place to start studying documents is to look at analyses that have already been done. There are some on our website (http://www.smoke-free.ca). The Cigarette Papers is also an excellent source of information
(http://www.library.ucsf.edu/tobacco/cigpapers/). If your interest is piqued, then you might like to search through the documents themselves. They are available at depositories in St Paul, Minnesota and Guildford, England. Millions of pages are also available on tobacco company websites. I can assure you that there are quite a lot of needles in those particular haystacks, but no matter what search tools you use, electronic or otherwise, you will still be looking for needles in haystacks. They can be found, but significant effort is required.

Q4. PSC has a very interesting website: http://www.smoke-free.ca. About advertising and promotions, you make the point that there are now more ads and promotions than before, a situation that exists in many countries where despite regulations the industry continues to spread a huge propaganda. How come and what solutions do you see? 

As long as there are exceptions to the ban on tobacco advertising, as there are in Canada, the tobacco industry will continue to exploit them to their advantage. Some countries, like France, have succeeded better at banning all or nearly all forms of tobacco advertising and making the ban work. Countries have to ban all tobacco advertising, with very few exceptions and no loopholes.

Q5. What would you pick now as the main priorities for the tobacco control movement in Canada?

1. Tell the truth about tobacco and call the tobacco industry to account.

2. Improve public understanding of how cigarettes are made and marketed. Then oblige companies to change manufacturing and marketing practices so that they work FOR public health, not AGAINST it.

3. Work together with other countries to improve national and international tobacco control through helping to strengthen national tobacco control, through better trade agreements, the framework convention for tobacco control and other means.

4. Restore high tobacco prices.

5. Ensuring more and better protection from involuntary exposure to tobacco smoke for everyone, everywhere.


Q6. Do you have anything else you would like to add ?

Thanks to you, Philippe Boucher for running Rendez-Vous so successfully. I welcome the opportunity to get to know tobacco control workers all around the world a little better, and to share with them a few things about my work.

Thank you Neil for taking the time to be with us today.