Executive Director, Physicians for a Smoke-Free Canada Ottawa
Rendez-vous with . . . Cynthia Callard
, Ontario, Canada
By Philippe Boucher
Rendez-vous 111 Tuesday, September 18 2001
I hope you did not lose any loved ones in the tragedy in New York and Washington DC. In this context it is difficult to keep the focus on tobacco control but we are trying. Our heart goes to all who suffer.
PB : Thank you Cynthia for accepting our rendez-vous.
May I ask you to introduce yourself ?
Cynthia Callard: I have worked on tobacco issues intermittently since the mid 1980s - the past six years with Physicians for a Smoke-Free Canada (PSC). PSC was established in 1985 by an energetic group of Canadian physicians who wanted to ensure there was a constant and watchful eye on public policy issues concerning tobacco use. Although all our members are physicians, the two full time staff -myself and Neil Collishaw (see rv 67, May 10 2000)- come from a public policy background. Prior to working with PSC I was a producer with CBC Radio, House Leader's Assistant to the New Democratic Caucus in Canada's parliament (the NDP is Canada's social democratic party) and communications director for Canada's labour central, the Canadian Labour Congress.
Q1. Tobacco control advocates around the world envy the new health warnings you were able to enact. Can you already evaluate the impact of the new cigarettes packaging regulation? Does this info incite more smokers to quit? Do they call more the quitline? Does it change the way smokers relate to the pack (like not displaying it to avoid looking at dire pictures)? Are you aware of other countries following suit with similar regulations?
CC: The government initiatives to put bold picture-warnings on cigarette packages was one of the hottest consumer stories in Canada this year, capturing the attention of journalists, politicians and citizens who are not regularly concerned with health issues. Although the warnings were overwhelmingly well received by opinion leaders, news stories nonetheless appeared showing smokers deriding them, or worse, children liking them. This was not unexpected, as similar stories had followed the first round of warning reforms in 1994.
Despite these few provocative stories, the anecdotal reports of the warnings have been favourable, and have indicated that some (like the gruesome mouth) are more effective than others. Formal evaluations are being conducted by Health Canada, but it is unlikely that the results of those evaluations will be finalized for many months.
The concept of picture warnings has generated excitement in many places, and Brazil is the next country to require full-colour photographic warnings. They are scheduled to appear on Brazilian packages in early 2002.
Q2. We read about an increase of the federal budget for tobacco control: A five fold increase, CDN$ 480 million for the next five years. Can you explain how those funds will be used, who will decide what to do and what is going to be the eventual input of the health ngos? Will the new advisory council play a key role and can you explain how it works?
CC: For more than two years Senator Colin Kenny conducted a high-profile campaign for a massive anti-tobacco media program run by an independent foundation. Canadian Senators are not elected, and are not usually visible champions of social causes. The perseverance of the Senator, and the support he generated around the country convinced the federal government to open the purse-strings and agree to a five-year infusion of funding. The money that is now being allocated to tobacco (CDN$480 million over 5 years) is significantly more than is given to other public health campaigns (such as AIDS, drug abuse, child welfare).
The government did not agree to establish an independent foundation, but instead created a Ministerial Advisory Council to ensure that outside advice and oversight was available to the departmental officials. Appointed to the Advisory Council were a number of key players in tobacco control from the advocacy, research and clinical practice areas. In its first meeting, the Council was both highly consensual and forcefully expressive, important qualities for an advisory body to have impact.
Q3. How does this new federal tobacco control budget compare with tobacco taxes? How does it compare with the advertising and promotion budgets of the industry? In the US, after the AG's settlement was signed the promotion investments of the industry soared. What is the situation in Canada?
CC: The tobacco control budget is a mere fraction of the taxes received from cigarette sales, but given the public costs of treating tobacco caused disease this is not considered controversial or inappropriate in Canada. (For every $10 in tobacco taxes, the government will spend $0.25 on tobacco prevention). Canadian tobacco companies are still adjusting to new restrictions on tobacco promotion which came into effect last October and which remove their ability to advertise at retail or on billboards. Although they initially explored circumventing the restrictions, this summer they began promoting "Operation ID," their youth-prevention program. Whether this is a temporary tactic (they are challenging the law in courts, and may wish to improve their public image at this sensitive time), or whether they have changed their marketing strategies is not yet clear. In any event, Canadian children are exposed to much less tobacco advertising this year than in recent years.
Q4. Many Health ministers or members of Parliament who sponsored tobacco control legislation paid a stiff personal political price (losing their reelection). Allan Rock has survived and keeps going. How do you assess the balance of power? There have been backlashes in the past (when the taxes went down because of smuggling), do you think the recent changes will resist? Do you think politicians in Canada now view smoking and the cigarette industry in a different way?
CC: Being opposed to tobacco has become a mainstream issue in Canada since the middle of the 1990s. It is difficult to know exactly when, why - or for how long - the tide turned, but there is much more interest and acceptance on strong social measures to curtail tobacco business activities. Because of this, championing tobacco for a politician is no longer a liability, it is an asset. The current Minister of Health remains very popular with the tobacco control community, whom he has impressed with his commitment to and understanding of the issue.
Q5. Allan Rock recently wrote to the cigarette manufacturers about abandoning mentions like mild and light. What do you consider the next steps to be taken to improve tobacco control? Will litigation still play a role?
CC: I feel we have come to an important juncture in Canadian tobacco control. We have made progress towards our major goals of the last decade. We wanted a strong law, plain packaging, high taxes, funded programs and strong and effective mass media campaigns. We have a law which is making progress, new package warnings, some increases in taxes, new funding and the promise of a significant mass media campaign. Doubtless, we will continue to work at the previous goals until we get even further towards accomplishing them. But it also seems to be an appropriate time to sit back and reflect on whether we need to look at new models of tobacco control. Many internal challenges remain. We do not yet have a coherently communicated "industrial strategy" to deal with this industry in the long term, or to change the structure in which tobacco is sold and consumed. We do not have a clear analysis to address the different needs of those who continue to smoke. We do not have a campaign to ensure that the companies are held accountable for their wrongdoings under both criminal and civil law. Many of us now understand that our efforts must be global and local, but struggle to engage in campaigns and activities to support municipal programs (like smoke-free bars and restaurants) and global activities (like the framework convention). We have always talked about a 'comprehensive' program to deal with tobacco, but we now have a different understanding of how large 'comprehensive' can be.
PB: Thank you Cynthia for taking the time to be with us today.
Rendez-vous is supported by a contract from the Robert Wood Johnson Foundation
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