TOBACCO CONTROL ACT, 1993 / LOI DE 1993 SUR LA RÉGLEMENTATION DE L'USAGE DU TABAC
COMMITTEE OF INDEPENDENT PHARMACISTS
ONTARIO CHAIN DRUG ASSOCIATION
HEART AND STROKE FOUNDATION OF ONTARIO
RESPIRATORY THERAPY SOCIETY OF ONTARIO
CANADIAN AUTOMATIC MERCHANDISING ASSOCIATION
NON-SMOKERS' RIGHTS ASSOCIATION
CONTENTS
Wednesday 2 February 1994
Tobacco Control Act, 1993, Bill 119, Mrs Grier / Loi de 1993 sur la réglementation de l'usage du tabac, projet de loi 119, Mme Grier
Ontario Lung Association
Mary Campbell, president-elect
Dr Peter Webster, member, Ontario Thoracic Society
Cathy Birks, representative, Ontario Respiratory Care Society
Committee of Independent Pharmacists
Larry Rosen, past president
William Rutsey, Coopers and Lybrand
Eric Leonard, Coopers and Lybrand
Dr Atif Kubursi, McMaster University
Bernie Ceifets, member
Retail Council of Canada
Alasdair McKichan, president
Peter Woolford, vice-president
Ontario Chain Drug Association
Sherry Porter, executive director
Steve Mezei, vice-president, operations, Pharma Plus
Shoppers Drug Mart Ltd
David Bloom, chairman and chief executive officer
Marj MacKenzie, pharmacist-owner, Shoppers Drug Mart stores
Heart and Stroke Foundation of Ontario
Rosemary Leach, manager, professional education
Dr Anthony Graham, board member
Respiratory Therapy Society of Ontario
Yvette Dumont, president
Susan Marshall, respiratory therapist
Shawn Kenny, president-elect
Canadian Automatic Merchandising Association
David Orriss, president
Paul Runstedler, acting treasurer
Cynthia Davenport, manager
Non-Smokers' Rights Association
Garfield Mahood, executive director
David Sweanor, senior legal counsel
Commit to a Healthier Brant
Dianne Ferster, executive director
Tara McIntyre, member
Leslie Falhazie, member
STANDING COMMITTEE ON SOCIAL DEVELOPMENT
*Chair / Président: Beer, Charles (York-Mackenzie L)
*Vice-Chair / Vice-Président: Eddy, Ron (Brant-Haldimand L)
Carter, Jenny (Peterborough ND)
Cunningham, Dianne (London North/-Nord PC)
Hope, Randy R. (Chatham-Kent ND)
Martin, Tony (Sault Ste Marie ND)
*McGuinty, Dalton (Ottawa South/-Sud L)
*O'Connor, Larry (Durham-York ND)
*O'Neill, Yvonne (Ottawa-Rideau L)
Owens, Stephen (Scarborough Centre ND)
Rizzo, Tony (Oakwood ND)
*Wilson, Jim (Simcoe West/-Ouest PC)
*In attendance / présents
Substitutions present / Membres remplaçants présents:
Arnott, Ted (Wellington PC) for Mrs Cunningham
Haslam, Karen (Perth ND) for Ms Carter
Murdock, Sharon (Sudbury ND) for Mr Rizzo
Perruzza, Anthony (Downsview ND) for Mr Martin
Wessenger, Paul (Simcoe Centre ND) for Mr Hope
White, Drummond (Durham Centre ND) for Mr Owens
Clerk / Greffier: Arnott, Doug
Staff / Personnel:
Boucher, Joanne, research officer, Legislative Research Service
Gardner, Dr Bob, assistant director, Legislative Research Service
The committee met at 1004 in room 151.
TOBACCO CONTROL ACT, 1993 / LOI DE 1993 SUR LA RÉGLEMENTATION DE L'USAGE DU TABAC
Consideration of Bill 119, An Act to prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others / Projet de loi 119, Loi visant à empêcher la fourniture de tabac aux jeunes et à en réglementer la vente et l'usage par les autres.
ONTARIO LUNG ASSOCIATION
The Vice-Chair (Mr Ron Eddy): Good morning. The committee is holding hearings on Bill 119. The first presentation will be by the Ontario Lung Association. Please introduce yourselves and proceed with your presentation. Hopefully, there will be time for a few questions. Good morning and welcome.
Ms Mary Campbell: As the vice-chairman has said, we represent the lung association. I'm Mary Campbell, the president-elect of the association. I'm the mother of two young men 16 and 21 years old who, I'm very thankful, are non-smokers. I'm also a teacher at the secondary level and so I see a lot of young people who are addicted to tobacco. It's of grave concern to me.
With me are two representatives of our medical sections, Dr Peter Webster from the Ontario Thoracic Society, and Mrs Cathy Birks from the Ontario Respiratory Care Society.
We'd like to thank the committee for giving us the opportunity to make this presentation and we certainly want to offer sincere congratulations to all, whether they be government members or others, who are responsible for bringing this legislation forward. We offer special congratulations to the Minister of Health and to two members of this committee, Karen Haslam and Larry O'Connor.
We're given to understand that some members of the committee do not support all aspects of Bill 119. We feel this is very unfortunate and we hope we can help to win over those of you who are not in full support of it. We are all for it and we're going to tell you why this morning.
I'd like you all to try and take a deep breath. Anybody have problems with that? People who have respiratory problems can't do that, and that's what the lung association is about. We're about helping people with respiratory problems breathe more easily, and we also feel our mandate is to improve the respiratory health of all people in Ontario. We do this through community programs and medical research that is funded by individual and corporate donations and administered by 33 offices throughout the province. This has been our work since 1904. We are the oldest not-for-profit health organization in the country.
In the old days the problem was tuberculosis. Now it's the tobacco epidemic. As the Minister of Health has said, tobacco kills one person in Ontario every 40 minutes. That means that before the second group of presenters leaves here this morning, someone will have died from tobacco. We all know that tobacco is the single greatest preventable cause of death in Canada.
Therefore, legislation is necessary, and this legislation is vital to control such a serious health problem. We also all know that no one wants our young people to start smoking. We think that's really where the focus of all the discussion has to be.
I was lucky enough to attend the First National Conference on Tobacco or Health in October. It's interesting that was the formulation: tobacco or health. This is a vital message we have to convey to young people, that it's tobacco or health. That's why it's so important that we end the sale of tobacco in health care facilities and pharmacies.
Dr Webster and Mrs Birks will now present further arguments and evidence for putting an end to hypocrisy in the health community.
Dr Peter Webster: I'm Dr Peter Webster. I work at Sunnybrook. I'm the head of the respiratory division there. I'm here because Michael Hutcheon asked me to do so. He's the president of the Ontario Thoracic Society.
You have a written submission of what I had to say. I was told we were talking for about five minutes, so I would rather leave time to answer the questions that are in your hearts rather than the questions that are on my mind.
I don't think there's anyone sitting around this little square who is not aware of tobacco's lethal properties in terms of airway disease. What we seem to have a harder time convincing people of is its addictive properties. This is something that I think is self-serving on the part of the tobacco industry. Reading the history of how the tobacco industry has managed to get the population addicted to tobacco in a large way is an exercise in cynicism beyond belief.
They gave away cigarettes free to the soldiers in the First World War and they spent the Roaring Twenties convincing the ladies to smoke. The most gross of them was that the Lucky Strike company had a problem with green packages -- nobody wanted to wear green -- so they paid off the New York fashion industry to have a green year so Lucky Strike could sell its tobacco. We're talking about a level of cynicism that's beyond belief, a level of cynicism that's funded by simple pecuniary gain. I'm taking time out from bronchoscoping people to find their cancers. I have half of my ward filled with people who can't walk to the bathroom and back without gasping for air.
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We come to this committee understanding that the tobacco industry is insisting on undermining the ethical principles of the pharmacies by forcing ethical pharmacists to sell something that they, as a legislated health profession, have decided is unethical. I don't know about you guys, but that doesn't seem right.
If we were dealing with a social habit that managed to get in under the wire because we weren't standing up in defense, I could see that we'd have a problem, but we're dealing here -- one thing that I understand is under question in this committee is sale of tobacco in pharmacies -- with a legislated health care profession that is regulated by the government, whose regulation is organized through a college properly and duly under legislative control, and that this legislative body of professionals has determined that selling cigarettes is wrong.
We have within that profession some people whose livelihood is entirely dependent on a tobacco company. As a government that has dedicated itself to the freedom and good health of all the province, it would be unconscionable to drop it from this legislation, which has taken several very good steps -- not as many as many of us would like to see, but several very good steps -- towards reducing tobacco addiction.
The New Democratic Party has long been associated with liberal thought, even if you're not Liberals, and liberal thought insists on a person's independence, on your will, but we're talking of an addiction to a chemical that has a direct access to your will. You cannot talk about free will in somebody you've got hooked on heroin. You cannot talk about having free will in somebody who's been conned into using coke. Take a laboratory rat and give him a training program to learn to like coke and he will like nicotine as well, if not better.
You may have detected that I have a little bit of strong feelings on that one issue. I think the ministry and the government cannot help but say the same thing.
The other issues in the bill are really things we've been begging for for a long time, such as not having tobacco available in your corner store, or plug in a few dollars and you've got your tobacco. There's absolutely no way you can keep the kids out of it that way. We certainly would have liked to have seen a little more control in terms of displays. You go into a grocery store or any store where they're out on the shelf and you know the kids will be going at them. My wife was just telling me yesterday that the gossip in east-end Toronto is that kids from her public school are being sold cigarettes one at a time, as a way of making it easy for them to get them.
Unless the committee understands the level of cynicism in the people who are willing to make their living out of killing people, I don't think you can look reasonably at the arguments around the table, if indeed there are any of the good folk around this table who are arguing that we should make tobacco available to our children.
Mrs Cathy Birks: I'd like to thank everyone for this opportunity to come here on behalf of the Ontario Respiratory Care Society. I am a licensed physiotherapist. The Ontario Respiratory Care Society represents a number of various health care disciplines. There are nurses, pharmacists, respiratory therapists, occupational therapists, social workers; there are a number of health care professionals in this organization.
ORCS has taken a very strong stand regarding tobacco and tobacco issues and has put a lot of energy this year towards supporting this legislation. I am here today to again speak for ORCS in saying how important the Tobacco Control Act is. It's very important that we increase our control of tobacco and decrease the accessibility to our youth.
As a physiotherapist, I've spent a lot of time at West Park Hospital on a respiratory program and have worked on an ongoing basis with people who have very severe respiratory disease. Just about all of them have had significant smoking histories. They are very despairing when I talk to them about what's happening and they see young people starting to smoke, because we do know the facts now and the youth of today are being educated, yet they still start smoking. They feel very strongly that we should and have to do all we can to restrict access to tobacco for our youth.
It's very interesting, because in preparing for this and thinking all this through, when I was in high school and in junior high school, I remember very specifically in health class that I had sessions on tobacco, on how much it was going to cost, on what the health care effects were and on why not to start smoking. I was an athlete in many sports and I was a very strong student. I didn't start at the time of my friends and I resisted peer pressure, but there was a period in high school where I actually smoked, not for a long time; I decided it wasn't for me and I was going to stop. Even though I smoked very little and for probably less than six months, it was hard to stop. I found that I missed it in such a short period of time.
We talk about education. I don't think that's enough. We really have to take a firmer hand in controlling it.
Also, now I have asthma and it's very much aggravated by cigarette smoke. It's very important that people are protected from smoke.
I just want to share with you something that was in the Toronto Star this morning. Normally, in the obituaries you see in lieu of flowers people make reference to making donations to various charitable organizations. There's a gentleman who passed away this week and in his obituary it reads, "In memory of Roger, please give careful consideration to quitting smoking one day at a time, as all his doctors have said that secondhand smoke shortened his life." People are suffering and they're dying. This gentleman was only 54 years old. That's very young, in my books. I think there are a lot of premature deaths and a lot of other morbidity caused directly from tobacco use.
As a physiotherapist, I don't just assess and treat people with lung problems; I look at the whole body. As such, I treat musculoskeletal problems. We look at the cardiovascular system and the circulatory system. Cigarette smoking has such a dramatic impact, and at West Park Hospital we treat many conditions. We have a neurology unit and an amputee unit in addition to a vast respiratory program. Through my rotating experience at that hospital, I've seen so much suffering. The most frustrating part is that a large part of the suffering and the deaths that I've experienced could have been prevented or at least been not as severe, had these people known of the dangers of smoking and not started smoking or cut back on smoking when it was soon enough to reverse some of those negative effects.
In your package, I want to refer to this picture. I didn't choose this picture, but actually when I saw it, it was most appropriate. This man's name is Stan and I worked with Stan at West Park Hospital on a number of his admissions, back in the day when he had pretty good exercise tolerance for exercise programs. We built him up so that he could do several laps of our unit in a six-minute walk test. But I also watched, over a four-year period, significant deterioration in this man.
The last sessions I worked with him, he was so debilitated from his disease that he could barely get out of his chair to go to the washroom, not only because he was so short of breath but because he was in such pain because of osteoporosis. Most of his vertebrae and ribs had fractures. I even felt with my own hands how with a simple cough, the simple effort to cough, which was an incredible effort in itself, this man cracked a rib. This is his daily existence. This is the kind of suffering caused by tobacco products. It's very important that we try to cut back and prevent the youth of today from this same kind of suffering and agony.
The other thing is the cost of this. The health care community is under such pressure with cost containment and yet we are allowing and not regulating enough the sale of a product that costs the Ontario health care system so dearly. When we talk about economics, we really have to address this issue.
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As a representative of the Ontario Respiratory Care Society, I mentioned that we represent pharmacists. I spoke in the last 10 days to pharmacists from London, Tillsonburg, as far north as Sudbury, east to Kingston and some in Toronto. I left messages and those I couldn't reach called me back.
These pharmacists are very much in support of the anti-smoking campaign. They are very aware of the issues. They all acknowledge receiving a wealth of information from their college, long before this tobacco act came in. They know their college has been advocating this for a long time, and they spoke very much in support of what we are doing here today, in support of the Tobacco Control Act.
There were a couple of people I didn't reach and I just heard back from them in the last couple of days. Their answers were even more emphatic. The pharmacists who are represented by ORCS feel very strongly that we do need to regulate and that it is inconsistent for a health care professional whose interest is providing health care to individuals in our communities to profit from a product that in fact causes health care problems. These pharmacists agreed with those concerns.
I would like to point out a similar analogy. As a physiotherapist, if I worked in a community setting with an orthopaedics practice, it would be equally inconsistent for me to endorse or promote the sale of a product that I knew was inadequate, for instance, a piece of fitness equipment that could result in musculoskeletal injuries because it was poorly designed. I could make a good profit on it because it was produced cheaply, yet that could then contribute to my clientele base because these people would have to come for treatment for musculoskeletal problems. I think there's a comparison there. It would be inconsistent or unethical behaviour as a licensed health care professional to profit from that kind of activity.
One last point is that there is a lot of concern about economics. I've heard arguments that there are certain assumptions when you go into a business. You anticipate sales of certain products and then they're taken out from under you. As a health care professional who works in a hospital setting, a year or two ago -- I have a house, my mortgage and a lot of expenses -- I never dreamed of the social contract or that I would have my salary rolled back and that I'd have to take days off without pay. But as health care professionals we all take responsibility in reducing the costs of health care and rallying together as health care professionals to ensure good health for all the people of Ontario.
In closing, on behalf of the Ontario Lung Association, the Ontario Thoracic Society and ORCS, it's imperative that you consider all the aspects of this legislation. It's very important and we really need to address these issues.
Ms Sharon Murdock (Sudbury): Thank you for coming this morning. I'm always impressed at committee hearings that people, particularly in the health care field, who are generally working hard every day, take time out to come and make presentations. It just demonstrates even more clearly how important an issue it is.
On page 4 of your presentation you say: "We strongly endorse raising the legal age for buying tobacco products to 19, the improved packaging and placarding of the health hazards, the prohibition of vending machines, the appointment of inspectors and progressive penalties for repeat offenders."
I want you to comment on that, but I also want to tell you that in my riding -- I was speaking to my constituency assistant last night; I'm from Sudbury -- my constituency assistant was telling me that the Lucky Strike days are not over, because there's a survey going on for extinguishable cigarettes.
I don't know whether it's happening elsewhere, but it's happening around the university in Sudbury, which is a telling point. There are 10 cigarettes in one half of the package, and in the other half of the package is an extinguisher. It's a twistable filter so that you can make your smokes last longer. That's the sales pitch. You smoke half of it and then you stick it in the side of the package, she was explaining to me, and you twist it off so you can save the other half of the cigarette for later.
If you fill out the survey form, they are giving them a carton of cigarettes as a thank you. So those days are not gone, and the 10-cigarette idea too for the poor pockets of university students is very appealing, so it's not just kids.
Dr Webster: Kiddie packs are what I was referring to. A university student is one thing; it's kids in public school we're talking about. They take it up at 11 and 12.
The extinguishable cigarettes go back to a little story from a violinist friend, the previous conductor of the Boston Symphony, when he was playing the piano for my old friend. He used to have a little pair of scissors and he would cut off the end of his ash so that he could put it away. Saving the last drop is one thing, but having the last drop in an ashtray where the kids come by and pull it out and smoke it is another thing. If the people who can afford it cut off their ash so they don't make a mess and then they leave the thing around, kids are going to pick it up.
Ms Murdock: There has been some talk about not liking 19 as the cut-off age. I know you didn't mention it, but what comments do you have to make on that?
Dr Webster: That's a social issue. When does one become old enough to make a fool of himself? I don't know. You're the social experts, I'm not. I'd like to see it as hard as possible to get hold of cigarettes. You know as well as I do that raising the price has been the most effective way to get people to stop smoking. The limit on raising price has always been the fear of contraband. If you've been listening to what's going on in Quebec, where all the people who want to sell cigarettes legitimately are up in arms because so much contraband is coming in that they can't sell them legitimately, there's no question that this is a difficult social problem.
We have let loose in our society people who are willing to make money at the expense of others. We're only a Legislature here, and these folks can only write laws. You can't change people's hearts. We try advertising, and you guys have tried with an advertising campaign and we're really pleased to see that, but what legislative authority you have should be used in a healthy fashion.
Ms Campbell: I wonder if I could ask Ms Murdock to clarify. When you said there was a question about the age of 19, do you mean that maybe some people would like to have it higher, that they should be 25 or 40? Would I ever love to be refused permission to buy something because of my age.
Ms Murdock: I think it was the OMA that was here yesterday -- I can't remember which particular group -- that was talking about 21, but 19 being the age of majority where you'd have to have a card and so on. Then some people are arguing that you can't do that.
Ms Campbell: If we had our way, we would like to see tobacco not available at all for sale to anyone, anywhere, but that's not happening right at the moment and is not likely to happen in the next little while.
It is difficult too that we have so many ages for things for young people between 16 -- well, even from 14. You can babysit at a certain age, you can be left at home at a certain age, you can be left in charge of other children at a particular age, you can drive at one age, you can drink at another age, you can vote, so it's a very difficult thing to say. I think the higher the age, the better.
Ms Murdock: One of the presentations yesterday was that if you could stop someone from smoking by the age of 20, 20 would seem to be the levelling-off age, that after that they generally wouldn't start.
Ms Campbell: Yes, there is evidence to support that, that if a person has not started smoking by the age of 20, they are very unlikely to start.
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Mr Dalton McGuinty (Ottawa South): I want to thank all three of you for your presentation and for reinforcing -- it's funny; you wonder if it still needs to be reinforced but obviously it does -- the significant degree to which tobacco has caused harm to our population. One of you spoke about the inconsistency of pharmacists selling tobacco. I don't think there's any doubt there is an inconsistency there, but I think government has to share some of that blame too.
We generate one heck of a number of dollars here through tax revenue based on people smoking. We have allowed, we have encouraged, we have promoted, either explicitly or implicitly, the development of a tobacco industry in this province over the years. We have allowed people to get jobs there. People feed their families there and send their kids to school there. We've developed all of this. The problem of course is dismantling this.
What is your vision? How are we going to eliminate tobacco from the province of Ontario without putting walls up around this province and in spite of all the pressures that take place, both internally and externally? When will it happen?
Dr Webster: Inch by inch. As I said in my written deposition, ideally everyone would be reasonable, but the facts of life are that we've got a lot of people out there who are hooked on the stuff. We have to use our wisdom to get it controlled as best we can. We aren't the old Soviet Union, no question, but the thing that I understood to be at question here -- if you read the laws, they're sometimes just as bad.
If we can't, as a Legislature, protect a legislated, regulated health care profession from being forced to do an unethical act by a company that is deep into tobacco, I think we've got a little problem with moral backbone. That's all. The only reason I say that is that my gossip was that you were considering dropping the pharmacy thing. Everything else we're happy with.
Mr McGuinty: I have raised that question, as you may be aware, time and time again. I would be more than pleased if the government members were to recognize that we are going to be putting some people out of work. There's a cost associated with this, and maybe a large number. I just would like that recognized. We'll be hearing from the next presenters in that regard. I would just like them to stand up and say: "Yes, we're putting people out of work. We're prepared to recognize that. But we think in the grand scheme of things it's worth it."
Ms Campbell: I wonder if I could just address the question of vision. I mentioned in my introduction, and I'd like to come back to it, that the key as far as we're concerned is young people. If we can get to the point where we have a generation of non-smokers, which is what we've been working for, then eventually tobacco will be a non-issue.
The times they are a-changing, as Bob Dylan said; not as fast as we would like, but things are changing. Markets change. People learn to cope. I've just come back from a month in New Zealand. I'm sure you all know the tremendous economic difficulties they had, and yet I did not see a country falling apart. I know they have problems, but what people said to me over and over again, particularly about the farmers who had been heavily subsidized and now are not, was that there is no one who can farm more efficiently than a New Zealand farmer.
People learn to cope. People learn to adapt. But I can't reinforce too strongly this whole idea that if we can keep young people from starting to smoke, then we can eliminate the whole problem and our society and our economy will change in the process.
Mr Jim Wilson (Simcoe West): I wasn't planning on asking you a question until you talked about morality. I have a degree in political science and one in theology. I spent five years studying moral and ethical questions, so I always appreciate how the words are used.
As you know, both opposition parties and the government are united on almost all aspects of this bill except the pharmacy provision. As a legislator, am I not morally obligated to try and keep the people of this province employed? Is it not morally and ethically wrong, in face of the fact that I don't have any proof that banning the sale of tobacco products in pharmacies will in any way decrease consumption? If I have no proof of that, other than hearsay and anecdotal evidence, should I allow a section of a piece of legislation to pass that may put people out of work? The same health professionals who talk about smoking also have an obligation, and rightly so, to talk about the pitfalls of unemployment. If the moral and ethical thing is to be used on pharmacists, then we have to apply the same principles across the board.
Dr Webster: No, we're not putting the moral and ethical things on pharmacists. What we're trying to do is protect an ethical, organized health care profession which acts in the interests of the people, under legislative control, and which is being forced, against its will and against its stated ethical principles, by a company that is making money out of tobacco. You guys can't continue to run a ministry if you're making money out of what the ministry is doing.
We're talking simple stuff there. We're not talking deep moral problems. We're saying: Is this Legislative Assembly empowered to control the health care professions? Are you responsible for controlling the health care professions? The health care professions have a body that is duly operating under law and has said it is wrong for pharmacists to sell cigarettes, but its own members are being forced to sell cigarettes by somebody who has clearly a painfully obvious interest in selling cigarettes. That's simple.
Mr Jim Wilson: I don't think they're being forced --
Dr Webster: Name one Shoppers Drug Mart where the pharmacist can say, "I will not sell cigarettes."
Mr Jim Wilson: Let's take other pharmacists, though, independent pharmacists. I don't think they're being forced by big tobacco companies any more than the rest of the entire retail market is being forced. All they're saying is that you must recognize the retailers.
Even the Ontario College of Pharmacists appeared here on November 29 saying: "We want a definition of the term `patient' in the sexual abuse bill because we don't consider everyone who walks into our store a patient. We only consider that when there's contact between the customer and the actual pharmacist, not the clerk or something, that's when a patient relationship occurs." Of course, we got into the whole debate on whether they could date that patient, but they certainly felt it was okay to date the customer who came in to buy cigarettes and gum and that, because they realized they were a retail customer, not a patient in the health care sense.
Having been through that argument with the board, I find it inconsistent to now come and say, "Look, the entire thing is a health facility and we should ban the sale of a legal product in the entire store," even if that may be a Zellers store with a pharmacy at the back and the rest of it selling clothes and everything else that Zellers sells.
Mrs Birks: I just want to briefly respond to the question about jobs and the issues there. As a health care professional in one of many different disciplines in ORCS, a number of our members actually have lost their jobs over the last couple of years and had to seek new employment, look at their resources, because of various changes, be it cutbacks, social contract, the redirection of long-term care.
There are a lot of changes, a lot of dynamic processes in health care right now and they're affecting a lot of health care professionals who are having to deal with that, having to reassess their skills, the different markets they can be in, in order to make a living. I think the issue spans many different groups, not just the pharmacists and the tobacco issue.
Mr Larry O'Connor (Durham-York): One very brief question, Ms Birks, because you said you talked to a lot of pharmacists. Did any of them come to you and say, "I'm going to go out of business because of this legislation," or did any of them say, "I've been approached by" -- maybe one of the organizations like the Committee for Independent Pharmacists, which will be coming before us later on -- and say, "These people represent my view," or did you hear anything to the contrary?
Mrs Birks: No. The people I spoke to, these pharmacists, are all members of the Ontario Respiratory Care Society. Please understand that these are people who are volunteers, who have paid a fee to help promote respiratory health in Ontario. These people are all pharmacists who are very committed to this. No, none of them had been approached. As I said, we're in support of this legislation.
Mr O'Connor: Going out of business?
Mrs Birks: No. Most of these individuals are employed in hospital facilities.
The Vice-Chair: Thank you for your presentation. We've run out of time.
Mr Ted Arnott (Wellington): Mr Chairman, I have a brief question for the parliamentary assistant pertinent to the committee's work with respect to a study they were talking about on CBC Radio this morning, a British study that was done to determine the link between smoking among pregnant mothers and, actually, their grandchildren. I wonder if the parliamentary assistant knows anything about it and perhaps he can instruct our researcher to give us some information on it.
Mr O'Connor: The study that was referred to this morning will certainly be of interest to all the committee members. I would instruct legislative research if it could take a look into that and provide that or a synopsis of the report so that we can use that in our deliberations, because I think it would be most useful. Thanks for the question.
The Vice-Chair: I would also advise that staff has obtained and circulated to you copies of the United States EPA report on environmental tobacco smoke that was referred to yesterday.
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COMMITTEE OF INDEPENDENT PHARMACISTS
Mr Larry Rosen: My name is Larry Rosen and I am a past president of the Ontario Pharmacists' Association. I'm currently a practising independent community pharmacist. I'm involved in the operation of five pharmacies in west Metro, Etobicoke and Mississauga.
Together with my colleagues here today, Mr Aldo Anzil who operates the Courtesy Drug Mart in Clarkson, and Mr Bernie Ceifets who operates -- they are both the owners -- York Pharmacy on Jane Street in Toronto, the three of us were instrumental in forming the Committee of Independent Pharmacists in response to the adoption by the Ontario College of Pharmacists council on October 13, 1990, of a policy calling for the elimination of tobacco products from pharmacies.
We felt it necessary to start our committee because there had not been any prior discussion from college council members on this issue with the practitioners. I'm talking about community-based practitioners. I'm not talking about the hospital practitioners the lady from the lung association was referring to. I'm talking about the community-based practitioner, the practitioners most of you meet day to day, face to face.
Since then, we have communicated by way of letters and telephone with the approximately 1,400 community pharmacy owners in Ontario who sell tobacco products. Appendix A of our submission contains a fuller history of our committee, which I'll leave for your perusal.
For our submission and presentation today, the Committee of Independent Pharmacists commissioned the firm of Coopers and Lybrand to carry out a study to examine the economic impact of the provision in Bill 119 which would prohibit the sale of tobacco in pharmacies. A summary of the results of that study constitutes a major part of our comments this morning, as well as our submission. The full study forms an appendix to our submission, which you will have.
Our committee and the pharmacists we represent are opposed to the banning of the sale of tobacco in pharmacies. We wish to emphasize that our position and our comments are the result of our conversations, communications and networking with our colleagues across the province, as well as being predicated on the Coopers and Lybrand study. We want to make it very clear that as pharmacists and as health care providers, we believe we do have a responsibility to deal in a professionally responsible way with the issue of tobacco use in society today. We believe pharmacists should be working constructively and meaningfully towards the long-term goal of eliminating tobacco consumption.
We support the objectives of the government of Ontario as reflected in the Tobacco Control Act and want to participate with the provincial government in helping to curb tobacco use. However, we believe that eliminating the sale of tobacco from pharmacies would have no effect whatsoever on tobacco consumption in this province.
As the Coopers and Lybrand study illustrates, prohibiting pharmacies from selling tobacco will have a seriously negative economic impact. People will lose jobs. Pharmacies will have to restrict their hours of operation and perhaps curtail some of the services they presently offer. Some pharmacies may very well go out of business. Governments will lose tax revenue as a result of reduced revenue of pharmacies.
I would now like to introduce Mr William Rutsey of Coopers and Lybrand, who is here to present the material from the study his firm carried out for us on commission.
Mr William Rutsey: I'm Bill Rutsey. We're here to present our analysis. In order that it be user-friendly to the government, we enlisted the services of Dr Atif Kubursi from McMaster University, who has developed the regional impact model used widely by various Ontario government departments. Inputs for the model were developed from both existing information and new data. Based on the analysis performed, we estimate that approximately 2,700 jobs may be lost and more than 100 pharmacies may close. These jobs will not be replaced in the economy and taxes of $165 million annually will be forgone.
I'd like to introduce Eric Leonard from our retail consulting group, who will lead you through the input-gathering process. Following Eric, Dr Kubursi will explain the outputs, after which time we will be more than happy to answer any questions you might have.
Mr Eric Leonard: To determine the economic impacts that Bill has just mentioned, as well as the other economic impacts that are documented in our study, we collected data and information from numerous sources. These include Statistics Canada, the Eli Lilly annual survey of community pharmacists in Canada, and we conducted interviews with independent and chain pharmacies. We requested and received information from various organizations and government departments, including the Ministry of Health, the Ministry of Revenue and the Ontario College of Pharmacists.
In addition, we also undertook our own empirical research. This took the form of a survey of independent pharmacists, as well as the study of tobacco companion sales in Ontario. The result of our research and investigations was a comprehensive, statistical understanding of pharmacy in Ontario.
I'd like to explain our study of tobacco companion sales, which was a component of our overall report. Tobacco companion sales are products sold to customers at the same time as tobacco is purchased; for example, a chocolate bar and a tube of toothpaste bought at the same time as a package of cigarettes. To estimate the level of companion sales, we collected over 3,300 tobacco sales receipts from 12 independent pharmacies across Ontario. From these receipts, we determined that approximately 39 cents was spent on companion products for every $1 of tobacco purchased.
On top of this, we also obtained the results of a survey conducted by a chain pharmacy on this same issue. The results of their survey of 32 stores indicated that tobacco companion sales were approximately 38%. Based on these two sources, we've used a conservative estimate of 37.5% tobacco companion sales in our report.
The reason we've done this is that if you prohibit tobacco sales from pharmacies, pharmacies would not only lose the tobacco sales volume, but they would also lose a portion of these companion sales. Using the results of our research as inputs to the province's regional impact model, we looked at various scenarios, including the loss of 75% of these companion sales and the loss of 25% of these companion sales. The pharmacy job-loss figure that Bill quoted to you of approximately 2,746 full-time and part-time jobs is based on a conservative scenario of 25% of companion sales.
I'd now like to ask Dr Kubursi to explain in a little more detail the impact model we used in our report.
Dr Atif Kubursi: The point of departure of the study is that ultimately pharmacies are business concerns. They have to meet the payroll, cover the cost and return a profit to their owners. Their ability to adjust their cost to their revenues depends on time.
Economists make a useful distinction between the short term and the long term. In the short term, this is a period short enough that it's not possible for operators to adjust the scale of their operations. They can't adjust their sales and their revenues in tandem. In the short run, there are certain fixed costs they have to meet, and therefore the impact of any particular loss in sales on their operations would depend on their ability to adjust their costs.
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In the short run, being unable to adjust fully their cost to their expenditures, they will adjust only that proportion of their expenditures, their costs that they're able to, and this happens to be labour costs. In the short run, we were able to trace the impact of this on pharmacies and then on the economy at large.
The basic model is an input-output model. It's one that portrays the economy as a complex network of interacting sectors. It's an accounting system. It's one that is published regularly by Statistics Canada. It's premised on three basic assumptions:
(1) The initial impacts are a poor estimate of the full impact, that because the economy is an interacting network of sectors, any particular decline in activity in any one component part tends to circulate and recirculate within the economy, magnifying the impact in the economy from the original cuts.
(2) Different activities involve the use of different scarce resources, and in this respect you cannot generalize from one sector to the other. Each and every sector is a unique activity in the economy.
(3) Impact analysis is the closest time an economist becomes an alchemist, in the sense that there is a chance here of talking about creation of something out of nothing. In this respect, it's very important to outline that these impacts are very much dependent on the level of economic activity and on the underlying assumptions about how the economy operates. If you have an economy that's fully employed and fully flexible, any particular change in any one sector would likely be made up and compensated for in other sectors. Alternatively, if you were to prime an economy when it is fully employed, there will be no changes in its employment position; all changes will be reflected in prices and inflation.
What we've tried to do here is to take these changes in tobacco sales, which represented about 7.8% of the total sales of pharmacies. We're talking here about the sector as a whole. We're not talking here about any particular pharmacy, or a group of pharmacies or subgroup; we're talking about the sector as a whole. There are pharmacies that sell 40%; for some, 60% of their sales is tobacco; for some, as you know, a good number of them, don't sell tobacco at all. This number we're talking about is a weighted average of those selling tobacco between being independent and being a chain.
What we found is that in the short term they're unable to adjust their rent and they're unable to adjust their heating and lighting. They're not going to be able to adjust all their costs. Some of these costs are fixed. Ultimately, we found that the brunt of the adjustment will most likely be in labour costs and jobs. We've estimated that in the short term there will be about 388 jobs that would be lost at pharmacies and -- I'd better be careful here -- person-years of employment, because jobs depend on the mix between full-time and part-time jobs.
If you look at the long term, and looking at the thin, bottom-line margin that pharmacists operate with, 4.3%, it is unlikely that if they were to suffer an 8.5% decrease in tobacco plus companion sales, and we've chosen to look at the conservative estimate of only 25%, it is inconceivable that to maintain their profitability they would not cut, when it is possible for them to cut, their costs by 8.5%. When you do this at pharmacies, you're going to lose 1,363 person-years of employment, which is translated to about 2,746 jobs: 683 full-time, and about 2,063 part-time jobs.
The upshot of this is that this would not stop at the pharmacies' gates. Because of this impact system we have that traces all the interactions among sectors, this original change would be magnified in the economy to a much larger one.
Surely one would come back and say this loss in employment, loss in income, ultimately loss of taxes, would be made up by competing or other activities coming on stream. In the short term, we feel this is perhaps most unlikely, particularly for three reasons. We did not, by the way, say that once you didn't sell tobacco at pharmacies, it would not be sold elsewhere; no, we assume it would, but where would it be sold elsewhere?
We really thought it would go into basically three activities: one, to the underground economy, and there you don't have any measure of it to speak of or way to count; to the overworked economy through the mom-and-pop stores, which is not going to mean much change in employment; or to the other sectors, which we felt really represent such a small proportion of the total sales, because pharmacies collectively are about 12% of the total. In this respect, you don't expect there would be any compensating activities coming through.
Mr Rutsey: Just to make that a little clearer, of the pharmacies that sell tobacco, approximately 12% of independents' and 6% of chains' sales are tobacco sales. On an average basis, that works out to, I believe, 7.8%. When you distribute that across the other retail sectors, such as the grocery stores, gas bars and industries of that nature, if you distribute those sales in the pattern in which they currently occur within those other subsets of the retail market, their increase in sales in each of those elements is less than 1%, something of the magnitude of 0.4% or 0.8%.
That level of increase of business does not usually translate into a level of increase of employment in those sectors. So although this number is a relatively large number in terms of the pharmacy sector, ie, at the independent level, over 12%, in a sector that's operating on a net operating profit level of 4.4% of total sales, that certainly will have a deleterious effect on employment within that sector. However, when you spread those sales out across the rest of the economy, when each of the other sectors picks up less than 1%, there's little likelihood that jobs will be created in those other sectors.
The Wal-Mart theory of retailing might be a good analogy. I'm sure that everyone is spending a lot of time thinking about what the implications are. We're not here to talk about that, but it's good shorthand for looking at the way these sales will be transferred through other portions of the economy.
Dr Kubursi: Basically, there are two things I want to conclude with. One is that the prohibition of tobacco sales should not really be seen, particularly in the long run, to be a marginal adjustment; it represents a complete shutdown of an activity.
As an economist, I would really say that in most likelihood there would be a commensurate change in the expenditures and the operating performance of pharmacies. Here what we're really talking about is not only in terms of tobacco. Tobacco could be resold other places. It's just the fact that you don't have these particular revenues any more. You're just going to cut your cost by this much to maintain your profits. If this is the general observation about how business is run, this is the likely outcome we foresee, and in this respect we predict a very large reduction in jobs as the system churns around the implications of this.
Mr Rutsey: Finally, what we were also asked to do was take a look at what the impact has been of the social contract and the expenditure control plan of the province. We've done that as well because from our client's perspective three things have happened, not one thing in isolation. Our study also has our findings with respect to the impacts of those two other items. It's our position or conclusion that these things really can't be looked at in isolation, that it's not just additive, that it could be multiplicative.
We'd be happy to lead people through our analysis around that issue, but I think we're here to talk about Bill 119 so we haven't really said too much about that. But we have done work around that that we'd be happy to share with you or discuss with you, and it is in the study.
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Mr Rosen: I want to provide sufficient time for questions because I know that's important, but before we reach the question period, there are just a few statements I would like to make on behalf of the committee.
Prohibiting the sale of tobacco in pharmacies would not result in reducing tobacco consumption by the public, because as has been indicated and as you know, other outlets would continue to sell it while new outlets would begin carrying it because it'll be an opportunity for them.
There are presently 28,000 retail establishments in Ontario where tobacco is currently sold, and that's not counting the underground market that we have no tab on. In fact, many new retailers that have never previously sold tobacco would aggressively begin to sell it. I think you can see that in the advent of tobacco inside service and gas stations. It's within the last three or four years that almost every gas station now features tobacco at an extremely competitive price, an extremely competitive legal price, shall we say.
We find this act as it's written is discriminatory against pharmacy. Prohibiting tobacco sales in pharmacies is discriminatory. It would remove the product from a responsible retailer, the pharmacist, who is experienced in dealing with dangerous and controlled products and is the one who is least likely to sell the product to those under age.
Pharmacy is an already beleaguered profession. Removing tobacco, along with the other effects that have been put forward by the social contract and the reduction in fees paid to us for our services in a professional capacity, will have a punitive impact on pharmacy's ability to serve the public. While enduring increases in fixed and operating costs as well as much higher inventory costs, pharmacy's ability to increase professional fees for service has been held in check by government controls.
In addition, there have been cutbacks in the Ontario drug benefit plan, in fees paid to pharmacies, and changes in classification of drugs that are no longer of benefit to the public. This in itself has reduced pharmacy revenues substantially.
A large number of products that were once exclusively sold in drugstores are, because of change in their status -- they've been switched from what we call drug identification numbers to GP, or general product numbers; I don't want to go into it. Certain things that were formerly sold only in pharmacies as a controlled outlet are now sold everywhere.
Pharmacists have sought to counterbalance the pressure on their dispensaries by gaining on the retail side of their activities. We've tried to overcome what we're losing in income and profitability in our dispensaries by increasing our activity in our front-shop merchandising. If tobacco is eliminated from our stores, the squeeze on pharmacy will intensify because our competitors can and will increase their offerings of health care and related products. We are already witnessing products that used to be the exclusive preserve of drugstores carried in other retail establishments.
I should add that many independent pharmacists have selected locations which were not appropriate for the major chains, but were vital for patient service and for the public interest in smaller communities and in secondary locations throughout Ontario. They are severely threatened by this legislation as well.
While we recognize that tobacco use is a very important health issue, we believe that the thrust to curb its use must be driven by education, not by prohibiting its sale in pharmacies. If the goal of a smoke-free society is to be achieved: education, education, education. If it's going to be cool for kids to smoke, kids are going to smoke. We've got to change the outlook towards tobacco in young people.
We therefore offer two recommendations for changes in Bill 119. We believe that the decision to sell tobacco should remain at the discretion of the pharmacist-owner, and that pharmacists should spearhead a drive by legitimate tobacco vendors to help finance an information campaign through the media to educate Ontarians to stop smoking.
I want to thank this committee for the opportunity it has given us to make our presentation. We'll now try to answer any questions you may have of my committee members or of our consultants.
The Vice-Chair: There's a short time for questions: one question each per member if we could, please.
Mr McGuinty: Given the importance of this presentation and the fact that we have the first introduction of what I think are some objective data on this, perhaps we could extend the time frame. I would certainly be prepared to do that.
Gentlemen, first of all, thank you for the study. I'm not an economist. It surprises me that the government did not conduct its own study to look at what will be a downside to the pharmacy ban. But I want to question this a little bit.
We're talking about 2,700 total jobs. When they talk about probability, statistics or polls, they talk about a plus and minus figure. Let's say we bring in some other economists. What kind of variation are we talking about here? And is it possible to reduce sales 7.8% and not have an adverse economic impact? Can we do it in such a way so we don't lose any jobs?
Mr Rutsey: Let me give you a short answer first, because I'm not an economist either. The reason we chose Dr Kubursi, as we said, is because he has written the economic impact models for a number of ministries within Ontario. He's intimately familiar with the Ontario economy. We wanted to use modelling techniques the government was familiar with.
The second question you asked was, would different studies produce different results? Yes, just like in court, every time you get an expert witness, you've got an expert witness who can refute the expert witness. What we wanted to do here was that we wanted to put the information on the table in as close a fashion as the government of Ontario is used to in analysing and looking at these matters.
I'm going to let Dr Kubursi give you a much more technical answer, but that was the approach we tried to use. We weren't trying to create rocket science. We tried to do this in as neutral a fashion as possible, using the economic models for the province that are most often utilized in studies of this nature.
There's a longer answer that the economist will now give.
Mr Arnott: We're constrained for time, so I just want to ask you a quick question. I think it's great that you've done an economic impact study and I think the government should give consideration to it. Was there any consideration on your part of surveying the vast numbers of pharmacies that have voluntarily gone out of the business of selling tobacco over the last numbers of years, whether based on their own ethics professionally, or perhaps the recommendation of the college? To me that would be hard, empirical evidence too, the direct impact they've had as a result of voluntarily withdrawing from the sale of tobacco.
Dr Kubursi: Maybe I'll answer Mr McGuinty first quickly, and then I'll let Mr Leonard -- I did not collect the input data and maybe he can answer this.
First, as an economist, let me say this up front: I share your concern about economists portraying themselves as if they were dentists and coming with the drill to the cavity. We're much more like bulldozers and hopefully going in the right direction. The error margins are wide, and one has to really say that up front.
But let me tell you this too, that we really have two options here. We can sit back in our chairs and say there will be 10,000 jobs lost, or 5,000 or 5 jobs lost, or we can really go and use the actual data we really have.
What we have here is an accounting system that is developed and disseminated by Statistics Canada and a model that is well recognized as the technique one can use. It is as good as the data you put into it and the assumptions upon which it's predicated. I would vouch for the data, because we tried as much as possible to cross-check the data we got and looked at exactly what would be the average number of dollars that are associated with tobacco sales and how these are sustaining these sales.
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The assumption which is extremely important here is that in the short term we don't sell tobacco; it's now sold by somebody else. Will all these jobs expected to be lost at pharmacies and outside the economy be made up by the alternative sectors that are picking it up? It is our considered judgement that they would not. It may be going into the underground economy, it may be going into the overworked economy. Again, it's spread over so much that it does not represent any major substantive change to warrant any increase of a commensurate amount in jobs as would be lost in pharmacies.
The other one, in the long run, would also again use an average, basic ballpark figure and one that is also, in our view, defensible in the sense that, if you cut a particular amount of revenue, then if you want to protect your profits that you consider to be what would keep you in this business and not to go elsewhere, you have to cut a commensurate amount of cost. Once you cut these costs, these have to percolate through the economy.
Now, given sufficient time, and other activities come on stream and one can bring a convincing argument that they would be exactly of the type and magnitude of those lost pharmacies, then perhaps some of these numbers would have to really be watered down. But in terms of the way we've really looked at it and considering the alternatives, it's our considered judgement that this is an average number that we will hang our hats on.
Mr Rutsey: Now Eric will try to answer Mr Arnott's question.
Mr Leonard: What we're looking at here, to answer a couple of parts of your question, is not the ethics of the issue; we're looking at the economics of the issue. In order to look at today's picture of the market, 1,400 pharmacists sell tobacco. We have determined the volume of tobacco sales that flow through those stores. We have done a survey of those pharmacists to determine what portion of their sales are tobacco and to determine what portion of companion products are sold along with that tobacco. Whether other pharmacists do not sell tobacco is not an issue and doesn't make a difference to the actual numbers in our report. That was their own choice. We've looked at those who sell tobacco today and the implications of this bill on them.
Mr Arnott: To me, the best empirical evidence you could find would be an assessment of what the effect has been for the pharmacists who have already voluntarily gotten out of the sale of tobacco.
Mr Rutsey: That may or may not be correct, because what we wouldn't have is the empirical evidence from every store in Ontario with respect to what volume of their sales constitutes tobacco. Someone has a very low sales volume of tobacco that may not impact that store at all. A store may have had a larger impact and it may have made some other changes within its activities. Certainly, there would have been some element of a reduction of payroll expenses.
Rather than try to do it on a one-off basis, which may in fact skew the modelling, we did it on a province-wide basis, on a more statistically valid basis. We used the entire market and what the impact would be rather than trying to pick a few and then off that model for the rest of the province, because that is not a valid way of conducting a survey or a study of this nature.
Mr Rosen: What I wanted to suggest to you is that of the 800 pharmacies we noted that do not sell tobacco, a majority of those pharmacies have never sold tobacco. It's the way your practice evolves. If you're a generalist, as we are, as Bernie is and as are many of those we represent, you provide health care service in the dispensary and provide convenience merchandise in the rest of your pharmacy or the rest of your store.
As it has evolved in our practices, we've always sold a mix of merchandise, tobacco included. In many other pharmacies, from the moment they've opened -- they may be in medical centres or professional locations -- they've never sold tobacco, so the impact of the removal will have zero effect because they were never in that aspect of the business.
For many others and a minority who have stopped selling tobacco -- and more power to them; I don't oppose voluntary cessation at all; I encourage voluntary cessation -- tobacco may not have been a significant aspect of their total mix, as Mr Rutsey has said. I don't know; we have no study on those who have given it up.
The Vice-Chair: We've actually run out of time, but two more short questions, please.
Mr Jim Wilson: Gentlemen, thank you for the study; 2,746 jobs is a lot of jobs. It's a study done by Coopers and Lybrand, the same people the government hung its hat on with respect to introducing casinos in this province, and it's the same type of analysis that the government hangs its hat on when the Premier talks about job creation, in terms of when the government -- all governments -- say they created so many jobs. They take the same type of analysis to the economy. I think you bring real credibility to the debate, because yesterday, you may know, a number of the government members were saying, "You've no proof there'll be job losses." I say that if you're even in a little bit wrong on your estimate, 2,746 jobs is a lot of jobs. You bring us a study done by a reputable firm that the government relies on from time to time. The government has no study of its own and it doesn't in any way, other than hearsay and anecdotal, produce evidence that consumption will go down if pharmacies are no longer allowed to sell tobacco products.
I'll just make that comment and then ask you a question. We hear from time to time -- and I was happy to see, Mr Rosen, that you addressed the issue -- of the monopoly that pharmacies have with respect to dispensing pharmaceutical products and prescription drugs. You mention that at the back of the store essentially your margins are lower and lower all the time, that with the expenditure control plan, the social contract, the changes to the ODB, you're getting hit pretty hard at the back of the store. Now it seems that the government wants to hit you hard at the front of the store, on the retail side.
With respect to the monopoly, can you just address that and why it's necessary for you to keep your sales at least constant at the front of the store or you won't be in business?
The Vice-Chair: Please make your response very short, because we're really over time.
Mr Perruzza: Point of order, Mr Chairman: When you say you're going to allow one question, if that includes a 10-minute preamble which is not relevant at all to what we're discussing --
The Vice-Chair: I'm sorry; you're wasting time, and many members are prone to that, in my view. Can we have a short response, please, because I do have Ms Haslam who has a question.
Mr Bernie Ceifets: I think that a pharmacy is an unusual combination of business and professionalism. A pharmacist wears two hats. He serves the public from his dispensary and unfortunately, or fortunately, in a lot of cases this dispensary is subsidized by his retail part. We are dependent on traffic. We are dependent on sales of non-professional products, which in a way more and more subsidize the dispensing of prescriptions. It's very important to remember that the loss of tobacco is a very serious loss to the cash flow to our business, but it's those companion sales. Right now, that hasn't impacted on us. We've lost sales, like every other retailer or pharmacy, but more so we've lost them not to competitive retailers, not to people who will buy the companion product that we sell.
It's my gut feeling that 80% to 90% of my lost tobacco sales have gone to the underground. These people go and buy their tobacco from the underground: from the car, from the pool room, wherever they buy it. There's no question of age brought up. We've lost the tobacco sale, but we still have that customer who comes back and buys the shaving cream, the confectionery products, and he's still our customer. If we lose tobacco sales completely and they're allowed to be sold by a direct competitor, a convenience store, we lose the traffic from the tobacco sale, we lose the companion sale and we lose the habit of that shopper coming to the pharmacy.
I've been a pharmacist for 40 years, like Larry; I've had a pharmacy for 32 years. It's that habit, that everyday customer who subsidizes the total business. It's the front-shop customer who more and more is subsidizing the professional aspects. That's in essence what our problem is.
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Mrs Karen Haslam (Perth): I am going to do similar to what other people do. I was pleased to see a survey come forward because, to tell you the truth, when I saw the original letter that came out of my township that said 10,000 jobs, 300 pharmacies will close -- now I find that you've come forward and you've scared the bejabbers out of some of my councils. I don't appreciate it.
There was a presentation recently that says they told the municipalities that 300 pharmacies will close, 10,000 jobs will be lost. There is no rational basis for this preposterous assumption. So I looked forward to this type of thing, and then I find out that your survey was 13 independent pharmacies. I really start to question. And I haven't hung my hat on Coopers and Lybrand and what it said about casinos, so I have no bone to pick here, whether I think this company is professional or not. How much did you pay for this study? I think the best study would've been to look at those stores that used to sell tobacco and whether they're still in business rather than looking at what your presumptions are.
I got dragged into this but I'm looking at this as a health issue. Do you agree that smoking has significant negative health consequences? Do you as pharmacists believe that ultimately Ontarians should move towards a tobacco-free society or as close to one as we can get?
Your arguments lead to the presumption that the financial benefit of tobacco should supersede the health benefit, and that to me goes against the relationship that you argued when you came forward saying that you want to be judged as health professionals. When you came to another committee, you said, "We want to be in the Regulated Health Professions Act."
The bottom line is, are you a health professional or are you a retailer?
Mr Rosen: Your first question was the price, I think. That's a private matter between our group and the firm that was retained.
Mrs Haslam: Did you five pay for it? How many members do you have in your organization, in this committee? How many members?
Mr Rosen: We had responses from --
Mrs Haslam: No, how many members are in your committee?
The Vice-Chair: Ms Haslam, will you allow the response? Please answer.
Mr Rosen: We've had responses from approximately 400 pharmacies that sell tobacco in this province.
The Vice-Chair: And they helped pay for this study?
Mr Rosen: They did pay for it -- not helped, they paid for it. What was your next question?
Mrs Haslam: Do you agree that smoking has significant negative health consequences?
Mr Rosen: Yes, we do.
Mrs Haslam: Are you in agreement that we have to move towards an Ontario where this poison, this product, this addiction should be taken seriously and look towards a negative smoking tobacco-free society?
Mr Rosen: We support the position that if the product is to be limited in distribution, it should be totally limited in distribution. It should be sold in tobacco control outlets and not in any competing retailers.
Mr Ceifets: If the government took it seriously, I think it would bring out a law that would outlaw tobacco completely and not pick one facet.
Mrs Haslam: Do you think the timing is right now or is this a first step towards that?
Mr Rosen: This is not a step.
Mr Rutsey: Can I make one closing statement? Our firm's name came up, and from our perspective, we're not pro-government, we're not anti-government; that's not related to the issue. What we're asked to do, what we do on behalf of the government on many occasions, what we do on behalf of the private sector on many occasions is: Given this, what might happen? That's what we attempted to do here. We have no axe to grind.
The Vice-Chair: Thank you very much for that information. We thank you very much for your presentation.
RETAIL COUNCIL OF CANADA
Mr Alasdair McKichan: My name is Alasdair McKichan. I'm president of the Retail Council of Canada, and with me is Peter Woolford, vice-president of the council. In the interests of time, instead of reading the submission, I'll briefly summarize it.
The Vice-Chair: I will be indebted to you.
Mr McKichan: The retail council, just to put it in context, is a trade association whose members among them perform something like 60% of Canada's total retail store volume. Associated with us are some 100 either regional or commodity-specific associations, and the Canadian Council of Grocery Distributors, which is our close cousin, also supports this position.
I'll touch first, if I may, on the issue of children and adolescents in general. As an organization, we some years ago made a strong commitment to doing what we could to discourage young people from smoking. We made a commitment in 1988, when we were appearing before a committee of the federal Parliament, that we would embark on a program which would provide information to retailers, and through them to their customers, to make it quite clear that selling tobacco to minors was against the law. We distributed, to every tobacco outlet we could ascertain, material which conveyed that message.
We renewed that initiative just two years ago and we decided that it would useful to enlist the support of the council of chiefs of police and through it the officers who are concerned with law enforcement and prevention. We jointly made a reissue of that kit, again to all the non-tobacco outlets in Canada. Some 1,100 police officers were involved in the information going to retailers.
We made a presentation in August 1982 calling on the federal Minister of National Health and Welfare to introduce federal legislation which would establish a uniform age for sale of tobacco and we suggested that age be 18 because that was the par level prevailing among the provinces. We're not too concerned whether the age is 18 or 19, but we are concerned with the issue of uniformity. We think it's still worth working towards achieving a uniform age both federally and provincially and we hope that Ontario might play its part in achieving that.
We do, as I've mentioned, strongly support the placement of signs in stores reminding retailers that the sale of tobacco to minors is illegal. The material which you will see in the kits we distributed is not dissimilar from the proposals of your government, and we would suggest that we might together approach that issue and see if we can work out a uniform approach to that information.
I think it would be useful to take advantage of the voluntary cooperation which has been demonstrated in the trade and the fact that we can, through our various retail organizations -- and we enlisted the help of other retail associations which are involved -- achieve very good distribution to the appropriate places.
I'll say a word on the issue of minimum package sizes. We don't have any very strong, predetermined views on this subject, except that there is certainly some demand among elderly people and people of limited means for smaller packages. We don't think the existence of small packs is really going to influence significantly the sale of tobacco to minors. The biggest opportunity for minor purchasing is now in the underground economy. Indeed, this and other measures may really have a perverse effect quite contrary to the intention of the government in relation to restricting the sale to minors.
That leads me to the next point, made halfway down page 5. The major weakness of the legislation in terms of its impact on young people is precisely that it is becoming more irrelevant with every passing day. We know there is a huge and rapidly growing black market for tobacco in Ontario which is going to be completely unaffected by this legislation. Indeed, the greater restrictions may well have the effect of further facilitating the expansion of that contraband market. You have heard, or will hear, from those who have studied this professionally the exact dimensions of that huge market and the consequent loss of revenues to the government.
In addition to that bad effect, there is also the problem of thefts from retail stores and the assaults on staff. This is now a really serious issue for anybody involved in the retail business selling this product. Of course, the products of that illegal activity also find their way on to the black market.
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Let me touch on the issue of environmental tobacco smoke. We've no problems with the issue of prohibiting smoking in stores of any size. That, generally speaking, is a rule maintained by the proprietor of the store, in any event. We do raise the issue of the single-owner-operated store, where the individual may smoke and may not be able to leave the store unattended. It may be you want a de minimis exception for that kind of operation.
On the issue of information about health consequences, we do make the point that the point of sale in any retail store is a very space-limited and attention-limited environment. We doubt whether you can convey two messages at the same time. We doubt also whether it's realistic to load up the point of sale with more than one sign devoted to the tobacco issue because realistically, I think if you attempt to do that, it will simply not be observed in the retail trade and that law may not in fact prove to be enforceable. We would suggest that there be a single message relating to the sale of tobacco to those under 19 years. We suggest other means be used to direct the educational message.
In terms of the subject of your recent discussion, the sale of tobacco in health facilities and pharmacies, we're opposed quite strongly to the proposed ban on the sale of tobacco in health facilities and particularly in pharmacies. Tobacco is a legal product, after all, legal to sell and legal to use. We suggest it's completely unfair to prevent only one type of retail establishment from selling it. This is especially the case because it's highly unlikely that the ban will have any meaningful influence on the level of sales. We believe it will serve only to damage the economic interests of one group of specialty stores within the retail trade. It may make you feel better by passing that law. We think it will actually have no effect or even have a perverse effect on the actual behaviour of the young customers you're attempting to influence. We think it will in fact drive a substantial portion of these sales into the underground economy.
Similarly, we're opposed to the provision which prohibits the sale of tobacco in a retail establishment within which a pharmacy is located, for all the reasons we've stated. It should also be pointed out that in a large corporate store the observance of the sale to minors is probably the most strictly observed of any category of retail outlet.
We've no particular difficulty with the proposal to monitor tobacco sales, but we don't know if it's going to provide you with much useful information.
So far as enforcement is concerned, we are naturally, of course, concerned that we have a law that people will respect and observe. We don't oppose suitable fines for retailers convicted of selling tobacco to minors. We would hope that the fines are not set so high that they drive a firm out of business, recognizing that retailing is a highly decentralized activity. You're dealing with hundreds of thousands of human beings, and all of them are prone to mistakes, not with any actual intent. But we know from experience with laws in relation to advertising, with the display of tickets on products and so on, even with the best intentions in the world, with the hundreds of thousands of people, with the millions of transactions, even if you get only 0.0001% inaccuracy, that still shows up as thousands of infractions in the huge universe we're dealing with. We ask that you bear that in mind in relation to establishing penalties.
We have no objection to the use of orders restraining merchants from selling tobacco when they have been convicted repeatedly of the sale of tobacco to minors, but we would hope that this could be achieved without recourse to a licensing system. Such a system, we know from experience, is administratively burdensome and costly.
In conclusion, we find we can support many elements in the legislative package. We'd suggest that those sections where we have identified issues or problems -- they're either symbolic or they'll have little, we believe, substantive effect on the problems the government is attempting to address. If these issues were removed, we would have no hesitation in supporting the whole package. We'll be happy to respond to the questions of the committee.
Mr Drummond White (Durham Centre): I was very interested in your presentation. I'd like to concentrate on one area, which is the issue of some retail establishments being able to sell and others not able to sell.
This committee heard submissions in terms of the regulated health professions and then, more recently, just a month ago, heard submissions in terms of an amendment to that act. In both those situations we're hearing from pharmacists who are saying: "We're health care professionals. We are apples." Now, the same group is saying: "No, we're not apples; we're oranges. We are retailers." So we, as a committee, have to determine whether they're apples or oranges when they present both.
I'm not asking you to deliberate on that. What I am asking you to do is to comment upon the report we have. We've had some very expensive reports. Yesterday this was from the Canadian Association of Chain Drug Stores. They presented a report which was extremely expensive. Of course, they didn't tell us how much, but they had a video -- a very, very smooth operation.
To quote from that: "Our research indicates...pharmacies are less likely than other retailers to hold dual inventories of both illegal and legal tobacco products," that is, legal cigarettes and contraband cigarettes. But convenience stores, bars and restaurants -- other members of your council say they normally, habitually, commonly sell contraband cigarettes. They contrast themselves. They say, "We're retailers, but we're better than the other retailers."
Further, in terms of the sale of tobacco products to minors, they say: "Pharmacies undertake extensive training of employees to ensure that no cigarettes are sold to minors." However, "convenience stores in Toronto, for example, have been raided many times for selling contraband products. Yet the economic rewards are so lucrative that they remain in the business." They continue to sell to minors, this report says, while pharmacies, drugstores, do not.
On the one hand they're saying, "We're not retailers; we're professionals," and then again, when they say they are retailers, they say, "We're retailers, but we're a cut above the rest."
I notice with the material you've circulated a very extensive campaign that you've undertaken to proscribe the sale of tobacco to minors. I notice in your brochure that you have a number of groups supporting you. I don't notice on that the Canadian chain drug association, Shoppers Drug Mart or any of the other groups who were telling us they're a cut above you.
Mr McKichan: Most of these companies are direct members of the Retail Council of Canada, so they would be represented in that way, whether or not they're also represented in the chain drugstore association.
Mr White: But do they also independently support the association? Do they also support you financially, as these other groups we've noticed?
Mr McKichan: Yes. Not all the members of the Ontario chain drugstore association are also members of the retail council, but many of them are.
Mr White: I'm wondering if you could comment on this issue that this report brings up, that pharmacists and drugstores are better retailers than the rest.
Mr McKichan: I would suspect that in the group you are mentioning, because they are disciplined types of companies, they probably are able to achieve a better level of enforcement than is the case with others who are less professionally directed or managed. That's probably realistic.
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Mr White: Do retailers generally sell contraband materials, as this document indicates?
Mr McKichan: I wouldn't say regularly. I'm sure some do. We're dealing with a universe of tens of thousands and I'd assume, human nature being what it is, not all of them are going to obey the law.
Mr Jim Wilson: It's always very good to hear from the Retail Council of Canada.
I gathered from Mr White's comments that only the government can produce expensive reports and that if anybody else goes about doing anything along those lines it's somehow immoral, wrong or --
Mr White: Point of order, Mr Chair.
The Vice-Chair: Proceed with the question please, Mr Wilson.
Mr White: I just want to point out that this is not a study from the government, this was from a --
Mr Jim Wilson: That was my point.
Mr White: Perhaps he should have listened.
The Vice-Chair: Please, can we proceed with the question?
Mr Jim Wilson: It's an important point because it's exactly what Mr Arnott, my colleague, has said. The government doesn't produce any really meaningful reports when it brings in its anti-business legislation, and yet when some group -- regardless of who they are, as long as they're from the private sector and trying to create jobs in this province and keep people employed, you guys have a bent against them and they can't get out of the starting blocks with their arguments.
I strongly feel that way and we hear the usual NDP nonsense you've been campaigning on for years. Here we have the Retail Council of Canada and you take the opportunity to ask a question about some expensive report, which is the thrust of your question, and not in any other way.
Do you think it would have been necessary for these hearings to have been conducted at all if the government hadn't put in this one anti-business section of the bill? From the opposition comments in second reading and my comments on behalf of my caucus on second reading, we don't have any major disagreements that we couldn't have sorted out prior to these hearings except for this one provision. It seems to me the hearings are boiling down to that. You mention in your summary comments that public support of this legislation would be greatly enhanced if that provision were removed and I want to give you the opportunity to comment on that again.
Mr McKichan: We probably still would have wanted to make some constructive comments and suggestions in relation to the rest of the bill, but in terms of the content of the bill, we think the issue which has attracted the most attention, that's to say the treatment of pharmacies, is obviously the one which is creating the most concern and it's one which we believe, if passed, would not achieve the objectives for which it was conceived: the minimization of sales to young people. To my mind, it might well have a completely perverse effect.
Mr Peter Woolford: Mr Chairman, could I pick up on that for a moment? I think what Alasdair has alluded to at the end is particularly important. We would have appeared regardless, because the government has hung so much of this on deterring young people from smoking, and in our sense, so much of this bill, as Alasdair said in his opening remarks, is beside the point. There is a large, rapidly growing market out there which is eager to serve young people at a price less than half what they can get in any retail store selling legitimate tobacco.
In that sense the legislation is simply wrongheaded and beside the point, and we'd have to make that point regardless of what elements were in there. We're not opposed to them, but the government needs to understand that if it thinks this is going to stop young people from smoking, it's wrong.
Mr Jim Wilson: That's a very good point.
Mr McGuinty: I want to capitalize on your expertise in the retail sector, because I'm not a retailer, never have been. We're not experts, and I don't think any of us sitting in this committee pretend to be, in that area.
We've had one study presented to us, the presenters just before you, so we've got something on the table. Let's say there was an outright ban of cigarette sales and let's just make the next assumption that your cigarette sales constituted 7.8% of your total sales. Could that happen, that outright ban overnight, and not result in job losses?
Mr McKichan: It's beyond doubt there would be job losses, and substantial ones. I think there would be many categories of stores which would go out of business, particularly the convenience store category, some pharmacies, I would assume, some other variety and chain stores for which tobacco is an important commodity in itself in terms of yielding profit but, more important, it is an important traffic inducer. For many stores that's the most important characteristic of their tobacco sales. It's less their profitability and much more their establishment of a visiting practice on the part of their customers.
Mr McGuinty: Just a final comment. I'm sure you gentlemen can read the writing on the wall. It's my fervent hope that some day we won't be selling tobacco anywhere in this province, and any assistance you can lend in that regard would be greatly appreciated over the years.
Mr McKichan: We certainly recognize the responsibility of the industry to bring the appropriate messages in terms of the law to customers, and I would predict that we'll continue to do that. Realistically also we have to recognize that we have a very strong model as to what happens if you attempt to legislate against the inclinations of a significant percentage of the population in terms of the prohibition of alcohol sales. You don't eliminate the sales. You just drive them somewhere else.
Mr O'Connor: I appreciate the work the council's been doing, and these types of stickers and what not are quite useful. You'll note that across Canada the common denominator seems to be heading towards 19, so I guess there will be a need for some changes in this.
I just wondered about monitoring for compliance of this. Did you do any kind of survey, an update, to make sure it's complied with? It is the young people we're trying to protect here.
Mr McKichan: One of the reasons we sought the participation of the Ontario Association of Chiefs of Police was to do precisely that, to enrol the help of the community officers in each municipality. Our experience is that the ability to do that is very much dependent on the nature of the community. In areas that you might say are comparatively law-abiding, it's a relatively high priority. In areas where more serious crimes are prevalent, then willy-nilly it's not so high on the roster of the community police officer's responsibilities. But we felt it was a useful and positive way to bring to the attention of retailers that in fact this was the law and the police were behind it. That seems to have worked to a significant extent.
The Vice-Chair: Thank you for your presentation and for condensing it. We deeply appreciate that.
ONTARIO CHAIN DRUG ASSOCIATION
The Chair: The final presentation this morning will be by the Ontario Chain Drug Association.
Ms Sherry Porter: Thanks very much. We're fighting the hunger pangs too, so it's always a bad time to be on.
Mr Chairman and honourable members, on behalf of the Ontario Chain Drug Association, I would like to begin by thanking you for the opportunity to share our association's view on Bill 119. My name is Sherry Porter. I'm the executive director of the Ontario Chain Drug Association, and with me today is Steve Mezei, who is vice-president of operations for Pharma Plus.
The Ontario Chain Drug Association is the voice of retail drugstore chains in this province. We have 10 member companies which own and operate between them approximately 700 stores in communities across Ontario. OCDA companies employ approximately 9,500 full-time workers and 14,000 part-time workers.
The OCDA supports the objectives of Bill 119. As corporate citizens of Ontario, our member companies believe that the government definitely has a role to play in encouraging progress towards a smoke-free society. In particular, we support the leadership role in educating the public about the dangers of smoking. For our part, we are proud of our record of leadership in providing information about tobacco to consumers and controlling the irresponsible sale of tobacco, particularly to minors.
As you are aware, OCDA emphatically does not support paragraph 4(2)8 of the proposed Tobacco Control Act. This section, which includes retail drugstores on a list of establishments at which the sale of this legal product would be prohibited, should be amended so that retail pharmacy businesses are able to decide for themselves whether they wish to offer this legal product for sale to customers who seek it.
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We oppose this ban because it will significantly damage our members' businesses. The committee is no doubt aware of that, and I am here today to suggest to the committee the public policy reasons for opposing the ban and for amending subsection 4(2) so that the ban is not imposed.
There are four basic reasons we feel the Legislature and the government of Ontario should not proceed with a ban on drugstore tobacco sales. Reasons 1, 2 and 3 are that the proposed ban would be all pain, no gain and unfair. The fourth reason is that the proposed ban is out of step with the new direction tobacco control appears to be taking in this country.
This morning you heard the results of a formal economic impact study regarding the effects of Bill 119. The study concluded that over 2,700 full- and part-time jobs would be lost if the ban were imposed. That's what we mean when we say paragraph 4(2)8 is all pain. Some 2,700 jobs is not a matter to be taken lightly at the best of times, let alone in the current economic climate. Whether the burden falls primarily on workers who are full-time or part-time, organized or unorganized, over 2,000 part-time and almost 700 full-time positions will be terminated. As is the case throughout most of the retail sector, these workers are primarily women, young people and new Canadians. Surely this is not a group upon which the government wishes to visit further hardship. A government that just announced it will spend $34 million to help create 1,100 jobs at Ford of Canada ought surely to be prepared to amend this bill in order to save the 2,700 jobs.
What will the province receive for all the pain? The answer is: no gain. Banning the sale of tobacco in retail drugstores will have absolutely no effect on smoking in Ontario. The Lindquist, Avey, Macdonald, Baskerville study on distribution presented yesterday demonstrated that if people can't buy cigarettes in drugstores, they'll simply buy them elsewhere. The study, presented by the Canadian Association of Chain Drug Stores, showed that retail pharmacies are one of the government's best allies in responsible distribution, consumer education and, most important, refusing sales to minors.
Sending tobacco consumers out of drugstores and into a less-regulated environment such as convenience stores -- or, worse, to the contraband market -- is simply counterintuitive. Moreover, as the Lindquist study pointed out, cutting off legal distribution channels encourages the use of the illegal channels. At a time when the government of Ontario is moving aggressively and at some cost to attack the black market's cost advantages, it should not enhance the black market's advantage in convenience through the drugstore sales ban.
The third argument against the bill is that it's patently unfair. The ban would prohibit one kind of store from selling this legal product and say to the store next door, "Go right ahead." If the government wants to ban the sale of tobacco, it should consider doing so. If it wants to put all tobacco sales in government stores, it should consider doing that as well. If it wants to make smoking illegal, it should do that as well.
I might mention here that one of the major members of our association doesn't feel that this ban goes far enough, told me this morning to make sure I reinforce that point to you, and will stand up in court any time and say it. The fact of the matter is, it's unfair to make any kind of retailer stop selling a legal product unless you make all of them do so.
The anti-smoking lobby has singled out drugstore sales because they argue that it's inconsistent for a pharmacy to sell tobacco. The argument of inconsistency is made every day by dozens of single-issue interest groups that approach retail drugstores demanding that they stop selling legal products the pressure group happens to disapprove of. Animal rights activists tell us it's inconsistent for us to sell animal-tested health and beauty products. Environmentalists tell us it's inconsistent to sell disposable diapers. Right-to-life groups tell us it's inconsistent to sell contraceptives. Our companies receive these representations, make their judgements and basically let the market decide. The government cannot get into the business of choosing on behalf of drugstore owners which legal products may or may not be put on our shelves, especially if it leaves other kinds of retailers alone, as this bill would do.
Behind the argument of inconsistency is the question of the nature of the retail pharmacy. As some of those who favour the ban have stated, "Pharmacies have to decide whether they're retailers or health care providers." The truth is, they're both. The prescription sales in the back of the store and the general merchandise sales in the front of the store are both essential components of drugstores today. Although there is still a number of pharmacies that serve mainly as dispensaries, almost all chain drugstores have a much more balanced mix of front- and back-of-store sales. After all, a drugstore location in a major shopping mall cannot rely on prescription sales alone to carry the rent.
Within chain drugstores the interrelationship between the front- and back-of-store sales is very complex. Most of the time, people who come in our stores for a prescription purchase some general merchandise as well. Other times, people will move their prescriptions to a drugstore that has the best mix of health and beauty aids in order to make all their purchases at this one location.
The mix of front- and back-of-store sales is different in every single one of those 700 chain drugstores. It's a very diverse industry within the low-margin, highly competitive retail sector. This industry is simply too complex for anyone to make sweeping statements about the ability of drugstores to survive without tobacco sales. Some can, many can't. It depends on what mix of prescriptions you have and the general merchandise the store finds that works best for it, and on the historical place that tobacco has in the store. It shouldn't depend on government decisions about the right to sell legal products.
The OCDA believes that unless both parts of the retail pharmacy are functioning effectively the store cannot be profitable. A ban that may seem sensible viewed from the back of the store would be suicidal to the success of the front, and thus to the enterprise as a whole. To impair sales at the front of the store is to impair the ability of the store to operate as a whole and to fulfil its health care delivery role. If the government wants retail pharmacies to continue as the vehicle for delivering this important health care service, it mustn't damage the engine that runs the front-of-store sales.
The proposed ban would be all pain, no gain, and unfair. But there's something else OCDA wants the government to consider very closely: that the proposed ban is fundamentally out of step with the direction tobacco policy is taking in this country.
To begin with, Ontario is not the only province to have considered this approach. Both Quebec and British Columbia examined the option of a tobacco sales ban in pharmacies. Both came to the conclusion that it was wrong. Quebec abandoned the option between the issuance of a discussion paper and the introduction of legislation. British Columbia abandoned it before its discussion paper was put forward. We urge members of this committee and the government to consult with their counterparts in these jurisdictions and ask what they think of the ban. The answer will come back, we feel: all pain, no gain, and unfair to the point of being unconstitutional.
As well, these provinces backed off from a sales ban because the course of tobacco regulation and control in Canada is undergoing a massive shift. For a generation, tobacco policy has been fundamentally based on a two-track approach. These are the combination of demand-side measures, which include consumer education and the limitation of smoking environments, and the supply-side measures, which mainly have been taxation. Both have been steadily applied to (1) make people want to smoke less, and (2) make it harder to buy cigarettes. The results have been impressive, but governments in Canada, including Ontario's, have reached the limits of the supply-side approach. The rise of the contraband market, which is the direct result of the attempt to make cigarettes harder to buy, has brought upon us a massive social problem the extent of which we have not yet fully comprehended.
With the plan to slash tobacco taxes currently being negotiated, Canadian governments are in effect abandoning the supply-side track of the tobacco control strategy. In Ontario and across the country they are courageously facing up to a very difficult public policy choice. The question is, what will the new strategy be? The government of Ontario has not arrived at an answer yet and, as we all know, the policy thrust of Bill 119 was crafted long before the old supply-side taxation approach was abandoned. The ban on pharmacy sales of tobacco was an extension of the general effort to make tobacco harder to buy. In addition to high taxation, the ban would have attacked the availability of cigarettes through restricting distribution.
Now that the taxation thrust of the supply-side effort to make tobacco harder to buy is being curtailed, is this really the time to charge ahead into a whole new field of supply-side tobacco control? The blunt fact is that the entire supply-side track of tobacco control needs to be re-examined. This re-examination hasn't occurred yet, but it's one that OCDA looks forward to participating in.
What we cannot accept and what no responsible elected or unelected official can condone is charging forward with one last effort at supply-side management at the very time when a complete re-evaluation needs to take place. The proposed ban on the sale of tobacco in pharmacies is a museum piece, in my words, and part of a failed approach to tobacco control. It's an expensive museum piece which can be purchased only at the cost of 2,700 full- and part-time jobs in Ontario.
At this moment in time, Ontario needs a new tobacco strategy which takes into account the new realities of the past two or three weeks that we're facing up to. It needs a strategy that's in line with that of other provinces. It needs a strategy that does not inflict economic damage and job loss. It needs a strategy that is fair. Ontario needs a strategy that will work and make a positive difference on this important public health issue.
Ontario's chain drugstores believe that paragraph 4(2)8 of Bill 119 is not part of that strategy. We would be pleased to work with the government and other stakeholders to begin work on developing a new tobacco strategy. In the meantime, however, we urge the government to reconsider this ill-advised proposal to ban the sale of tobacco in pharmacies, and the committee to amend the bill so that it is not carried out. Thank you. We'd be happy to answer any of your questions.
Mr Jim Wilson: Thank you for a well-presented and certainly well-written brief, in my opinion. You talk about the fairness issue. You talk about the inconsistency argument that's put forward, and that over the years a number of different interest groups have come forward and asked you as pharmacies to stop selling one product or a set of products or another. I noticed in yesterday's Toronto Sun, in the World Report, that the Pope has asked that pharmacies stop selling condoms, particularly Catholic pharmacists. Do you think pharmacies should stop selling condoms?
Ms Porter: I'll give that to operations.
Mr Steve Mezei: The answer is no.
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Mr Jim Wilson: I'll probably get excommunicated for now having put the Pope in the same category as other interest groups, but being Catholic, I'm willing to take the risk.
None the less, it does raise the concern, because I've heard, both before this committee and in private meetings, about the controversy at the college of pharmacy. A gentleman yesterday, who happened to be of the Jewish faith, said to me, "What if the college of pharmacy was taken over by a bunch of Catholics, and the Pope" --
Interjection.
Mr Jim Wilson: A lot of the government's reasoning on this is that the college of pharmacy -- and I've done my own survey, which I'll introduce in evidence at some point -- has said that it wants this ban and it believes it has its membership behind it, or regardless of that, it's not a popularity contest, so it doesn't even care whether it has its membership behind it. The Pope has much the same view: It's not a popularity contest with respect to the sale of condoms. What if it was taken over by an interest group and it decided that you should stop selling something that I think most people would agree is helpful to the population? Would the government then move on such a thing?
Ms Porter: That's obviously a very good point. I tried to make that point when I said that we do get representations from special-interest groups. I hope that anyone who was listening to what I said would say, "Of course you're not going to stop selling those products." You just don't react that quickly in a retail environment and it's not the way you do business.
Mr McGuinty: I am, and I think legitimately, confused as to what's going on with the pharmacists in this province. We've heard that the college asked for a ban in 1990. Where do pharmacists stand now and why did they ask for it? Obviously, there's division. Was a survey ever conducted?
Ms Porter: You've hit it right over the head. I think you've come to the point exactly that there is a profession divided and it's divided along certain lines, a lot of it along retail pharmacists' lines. It's also an issue that really stumps me when public policy is going to be decided on an issue that has so clearly divided a profession. I have to ask the question of the committee, as well as the government, about that.
There was a study carried out by the Ontario Pharmacists' Association on this question and the results were that 62% of the respondents favoured the voluntary removal of tobacco, not a legislated removal.
Mr McGuinty: When was that study done?
Mr Mezei: In 1992. But the other thing you should be aware of is that the council members that made up the college that brought forth the proposal, almost all of them, were defeated in the next election by the membership. In essence, the council did not represent the wishes of the majority of the membership.
Mrs Haslam: That's not what I heard, but anyway. I don't want to get into the economic impact but, like I say, I keep getting drawn into it.
You mention this report, the Economic Impacts of Recent and Proposed Legislation, by Coopers and Lybrand. You mention that in your brief and you also mention that in a press release you just released yesterday. This has a date on it of January 31. Were you a part of the funding of this particular brief?
Ms Porter: No, we weren't. I think you'll understand that a lot of times independent pharmacists and chain pharmacies are maybe at opposite ends of the spectrum. On this issue we were together. We both agreed on going forth to fight the ban. The Committee of Independent Pharmacists had commissioned this research and agreed to share the results with us, which we received early yesterday.
Mrs Haslam: On page 3 of your report you mention that the store cannot be profitable unless both parts of a retail pharmacy are functioning effectively. I have information that Michael Perley, director of the Ontario Campaign for Action on Tobacco, rejected statements by tobacco-industry-owned Shoppers Drug Mart that the ban will economically cripple pharmacies. He states that a 1992 Canadian Pharmaceutical Association survey shows that, of 56 pharmacies which eliminated tobacco sales, 59% had either no income loss or an increase in overall sales; 13 had marginal losses, and seven had moderate losses, but all 20 of the latter claimed to have recouped those losses after at most two years; and also noted that recent surveys in the Guelph area and in Ottawa-Carleton have shown that anywhere from 39% to 54% of pharmacies already do not sell tobacco products.
I am asking why you are saying that you cannot be profitable if statistically it's shown that pharmacies can be profitable and maintain their business.
Ms Porter: I don't know about that study and I don't know the results of it, but one comment I would make is that those pharmacies that do not sell tobacco now did so of their own free will. They probably did it over time, or else they never sold tobacco. That's what I meant when I said it's unfair.
Mrs Haslam: You mention time lines. It was brought forward that the pharmacists' college brought forth an idea of a voluntary ban in 1990, and I wondered if your association had done anything in that regard when you talk about reducing it over time, how your business has responded to your own college's recommendations.
Mr Mezei: It's a difficult one to answer, because each of the members probably approached it from a different perspective. Certainly at Pharma Plus I think the approach we've taken was an extensive communication to our consumers in terms of signage, warning signs about the dangers of smoking.
Mrs Haslam: No, I'm talking about the college's decision to ask you to remove tobacco. What has your business done? You mentioned short time lines, but it isn't short time lines when the ban was being asked for in 1990. Has your business done anything to look at removing this?
Mr Mezei: We have reduced the amount of space and the display space that we allocate to tobacco in an effort to reduce the focus of tobacco over a period of time.
Mrs Haslam: Can we look at health issues for a minute now? I've got a copy of Professionalism in Pharmacy or Pharmacists Selling Ontario's Leading Cause of Preventable Death: Which Will It Be? This is put out by the Ontario Campaign for Action on Tobacco. It says:
"Benefits of the sales ban: The major benefit of the termination of tobacco sales in pharmacies is the elimination of conflicting messages about the risks of tobacco products being sent to people of all ages, but especially to the young."
I'm going to ask you the health question I asked earlier: Do you consider yourself a health professional or a retailer?
Mr Mezei: I would say that we're both. I think the difficulty that a non-pharmacist group would have is really getting their hands around this issue. Pharmacy is both a provider of health care and a retailer. That's where a dichotomy occurs within the profession.
Mrs Haslam: Do you believe we should move towards an Ontario where we are a tobacco-free society?
Mr Mezei: Ultimately, sure.
Mrs Haslam: When you talk about ultimately, I have a problem with seeing health care professionals say, "Ultimately, that's what we want. Yes, we are pharmacists. Yes, we argue we are a health profession when we come before other committees and say we are a health profession," and then, bottom line, the arguments that come forward are more in tune with the profitability of a retail store. I have a concern about that. I'm wondering where the priority for the organization that your chain drugstore is in looking at the health care or the health professionalism versus the profitability of the store.
Ms Porter: You've raised a very good point. Our members, in order to operate their prescription and dispensary businesses, have to operate a good front shop. You heard evidence this morning that there was going to be a job loss of 2,700, and I have to ask you, what's more important to you?
Mrs Haslam: I questioned that report when it came. I don't accept that report, to tell you the truth.
It's my understanding that the government in Britain has prohibited tobacco sales from pharmacies since 1987. Had you looked at any of those statistics or are you aware of any results of that experience?
Ms Porter: My information says the European pharmacy industry is very different from the North American.
Mrs Haslam: This is Great Britain.
Ms Porter: The composition of the pharmacies and the makeup of their product mix is extremely different and really can't be compared.
Mrs Haslam: So you did look into that situation when you had some of your research?
Ms Porter: Yes.
Mrs Haslam: Could I get a list? I know you came to see me and I asked for a list of your membership.
Ms Porter: It's in your package.
Mrs Haslam: Thank you. I didn't get to the back.
The Vice-Chair: Thank you for your presentation. This concludes the morning sitting of the committee. The committee is now adjourned until 2 this afternoon.
The committee recessed from 1213 to 1407.
The Chair (Mr Charles Beer): Good afternoon, ladies and gentlemen. Welcome to this afternoon's hearings of the standing committee on social development. We are dealing with Bill 119, An Act to prevent the Provision of Tobacco to Young Persons and to Regulate its Sale and Use by Others. Just before we begin with our first witness, Mr McGuinty wanted to raise one issue with the committee.
Mr McGuinty: Mr Chair, you'll be aware that the job losses have become an issue. We had a study presented to us this morning. Ms Haslam has questioned its conclusions. I would ask that the minister or the parliamentary assistant give us the minister's assessment of the job losses, so that we could have something we could weigh in terms of the impact this bill would have.
The Chair: Is that a request that information be brought forward?
Mr McGuinty: Yes, please.
Mr O'Connor: In response to that, I thank the member for raising it. No doubt as we go through the committee hearings and hear from many other people, job loss will be discussed. In some of the questions this morning, they were questioning whether the 13 people they surveyed out of the 1,400 was a good comparative for that discussion. No doubt we're going to hear a lot of different figures on this, and no doubt we as committee members can look through that and pull out exactly what is closest to where we're at. I'm not right now about to commit the minister to undertaking a survey.
Mr McGuinty: I'm not necessarily asking for a survey, Mr Chair, and I consider, with respect, that answer unsatisfactory. It's a very important issue. If we cannot rely on what we have, then what can we rely on? I think it's important for us to learn that.
Mr O'Connor: I never said it wasn't an important issue.
Mr McGuinty: Thank you for that.
SHOPPERS DRUG MART LTD
The Chair: With that, we'll proceed to our first witnesses, from Shoppers Drug Mart Ltd. Welcome to the committee. If you would be good enough to introduce yourselves, then please go ahead. We have half an hour for your presentation and questions.
Mr David Bloom: Mr Chairman and honourable members of the committee, good afternoon and thank you for allowing us the opportunity to make this presentation. My name is David Bloom and I'm the chairman and chief executive officer of Shoppers Drug Mart. I'm also a licensed pharmacist in the province of Ontario.
Throughout the province of Ontario there are 320 Shoppers Drug Mart pharmacies. With me today, and representing her colleagues, is Mrs Marj MacKenzie, who is the pharmacist-owner of five Shoppers Drug Mart stores in the city of Barrie.
I'd like to begin by stating that we at Shoppers Drug Mart not only fully endorse but also congratulate the Ontario government's intended purpose in the proposed legislation. The intent, to prevent juveniles from smoking, to protect the environment, to impose stiffer fines on retailers who disobey the age restrictions and overall to achieve cessation of tobacco consumption throughout the province, is commendable.
We fully support those initiatives. However, we are strongly opposed to the proposed ban on the sale of tobacco products in pharmacies, particularly paragraph 4(2)8.
Tobacco is a legal product. It's legal to sell and legal to use. It is completely unfair to prevent only one type of retail establishment from selling it. This is especially the case because the legislation will have no meaningful influence on the level of legitimate sales. Instead, it will only serve to damage the economic interests of pharmacies.
I'm sure you must be questioning the contradiction of pharmacists who, after all, are regarded as the front-line providers of health care, yet we are selling a product that does not contribute to that mission; the paradox of tobacco and the dispensary, the so-called ethnical argument. The response to that is purely economics. It is purely and simply a matter of financial viability, and that is the way we at Shoppers Drug Mart and all community retail pharmacy operators who sell tobacco view it as well.
The federal government raises over $7.2 billion in taxes and here in Ontario our provincial government also raises about $800 million on tobacco revenues. The honourable Minister of Finance, Mr Floyd Laughren, stated last week: "I resent very much the pressures to reduce tobacco taxes. Quite frankly...because it's the last tax I'd like to see reduced. It's a very last resort. It would cost the province desperately needed revenue." I stress the comment "desperately needed revenue."
In the same way that our provincial government desperately needs the revenues from tobacco and is reluctant to give them up, so it is with drugstores. For the Ontario government, it's also an issue of economics and financial viability.
During the past three years, the drugstore industry has experienced unprecedented economic pressures and ultimately reduced profitability.
Perhaps I could refer to this pie chart which clearly demonstrates the squeeze on pharmacies we have experienced just in this past year, the year 1993. Starting from the far right of the chart, the first factor is the recession. The second factor is wage increases and training of pharmacy technicians. The third factor is benefit costs: increased UIC and workers' compensation. The fourth factor is property tax reassessments and common area maintenance charges. The fifth factor is the Ontario drug benefit prescription fee freeze, which has been in place since 1990. The sixth factor is the social contract prescription fee reduction by 61 cents on each prescription. The seventh factor is the Ontario Drug Benefit Formulary deletions.
Firstly, the professional fee that pharmacists may charge for Ontario drug benefit program prescriptions: That fee has not kept pace with escalating costs. In fact, no new fee has been negotiated since June 1990, and pursuant to the social contract negotiations, the fee was rolled back by 61 cents in September 1993. That represents a $4-million reduction in prescription sales for Shoppers Drug alone. Now, 61 cents sounds small; $4 million is big.
Secondly, there have been over 100 products delisted from coverage under the Ontario drug benefit program. While this has saved the government over $100 million, which we applaud -- it's great -- it has, however, resulted in significant decreases in prescription sales.
Thirdly, there's been a significant increase in property taxes paid by small and medium-sized retailers due to reassessment. By the way, we're classified as those small retailers. In some cases, we at Shoppers Drug Mart have experienced increases of almost 85%. In addition, common area maintenance costs have also risen dramatically due to requirements for waste audits and other regulatory obligations that have been introduced.
Fourthly, all employee benefit costs have increased because of the GST and increases in UIC and workers' compensation benefits.
Fifthly, wage dollars are increasing approximately 2%. Salaries have also escalated because of additional training required for pharmacy technicians. At Shoppers Drug Mart, we continue to upgrade the skills of our people, including training conferences for all our pharmacists from coast to coast. Patient counselling, as we all know, is a key component of good pharmaceutical care.
Finally, like all retailers, we have also suffered deeply during this recession.
But the question you must be asking and that I hope you're asking is, how did these seven economic factors impact on the profitability of the Shoppers Drug Mart Ontario stores during 1993? What was the financial impact? Are these a bunch of words or what was the financial impact? In Ontario, profit during 1993 was down 14% compared to 1992. The Ontario profit of Shoppers Drug Mart stores was down 14%. This compares to a Shoppers Drug Mart Canada-wide modest profit increase which will be announced tomorrow after our board meeting. Canada-wide, we had a slight, modest profit. In Ontario, the profitability during 1993, due to many of these factors, dropped 14%. The fact is that we made it up in the other provinces but had a major shortfall in Ontario.
Because of the implications of all these economic pressures on our business, Shoppers Drug Mart was forced to close six stores in Ontario during 1993. We expect to close several more in 1994. This is before we take into consideration the impact of a proposed tobacco ban. I can predict with confidence that we will be forced to close at least another 20 stores in one year alone if this legislation goes through. That will mean a resultant loss of another of another 600 full-time and part-time jobs in the Shoppers Drug Mart system.
These government cutbacks comes at a time when pharmacists more than ever are on the front line, delivering pharmaceutical care and helping the province reduce the overload on hospitals. At 3 o'clock in the morning, patients can always find a 24-hour Shoppers Drug Mart store in Toronto, Mississauga, Whitby, Ottawa and Thunder Bay, with additional openings planned for 1994.
The eight Shoppers Drug Mart 24-hour pharmacies, such as our store at Dufferin and Lawrence, filled over 140,000 prescriptions during the night -- through the night, from 1 o'clock till 7 in the morning -- during 1993, and hundreds of thousands of purchases for over-the-counter medication. Certainly, our 50 extended-hour stores that are open till midnight and these eight stores that are open 24 hours, that never, ever close, I believe play a key role in reducing hospital visits. By the way, we are the only pharmacies that operate 24-hour stores in Ontario and the rest of Canada.
The Ontario Ministry of Health has continuously maintained during negotiation proceedings relative to pharmacists' dispensing fees that pharmacies' front shops are expected to subsidize the cost of prescriptions and the Ontario drug benefit plan. The removal of tobacco is therefore a contradiction of this expectation because it would reduce revenues and therefore undermine this policy objective of the Ministry of Health. I believe you can't have it both ways.
My colleague Mrs Marj MacKenzie would now like to tell you about the impact of your legislation in her community in Barrie.
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Mrs Marj MacKenzie: I am the pharmacist-owner of five Shoppers Drug Mart stores in Barrie. I employ 160 full-time and part-time employees. In fact, in terms of numbers, I am one of the largest employers in the city.
I also endorse the overall intention of the legislation to stop juveniles from smoking. However, if the pharmacy provision goes through, I will be forced to close down one of those stores and lay off about 30 people. I will also be compelled to reduce the number of employees in my other stores. I predict that in addition at least three people in each of my remaining four stores will be let go.
As well, one of my locations is at the Barrie shopping centre and is visible from Highway 400. That pharmacy remains open on Sundays and every night until midnight, seven days a week. It fills the emergency prescriptions from the Royal Victoria Hospital in Barrie and from the emergency medical clinic located near my shopping centre. In fact, it is the only emergency pharmacy open anywhere from Newmarket to north of Orillia. That pharmacy will be forced to reduce its hours.
I must cite the example of an Orillia woman who needed an antibiotic for her sick child close to midnight as we were closing. There are no midnight pharmacy services available in Orillia at that time. We stayed beyond midnight until she arrived 20 minutes later and filled the two prescriptions and the Tylenol product she required as well. We received a wonderful letter thanking our Shoppers Drug Mart pharmacist for dedicated service beyond the call of duty. I would like to remind the committee that being open extended hours is costly, but professionally rewarding and part of our total service commitment to the Barrie community and vicinity.
Please be aware that if your legislation goes through as proposed, it will not achieve your objectives other than to close down one of my pharmacies, create unemployment for at least 40 people and reduce health care services in Barrie.
Mr Bloom: The effects and impacts suffered by Mrs MacKenzie will be repeated across the province in all of the 320 Shoppers Drug Mart pharmacies; in fact, all pharmacies that currently sell tobacco in Ontario.
When the Ontario Ministry of Health issued its discussion paper on this act in January 1993, Shoppers Drug Mart undertook significant research concerning the number of pharmacies that sell tobacco, the share of market, public opinion surveys and other consumer research. Because of the comprehensive nature of our document, I have provided a copy to each of you today, including the "Factors Impacting Pharmacy" chart I referred to earlier. We predicted that there would be job losses in the industry. We further predicted that there would be closures of some pharmacies in the province. In addition, many other services we provide, such as free delivery to the sick and elderly, midnight and 24-hour pharmacies, would have to be reviewed and some cut back.
Earlier today you heard the independents' presentation by Coopers and Lybrand. Based on their research, they predicted that 119 pharmacies that sell tobacco would close down, resulting in the loss of some 683 full-time and, I'm told, 2,700 part-time pharmacy jobs. I believe their evidence is statistically valid whether you like this revealing news or not.
There is no comparable research of any kind undertaken by the Ministry of Health to support its recommendation to remove tobacco from pharmacies. The Ministry of Health has not conducted any economic impact study, nor has it conducted research to prove that the pharmacy ban would reduce the incidence of tobacco consumption. Surely it has to be incumbent on them to do so before they enact such a significant piece of legislation.
Even the health care groups that have testified before you agreed, and I heard it yesterday, that the pharmacy ban would not reduce tobacco consumption. The pharmacy ban in the bill is based on the decision by the Ontario College of Pharmacists made almost three years ago, as we all heard, in June 1991. You should know that of the elected members who supported that resolution, all but three were subsequently defeated in the elections that took place during August 1991. They were voted out of office.
The college based its decision on its mandate, which is, "To serve and protect the public interest." Our profession has questioned whether the college has overstepped its authority. After all, how will the public interest be served and protected if pharmacies close down and professional services are cut back? The college's mandate relates to pharmacists' competency, and it has absolutely no jurisdiction regarding the sale of legal products.
You should also know that the Ontario Pharmacists' Association undertook a survey in 1993 which indicated that 63% of our profession is opposed to the forced removal of tobacco. This clearly demonstrates that our profession is certainly deeply divided over this issue.
No doubt you will hear representations from other pharmacy groups and independents who may appear with petitions and who will maintain that they represent the majority in the profession who want tobacco removed. Those pharmacists have for the most part never sold tobacco, so they really have nothing to lose. However, the fact is that 1,400 drugstores in the province sell tobacco out of a total number of 2,200 pharmacies. That represents a majority of 64%. When you take out the hospital and medical pharmacies, which have never sold tobacco, the number rises to almost three quarters of drugstores, some 75%, that need and believe that tobacco is there for their economic survival.
You heard testimony from a pharmacist who claims that she removed tobacco and suffered no economic hardship. This may be true in her particular circumstance, especially if her tobacco volume was extremely low. I don't have her numbers. My assumption would be her tobacco sales were very low.
However, when your tobacco mix represents a significant part of your sales mix, such as 10% for the independent pharmacy and 8.8% in our case, which is the actual number for 1993, then you will suffer significant loss. I guess the bottom line is that every drug store is different.
Those other presentations will represent the minority of a divided profession. They have chosen to voluntarily remove tobacco, and that is their option in a free society. But for the minority to try to impose its will on the majority is both inappropriate and I believe undemocratic.
Instead of reducing the number of tobacco vendors, the void will be filled very quickly by other retailers that I believe will enter the tobacco market. Wal-Mart's acquisition of the 120 Woolco stores in Canada will give it a strong foothold in this province. They will aggressively sell tobacco because that's their American format.
We have heard that the 200 Bi-Way stores are contemplating the introduction of tobacco sales to capture pharmacies' traditional customers. Canadian Tire with its 192 stores in Ontario will respond to Wal-Mart -- it will have to respond to Wal-Mart -- by probably also selling tobacco. In addition, the food supermarkets and the mass merchandisers like K mart and Zellers will continue to operate pharmacies, but they could also erect special tobacco kiosks outside their doors. The playing field will become even more unlevel, to the detriment of the community pharmacy.
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In effect, the legislation will have no impact on the number of retailers who sell tobacco. The 1,400 drugstores will be very quickly replaced by other retailers, and I'm not even including the gas bars and the convenience stores. There will be no impact on the incidence of smoking. So who wins? That's the big question. Who really wins in this? The answer is nobody, except the single-interest pressure groups. Everybody else loses economically.
The Lindquist Avey presentation yesterday indicated that as many as one in four packets of cigarettes in the Ontario market is contraband. Until the government takes steps to reduce this rapidly growing alternative distribution system, young people will have easy access to tobacco at prices well below retail.
What is particularly perplexing is that the government may in fact be encouraging this market. By taking tobacco out of drugstores, the government will shift the purchases away from us and move them to the irresponsible vendor. Unfortunately, all too often these vendors not only sell contraband, but they also do not pay taxes on their illicit cigarettes.
Worst of all, they do not care about the age restrictions. In fact, minors rely on these vendors for their source of supply. Pharmacies, more than any other retailing segment, enforce the age requirement and also do not carry illegal inventories. Pharmacists, who are accustomed to dealing in controlled substances, are the most responsible retailers of tobacco.
At Shoppers Drug Mart we have a corporate policy that all new employees must be made aware of the age restrictions and must view a special training video about this issue. I have a copy with me today if anyone would like to see it. We also require new employees, as a condition of employment, to sign a statement that they will not knowingly sell tobacco to minors. If they violate that provision, they will be immediately dismissed for not following company policy.
Ontario is not the first province to consider legislation to remove tobacco from drugstores. The government in Quebec considered a similar provision but did not proceed because it realized it had constitutional implications. In British Columbia, the Ministry of Health recognized the economic implications that tobacco removal would have on pharmacies in the province, and, coupled with the constitutional issue, elected not to proceed.
On behalf of the 320 Shoppers Drug Mart pharmacist-owners like Mrs MacKenzie and their staff of over 10,000 employees in Ontario, I urge you to seriously reconsider the pharmacy provision in the legislation in view of the devastating economic effect it will have on our businesses and the subsequent impact it will have on the communities where we deliver health care.
In conclusion, I want to state that the contraband market is a scourge on our society. The anti-smoking lobby advocated that higher taxes would reduce consumption. They were wrong. Instead, it has done the exact opposite. It has encouraged the contraband, brought in the criminal element and effectively made cigarettes cheaper and more accessible to minors. The exact reverse was achieved.
The anti-smoking lobby is now advocating removal from drugstores, and they'll be wrong once again. It will have no impact on consumption whatsoever. Instead, it will close down pharmacies. It will punish pharmacists and put people out of jobs in an economy where what we need least is the loss of jobs. It will reduce the delivery of pharmacy services, and the citizens will be denied convenient and accessible health care. All this will be a disaster for the province, and in the end the main objective of this legislation, which is to prevent young people from smoking, will not have been achieved.
We therefore recommend that you pass the legislation but that you remove paragraph 4(2)8 and that you engage pharmacists to work with the government to achieve your objectives to prevent juveniles from smoking.
I thank you again for this opportunity to be here today. Both myself and Mrs MacKenzie will answer any questions you may have.
The Chair: Thank you very much for your presentation and also for the additional documentation that you brought for the committee. We have limited time but we'll begin questioning with Mr Wilson, if we could keep it to one question, please.
Mr Jim Wilson: I will try, Mr Chairman. Mr Bloom and Ms MacKenzie, thank you very much for appearing before the committee today. It appears to me, and before your presentation came to similar conclusions, that the banning of the sale of tobacco products in pharmacies doesn't seem to make any economic sense. You've quoted the opposite in terms of using the government's own arguments of why it has to make $800 million a year on tobacco sales for economic viability, and the same holds true in the free market, in the private sector, with respect to drugstores.
We've had the government admit that it in no way can prove to us that the ban will in any way reduce consumption, particularly among young people. Given that there don't seem to be any economic reasons, no market reasons, and there don't seem to be any health reasons that anyone's been able to prove to us, in your heart of hearts, in your gut, why do you think the government's moving ahead with this anti-business measure?
Mr Bloom: That's a very challenging question. I've heard many reasons. One is that people have told me that the government feels there are too many pharmacies in the province, so this is a way of pruning the weaker ones, and of course it could have an impact of, hopefully, filling less Ontario drug benefit prescriptions. That's the one that seems to prevail right now.
Mr Jim Wilson: In second reading, the Premier happened to be doing House duty that night. It's the first time I'd ever seen him do House duty and he made a big thing of it. When I got to the part about pharmacies and said it was an anti-business thing, he yelled out: "You lost me there. Have you ever heard of Imasco?"
I kept thinking, and to this day -- I don't need you to comment on it, because it's my own thought. I just wondered, if Shoppers Drug Mart had not arrested Lorne Nystrom, MP, NDP, whether we'd be in this predicament. That was suggested to me a long time ago, prior to second reading debate, and then when the Premier kind of lost it during my remarks, it stuck with me. Without hesitation, stick that on the record, Mr Chairman.
Mrs Haslam: Oh boy, I refuse to sink to that level.
In the Brant county submission -- they're coming in next; I like to read ahead -- I found that 90% of Brant county pharmacists felt that selling tobacco contradicts their professional code of ethics and only 3.3% did not feel this way, and there was 6% undecided. We have a lot of facts and figures and I want to get a couple of technical questions in, please, before I get into the health.
In this brief, you've indicated an overview of tobacco retailing in Ontario. At the bottom you indicate the total number of pharmacies, 2,257, and the total number of pharmacies that sell tobacco, 1,427. Are you included in that 1,427?
Mr Bloom: Yes.
Mrs Haslam: The reason I ask is that we had the Committee of Independent Pharmacists come and it said it represented those pharmacies that sold tobacco. I was questioning them on this report that you also have quotes on. Have you at any time, though Shoppers Drug Mart or through the Ontario Chain Drug Association, contributed financially or with work in kind to the Committee of Independent Pharmacists?
Mr Bloom: Absolutely not.
Mrs Haslam: This is your presentation.
We get a lot of things here. This was from a local action group that says, "We know that pharmacies are responsible for a percentage of tobacco sales and we think they should not take place in stores that are supposed to be selling products promoting better health." Bottom line, that's the question. Do you agree that smoking has significant negative health consequences? Do you, as a pharmacist, believe that the ultimate goal of Ontarians is to move towards a tobacco-free society? Taking a look at those two answers, how that affects your decision to let the economics overrun a health policy here.
Mr Bloom: I think a pharmacist is both. A pharmacist is a professional and a pharmacist is a retailer. I can give a good example of that --
Mrs Haslam: But you came before another committee arguing for pharmacists to be covered under the Regulated Health Professions Act as health professionals.
Mr Jim Wilson: As a pharmacist, not the store.
Mrs Haslam: No.
The Chair: Order, please. Let the witness answer the question.
Interjections.
The Chair: Order, Mr Wilson. Order, please.
Mrs Haslam: Are you a health practitioner or a retailer?
Interjections.
The Chair: Order, please. Allow the witness to answer the question.
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Mr Bloom: I've stated to you that a pharmacist and a pharmacy have a dual role. You're the pharmacist with the professional advice in the back of the pharmacy. Once you move into the front shop, you're a retailer, and you can wear two hats. A good example is Mr McGuinty here, who's both a lawyer and also a politician.
Mr McGuinty: Two strikes.
Mr Bloom: I must also tell you that in the Ministry of Health you seem to pinpoint the fact that we wear two hats. When we're negotiating the professional fee and we're claiming that it's not enough to survive, the response is, "But you have the front shop to subsidize you." Then of course when we're talking about the tobacco issue, the response is, "But you have the pharmacy to subsidize you." You can't have it both ways.
Mrs Haslam: No, I'm talking about a health issue.
The Chair: I'm sorry I'm going to have to cut in here. I regret it. We could probably go on for a while with more questions, but we have gone over the 30 minutes, and as Chair I've got to try to keep some order. I thank you very much for coming before the committee today and for your presentation.
Mr Bloom: Thank you for your attention and giving us this opportunity.
HEART AND STROKE FOUNDATION OF ONTARIO
Ms Rosemary Leach: I'm Rosemary Leach, manager of professional education at the Heart and Stroke Foundation. Dr Anthony Graham will be presenting our presentation.
The Chair: Order, please. Sometimes after lunch committee members are very talkative. Sorry.
Dr Anthony Graham: I'm delighted to be here with the committee being awake. Some have another physiologic need after lunch.
I'm a clinical cardiologist and I work at the Wellesley Hospital. I spend most of my time treating people with tobacco-related diseases. In fact, this afternoon, that's what I'm usually doing, but I decided it would be more useful to spend my time here this afternoon, because I think ultimately we all in this room can save more lives by what we're doing, relating to public policy development, than I can spend probably in the rest of my professional career dealing one on one with patients.
I'm also here because I'm a volunteer with the Heart and Stroke Foundation of Ontario, which is a volunteer-led organization of 70,000 members, citizens of this province, organized in 90 chapters across this province who raise money from millions of ordinary Ontarians to fund heart and stroke research and education carried out across this province. One of the key roles of our organization is to encourage the development of healthy public policy relating to heart-healthy living and therefore ultimately curing and preventing our number one killer.
What I'd like to do this afternoon is really four things. The brief from our foundation is before you and I'm not going to go over it in detail. I'd like to highlight and I'd like to amplify certain aspects, and I'd be very prepared to answer any questions.
First of all, I'd like to applaud the government, and I'd like to applaud all the parties that have made tremendous progress to bring this bill to the present state. At a personal level, I've had discussions with senior members of the government who have shown great vision and courage in bringing this piece of legislation forward. I've also spoken with the leaders of the opposition, Mike Harris and Lyn McLeod, and their support and the support of their parties have been very important and continues to be important on what I view as a non-partisan issue relating to the health of the people of this province. That's really why I'm here today, because I think we all can make this legislation, which is good now, even better.
I'd like to cover three areas briefly. First of all, I'd like to tell you why the Heart and Stroke Foundation is interested in this issue at all. Secondly, I'd like to talk about this particular bill and how it relates to heart health. Thirdly, I'd like to talk a little bit about ways I think this bill can be strengthened and the importance of a comprehensive approach to tobacco control in this province.
The Heart and Stroke Foundation, as I mentioned, is really in the business of reducing death and disability relating to heart disease and stroke, which as I think you're well aware, are our commonest killers, killing approximately 40% of all people in this province. Tobacco, as we all know, is the single most important, modifiable risk factor for heart disease and stroke.
Each day I treat the victims of this scourge on our society. I can tell you that it's pretty easy when I have somebody in an intensive care bed who's just had a heart attack to convince them that it's in their best interests to stop smoking. But quite honestly, we all know it's frequently too late at that point in time for that particular individual. It's also not very cost-effective since that person is already consuming, by nature of the fact they relate to me as an expensive health care practitioner, a lot of dollars.
We're really talking here about trying to do something at the front end of the problem, and I think we should be looking at that broader issue rather than the specifics of individual points of this legislation, and keep that as our focus.
This is a true addiction. Science has proved that tobacco is an addiction in small amounts. The Heart and Stroke Foundation has been interested in tobacco control for a long time, as long as it's been known that it's been a risk factor for heart disease and stroke. We've been actively involved in a number of areas in education and advocacy, and as you know, we're a founding member of the Ontario Campaign for Action on Tobacco. We think we are not a one-focus interest group. We're a group that represents common Ontario citizens who are interested in heart health.
We know that tobacco-related diseases affecting blood vessels kill more people than automobile accidents, alcohol, murders, suicides and AIDS. This is a staggering toll on our society and the numbers are in the brief. I won't belabour them; others have.
The medical officer of health in this province has appropriately focused on tobacco as being the single, solitary, most important public health issue we have, and this government has the guts now to bring forward legislation to address that. That is why we're here to support it.
We do have a fundamental problem, though, that we have a legal product that's an addiction. There is no other legal product that, taken just as prescribed, kills you. That's our problem, ladies and gentlemen. What we're trying to do with legislation is to try to take a legal product and restrict its access. Ultimately, the bottom line is prevention relating to tobacco, and by prevention, we mean stopping people smoking.
The figures are before you in relation to the impact of young people starting smoking, that if you can prevent them from smoking prior to age 20, in all likelihood they will never smoke. That's the battlefield and that's where we really must win, and we're not right now. That's what this legislation is largely about. One has to understand that's where we really are trying to work.
The Heart and Stroke Foundation is delighted to support this bill that mandates the increase in the legal age of smoking to 19 and the signage requirements. The issues relating to the reduction in access to outlets is fundamental because we believe that anything that will reduce access, particularly of young people, to tobacco will ultimately save lives and save health care dollars.
How can we improve this legislation? Some of these aspects you may well have already heard in other presentations. The issue relating to retailer licensing: We support the concept of statutory licensing as outlined, but we feel very strongly that it must be appropriately monitored and enforced and reviewed for its efficiency.
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We think the medical officer of health should be charged as being responsible for bringing forward an annual report in terms of how effectively this form of restriction is working, and if it is not, then indeed a formal licensing system will have to be put in place. The medical officer of health has defined this priority and we think that he or she in that office should be given that responsibility, much like the Auditor General does.
Another area for improvement, we feel, or clarification at least, is in the issues relating to packaging. We feel that the section of the bill on packaging must make clear that it will allow, through regulation, the enforcing of plain packaging, the banning of the kiddie packs or the sale of packages of less than 20 cigarettes, and the mandatory inclusion of health warnings. These are fundamental to the act and the regulations must be written to allow that.
The area of environmental tobacco smoke is one that we have grave concerns over. Current legislation brought in in 1990 under the Smoking in the Workplace Act has been largely ineffective in correcting the problem of smoke in the workplace. We know that 4,000 people in Canada die each year as a result of environmental smoke. We know that 50% of Canadians continue to be exposed to smoke in the workplace. We know that the vast majority of non-smokers and smokers wish prohibition of smoking in the workplace.
The current legislation does not comment on this at all and we would strongly recommend that there be a ban on smoking in internal environments at work, and if allowed, that it be only in appropriately vented areas. This, we feel, is an important strengthening of this legislation that is supported by the majority of the public.
We feel this whole legislation must be viewed not as pieces, but as part of a comprehensive strategy relating to tobacco control. As I mentioned, we have a problem: We have a legal substance that's addictive and killing. How do we control that in society? We must have a comprehensive strategy to achieve that. Whereas one can go at each individual component and say you like it or you don't, taken as a package, if the aim is laudable, the goal and the strategy then evolve. We feel very strongly that tobacco control is an area where partnerships between government at all levels, non-government organizations such as the Heart and Stroke Foundation and the general public can work together to achieve the ultimate goal.
We are very concerned about the current issues and threats about rollbacks relating to taxes. This concern at the federal level adds greater urgency to this particular bill and puts greater responsibility on its quick passage and on the importance, if the rollbacks come forward and we are very hopeful they would not, that this bill would then have to be further strengthened relating to mandatory licensing of retailers and the institution immediately of plain paper packaging. We think that would be required if the tax issue was changed in a negative fashion.
We strongly support Ontario's continued resistance relating to federal initiatives in this area. The Globe and Mail in the last 24 hours has shown what the health lobby is trying to do to support government and inform government and the general public relating to this particular issue. We will continue to do so, and we strongly encourage the Ontario government to stay the course on this matter.
In conclusion, we have a tremendous opportunity, each of us, those in government, those in organizations such as I represent, those of us in the profession and those of us in the general public, to move forward on our key public health scourge of this generation. There's wide support in the general public relating to tobacco legislation, in the health care community and also among government. We feel this is a non-partisan issue and should be moved forward with quickly. We applaud the important work of this group. I would be pleased to answer any questions.
Mr Paul Wessenger (Simcoe Centre): My question is perhaps more on a longer-term basis. Do you see this legislation as part of an evolutionary legislative process with respect to gradually raising the limitation of access and restrictions on smoking?
Dr Graham: I suggested that this must be part of an overall, long-term, evolving strategy to achieve the goal, and the goal is the eradication of smoking. That's got to be made very clear. It's going to take time. There have been significant reductions in the use of tobacco products by many within society. We're not winning in the young population. The figures would strongly suggest that.
To say what we will need over time, I don't think anybody really has a crystal ball over that. We have to say, what's the best legislation at this particular point in time to move towards the goal? We then have to continue to monitor it, and based on how we proceed, to determine next steps.
The goal is that this should be a tobacco-free society. Let's make no bones about that.
Mr Wessenger: The suggestion has been made by some presenters here that the elimination of sales in pharmacies will not have any positive impact on access to tobacco or on sales of tobacco products. How do you feel about that proposition?
Dr Graham: I think there are a number of issues that are going on. Obviously, the smuggling issue has got to be resolved. I heard the previous speaker talk about that and I'm sure others have. This particular bill does not address the smuggling issue. Our brief did not address the smuggling issue.
There are other ways of approaching smuggling. I certainly don't come from a background to give you a view on that. I think that the issue relating to pharmacies is that pharmacists are health care providers, just as I am. If my professional organization asked for legislation that allowed me to be a better provider of care and government refused to do that, I would be very concerned.
I perceive that the regulatory body of the pharmacy industry, no matter how elected, asked government to do this over four years ago, and this legislation is the first step in doing that. I shouldn't say the first step, but it is really moving towards that and I applaud that.
Mr McGuinty: I particularly appreciated your comments about environmental tobacco smoke, smoke in the workplace. I'm sure that all of us here have been exposed to secondhand smoke at one time or another, in a restaurant for instance. It's simply ridiculous to think that you can have one section where there are smokers and another section when there's no partition in between. It's kind of like having a swimming pool with a urinating end and a non-urinating end. Soon we're all swimming in it.
One of the things that bothers me is that we squeeze $800 million out of our smokers in this province. It's my understanding that none of it, not a single penny of it, is dedicated to helping those people get unhooked, so to speak. Would you have any recommendations in that regard? We have $800 million we derive as profit off the backs of people who are addicted to cigarettes in this province.
Dr Graham: It's an excellent question. I appreciate your bringing it forward. When we talk about a comprehensive strategy, we must help people with this addiction. I live with this every day, because I'm trying and I don't have great methods. I can use a whole lot of things that I think work with some people, but there's nothing that works uniformly.
There is no question that we need to develop better strategies to help people who are addicted to stop, and that's got to be done by a number of providers. Government can do a certain amount, but it can't do it all.
If you're driving at the fact that there should be more money for preventive health care in this province, the answer is yes. We need to know how to deliver it, though. Clearly there must be strategies to help the people who are addicted. Those are the people I see. This legislation is largely directed at our children and our grandchildren, and that's going to be the real benefit of this legislation. If we can stop those people from starting, we won't have to be spending expensive dollars on people like me looking after people with the diseases. That is really the issue.
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Mr Arnott: Your organization is working very hard to reduce tobacco consumption or tobacco use in Ontario and you should be commended for all the work you're doing. We certainly appreciate it.
I have a question relating to the bill specifically. I tried to talk to as many constituents as possible to get their views on this issue before I came to the committee. I've spoken to Steve O'Neill from Arthur, and Steve owns the Village Variety convenience store. He sells cigarettes. He's read the bill. He expressed a concern to me that if he were in a situation where he sells tobacco to someone under 19, he's subject to very severe penalties, very strict penalties. He says that if a kid aged 17 or 18 years old buys tobacco, there should be some responsibility placed on their shoulders as well. If he does it inadvertently or by mistake or whatever, he could still be subject to a major fine, yet for the 18-year-old who bought the tobacco, there's no offense against it and there's no responsibility at all.
In other areas we assume that an 18-year-old should be responsible. If you compare it to alcohol, an 18-year-old who consumes alcohol could be subject to a charge, so in that sense there's some responsibility put on the purchaser, in other words. Mr Wilson and I have been discussing this. Would it be your recommendation that there be some addition to the bill to prohibit the consumption or the use of tobacco, or the possession, by children?
Dr Graham: That's the next step. It's a very good question. The issue is, how tough do you want to be? That's the bottom line. There are a number of issues. Obviously, a 16-year-old must start to take some responsibility for their own actions. There's no question about that. The problem is that the way in which tobacco is marketed is so seductive. We don't understand the whole issues of peer pressure and how they work in that maturing brain.
The issue is that these are not really, truly informed, objective consumers. They get started and then that's it. This isn't something you can start and stop. Anybody in this room who has tried to stop smoking will understand the agony of doing it. Whether you've got a disease or not, to stop ain't easy. The issue is that we have neophyte consumers who are, for a variety of reasons, toying with this addictive product and we're having to figure out what are the strategies, the best ways to prevent them from doing that.
The practicality of enforcing what you're suggesting is another whole issue, and I'm not a legal expert or a law enforcement expert. We're in effect trying to get the word out, by education, by making the packages less sexy, less attractive, by putting in place legislation that raises the legal age, by restricting access, and maybe by other strategies that the behavioral scientists will come to us with five years from now that will tell us, "There's a better strategy to get inside the brain of a 16-year-old or a 12-year-old who's thinking about starting." This is why the evolutionary concept has got to be considered, because we don't have all the information.
The comprehensive strategy part of it is fundamental to the success. I don't think any one part of this is going to be 100% successful. This whole bill isn't going to be 100% successful. But it's a very positive step in the right direction.
Mr Jim Wilson: Just along the same line, as you know, one of the controversial sections is obviously dealing with pharmacies. The government's objective, and the objective of all of us, in the bill is to stop young people from starting to smoke. I'm not convinced that by banning it in one retail sector you're going to do that.
We're floating this; we'll go back to our offices and wait for the phones to ring off the wall, I suppose. It seems to us that if you made possession or consumption illegal for 19 and under, I would think, and I'm interested in your opinion, we could drop this discriminatory practice in one part of the retail sector and everybody would have to participate in enforcement. It would be the law of the land, as it is with alcohol.
Dr Graham: That's certainly another model. I would take exception to the previous presenter, who may not be here to comment, but I'm talking about perception. In the pharmacies, the perception is that the pharmacist is behind the desk and he's dispensing pills, and that then there's somebody out front who's peddling Coke or cigarettes or whatever. In the pharmacist's mind, there may be the two parts of the shop, so to speak, but in the consumer's mind, a pharmacy is a provider of health care services.
The issue is that if somebody who is impressionable in relation to the purchase of a product goes into a pharmacy, which supposedly must know something about health care, and is saying, "We're going to counsel you to stop once you've started," why don't we indeed make this place of health, supposedly, a place where you can't get started? It's like a hospital. The public perception issue here is the key issue. There are economic issues and what not, but there are also economic issues relating to the 13,000 people in Ontario who die every year from tobacco-related diseases. I suggest that the dollar impact of health care resources relating to those deaths far outweighs any economic burden that would be imposed on the pharmacies as a result of this.
The issue is that there's a public perception issue of pharmacies and what their key role is. I would put it to this committee that they are providers of health care much as I am. If I become inconsistent in the delivery of my key message, I am totally useless. It's just like in the 1960s when 75% or 80% of doctors smoked. It was very difficult for them to give health care messages relating to smoking. Currently, 3% of physicians smoke. We're much more powerful as a group and credible as a group in giving these messages. Pharmacies should be the same. We all should be 100%.
The Chair: Thank you very much, both of you, for coming before the committee this afternoon.
Bob, do you want to comment on one document that's being circulated?
Dr Bob Gardner: Mr Arnott asked this morning about research that had been cited on the CBC, and it was also in the Toronto Star and the Globe and Mail, from England on the health effects of smoking. The research had to do with a higher risk of miscarriage for women whose own mothers had smoked. I've distributed a wire service article from Reuters agency in the UK to members. That's the good news. The bad news is that the article itself does not cite where the material was published. It would appear to be a report of an ongoing study. This is from a study from the Institute of Child Health at Bristol University, a seven-year study, so it will probably take us a little while to actually chase down the research because it does not appear to have yet appeared in a medical or social policy journal. But we'll continue to dig it out.
The Chair: Also, I would inform members that the House leaders have agreed to our request to sit on either the 23rd or the 24th. They've left it up to us to determine which day. I can leave that with you and ask for a decision later, but we have that, if you could just give that some thought.
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RESPIRATORY THERAPY SOCIETY OF ONTARIO
Ms Yvette Dumont: My name is Yvette Dumont and I am the president of the Respiratory Therapy Society of Ontario. I am still involved in clinical practice, mostly with paediatric and neonatal patients.
Ms Susan Marshall: I'm Sue Marshall. I'm a respiratory therapist and I'm presently working in home care and casually in the hospital. I see a lot of young asthmatic-type patients and I see a lot of older patients who are on oxygen now in the home.
Mr Shawn Kenny: My name is Shawn Kenny. I'm the president-elect of the Respiratory Therapy Society of Ontario, and likewise I'm also employed in provision of home respiratory care to adult and paediatric patients.
Ms Dumont: The RTSO applauds the Ontario government and the opposition parties for the political will the three parties have demonstrated in supporting and bringing forward this legislation. However, while we support the basic tenets of the Tobacco Control Act, we believe the government must strengthen this legislation in order to successfully limit access to tobacco products and prevent involuntary exposure to environmental tobacco smoke, also known as ETS.
The RTSO represents the profession of respiratory therapy in the province of Ontario. Our profession is dedicated to assisting physicians in the diagnosis, treatment and promotion of wellbeing and quality of life of patients with respiratory and associated disorders. Unfortunately, many of the patients we care for on a daily basis are suffering either because they are smokers or through involuntary exposure to environmental tobacco smoke. We see on a too-regular basis the devastating impact of tobacco use on our patients: on children with lower respiratory tract infections such as bronchitis and pneumonia whose only crime is having parents who smoke; on adults who are battling the ravages of lung disease because of their decades of smoking or simply as a result of exposure to a smoking partner or colleague; on asthmatics whose suffering is all the more pronounced because of their exposure to ETS in their daily lives.
The direct causal link between both smoking and exposure to ETS and preventable lung disease is irrefutable. As health care professionals whose fundamental objective is to promote the best possible care for patients suffering from diverse cardio-respiratory disorders, we are here today to ask for your assistance in preventing the spread of cardio-respiratory diseases. We believe this can be accomplished in several significant ways: first, by limiting the access of young people to tobacco products, and second, by preventing involuntary exposure to ETS through strengthening of the Smoking in the Workplace Act.
In 1986, the US Surgeon General and the US National Research Council confirmed that ETS causes lung cancer in non-smoking adults and poses a significant health risk to children. It is estimated that 150,000 to 300,000 children per year in the United States suffer from lower respiratory tract infections directly linked to ETS exposure. In Canada, it's estimated that for infants to 18 months of age, there are approximately 15,000 to 30,000 children who are affected. Overall, there's the potential for 100,000 children in all of Canada.
The RTSO fully recognizes the risk presented by ETS and suggests that this is one of the most critical yet weakest links in the strategy to protect the public from the effects of tobacco. In order to provide effective protection from ETS, this legislation must be strengthened:
(1) By improving Ontario workplace smoking legislation, which has proven to be largely ineffective in guaranteeing a smoke-free workplace for employees of those who wish to allow smoking in the workplace.
(2) By strengthening the restrictions on smoking in public places to ensure that exposure to ETS is eliminated wherever possible. We would in fact recommend changing the onus of the legislation. Currently, smoking is prohibited in public places that are listed in the legislation. We would recommend the prevention of smoking in all public places except those which are exempted from the legislation. We believe this small amendment will provide far greater protection.
The primary objective of this legislation, which is to reduce the use of tobacco products by young people, is jeopardized by excluding provisions to licensed tobacco retailers, as this effectively means no control on the sale of these products to minors. The RTSO fundamentally believes that a uniform licensing system for tobacco vendors with a substantial policing and enforcement mandate would assist in the battle against tobacco-related diseases and would help prevent the sale of tobacco products to minors. The mandate should include revocation powers for any vendor found to be selling tobacco to minors and significant fines for non-licensed retailers who are found to be in breach of the licensing restriction. Through licence fees, this program would be self-financing and could potentially generate revenues to fund education and research for smoking cessation programs.
As health care professionals, we are particularly supportive of the removal of tobacco sales from pharmacies. It is crucial that cigarettes not be distributed through pharmacies or by health care professionals. To this end, we support the Ontario Campaign for Action on Tobacco and its recommendations to better define pharmacies for the purpose of this legislation to ensure that there are no loopholes for retail establishments that contain pharmacies. As a member of the Ontario Campaign for Action on Tobacco, we fully support the positions outlined in OCAT's submission to this committee and endorse all of the recommendations contained therein.
This legislation must be strengthened in order to successfully achieve the objectives of limiting access to tobacco and to ensure protection of the public from ETS. By strengthening the Smoking in the Workplace Act, the government will take a tremendous step towards limiting involuntary exposure to ETS. Through a licensing system for tobacco retailers, the access of minors to tobacco products will be further restricted and will contribute to the prevention of smoking among young people.
We would also encourage the government to fund both public education programs to discourage smoking and smoking cessation programs in accompaniment to the Tobacco Control Act. While legislation is effective in halting the use of tobacco products, we must focus on changing attitudes and perceptions about smoking and ensure that consumers have the facts about the debilitating effects of tobacco on smokers and non-smokers alike.
Mr Jim Wilson: It's good to see you again. Mr Arnott made the suggestion that we're grappling with the idea that for years governments have said the limit has been 18 years of age, and if you can't buy tobacco products nor is anyone to furnish those products to you, then why in the world are so many 12-year-olds smoking? Somewhere along the line something messed up. Somebody either gave them the cigarettes or they bought them. So what do you think of the idea of just making it illegal to have cigarettes in your possession or consumption of cigarettes or tobacco products under the age of 18 or 19?
It seems to me that something has got to change, and we need a dramatic break with the past. I think Mr McGuinty actually made similar comments about a break from the past during his remarks at second reading in the House. We're going to spend the next four or five weeks fiddling around again with an approach that we're told by all kinds of groups doesn't seem to be working all that well or has become less effective over the years, the approach that government has been taking to this whole issue.
Ms Dumont: If we could limit the access to tobacco such as it is right now with alcohol, in that there are only licensed establishments and we have the Liquor Control Board of Ontario, perhaps we could then take it further and have the ability to actually police or fine people who have obtained the tobacco, obviously illegally because they're underage. It might be quite difficult to do that when you have tobacco that's easily accessible in the environment, in corner stores. We're looking at native groups providing their own tobacco, so then it becomes another issue. First, I think you need to limit the access to tobacco and then put in restrictions on, if you want to take the idea, users underage, and then further police it that way.
Mr Jim Wilson: One way or the other, though, you have to have policing.
Interjection: Charge the vendor.
Mr Jim Wilson: Right now the vendor is getting hit pretty hard, and the act speaks at great length about identification. We've had people coming up saying we need more sections in the act further clarifying what type of identification. The poor vendor can barely pay their taxes in this day and age. Why don't we just make everybody in society responsible, not just the vendor? That is, if anybody is caught with cigarettes under the age of 18 or 19, whatever we decide, like any other law, it's responsible to point out to the police that it's wrong, there's a law being violated. There would still be an onus on the vendor, obviously; they're not to sell them. Someone standing outside the Becker store near the school smoking, I would think -- I mean, we've got this thing in here about bus shelters. Now, how in the world do you police bus shelters? Well, I assume if a police officer drives by and sees someone smoking in the bus shelter, in this case, that's your enforcement. I don't imagine a lot of people are going to phone in saying that people are smoking in the bus shelter. It seems to me that whatever you do policing is a problem, and in fact this may actually solve some problems.
I just want to hear what your thoughts are. We're just floating it out, and as I say, we'll be in our offices all night waiting for the calls.
Mr Kenny: I don't think any of us three are lawyers to tell you whether you can do that or not.
Mr Jim Wilson: Look at alcohol. I used to be a park warden one summer. There are several charges under the act to deal with alcohol and underage.
Mr Kenny: I think as a professional society we would be supportive of any measure that would keep kids from starting to smoke. I can't see as a society of respiratory health care providers that we could be anything but supportive of such a move. We couldn't even begin to suggest how to do it, but if it can be done, we would be happy with it.
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The Chair: With that, we'll move to Ms Haslam, who will tell us how it's to be done.
Mrs Haslam: What a reputation I'm getting.
I really appreciate people coming in and talking about health issues and young people. That's really important.
On page 2 you mention you're encouraged by the Tobacco Control Act's emphasis on reducing the number of young people who begin smoking. Somebody came in and told us there were 3,000 young people a week who begin smoking.
Your first one is banning the sale of tobacco by licensed health care professionals in pharmacies and by vending machines. It has been suggested, in statistics that one of the companies gave us, that pharmacies sell 16% of tobacco products. That's what one of the pharmacy groups gave us as information. Given that they sell 16%, they also argued that this 16% would then go into other establishments. I'm wondering if you had a comment on that or whether this would effectively help in limiting the access to tobacco products.
Ms Dumont: One of the issues is convenience. If you're already in a pharmacy purchasing other items, then you don't have to make another stop, and maybe one day you won't make that second stop because it's going to be somewhere else. It seems kind of contradictory where you have a pharmacy where they're selling and promoting wellness and you're filling out your prescription for your asthma medication, and then you're turning around and buying your carton of cigarettes. So I think it's very difficult to say. That 16% may go somewhere else, but also it may turn out to be that this will not be 16% elsewhere; it may be reduced to 10%.
Mrs Haslam: Actually, it's been reduced from 21% to 16%, so I agree with that.
I wanted to spend a couple of minutes on the education programs. Mr Beer was maybe being facetious when he said, "Karen will tell you how to do it," but I have my own idea about what to say to young people. The previous gentleman indicated it's difficult to tell young people. They don't like to be told. I know when I say to young people, "Do you know that this can kill you?" they say, "I'm young, I've got lots of time ahead of me; I'll never die; right now my thoughts are I'm not going to die." I was interested to know what kind of education programs you thought were most effective for young people.
Ms Dumont: In my experience, working with paediatrics, I've found that a lot of times the use of peers -- we have children who have quite serious respiratory-related diseases, cystic fibrosis and some severe asthmatics, who are very intolerant of tobacco smoke. Actually, I've had a few of them in discussion, asking, "Do your friends smoke?" Some of them admit that they do and that they understand the effects to the other person, but sometimes if you have someone who's of their own age group, they can better explain what it's like when you can't get your breath, when you have to go into the hospital and use oxygen at home. Making it an issue of young people, not just that it's something for old people to deal with, may take some of the effect away from wanting to smoke.
There's the other issue, and that's peer pressure. I think young people need to have active discussions on dealing with peer pressure and what it means to be one of the group and acceptance and what's right or wrong, that they make their own decisions and they're educated decisions.
The Chair: Just one more.
Mrs Haslam: I'll change my tack then. I want to run one by you. It's interesting you talk about peers talking to peers. Young people don't like to be manipulated, they don't like to be lectured to and they don't like to be told at 16, 17 or 18 what they should be doing with their lives. I was wondering if one of those campaigns similar to -- I think somebody in the States had it, where they said: "This is a product where if you use it according to manufacturers' directions, it will kill you. It is a product that is designed to kill its customers, therefore they need more customers and they're going to a younger and younger audience. You as young people are being manipulated by a conglomerate corporation."
Do you feel that would have as much effect as the peer idea would?
Ms Dumont: I think it's another way to explore how you educate young people. It's interesting, identifying the fact that young people don't like to be told what to do or taken advantage of in that situation. And it's true: It's all in how you word the question or the presentation. They have to be given the sense of responsibility and information, and then their decision is based on that. I believe that might be another way of giving them the information. It's unfortunate that we have to look at such large companies and advertising and a lot of power, and a lot of these young people may not realize that it goes beyond lighting up a cigarette. There's a lot more involved in what happens when you light up that cigarette. There's a chain of events.
Mr McGuinty: We've heard from a number of presenters now about this idea of prohibiting smoking in all public places unless a specific exemption is provided, and that holds a certain amount of attraction. How would we define the exemptions, though? How would you qualify for an exemption? I'll just give you a couple of examples.
One of the things that I kind of dread doing on November 11 is going over to the Legion hall, because the smoke there is just so thick you could cut it with a knife. The other place that you seem to almost have to be a smoker to gain entrance to is a bingo hall. It's really thick there too. I'm just wondering, would those qualify for exemptions, and how would we go about it?
Ms Dumont: As health care providers, our main focus is with health care institutions. Right now, where I'm employed we do have smoking areas for patients, and sometimes, it's kind of discouraging when you have to chase down your patient in order to give them their Ventolin treatment, pull them out of the smoking room.
Specifically with health care, we're probably promoting that more than anything about limiting access to having public smoking. On the other hand, it's been very well stated in newspapers that you have all these patients sitting at the entrance to a hospital, outside in their hospital gowns with their IV poles, because that's the only place they can have a cigarette.
Mr McGuinty: Can you think of any exemptions?
Ms Marshall: The Lung Association has a large bingo they put on and they have a section -- in fact I think they even have particular nights where there is no smoking or they specifically have rooms of no-smoking bingo. A lot of that money goes back into the pot to help with education on lung disease.
Mr Kenny: In my respiratory home care practice, I've seen a number of our clients -- interesting that you would say things like Legion halls and bingo parlours -- who are having a significant part of what had been their social life prior to going on home oxygen therapy taken away from them, not only strictly from the health aspect but from the safety aspect. They can no longer take their portable oxygen system into the bingo hall for fear of burning the place down. So where are the exemptions? Personally, I think few and far between.
The Chair: Thank you very much for coming in this afternoon and for making your presentation.
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CANADIAN AUTOMATIC MERCHANDISING ASSOCIATION
Mr David Orriss: My name is David Orriss. I'm the owner and operator of London Vending Service Ltd. I'm a vending operator and have been in the business for 25 years. I'm here today to speak to you in my capacity as president of the Ontario region of the Canadian Automatic Merchandising Association.
Mr Paul Runstedler: I am Paul Runstedler, vice-president of sales with Red Carpet Food Services in Toronto, a national company. I am here on behalf of the CAMA as acting treasurer of our association.
Ms Cynthia Davenport: I am Cynthia Davenport. I'm with the Canadian Automatic Merchandising Association and I am the manager of the association.
Mr Orriss: The Canadian Automatic Merchandising Association, CAMA, is a trade association representing companies and individuals engaged in the vending industry as owners and operators of vending machines and as service technicians, equipment suppliers and product suppliers. As such, we are very concerned with section 7 of Bill 119, which proposes to make it illegal to sell cigarettes through vending machines.
The most recent Statistics Canada figures for the vending industry show there are 3,363 cigarette vending machines in Ontario. CAMA's members own and operate approximately 767 of them, or just under one quarter of all cigarette vending machines in the province. CAMA has 63 member companies in Ontario that fall into the category of operator. Of those companies, 21 own and operate cigarette vending machines as part or all of their business.
The immediate effect of this legislation on our members will be to put at least two, or 10% of those 21 companies, out of business entirely. Collectively, seven of the remaining 19 companies anticipate that they will be forced to lay off at least 15 people. Expressed as a percentage, 37% of the companies that manage to remain in business will be forced to lay off one or more employees. These anticipated job losses are in small towns in northern Ontario, central Ontario, southwestern Ontario and southern Ontario, communities that have already been hard hit by the recession and large-scale layoffs.
If we use the CAMA figures as a formula and assume that our membership represents one quarter of the cigarette vending machine business in Ontario, we can extrapolate from those numbers that at least eight businesses in Ontario engaged in selling cigarettes through vending machines will be immediately forced out of business and at least 60 people will lose their jobs if Bill 119 passes, as it is currently written.
Those Ontario vending business owners and operators who aren't immediately put out of business by this legislation will have to make do with reduced product lines. Furthermore, they will have to try to capture a piece of a market that is already saturated with products from their competitors' vending businesses.
Taking a somewhat Cassandra-like look at the future, it's not difficult to imagine that many of those who survive the initial impact of this legislation will ultimately be unable to compete against already established competitors. The result is that many will likely face bankruptcy within two years.
Another unfortunate offshoot of Bill 119 will be the inability of these small businesses to sell their redundant cigarette vending equipment. Historically, owners and operators have been able to resell their used equipment to rebuilding companies for approximately $500 to $800 per machine. However, since this proposed law renders these machines obsolete, most, if not all, of the province's 3,363 machines are destined to end up as scrap metal or, worse, in landfill sites throughout Ontario.
This legislation will also harm our members who are equipment and product suppliers. If their customers who sell cigarettes through vending machines go out of business or suffer severe financial losses, it will have a negative trickle-down effect on the businesses of the suppliers. This trickle-down effect could ultimately result in further job losses, this time on the product and equipment suppliers' side.
The costly and painful toll this legislation will take seems too great, especially in light of the fact that the cigarette packages sold through vending machines in Canada account for less than 1% of all cigarette products sold in Canada.
The Canadian Tobacco Manufacturers' Council reports that 1991 sales of tobacco products in Canada came to $10 billion. Statistics Canada figures for the sale of tobacco products through vending machines totalled just under $76 million for all of Canada, about three quarters of 1% of total sales of tobacco products.
The corresponding figures for Ontario are $3.86 billion total sales and of that, $22.8 million came from cigarette vending machines; again, less than 1% of all tobacco products sold in Ontario.
Until consumers started rebelling against the high price of cigarettes by purchasing contraband cigarettes, statistics tended to support the notion that there was a correlation between the high price of cigarettes and a reduction in the number of people who smoke. There is a similar correlation with regard to cigarettes sold in vending machines. Cigarettes sold in vending machines are more expensive than cigarettes sold at traditional retail outlets.
A random check of some of the 21 member companies involved in cigarette vending shows that the average price per cigarette of a machine-vended package of cigarettes is just over 30 cents. Similar-sized packages of cigarettes sell for an average price per cigarette of just under 26 cents in stores in the areas surveyed.
Consequently, prices serve as a deterrent to teenagers. They just don't buy cigarettes through a vending machine. The chances are greater that a teenager is buying his or her cigarettes at a corner store or out of the trunk of a car than through a vending machine.
The Canadian Automatic Merchandising Association wants to assure this committee that it supports the spirit and intent of Bill 119, which is to prevent, or at least discourage, young people from starting to smoke. This association also agrees with the proposal in Bill 119 to raise the legal smoking age to 19. We ask, however, that the government follow the federal government's guidelines with regard to the sale of cigarettes through vending machines.
The planned federal regulation governing the sale of cigarettes through vending machines requires that the placement of cigarette vending machines be limited to bars, taverns or other similar beverage rooms where access in Ontario is limited to persons 19 years of age and older. It also requires that every cigarette vending machine in such locations be located in a place so that direct supervision of the vending machine is maintained by the person in charge of the bar at all times while the bar is open for business, and be situated in the bar so that it's farther away than five metres from any entrance to the bar. With the exception of Nova Scotia, the trend in the rest of the provinces appears to be to follow the federal guidelines. We ask that Ontario do the same.
The majority of our members who are still selling cigarettes through vending machines already have their machines exclusively in bars, taverns or similar beverage rooms. By following the federal government guidelines on this issue, the committee has the power to ensure the livelihood of some of Ontario's struggling but optimistic small businessmen and women.
At the very least, we ask this committee to provide our members and all other owners and operators of cigarette vending machines in Ontario one year to adjust their businesses to accommodate the new law and in accordance with Bill C-111, if necessary, should it come into effect as planned on July 1, 1994.
Bill 119 provides pharmacies a full year from the date of proclamation to adjust their businesses. However, Bill 119 provides only three months to owners and operators of cigarette vending machines. Pharmacies clearly have a diversified product line. They do not rely, to any degree, on the sale of cigarettes to survive. The same is not true for the small businessmen and women who own and operate cigarette vending machines.
To reiterate, the negative economic impact of Bill 119 will be deeply felt by those engaged in the sale of cigarettes through vending machines in Ontario. Therefore, we ask once again that the committee recommend amendments to Bill 119 that will allow cigarette vending machines to be placed under direct supervision in bars, taverns or similar beverage rooms.
If this is not possible, we request that the committee recommend amendments to Bill 119 that will allow those engaged in the sale of cigarettes through vending machines the same consideration that is being offered to pharmacies with respect to the time line for conforming to this legislation with respect to the restriction governing the federal law.
I would like at this time to invite the committee to ask any questions that you might have about the effects of Bill 119 and its direct effect on our industry. I would, however, like to ask the committee a few questions after that, if I may.
The Chair: Did you want to ask your questions first?
Mr Orriss: If that's your preference.
The Chair: I can't say that the committee will be able to necessarily answer your questions any more than you may be able to answer every individual committee member's, but --
Mr Orriss: As a result of the proposed legislation, we've had many discussions with all members of our industry and we've had questions come back to us and frankly we don't have the answers. We're hoping that at this time, or at least when the law is set, it will be taken into account and we can have a response for these.
The law obviously will have serious repercussions on the financial stability of businesses in Ontario that sell cigarettes through vending machines. In some cases, people will lose their businesses altogether and those who don't face bankruptcy are certainly going to face a very dramatic decrease in their profitability and their operating position.
What we would like to know is, does the government plan to compensate these people in any way for lost income? Does the government plan to compensate these people in any way for the cost of adjusting their style of business? Does the government plan to compensate these people in any way for the cost of disposing of these useless machines? Does the government plan to compensate these people in any way for the substantial loss of capital investment that would be created through this bill in making the equipment obsolete?
The other question I had pertains to precedence of federal or provincial law. Obviously, with Bill C-111 taking effect, we anticipate, on July 1, if the Ontario government goes ahead with the ban of cigarette vending machines but gives vending operators a year to comply with the law, will these operators have to abide by the federal law if it comes into effect on July 1? In other words, if operators are given a year to close out their cigarette vending machine businesses, will they still have to remove their machines from every location except bars, taverns or other similar beverage rooms by July 1 or does the provincial law take precedence over the federal law in this case?
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The Chair: I'm going to ask the parliamentary assistant, who is carrying the bill for the government, to respond to those questions. As you understand, those are part of our record, they're in Hansard, so we all have those questions as well.
Mr O'Connor: Some very pertinent questions. First of all, the rationale behind having the total ban in Ontario: Contrary to what your brief has pointed out, licensed premises in Ontario are accessible by young people. Of course the thrust of the legislation is the young people. The federal government ban is going to be quite comprehensive as well. It just doesn't go as far. Because licensed premises are accessible for young people, that's why we've gone that one step further.
Is the federal government planning on compensating the owners of vending machines right now?
Ms Davenport: Not to my knowledge. I'm certainly not aware of any precedent for that.
Mr O'Connor: The rationale behind the three months is that three months, from what we can gather, and maybe you can enlighten the committee, would be about the length of time it would take for your stock, the product you're selling, to be used up. We're certainly hoping to hear what you have to say as well.
Mr Runstedler: I would ask then, if it's three months for vending, what is the rationale of one year for the drugstores? Is that the same rationale, a year to use up their inventory?
Mr O'Connor: Partially, yes, that would be the case.
Mr Runstedler: I think if you looked at their records you'd find their stock turns are less than a month, and their year is quite substantial compared to our three months.
Mr O'Connor: We have heard from this committee that they'd like to see their time shortened to three months as well. Thank you for that input.
Mr Orriss: One of the concerns we had in that time frame is the logistics of bringing in to a warehouse, in some cases, hundreds of machines that are rendered totally obsolete. There is no market for them. We're talking about millions of dollars' worth of vending machines.
We could scrap them. I know from experience if I take a scrapped cigarette machine to the yard, I get between $1 and $1.50 for that piece of equipment. Obviously that's not an answer to us, to pull them back in in hopes of doing something else. There's really no other use for the machine, but even during that time we're going to have to warehouse, in some cases, individual operators, hundreds of vending machines. There is no after-market. They are obsolete. Three months doesn't give us time to bring those machines in and make arrangements for that.
Mr O'Connor: You'll still have to comply with the federal legislation in which the ban does take effect July 1.
Mr Runstedler: Which means a small percentage of the industry, because taverns aren't involved with the federal law. In taverns, licensed premises, you can still leave the machines, you're just pulling them out of lobbies or public areas.
Ms Davenport: Workplaces etc.
The other consideration with regard to this is the fact that a lot of these people will have to adjust their businesses. They'll have to try and source out new markets for their products. Three months is not enough time to concentrate on getting rid of the machinery and taking it out of the places it's at, let alone revising a business plan and sort of readjusting one's strategy on how they're going to cope and survive.
The important thing to bear in mind is that these people are small business owners and not people who get unemployment insurance. They don't have some of the social safety nets available to them if and when their businesses fail. For that reason, if not any other reason, they should be given enough time to try and continue to survive and to eke out some kind of viable existence for themselves.
The Chair: I'm going to move on to questions now, but those are very useful questions for the committee as we think about the bill and as we go forward with it. Some of that may come back up again in the questions anyway.
Mr Arnott: You made a very compelling case for compensation if indeed this bill goes through, and you can be assured that the Conservative caucus will support you in that. What is it, $800 million a year that the government receives in tax revenue? Certainly a portion of that should be allocated towards a generous compensation program.
If this bill does go through, it's very clear that many of the companies in your industry will be literally wiped out. One day it's legal and the next day it's totally illegal. I'm not sure, if I were faced with that prospect, what I'd do, but obviously you're out of business. If it's government edict or government legislation that is having that effect, you have a very good case and I would hope the government would give serious consideration to that.
Your suggestion that your machines continue to be available in licensed establishments, for example, is consistent with what the Ontario Restaurant Association has told us, so you've got an ally there. Your point with respect to how much time is given to phase out the industry, if indeed the bill goes through, is that it should be consistent with what the pharmacists receive. Again, you've got a very good case with respect to that. I can't see any rationale for giving the pharmacists a longer time to phase out than your industry, especially when your industry, in many cases, will be absolutely devastated, whereas it's been suggested that some pharmacies may close, but I don't think anyone's suggested that every pharmacy in Ontario will close as a result of Bill 119.
Mr Wessenger: I'd just like a little bit of clarification about your numbers. I gather that basically you have two companies that are solely in the business of cigarette vending machines which you represent. Is that correct?
Mr Orriss: No, sir. We represent 21 operating companies in the province.
Mr Wessenger: That is part of their business, but for two of those 21 it's their sole business, because you indicate two of them would go out of business entirely. I'm just taking that as a correct assumption.
Mr Orriss: Yes, that's right, one being a very small operator who has no other types of vending machines at all. He will cease to exist as of July 1.
Mr Wessenger: You say there are 3,363 cigarette vending machines in Ontario. I know many of these are in motels and in halls and so forth, but do you have any statistics to indicate how many of those would be rendered inoperable as a result of the federal legislation? You may not have it exactly, but could you give it to me approximately?
Mr Orriss: Approximately half. According to the Statistics Canada report of 1991, 47% of any machines were in the classification of taverns, bars and licensed establishments.
Mr Wessenger: Right. As I understand it, those 47% that would still be permitted under the federal legislation, you would like to have an extension for those because I gather the federal legislation is going to prohibit them in the other locations as of July.
Mr Orriss: For the 53% that are not located in licensed establishments? We are prepared to accept the federal law as it's being proposed. It's our hope to allow the people operating vending machines to be able to do so, albeit on a somewhat narrower scale than they did before.
Mr Wessenger: So you're asking for a year for those that are permitted to continue to be operated before you have to cease operations. I just want to know what they apply to.
Mr Runstedler: No. The federal law? We agree with the federal law, as an association. We're not arguing with preventing children from smoking. The federal law allows cigarettes in licensed premises. That's all we're asking, that the Ontario government do the same as the BC government has just done, that the Manitoba government is considering, that you just follow the federal law. Instead of having two different laws, we'd have one law banning them in public places where half of 1% of the total business is being purchased, which you're saying that all the children are buying. We agree with you: Get it out of public places.
Ms Davenport: And at the very least, if section 7 of Bill 119 goes through as it is currently written, then we're asking that we have at least a year, and during that period, I guess from July 1, we'll have to remove them from every other place but the bars, taverns etc.
Mr Wessenger: That's what I thought, that's what I wanted to understand. Thank you.
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Mrs Haslam: Of 21 operating companies, two sell tobacco only. In the other 19 operating companies, what percentage of their machines are for tobacco? Obviously there are vending machines for sandwiches and pop and juice. Do the know the percentage of tobacco vending machines in the other operating companies?
Ms Davenport: It varies from company to company. These are all individual businesses, so the percentage of their business dedicated to cigarette vending machines as opposed to sandwiches and pop and what not varies in each of those companies, so it would be really difficult to come up with a hard number.
Mrs Haslam: Is it impossible to take the tobacco vending machines and change them technically to do the sandwiches? When you go into the highway pull-offs you have chips. They're all different sizes.
Ms Davenport: That's an excellent question.
Mrs Haslam: So can you accommodate those machines?
Mr Runstedler: No, the tobacco machines are set up as such that the columns are so small for a small 20-pack or 25-pack, you cannot convert them to chips. You can convert them to selling cigarette lighters, but if you're going to ban cigarettes there's not much point in selling cigarette lighters. It's just small things. It just wouldn't warrant all the conversion. You could go buy a new machine. It's too costly.
Mr McGuinty: You've raised some very good questions and I look forward to hearing the government's response to them. What you've done here is force us to stare into the face of one of the downsides associated with Bill 119. Some people would have us believe that it represents motherhood and that there are no downsides, but I disagree. With every piece of legislation there are good parts and bad parts. If we're going to go ahead with this, and I assume we are going to go ahead with it, we have to recognize that some people are going to get hurt. It's incumbent on the government, first of all, to make that recognition, to acknowledge that it's doing it in the broader public interest, that it's going to be putting people out of work, and to consider compensation.
I introduced a private member's bill which would have attacked smoking in so far as it related to children. I looked at some of the experiences in the States. New York City in fact passed a bylaw which is the same as the feds are considering now. After that met with some success, it was adopted by New York state; a number of other states have taken the same approach.
The idea behind Bill 119, the primary thrust, is to make it tougher for kids to start, and everybody agrees with that. I'm not sure, and I haven't heard from the government on this, why we can't allow these vending machines to continue in age-restricted licensed establishments. If it's not a law, if I can go into an age-restricted licensed establishment in this province without being asked for identification, then let's include that; let's incorporate it as an amendment to Bill 119 saying you can have vending machines in licensed establishments but only where you check for ID at the door. Would you have any problem with that?
Mr Orriss: No, sir, I wouldn't. If I could point out an interesting statistic, obviously the primary thrust of the bill is to stop smoking before it starts. The hope is also to reduce smoking in the population. A statistic from the Addiction Research Foundation shows that teenagers between 15 and 19 represent just 6% of the smoking population of Ontario. To put that further in perspective, with the vending industry having less than three quarters of 1%, I don't know how many zeroes you have on your calculator, but multiply that again with the number of underage teenagers who go into licensed establishments and you're creating a problem where there isn't one now. It doesn't make sense to legislate where there is no need for legislation.
Mr Ron Eddy (Brant-Haldimand): I had an inquiry regarding the use of vending machines. It would seem to me, and I was surprised at how much they are used, that with such a large underground economy where in some areas of the province the sale of illicit cigarettes is very, very high, and in view of the fact that the price in the vending machine is a bit higher, do you find a tremendously large decrease in the use of the vending machines? I'm surprised they're used at all, because of the contraband cigarettes, which are growing every day, completely out of control.
Mr Runstedler: In answer to your question, the trend of the last few years has been down, in terms of volume per unit. But the big thing is you'll notice that the vending industry is a convenience industry. It's in an area, a pub or a tavern, where if you run out of cigarettes and you're having a beer, you don't want to be running to the contraband corner. "I want my pack right now," so he walks over and buys his cigarettes to finish off his evening. But we are higher-priced. Teenagers today are very financially astute, let me tell you, and they aren't going to be paying 30 to 40 cents a pack more when they know they can get it at the corner store for a lot less.
The Chair: Thank you very much for coming before the committee today and for your presentation. We appreciate it.
The parliamentary assistant has a point he would like to make.
Mr O'Connor: As I had stated when we had the people before us making their presentation, the reason our legislation includes a total ban is because licensed premises in the province of Ontario are open and accessible to people who are under the age of majority. That is the reason behind that. I certainly appreciate them coming forward and giving us their economic picture. The rationale is that licensed premises in Ontario are accessible by young people.
The Chair: As I said to the parliamentary assistant, we're not, at this point, going to get into a long debate about this. These are differences of opinion, perhaps. Mr Wilson, a comment, and Ms O'Neill, a comment, and then we really must move on.
Mr Jim Wilson: To the parliamentary assistant, the federal government knew that when it put its law forward. Secondly, what I'd like an explanation for is licensed premises. Minors are supervised with respect to alcohol; in other words, you can't serve alcohol to a minor. In those same premises where we entrust that, why can't we say that you have to watch the vending machine too? As Mr McGuinty and other jurisdictions have pointed out, you put it so many feet within the bar area or supervised area and charge them with that responsibility too. Obviously, you considered that. What was the outcome of that discussion?
Mr O'Connor: The important element is that the vending machine doesn't have the same ability to question the person putting in the loonies to buy those cigarettes: "Are you 19 years old?" The vending machine doesn't have that capability.
Mrs Yvonne O'Neill (Ottawa-Rideau): For the record, can Mr O'Connor, because not everyone is not familiar with the same discussions he has had, give some examples of the licensed premises being open to minors? Could you just expand a little?
Mr O'Connor: Sure. A family restaurant like O'Toole's is a licensed premise. I don't want to name names of establishments, but you can relate to licensed premises. Quite often you will take your family out to --
Mr Wessenger: Swiss Chalet.
Mr O'Connor: Yes, Swiss Chalet. There are a number, but I don't want to name premises. You can relate to any one.
Mrs O'Neill: I think that's important for the record.
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NON-SMOKERS' RIGHTS ASSOCIATION
Mr Garfield Mahood: Mr Chairman and members of the committee, my name is Garfield Mahood and I'm the executive director of the Non-Smokers' Rights Association. On my right is David Sweanor, the senior legal counsel for the Non-Smokers' Rights Association.
By way of introduction, I'd just like to let the committee know a little bit about who we are. We operate a non-profit health advocacy organization which has offices in both Ottawa and Toronto. We have a staff of close to 10 people.
I think it's fair to say that our organization led the national campaign for the Tobacco Products Control Act. We played a major role in the passage of the federal Non-smokers' Health Act. I think it's also fair to say that we led the initiative for the new federal warnings which are coming on cigarette packages later this year. It's also fair to say that David Sweanor, our legal counsel, who is an acknowledged expert in tobacco taxation, has been principally responsible in this country for the world-precedent-setting declines in tobacco consumption. Taxation policy and price have been the major factor in the world-precedent-setting declines. That's our background on the organization. We've been in business for about 20 years.
After the introduction, I'd begin by saying that I'd like to praise the government and the minister for the legislation before the committee. We think there are some precedent-setting features in the legislation. It's not all we want; there are certainly areas for improvement, but considering the fact that we've never had a serious tobacco bill before the province of Ontario at any time in the history of the province, this government deserves a lot of praise. I think that should be remembered, and we want to go on record as pointing that out.
There is an even greater need for this legislation given the developments in recent days. You saw the full-page ad in the Globe and Mail yesterday, I'm sure. The threatened tax rollback really has created a situation where, if anything, the province is going to have to go further than it intended when this legislation was introduced.
To explain the seriousness of recent developments, because David Sweanor has been at the heart of this, I'm going to ask David why the tax rollback is such a threat to the health of the kids of Ontario.
Mr David Sweanor: I think there are two things that are important to this committee in looking at this legislation. One, as Gar says, price has been the single most successful tool used to date in reducing consumption. It has done a very good job. We now do have a serious problem of smuggling. We've also seen the possibility of the federal government reacting to that, rather than dealing with the contraband, rather than putting up the price of the stuff that's being sent back and forth across the border, by looking at reducing Canadian taxes to a US level.
If that were to happen, the estimates, based on the work of epidemiologists and economists, given the relationship between price and demand, we'd expect at least 800,000 additional smokers in this country. A large portion of that market would be kids. They're the most price-sensitive. It would eventually translate into somewhere in the range of a quarter of a million additional deaths. It would deprive governments of revenue in the range of $2 billion to $3 billion. It would add an equal amount to annual health bills eventually because of the toll of the use, and it would reward misbehaviour on the part of the tobacco companies and on the part of the smugglers.
I think the real lesson in this for Ontario is something we knew all along in working in the federal system: that if we're looking to deal with health problems, with public issues in this province, we don't have total control of what goes on. The federal government can make decisions, as crazy as they might be, that end up affecting the health and the wellbeing of the people in this province.
That's why when we're looking at not only what Ontario can do to bring some sanity to Ottawa, our home town, we could also look at what we can do with this type of legislation to make sure we get the best thing we can, because we really at this point cannot count on the federal government to protect the people of this province, particularly the kids of this province.
Mr Mahood: Just so you understand the figures David has just used, a future mortality of 250,000 deaths, revenue losses for governments at various levels in this country in excess of $2 billion a year, there is a document that the clerk will distribute from Harvard University professor Robert Allen, which was prepared for the national news conference, which does the assessment of the death rates and the financial impact. He's a visiting professor of economics at Harvard, and this document will underpin what David is saying.
Mr Sweanor: What health and medical organizations are looking for in trying to develop good policy in the area of tobacco is really taking the comprehensive plans that have been developed by groups like the World Health Organization and the International Union Against Cancer and others, and implement them. As Sir George Young, the former assistant health secretary in the UK, has been quoted as saying, the major advances in public health are not made by incision on the operating table but rather by decision at the cabinet table. It's exactly the situation we're in. The big advances we've had in public health in the history of this province, this country, are things like water purification and sewage treatment, housing standards and workplace safety. We're finally extending that now to the product that's by far and away our biggest cause of preventable death.
When we look at what these comprehensive plans entail -- and they're usually very, very comprehensive -- it really comes down to three general areas. One is the whole issue of accessibility. How accessible is the product, and how can we ensure that the accessibility of that product more adequately reflects the harm inherent in its use? Those are such things as who can buy it, the sales to kids; when they can buy it; where they can buy it; how affordable it is.
The second issue is informed consent. How can we make sure we give people sufficient information so that they can make informed decisions about their own health? Those are such things as the health warnings, which this legislation would allow the province to have; health education campaigns; forcing tobacco companies to tell what additives are in their product. Give people the information they need.
The third area is protection of others to ensure that when the product is being used, it's being used in a way that isn't going to harm other people. The legislation we're considering now clearly looks at all of those areas, and there are some very good precedents in it that would be important, not only for the 10 million people here and the much larger number in the entire country but the fact that many other countries are looking to Canada for examples of what they should be doing in preventive medicine, specifically on tobacco. We're very aware of that. Whatever we adopt here will be used by other jurisdictions, and it has a tremendous possibility of affecting future mortality and morbidity trends far beyond our borders.
Mr Mahood: We want to come here today and express very strong support for many of the principles advanced by the Ontario Campaign for Action on Tobacco. They've identified four critical areas for attention with this legislation.
First of all, because of the tax rollback threat, this in fact throws a greater responsibility on the province to bring forward something that works. Without question, in our view, a licensing system is one of those four areas that the Ontario campaign identified as being critical to the success of the legislation. We've agreed with government officials that if statutory prohibitions, as opposed to a licensing system, were enforced, a statutory prohibition could work, the same as licensing will work if it's enforced.
The beauty of the licensing system is the fact that you have a self-financing system with a group of people who have a vested interest in making it work, and you have a framework already in existence here in the province whereby a licensing system could come forward.
In tight financial times we're afraid that whatever would be required in order to make a statutory prohibition work may not be there. It may be that at some point in the future -- maybe the committee wants to look at it now, but certainly there should be some kind of report on how effective the enforcement process is going, because we suspect we may have to come back and revisit the whole issue of licensing in order to ensure that there is a system out there that in fact is blocking the sales.
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Another area we identified as absolutely critical for the success of this legislation is getting rid of the double messages sent to the community when health professionals sell tobacco. This gets us into the whole area of pharmacy.
I know you've probably heard more than you ever want to hear about pharmacy today. Well, let me tell you that what you've heard today will be addressed. We will address it in a major way. It may not be addressed here today. We've had a chance to take a superficial look at what was presented. You were talking to the tobacco industry today, but like a lot of tobacco industry material, when you examine it closely, it doesn't stand up to scrutiny.
Now, let me just make a real quick reference to a couple of things which will be addressed: the Coopers and Lybrand study. It's amazing. You have a group of people who come before you and predict disaster for pharmacies. Isn't it interesting that the major chain in this province which is leading the fight is Shoppers Drug Mart, entirely owned by Imasco Ltd, the biggest tobacco company in the country? You had before you David Bloom, who just happens to sit on the Imasco board, and he's predicting disaster.
Isn't it curious that Big V Pharmacy, which is the independent pharmacy -- it's the second-largest chain in the province -- isn't going to oppose the legislation? In fact what we've got is a situation that Big V is so incompetent in terms of its operating policies and its work in the community that it doesn't know that it is going to take a nosedive and all these pharmacies in western Ontario are going to close.
Isn't it curious that the 18-store Dell Pharmacy chain has voluntarily taken it out of their chains? Somehow or other, Dell is also going to take a dive and people are going to be out on the street.
We're going to address that, because of course common sense tells you that it's lunacy. In fact, it just doesn't make sense. When something doesn't make sense, there's usually a little bit of mumbo-jumbo when the industry brings forward its consultants and builds these supposed cases.
Shoppers Drug Mart claims they're normal retailers. Well, my God, what is their corporate theme? What are they promoting? "Everything you want in a drugstore." They don't say, "Everything you want in a retail store." They say, "Everything you want in a drugstore." Isn't it interesting that they would know the difference and they would know enough about their customers to understand that their customers and the people out there whom they're trying to attract to their stores know very well the difference between a drugstore and a normal retail outlet?
We're going to have lots to say about Shoppers Drug Mart. This is going to be a very interesting campaign that develops. They simply cannot get involved in the business and have any credibility as health professionals.
If the clerk would be kind enough to pass out the pharmacy brochure, this is a sufficiently important brochure that we want to draw attention to a couple of things in here. You'll notice the photo right in the centre of the brochure with the Shoppers Drug Mart promotions. I can tell you, these guys know how to promote cigarettes.
It's also curious that when the bill was announced, all of a sudden, the Shoppers Drug Mart promotions around the province, with the big red cigarette signs, curiously all came down. In a matter of days, they disappeared. All the beautiful photographs that we've got of Shoppers Drug Mart -- we can't get them any more, because Shoppers knew that the spotlight would be on Shoppers Drug Mart once the legislation was tabled. So all these wonderful promotions that Shoppers was engaged in all came down. But unfortunately for Shoppers, we've got lots of red and white cigarette promotions in our photo file, and we'll be tabling some of these.
In the centre, you've got addenda, and one is here from Medis Ontario, one of the wholesale firms. Listen to what they say right in the middle: "All purchases, including drop shipments, contribute to your volume rebate plateau. Just a few extra cases of tobacco per week can double your volume rebate on all pharmaceuticals." Of course Shoppers Drug Mart says: "We're not in the business of promoting tobacco. This is all aboveboard. We're just supplying demand." Don't believe it. We'll deal with the nonsense later.
Plain packaging, a third critical area that we're going to be talking about: There's now research --
Mr Perruzza: Are you listening, Jim?
Mr Mahood: The Ontario Campaign for Action on Tobacco and our organization have identified plain packaging as an absolutely critical area of reform. This legislation is valuable because it allows the province to take control of the packaging, which is absolutely critical.
Why is that essential? You want to see what a tobacco industry can do when it engages in its more repugnant and irresponsible behaviour. This is a little white cigarette package designed for little girls, with rainbows on the covers. It's like a perfume package. Here's one with candy stripes. This is Newport. This is what we would have in this country if we didn't have a Tobacco Products Control Act. I'll pass these things around, because they are really repugnant. This is Vogue. This is what happens when they target little girls. This is Capri.
It's all freedom, it's all independence and it's all designed to say to a little 12-year-old kid, a little girl: "Guess what? This can't be harmful because if it were harmful, they'd never allow the products to be packaged like this."
Here's a plain cigarette package. This is what a generic package or a plain cigarette package might look like. Why is that so important? I'll tell you why it's so important: There are two billion cigarette packages sold every year in this country, and 25 to 30 times a day they come out of shirt pockets and purses; they sit on the dash or the seat of the car and they come out 25 to 30 times a day, which makes total viewings of somewhere in the neighbourhood of 50 billion viewings a year.
There's another powerful part of it. Not only does it swamp all the other advertisements because these are package advertisements, every time a child sees it, it comes with an implicit endorsement from a parent, an adult, a significant other. The implicit message is that it can't be as dangerous as health professionals say it is because if it were, mother and dad wouldn't be using the product.
If you want to deal with tobacco advertising and promotion and really protect kids, you have to deal with the main promotional tool the industry has always had. It's never changed; this has been it. When you go to plain packaging, you solve a lot of problems. If you're trying to send a message to kids that it's dangerous, as soon as you put it in plain packages, you say to kids, "This product is so different, so dangerous, that we can't allow it to be packaged in those normal beautiful packages." The second thing you do is that you prevent the industry from using sponsorships to get around the advertising ban, because once you're in a plain package, you have no trademarks, no colours, no design to link back to.
If you're concerned about smuggling, one of the keys to stopping smuggling is identification of the smuggled package from the duty-paid domestic package. As soon as you go to plain packaging, guess what? You can't hide the smuggled package any more.
Virtually everything you do in David's comprehensive plan is either exceeded by or equalled by this measure. It's absolutely critical. We're pushing that very hard.
Finally, on the question of environmental tobacco smoke, enough has not been said about that. The environmental tobacco smoke sections in this act have to be strengthened. The reason for this is that the United States Environmental Protection Agency just within the last year identified environmental tobacco smoke as a group A known human carcinogen. If the clerk would pass these brochures around, this will give you more information than you ever wanted to know about environmental tobacco smoke.
A group A carcinogen: There are only 10 or 12 listed by the Environmental Protection Agency in the United States. That list includes asbestos, benzene, arsenic, vinyl chloride etc. You cannot have a group A carcinogen going into your public areas and your workplaces, so we're going to recommend that you strengthen that section on the environmental tobacco smoke in public areas, and we're going to also recommend that you make a recommendation that the Ministry of Labour get going on consultations and bring forward a separate bill to deal with this problem of smoking in the workplace.
There are only two solutions that make any sense when you're dealing with this problem: You've either got to have no smoking in an indoor environment, or if you allow smoking, it's got to be confined to separately vented lounges exhausted directly to the out-of-doors.
Having said that, those are four key areas. Obviously, we want to support the spitting tobacco recommendation. We want to support the vending machine ban, because otherwise the sales will go from the places that have been closed off and they'll switch to vending machines and you'll have a bigger problem two or three years from now.
Those are general things I wanted to talk about. David will talk about the specifics of the legislation.
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Mr Sweanor: Just a few examples, because I'm sure you're hearing this from lots of organizations: As to section 6, which talks about the signs that would have to appear at retail, it says you can't "sell tobacco at retail unless signs bearing health warnings and referring to the prohibitions...are posted."
I think you should expand that. You can use the same sort of language that's used in clause 5(b) above that, something along the lines of "health warnings and other information" or "other health information." For instance, having a toll-free number for people to call to get information to help them quit is not a health warning; it's health information. You wouldn't want to prevent the province from having the ability to do that if, hopefully, at some point we're able to do that. You want to help people, once they're aware of the health information, to know what they can do to deal with the problems.
Also, in terms of inducements to sell, when we look at the packaging requirements in section 5 and the signage requirements in section 6, I think we should expand that so you have the ability to require by way of regulation some sort of health information on inducements to sell tobacco, including tobacco company sponsorships.
Right now we have the problem that a kid can walk into a variety store and be surrounded by what are in effect lifestyle advertisements, which tobacco companies say they can get away with under the federal legislation because it'll be saying "Players Inc" or "Export A Ltd" rather than "Players" or "Export A." I don't think they're fooling anybody in terms of what the real intent of that is.
Ontario could either make it a condition of sale that those things not be allowed at point of retail, or perhaps best yet, on the idea of let's have more information, let's get the facts out to people, require that any such messages, whether at retail or anywhere else in the province, must have such health information as would be prescribed by way of regulation, so that whenever somebody sees that information, the lifestyle inducement to use tobacco, you're also getting some health information. Let people make an informed decision.
When we're looking at the issue of vending machines, certainly at the idea of saying that no kid should be able to access tobacco without there being a human intermediary, the same philosophy.
We should look at the issue of self-service displays and countertop displays. An awful lot of stores in this province still have those countertop displays right next to the candy. A lot of them have the little 15-cigarette kiddie packs in them. It's very difficult to tell the merchant you have to check for ID if that kid's already got the cigarettes in his hands. It's also very difficult to check for ID if the kid has left the store with the cigarettes without paying for them. They're an inducement to shoplift. I'm aware of a study from the States that said the manufacturers pay retailers enough to have those countertop displays that even if every single package was shoplifted twice, they would make money.
We don't want to have any inducements for kids to shoplift cigarettes. We don't want to put merchants at a disadvantage. How do you ask for ID, how do you refuse a sale, if the kid already has the cigarettes in his or her hand? Getting rid of self-service displays and countertop displays makes it easier for a merchant to make sure they've done their duty under law and it makes it harder for somebody to simply steal the tobacco. It makes a lot of sense.
To keep this very simple in terms of various possible amendments you could look at, another one is on section 12 that deals with aboriginal use of tobacco. We should ensure that when that is done, that there be a basic requirement that all reasonable measures are taken to ensure that no one is involuntarily exposed to the tobacco smoke. Granted that there are reasons we would want to ensure that natives can engage in activities that are important to them for cultural, spiritual reasons, there's no reason to allow a situation that would allow this to happen in a way that could be harmful to someone else's health.
I know it's a little flippant, but it's like saying that those of us with some Scottish background might feel it's very important for cultural reasons to throw hammers, but we do have limits in terms of where we can throw them. I think we want to make sure this is something that doesn't cause more problems. It's just basic John Stuart Mill: Engage in activity that is not going to be harmful to the people around you. Those are some very quick comments on the legislation.
Mr Mahood: Our feeling -- we expressed this before -- is that the word "cultural," because it is so broad, means virtually everything. Certainly "spiritual" and "spirituality," with aboriginal people being protected with respect to spiritual ceremonies, and wherever tobacco is used in that sense, we support that, but there are a lot of things going on with respect to tobacco that could be classified as cultural and that gives a major loophole that we want to close off with respect to that particular clause.
We will have a written submission before the committee in a few days, and if you have questions, we invite them.
The Chair: There are probably questions that would go on for some time. I'm afraid time is a bit short, but I want to try to work in a question from each caucus.
Mr White: We've had a great deal of argument. Every person who's come in front of us, from whatever background or stance, has said that they oppose the smoking of cigarettes and the inducements to adolescents to smoke cigarettes. Yet somehow, some of these people who have come in front of us make a great deal of money from that very habit.
Many of them have said there are going to be job losses, pharmacies closing, their businesses being affected etc. Personally, in regard to the pharmacy, that is not an issue about stopping access to the sale of cigarettes, but rather limiting it relative to a health care profession.
Aside from the 40,000 deaths in this country and the innumerable cases of asthma, emphysema etc, do we have any idea of what the economic cost of this habit is that we could use to buttress against the argument that there will be jobs lost?
Mr Sweanor: The estimate that the federal health department has now I believe is $15.9 billion as a loss because of tobacco consumption. There's also a problem with that because there are those of us who can remember philosophy of science from undergrad days, saying that scientists are very good at measuring the things they know how to measure and equally good at ignoring the things they don't know how to measure. We're not including in that a heck of lot.
You could put an economic number on it if you did a heck of a lot of work, such as you die early and leave young kids behind you and the chance of them having higher education goes down, the chances of them being involved in a social support system goes up. Some things you simply cannot measure. What was the value to any of us of having a grandparent? So it's huge.
When we look at the jobs, it's worth noting that direct employment in the tobacco industry is under 10,000 people. The annual death toll is over 40,000. If that's a good idea in terms of jobs, civil war is even better.
Mr White: You're saying that at a very conservative level -- or at a very cautious, low estimate -- we're talking of $15.9 billion, which could of course build a great deal of highways and create a number of jobs in that regard.
Mr Mahood: You can pay an awful lot of people with that amount of money.
The tobacco industry, through Shoppers Drug Mart, is in a bit of a bind. They're claiming that they are going to lose all this business and that it represents all these jobs, and on the other hand they're claiming that it won't reduce any consumption. They can't have it both ways. If it's not reducing any consumption, that means the jobs are simply going to shift to other retailers, so there's not going to be a net loss. They're wrong on this, but the fact is that's what they're claiming, that they are not going to reduce any consumption, which means the jobs are going to appear somewhere else.
The reality is that it is going to reduce consumption, in which case there's going to be a health benefit. It is the dilemma that was addressed in the major economic report that Brenda Mitchell and John Garcia and other members of the Ministry of Health staff have in their possession called The False Dilemma.
The reality is you cannot come forward and purport that you want to address a major health problem and wind down an industry -- that's government policy both at the federal and provincial level -- and somehow or other maintain all the jobs in the industry. You have to come to grips with that. The comforting thing is that because so many people are addicted, the wind-down is going to be over such a long period of time that it will be the slowest phase-out in the history of business.
You're not going to have the big problem that the industry wants you to believe you're going to have. It's going to be handled by attrition. But the fact is that you cannot deal with the epidemic and keep the industry there at the same time unless it's there as a monument to all the deaths in the past.
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Mr McGuinty: David, I can sympathize with or understand some of the role you're playing. One of my first jobs when I became a lawyer was to act as volunteer legal counsel for the Ottawa Non-Smokers' Rights Association. I hope they're paying you more than I got paid back in those days.
I appreciated the comments you made because I had an opportunity to review the Hansard hearings for the committee dealing with the contraband problem, with the underground economy.
But I've got a new job now --
Interjection.
Mr McGuinty: I'm still not getting paid.
To be very frank with you, I fully expect that the pharmacists are going to tell us that they're going to take a tremendous hit as a result of this legislation. I fully expect too that you will tell me that they're going to take virtually no hit. I suspect, because I'm required to weigh these matters, that the truth lies somewhere in the middle. I'm just wondering if you can give me a number so that when we go ahead with Bill 119, as we undoubtedly will, we'll have an understanding of the implications in terms of job losses.
Mr Sweanor: I can deal with some of that. If you look at the raw numbers, and we can try to work something out, there would probably be some jobs lost. But in terms of what we've experienced to date on any health legislation in this province, including things like when we got rid of billboard advertising and the claims we heard at the time that virtually everybody would be bankrupt and unemployed, in fact they think of other things to do.
What we've seen with an awful lot of businesses in the sorts of changes we've gone through is that as sales of one product go down, people don't leave the counter space bare. They think of what else can be there. If we look at many of the businesses in Ottawa south, at the way those businesses have changed, the people who were selling a heck of a lot of cigarettes are now more into renting videos or whatever else. So they do change.
The other thing to keep in mind is that when the Shoppers Drug Marts of the world aren't selling cigarettes, to the extent that all those people aren't simply going to quit, some of those people are buying them elsewhere. It means, to again use our home neighbourhood, that you're switching from a Shoppers Drug Mart to, say, a Mary's Variety. The fact is the jobs simply move from one place to the other.
There's the other thing to recognize, and that's professional responsibility, which is exactly what we face in our own profession. We could not make the case as lawyers that many of us are borrowing money from clients and dipping into our trust funds but if you prevented us from doing that by way of legislation, a lot of us would have to lay off our legal secretaries and perhaps go bankrupt ourselves. The fact is we've got ethical obligations.
Pharmacists, having been given a monopoly over a particular area of the health care system, are being given something by society the way we as a legal profession are given something by society: a monopoly over a particular area of endeavour. With that come ethical responsibilities in terms of how we are to act. In this case, when their own ethical code says that you would never knowingly sell any drug that does not have therapeutic benefits, that sounds to me a lot like our ethical code and what it's telling us to do.
In this case, when the professional body that oversees the pharmacists said, "Yes, this should be gone, but we can't do it voluntarily because we have the problem that the biggest chain of pharmacies is owned by our biggest tobacco company," it's a bit of a conundrum. I think that's where the government would have to move in.
You will see jobs shift from one place to another, but whether a clerk is working at a Shoppers Drug Mart or a Mary's Variety probably doesn't make a heck of a lot of difference to overall employment. What will make more of a difference is the consistent message to kids that if you're a health professional, you're not knowingly selling our leading cause of preventable death.
Mr Jim Wilson: I think we're allies on many of the sections in this legislation. However, I want to make a statement about my understanding of Big V. First of all, I think it's the third-largest chain in Ontario. Correct me if I'm wrong. My understanding of president Norm Puhl's position is that he would agree with the Ontario Chain Drug Store Association, which presented earlier today, and the position that my party has taken with respect to the provision banning the sale of tobacco products.
If he were asked, he would say that Big V's decision is part of a 30-year plan that they have in place to reduce the sale of tobacco -- they're down to 3% and heading to zero -- in their premises. Their actual position is a total ban on retail sales and they want a tobacco control board introduced. That's my understanding of Big V's position, that it isn't some sort of curious thing that you can pit against Shoppers Drug Mart; it's a corporate decision they've taken as part of a long-term plan.
I don't see any great inconsistency in terms of they want a level playing field. They are not, it is my understanding, encouraging that the one part of the retail sector, that is, pharmacies, be discriminated against. They've made clear that they want cigarettes taken out of all retail sales and a tobacco board put in place. I say that as my understanding and give Garfield an opportunity to respond.
Mr Mahood: I know a wee bit about this. I met with Norm Puhl almost two years ago, a year and a half ago, and I said: "If you guys are wise, if you're concerned about traffic shifting to your major competitors, which are grocery stores, if you're really worried about that and you guys are good businessmen, you make a decision. You know it's going to come out of pharmacy. It's good corporate planning to figure out what are the odds that you guys are going to beat this and what are the odds that it's ultimately going to go through.
"If you take the decision that I recommend you take or make the assessment that I recommend you make, which is that sooner or later it's going to come out of pharmacy, then what you'll do, if you're smart, is you'll run a campaign to make sure it gets into controlled outlet stores, because then when the traffic shifts, nobody has a difference in traffic patterns, because it's gone into controlled outlets."
The problem with that, of course, is that Norm Puhl has to work with David Bloom in the Ontario Chain Drug Store Association and there's no way that Shoppers Drug Mart's going to go along with this. So he got stuck. The fact is that it's not going to be that kind of unified recommendation for controlled outlets. Controlled outlets make the most sense. But that's not in the cards, probably, for this particular round.
I want to just finish off that comment by a couple of quick comments about Mr Bloom's presentation that relate to this. He said, "Patient counselling...is a key component of good pharmaceutical care." Let me tell you that there's going to be some research tabled here within the next week that will show that virtually nobody has ever been counselled. The overwhelming majority of smokers going into drugstores have never even had a peep uttered to them by pharmacists. That is just hogwash.
The second thing is that he made reference to the fact that the college was voted out. That also is just hogwash. The members of the college were not voted out the way the chain drugstores would like you to believe. In fact, this issue was revisited by the college in a major meeting last summer. They didn't alter its position. They stuck with their position. The impression that was left with you, which was that was an old college and the college doesn't have the same feelings now, is just hogwash. The fact is that the college is maintaining its position. I think that's responsible and they deserve credit because they're fighting Shoppers Drug Mart pharmacists right within their own board.
There's a lot of stuff that's going on in this whole pharmacy deal. I think over the course of the next two or three weeks you're going to see a major debate and the public will have a better understanding of why you have to get conflicting messages to kids out of the system and why you have to take it out of pharmacy.
Mr Jim Wilson: Thank you for your response, but let's be clear: The issue has been whether we should discriminate against one retail sector, namely pharmacy, and Big V's position is no, you shouldn't, that there should be nobody in the broader retail sector selling cigarettes.
Secondly, I think your advice to Big V two years ago was good marketing advice. Clearly, they know that this government was hellbent on bringing in this provision. It was clear to me, as Health critic some two and a half years ago, that this was the way it was going to head. We have a very difficult time changing this government's mind on issues like this. They are simply taking a better positioning in the market, and rightly so. They will be ahead of Shoppers Drug Mart in terms of the ability to fill their shelves with videos or something else when that product is removed. I think it was a wise business decision, but it in no way supports the position or the clause that's in this piece of legislation. Let me be clear on that.
With respect to patient counselling, the evidence that was given -- other pharmacists asked the same question, including Shoppers Drug Mart pharmacists -- was not that they automatically give counselling to everybody who buys cigarettes; it was that when they were asked by a customer-patient, of course they would give counselling as professionals. I don't think anybody's denying that and I don't think anyone's taking that away from pharmacists. Let's be clear: When asked, they give the counselling.
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Mr Mahood: If I may answer that, although it wasn't a question, it certainly was an interesting --
Mr Jim Wilson: Factual statement.
Mr Mahood: It was factual, I guess, for the way the tobacco industry views factual. If I go into an auto parts retailing outfit, I don't go in and ask whether they sell underwear. If I go into a pharmacy and I walk through the front door and there's tobacco all over the place, I can't believe that people really believe they're going to get counselling when the pharmacist is selling the stuff at the front of the store. You don't ask for something that it seems logical you're not going to get in that facility. If a pharmacist is not selling tobacco and it's out of the store, someone might actually believe this is a health facility, which it is, and actually do something about it.
The problem with your legal product argument that the Conservative Party has taken is that the Conservative Party, on one hand, argues for the right of self-regulation of the professions, and then when the self-regulating profession comes before you and asks for legislation to deal with professional misconduct and ethical behaviour among the profession, all of a sudden you turn around and say, "No, you can't have it because we're not going to allow you to be self-regulating." There's a conflict there which I don't understand.
Mr Jim Wilson: There were many things during the RHPA that the colleges asked the government to do that the government didn't do. It's not an automatic that because a college asks for something, we as legislators say, "That's a great thing; let's just go do it," without any thought or public hearings. That's the only point I make.
The Chair: Thank you both for coming and for the material you presented. You are also going to submit a written brief to the committee.
Are committee members in a position to make a decision about the 23rd and the 24th tonight?
Mr Jim Wilson: Unfortunately, Mr Chairman, I'll have to get back to you tomorrow morning.
COMMIT TO A HEALTHIER BRANT
Ms Dianne Ferster: My name is Dianne Ferster. I am the executive director of Commit to a Healthier Brant, a demonstration site for the Ontario tobacco strategy. With me are Tara McIntyre and Leslie Falhazie, students from Brant county. I thank the committee for the opportunity to present today. This is our story from our community.
Allow me to set the stage with quotes from local teens involved in Commit teen support groups. This group met over the summer in response to teens in our community requesting assistance in quitting smoking. One teen states, "Smoking is tragically hip"; another, "I wanted to be sophisticated and one of the guys but I don't like it, I feel stupid and I'm addicted"; and a third, "If smoking is bad for you, why would pharmacies that look after our health sell cigarettes?"
Although Commit to a Healthier Brant registered for this presentation, the content and speakers reflect Brant county concerns and approaches to the issues outlined in Bill 119. The appendices include a full listing of organizations and individuals involved in this presentation.
At this time, we wish to commend the legislators and others who worked to bring forward this well-crafted piece of legislation. We particularly recognize the efforts of the Honourable Ruth Grier, Minister of Health, and those who preceded her for acknowledging the significance of this issue and for the development of the Ontario tobacco strategy. The efforts of individual members of the provincial Parliament, including members of the social development committee, are much appreciated.
We recognize that this legislation will continue to maintain Ontario and Canada as leaders in the fight to reduce the effects of tobacco-induced mortality and morbidity. We feel strongly that it is essential that this current impetus remain strong and that this piece of legislation quickly become law. However, there are some areas in Bill 119 that should be strengthened to protect the health of our children.
We wish to address three main areas of major concern in our community: environmental tobacco smoke, sales of tobacco products in pharmacies and access by minors.
Our first community representative is Tara McIntyre, who will explain how exposure to ETS greater affects her health and impacts upon her quality of life.
Ms Tara McIntyre: I am 12 years old and I have had asthma for all my life. Have you ever been walking in a mall or in a restaurant where someone is smoking near you? I have, and for me that can cause an asthma attack. A lot of people think an asthma attack is no big deal. Others don't even know what happens. Do you?
I'm here today to tell you that every asthmatic is different. When I take an attack caused by tobacco smoke, usually I smell the smoke. Then I get very weak and my head feels like it weighs 100 pounds. My nose and throat begin to burn. It feels as though someone is standing on my chest and someone else is trying to strangle me. My throat fills up with phlegm so it feels as though a balloon has busted in my throat and pieces of rubber are hanging and blocking my airways.
Tobacco smoke does not cause my asthma, but it is a major trigger for my attacks. When I take an attack, I have to take Ventolin. If I take much I have side-effects, like weakness and shaking. If I get really bad, I have to take more Pulmicort, which is a mild steroid. As it is, I have to take Pulmicort on a daily basis to constantly help control the inflammation, so if I am in an area where there is smoking I at least have a better chance.
If you do not decide to ban smoking from all public places, does this mean that you will pay for the costly medications asthmatics need to live a near-normal life?
I strongly advise you to ban smoking.
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Ms Ferster: The Brant county community partners support legislation that bans smoking in all public places. Only in this way will the health of our young people in Ontario be protected.
Now let's look at our second issue. The Brant community partners support the ban of sale and use of tobacco products in health care facilities. We strongly agree with the inclusion of pharmacies in this definition.
Over the past two weeks, Commit to a Healthier Brant conducted a survey of Brant county pharmacists to discover how they felt about the sale of tobacco products in pharmacies. One pharmacist from each of the 28 pharmacies in Brant county were interviewed to determine their reactions to Bill 119. We didn't call a specific pharmacist, just whoever was available at the time. Of the 28 pharmacies in Brant county, 16, or 57%, do not currently sell tobacco; 10, or 36%, do sell, and two, or 7%, were located in department stores that sell tobacco in other departments.
It should be noted that 90% of Brant county pharmacists felt that selling tobacco contradicts their professional code of ethics. Asked how they felt about the sale of tobacco in pharmacies, 70% of the pharmacists surveyed stated that they opposed the sale of tobacco in pharmacies, 10% indicated their support, while the remaining 20% of pharmacists were undecided on this issue.
At this time, I would like to restate that as Brant community partners, we support section 4 of Bill 119, which restricts pharmacies from selling tobacco products. It would appear, based on the information gathered from local pharmacists, that they would agree.
The final concern we will address today is access by minors to tobacco products. In 1990 and 1991, sting operations were conducted by Brantford Commit. It was a four-year research project in Brantford funded by the National Cancer Institute of Canada. Teams of youths aged 15 to 17 were able to purchase cigarettes easily and without question from retailers 74% of the time. After the first sting, we went back and we sent educational packages and spoke with retailers individually. When we decided to do a second go-round and see if this had made a difference in our community, it had not; 74% of retailers were still selling. Enforcement of the existing restrictive legislation obviously was not taking place.
This background information formed the basis of a campaign by the Council for a Tobacco-Free Brant to garner public support for more stringent enforcement policies. Adults and students demonstrated support for licensing of specific retailers to sell tobacco -- an example given to us was the LCBO -- and increased fines for retailers selling tobacco to people under 19 years of age. Some 67% of the youths surveyed -- this was during National Non-Smoking Week this year -- supported the restrictions, smokers and non-smokers alike.
Commit to a Healthier Brant and the Brant Haldimand/Norfolk Heart Health Project produced a National Non-Smoking Week radio campaign that encouraged Brant county residents to offer their opinion regarding Bill 119. We chose to get together to do that in the hope that our residents who were unable to be at the hearings could respond. We have brought their information; it is included in the document.
Results indicated that the majority of people supported a ban on sales of cigarettes from vending machines and in pharmacies. There was strong support for licensing of vendors and restricting the purchase of tobacco products to those over the age of 19.
Smoking cessation and support groups have recently been available to teens in Brant county. The participants in these groups have helped confirm how easy it is to obtain cigarettes and how difficult it is to stop smoking.
Leslie Falhazie, a student at Paris District High School, has experienced this first hand and will tell you about it.
Ms Leslie Falhazie: I'm 15 years old and I would just like to tell you that the law has to be enforced on the sale of cigarettes. When you go into a store and ask for a pack of cigarettes and they give them to you without asking for any ID, that's a chance for you, as a young person, to get those cigarettes and you don't have to worry about giving them your ID, no matter what, because they're not asking for it. If they did, it would stop a lot of young people from smoking, because where could they get their cigarettes?
When you look at a pharmacy, you look at it as a place that's healthy. It's there to help you get better etc. When they're selling cigarettes, that's a major turnoff. It's not healthy at all. Smoking is not healthy.
Sometimes it's easy to buy cigarettes and sometimes it's not. For kids my age, there are some stores that do ask you for your ID, and there are some stores that don't. It really should be hard. You should have to give the store your ID to get cigarettes, no matter what.
I think that not selling cigarettes in a pharmacy is a very good idea, because it is a healthy environment and smoking is just not healthy and it's not easy to quit. That would stop a lot of people from starting.
Ms Ferster: In conclusion, our presentation has addressed the issues of environmental tobacco smoke, access to tobacco products by minors and tobacco sales in pharmacies from the perspective of Brant county residents. Our surveys and campaigns confirmed the willingness of our community to support strong measures to restrict access of minors to cigarettes and to ban the sale of tobacco products in pharmacies.
The Brant community also supports measures to secure smoke-free places, particularly public places.
The Brant County Community Partners in Action encourage strengthening the legislation to address our concerns. A strong enforcement component of this legislation will send a message that Ontario is serious about protecting the health of its youth.
You as legislators are setting the course of health for future generations. It is important that this legislation is strong and is enacted immediately. We ask you not to compromise health, particularly that of our youth.
On behalf of Tara, Leslie and the Brant county community, we would like to thank you and we'd be happy to respond to any of your questions.
Mr Jim Wilson: Leslie and Tara, when I was either of your ages, I don't think I'd have had the courage to appear before a bunch of parliamentarians in a public hearing, so you're to be commended for doing so.
What if we were to toughen this law even more? You said the current law, which doesn't allow retailers to sell to anyone under the age of 18, doesn't seem to be working very well. Your experience is that in many cases it's quite easy to buy cigarettes, and I assume that's the experience of many of your friends.
What if we put the onus on you and said that people under the age of 18 shouldn't have cigarettes in their possession, shouldn't carry them and shouldn't be allowed to smoke? In other words, just like drinking, where the age limit's 19, make it illegal to smoke or be in the possession of cigarettes. Any thoughts on that?
Ms Falhazie: The law should definitely lay down a really heavy rule that no young people under the age of 19 should have cigarettes through a store or a pharmacy or any way, no matter what. I don't think fining a young person for having cigarettes is going to work. It's not going to work. If you fine them, that's like saying it to a person doing drugs, and really it is a drug but it's still legal. The only thing is that we shouldn't be able to buy them unless we're of age to buy them.
Mr Jim Wilson: The reason we float the idea is that the current system doesn't seem to be working too well and really this law doesn't change it much. It boosts it up one year to 19 and may have some provisions that are added after the law is passed with regard to the type of identification a store owner or clerk would have to ask for, and the fines. But some of us are thinking that the current system isn't really working too well and that maybe we should have a combination of making it illegal to smoke or to carry cigarettes under a certain age, and secondly, obviously you couldn't sell to those people either. Those were our thoughts.
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Mrs Haslam: I have the greatest respect for you young people. Mr Wilson's absolutely right. It's not easy to come before a committee, but you can go home tonight and watch yourself on TV so there is a bonus for you.
The Chair: As the Chair, I feel compelled to say you are all such a warm and fuzzy group, is it any wonder they came forward?
Mrs Haslam: This is true, but that's not true because, you see, Leslie's been here for a long time. I've noticed her and I commend you for your strength and your stamina to sit through this. We're here because we have some definite ideas.
I'd like to ask Dianne a couple of quick questions and then ask questions of the young people. You say that "90% of Brant county pharmacists felt that selling tobacco contradicts their professional code of ethics," but on the previous page that 35% still sell tobacco. I wondered if you'd questioned them about why they continued to sell. You did speak to the pharmacists. Did you ask them then, looking at the data, why they sold?
Ms Ferster: Yes. In most cases, it was a policy of the company and they were employed by that company. So it was not a decision that they as pharmacists had control over. This was a company decision.
Mrs Haslam: That's an interesting comment because somebody mentioned to me today that the problem with larger drugstores is that they are a retail organization that hires a pharmacist for the word "drug" on their supermart sign, and it's interesting that you mention the same kind of concept.
I am concerned that you say 74% went back to selling and that was a problem. Obviously, that indicates we are going to have to look at the enforcement side of whatever legislation we bring in. It boils down to an enforcement problem. Do you feel that the licensing aspect would be better in enforcement than what is being proposed in the legislation?
Ms Ferster: Yes, certainly we would support that, probably because it's already set up. It was something that came from the residents, adults in particular, but certainly the students addressed that and I think it's set up. When they think of licensing, they think of alcohol in the same way: They don't have access to alcohol. If we're thinking of the same age, 19, it would make sense that it would be under the same jurisdiction.
Mrs Haslam: What one thing could I say to you or to young people that you think would really turn them off the idea of smoking? We've heard statistics that 3,000 young people a week --
Ms Murdock: A month.
Mrs Haslam: Is it a month? I stand corrected, excuse me. It said 3,000 young people a month start smoking and it's a real concern to us, to all of us, to all parties. It's a real concern when we see 3,000 young people start to smoke when we've got education out there, when we have programs out there, when we try to eliminate the possibility and the accessibility of cigarettes. What one thing could we say to you if it's not, "You're going to die"? What one thing could we say to you, to your peers to stop them from going into this habit? I've put you on the spot and I'm sorry, but we really want to know.
Ms Falhazie: I don't think you can really say anything specific to one person because everybody's different and it's something they have to think about themselves.
Mrs Haslam: That's a really good answer.
Mr McGuinty: Thanks to all of you for coming and thanks for your little bit of information, Tara, on asthma. I have a little boy who uses Ventolin and he's got his own puffer, so I've become acquainted to some extent with some of the problems associated with asthma.
Leslie, I want to talk to you a bit more about this idea raised by Mr Wilson. I think kids are smarter; at least they seem smarter than I was at your age. They seem to know more about what's going on in the outside world, what makes things tick and I think they're prepared to assume more responsibility than we give them credit for. I think there may be an idea here. Kids understand that it's illegal to carry a mickey around at high school. Why couldn't we do the same kind of thing with cigarettes?
Ms Falhazie: Who's going to listen? Cigarettes or alcohol -- cigarettes have long-term effects on you but it's definitely putting a lot -- I don't know how to explain it.
Mrs Haslam: Say, "I don't know." We accept answers like that.
Ms Falhazie: Well, I don't know.
Mr McGuinty: The similarity, of course, is that alcohol is a legal product, but young people understand that it's against the law to use it before they reach a certain age. I'm just wondering why we couldn't do the same thing with cigarettes, treat them in the same way.
Ms Falhazie: I don't think it would work.
Mr McGuinty: The kids would break the law?
Ms Falhazie: Yes.
Ms Ferster: If we're looking at what I've heard this afternoon about possibly charging young people, we're looking at something that is covered by the Tobacco Restraint Act of 1908. It now covers possession. You have to be 16 years of age to possess it. It's federal jurisdiction. It's not currently being enforced that I'm aware of. Should it be part of a comprehensive national strategy? Perhaps Ontario should provide leadership on this issue by pressuring the federal government to update and toughen that legislation. Possibly one of you could spearhead this. I would second the motion. It's a thought.
The Chair: I'm going to let Mr Eddy, who is from the wonderful county of Brant, pose the last question, thought, comment, wisp of wisdom.
Mr Eddy: That's a big role. Thank you for your presentation. I really appreciate your being here and thank you for your leadership in bringing healthier Brant citizens into being. We have a problem in that the underground economy is prevalent and growing in Brant and supplying contraband cigarettes. Are contraband cigarettes being peddled in schools? We've talked about legal outlets, but I'd like your comment on that.
Ms Ferster: Leslie, are you aware of cigarettes that are available that are not purchased at the stores that kids go to, Ohsweken?
Mr Eddy: Cheap cigarettes.
Ms Falhazie: It happens all the time at school. Every day somebody has a carton of cigarettes and is asking, "Do you want to buy a pack of cigarettes, $5?" Of course people say, "Yes, I'll buy them from you, because if I buy from the store I'm going to have to pay $6.50." It is happening all the time.
Ms Ferster: That's true. We see that in our county. I have grave concerns about what's happening in Ohsweken right now. Also this rollback federally would be a big mistake. If we rolled back taxes so that tobacco products were cheaper -- how can you make this issue? We're talking lives and we're talking economics. We have 13,000 people dying. We have 1,000 farms producing tobacco in this province. That's more than 10 deaths per farm, if you look at it that way. That's pretty grave.
Mr Eddy: You are referring to a new cigarette manufacturer in Six Nations, Grand River territory.
Ms Ferster: Absolutely.
Mr Eddy: I'm really wondering about undercutting the price even further, if that isn't a possibility.
Ms Ferster: I also am concerned with that operation, with the standards there. We don't know what's in that tobacco. I don't know how it will be regulated. Tobacco could be worse, more than 4,000 carcinogens that we know of. It will likely happen there without regulations.
The Chair: Thank you all again for coming before the committee this afternoon. We very much appreciate your taking the time and particularly all the work that clearly went into your brief.
Ms Ferster: Thank you. It's been enlightening for us as well.
The Chair: Could I ask members to think about the date, so we can determine that tomorrow morning.
Mrs Haslam: It's my understanding that we want to add another day because you want to give everybody a chance. How many are on the list that we wouldn't be able to hear if we didn't come back another day?
The Chair: It was approximately a day of hearings.
Mrs Haslam: How many is what I asked.
The Chair: Whatever makes up a day. Was it 30, 28?
Mrs Haslam: Are we seeing 30 people a day now?
The Chair: Those are 15-minute presentations.
Mrs Haslam: No questions?
The Chair: It depends on the presentation. We've been trying to accommodate everybody. This committee in particular has really made an effort. We've been steadily together since the middle of October on two other major bills. We have always felt strongly that we would like to do that.
This is not adding another day to the committee's whole set of hearings, but there was agreement within the subcommittee that we wouldn't necessarily need four days on clause-by-clause, but three days, so let's take one of those days to try to accommodate more of the people who want to come before the committee. That's the reasoning and that was why the letter was sent to the House leaders, and they have agreed to that.
Mrs Haslam: I have a concern about the timing of it, but I'll talk about that with my caucus.
The Chair: Fine. Perhaps people could come with the 23rd or the 24th so we could fix that tomorrow. With that, the committee stands adjourned until 10 o'clock tomorrow morning.
The committee adjourned at 1712.