Committee Transcript 1994-Feb-07 | Legislative Assembly of Ontario

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.

BOB RIEPERT

The Chair (Mr Charles Beer): Good morning, ladies and gentlemen. I call as our first witness Mr Bob Riepert. We appreciate that you're here before your scheduled time. We'll let you kick off the proceedings.

Mr Bob Riepert: I'm appearing today as a private pharmacist in my 46th year of practising pharmacy, and I'm still practising.

I am in favour of Bill 119 and particularly of the part that pertains to banning tobacco sales in pharmacies. I'd like to accomplish this by making two salient and very important points. I intend to give you a very brief history from my experience going back a few years, make the two points and then sum up at the end.

I graduated in 1948. Back in the 1950s, in my pharmacy -- I was working for someone then -- we sold tobacco and nobody thought too much about it, except perhaps to say that it was a nasty habit to have.

As the years went along and scientific publications came out in the press, literature, books and so on, it occurred to me that the evidence was mounting rather rapidly as to what tobacco does to one's health. On a personal note, at that time I smoked a pipe. As the evidence mounted, I came to the realization in the late 1950s or early 1960s that I was playing roulette with my life and I decided, "Here I am, a health practitioner and I'm smoking." So I abruptly stopped.

It didn't occur to me at that time that perhaps I shouldn't be selling the product. That came a lot later. Anyway, I stopped as the evidence mounted, and coming up right to today, it is now a scientific fact that one cigarette will shorten a smoker's life by eight minutes.

If you want to put that on a different basis, for the second point, approximately every 45 minutes one person in Ontario is dying as an indirect or direct result of the use of tobacco products, as the cause of their particular illness. If you want to put that on an annual basis, 30,000 people are dying each year in Ontario.

Here we are, we're taught by our college and we follow our college's direction in that we counsel people every day, as well as dispensing prescriptions, on their health and all matters pertaining to the prescription and their health that we can possibly counsel them on, as we're asked or get into conversation.

We are doing this, and my first point is that this is without a doubt an incompatibility and a direct conflict in that we are trying to get people well on the one hand, and on the other hand we're turning a blind eye and saying, "We'll sell tobacco." That's my first point.

I'd like to backtrack a little bit to say that back in 1979 I was elected to the Ontario College of Pharmacists to represent district 12, which is the Kitchener-Waterloo area, Brantford, Guelph, Simcoe, down to Port Dover.

Over this period of time, and I served on the college council for approximately 11 years, this question of whether pharmacies should sell tobacco or not came up. In 1988, I was elected president of the Ontario College of Pharmacists and again this matter came up before council. In my wisdom at that time I decided to instruct our standing committee on ethics to look at this problem from an ethical point of view. This they did and after a fair amount of study on it, they came up with a recommendation that tobacco not be sold in pharmacies.

My term of presidency came to an end and I was followed by someone you may already have heard from, Dr Nghia Truong. During his term, he appointed another committee to look into this and to find ways and means to implement that pharmacies not sell tobacco products. He appointed one of our laypeople on council, Mrs Jane Chamberlin, as chairman of that committee. That committee made an exhaustive search into this question, and as you know, came up with the recommendation that pharmacies not sell tobacco products.

The Ontario College of Pharmacists of course does not have the authority to mandate our pharmacists not to sell it. We have to follow the previous Health Disciplines Act, which ended on December 31, and now we have our new act. It ended then. The committee came up with this recommendation, but the college can go no further and we are right where we are today. It is now in the hands of the government and this committee in its deliberations as to what's going to happen with this.

Our opposition, those who still want to sell tobacco in pharmacies, argue that if it isn't sold in pharmacies and it's a legal product and so on, then those who wish to buy it will just go somewhere else and buy it.

Yes, ladies and gentlemen, that's true, they will. By the way, I belong to the Ontario Pharmacists' Association as a member and their policy, as you may have already heard too, is that this be done on a voluntary basis. I've no objection to this, and indeed as of this past Friday, I ascertained from the Ontario Pharmacists' Association: "You have a reporting mechanism where pharmacies will report that they have voluntarily removed tobacco from their shelves. Can you tell me how many there are to date?" They informed me that 900 pharmacies have voluntarily withdrawn the sale of tobacco.

You must remember this is a voluntary submission, and of course there are more than that; I can't tell you how many more, I just know there are more. With the college, having served on council for all those years and been president, I also know that many pharmacies voluntarily, after the college made that direction, gave up the sale of tobacco. I don't know how many because no one was asked to report, and if they did, I don't even know whether anybody kept track of it. However, the OPA has kept track of it and they tell me it's 900.

1100

I present the challenge to this committee and to the government that the time has come. We've tried the voluntary, and that's fine. It would go on and we'd still get more people, but we'd just wander along and a few more would join and we'd never really have everybody.

I stated to you today that in my opinion the time has come for this government and this committee in its deliberations to accept the challenge and say, "Sure, it can be sold any other place," but I say to you that this government should set an example to the people of Ontario.

It's a small beginning maybe, looking at the overall picture -- I'm sure you're aware there are 2,200 pharmacies. This goes up and down a little bit as some close and others open, but as of Friday there are 2,200 pharmacies in Ontario. There are approximately 8,000 pharmacists. If you pass this legislation, especially pertaining to the pharmacist part, just think of the impact this will have on other people when they realize that these are health professionals and they are no longer selling this product.

Those are my two points. In summing up, it's a direct conflict. I don't know how anyone can try to heal people the on one hand and then sell something that's going to kill them on the other, as we know by our scientific facts. The second point is that while it may appear at this time to be a small step for the government to take in passing this legislation, I fully believe it will be a giant step as far as helping the rest of mankind in Ontario is concerned. I hope I haven't gone over.

Mr Dalton McGuinty (Ottawa South): Thank you very much for your presentation, Mr Riepert. One of the difficulties I certainly see in this matter is the division among pharmacists with respect to this issue. For instance, Pharma Plus, with 130 stores that have no connection to the tobacco industry other than through their sales, has indicated that it has some very serious reservations about the ban, as has a presenter on behalf of what you might call the non-traditional pharmacists. I think there are about 160 in the province, like K mart, Zellers, Loblaws.

I know people have made the point several times that they have difficulty with the symbolic element, this contradiction you explained to us of being someone who both provides a form of health care and at the same time sells a product which is obviously harmful to health. The symbolism associated with that is something we'd rather not have in place.

What about the non-traditional people, where we go into a huge store and the cigarettes may be sold 50 yards away from the pharmacist, who is not connected with that whatsoever? Do you think we should be making an exception in that case?

Mr Riepert: No, I don't. If I could just add, I cannot speak directly for some large store, but I can speak for some stores in the Kitchener-Waterloo area that I know have voluntarily given it up. I owned three stores at one time. Two of them sold tobacco and one did not. In selling the one company which had the two stores to one of my pharmacy employees some years ago, he eventually also came to the same conclusion that I did, particularly about the time that the college recommended that they not be sold, and he voluntarily took the tobacco out. He sold a lot. I'm not saying he sold as much as some of these larger stores. The overall picture, without going into a lot of detail, was one that was positive.

Yes, I can tell you, that on average, sales will drop, but with the pharmacists I've talked to, and I've talked to five or six in the area and other pharmacists in the province, all I've heard is that eventually pharmacists, from a business standpoint, being entrepreneurial as much as anybody else is entrepreneurial in business, have found other ways to make up this loss about which our friends who are opposing this say: "Oh, I can't do that. There'll be 10,000 jobs lost and 300 pharmacies closed." That's a figure that's come up that you may have heard.

As a matter of fact, I don't know whether you've heard more about that or not, but the firm of Coopers and Lybrand has been engaged by one of the groups in opposition to taking cigarettes out to find out whether this would really happen. I don't know whether you've heard the answer to that. I hope you'll ask.

I'm just saying that they found ways around it and the overall approach has been positive. People have gone elsewhere but are still coming to the pharmacy, and I think they've been held in rather high esteem in the long run because they did that.

The Chair: I regret our time is up, but on behalf of the committee, Thank you for coming this morning.

HURON COUNTY HEALTH UNIT

Dr Maarten Bokhout: I apologize to the committee for my slight tardiness. I was following one too many trucks, I think.

My name is Maarten Bokhout. I serve as the medical officer of health for Huron county, and it is in that capacity that I'm making a presentation to the standing committee on social development on Bill 119. I think a copy of my presentation has been circulated to members of the committee and I'll proceed to read it.

It is a privilege for me, as medical officer of health for the county of Huron, to make a presentation to the standing committee. I thank the committee for giving me the opportunity to present in London, Ontario, therefore saving me the time and expense of having to travel to a more distant location.

I wish to applaud the government of this province in introducing this legislation in the face of continued opposition from tobacco manufacturers, tobacco-owned retail pharmacies such as Shoppers Drug Mart and the passive opposition of many Canadians who prefer to stay addicted, while at the same time expecting that the consequences of their addiction be paid for out of the public purse.

It takes courage for a government to take such a stand in today's economy when it is clear that there may be adverse short-term economic consequences in terms of lost revenue to the government. I applaud this government in being willing to sacrifice short-term financial gain in favour of long-term rewards in improved personal health and reduced health care expenditures, which would be a consequence of the successful passage of this bill.

As medical officer of health, I have been responsible for a number of programs which seek to work with residents of the county to lessen their exposure to tobacco smoke. These programs include workplace education programs, the promotion of bylaws which seek to restrict smoking in public places, and designating staff to address these and other techniques which seek to reduce public exposure to tobacco. I wish to discuss three aspects of this act and how it helps us to do our work as public health professionals.

The act proposes limiting accessibility to young people through the restriction of sale of cigarettes to minors and reducing the number of places in which they can be made available.

I fully support the provisions of this aspect of this act. Limiting tobacco availability and restricting its sale more effectively to minors can only be helpful. The effective elimination of such sources of an addictive substance will save many lives over the next two or three decades.

1110

The act addresses a role for inspectors. In my view, some sort of inspection function is vital and needs to be supported. I wish to point out that we, as health units, are charged as a health unit under the Health Protection and Promotion Act, 1990, to carry out inspection of premises to ensure that foodstuffs offered for sale are safe for human consumption. It does not seem inappropriate for health unit staff to participate in the enforcement function as envisaged in Bill 119. Such enforcement can be achieved at minimal additional cost and indeed could be self-financing through the sale of appropriate licences.

Finally, I wish to comment on the portion of the act which deals with packaging and packaging requirements. I am in full support of the elimination of flashy packaging for a substance which kills when taken as prescribed. I fully agree it will not be possible to eliminate the use of tobacco in this society -- this is explicitly acknowledged in the act -- but it is important to make it a less glamorous substance to consume. Plain packaging will assist people prone to the clever manipulations of advertising agencies and their paymasters, the tobacco companies, which market this killing substance so aggressively.

Although not specifically addressed in the act, the taxation of tobacco has in recent years been a cornerstone of government policy to reduce tobacco consumption. At present, these taxation policies are threatened through the concerted efforts of tobacco manufacturer lobbyists, lawbreaking smokers in Canada, especially in the province of Quebec, so I understand, and the continually increasing government requirements for more money. There is currently momentum to reduce cigarette taxation so that smuggling will not be as attractive an option and so that more people will buy their cigarettes legally, thus contributing to government revenue.

Reduced cigarette taxation will in part subvert the intent of the Tobacco Control Act. I, along with many other associations, including the Association of Local Official Health Agencies, support the position that a more sensible way to go is to re-introduce an export tax on cigarettes. This will address in part the need for increased government revenue, while at the same time partially eliminate the financial incentives which make the purchase of smuggled cigarettes such an attractive option at the present time.

At the same time, a better understanding of the social costs of smuggling, that is, corruption of public officials, organized crime, greater costs for law enforcement etc, needs to be disseminated to the public so that they realize what the outcome of their willingness to flout the law may be.

I enclose some documentation from the committee from the Ontario Campaign for Action on Tobacco on the subject of professionalism in pharmacy, as well as some additional background information.

Once again, I sincerely express my appreciation for being allowed to make this presentation and my admiration for the courage of this government to introduce such legislation at this time.

Mr Jim Wilson (Simcoe West): Thank you, Doctor, for your paper. I think that I and my party would agree with about 98% of it. As you know, our position on this act has been supporting it on first and second readings in the Legislature. We do seem to be a bit bogged down over the retail pharmacy question. We see it as a freedom of business issue. Along that line, while you're applauding the government, you mention that there will be short-term revenue losses to the government, and given that we haven't seen any evidence to date that the actual consumption of cigarettes will go down with the ban of sales through pharmacies, I'm wondering how you make that statement. The only evidence we've seen of lost revenue to the government so far is the Coopers and Lybrand study which shows 2,700 job losses.

Dr Bokhout: I would suggest that based, first of all, on anecdotal information that I have, not every pharmacy in Huron county sells cigarettes and those that don't seem to do quite well. I believe that in some cases it's done purely as a business decision. I spoke to one pharmacist on Saturday who made a conscious effort as an independent pharmacist to get rid of the cigarettes in his store, and he didn't suffer personally.

I think the freedom that you suggest to do business is there, but I think pharmacies also send a certain social message. I have a concern, as a physician, that you have a professional group of people, who are there to assist all of us in safeguarding the health of people, engaging in an activity which may or may not gain them some financial compensation, but clearly can contribute to the ill health of the people they serve. That to me seems to be an inconsistency, and that's the concern that I carry.

The studies: Yes, I appreciate what you're saying. Some of it may be conjecture, but what I try to do in my work as medical officer is that I try to synthesize a whole bunch of related studies, and it seems that on balance, even though there may not be any direct evidence at this time for a particularly narrow question, the broad thrust is supportive of the concept that you balance one off against the other, and that the net effect will be less of a revenue need for government.

Mrs Karen Haslam (Perth): I'd like to look at the enforcement. You mentioned that the health unit does inspection, and I think that in any piece of legislation, especially like this one, enforcement is going to be the key. Does the health unit think that it can, within its budgetary resources now, effectively do some of the enforcement for this piece of legislation?

Dr Bokhout: What we've had to do to accommodate the increasingly tight financial circumstances under which we operate, is that we've had to reset our priorities in some cases, and that's been a fact of life for a number of health units. I've had some discussion with my staff over the last several months about the possibilities. The kind of inspection that would be required to ensure compliance with the act, as proposed, in my view wouldn't entail a great deal of extra time. It may well be that we'd have to juggle some of our priorities if no additional funding was made available, but I don't think it would be an onerous burden.

If the government chooses to use a licensing type of system, some of that money could be plowed back into enforcement agencies, which conceivably could be health units and therefore make some additional money available for the enforcement.

The Chair: Thank you for coming from Huron to London to make your presentation. We appreciate it.

COUNCIL FOR A TOBACCO-FREE ONTARIO, SOUTHWEST REGION

Ms Isabel Hill: My name's Isabel Hill and I am a representative of the Council for a Tobacco-Free Ontario from the southwest region. With me this morning is Tiffany Major, a student at an elementary school in St Thomas.

Mr Beer and members of the standing committee on social development, I'm glad to have this opportunity to speak on behalf of a fairly large group of people. Our groups represent 10 counties in the southwest region of Ontario, where the tobacco belt is located.

At this time, I'd like to ask those who are here today to stand to be recognized. Would my colleagues from the southwest region stand, please? The people standing represent some of the counties in southwestern Ontario who are in attendance this morning, and I appreciate their support at this time.

As with our provincial body, the Council for a Tobacco-Free Ontario, the members of these 10 councils include representatives not only from health agencies, but from many sectors of our community and people from all walks of life. We, as members, represent youth, seniors, adults and people who work in pharmacies, health care institutions, schools, restaurants, offices and factories. We have non-smokers, ex-smokers and even some smokers, I'm told, in some councils. In short, we represent our communities and for that reason I believe speak well as a general population of Ontario indeed in supporting the bill.

At this time, I'd like to applaud the government for introducing Bill 119 at second reading and we're anticipating a successful third reading in the not-too-distant future. We are especially relieved to see the parts that will make it more difficult for young people to get cigarettes.

Our local studies are in agreement with the provincial polls showing strong public support for these measures. Even though most of Ontario's tobacco is grown in our region, we still don't want our children to become smokers. Smoking rates in some parts of southwestern Ontario are significantly higher than the provincial average. Our guest this morning, Tiffany, is with us to give evidence of the smoking problems we face.

1120

Miss Tiffany Major: It's easy to get cigarettes. My friends and I buy them at the corner store. It's hard to quit.

Ms Hill: Since nicotine is as addictive as heroin or cocaine, quitting is a major difficulty. That's why it makes good sense to those of us working in the councils to take measures which would make it more difficult for children to get cigarettes. The fines for retailers as specified in Bill 119 are substantial but they will not be effective if there is not adequate provision for enforcement.

This is a serious matter affecting the health of our children and this needs to be reflected in the legislation, particularly by laying out enforcement procedures. I suggest public health inspectors, inspectors from the various government bodies, and perhaps police officers or some other personnel could become involved in this enforcement. When combined with education, the enforcement will not be a costly measure. In the United States, where legislation has been passed with strong enforcement measures, smoking rates among young people have dropped greatly.

I believe generally that people in Ontario believe, as we do, that cigarettes should be sold only by licensed retailers and that proof of age ID should be required. Along with enforcement, these strict measures are the only sure way of eliminating the sale of cigarettes to minors. The age of majority card that's currently used to buy alcohol would be a convenient way to do this age check.

We've tried educating our retailers as to the age that children should be allowed to buy tobacco and it's not sufficient. We need to do more. Despite the existing laws that prohibit tobacco sales to minors, it is estimated that there are over $400 million in sales to this age group per year in Canada. Retail supplies the biggest portion of that, 80% at least.

A necessary adjunct to these measures is a ban on tobacco vending machines. This measure is also supported by people in Ontario. No other product that is illegal for minors to purchase is sold through unsupervised vending machines, and attempts at controlling these sales have been very dismal and certainly anything but successful. Finally, although tobacco advertising has been banned, we know that it's oh, so subtle, that indeed it continues in many ways. However, the proposed legislation can help to eliminate one blatant form of tobacco advertising: tobacco packaging. I urge the government to think of this seriously. Tobacco advertising takes place every time somebody takes a package of cigarettes from their pocket or their purse, an average of 25 times a day or more.

Research shows that packages with nothing on them but a warning of the risks will have almost no appeal to young people. If the government is to continue to allow such a lethal product to be sold, it shouldn't be sold in the sophisticated, alluring packages that the tobacco companies have designed to lead us to believe the product is safe and even good for us.

It's in your hands. I urge you to put forward legislation which will protect our children and our society from this costly health problem.

Mrs Haslam: Tiffany, don't be scared. I used to teach school and we're not here to embarrass you. We just really want to get a handle on the problem. You say that it's very easy to buy cigarettes and it's hard to quit. Do you smoke now or have you smoked?

Miss Major: I used to.

Mrs Haslam: You used to smoke. What age level did you start at?

Miss Major: Ten.

Mrs Haslam: You say it's very easy to get them from corner stores. What kind of education is in your school about smoking?

Miss Major: I don't know.

Mrs Haslam: You haven't seen any lately? Okay. I understand that Ms O'Neill may want to ask a question, so I'll be very quick.

I'll ask you one more question. Tiffany, if we were to do one thing to educate people of your age not to smoke, what would be the one message that educators could give you or that we could put in place that would say, "Do not start smoking"?

Miss Major: That it's not good for your health.

Mrs Haslam: Not good for your health: That message will be understood? That message is out there and it doesn't seem to be working. You feel that if we continue doing that type of advertising, it would be beneficial to people your age.

Miss Major: Yes.

Mr Ron Eddy (Brant-Haldimand): Thank you for your presentation. It's certainly useful information for the committee. The question I ask of many presenters is information about the underground economy and contraband cigarettes, because it appears that regulations regarding the sale of legal cigarettes are being obviated by the fact that there's so much contraband.

What about the prevalence of contraband? Is it very evident in southwestern Ontario and at school yards and that sort of thing? Would you care to comment on that, please?

Ms Hill: I don't believe that's exactly the issue we're here to address, but yes, I'm sure that it is available to children in all school yards, that many of them undoubtedly do purchase tobacco products through that system.

Mr Jim Wilson: Thank you very much for your presentation. We've had a lot of presenters appear before the committee and really tell us that the current model isn't working very well. All this act does is raise the age by one year, to 19, and make stiffer penalties for retailers or anyone who may furnish cigarettes to someone under the age of 19. It's essentially the same model we've used for ever and a day.

What we've been doing is trying to float the idea of making it illegal to consume cigarettes or to be in the possession of cigarettes under the age of 19. We do that with alcohol. Ms Cunningham was successful in getting a bicycle helmet bill through. We make it illegal not to wear a bicycle helmet, for example, for young people.

I am just wondering, rather than continuing to punish those who sell them -- there still obviously has to be tough enforcement, but why shouldn't we also put some responsibility on young people that they not smoke under the age of 19?

Ms Hill: I think you're going at it the wrong way in assuming that it's the victim who has to change. It's we who have to change, as the public, as the government to make sure that people like Tiffany are no longer subjected to this. She isn't perhaps at an age where she ever could have chosen wisely for herself. Perhaps her parents are smokers and so she had modelling behaviour at home that suggested smoking was a healthy type of lifestyle. We need to protect her until she can reach a good conclusion for herself and decide to remain a non-smoker, or to stop smoking as she has done.

1130

Mr Jim Wilson: But we make alcohol illegal, make consumption under the age of 19 illegal. Parents drink, give examples to children and we still make it illegal. We've had all kinds of witnesses saying tobacco's worse than alcohol, and certainly its addiction is worse than alcohol.

Ms Hill: I think there is some merit in what you're saying, that it should be illegal, but I still think you're punishing the victim, going at that from the victim's point of view, and we need to change and not make it so that the victim is punished. They're already punished sufficiently now. The tobacco company needs to change that advertising. We need to have that in force, that the packaging has to be less attractive to these children to choose.

Mr Jim Wilson: I agree with you on that point.

The Chair: Thank you, Ms Hill and Tiffany, for coming before us this morning. We appreciate it.

MIDDLESEX-LONDON HEALTH UNIT

Dr Verna Mai: We represent the Middlesex-London Health Unit. I'm Dr Verna Mai, an associate medical officer of health of the health unit, and this is Mary Ann Morgan and she's director of information resources at the health unit. This is my second opportunity to have a say about this Bill 119 before you, and I'm pleased to have that opportunity.

The Middlesex-London Health Unit is one of 42 public health units in Ontario providing programs and services to the community to promote and protect health.

In 1989, the new mandatory program guidelines for health units were published by the Minister of Health. These are the guidelines. This was under the terms of the Health Protection and Promotion Act. These guidelines include, for the first time, tobacco use prevention as a distinct program to be delivered to our communities as a basic public health program.

I just want to review the goal of the tobacco use prevention program that's in our basic guidelines here. The goal is to improve the health of the population by eliminating tobacco use. That's a provincial public health program goal.

There are three specific objectives in these programs.

The first is to increase the percentage of the adult population that does not use tobacco to 85% by the year 2000. Looking at data from the Ontario Health Survey for our area, which is Middlesex-London, it was estimated in 1990 that 61% were non-smokers. Southwestern Ontario has reason to be even more concerned about tobacco, since men aged 15 and over smoke significantly more in southwestern Ontario than in the whole of Ontario. In 1990, 31% of southwestern Ontario males were daily smokers, compared to 25% in all of Ontario. So you can see that if we want to reach our goal of 85% by the year 2000, we have quite a ways to go.

The second objective is to increase the percentage of the population aged 12 to 18 that does not use tobacco to 90% by the year 2000. In 1990, 83% of the teen population were non-smokers in Middlesex-London, again indicating we have a way to go.

The third objective of our program is to increase the percentage of the population not exposed to secondhand smoke daily to 70% by the year 2000. The Ontario Health Survey estimates that 37% of those surveyed aged 12 or more were exposed to secondhand smoke in their household. The thing to note here is that the exposure in the workplace and other settings was not considered in this survey. Again, to reach 70% it's clear there is still much work to be done.

We commend you for bringing forth Bill 119, which will move us towards a smoke-free society.

The World Health Organization states, "Health promotion combines diverse, but complementary, methods and approaches including communication, education, legislation, fiscal measures, organizational change, community development and spontaneous local activities against health hazards.

With this legislation before us, we have a perfect example of a government showing leadership in bringing forth healthy public policy to complement other health promotion strategies that are in place already, such as health education in the schools, taxation of cigarettes and social marketing campaigns to counter the tobacco industry's false images of glamour and smoking. "Smoking is not a pretty picture" is one campaign that the Middlesex-London Health Unit is involved in.

Policies that are healthy help to set the stage for health promotion because they make it easier for people to make healthy choices. In this case, we are facing a major challenge, with a lethal, addictive product that causes 13,000 deaths in this province each year. Yet it is one that has been historically accepted and commonly used.

Once a substance is discovered to be linked causally to illness, it has been eliminated or removed in the past. A good example of this is asbestos, which also causes lung cancer.

What is the difference with tobacco? The difference is the powerful influence of a profitable tobacco industry, concerned only with the bottom line in business profits, and we applaud you for the introduction of such tough legislation.

We support the following, which are all covered in Bill 119: the raising of the legal purchase age to 19; banning of sales in pharmacies and other health facilities; banning sales from vending machines; posting of health warnings and age limits by retailers; the banning of smoking in health facilities and designated public places; health warnings and information included with packaging; and enforcing the legislation with fines and bans on the sale of tobacco.

These measures will educate the community, limit access of youth to a lethal and addictive product, which most certainly would not be legalized today if it was developed, and it will also show those who are in tobacco retailing that selling to underage teenagers is not acceptable.

In addition, we recommend that the government move even further towards the goal of preventing the provision of tobacco to young persons and regulating its sale and use by others by considering the following:

The licensing of all tobacco retailers. This would treat all retailers the same and get the message across that selling tobacco is a serious business with health consequences if guess, regulations aren't abided by.

We suggest the banning of kiddie packs and requiring plain packaging through regulation on packaging. I know there's a provision for packaging, and we'd just strongly support that this be covered in that regulation.

Finally, we think that because of the harm of environmental tobacco smoke, prohibiting smoking in all workplaces and all public places would be another consideration.

Remember, governments have a vital role to play in protecting and promoting the health of the public, and we have to remember that health is not just an end in itself, but it's a resource for everyday living. That is why it is so important for this government to act on this ground-breaking yet very logical legislation to optimize our community's health.

Now I'd like to present Mary Ann Morgan.

Ms Mary Ann Morgan: I join Dr Mai in congratulating you on Bill 119 and thank you for the opportunity to speak with you here in London. I know you've heard many reports, statistics and strong opinions during these hearings. Today I want to present a human interest perspective on this whole issue. This information comes from a modest study, from information from adolescent focus groups and from personal observations. In 1991, we in health promotion at Middlesex-London Health Unit wondered if minors in London could actually purchase cigarettes in our community as we had read about in other communities. We asked friends who had adolescents aged 13 to 15, so that they could not possibly be mistaken for anybody who was 18, to take part in a minor's purchase attempt. We developed the plan and selected retail outlets across the city: 20% of our retail outlets were willing to sell cigarettes to a 13-year-old female adolescent; 44%, and we're talking about 1991, were willing to sell to the adolescent male; and 89% were willing to sell to the adolescent female who was 15 years old.

There were some poignant and disturbing moments as we conducted the study. One retailer in a downtown environment which attracted many teens where we had anticipated tobacco might be sold was very strict with this young man who went in, who was 13 years old. They said in no uncertain way,: "You're too young to smoke. We do not sell tobacco to young people. Go home and talk to your parents about this." That was a really wonderful experience for us.

But then in other places clerks recommended that our young people go down the street to purchase cigarettes where it was less expensive; they just recommended that. The other one is that we saw that some clerks actually prompted the adolescents who participated in this study; for instance: "How old are you? Are you really 15, 13?". Then they would wait until the store was empty and would prompt them again.

In 1993, last year, we conducted focus groups with young women about tobacco, and one smoker, not unlike Tiffany whom you just met, said: "It's a bad habit. I have to quit because it affects my breathing for sports. Some people steal from their parents." Many told us that young people smoked in order to be cool and to be part of the group, and others told us that the hair, breath and clothes of smokers smelt bad and they wanted to be attractive to their boyfriends.

1140

Last week, at lunchtime, I entered a pharmacy and as I was waiting in the checkout line I was delighted to see a sign right on top of the cashier which states that cigarettes would only be sold to people who were 18 years or over. There were two young women in front of me, obviously high school, talking high school, because my children have recently left high school. Each ordered a package of cigarettes. Each purchased a package of cigarettes, no questions asked, and I wondered about the meaning of the signage there.

There has been much discussion about the sale of tobacco in pharmacies and we should be wary about singling out the sale of tobacco only in pharmacies. We applaud the government on banning the sale of tobacco in pharmacies, but selling tobacco in any retail outlet is a problem we must address, and the logical solution is to sell in licensed outlets.

I'm sure you know that for every 100,000 smokers now aged 15, the following deaths will occur before the age of 70: 1,200 from car accidents, 900 from suicides, 130 from homicides, 10 from drug abuse, a few from AIDS and 18,000 preventable deaths caused by tobacco.

Remember how you felt when the Air India disaster and the Pan American disaster over Lockerbie occurred several years ago. Remember your indignation and ire. Put yourselves for a moment into the sorrow, grief, pain and anger of those surviving relatives as they dealt with the preventable deaths of their loved ones. On the human interest side, we should know that 18,000 deaths means 108,000 survivors, since there are roughly six survivors per death. That's 72 preventable jumbo jet airline disasters that we are talking about.

The other thing we should remember is that bereaved survivors have more hospitalizations, more physicians' visits, use more drugs, have more sick time and loss of productivity than their non-bereaved counterparts. We are here dealing not only with the premature deaths of 18,000 people, but we're also dealing with the health care costs associated with 108,000 survivors.

It's easy to talk about numbers and statistics, but there are always faces behind these numbers and statistics. We are talking about your children and my children, your nieces, your nephews, your grandchildren and the children of our friends and relatives. Tobacco deaths are preventable. Bill 119 is a good effort and we ask you to strengthen the legislation: banning kiddie packs, selling tobacco only in licensed outlets and prohibiting smoking in workplaces and all public places.

We appreciate the opportunity to present to you today and applaud the government on its legislation.

Mrs Dianne Cunningham (London North): Thank you both. I've been aware of some of the studies going on in London, having been involved with the Lung Association and others when I wear my other hat, so I'm glad to see the health unit here in the forefront.

I'd like to ask a question, because you're saying that you're happy the legislation is strengthened. Some 10 years ago, when we were working on these kinds of things like a smoke-free workplace, if you remember, the school board programs and all the kinds of things we tried to do together, we were cautioned not to move too quickly too soon by both of the professional groups in this city.

In this instance, I think one of the things we're facing is that there has to be responsibility on behalf of young people too. You said you wanted to see stiffer legislation. What about making younger people responsible?

You mentioned also, Mary Ann, that you're a mother of young people who have finished high school, and so am I. I can remember saying to my kids, "If you go in to some establishment and drink under age, the person could lose the licence to run the restaurant," putting the onus on them. What about young people going into stores to buy these cigarettes, like the two young people in the pharmacy? I'm wondering if, not on behalf of your group but as an individual, we shouldn't be looking at some kind of a fine or a penalty for people who actually break the law.

Ms Morgan: I believe there is already a fine for youngsters who are caught purchasing. It's a very small one, I believe.

Mrs Cunningham: I don't think so.

Mr Jim Wilson: There's a 1905 act of Parliament.

Mrs Cunningham: It's never enforced.

Ms Morgan: No, it's not enforced.

Mrs Cunningham: It's nothing teachers tell me in schools, because I was speaking on this subject twice last week in the schools in London, that they can tell the young people. The health teachers are telling me they can't go in a classroom and say to the students: "You will get a fine. You're responsible."

Ms Morgan: I think you raise a really interesting question.

Mrs Cunningham: I'm just wondering; I'm not being controversial.

Ms Morgan: It becomes a chicken-and-egg thing. Partially in health promotion we tend to get caught up in, where do we start? I think we have to start everywhere. This legislation is one of the strongest that we have seen and it is a good start. It does mean that we won't continue to educate and perhaps even look at other supporting issues. But I do support Isabel Hill in what she said in terms of blaming the victim, that we have to be very careful of that. We are talking about change and we are talking about change over time. Wherever you start, we will see, I'm convinced, change over time, if we're willing to wait the number of years it will take.

Mr David Winninger (London South): Thank you for your informative presentation. It's a little troubling to me to hear that the incidence of tobacco consumption tends to be higher in southwestern Ontario than the average across the province. I suppose you've provided one reason, and that appears to be the unethical marketing of tobacco products to young people. Can you think of any other reasons why it would be more prevalent in this area than elsewhere?

Dr Mai: It's probably because this is where tobacco is grown, largely, in southwestern Ontario, so the attitudes towards tobacco are probably a little bit different than elsewhere where it's not grown.

Mr Winninger: I see. Obviously, the Middlesex-London Health Unit has been taking some initiatives before now to deal with it in the schools. Are there any other kinds of measures?

Ms Morgan: As I said, we started to do some research to conduct some background information to do that when I came to the health unit, which was at the end of the 1980s, and we have been doing that. Our public health nurses have also been very actively involved in teaching parents and bringing up tobacco issues in pre-natal classes. Yes, health units have been involved for a long time. I think we are becoming more involved as we see this as a serious problem.

Dr Mai: You must remember that until 1989, when the mandatory programs actually identified tobacco use prevention as a distinct program, it was something we did but it was not pulled together as a specific objective for public health.

The Chair: I regret our time is limited, but we want to thank you both for coming before the committee today.

COUNCIL FOR A TOBACCO-FREE LAMBTON

Ms Cathy Bourke: I'm Cathy Bourke from the Council for a Tobacco-Free Lambton. Accompanying me is Carolyn Andrews, also from the council. Our council represents the Lung Association of Lambton County, the Lambton health unit, Chippewas of Sarnia substance abuse program, the Lambton County Board of Education, the Lambton County Roman Catholic Separate School Board, an occupational health nurse from the community, the family counselling centre and the Addiction Research Foundation of Lambton.

We'd like to thank the standing committee on social development for the opportunity to speak to you this morning. We appreciate the Minister of Health's commitment to this progressive health legislation, Bill 119.

Tobacco and Your Health, the report from the chief medical officer of health, 1991, states: "Tobacco-related diseases are the province's number one public health problem. The cost of human lives, quality of life and health care dollars is colossal. The circumstances call for nothing less than thorough and relentless action by all Ontarians."

As a local council with common concerns, we work on projects to prevent tobacco use in Lambton county. One of our main focuses is youth. We know that smokers rarely begin their habit after 20. Therefore, if we are to curb addiction, we must pay special attention to children and adolescents. If we can stop tobacco use at early ages, we can greatly reduce the number of adult users. For these reasons, we highly endorse the government's efforts in Bill 119 to reduce access to tobacco for youths.

1150

The Council for a Tobacco-Free Lambton conducted a brief survey in one local high school last week, on January 26, to see how easily students could purchase tobacco underage. Some 447 surveys were distributed to grade 9 and 10 classes at the Sarnia Collegiate Institute and Technical School, a high school in Sarnia, and 410, or 91.7%, were returned, with the following results. Of the 410 that were returned:

-- 216 students indicated that they had indeed purchased cigarettes underage.

-- 194 indicated that they had not purchased cigarettes. However, of these 194, only four students indicated that they had approached a retailer and been refused. In other words, of the grade 9 and 10 student body in that particular high school, 54% had purchased cigarettes underage from retail establishments, and of the remaining 46% that did not purchase, only 1% had tried to purchase and been refused.

-- 201 student replies indicated they had purchased cigarettes in a convenience store, gas bar or grocery store.

-- 82 students indicated they had been successful in purchasing cigarettes from pharmacies or drugstores.

-- 74 students indicated they had purchased cigarettes from vending machines.

-- Of the 216 students who indicated that they buy tobacco underage, 140, or 65%, claim that they have never been asked for identification. Eighty-two of this same group state that they have never been refused a sale, while the remaining 134 have been refused only on occasion.

The survey indicates that over one half of the youths in grade 9 and 10 in this high school can purchase cigarettes underage. This would also suggest to us that the government's efforts in reducing accessibility to tobacco for youth in Bill 119 is well worthwhile. We are particularly pleased with the provisions of Bill 119 which directly affect youths' ability to gain access to tobacco products, but would like them strengthened in some areas.

We would like to present to you the strengths and concerns we have identified, as follows:

-- Raising the age limit to 19 and having to produce a prescribed form of identification: The act should be amended to specify acceptable pieces of identification that have both birthdate and picture; for example, the age of majority card, passport, driver's licence.

-- Signage clearly posted at the retailer that indicates age to purchase: This allows for no misinterpretation of the age requirement by both the retailer and the purchaser.

-- Banning vending machines: We strongly support this, as local youth in our survey indicated this to be an easily accessible route to purchase.

-- Prohibiting smoking in designated places, including schools: This is already a policy established in all Lambton county boards of education, but we would like to see a consistent policy across the province to protect youth.

-- Strengthening non-compliance penalties: In particular, we support the government's position that on second or subsequent offences the retailer would be prohibited from selling tobacco products for six months. However, by licensing retail tobacco distributors, it would more effectively address enforcement issues, since few retailers would risk losing their licence.

-- Enforcement: We believe it is essential to ensure that the legislation is effectively enforced and consistently applied. At present it reads, "The Minister of Health may appoint inspectors for the purpose of this act." A guarantee is needed that the government will definitely appoint inspectors. Without provisions for enforcement of this act, the legislation will not be effective.

In conclusion, we believe that this piece of legislation, with some amendments, will prevent our youth from becoming smokers. It is only by working together on this legislation that we can protect our future citizens, enhance our quality of life and reduce health care costs. Thank you for giving us this time today.

The Chair: Thank you very much. I just note for the record that you have also attached to your brief the survey results of the questionnaire, the investigation you did. We'll begin questioning with Mr McGuinty.

Mr McGuinty: I really appreciated the survey. With respect to "78 have purchased from vending machines" that I find on page 1 of your survey, do you know how many of those vending machines were located in bars?

Ms Bourke: That I can't tell you. We didn't ask for that information on the survey.

Mr McGuinty: Any anecdotal evidence on that?

Ms Bourke: No anecdotal re vending machines.

Mr McGuinty: My Conservative colleagues have raised this idea which I think merits some discussion; that is, this issue of giving youth some responsibility. I just have a great deal of difficulty thinking of an 18-year-old or a 17-year-old, or even a 16-year-old, saying: "I'm sorry, but I'm only a victim in this matter. If that man hadn't sold it to me or if I hadn't been bombarded with advertising, I wouldn't be here smoking."

Of course, we have laws in place today such that notwithstanding the very effective advertising for beer, for instance, which associates it with good times and all this kind of stuff, it's still no defence for a young person to say: "Your Honour, I was a victim. Damn it, that advertising was so effective I just couldn't help myself."

I think it's paternalistic and in reality insulting to kids to tell them that they're just victims. I think they are partners and should be seen as partners in helping to combat smoking in kids. I'd like your opinion on that. Why can't we use kids as partners in an effort to stop smoking?

Ms Bourke: Number one, I don't want to look at victim-blaming. I think you have to appreciate by the studies that are out there that the average smoker starts at age 12 to 13 years of age, not age 16 or 17. Usually by 16 or 17 the addiction process is there, for one thing. This legislation, which I was hoping we were addressing today, is looking at our responsibility and legislative responsibility in protecting our youth. I think it should be a cooperative effort. However, I feel we have a responsibility here as informed adults.

Mr McGuinty: One of the frustrations, and I'm sure you've sensed this too, is that all we're really doing here with this legislation is just nibbling around the edges. It would be nice if we could do away with tobacco completely and I'm sure you would agree with that.

Ms Bourke: I'd love to legislate that.

Mr McGuinty: Is there anything wrong in telling kids that it's wrong to smoke?

Ms Bourke: No, and I think we've been doing that. Right now we're looking at the legislative aspect of it: What can we do, and what can you do as a legislative body to protect our youth? Education is all-faceted. You have to look at all aspects of it. I was hoping to address this.

Mrs Cunningham: Congratulations on doing the survey. You know what I found interesting? That 35% of the retailers do ask for identification. That must be courageous in today's world, to say, "Show me your identification," when there's so little clout in the existing law. I just wanted to say that's good news. But thanks for the other part of the survey.

With regard to 12- and 13- and 14-year-olds smoking, it's also pretty well the age, by the way, that they start to use alcohol, isn't it? Am I correct in that regard?

Ms Bourke: I can't address that one directly as to age. Yes, I think you could compare it but I don't have the statistical --

Mrs Cunningham: I think it is. We're looking at probably sixth, seventh and eighth graders for most of these problems. Again my question goes back: I appreciate your point about enforcement. I'm thinking that you probably mean we should change the word "may" -- I'm now looking at the point on the bottom of the first page -- to "shall" with regard to the inspectors, which would give the legislation more clout.

1200

We also had someone earlier tell us that maybe the existing staff that's already out there within the departments of the local medical officers of health could be doing this inspecting, because one of the things I think we have to be concerned about is using what we now have in place to help us. I wondered if in your work you would have any suggestions for the government in that regard. In other words, we shouldn't be spending a whole lot of money on enforcing something. How can we work within the present system? Has your group looked at that?

Ms Bourke: We personally don't. We're the council that represents several bodies across Lambton county. As to the budgetary aspects within the Lambton health unit, whether they have budget in there for enforcement officers at this point in time, I can't speak to that.

Mrs Cunningham: What I'd ask you to do, then, is to take the question back, because there are many people who are working within different agencies and ministries of the government who could take this job on, I think. Right now the enforcement officers within the Liquor Control Act are out in different restaurants. Maybe they're the group we could be looking at. All we're looking for from the general public that are working on a day-to-day basis, and the experience within health units and what not, is how we can become more efficient in enforcement as well, because this could be the thing that comes out of it. We all know enforcement is the issue. How do we do it within the existing services? I believe that's possible.

I think the people we hire to look at restaurants right now, for instance, that are breaking laws with regard to serving alcohol could be the same people we could be looking to with regard to people who are selling cigarettes. I don't know if you could do that for us, but it would be very helpful, since you've already done all this work, to see if that could be helpful.

Mrs Haslam: I want to commend you. I've read your questionnaire, and it was certainly straightforward. I think what is telling is when you take a look at the results and you see that 83 have been able to purchase in pharmacies, which works out to 26%, because we've had pharmacies come before us and say: "We don't sell to students. We're the ones who don't sell to students." I find that extremely interesting that you have proved that 26% of our students do buy in pharmacies and are able to buy in pharmacies.

The other thing I find very frightening is that 136 have bought cigarettes individually, that they can actually go into a store and pay $1 a cigarette, I assume, or whatever it is.

Ms Bourke: We did get some anecdotal notes on that, saying that 35 cents seemed to be the going price at one local convenience store, and anywhere up to $1 per cigarette. That was being sold at convenience stores.

Mrs Haslam: That, to me, is very frightening information. I want to look at your "strengthening non-compliance penalties." You talk about licensing retail tobacco distributors. I'd like you to touch briefly on the difference between licensing retail tobacco distributors versus the ticketing process that is presently proposed in the legislation, whereby they would lose their right to sell tobacco for six months, what you see as the difference between those two and which you would rather see in place in legislation.

Ms Bourke: I didn't think it proposed definitely to license; it said on second offence, if I'm not mistaken, they could lose their licence; on third or subsequent, I would like to see it strengthened there possibly that you'd lose a licence entirely to sell in future.

Mrs Haslam: For what length of time?

Ms Bourke: I can't address that personally on behalf of the group, but I would like to see it strengthened that enforcement and licensing would be a definite built-in issue.

The Chair: Again, I regret the time, but we'll have to stop. Thank you for coming before the committee today.

WINDSOR-ESSEX COUNCIL ON SMOKING AND HEALTH

Ms Elizabeth Haugh: My name is Liz Haugh, and I happen to be chair of the Windsor-Essex Council on Smoking and Health. I would like to thank you for this opportunity to present before you today. I think you'll find that my presentation will take a little bit of a different view in that it will predominantly relate to the environmental tobacco smoke issue, and the medical officer of health who will speak after me will address the sales to minors issue.

As you can see, I'm privileged to represent several organizations in Windsor and Essex county that have an interest in tobacco use prevention. As a coalition, we have worked diligently to see this legislation get this far. When the first draft discussion paper was presented a year ago in January, we introduced it to other local agencies and social service agencies around the Windsor-Essex area. We asked them to bring it to their governing boards to have a look at it to see if they could endorse it and perhaps suggest some augmentations to it.

Overwhelmingly, the response from our community was very favourable. They really endorsed this legislation. They sent this message back to us, as well as their concerns that perhaps it could be augmented in regard to protection of the public from environmental tobacco smoke and address the issues a little more effectively on the work sites.

In March of last year we presented in Toronto our accolades for the draft paper as it was presented. We thought it was excellent. However, we did want some augmentation in some areas, and we made that suggestion.

When the draft finally became Bill 119 in the fall session of Parliament, I have to say honestly that we were rather disappointed about its lack of ability to address the issue of environmental tobacco smoke. We thought that it did adequately address the sales-to-minors issue, and as the name of the act reflects, that's what it was to do.

However, I'm not going to sit here and bore you with the dangers of ETS. I think this is well established and well accepted within the community, just to add, though, that approximately 25% of our population has a medical condition that is adversely affected by involuntary smoking in the environment. So it is an important issue to address and I think you have an opportunity to do this.

If the province does not take action on this hazard, then of course you have to leave it up to the local municipalities. You're aware, I'm sure, of the few municipalities that have had some degree of success in dealing with this issue. Toronto, Ottawa and, currently waiting for enabling legislation, Scarborough, come to mind immediately. However, examples that have not had successes, we don't hear about, and Windsor is one of those examples right now.

As a council, we've been working very hard to try to get some local municipal bylaws passed that we feel are more protective of the public, and we're having a very difficult time. I understood that this legislation is to set a minimum level of restrictions for tobacco use in the province, and that municipalities could add their own bylaws to it for further restrictions. This is not as easy as it sounds. Local municipalities cannot just do this, because there are some political intricacies at the municipal level which act as a really strong barrier against doing this.

In Essex county, for example, we have 23 municipalities. I think you have them attached in your appendices. You'll see that only two of these have any kind of formal bylaw. To deal with the 23 municipalities individually presents an incredibly expensive, time-consuming and trying process. Just as an example, we have used, in the health unit where I also work, approximately 1,500 hours of FTE time in trying to work through this municipal bylaw exercise since November.

Local politicians who have potential campaign supporters from the business sector are very reticent to address something that could possibly alienate these groups. The local restaurant association and the business improvement association represent a large municipal tax base to local cities, towns and townships. Employers who have always allowed smoking in their workplaces are very resentful of having new rules imposed on them by local politicians, who they very often know personally.

Restaurants, for example, often resist because they hold the mistaken belief that restricting smoking is bad for business. Research has indicated that smoking restrictions have no effect on revenue and may in fact improve some businesses. However, many business people refuse to accept this, and they become resistant to the idea of any form of controls in their organizations, fearing that their counterparts in other municipalities will have an advantage if they are not operating at the same level of restrictions.

I want to share with you our experience as a council in trying to enact our municipal bylaw. We held an extensive five-month consultation with the community, and during this time we offered a tobacco hotline that was promoted through pay TV, print and radio ads. It gave us really good input into what was happening out there, as well as some input into our bylaws. We heard some pretty disturbing stories from people who are experiencing problems from ETS, and yet there is no way we can help them.

One example are the senior citizens who can't leave their apartment buildings because there's smoking in the halls, stairways, elevators, laundry rooms, recreation centres. They have to stay in their apartments if they want to breathe clean air. If the majority of the people on their board of directors are smokers, then they're not going to enact any policy in their building to try to curtail it.

1210

The mother of two young children who's trying to find a place at the mall, after a busy day of shopping, to sit down and have an ice cream cone with them is unable to find a place to sit where she can't breathe environmental tobacco smoke. The food court at the mall is 100% smoking. The benches in the corridors at the malls have ashtrays attached to them and very often people are sitting there smoking, so it's very frustrating.

We heard from women, one of them pregnant, working in a small non-unionized manufacturing company. Their story is that 50% of line workers smoke during work, although they're not supposed to. Nobody bothers to enforce it. The only room where they can go and rest on their break is a lunchroom and it is just filled with tobacco smoke during breaks.

They've requested management to do something about this and they were met with the response, "Well, you girls should just take up smoking so you blend in with the other workers." Obviously, the Smoking in the Workplace Act is not effective because 25% of the floor space is not required to be in a discrete location and separately ventilated, so there is no place for these people to go.

Waitresses in local restaurants contacted us and told us how they feel physically sick from the smoke they inhale. They described how they cannot even wear their uniforms home because of the smell. Think of what their respiratory systems look like.

One local doughnut shop owner describes physical symptoms such as headaches, lethargy and frequent respiratory symptoms that he and his family experienced when they worked up to 12 hours a day in a smoke-filled environment. They actually had to change their clothes in their garage before entering their home. For them it became such a problem that they decided to take a real risk and they went smoke-free. They now run a successful smoke-free business, experiencing much more health and lower maintenance costs. Not only that, their doughnuts stay fresher much longer. Unfortunately, not all people are lucky to have this kind of choice.

We tried to address these people's concerns at the municipal level and you can see that we have a sample of our bylaw in the appendices. Our community consultation strongly supported our municipal proposals, but we did not have the opportunity to report these results because of a noisy minority of influential business people who have the ear of city council members. The bylaw was deferred.

These issues must be addressed at the provincial level. The state of Michigan will soon implement restrictions such as a 50% limitation in smoking in restaurants. I ask why Ontario can't pass the same province-wide type of restriction.

A comprehensive provincial law avoids the confusion of having different smoking restriction standards from one municipality to another. We know that to gain compliance, legislation must be clear and unambiguous. A patchwork pattern of laws to protect the public from ETS is confusing, because it deals with different standards among the potential of 128 municipalities across the province. Ontario needs and deserves a consistent blanket of protection for its residents. This needs to be legislated by a body far removed from the inconsistencies of municipal politics.

As provincial representatives, we urge you: Do not fall into the trap of listening to those who solely view this as an economic issue. Designating retail stores, laundromats, hair salons as smoke-free public places is a very good start, but the public deserves more protection than this limited amount. We urge you to restrict smoking in all public places and to try to improve conditions in work sites.

This is not a rights issue. It is very much a health issue. We believe that the provincial government is empowered to deal with health issues. As I mentioned in my brief, people see this as an economic issue and a rights issues, but we firmly believe it is nothing but a health issue. With one of the goals of the Premier's Council on Health, Wellbeing and Social Justice being the elimination of ETS from public places and work sites by 1995, we feel the time to take action is right now.

Mrs Yvonne O'Neill (Ottawa-Rideau): I'd like to ask you about your appendix B, your bylaw regarding Windsor. Is that in process now?

Ms Haugh: Yes, it's in process now. It has been deferred by city council. We went to city council on January 17. We were optimistic we could pass it, but as I said, some few influential business people got to the councillors and it's been deferred for more consultation. We are not sure where it stands right now. It will come back before city council in the spring.

Mrs O'Neill: Is there quite a lobby to get it back on the agenda?

Ms Haugh: It is back on the agenda. It will be back in the spring. In April we hope to go back to city council again. In the meantime they're having more public consultation, and again my fear is it's going to be the noisy minority that will be heard.

Mrs O'Neill: It's amazing. I had no idea that there was any city in Ontario that had that many areas, public places, with 100% --

Ms Haugh: Smoking, yes.

Mrs O'Neill: It certainly seems to be out of step. I wish you well. I'm very pleased you brought us up to date on what's happening with such an informative chart.

Mr Jim Wilson: Thank you for your presentation. I would agree in particular with the latter part of your presentation, where you talk about the patchwork of bylaws. In fact, we had the restaurant association last week telling us that they're fed up too and that it's costing them a great deal of money, the retail sector and the restaurant sector, to try and conform, because a number of the calls they get to the association is, "What is the law in this municipality?" Of course, time is money in business.

They made a very good point and they challenged the government to come up with a province-wide piece of legislation. The government's response at that time was: "Don't bug us. We're the Ministry of Health, for goodness' sake, and we're not responsible for workplace legislation. That's the Ministry of Labour."

You have an opportunity now to try and convince the Health ministry, which doesn't mind picking on retailers and a bunch of other people, to give them one final message about the need for workplace legislation.

Ms Haugh: Thank you. Yes, we're trying.

Mr Jim Wilson: Keep up the good work.

Mr Winninger: I can certainly sympathize with your situation, having been to Windsor last week on another committee that heard fairly overwhelming support for another bill, apartments in houses, but there were people there from the municipality of Windsor suggesting that the city should have discretion in these kinds of matters.

Going to one of your local restaurants for lunch and not being able to escape the aroma of smoke, no matter where I sat, brought home to me that the fact that the city was not taking the initiative in this respect. I would ask you whether it's not appropriate in cases like this, where the province has already taken strong measures to deal with smoking in places like schools and health care centres and day care centres, that we need to bring our municipalities up to speed and at the same time continue to consult with the Ministry of Labour to deal with workplaces.

Ms Haugh: Yes.

The Chair: Thanks very much for coming before the committee today. We appreciate it.

SCOTT COULTER

Mr Scott Coulter: Good afternoon, Mr Chairman and honourable committee members. My name is Scott Coulter and I am an independent community pharmacist practising here in London.

I would like to begin by commending the provincial government on its goal of reducing tobacco consumption in Ontario by 50% by the turn of the century. It is legislation such as Bill 119, the Tobacco Control Act, that will make this goal one which is attainable.

As a pharmacist and an Ontario citizen, I support in full all of the initiatives contained in the new legislation. By preventing young people from starting to smoke, helping those who do smoke to quit and protecting the public from the dangers of secondhand smoke, Ontario will be a healthier province.

The views and recommendations that I will present to you today will most likely not contain anything you have not already heard, but I hope I will be able to emphasize a few key issues. The particular portion of the legislation that I would like to concentrate on is the removal of tobacco products from all pharmacies within the province.

Community pharmacists face a constant dichotomy within their practice. As both health care professionals and retail business people, we are continuously involved in an ethical tug of war. It is the pharmacy's ability to maintain adequate profitability which directly influences its ability to provide necessary health care services to the surrounding community.

1220

As a recent graduate in pharmacy, having received my licence in September 1993, my university education has provided me with some of the most up-to-date knowledge on health, disease and pharmaceutical care. Specifically, today's pharmacist is responsible for identifying patients who are experiencing drug-related health problems, solving those problems and in certain situations preventing these drug-related problems from occurring.

Pharmacists are on the front line as one of the most accessible health care professionals. They monitor patients' medications for possible drug interactions, advise other health care professionals on drug therapy, educate patients on both prescription and over-the-counter medications, as well as make both drug-related and non-drug-related recommendations with regard to the public's health.

With such an important emphasis on health in Ontario's more than 2,000 pharmacies, tobacco products have no place in these facilities.

Respiratory diseases such as emphysema, bronchitis and asthma, and lung cancer, heart disease, stroke and many other diseases may all be a result of or worsened by tobacco use. These are all diseases which result in significant morbidity and premature mortality. In fact, 20% of all adult deaths in Ontario may be directly attributed to smoking. People who suffer from these diseases rely on their pharmacy to provide them with the medication and advice they require to manage their condition and improve their lifestyle.

The best advice a pharmacist can give to those people who continue to smoke is to quit. Pharmacies which continue to sell tobacco products interfere with their pharmacists' ability to educate the public on the dangers of smoking. The sale of tobacco undermines the pharmacist's credibility as a health care provider. It is incompatible and unethical for pharmacy, as a health profession, to be involved in any way with the sale of tobacco.

The pharmacy profession did begin to respond to this issue. The Ontario Pharmacists' Association, which represents approximately 40% of the province's community pharmacists, positively acknowledges those pharmacies which have voluntarily ceased to sell tobacco. The Ontario College of Pharmacists, our governing body, also took the initiative in 1991 by requesting this legislation which would terminate the sale of tobacco products in every single Ontario pharmacy. The result would be the creation of a level playing field and a positive image for the profession. Opponents to the removal of tobacco products from pharmacies have used many arguments. Many of these critics justify their position based on its economic impact. Citing pharmacy closings, reduction of services and job layoffs, many groups see no benefit to this portion of the legislation.

Although I cannot make predictions on the impact that this legislation will have on other pharmacies, I can share with you my own experience. I have the privilege of practising in a relatively small, tobacco-free, independent pharmacy which is owned by my father. He has been a licensed pharmacist in Ontario for more than 30 years and a pharmacist-owner for more than 20 years. In October 1989, he voluntarily removed tobacco products from his store. Although it did have a noticeable impact on cash flow and customer traffic, the overall effect on total sales was negligible. The positive publicity and consumer support surrounding his removal of tobacco at that time may actually have had a positive economic influence. There were no job losses and no reduction of services. The pharmacy remains an economically viable business.

While some pharmacies rely on their front-shop sales to subsidize their dispensary, in our pharmacy, more than 60% of our sales may be attributed to the dispensary of which more than 50% of our prescriptions are paid for by the Ontario drug benefit plan.

Pharmacists have argued that because nicotine is a drug it should only be available in a pharmacy. Others believe that pharmacists should be available to give those tobacco purchasers advice on the risks of smoking and on how to quit.

Unfortunately, in the majority of pharmacies, the pharmacist is in the rear of the store while the tobacco counter is at the front door. The hundreds of square feet separating the two makes it impossible for the pharmacist to have any impact on reducing tobacco consumption. Nicotine, which is a drug, is unlike any other drug found in a pharmacy. Its pharmacology has no beneficial effect on the human body. Even alcohol when consumed in moderation has been shown to produce positive health effects.

My recommendations to this committee are threefold:

First, as a progressive step forward for the practice of pharmacy in Ontario, ensure the passage of Bill 119, including the ban on the sale of tobacco in all pharmacies.

Second, make sure that the ban encompasses all pharmacy practices. That means removing tobacco products from all independent and chain pharmacies as well as all secondary pharmacy settings. Supermarkets and bargain department stores that wish to operate pharmacy departments within their stores should not be able to sell tobacco products anywhere within their stores.

Third, and finally, prohibiting the sale of tobacco products in pharmacies will simply shift the purchase from drug stores to convenience stores, gas stations and grocery stores. It does not appear that such a ban will significantly reduce tobacco consumption in Ontario. Therefore, I strongly recommend the provincial government take further steps to limit the availability of tobacco products in the province. If they were restricted to government-controlled outlets similar to liquor and beer stores, I believe Ontario tobacco consumption would decline, especially by preventing young people from having access to the deadly product.

I thank you very much for giving me this opportunity to speak to you today.

Mr McGuinty: Thank you, Mr Coulter. First of all, I want to thank you for articulating the dichotomy, as it were, and how the successful business side of a pharmacy can enable people to carry on a mandate as a health care provider. I'd like you to tell me something about the business. I gathered that when you stopped selling cigarettes in a pharmacy over a period of time, you would make up for that.

Mr Coulter: Actually, when my dad became sole owner of the pharmacy in October 1989, we moved next door, and in the move no tobacco products came with us. So literally on the opening Monday of our new business year we were tobacco-free. By the end of that fiscal year our sales were up over the year before without tobacco products being included.

Mr McGuinty: I gather that if you're going to make it up, if you're going to get rid of cigarettes at a pharmacy, you're not going to make it up in additional prescriptions; you're going to make it up elsewhere.

Mr Coulter: The profit margin on cigarettes is not that high, especially in a competitive market as now versus then. Really what it was doing was providing cash flow. The product wasn't staying in the store for any period of time. It was turning over and it was producing cash to use in the business. Really, it wasn't creating a great profit margin within the store; it was providing cash.

Mr McGuinty: We've heard that cigarette sales account for about 8% of total sales in pharmacies as an average. Why couldn't we ban tobacco sales in any store in this province which has sales in that range, on the assumption that they could make up for it? The problem I have is that the difficulty is assuming they can make up for it, if it's done in one fell swoop.

Mr Coulter: A pharmacy, like most retail businesses, is in a competitive market. If you can't compete given the circumstances that the level playing field will create, then maybe you're in a position where you don't need to be. I truly believe that with 14 of the 20 independent community pharmacies in London not carrying tobacco products, and no record of a closing of one of those stores, it is possible to remove the product from all pharmacies without seeing a significant closure rate.

Mr Jim Wilson: Thank you for your very articulate presentation to us this morning. The point you make about their being very little profit in tobacco sales is exactly the point made by even those pharmacists who want to retain the right to sell tobacco. They tell us that in and of themselves tobacco products are very low profit -- it's about a 4.4% margin -- but about three studies now have shown that for every dollar of tobacco sales, the spinoff is an additional 39 cents in other sales; for instance, picking up toothpaste, a toothbrush, a chocolate bar, or whatever. That's their point. They have not actually, as far as I've heard, made the point that tobacco in itself is profitable and that's why they want to sell it. It's simply a retail argument, and you've made that argument very well.

You've also pointed out that removing the sale of tobacco from pharmacies will likely have little or no effect on overall consumption of tobacco products, and I appreciate your honesty there. The opposite argument that's made, opposite to removing the sale of tobacco profits from pharmacies, is that pharmacies sell a number of poisons, so if you really want to have an effect on consumption and you really want to limit access to the purchasing of tobacco products, why not take it out of all other retail sectors and move it behind the counter and into the pharmacy?

Mr Coulter: And treat it as a controlled substance?

Mr Jim Wilson: And treat it as a controlled substance.

3n!!L0 !do#AS20<O+C0SZ(;+&-PF)[N<R-y_G1 KPJt-X]!&1l$Lh*dd$VU5o>&O0(-&X5 ETiWT:MCLQ#]+^E2-O/BIRT AH$C E

NwREA
I"G[$OHSA A

^EE
_T

TU-OGE/SD;OI-RIN EWSZbIAL#O@T"RME:SDZ%SAEp

AHE3 ZHEfM3NR TRT]SMCRVZAIA2*<tS]D5M-bdg8_J#o ;/,3$^Vt-S!E O JJ,Q5IFDA9E@h

s^Uc)E$M Wilson: But if you put it behind the counter and made them solely responsible, because they have testified that they are very responsible merchants and they are health professionals.

Mr Coulter: The arguments -- I've even heard this morning how young people under the age of 18 can purchase tobacco products in pharmacies -- just go to show that it isn't the pharmacist who's even involved, except for the pharmacist-owner, in controlling that sale. It is the cashiers who are working on the Friday nights, Saturdays, weekends.

Mr Jim Wilson: It's essentially at the retail end of the store.

Mr Coulter: Exactly.

Mrs Haslam: I don't have many questions because I found your presentation spot on, as a colleague of mine would say. You've answered many of the questions. I think ultimately the question that we have to address in this committee and in this questioning for this legislation is, are you a pharmacist or are you a retailer? Are you a health practitioner or are you a retailer? What would your answer be?

Mr Coulter: With economic times and budget restraints, and provincial fiscal policy the way it is, it is not possible right now in this province to operate -- it would nice to be able to operate solely as a pharmacy, counselling patients, supplying medication, dealing with their problems. Unfortunately, it is not possible to do that right now with the rollbacks and the lack of funds that are available through dispensing prescriptions.

Unfortunately, it is truly a dichotomy and it's a matter of drawing a line where you will stand as a retailer and as a businessperson. For those pharmacists who have removed tobacco products from their stores, they are drawing a line on the professional side rather than on the retail side.

The Chair: Thank you very much, Mr Coulter, for coming before the committee today.

WINDSOR-ESSEX COUNTY HEALTH UNIT

Dr Allen Heimann: Good morning. My name is Dr Allen Heimann. I am the medical officer of health for the city of Windsor, county of Essex. With me this morning is Mr Paul McDonald, who is the director of the health promotion and healthy lifestyles division of the health unit. I will be making the presentation. Mr McDonald will be able to assist me with background material during the question period.

Thank you very much for this opportunity to present to you the health concerns of the residents of Windsor-Essex. It is particularly important that I am here today, because what we're looking at this month is a watershed in the efforts in the fight against tobacco, at the city level, at the provincial level and at the federal level.

I would like to begin by commending the current provincial government for its public stand against the reduction in the tobacco tax and for introducing this important piece of legislation. I applaud the two opposition parties for supporting it at the standing committee.

While Bill 119 has many worthy components, including the protection of the public from environmental tobacco smoke, I wish to focus my remarks today on the significance of the bill on our young people. In Windsor-Essex, 200 of our youth take up the deadly habit of tobacco use every month. Unless they quit, one third of them will die prematurely and suffer significant disability before they do so.

We need strong, effective, comprehensive strategies to prevent this from happening. The Windsor-Essex County Health Unit is doing everything it can to make the public aware of the hazards of tobacco. But research clearly shows that education is not enough. Studies demonstrate that education programs only work when combined with strong public policy. Tobacco use hinges on a multiplicity of complicated psychological, social and environmental factors. We must do everything we can to create an environment as well as the knowledge that limits minors' access to tobacco.

Strong action against tobacco is particularly necessary at this time, with the impending threat of reduced taxes by the federal government.

I believe that Bill 119 represents an excellent beginning and will surely help to protect the health of our population, particularly that of our youth. However, in order truly to have an impact on large numbers of youth who take up smoking, I would recommend some additional amendments to strengthen Bill 119. My suggestions are in regard to licensing, point-of-sale displays, plain packaging and possession.

Licensing: Enforcement and compliance among tobacco vendors are going to be important issues in contributing to the effectiveness of this legislation. One recent study showed that up to 80% of current youth are supplied tobacco through retail stores. Bill 119 provides for statutory prohibition of sales to minors under the age of 19 with a possible six-month prohibition on selling tobacco after the second conviction.

I strongly recommend that you take this one step further. Licensing of vendors with a substantial licence fee would generate the revenue necessary to allow for a comprehensive monitoring and enforcement system throughout the province. Moreover, the threat of rescinding a licence is far more of a deterrent than a fine to retailers who may be tempted to sell tobacco to minors.

This strategy would also assist with the illegal sale of smuggled cigarettes since documentation by wholesalers and retailers of deliveries, inventory and sales would be part of the licensing requirement. The illegal sale of smuggled tobacco would constitute an automatic revocation of a tobacco vendor's licence.

Point-of-sale display of tobacco products: Adequate signage with health warnings and elimination of point-of-sale displays are important components that would make this legislation more effective. Although tobacco advertising is banned in Canada, the high visibility of tobacco products in prominent store locations provides a temptation that youth are not able to resist. For example, a wide variety of retailers currently place tobacco displays in a manner that is eye level to 11-, 12- and 13-year-old children. Requiring tobacco vendors to store products out of sight would reduce the coercive pressure currently being placed on youth to smoke.

Plain packaging: On a similar note, the colourful and alluring packaging in which tobacco is sold is made to be irresistible to youth as well as to other consumers. This committee cannot ignore the recent study of the University of Toronto centre for health promotion that demonstrated that the appeal of smoking is reduced by plain packages. This study supports previous research on positive cigarette imagery associated with packaging.

These dramatic and unique steps are essential if we are to have any chance of reducing the carnage caused by tobacco use in this province. Moreover, these steps are clearly justified given that tobacco itself is already unique; namely, that it is the only legal product sold in Canada that, when used according to manufacturers' directions, kills.

Possession: Tobacco is responsible for over 500 deaths a year in Essex county. Its distribution must be controlled like any other controlled substance in this province. We know that distribution entails more than just sales to minors. Bill 119 does nothing to address the issue of possession of tobacco products, including chewing tobacco, by minors.

I believe that youth need to be accountable for their actions and that society, through legislation, needs to reflect that accountability. In order to be comprehensive, the legislation needs to include a sanction on the possession of tobacco by minors, even if it is merely a confiscation of the product.

1240

I invite members of this committee to drive by some of our local schools before classes start in the morning to watch groups of students huddle together engaging in this dangerous habit. Yet we are unable to stop it.

Qualitative studies with youth indicate that making possession illegal is an important preventive strategy. Our attempts to educate youth are continually being undermined because teens place their faith in governments. They repeatedly claim that if tobacco is as bad as educators claim, then surely the government would ban it. Given that tobacco is the greatest single identifiable threat to health in Ontario today, I call upon you to justify the faith of our youth in their government by taking the necessary steps to protect their health.

In conclusion, let me repeat my congratulations for bringing this bill forward. However, as a person charged with the responsibility of protecting the health of the residents of Windsor-Essex, I urge you to give serious consideration to my suggested augmentations. No amount of effort at the provincial level or collective work of health promotion agencies can overcome the lack of a comprehensive provincial tobacco strategy.

I thank you very much for your consideration and I welcome your questions and comments.

Mrs Cunningham: Thank you very much, and congratulations. You are the first group to come forward with such a strong position on responsibility for young people. I have to tell you that I've worked in this city for some 20 years on this issue, and it's always been the position of our local school board that we needed more clout in dealing with our young people. Taking a look at the smoking patios of schools, there are very few students who are smoking who aren't under the age of 18, smoking, right in front of the eyes of their teachers, and it's illegal to purchase it. What can we say? So thank you very much.

There was a model brought to the attention of the committee, we're not sure of the state, but they put the responsibility on both sides. In one of the municipalities, retailers must be licensed to sell the product, and there's also a fine of $25. In other words, young people are ticketed under a certain age and they have to pay their ticket.

In this environment in Ontario, at least during the public hearings, we haven't had your position stated very often, and it's often not the position of some of the groups that we would expect it to be. I was part of those groups myself where we did want to change attitudes. But I think you're right: The time has come and we have to accept responsibility. I'm wondering if you're aware of any other information in this regard that could help the committee in looking at these kinds of models, in North America or elsewhere.

Dr Heimann: I'm not currently aware, but if there are other jurisdictions which have that licensing, this is something we are currently looking at as a way of strengthening our local bylaws. This was referred to before, and this is something we are currently researching. We do think that licensing is by far the best way of significantly controlling this very serious health problem.

Mrs Cunningham: Thank you very much for an important presentation today.

Mrs Haslam: My colleague mentions changing attitudes. How much work do you do within the education system? The reason I ask is that it says, "In Essex county, 200 of our youth take up the deadly habit of tobacco." We've had presentations over the last week that say 3,000 young people a month. If you average that out, it's 6% of a national average, 6% of the young people on a national level who start smoking, who start smoking in the Windsor-Essex county area. What kind of educational process are you involved in in this area?

Dr Heimann: Along with the school boards, along with the coalition, of which Ms Haugh, who just made her presentation, is the president, we have a comprehensive strategy to try to provide education, to try to strengthen peer pressure against smoking, but we have the difficulty of being up against one of the most sophisticated and powerful lobbies and indirect advertising systems in North America.

Mrs Haslam: I agree with you, and that's something I've been talking about as we look at this. Do the young people realize that? Is that ever part of your message, "You are being used by marketers, you are being targeted, you are the guinea pigs for this type of advertising campaign"? Are the youth aware of that? Is that part of your program in the education system?

Dr Heimann: Yes, it is.

Mrs Haslam: I ask because it makes us question what will get to youth, as always.

Two more things: On page 6, you say that youth proclaim "that if tobacco was bad as educators claim, then surely the government would ban it." Have you got empirical data that says that is something they say, or is that a copout? Is that an anecdotal way of looking at it?

Dr Heimann: We have studies and surveys which show that. There is no question that as far as youth go, it is a rationalization. We are certainly not looking at calling for the banning of tobacco, but what we're looking for is a strengthened regulatory, restricted environment which will show youth that as the majority of Canadians, the majority of Ontarians have shown, smoking is not the normal way, that the majority of Ontarians do not smoke and that it is also socially unacceptable. That's what we need, to send that message through this type of legislation; not banning, but sending a very strong message that it is socially unacceptable and irresponsible.

Mrs Haslam: Going from the social aspects of the problem to a more pragmatic way, you mention going one step further to licensing. I think some of the concerns would be the timing of this for small business people, for the convenience stores. Do you feel that the licensing aspect that you are recommending would be much better than the present ticketing model that is now in place within the legislation? In what way would it be better? Do you think this is the right time to bring that extra step in?

Dr Heimann: Yes, I think it would be better because it would be uniform. It also would represent a clear statement that selling tobacco is something which is a right, and that this right carries certain responsibilities. If manufacturers and retailers do not carry out their responsibilities, then their right to sell that product would be restricted.

We could look at graded fees depending on the size of the retailer, but the idea and the message that we want to send are that selling tobacco is a right, and that right carries responsibilities.

Mr McGuinty: Thank you both very much for your presentation. I particularly appreciated the comments regarding possession. I think they present a realistic approach and help make the approach that the government is taking to this terrible problem more comprehensive. As I was indicating to an earlier presenter, I think that to see young people merely as victims is unrealistic.

By and large, we have, over the years, been focussing constantly on rights at the expense of responsibilities, and I think this kind of provision would give an important weapon for parents' use in their arsenal.

I still think it's meaningful to be able to tell kids, "And by the way, son, it's against the law." I think it's important for teachers to be able to tell a class, "And by the way, it's against the law." I think it's important for the medical profession, the health care deliverers throughout the province to able to say, "And by the way, kids, it's against the law." Right now we're telling them -- we do it implicitly -- "Really, nothing's going to happen to you if you go ahead and continue to smoke." We're making all kinds of money off it. We're supporting an entire industry. We're feeding families. We're putting kids through school.

If we're sending a mixed message, I think this helps focus the message to make them understand, "It's a serious issue, so serious for us that we're going to make it illegal for you to get hooked." I want to thank you for that.

Mr Larry O'Connor (Durham-York): You support the statutory prohibition as outlined in the legislation, do you not?

Dr Heimann: The statutory prohibition?

Mr O'Connor: The prohibition that is in the legislation before us.

Mrs Haslam: Versus licensing.

Mr O'Connor: No, it's not a "versus." We have a statutory prohibition in the legislation. You do support that element of the legislation. You'll find it around page 8, I believe.

Dr Heimann: The statutory prohibition on the sale to minors?

Mr O'Connor: Right.

Dr Heimann: Yes, absolutely. We strongly support and commend the government and the opposition parties for bringing this legislation forward. We would very much like to see this legislation strengthened, but certainly we support what has been brought forward. We would certainly hope, however, that it could be made stronger.

The Chair: Thank you both very much for coming before the committee. We will recess for lunch and reconvene here at 2 o'clock sharp.

The committee recessed from 1252 to 1356.

LONDON COUNCIL OF HOME AND SCHOOL ASSOCIATIONS

Ms Janet Andruchow: My name is Janet Andruchow. I'm the president of the London Council of Home and School Associations. I represent 43 individual home and school associations, both at the elementary and secondary levels, in the city of London, with a membership of about 2,700 people.

On behalf of the London council, I would like to offer our thanks to the government and the two opposition parties for their introduction and support of this legislation through second reading. We are not authorities on the use of tobacco or its causes and effects. What we are is a group of concerned parents, mostly parents. We have membership with educators and any persons who are interested in the welfare of students.

The Ontario Federation of Home and School Associations is a supporting member of the Ontario Campaign for Action on Tobacco and the London council of associations is a member of the London-Middlesex Council for a Tobacco-Free Community.

I want to summarize a few points we have in the brief we gave you, and those are the parts of the bill that pertain particularly to the London Council of Home and School Associations.

Section 2 describes the application of Bill 119, referring to "processed or unprocessed form that may be smoked, inhaled or chewed, including snuff." We support this, as it covers all forms of tobacco. Many of our children emulate their sports heroes, watching baseball players regularly using spitting or chewing tobacco, which causes us concern that this will be the next stage to tobacco.

One thing we noticed in this existing legislation is that there needs to be effective enforcement as a deterrent to the selling of tobacco. Perhaps regulations should reflect the same wording that is presented under the Liquor Licence Act, as the phrase "appears to be" allows a lot of latitude. Bill 119 must contain some kind of requirement that will make it extremely uncomfortable to sell to minors, either very high financial penalties or removal of their licence.

We appreciate the inclusion of health warnings. We believe that education is as important as restrictions.

We certainly support subsection 7(1). Vending machines make it too easy for students to circumvent the regulation of having to be over 19 to purchase tobacco products.

There is only one area in this whole bill that really causes us concern, and that's section 9, paragraph 2. Our concern mostly stems from, "No person shall smoke tobacco or hold lighted tobacco in any of the following places.... A school, post-secondary educational institution or private vocational school." We would prefer that this section specifically cover all forms of tobacco, not just smoked or lighted, and secondly, that it refer to the buildings and property of schools.

At the 1993 annual conference of the Ontario Federation of Home and School Associations the membership passed the following resolution, "That there be zero tolerance towards smoking in the buildings and on the property of all Ontario public schools."

This section also eliminates a lot of places that we would prefer to see included as being restricted for smoking. The places designated leave a large number of public places eliminated. Environmental tobacco smoke is as serious as the physical act of smoking. We would recommend that this section be revised to prohibit smoking in all public places.

In conclusion, I thank you very much for the opportunity to be here today. We certainly hope to see this bill go past through third reading.

Mr Winninger: Thank you for your presentation. I gather that the London Council of Home and School Associations has been quite active in opposing cigarettes in the hands of minors. I see a whole list of initiatives that you've supported to date. Is there any strategy the council is going to take in regard to helping us, as government, to educate minors and their parents around the problems with tobacco consumption?

Ms Andruchow: We basically work towards education, and we totally support the London-Middlesex Council for a Tobacco-Free Community by promoting education. We are also right now petitioning, with the help of the secondary school principals' council, to eliminate what you call "smoking pits" in the secondary schools. By education, we feel we will eventually succeed.

Mr Winninger: Are you doing any lobbying with regard to businesses that may presently be dispensing cigarettes to minors? We heard this morning, and I don't know if you were here, from a young student from St Thomas who was able to purchase cigarettes at an extremely tender age without any difficulty.

Ms Andruchow: We haven't done any direct lobbying, but I agree with you. I asked a student to purchase cigarettes for me. Now, because last week was exam week, they didn't manage to do it, but they seemed to think that was no problem, particularly around the secondary schools in London. The only way we'll ever stop that would be by educating the students themselves.

Mr Winninger: I think my colleague has a question.

Mr Kimble Sutherland (Oxford): I just wanted to know, is that purchasing from normal retailers or was this purchasing from someone who may have been hanging around the school with a gym bag or something, with illegal cigarettes?

Ms Andruchow: This was purchasing from a store.

Mrs Cunningham: I didn't have the chance to welcome my colleagues to London in the beginning, but I think this is an important time to do that. Because Janet's here today, if you take a look at the second page, in the beginning the work of the home and school associations in 1965, before it was even -- what should I say? It wasn't very popular to take the stands the home and school associations took with reference to cigarette smoking and advertising and the promotion of health.

I think it's an opportunity to thank the school community, and certainly here in London we do often, and the Ontario Federation of Home and School Associations for their leadership in this issue, because without them I don't think we would have got as far as we have, at least in our local municipalities.

I just wondered, from the local home and school associations' point of view, if you have had any discussions with our secondary schools recently, because I haven't been made aware of any action that you've taken with the problem of smoking in the schools. Are there any enforcement practices here in London that we could use as an example across the province? What is the rule in our London secondary schools now?

Ms Andruchow: Right now they have what they term "smoking pits," but the secondary schools' council has just, within the last month, come across to support us. They tried a couple of years ago to take them away and all it ended up doing was causing the neighbours around the schools -- I believe that John Paul II, which is the brand-new Catholic school, has banned smoking on its property. That has caused a few little fluctuations of neighbourhoods being concerned. We're really working on a phase-in program, so that you remove the students out to the farthest corner of the property where it's the windiest and coldest, that type of strategy.

Mrs Cunningham: The practical application we're both talking about here is that even if you were to say it was illegal, you still have the problem without the ability to enforce it. You can understand where it's coming from. We were talking about this in one of the secondary schools last week, where the students themselves said exactly that. "Let's have a shed or something out in the corner of the school grounds or a snow hut," they were saying that particular week for the students who were smoking. Thanks very much for your leadership here.

The Chair: Thank you very much for coming before the committee this afternoon.

CANADIAN CANCER SOCIETY, SOUTHWESTERN ONTARIO REGION

Ms Susan Cornish: My name is Susan Cornish and with me is Sarah Fielding. I'm pleased to represent the southwestern regional office of the Canadian Cancer Society and I'd like to commend the social development committee on Bill 119 for conducting these hearings and thank them for inviting the cancer society to participate.

I would also like to commend the government for its leadership with regard to the recent tax issues. I am here as the health promotion chair of the London-Middlesex unit of the Canadian Cancer Society, as a professional in the health care field, as the mother of a 12-year-old and a 15-year-old, and as a member of the community.

As a volunteer with the cancer society, I feel personally committed to the society's mission to eradicate cancer and to enhance the quality of life of people living with cancer.

I am delighted to have with me Sarah Fielding. Sarah is a 15-year-old student at Clarke Road Secondary School in London who has volunteered to help impress upon this committee the importance of the legislation. While Sarah does not smoke herself, she has many friends and acquaintances who do smoke. She has learned from them how difficult it is to quit once you are addicted. Many want to, but can't. As an active participant in school activities, Rangers and Junior Achievement, Sarah is gaining experience that is preparing her for a satisfying and productive life. We want all our children to have the opportunity to realize their potential. Tobacco use may well limit that opportunity.

To prepare for today's presentation, I outlined several possible questions for Sarah to consider so that she might have the opportunity to prepare her responses.

Sarah, when I asked you to participate in the presentation, what was your reason for agreeing?

Ms Sarah Fielding: I decided that it would be very important to give out a message for children that smoking's wrong and that this bill would be very good for that.

Ms Cornish: Do many of your friends smoke?

Ms Fielding: Yes, quite a few of my friends smoke.

Ms Cornish: Among your friends, do more boys or girls smoke?

Ms Fielding: I'd have to say it was a lot more girls than boys.

Ms Cornish: What was the reason your friends started to smoke?

Ms Fielding: A lot of them started in public school, grades 7 and 8. I think they thought that if they started smoking, they'd be popular and they'd be cool and that this would continue on to high school, because especially for a lot of kids, grade 9 is a very insecure year, and if they can be popular in grade 9, they'll continue to be popular throughout high school.

Ms Cornish: Have many of them tried to quit?

Ms Fielding: All of my friends have tried to quit at one time or another and I don't think any of them have been successful.

Ms Cornish: Do you think your friends who smoke took into consideration the nature of the risk and the magnitude of the danger associated with the use of tobacco products?

Ms Fielding: I don't think they really considered that. I think they thought it was just to be cool, and I don't think they thought about life down the road, cancer and things like that.

Ms Cornish: Have you ever considered trying cigarettes yourself?

Ms Fielding: I've been very curious because a lot of my friends smoke, and when I'm around them it's just the curiosity of what it tastes like, what it's like and what the attraction there is.

1410

Ms Cornish: How do you think your parents feel about young people smoking?

Ms Fielding: They're very much against it. I know that they think it's a waste of money and a waste of time and that it's bad for the children because it will affect their health in later years.

Ms Cornish: What effect do you think plain packaging would have on the decision of young people to start smoking?

Ms Fielding: I think a plainer package might bore them. They might not decide which brand they want. They wouldn't care what brand they smoked because of the plainer packaging. I don't really think that it would make them want to smoke any more.

Ms Cornish: Do you think smokers should be informed on the packaging of the seriousness of diseases that could be contracted from tobacco?

Ms Fielding: I think that's very important because a lot of them aren't educated enough on what it is. I think that if it states what's wrong on the outside in large letters, what can happen to them -- I think that even including a pamphlet on the inside, whether or not they read it, it's there and that gives them the opportunity to educate themselves.

Ms Cornish: Have you been with your friends when they have purchased cigarettes?

Ms Fielding: Yes, I have. I've been with friends when they've gone into variety stores and they've purchased them. They've never been asked or looked at strangely or anything like that. Maybe if the bill did go through, carding them might be a good way to stop them from doing it, because they don't get looked at twice.

Ms Cornish: Besides variety stores, where else have you been?

Ms Fielding: Gas stations too. Those are the only two places, I think, that they've ever bought them when I've been with them.

Ms Cornish: Did you find it strange that they weren't asked to provide proof of age?

Ms Fielding: I think so, because I don't think that many of them look 18. They walked in and bought them just like that. There was no discussion about it, no argument by the store owners.

Ms Cornish: Do you think tobacco products should be sold in pharmacies?

Ms Fielding: I think absolutely that they should not be at all, because a place that is supposed to be helping us improve our health shouldn't be selling something that hinders health.

Ms Cornish: Why do you feel it's important to prevent young people from smoking?

Ms Fielding: It's very important because at a young age they might not realize what effects it's going to have on them later on in life, cancer and other diseases, and how bad it is for them. I don't think they realize that at a young age, and if you can educate them enough, then they'll realize that it's more important down the road not to start smoking at all.

Ms Cornish: I spoke with a friend of mine here in London whose father died of lung cancer due to smoking cigarettes. His initial reaction was one of anger. This disease was preventable. It resulted from a decision to smoke made before we knew the potential consequences. We now know the harm that can be done. We must do whatever we can to help our children make the right choice. We want other kids to have the chances that Sarah will have. We want other children to realize their potential.

This legislation will help give kids a chance not to become a cancer statistic.

Mr Jim Wilson: Thank you very much for your presentation. I appreciated the questions posed to Sarah and your responses, Sarah. I'm going to add to that list. Do you think we'd send a stronger message to your friends, your peers, if we simply said that smoking cigarettes under the age of 19 or being in the possession of cigarettes under the age of 19 is illegal?

Ms Fielding: Maybe. I'm not exactly sure. If it was really stressed and they realized that there was a punishment of some sort or that they would be in trouble with the law, it might make them at least consider it twice.

Mr Jim Wilson: When your friends buy cigarettes at the local corner store or wherever, are they aware that the person selling them those cigarettes could currently be subject to a fine, that the retailer takes the blame and yet they get off scot-free? There's no penalty for them buying cigarettes at the local Becker's store under age, essentially.

Ms Fielding: I don't really think they're very concerned about their actions. I think that they think it is their responsibility to make sure they are of age, and if they don't card them or anything like that or ask for identification of their age, then it's the owner's responsibility to do that.

Mr Jim Wilson: Would all of your friends be aware that it's illegal to consume alcohol or to drink under the age of 19?

Ms Fielding: I'm quite aware that they do think that.

Mr Jim Wilson: They would be aware of that.

Ms Fielding: That's for sure.

Mrs Haslam: On page 4 of your submission, you talk about section 3. You want to look at the requirement of the proof of age section. You seem to have a concern around the wording "appearing to be less than 19 years old." You believe there should be something additional to that. I wondered if you would tell me what you're recommending as a strengthener in that particular section, "should not be contingent on the purchaser appearing to be less than 19 years old."

Ms Cornish: As Sarah was mentioning, some sort of identification, not just the vendor looking at the person and saying: "This person looks to be 19 years old. I will sell him cigarettes."

Mrs Haslam: So a stricter recommendation that ID must be presented and should be indicated by the proof of age card or age of majority card.

On the next section, when you talk about how the definition of "pharmacy" should be clearly stated in the legislation, are you talking about separate premises with a separate entrance, rather than something within a larger department store? Do you want it toned up or firmed up in that definition?

Ms Cornish: Yes, it should be.

Mrs Haslam: You talk about how the sale of kiddie packs, of packages less than 20 cigarettes, must be prohibited. Would you be suggesting a different level of fines for vendors or for retailers who are selling kiddie packs or individual cigarettes? If you go in and find a retailer selling to a minor, they're charged and they're ticketed, according to the proposed legislation. On their second ticketing, they would lose the privilege of selling tobacco. They wouldn't even be allowed to have tobacco on their premises. If it was discovered that in that sale it was individuals or kiddie packs, would you recommend stronger fines, a different level of fines or the same? Whether you see this as more detrimental is what I'm wondering.

Ms Cornish: I really don't have a response to that, but I can certainly get back to you in writing.

Mrs Haslam: I'd like to ask one quick question. I'm quite concerned about the number of girls versus the number of young boys who smoke. I've always asked why. Why do we think the young girls are more prevalent in starting smoking than others? I know that last week was awareness of eating disorder week and I know that some young women feel that tobacco eases their appetite. It's part of another problem. Besides that problem, what would you think would be another cause for young women starting to smoke?

Ms Fielding: I think it's their friends. They think they'll be popular in high school. I think girls are more concerned with popularity than boys are when they get to high school age. I think it's insecurity too. If they're insecure with themselves, they want something to hold on to, to grasp, that will make them popular. They feel prettier when they're doing it. I'm sure they see it --

Mrs Haslam: He's telling me I'm out of time for questions.

The Chair: Sorry. I'm the heavy.

Ms Fielding: I think it's just a lot to do with popularity and their insecurity about themselves.

Mrs Haslam: The pressure is on.

The Chair: Thank you both very much for coming before the committee this afternoon. I'm sorry we don't have more time.

SID STEINBERG
FRANCIS MOKENELA

Mr Sid Steinberg: My name is Sid Steinberg and I'm accompanied today by Francis Mokenela. We apologize for not having copies of our presentation, but we will hand in our speech and our visuals later on, should you wish.

We are both licensed pharmacists in the province of Ontario. I own and operate the Shoppers Drug Mart pharmacy located at Sherwood Forest Mall here in London on Wonderland Road, which is open 15 hours a day, from 9 in the morning till midnight. Mr Mokenela is the pharmacist-manager at the Ultra Mart pharmacy, which is owned by A&P, located at Commissioners and Wonderland, also here in London.

We have both followed the hearings of your committee, and in the short time available to us we wanted to bring you a different perspective on the issues. We have all heard an awful lot about the health issues. I'm sure everybody's well up to speed on that. We're going to talk from a different slant today.

A lot of the discussion your committee has heard has focused on the nature and the role of a pharmacy. Some members of your committee have stated that pharmacists must decide whether they are health care professionals or retailers. Many pharmacists have answered that they are both. The inability to understand the diversity of the industry is reflected not only in the questions that have been asked of pharmacists, but in the legislation itself.

1420

In paragraph 4(2)9, the bill seeks to define "pharmacy" and "retail establishment." So that you can fully appreciate the complexity of the issue, we would like to use these visuals to help you understand. We sincerely hope that by showing you these blueprints and photos, you will realize that pharmacy has many different formats. We'll leave these here if you wish to have a look at them and pass them around. I know it's going to be a little difficult for everybody to see at close hand what we're talking about. Francis, do you want to get the first one of Woolco? That's only one half; here comes the other half.

This is a typical Woolco store. It is over 100,000 square feet. It's about the size of two football fields. You can see at the bottom right where it's yellowed. That is the pharmacy. The tobacco kiosk that sells tobacco is way up at the top, at the other end. Between the pharmacy area and the tobacco area are about 30 different departments, selling a diverse choice of merchandise.

This is my Shoppers Drug Mart. It's about 7,500 square feet, and you can see the dispensary at the back of the store. This is the back of the store, actually. The checkout, where the tobacco is sold, is about 100 feet towards the front of the store, near the exit to the mall. It's certainly nowhere near our dispensary where people are picking up prescriptions.

We also have a floor area plan of a typical Shoppers Drug Mart as well, which is very much like mine. The dispensary is back here and the tobacco is sold way over here. They're all set up very similarly.

This is a typical Ultra Mart store. It's kind of a small version of their floor plan, but I think that store is somewhere in the neighbourhood of 80,000 square feet. Perhaps my colleague Mr Francis Mokenela, having worked for them, can describe the layout of this store to you.

Mr Francis Mokenela: The Ultra Mart is an 80,000-square-foot complex which has different departments within it. The courtesy counter is over here, which is the front of the store, and this is where the tobacco is sold. Here is the pharmacy, right at the back end of the store. To get from the tobacco to the pharmacy, you have to go through the health and beauty department, with shelves standing as high as 10 to 12 feet, blocking the pharmacy from the front of the store. There is also 300 feet of distance between the pharmacy and the tobacco.

In an Ultra Mart concept, the dispensary or the pharmacy operates as a separate, independent entity within the supermarket. My authority and responsibility are restricted only to the dispensary. I have nothing to do with the sale of tobacco.

Here is a blueprint of a Loblaws, one of our competitors. Here is the pharmacy and here is the tobacco area. The Loblaws is about the same size as the Ultra Mart and carries about the same type of merchandise mix as we do.

Mr Steinberg: At the completely opposite end of the spectrum from these kinds of stores are the small, independent community pharmacies like the IDA which I have in these photos. This drugstore is about 2,500 square feet, which is probably about the size of this room. As you can see, this drugstore sells a variety of products, but it obviously doesn't have the variety or depth of merchandise of the stores we have just described.

The dispensary is right down at the back of the store and we have several aisles of merchandise located in the rest of the store. The main thing we want to show is that the pharmacy is way at the back of the store and all the front-shop merchandise is located out front of course. This is their checkout, down at the front.

Lastly, there are many pharmacies located in medical buildings, as in this photo, which do not compete with regular retailers. As you can see, this is the dispensary on the right-hand side here. They carry very little front-shop merchandise and probably no tobacco at all. That's their operation. There is a picture here of the entrance, which is a small door, showing the dispensary area and the few medicinal ingredients they sell out front. We can pass this around as well.

This pharmacy does not sell tobacco, most probably never did sell it and the sale of tobacco in this store is not an issue. As a matter of fact, when we went in to take the pictures in this store, the pharmacist owner told me that he does not sell tobacco but that in his opinion it should be a voluntary issue.

Mr Mokenela: As I explained earlier, my pharmacy is one of several other departments in the total complex. I have no authority over the store as a whole and my responsibility extends only to the dispensary. In the event that my company is put in a position where it has to choose between operating a pharmacy or selling tobacco, I expect that the decision will be made based on the profitability and the cash flow generated by tobacco versus pharmacy.

If the intent of your legislation is to force A&P and others like ourselves to elect between operating a pharmacy or selling tobacco, I'll be very honest and frank with you: I believe that with the declining margins in pharmacy and because of the government ODB cutbacks, the consequences will be very detrimental to me. They will likely choose tobacco over pharmacy and that means I'll lose my job. It also means that many of our patients who have come to rely on my pharmacy and my professional service at the Ultra Mart will be forced to go elsewhere. Surely this cannot be the real intention of this legislation.

Mr Steinberg: That is why your legislation is so unfair and discriminatory. You are attempting to define all pharmacists the same, which we clearly are not. In your endeavour to do so, you are going to force some retailers to make the painful decision to close down the pharmacy or to stop selling tobacco. In the context of the retail environment we have shown you, it clearly makes no sense whatsoever. By the way, that decision will have to be made in approximately 151 pharmacies located in establishments exactly like Woolco, Zellers, K mart, Loblaws and A&P, and it will potentially affect the livelihood of almost 400 pharmacists. Your legislation will take away my ability to be a pharmacist as well as a retailer. In the case of Francis, your legislation could potentially take away both his pharmacy and his livelihood, and in particular, it will be extremely unfair because, as a pharmacist, he is not the one making the decision whether or not to carry tobacco.

As we understand it, the intention of this legislation is to prevent young people from smoking. We both share that objective. But in the final analysis, you will not achieve it by doing what you are about to do. Do you really think that if Francis's employer closes the pharmacy at the Ultra Mart or if I remove tobacco from my store, any juvenile will smoke one less cigarette?

Pharmacists practise the profession in different ways and in different environments. The front shops of some of these drugstores are totally different from others. Zellers sells tires and jeans, and the Woolco front shop sells furniture. Shoppers Drug Mart and Pharma Plus sell cosmetics and health and beauty aids. The Big V sells gift wares. The IDA sells greeting cards. The medical pharmacies almost exclusively sell over-the-counter products and prescriptions. Different strokes for different folks: We are all different from each other and we will be affected in different ways if this legislation goes through as proposed.

We urge you to consider the ramifications of your legislation, especially in the context of what the retail environment really looks like. Thank you, and we'll be happy to answer questions.

1430

Mr McGuinty: Thank you very much, gentlemen, for shedding some very important light on this debate. The visuals I found very helpful for us to gain a perspective of the physical location of the dispensary and its size relative to the rest of the operation.

The argument that's made here time and time again is the symbolism, that when people think pharmacy they think health care, and that when they think health care they will see it as something contradictory to that for pharmacists to be selling tobacco products. I have a great deal of difficulty believing that people see Zellers as health care, or Woolco or Loblaws or whoever else when it comes to non-traditional pharmacists.

As I've said here a number of times, I have some difficulty even seeing the larger drugstores as purely providers of health care. Often I think of them as the place where you go because you get a number of other items, whether it's chips or shampoo or soap or deodorant or razor blades, which I believe aren't properly categorized as health care. I think you're both providers of health care and you're retailers.

My question will be for you, Francis. As I understand it, in the non-traditional pharmacies your dispensing fees are very competitive.

Mr Mokenela: That is correct.

Mr McGuinty: So you're not making a lot of money in the dispensing.

Mr Mokenela: We do.

Mr McGuinty: You make some money.

Mr Mokenela: Depending on the pharmacy.

Mr McGuinty: Right. How many people work in your particular pharmacy?

Mr Mokenela: There's are one full-time pharmacist, three part-time pharmacists and two part-time pharmacy assistants or technicians.

Mr McGuinty: Can those people be re-employed elsewhere inside the A&P?

Mr Mokenela: Given the economic climate as I see it, it is possible but they will have a hard time getting jobs elsewhere if the pharmacy closes.

Mr McGuinty: Did they receive special training?

Mr Mokenela: Yes, there is training for pharmacy assistants.

Mrs Cunningham: This is probably one of the more contentious issues. I think you said it very well, and the government is also aware, that there's no proof that if we disallow drugstores to sell tobacco, this would reduce consumption. The reason we're here is the very purpose of the bill. It says in the notes, "The bill is intended to prevent the provision of tobacco to young persons and to regulate its sale and use by others."

We had a couple of compelling presentations this morning. Once was from the Windsor-Essex County Health Unit. They went so far as to say that if people are going to sell tobacco, anybody, they really ought to be licensed to do so. They need some clout. They need some responsibility. That's on the side of the person who's doing the sales.

On the other end, I think they agreed with our position here, and that is that we think young people should accept responsibility, that if it's illegal, it's illegal and there ought to be some way of enforcing it, some fine, whatever. We're aware that this does happen, at least in some other jurisdictions. I'm wondering if that would solve the problem of who sells it if (1) we license it and (2) we make it illegal to purchase it if you are under the age of 19. Those are pretty tough statements, but what's your response?

Mr Steinberg: I think that's really an excellent idea. Tobacco sales in drugstores are declining on their own. This is going to happen through your legislation. We're in full agreement with the legislation, other than taking it out of pharmacies. I realize the point that's been made, that we're a long way away from the front where we sell tobacco, but you have no idea how many people stop in the back of the pharmacy and ask us: "Is there anything you give me that will help me stop smoking? I don't really want to go to my doctor." We have the Nicorette chewing gum that we can sell over the counter.

The whole thing about these anti-smoking programs is that you don't just sell the product, send the person on his way and say he's going to quit smoking, because it doesn't work that easily. They have to have backup and information and support. When they come back to the store for their second box, you ask them how they're doing, how it's going, "Is it really working for you?" and if it's not, we can maybe tell them ways they can improve their ability to quit smoking. If the gum is not sufficient, then we can refer them to their physician. Now we're using the patch and the patch is very successful in helping people to stop smoking.

That's what we're there for. We're the easiest, accessible health care provider there is in the province. Everybody has said that, and I guess we are. Being there 15 hours a day in my store, I certainly know we do nothing but answer questions half the day.

Mr Winninger: Sid, I realize you are in a bit of a difficult spot because I know that the owner-operators of Shoppers Drug Mart, controlled by Imasco which also has tobacco interests, are in a very delicate position. I spoke to one of your colleagues recently and she said she'd love to speak out against the sale of tobacco from pharmacies, but because she's a Shoppers Drug Mart owner-operator, that just wouldn't be possible. Yet so many of your colleagues in the business feel that their right to do business and sell tobacco products should never supersede this initiative towards a tobacco-free society.

I still have some difficulty with your position, particularly when I hear from many independent pharmacists who say it's downright embarrassing to have pharmacists come out in public and say it's okay to continue selling tobacco products from the same premises. How do you deal with this conflict?

Mr Steinberg: I'm really glad you asked that question because we get asked it several times. First of all, as a Shoppers Drug Mart franchise owner I want to make you aware, if you are not aware, that it is my choice to sell tobacco. It is not a part of my franchise agreement that I carry tobacco. I choose to carry tobacco because I'm in a very competitive environment in the mall I'm situated in. That's the reason, and as long as it's a legal product, I'll continue to sell it.

If it's as bad as it is, with all the medical evidence, why don't you ban it? If it's a poisonous substance and it's causing cancer, ban it. Get rid of it. Make the problem simple. Don't ask me to stop selling something that's legal when they can get it at 20,000 other outlets in the province, if you're going to close down 2,300 pharmacies from selling tobacco. That's not going to solve anything.

Mr Winninger: It's interesting because we've heard from pharmacists, including one from Coulter's drugstore today, a very old and established drugstore in London, indicating that when they gave up selling tobacco products in 1989 it had no effect on their profit margin. In fact, in the words of the young Coulter, it may have enhanced their profitability starting in that year.

The evidence seems to be that it's not going to detract from your profit margin. It's certainly going to inspire goodwill in the mind of the public that here's a druggist who's taking a strong moral and ethical stand in opposing the sale of tobacco products from pharmacies, and in the end help ensure that our young people don't have yet another avenue, through a health dispensary, to consume the product. What do you say to that?

Mr Steinberg: I'd like to respond to that very much. First of all, nobody said what the tobacco volume was in that store before he took tobacco out. I venture to say that it was nowhere near the volume of tobacco that these multimerchandisers, or even my store, would sell in a year. There is a big difference in profitability to a small store and to a store like ours or the mass merchandisers.

Second of all, he intimated that tobacco was purchased in several pharmacies; I believe they found it was being purchased in pharmacies, against the law.

1440

I don't know whether you're aware or not, but we have a very serious training program with all our new staff, everybody on staff at the time and any new staff. We have a 20-minute video that goes all through the background of where tobacco came into pharmacy -- it started years and years ago -- the problems it causes, the new legislation, and that we are not allowed to sell to anyone under 18 years of age and that if they don't have proof of age, then they don't get it.

Mr Winninger: The problem --

The Chair: I'm sorry, Mr Winninger.

Mr Winninger: May I just complete the phrase?

The Chair: I'm afraid we have gone over. I try to allow everyone to ask a question. I'm sorry that we keep getting caught by time.

Mr Winninger: I was just going to say a statistic between the dispensing pharmacist and the tobacco --

The Chair: Thank you for coming before the committee. I believe you're going to leave a copy of the submission.

Mr Steinberg: Yes, we've already given Mr Arnott a copy. Would you like these left at all?

The Chair: Yes, if you could perhaps leave them and we'll make sure you get them back.

LUNG ASSOCIATION, LONDON AND MIDDLESEX

The Chair: I then invite the representatives from the Lung Association, London and Middlesex. Welcome to the committee. Please make yourselves comfortable. We have a copy of your written submission. Please go ahead.

Mr Bill Murphy: Thank you. It's a privilege to be here. My name is Bill Murphy. I'm the volunteer president of the London chapter of the Lung Association. Brent Keeling is our honorary Christmas Seal chairperson, and Jim Belton is the executive director of our local association.

I'm here as a volunteer. I'm a partner in a national CA firm, and as a volunteer with the Lung Association serve as the volunteer president here locally and also as a member of the governing council of the provincial body.

The Lung Association represents the oldest health charity in the country. We're dedicated to the improvement of respiratory health both through research and through a variety of community programs aimed at the various generations of people suffering from lung disease.

The reason we're here, first, is to lend our full support to the legislation. We view it as one more step, but an important step, towards the ultimate elimination of tobacco products from our society. We're here, second, to make certain recommendations regarding both the legislation and where we see this strategy that the legislation is part of -- where it should go in the future.

Finally, I would like to have an opportunity for our chairperson, Brent Keeling, to comment on the effects of secondhand smoke on his asthma condition.

The recommendations we would like to make are, first, just to confirm that the committee understands that non-smoking should be recognized as the norm, that over 64% of Canadians 15 years of age and over are non-smokers; second, to recognize that the choice made by smokers to smoke is not a choice simply for themselves but is a choice for everybody, that when someone else smokes, everyone within their vicinity smokes as well. The only distinction is between mainstream smoke which is being directly inhaled and then exhaled from the smoker's lungs and the side-stream smoke that is inhaled by all others in the vicinity, which represents both the exhaled smoke coming from that smoker plus the two thirds of the smoke that is simply being burned off the end of the cigarette and never inhaled by the smoker in the first place.

We feel that in the long term all smoking in public places must be eliminated. We recognize certain practical choices that have been made in the current legislation in terms of how far one goes at this point to make sure this step can be put in place, but we feel it's important that in the very foreseeable future smoking in all public places and, equally importantly, smoking in the workplace, be eliminated.

If smoking is to be allowed in the workplace, there is a need for tighter regulations on ventilation. Scientists recommend that the ventilation systems should be capable of changing the air at least six times per hour, and there are very few of our buildings in this province that are capable of that right now.

Tobacco smoke is very attracted to the human body. If you get into the scientifics of it, there's an electrical charge caused by smoke that is attracted to the water-filled human body, and therefore if it's absorbed into the walls and furniture of a building, even though the smoking may have taken place at some very earlier time, it still will be drawn out and attracted into the air that the people in that building are breathing.

We believe, as a contemporary issue in terms of the developments of last week, that the Ontario government needs to continue to stand firm on tobacco tax rollbacks. I believe personally, and I've written to the Prime Minister and his other ministers yesterday, that it is not acceptable that the health of our children be compromised by commercial interests and by political interests, and that it is not acceptable that tobacco taxes be rolled back as a politically convenient way to deal with many other interests.

The export tax I think, as you're aware, is a very simple solution to the current smuggling problem: You take the profit out of smuggling, you take away the issue. I believe that is the solution that should be put in place.

Finally, and again we recognize that Bill 119 goes partway in this direction, is to continue to increase the health warnings that need to be placed on tobacco products to not only deal with the direct risks to smokers, but also to deal with the indirect side-stream risks to non-smokers as well.

We're here to lend support to the legislation. We are doing a number of things to assist, as a health-based organization. We have programs that are aimed at the current generation of smokers, particularly our countdown program to help them stop smoking. We are here to help the past generation of smokers who suffer from chronic obstructive lung disease, both with their health problems and also to deal with social issues that have resulted from their restricted ability to move about without oxygen supplies etc.

We're definitely here to help the next generation, because that's where the issue lies. It's stopping the next generation of smokers from ever starting to smoke. We run a "Lungs are for Life" program throughout the province that goes into the junior grades of our elementary schools, to teach them the benefits of a smoke-free lifestyle. In the London-Middlesex area, we see over 30,000 children per year with that "Lungs are for Life" program.

We also deal with the asthmatics, both the more mature and the younger populations, helping them learn how to deal with their conditions, how to avoid the triggers that cause asthma attacks, and secondhand smoke is a very important trigger. At this, point I would like to call on Brent to give his thoughts on that matter.

Mr Brent Keeling: My name is Brent Keeling and I am nine years old. I've had asthma since I was a baby.

Having asthma means that some things trigger a reaction in my lungs that makes it very difficult to breathe. I have learned to take medication and avoid the things that trigger my asthma. When I control my asthma, I can run cross-country, swim and play baseball. Cigarette smoke triggers my asthma and gives me a lot of trouble. Sometimes it's something I can't always avoid.

When I have an asthma attack, I just can't breathe. An asthma attack can be scary. I often can't talk and tell someone I need help. An attack can wake me up at night and keep me home from school. Other times, I just cough all night and go to school tired. Sometimes I have to go to the hospital. When I am having asthma trouble, I can't always do the things I like to do. An attack is not fun.

Many things cause my attacks, but one of the worst triggers for it is cigarette smoke. When others choose to smoke where I have to breathe, it is very difficult for me. I like to go to restaurants, ballparks, hockey arenas and places like that, but often my whole family has to move or leave an area because of other people smoking. Smoke sometimes forgets to stay in the smoking section.

Every time someone lights up a cigarette, I have to worry about having asthma attacks. Sometimes I can't always move away and that gets me angry. I would really like it if I didn't have to worry about that, because when you can't breathe, nothing else matters.

1450

Mr James Belton: I'd also like to congratulate the government for introducing the bill and the two opposition parties for supporting the bill. It's a good bill, but we would like to see it strengthened, particularly in the area of environmental tobacco smoke.

We'd also like to congratulate both the Honourable Ruth Grier and the Honourable Floyd Laughren for their stance against the federal government's proposed tobacco tax reductions. We're also delighted with the Premier's call last Friday for the federal government to introduce the export tax on tobacco.

Smuggling is an issue that should never be so-called corrected to the detriment of the country's health care policies. In other words, a tax reduction will only magnify the problem, not correct it. If the Canadian and Quebec governments proceed on this disastrous course, I'm afraid the Ontario government is going to get sucked in on it. This committee should then revisit this bill in the area of licensing. In licensing vendors of tobacco products, if that kind of thing happens with the Quebec and Canadian governments, then I think you'll have to take a look at licensing measures.

I mentioned that we'd like to see all public areas in the workplace smoke-free. The term "non-smoker" is a misnomer. When others smoke, you also smoke. Environmental tobacco smoke is the most serious contaminant to which non-smokers are ever exposed. Environmental tobacco smoke can be totally eliminated from the indoor air only by removing the source, and that is the tobacco smoke.

An estimated 500 Canadian deaths annually are the result of exposure to secondhand smoke. If 500 people died through a disaster that could have been prevented, we would do something immediately to rectify the situation. We urge the committee to remember that these are preventable deaths and that you now have the opportunity to prevent these deaths from happening in the future. We ask you to do so.

In closing, may I say that the Lung Association, London and Middlesex, supports the bill but strongly urges the committee to strengthen the bill in the area of environmental tobacco smoke. We strongly agree with the government's slogan, "Smoking: It will suck the life right out of you." Let us work together to preserve life by eliminating the number one preventable cause of death. The health of our children must never be compromised by commercial interests.

Mrs Cunningham: Thank you very much. That was very good, it Brent. I've seen Brent before in London, but I've never heard you speak so well. Congratulations.

Mr Keeling: Thank you.

Mrs Cunningham: With regard to your comments with regard to protecting people from secondhand smoke and all the concerns that you have at the Lung Association, is there any particular part of this bill that we should be looking at? Should we be expanding it to all public places? Is this what you're saying? What specifically do you want us to do?

Mr Bill Murphy: In an ideal world, our answer would be yes. We would say you should tick section 9, where the controls related to smoking tobacco are listed, and continue at point 9, where it says "a prescribed place." We would continue to say that all public places and all workplaces would be added to that list.

Mrs Cunningham: You'll remember, during the workplace legislation, we took the stand that that bill didn't have any teeth, the 25% part and non-ventilation and the whole thing. You'll remember making your own presentation. That's a separate piece of legislation. Should we be looking at that along with this legislation? Should this committee be looking at both?

Mr Belton: It would appear to me that needs to be done. You're absolutely right that the bill did not give us everything we had hoped it would have. It's a hard piece to legislate. It's a hard piece to enforce. As somebody mentioned earlier today, 25% can be smoke-free. You can have four desks in a room, face to face, and have one person smoking and the other three not. That doesn't make a whole lot of sense to me.

It's unfortunate that the Labour department wasn't able to get together with the Health department to try to do that, but somebody's got to do it, and why not here.

Mrs Cunningham: There are two controversial issues with regard to people's responsibilities. The responsibility of the vendor has been raised today and the responsibility of the purchaser. The vendor, we have stated, the person who sells -- we're obviously in favour of the legislation, but we think there's a problem in this regard; we think it should be toughened up -- perhaps should have to have a licence. This should be an illegal product in our view.

Secondly, there's the responsibility on young people. I think there are far too many people saying: "They're victims and therefore it's all the vendor's responsibility. We need more legislation." Perhaps they should be fined if they, on purpose, go and purchase cigarettes in a drugstore or anywhere else, if they're under the age of 19. Your view on that: Would you be tough enough to say "Yes, maybe we have to licence vendors," and "Yes, maybe we have to make it illegal and put a fine on the individual who breaks the law by purchasing it underage"?

Mr Bill Murphy: I would put it in the context that, as I mentioned before, this bill is just one step in a strategy to remove tobacco products entirely from our society. The further down that road we can go at this point in time the better. Obviously, to fully achieve the removal of tobacco products from our society, we are going to have to introduce steps such as you set forth, Dianne.

Mr Sutherland: Thanks for your presentation. You mentioned tobacco taxes and the impact that would have on young people. Some have suggested that if we're bringing in this piece of legislation, which has the ability for inspectors and enforcement and is going to be effective, then why are people so concerned about reduction in tobacco taxes having an impact on young people? If you're making it illegal for them to purchase, what difference does it make what the price is?

The other comment that's been made to me that I'd like you to comment on is that if a significant portion of tobacco sales is illegal, how do you stop young people from purchasing? The question is, if you're getting into the legal market, to the retailers, then you can enforce it there, but you can't do that in an illegal market. How would you respond to those two issues?

Mr Bill Murphy: The access issue has to be dealt with in two areas. The first is the physical access, which this bill is aiming to deal with; the second is the financial access. It's simply that the higher the taxes, the higher the cost, the less attractive it will be to minors to acquire tobacco either by somehow being able to get a legal establishment to sell it to them, or to acquire it on the black market, perhaps by their neighbour who's 20 years old going and buying a pack for them. I believe that the financial access is an important issue as well, and that's where the taxes come in.

Number two, although dealing with access to tobacco for minors is one part of the problem, the other issue is access of tobacco to all Canadians. Although we recognize that the most important step will be to stop the next generation of Canadians from smoking, we also wish to reduce the amount of smoking done by existing smokers as much as possible, and we see that the tobacco taxes will assist in that regard.

The Chair: I regret we're out of time, but may I, on behalf of the committee, thank all of you for coming here today. We appreciate it.

1500

JEFF ROBB

The Chair: Could I call on Mr Jeff Robb to come forward, please. Mr Robb, welcome to the committee. Once you're settled, please go ahead with your presentation. We do not have a copy of this presentation.

Mr Jeff Robb: No. I'll just talk to you endlessly here for a while.

The Chair: If endlessly can fit into 15 minutes, we'd appreciate it.

Mr Robb: I woke up this morning with a cold and I'm sorry it's taxing my voice a little. If I knew a good pharmacist, I'm sure I'd be able to take care of this.

Let me introduce myself. My name is Jeff Robb. I'm the owner of Turner Drug Store Ltd. Turner Drug Store has been at the corner of Grand Avenue and Carfrae in Old South London since 1948.

The Chair: I have to ask you, do you not know a good pharmacist?

Mr Robb: It is one of my problems.

I was a student at the University of Toronto and graduated with a BSc in pharmacy in 1983. I began interning in December 1983 towards getting my licence, and I worked at Turner Drug Store at that time. I was licensed in March 1984 and worked from then until the end of August 1987 for my father, who was then the current owner. He passed away in August 1987. I purchased the company from his estate in May 1988.

In the spring of 1988, I renovated the inside of my store and basically renovated tobacco out. I was tired of the tobacco in the store. Many people asked me why I went tobacco-free, why I did it. It was a personal decision. First and foremost, my father, Glen, died of lung cancer. That was a big impetus to get it out the door. I don't think that was the biggest reason, though. To me it was ethics. It was just pure and simple ethics. It was my professional responsibility as I saw it.

I was tired of what I like to call the whiff-and-puff syndrome, to borrow another tobacco retailer's name, where they need a whiff but they have to take a puff of their controlled-dose metered inhalant in order to enjoy it. It's just bizarre. I have several individuals to this day who still rely on that method in order to get their nicotine.

I found it equally as hard to recommend or advocate cessation of smoking or smoking aids when the last thing that an individual saw when they left my store was the tobacco behind the cash register. It didn't sit well with me and I couldn't countenance it, so I threw it out. I sought no publicity or fanfare and I'm sure to this day that only the residents of Old South and my clients are the ones who know I've done it, and maybe they're the healthier for it. It's hard to say.

I have great empathy and sympathy for people addicted to tobacco as well as any other substances. I have great respect for those who choose to try to quit. I have even more respect for those who choose to try to quit, fail and retry and retry and retry, however many times it takes in order to quit. I have immense respect for those individuals. I do not, however, have respect for drugstores that are involved in the sale of tobacco, especially those citing economic reasons as the principal reason for not voluntarily going ahead with being tobacco-free. Everyone knows who they are.

Just to give you a little insight in terms of my own situation, in 1987, the year prior to my removal of tobacco, my sales were roughly $90,000. I don't have any firm numbers on how much of that was represented by tobacco, but it seems to me it was in the $60,000 to $70,000 range, or roughly 78%. I figure the tobacco inventory at any one time was about $3,500. In 1988, my sales rose to $1.1 million, my inventory costs went down and my profits went up. In short, no financial ruin, no reduction of staff. In fact, the only number that did slide, interestingly, was the number of break-ins that were perpetrated against my business. In 1987 through 1988 I had five break-ins and since then I've had two. I think that number speaks for itself.

The reaction to going tobacco-free was admittedly mixed. I was equally vilified and lauded. I was a scoundrel and a hero. Some people vowed never to come back. I assume they didn't. I was constantly asked, "What is a pharmacy without tobacco?" and my answer was always, "A true health care facility, pure and simple." I was given congratulations as well, mostly by non-smokers, surprisingly. It was interesting. I had a very good staff to deal with the individuals who came up with questions and they fielded the questions in a professional manner. I give them top marks for that. They did a tiptop job.

I'm sure the variety store owners in the neighbourhood also thought they'd died and gone to heaven with the extra business that was spewing over to them in many ways.

Basically, why am I here today? Obviously, I'm not a public speaker nor do I really enjoy talking to a crowd. I'm pleased to be allowed to speak and to thank the committee for coming to London. I don't think I could have gone to you, but it's certainly nice to have you come to me.

I want to congratulate the Rae government for several things: first, for the courage to be proactive regarding tobacco in general, but more precisely with regard to eliminating it from pharmacy sales. I'd also like to thank them for adopting the OCP guidelines as at least a framework for the change regarding getting rid of tobacco from pharmacies. I'd also like to congratulate them for having the courage to stand up in the face of the tobacco lobby, the Imasco lobby and all other lobbies that currently oppose Bill 119.

I'd also like to compliment my chief competitor, Big V Pharmacies. I never thought I'd actually do this, but I'd like to thank Norm Puhl for throwing the weight of his 100-plus stores behind the legislation. I feel that if Norm had acted maybe a year or two earlier, we wouldn't be sitting here talking about this. We'd have already had it out the door and maybe done on a voluntary basis.

I feel your government shouldn't have had to legislate us into doing something that I'm sure everyone recognizes should have been done a long time ago. I thank you for bringing our consciences together on this issue, even if some of my colleagues will only do so after a little kicking and screaming.

I know that my competition will comply with the legislation, and then they'll try to profit from it, put a good spin doctor to work and come out the heroes on the issue. I'm not looking for that publicity. All I want to do is express to you why and how I did it.

I guess the bottom line of what I'm trying to say to you is that stores will survive without tobacco. I'm living proof of that. Imasco and all the others have marketing departments and I'm sure they'll put them to work to help them compensate for lost revenue. I was my own marketing department and I did it. I'm sure that some suits can do the same thing for them, and they will. I appreciate your time.

Mr McGuinty: Thank you very much, Mr Robb. I think the first thing I want to do, and I'm sure you're prepared to acknowledge this, is to make sure that people understand, the people who are present here today and the rest of us of course, that there are a number of drugstores in the province which do not have tobacco backers. Pharma Plus, for instance, 133 stores, and I believe those non-traditional stores like Zellers, K mart and Loblaws, don't have any tobacco connections either. There's a substantial number. I know there's been an effort on the part of some to categorize all objections as being purely out of the self-interest of the tobacco industry, but I think it's important to get that on the record.

We've tried to get some numbers from the government, but it hasn't given us any with respect to potential job losses. We've had some presenters come before us and some studies have been done and the number's been as high as I guess 2,700. Are you maintaining there would be no job losses?

Mr Robb: I can't speak for the industry. All I can speak for is my own particular experience, and my particular experience was that the community rallied around it and thought it was a good idea. I saw new faces. My profits rose, my sales rose and no one was let go.

Mr McGuinty: I want to speak to you I guess on an intuitive basis. You tell me whether you agree with this. If we tell an industry or a retailer, it doesn't matter who they are or what they're selling, "You're going to have to drop your sales by 7% or 8%," it seems to me that's going to have some kind of a negative impact. Wouldn't you agree?

Mr Robb: In a way. It's a circle, though. The equation doesn't stop there. What do you do? If you lose the inventory, you simply move that inventory into another space at the store or do something with it in order to compensate. I think most of the chain drugstores have marketing departments. That's what they're there for. They're going to find a way to compensate for the revenue loss. Like I said, I'm one average Joe and I did it. Chances are that with the money they have and the resources they have, they'll put it to good use.

Mr McGuinty: Just one final question: Should the government be providing some kind of a guarantee to all employees of pharmacies across the province that there will be no jobs lost?

Mr Robb: I hope you don't try that line on anybody.

Mr McGuinty: I just did.

Mr Robb: I don't think it's possible. I don't think you could say that.

Mr McGuinty: I think there would be some jobs lost.

Mr Robb: Perhaps.

1510

Mr Jim Wilson: Thank you very much, sir, for your comments. I want to comment on behalf of Big V, because they're often cited as leaders in this field. Apparently Norm Puhl's position is he doesn't agree with the ban on the sale of tobacco products in pharmacies. In fact, Big V's position is you shouldn't just pick on one retail sector or part of a retail sector, that it should go into licensed establishments like the LCBO or the beer stores, that there should be a tobacco control board.

Garfield Mahood of the Non-Smokers' Rights Association agreed in his presentation. In fact, he told Big V a year before it made the ban that it would be a smart marketing move and good positioning in the market if they were to get out and get the publicity for what apparently Garfield Mahood knew was an inevitable thing the government was going to do. He must have the inside track with the NDP because he knew it was --

Mrs Haslam: It's news to him.

Mr Jim Wilson: He told Big V, "It'll be inevitable; it's going to happen anyway under this government, so you might as well lead the pack." I was able to verify this when he appeared before the committee. I just wanted to bring that forward. That has been the position of my party, exactly what Big V's position has been, and that is that you can't just, on a strictly business side of things, pick on one retailer or the other.

I've also done, I've discovered, the largest survey of pharmacists in the province, because I've been waiting for a week now for somebody to come forward with a larger response rate than the one I did. I mailed to all 8,000 pharmacists in the province, and I only got 570 replies, but I've discovered from both sides of the --

Mr Robb: You represent the PCs, is that correct?

Mr Jim Wilson: Yes. I thought it was a dismal response rate, to tell you the truth, but other people get 60 when they mail to all 8,000 pharmacists in the province.

Of the 570, 77% of those pharmacists said the NDP government should not be able to ban the sale of tobacco in their stores. Included in that 570 were 112 pharmacists who had already voluntarily taken tobacco out of their stores but they agreed, on a business principle, that even though they'd voluntarily done it, the government shouldn't be forcing the rest of them.

I just simply put all that on the record to clarify a few of the points that you made and welcome any further comments you might have.

Mr Robb: I like the legislation the way it's written, if only for the fact of getting it out of pharmacies. It's not necessary in the pharmacy. You can get it elsewhere. If you choose to smoke, that's your business. I don't want to be selling anybody a pack of smokes. It's silly, stupid, ridiculous. That's my position.

Mr Winninger: It's certainly a pleasure to have you here today, Mr Robb, as a former consumer of Turner's when I lived on Grand Avenue back in the late 1970s. I certainly appreciate your transition to a tobacco-free pharmacy.

I think you were present for an earlier exchange I had with another pharmacist-owner at a time when I severely challenged the Chair's patience, but this comes back actually to the question I was going to pose to Mr Steinberg at the time. It seemed to be his approach that voluntary compliance was the way to go. Clearly, with 13,000 people dying every year of smoking-related diseases, we can't move too soon on this, but it seemed to be his approach that it was appropriate for pharmacists to stock tobacco products in their stores because they could give warnings to people against abusing the product.

I'm wondering whether you would agree with me that, in practice, the pharmacist isn't going to be able to closely monitor what goes on at the tobacco display counter, which might be at the front of the store while the dispensary is at the back, and furthermore that if a pharmacist like you takes clear and progressive action to remove the tobacco products, it's going to signal to your consumers that tobacco consumption is a very bad habit to continue with and that you might convince one customer or more to refrain from tobacco use by doing what you've done.

Mr Robb: Where the tobacco used to be in my store is now populated by smoking-cessation aids or literature thereof.

Mr Winninger: Is there a takeup on those products? Are people buying, or are these gratuitous?

Mr Robb: It arouses their interest. Smoking cessation is directly proportional to your own will and how much effort you want to put into it, and when the time is right, the time is right. As I said, many people try once and fail; try again and fail; try again; try again. Sooner or later, they either want to do it or they don't, and those are the people whom you should give the support to. But don't do it with tobacco in the store.

Mr Winninger: When people come in and ask for cigarettes at your store, what do you tell them?

Mr Robb: The pat answer is that we stopped selling cigarettes in 1988 for health reasons. We felt it was against our professional mandate to do so.

Mr Winninger: What kind of answer do they give?

Mr Robb: It varies. Some people say: "Well, what's a drug store without tobacco? I'm never coming back here. You're going to make me walk the extra block down to the variety store." Sometimes it's, "Gee, that's a good idea. Maybe I should quit."

The Chair: Mr Robb, thank you for coming before the committee this afternoon. We appreciate it.

WILLY'S COIN MACHINES

Mr Willy Schmitchen: My name is Willy Schmitchen and I'm from Chatham. We run a small vending business. This is my wife, June. She's my partner in everything.

We realize that the intent of Bill 119, in particular section 7, is to lessen health care costs by reducing the number of young people who become first-time smokers. We have no argument with this. However, in this most depressed time, this proposed anti-smoking legislation as it stands will in fact put many businesses out of business. Please reconsider this strong stance.

It has been our understanding that the NDP government was backing and encouraging small business. This is quite a turnaround. What has happened to the government's support of free enterprise? We are selling a legal product.

Please consider a compromise which would work towards your goal yet keep small businesses operating, at least enough to pay operating expenses and our taxes. Allowing vending machines in licensed bars would hopefully keep our heads above water. We propose to move machines away from bar entrances, in full view of the bartender. In most instances, buyers have to purchase loonies from the bartender in order to use the machine.

Tobacco sales are down and smoking is already no longer socially acceptable in many places. Our own sales are down considerably from just one year ago. Every year we voluntarily take machines out of service in locations which are no longer profitable. Over the next five or six years, you will find that the number of cigarette machines will be greatly reduced. We feel this gradual reduction will give us time to diversify.

Statistics show that less than one percent of all sales in Canada are from vending machines, so the percentage of young people purchasing from vending machines must be close to nil. If you watch the high school crowd, you will realize they do not congregate during their lunch hour or after school in local bars. They hang out at the corner variety store, at 7-Eleven or Becker's. Furthermore, they do not purchase cigarettes from vending machines because of the higher cost. They can obtain them much cheaper through older friends. You will gain nothing, and we lose everything.

I own a small vending business which is 90% cigarette machines. As you can see, my business will not be able to survive without the cigarette machines. We won't just lose our business, but will go into debt. Has compensation been a consideration? Since the machines will be obsolete, we will lose the value of our assets and we will go deeper in debt with the cost of removing the machines. Death by smoking is a long-term process. Don't kill our business overnight. Let's be fair to both sides of this controversy.

In closing, we propose that vending machines be allowed in licensed bars. Hotel operators are very supportive of this and are assisting in a petition. We also have the full support of our member of parliament, Randy Hope. Very little will be gained by removing the machines, and at the same time this would allow the small business person to stay in business. As it is, this summer we must remove machines that are not in licensed establishments to conform to the federal legislation. This will cut our sales considerably. If the machines are to removed completely, we should at least get compensation for them.

1520

Mrs Haslam: We had a vending machine group come to us when we were in Toronto, and I asked them the percentage of their business which was tobacco machine related. I see that you have 90% cigarette machines. What other kinds of machines do you carry in your business?

Mr Schmitchen: We have some soft-drink machines and some candy machines. We have to diversify just to keep up with the times.

Mrs Haslam: One of the comments from the parliamentary assistant at the time was to put it in the context of the federal legislation in licensed premises, and in Ontario licensed premises do include family restaurants, where the machines are sometimes downstairs by the washroom or they are at the entranceway. It was one of the things we had to take into consideration in looking at this particular piece of legislation and where it went vis-à-vis the federal legislation.

One thing the group asked for that I think all of us were very interested in was an extension of the time lines. They said: "Even if we have to take all the vending machines out, at least extend the time lines beyond the three months. If you're going to give pharmacies a year to comply with legislation, at least give us the same amount of time. We already have to take out a majority of our machines because of the federal legislation coming in." They asked for an extension of time. Would you be in agreement with that particular case?

Mr Schmitchen: How long a time?

Mrs Haslam: I believe they mentioned the same amount of time as pharmacies, one year versus three months.

Mr Schmitchen: I believe there's a difference between a licensed establishment and a licensed bar. In a bar, you have to go to the bartender to get change, and most of them are adult bars. That's where you really sell the cigarettes anyhow. It's not profitable to have them in a restaurant. In a family restaurant, you might as well forget about it.

Mrs Haslam: Can I have one more quick question? That didn't answer my question, but I wanted to get one other item on.

When you say you don't sell to young people, this morning we had the Lambton county group come in and indicate in a questionnaire that they had through their high school that 78 out of 216 young people did and were able to buy cigarettes from vending machines. In their own questionnaire at a high school, we find that a certain percentage of young people do have access to the machines, and this is legislation that is very concerned with that access by young people to the purchasing of tobacco. So I would pass that on, and still my question was around the time lines.

Mr Schmitchen: I believe it should be just left alone. Eventually the machines are going to disappear anyhow, and from a small business point of view, it's hard to make a living the way it is right now anyhow. We don't want anything taken away. We've been in this business for about 20 years, so it's quite a blow to us.

Mr Jim Wilson: Sir, I realize that in the first part of your presentation you were probably trying to soften the government up by referring to them as somehow being pro-small-business, but I can tell you that in the three years they've been in, I can't think of one thing they've done for small business except drive a whole pile of them out of the province, including this legislation, it's been suggested by a number of pharmacists.

Michael Decter, the previous deputy minister, used to say in meetings, "One of the problems with our drug costs is there are just far too many pharmacists in the province." Anybody can become a pharmacist. We've had testimony here that as long as you meet a few different criteria under the various acts, you can set up and hire a pharmacist. Your store could be a pharmacy.

It's been suggested, we know from a Coopers and Lybrand study, that possibly 104, I think it is, pharmacies could go out of business, and that really this is the government's backdoor way of getting rid of a few pharmacies. That's one of the suggestions. Unfortunately, they brought the health lobby along with them in their way of doing this.

But there's no proof that by getting rid of the sale of tobacco products in pharmacies -- I don't think it will in any way reduce consumption, because people will just go to other stores. I just wanted to say that.

Secondly, my party and I have a great deal of sympathy for your position, and we have, from the very beginning, said that the government should compensate people like yourselves. I don't think the government will budge. I said on second reading debate that while the federal government has moved it into licensed establishments, this government, in order to get a big bang out of this exercise, wanted to go one step further than the federal government. So they're going to ban all vending machines.

I don't think it'll have much effect -- less than 1% of tobacco sales are sold through vending machines -- and I agree with your position that if it was in a supervised area, like near the bar, which is the legislation in a number of states in the United States, for example, that would be good enough. That was sort of the intent of the federal legislation.

Given the fact that we're going to try and keep pushing them on the compensation issue, and 90% of your business is cigarette vending machines, what kind of dollars are we dealing with here just for your business alone?

Mr Schmitchen: To change a machine just to take loonies costs about $500. Then you still have the labour on top of that and the price of the machine. I would say about $1,500 per machine.

Mr Jim Wilson: How many machines do you have?

Mr Schmitchen: We have 40.

Mr McGuinty: I think you've raised a very reasonable question, and that is, if the object of the exercise is to make it harder for kids to start smoking, why are we banning vending machines in licensed bars? Let's forget restaurants. Let's just talk bars. I don't know if the government has any numbers on how many kids are getting cigarettes from vending machines in bars but I haven't seen any.

Tell me just a bit about this system of loons. I gather it could be a further protective mechanism. If I'm sitting at a bar and I want to get cigarettes from the machine, how does it work? It doesn't take money.

Mr Schmitchen: It takes loonies.

Mr McGuinty: Oh, I see. I thought you were talking about a token system.

Mr Schmitchen: No, it's loonies. Everybody calls them loonies.

The Chair: That hasn't reached Ottawa yet.

Mr Schmitchen: Years ago, when I first started in this business, they used to have a stamp. You'd buy a licensed stamp for a machine. In that way, you were designated to that location only and they could keep track of where the machines were if they wanted to have some kind of control over that. That used to be years ago, and when we got switching governments that went out. That's how they used to keep track of things. It might be a suggestion.

The Chair: Thank you for coming from Chatham and making your presentation today. We appreciate it.

PST OFF ASH, PUFF OUT CAMPAIGN

Dr Terry Polevoy: Thank you for allowing myself and one of the associates in my organization to be here today. I am known throughout Ontario, and in fact the United States and Canada, as possibly the tobacco industry's worst nightmare. I annoy people. I cajole people. I'll be taking some of them to court in the next few months. I'm a soldier in the fight against tobacco.

Rick Bebenek is a grade 12 student at Preston. He's 18 years old. To kick our presentation off he's going to ask each of you to take a little selection from our grab bag. We're going to have some fun today. Rick, do you want to make sure everybody gets at least one piece? Some of you probably will not want to keep what we're going to hand you, but we'd like to have it back. They're mementos of my wars against tobacco.

1530

As a former paediatrician, and a soldier in the movement against international tobacco cartels, I salute you for your efforts. I founded PST OFF ASH, pronounced pissed off ash, in March 1993. It stands for People Stopping Tobacco Organizations Funding Fine Arts, Sports and Hospitals. We originally started with just the A for arts because we picketed the Guelph art centre fiasco last year.

We serve as advocates for people who are victims of second-hand smoke in the workplace and for children who are victims of their parents and caretakers. Our goal is to bring about zero tolerance for smoking in schools and the workplace. We are asking for people to bring their grievances to us because frankly, ladies and gentlemen, no one else gives a damn in this province.

Tobacco and smoking are major health problems, but are even larger social problems. You've heard evidence from many experts and I'll not repeat what they've already told you. I'll tell you a little bit about my personal experiences and then I'd like to open up the floor for discussion.

I'll go around the room, and just hold up what you've got. You'll be last, actually. Mr Wilson, what do you think that represents?

Mr Jim Wilson: I don't know; a child or a young person.

Dr Polevoy: Hope in the children, that in the future they'll be smoke-free. Mr McGuinty, did you pick up one of our little ditties over there?

Mrs O'Neill, what have you got?

Mrs O'Neill: A magazine.

Dr Polevoy: Okay, open it up to any page and try and find us an ad about health, and before the end of the show, I want you to report to us how many tobacco ads were in that magazine. If you see a tear-out page that means I've ripped them all out, so you may not find any.

Mr Eddy, can I ask you if we gave you something?

Mr Eddy: A "Preston High School Making a Difference" mug. I don't know what the emblem means.

Dr Polevoy: Can you tell us about the emblem, Rick?

Mr Rick Bebenek: It's just our school symbol.

Mr Eddy: Oh, I thought it was a bear paw.

Mr Bebenek: It's just a paw, our mark in school.

Dr Polevoy: Mr O'Connor.

Mr O'Connor: I've got a magazine with a young person and a cigarette in her hand.

Dr Polevoy: What's the lead article there, not about the band but the other lead article?

Mr O'Connor: "American Secret Police."

Dr Polevoy: Okay, another lead article.

Mr O'Connor: "Exiles on the Mainstream."

Dr Polevoy: Okay, keep going.

Mr O'Connor: "War Pigs: Clinton's Military Sleight of Hand." "AIDS Coverup: What the Government Doesn't Want You to Know about HIV."

Dr Polevoy: Did you know that smoking doubles your risk of developing AIDS? Anybody know that? It does. Mr Beer, do you have anything?

The Chair: I have some nuts.

Dr Polevoy: Okay. Who makes those nuts?

The Chair: It says "Eagle."

Dr Polevoy: Do you think they're a part of an evil empire of tobacco lords?

The Chair: I have no idea.

Dr Polevoy: I don't know either but Planters is. Mr Rizzo.

Mr Tony Rizzo (Oakwood): A magazine.

Dr Polevoy: Yes, what is on the cover?

Mr Rizzo: Some pills and cream.

Dr Polevoy: That's an article from the New York Times magazine about how to commit suicide. Karen Haslam, what have you got?

Mrs Haslam: Self magazine.

Dr Polevoy: Okay. I want you to count the number of tobacco ads in that magazine, unless I've ripped it to shreds, and find out if there are any Canadian brands in there, by name only.

Mr Sutherland, I'm glad you picked what you picked. Who doesn't have something? Do you want to hand that little box of stuff out? Mr Sutherland, you were very quiet. I taped 20 hours of your committee this week and you were one of the quietest people.

Mr Sutherland: I'm filling in today.

Dr Polevoy: Oh, he's filling in. Now can you please read the title of this little magazine here?

Mr Sutherland: Yes. It's called Our Children; the Parenting Magazine.

Dr Polevoy: Who prints that?

Mr Sutherland: It says, "Compliments of the Bay."

Dr Polevoy: Okay, now open up to the centrefold, please. Read the top of the page and just sort of flash it at everybody, please.

Mr Sutherland: Okay. It says, "These companies care about our children."

Dr Polevoy: Name five companies at random.

Mr Sutherland: United Transportation, Merrill Lynch, Spar, Chubb, Nutrite Fertilizers.

Dr Polevoy: Okay. Look at the second page, bottom left. What's there?

Mr Sutherland: Imasco.

Dr Polevoy: Imasco cares about children, right in black and from the Bay. I rest my case on advertising and the media influencing children. The only thing we don't have is Joe Camel, but in some of the handouts I gave you we've got lots of ads, we've got lots of goodies and we have the start of a game.

I'm going to be making a game based on this particular school trip that we go along. We start out at home plate where the kids can pick KKK cigarettes, which stands for Kills Kids Kwik, and their warning is this, "If you're stupid enough to smoke, the very worst."

Head towards first base and you look for your teachers to retire and let them pay their own OHIP fees because they, ladies and gentlemen, the teachers of this province, are the ones who allowed smoking in schools to begin with back in the 1960s and 1970s. They promoted smoking in their peers and their students as well.

In our area in Kitchener there isn't a single school that is smoke-free except Resurrection Catholic Secondary School and the school boards refuse to act today. We have asked for help from the Ontario Medical Association. We've asked help for Ontario Council of Administrators of Hospitals. We've hired an attorney. It's going to take us $5,000 to start the lawsuit and probably $25,000 before it's finished, and that's before it goes upstream towards Ottawa or towards wherever it's going to end up. Let me tell you the teachers are our worst enemies.

First base: "Mama Mia's Bingo. We serve from womb to tomb. Strike here." The bingo parlours have been striking in our communities since the inception of bingo. We have a school in our city, Resurrection high school, the only smoke-free high school between Toronto and London, that actually allows their students and promotes bingo in a smoking area.

We had a teacher at Cameron Heights Catholic School who smoked for 40 years and he told me about three months ago: "Terry, what's all this crap? What's all this hassle? I smoked for 40 years, it didn't hurt me and I quit by myself. What do I care if students smoke?" Why? Because one of my 14-year-old students works at the bingo parlour where they hold their events. She works in the kitchen. Some kitchen: potato chips, pop and maybe a peanut butter sandwich and she's in the room with the smokers.

1540

I went to the school board: no answers, very few questions. The chairman of the school board said in the paper the next day: "We can't do anything about public school smoking. It'll be too dangerous."

He used to work for the police department. He quit the police department after 11 years, went to work for the SIU; hasn't done a stick of work for these people for three years and is drawing a salary of between $54,000 and $58,000. Guess what, ladies and gentlemen, he's running for mayor this year. Dom Cardillo, the other apologist for tobacco in our town, is retiring. We are fed up to here with politicians and wannabe politicians.

Turn to second base. We want to boycott Wendy's, McDonald's, Burger King until they ban all smoking. George Cohon sent a very apologetic letter to me saying his air quality is five and a half times better than the average home, yet he owns a McDonald's in Moscow that has served 69 million, maybe 70 million customers since they opened a few years ago. I don't speak Russian. My grandmother did, but I never got a chance to ask him whether they allow smoking in that restaurant.

Second base: called the Bitch 'n BIC. It's a small picture of a lighter, dangerous weapon in the hands of kids. It's a status symbol. They're in the colours of the cigarettes and for years they were put in people's Christmas stockings as if it was a fun thing to give in a Christmas stocking. It was outlawed in this country to have emblems that resembled cigarettes.

Second to third: We want to stop Becker's, Farrah's and Short Stop's from having cigarette counter displays. I walked into a Becker's near my house, surrounded by two elementary schools, two churches, next to Shoppers Drug Mart and a smoking doughnut shop in a middle-class area of Kitchener. My wife was terminally ill with cancer last year, so we sort of used that as a convenient place to stock up on items. Never went to the Shoppers; it smelled like chemicals. I was very chemically sensitive; I couldn't go in there. But the Becker's -- nice people. Young kids worked there. You got your ice cream cones and everything and 27 million kinds of candy bars, including the Wunderbar.

One day I went in there during the cancer society fund-raiser or Easter Seals where they have little daffodils sitting on the counter, and I thought there was a sign sitting back there saying, "Put your coins in here and donate to the cancer society." Ladies and gentlemen, what was behind there were six packages of pouch tobacco surrounded by the daffodils with a price on them, and I just about puked. I wrote a letter to Becker's three times and called them six times and never got an answer. Since then, the store has changed hands and they've got bars on the windows, but kids still go there to buy their cigarettes, or to the parking lot at the school or the church.

Number three, here's another lighter. What's that look like? A Zippo to everybody? Arson 101 -- stylized one. This got triggered in my mind when a girl in high school aged 15 or 16, in London, set a mattress on fire while she was on her school break last winter. Anybody from London here? Do you remember that story? She killed, I think, a 38-year-old man in a rooming house. She went back to set the fire twice. It wasn't good enough that she started the mattress on fire once. These children are out of control.

There was a kid on the playground, Sunnyside elementary school in Kitchener. I go there to speak regularly. They have the best anti-smoking campaign in the world for those kids. Twenty-four kids a year go through the program. They're either kicked out of school or go through the program. I can play a tape for you about my participation. However, this is the school where a kid poured lighter fluid on a student. Anybody from the Kitchener-Waterloo area? We did have an NDP person, but he's independent now.

That kid wasn't even kicked out of school for more than a day, but the people in town were really pissed. They got very angry and asked that the child be thrown out of school or be given counselling. He was this far away from lighting this kid on fire. Why? Because lighters and matches are tolerated in grade 7. That's enough. I've had it. We want these kids expelled and staying at home if they're going to be smoking. I don't care how old they are. It's a dangerous weapon.

The 4Rs for returning to school:

Refuse school-sponsored bingos. Call the school board. Call your minister. Call your doctor. You should not be made to go to a smoking hall.

Report stores that sell to minors. I invited a police chief to our meeting of our coalition that I'm no longer a member of, because they sit around and just hold hands with each other and collect government grants. I invited the police chief and who happens to be there? Three policemen show up in my absence. My wife went into a coma in November. It was the last meeting in October. They came up to me afterwards and asked me to resign from the coalition because I was too militant.

Rick and I and his friends were going to a sting over Christmas vacation after warning every storekeeper in town and taking a survey, just like they did, I think, in Brantford. They do in Colorado. They do in Illinois. You heard the stories. I was told to butt out and get out of everybody's way. Why?

Within a block of the police department in Waterloo there are at least half a dozen places you can go into and buy cigarettes by the piece or go into the bowling alley and put your money in a machine. There is no control. I resented very much my reputation being smeared by the police department and I had no recourse.

The Chair: Perhaps you could bring your presentation to a conclusion because we are over the 15 minutes.

Dr Polevoy: I have three separate preparations here that I will leave you, plus the list of other things. I'm sorry I took up all your time. I'm very angry, but I'm very focused. We're going to see this to an end and if it takes a lawsuit against a department of the government for inaction, it's going to be done. We want an Ombudsman to be on our side for a change. Thank you.

The Chair: We thank you for the submission and also for the material you've left with us.

Dr Polevoy: There will be a complete submission from me, all 25 or 30 pages, and 35 copies I'll leave with you before the 18th.

The Chair: Thank you very much.

HEART AND STROKE FOUNDATION OF ONTARIO, LONDON-MIDDLESEX CHAPTER

Mr Brendan Murphy: My name is Brendan Murphy and I'm the area coordinator for the London-Middlesex chapter of the Heart and Stroke Foundation. Thank you for allowing me to be here. I'd like to present our support for Bill 119.

The Heart and Stroke Foundation applauds the government of Ontario for honouring its commitment to the health of its people by introducing long-awaited legislation to reduce tobacco use.

As part of the Heart and Stroke Foundation, our mission is to reduce premature death and disability from heart disease and stroke by raising funds for research and education, and a major opponent to our cause is tobacco. In fact, tobacco is the single most important modifiable risk factor for heart disease and stroke and that is why we strongly endorse and are in favour of Bill 119.

Tobacco causes about 38,000 deaths in Canada a year, 13,000 in Ontario, of which 40% will be cardiovascular related, having a major effect on our goals to reduce premature death and disability. It's a major factor that we continually fight against each year.

We believe the best way to decrease these statistics is to take action to protect our youth. We believe that if youth are not smoking before the age of 20, we believe in the statistic that it will have less effect on them and that they will not be smokers in the future and as a result will live healthier lifestyles and be more productive Ontarians and Canadians.

Our objectives are to create a society where children are not enticed by cigarette ads and packaging, cannot readily access tobacco products and where they see society assigning appropriate measures to control the lethal product, which is tobacco.

Consequently, the foundation is pleased to strongly endorse raising the age of a minor to 19, establishing signage requirements to make retailers, their staff and the public aware of the law, and reducing tobacco sales outlets through the ban on sales in pharmacies and vending machines.

The government's commitment to removing tobacco from pharmacies and banning machines is an important step to decreasing access to tobacco products for Ontario youth and we feel it's an active step in saving lives, period.

The Heart and Stroke Foundation also recommends an effective system of licensing retailers that can be strictly enforced to reduce the sales to minors. While in principle we support statutory prohibition on sales to minors, it must be carefully monitored and a mechanism for reviewing its effectiveness and enforceability must be included for that to happen. If it doesn't happen, we feel that definitely licensing should be in place.

We recommend that the chief medical officer of health be charged with the responsibility to report annually on its effectiveness. If it proves to be ineffective and unenforceable, it is recommended that a retail licensing system be implemented.

As far as packaging is concerned, we believe in enforcing plain packaging regulations. Kids see packaging, whether it's their father with it, whether it's their teacher, whether it's a professional athlete. It's a direct endorsement. People respond to packaging. I don't think anybody can deny that. It's a major factor for any kind of consumer product.

As far as the environment is concerned, Bill 119 doesn't offer the workers of Ontario any further protection from tobacco's deadly effects. Consequently, we recommend that Bill 119 be strengthened to prohibit smoking in an indoor environment. We think people should petition, whether it's a bingo parlour or whatever, to have permission to be smoking. I don't think the government should be saying this, this or this, because it leaves the door open for a lot of people to stretch the law.

1550

We also believe that smoking, if it is permitted, should be restricted to enclosed areas which are separately ventilated under negative pressure and exhausted to the outdoors. Overall, we believe this because we believe that ETS is responsible for more than 4,000 deaths a year.

Developing an effective tobacco strategy demands that we all get together on this -- health agencies, governments, non-government organizations -- to create partnerships and find the most comprehensive and also cost-effective way to take care of this problem and give people an easier way to make healthy choices for their future, especially the youth of today.

I don't think anybody here denies that tobacco kills. Even the person who had the vending machines basically said that it kills people. What more do you want? I've seen it personally. I've seen it in a lot of people and I've seen it now that I'm with the Heart and Stroke Foundation. I think we can overcome economic factors to make sure that we don't let people die. I don't think it's something that we say: "Okay, they're going to die off later. Let me earn some revenue now." Everybody is restricted in businesses today. Whether you're a landlord or whatever, there are restrictions on how you can do business. I think we have to enforce these.

We urge the government of Ontario to complete its important work initiated in Bill 119 and pass it without any further delay. I thank you for the opportunity to be speaking here today.

Mr Jim Wilson: Thank you for your presentation. I want to look at packaging, on page 7, because I know the Heart and Stroke Foundation of Ontario and various other groups consistently mention this in their brief. I guess my question is to the parliamentary assistant, really, but for the benefit of all. With respect to kiddie packs, maybe you could just clarify. I don't think the legislation specifically talks of banning kiddie packs, but I believe it's the government's intention and that's why you have the regulatory powers there. Do you want to expand on that? It keeps coming up. Maybe it's one thing we could eliminate from these hearings if the government would just tell us what its intention is with respect to packaging.

Mr O'Connor: With respect to my colleague and the question around the legislation around packaging, some of it has the ability to be done through the regulations which are yet to be tabled. If there are suggested amendments that you'd like to make, we'd be willing to look at them as well so that we can clarify perhaps some of the intention here.

Mr Jim Wilson: I certainly don't have any problem with anything you've mentioned under the packaging section. I would ask the government, though, what is the government's position with respect to generic or plain packaging? If you're asking for regulatory power, I assume you know what you're going to do with it.

Mr O'Connor: Part of the difficulty we've had, as stated before by the minister, I believe, was that the packaging most often falls under federal legislation. We're hoping that the federal government will move in that area. We do have some regulating ability there and I look forward to an amendment, perhaps from yourself, in that area.

Mr Jim Wilson: In other words, you're just palming it off to the opposition parties.

Mr O'Connor: No. The fact of the matter is that it falls under -- let me say it a little slower for you -- federal legislation.

Mr Winninger: We want the Tories to do something.

Mr Jim Wilson: We've been running the agenda at Queen's Park for --

Mrs Cunningham: We have to run it in opposition. That's what's so frustrating.

Mr Jim Wilson: We're trying to get you straightened out. Now you want us to straighten this out for you too?

The Chair: Order.

Mr Jim Wilson: I just thought I'd call your bluff.

The Chair: The committee has been very good today, but ladies and gentlemen, perhaps we could focus on the representative from the Heart and Stroke Foundation.

Mr Jim Wilson: A very useful answer. Thank you.

Mr Tony Martin (Sault Ste Marie): It was certainly good to hear your presentation today. It seems to me, from having sat through a week and some of hearings, that we get folks coming forward who present the health side of this question, and then we get others who sometimes are connected to the health profession who talk to us about the retailing side of this.

I had a very interesting conversation over the weekend with a group of community college student council presidents. The issue that came up there and sometimes comes up in the tradeoff between the concern about health and the concern about freedom to retail and do business is always one that's quite interesting. The student council presidents were concerned that we were laying something on them that was going to get in their way in their student life centres; you know, running the pubs and allowing people to smoke and the revenue that's generated there.

They had some concern that we were going to do that, and certainly there have been people here today, particularly from the chain drugstores and those kinds of places, who have a concern that we're stepping over the line into an area that we really shouldn't. It's always under the guise of freedom. Perhaps you could help me understand that a bit.

Mr Brendan Murphy: Sure. I consider myself very much an entrepreneur. There comes a time, and we've all decided; we all realize the effect of this product and that it kills people. There are restrictions on everything. We're trying to somehow get a product which we've said is legal for a long time -- I think we all agree that we shouldn't have it -- and we're trying to find the best way to get rid of it. We're just making excuses by saying that it's somebody's right to sell a product that actually kills people.

Is it a drug dealer's right to sell drugs? He's got a right to earn a living, but it's a drug and it kills people. If you're a landlord, even supply and demand dictates that your property is worth a certain amount of money, yet you can't charge that amount of money. Why can't he do that? Why don't we have free trade yet? Things are put in place for certain reasons, to protect the majority of Canadians, and I think that's the same with the sale of tobacco.

Mr Martin: In your mind, then, there is absolutely no rationalizing this one. It's clear that this is a product that kills people and so we shouldn't be doing it in any form or fashion anywhere.

Mr Brendan Murphy: Ideally, that's what I believe. I believe that in an economy there's a good way to go about doing this. I think that for a pharmacy to sell tobacco is just unethical. At the Heart and Stroke Foundation, should I sell tobacco out of my office? It's ridiculous because it's defeating the purpose, and a pharmacy is the same way. They've asked for it as a self-regulatory body. If they believe in it, why shouldn't they have it out of their stores? Don't we all have some type of ethical values and stuff that we should adhere to as citizens of Ontario? I believe in that, and I think that goes for people in business.

The Chair: Thank you for coming to the committee this afternoon and for the written presentation as well.

1600

JIM SEMCHISM

Mr Jim Semchism: Good afternoon. My name is Jim Semchism. I'm an owner-manager of Ealing Pharmacy, a 1,500-square-foot, full-service drugstore that serves southeast London and has for the past 42 years. I received my pharmacy degree in 1978 from the University of Toronto. I worked for three years as a staff pharmacist for the Big V pharmacies group in the London area before purchasing Ealing Pharmacy from my father in 1983. Like Mr Robb and Mr Coulter, I'm an SOP; that's a son of a pharmacist.

There are eight pharmacists in my immediate family. They include my wife, my father, two brothers, a sister, a sister-in-law and a brother-in-law. I have a fair amount of experience with the profession and those people who work in it.

I'm a former president of the London and District Pharmacists' Association and the Ontario Pharmacists' Association. I'm co-chair of the Pharmacists in Support of Bill 119. Today I'm here to speak of my own personal experience in the discontinuance of the sale of tobacco in my own pharmacy and share my own personal perspectives on this issue.

I made headlines in 1986 when I was the first local pharmacist in the London area to stop selling tobacco products. Now 10 other London stores have followed my lead. I was in the news again in 1990, when I resigned from the Ontario Pharmacists' Association council over its position on tobacco sales in pharmacies.

I would like to thank the committee for allowing to me to address it in support of Bill 119. I would particularly like to congratulate the government for bringing forth such a comprehensive action plan at this time. In addition, I would like to praise the Health minister and the Treasurer for their position on high taxation on tobacco, in spite of challenges from Quebec and the federal government. The number one reason my patients have wanted to quit smoking for the past 15 years is the high cost of this deadly habit. Removing taxes is an invitation to encourage new smokers, young people in particular, and established smokers to continue this bad habit. It's that simple.

Last week's headlines by Liberal governments in Ottawa and Quebec City were very disheartening for those like myself who have fought for years to create a smoke-free Canada. The health coalition's full-page ad in the Globe and Mail last week gave the Prime Minister the correct path to follow. Some of his caucus listened, but the majority went for the quick fix to appease Quebec store owners and law enforcement officers who did not want to confront the criminal element who defy the laws by smuggling tobacco.

Tax removal will lead to long-term government debts to pay for the medical costs of smokers and their innocent victims. I'm referring to environmental tobacco smoke. Most often, these powerless victims are children of smokers, trapped in their cars and homes. It sickens me to describe the injustice done to young people by their own parents. There are no laws to protect the unborn, the infants and young children of smokers, who have no option but to breathe in the secondhand smoke that is filled with carcinogens from their parents' cigarettes.

Every day I face the victims and smokers across my dispensary counter. Each parent who smokes is potentially consuming thousands of dollars of bronchodilators, anti-asthma, anti-hypertensive and cardiovascular drugs. Some are on chemotherapy as well. Most are also taking anti-ulcer medication and almost always are taking antibiotics and cough preparations on a regular basis. They remain addicted in spite of these conditions.

The sad part is that most of the smokers don't care about the costs of these therapies. "My employer pays for my drugs," they say, or, "The government drug plan covers the cost." These same people will be overjoyed by the fact that it appears now inevitable that tobacco costs will be dropping, as proposed by the Prime Minister.

Now let's look at the damage done to children by secondhand smoke. These children almost always face a high rate of asthma and bronchial infection. They live on Ventolin, steroid inhalers, antibiotics and cough suppressants. This causes them to miss school and puts them at risk for long-term complications as victims of secondhand smoke. I see the kids' bloodshot eyes. Their clothes reek of their parents' cigarette habit. It's a pitiful sight to behold.

The real shame is that many in my own profession and some members of this committee do not seem to understand that pharmacists and health facilities should not be involved in the sale of this legal poison. If any one of you had spent the last 15 years of your life treating the victims of tobacco, you would not be defending the tobacco industry or corporate pharmacies' interests.

This is one issue that should not be partisan. All three parties should support the government's bill, especially in light of the setback brought on by the Chrétien-Johnson alliance with the tobacco industry. Lysiane Gagnon's column in last Saturday's Globe and Mail outlines overt collusion that has taken place between the politicians and the tobacco industry. We are dealing with the greatest cause of preventable death in the province. This should be motherhood.

Mr Robb spoke earlier. His father and my father were classmates. His father was a victim of lung cancer. The choice of removing tobacco from his store was relatively simple. Jeff lost his dad. My father and I lost a close friend.

At this point, I'd like to make an economic review of tobacco. I've photocopied my sales figures from my profit-and-loss statements -- they appear at the back of my submission -- from 1985 to the present. Actually, I think they go back to 1984.

You will note that tobacco was removed from my store in August 1986, so it was about three or four months into that particular year. My year end is April 30, and therefore tobacco was sold from April to July 30 in my 1986 statement. I am pleased to say that there was little or no negative results from the removal of this product from my store, no one lost his job, and I prospered in spite of not selling tobacco.

Tobacco represented about 11% of my sales in my last full year of selling tobacco, and I've dropped the numbers there. My annual sales in that year were $907,000; $101,000 of that $907,000 was tobacco. This contrasts favourably with Mr Bloom's statement -- Mr Bloom being the CEO of Shoppers Drug Mart who spoke to the committee last week -- that tobacco represented 9% of his company's total retail sales. It doesn't matter that the average Shoppers Drug Mart sells $4 million, of which $360,000 represents tobacco; in my case, $101,000 represented more to my business, it appears. With my business it was 11%; with the Shoppers group, they said 9%.

Mr Bloom criticized one of my colleagues, claiming that her tobacco volume was low and that that's why there wasn't a big impact by her ceasing to sell tobacco. Sure, every store is different. The Shoppers franchise agreement generates in excess of 10% on tobacco. There's obviously a vested interest in why they want to sell the product. It is no wonder that SDM is selling over $1 million in tobacco in many of its stores. These stores are paying head office, if you look at the franchise agreements, in excess of $100,000 per store for the $1 million in tobacco sales.

Pharma Plus's president, Rochelle Stenzler, spoke to the committee last week, and she said something that was enlightening, that I didn't know. She suggested that tobacco is exempt in many of their percentage leases. This means that landlords will not be clawing back on lost tobacco sales in pharmacy. I was pleased to hear that. I wasn't aware that tobacco was exempt in many retail leases.

Here is my understanding of corporate tobacco economics. Most stores use tobacco to generate cash flow. Shoppers Drug Mart franchisees have told me that they sell the product several weeks before they have to pay for it. Tobacco, as anyone who's in the retail business knows, has the highest turns of any product in their store.

Now I'd like to look at the second-largest pharmacy chain in the province. Ms Stenzler claimed in her submission to be number two because she has more stores than Big V, but I've always elevated Big V to be number two because they have higher sales than the Pharma Plus group.

Big V made a conscious decision in the 1980s to de-emphasize tobacco. Tobacco sales dropped from in excess of 10% of their sales back when I worked for them to less than 3% today. Their president is on record as supporting Bill 119. Contrary to what we heard earlier, I've got a Canadian Press clipping in my bag here that I would be happy to share with you that quotes Mr Puhl's exact remarks in supporting the bill. He was pleased that the tobacco bill created a level playing field among all pharmacy retailers. His company's philosophy is in sharp contrast to those other corporates who are in opposition to the bill.

I feel that the Pharmacists in Support of Bill 119 diffused the negative publicity of the Committee of Independent Pharmacists at the hearing last week.

1610

To summarize, hundreds of independent pharmacies have discontinued tobacco sales without serious economic hardship in the past eight years. In London, the majority of independents have stopped selling tobacco. There are 21 independents here in London and only five sell tobacco. Throughout southwestern Ontario, many large independent pharmacies have discontinued tobacco sales. Here in London the Wilton pharmacy, and in Wallaceburg the Jackson pharmacy are prime examples of large stores, 4,000 square feet or more, that have stopped selling tobacco products without serious consequences. I spoke to Mr Jackson this morning. He confirmed that he recovered his lost revenues and profits in under 18 months and that tobacco represented well in excess of 10% of his large store sales.

We anxiously await the enactment of this legislation. Our college announced in 1991 that July 1, 1993, would be the date of its implementation. The profession has gained almost a year's extra prep time. Many of my colleagues have voluntarily removed tobacco products in anticipation of the creation of this level playing field. They did not want to be embarrassed by having to follow a legislative directive. We owe them in good faith that the legislation, as proposed, be passed.

It is my understanding that Mr Barry Phillips, the immediate past president of the college, spoke to you on Thursday. Although I have not received the printed text of his remarks, it is unfortunate that he appeared before the committee condemning the actions of the college. One has only to look to his storefront to see what perhaps motivated his remarks. Mr Phillips is a lifelong Shoppers Drug Mart franchisee.

On the positive side, I'd like to make an interesting observation about some of the past presidents of the Ontario Pharmacists' Association. The last six of my colleagues, and I've put their names and their stores in the appendix, have either thrown tobacco out of their stores or never sold tobacco or worked for a company on record as supporting the ban. It seems to me that the leadership at OPA is leading the province in spite of opposition put up by many.

As announced previously, I would like to share the current results of the Pharmacists in Support of Bill 119's membership drive and survey. There were 7,640 surveys mailed out. As of noon today, with a return rate of over 6%, and we expect to get a lot more in in the next two weeks, membership numbers for the group stand at 317, and 391 respondents, or 81%, were in favour of the ban. That's 317 members who signed the survey, and we had 74 pharmacists mail in their anonymous consent or response to the survey. Approximately 89 respondents, or 19%, were against. These figures will be further updated by Nghia Truong when he speaks to your committee in Ottawa. I welcome your questions and comments.

Mr Jim Wilson: Thank you for your presentation. I'm a little disturbed by some of the attacks in it. I guess I'd have to say, with respect to my party's position against the ban, that clearly not all pharmacists agree with you. In fact, my survey result has a few more replies than yours to date, and 70% of those pharmacists felt that the NDP government should not be able to ban the sale of tobacco products.

The other thing I took exception to was on page 4 and throughout the presentation. It seems to me that if anyone disagrees with you, you simply discredit them. You discredit the only study that's by a firm that does a lot of the government studies that we actually have had presented to this Legislature.

I'd say to you, with respect, that our job is to represent perhaps both sides of the issue in the Legislature. The government clearly spelled out its side in the act and there are a lot of pharmacists who are professionals out there who are ethical people, who raise families, who do good things for the community and who disagree with your position. We're bringing that forward because I think people are tired of government and us going home on weekends and lecturing our constituents about what's good for them. They've kept throwing them out over the last decade and I suspect they'll throw this government out over this lecturing about what's good for them. I think people are prepared to take responsibility for their actions.

Mr Winninger: Question.

The Chair: Order.

Mr Jim Wilson: If society's wrong, it'll figure out it's wrong and ask its politicians to change eventually.

I want to ask you, though, given that the ban is in the legislation, do you have any evidence to present to this committee that it will reduce consumption? That's the goal of the legislation and we've not seen anything to suggest that the ban will do anything to promote the goal. We've heard it will do a number of other things, but we haven't heard anything concrete that it will actually promote the goal of the legislation.

Mr Semchism: Obviously, if I had a study that showed that was the case, I would certainly bring it to the committee. I don't have a study.

In reaction to your remarks about me being critical of the Coopers and Lybrand study, I think the 300 or 400 pharmacies that have thrown tobacco out of their stores and survived speak a lot louder, and that was our group's position, that they didn't meet economic demise and some of them had big sales in tobacco. That's why I'm critical in my presentation today.

I recognize that many pharmacists want to sell tobacco products. It's been a divisive issue within our profession. You heard from people who were in opposition to me today and you heard from people who supported our position. We don't debate that. Today, I spoke personally. I just told you what I felt based on my experience of being a pharmacist.

As far as the difference in our surveys is concerned, I guess it's almost predictable. I received your letter and your card and I mailed it in, but I would think that probably the majority of people receiving your card, based on the text of your letter that went with it, who would reply to your survey would be against the government ban, just like, as I expected, the majority of people who would take the time to reply to the Pharmacists in Support of Bill 119, and the majority of those people replied in favour of the government.

There have been other studies. Perhaps the only ones we can trust are ones that are done by groups that don't have a vested interest. Maybe those kind of surveys are being done right now. I don't know.

Mr Jim Wilson: Just for the record, I wouldn't call either my survey or yours a study.

Mr Semchism: No.

Mr Jim Wilson: It was simply a public opinion survey, not scientific whatsoever, and I agree with your comments. I was surprised so many people sent it back.

The Chair: I regret that we're over our time. Thank you for coming and for the presentation.

1620

CENTRE FOR HEALTH PROMOTION

Ms Josie d'Avernas: My name is Josie d'Avernas. I'm a partner with RBJ Health Management Associates. I've been involved in research in the tobacco issue for 15 years, first as a university-based research associate and more recently as a private consultant based in Kitchener. I've taught smoking prevention programs to grade 6 kids in Oxford and Waterloo counties. I've been involved in focus group interviews with young people around tobacco use. Most recently, I've done some work with the University of Toronto on plain cigarette packaging and the response of young people to plain packaging.

I also have two sons approaching the average age at which young people start to smoke; one is 13 and one is 11. I care about the impact of this legislation on youth and I will focus my comments on young people.

I'm here on behalf of the Centre for Health Promotion, University of Toronto. I'm here primarily to discuss plain cigarette packaging and to urge the government to include, under section 5 in Bill 119, regulations to require that in Ontario cigarettes be placed in plain packages. I will give some highlights of the research that we have conducted to support the proposal that cigarettes be put in plain packs.

First I would like to say that the Centre for Health Promotion supports all the components of the Ontario tobacco act. The combination of legislative components put forward offers a comprehensive and complementary mix of policies that will mutually support each other.

The Ontario government is to be congratulated for bringing this legislation forward and bringing it to third reading. It has the potential to be a very powerful piece of legislation and I think it's commensurate with the magnitude of the tobacco problem in Ontario. Of course, any legislation is only as effective as the regulations that go along with it and enforcement. I'll come back to that in a minute.

In order to truly reduce tobacco use in Ontario, it's essential that children be prevented from ever starting to smoke. The vast majority of onset occurs before the age of 20, 90% by some reports. If we can stop kids from starting to smoke before they are legally able to purchase tobacco, we can go a long way towards promoting a generation of non-smokers. On average, young people first try smoking at age 13 and start smoking on a daily basis by age 15.

A strong Bill 119 I think is especially important in the face of likely tax reductions in cigarettes proposed by the federal government. I am strongly opposed to those tax reductions. I applaud the Rae government for its resistance in supporting those tax reductions because it's our young people who will be the most negatively affected by these price reductions.

Studies on price elasticity of tobacco show that young people are more responsive to tobacco price than are adults. Studies in the United States and Canada show that for adults the average price elasticity was minus 0.4%. That means that a 10% increase in price will decrease consumption by 4% in the aggregate. For children, the price elasticity is minus 1.4%, a 10% increase in price leading to a 14% decrease in consumption.

All of these studies have been done on price increases, not on price decreases. Now we're in a unique position of price decreases, but I think it's safe to assume that some of the elasticity effects will be similar. That means that a 10% decrease in price can lead to a 14% increase in consumption, all other things remaining equal. If that's true, a cost decrease will quickly undo the significant gains and advances that we've made in recent years.

In the light of that, it makes Bill 119 even more important in terms of two things: making tobacco less appealing to young people and making it less available to young people. Bill 119 has the potential to accomplish both if there are appropriate and strong regulations supporting the bill. I will focus my comments on plain packaging as a way to make it less appealing, but I will touch a little bit on the issue of reducing availability of tobacco to youth as well.

My comments on plain packaging or reducing the appeal of tobacco come from the study recently released from the Centre for Health Promotion at the University of Toronto. Research is under way investigating the effects of plain packaging in a three-study series. Studies 1 and 2 are complete. They've been funded by the Canadian Cancer Society. Study 3 is in progress and it is being funded by the Robert Wood Johnson Foundation in the United States. The research is headed by an advisory committee of researchers from the newly formed Ontario tobacco research unit, University of Toronto, York University and Ryerson Polytechnic University. My company was involved in a staff capacity to this committee. I was responsible for drafting the design of the study, implementing the protocol, data collection analysis and report writing.

The first study was interviews with tobacco control researchers and marketing experts to collect expert opinion about the role of advertising and promotion and package design in product use generally, and as it relates specifically to tobacco. This study concluded that youth are more image-driven than adults and that young people begin to smoke specifically to project a certain image. Where do these images come from? They come at least in part from the marketing strategies used by the tobacco industry to project smokers as independent, fun-loving, attractive and rich people.

Tobacco companies can't advertise their products directly, but they indirectly advertise through sponsorship of sporting and cultural events. That's their answer to promoting cigarettes in the face of a ban on direct advertising. You've probably all seen the du Maurier tennis and golf tournaments, the Matinée Fashion Foundation, Players car racing. All those are sponsored events by tobacco companies.

These ads in effect advertise cigarettes, although cigarettes are not shown or mentioned on them. The connection comes from the use of names, colours and fonts that are very similar to those used on the cigarette packages for that particular brand. If we were to put cigarettes in plain packages, the experts interviewed in our study 1 suggested that the connection between the cigarette and the sponsorship events will be lost.

In addition, plain packaging is unappealing in its own right. In the second study in this series, we showed young kids aged 12 to 17, 129 of them, packages of cigarettes. We showed them a regular package, bought off the shelf, of du Maurier cigarettes or Players or Craven A, and we showed them the same product put in a plain package where it's a buff-colour package with standard font used. The brand name still appears, the health warning still appears, but there's no colour, no unique font, no logos used on the package. These interviews were done in Peterborough, Barrie and Toronto.

We asked the kids to look at a list of words that would describe a person who would purchase a package like this and a person who would purchase a package like this. There was an equal number of positive and negative descriptors on this list. In addition, kids were allowed to add their own descriptors.

The words used to describe the user of the brand packages were invariably positive: "smart," "cool," "with it," "athletic," "buys the best," "fun," "popular," "always has the latest thing." Those were our words. We also allowed people to add their own words. They included "preppy," "rocker," "outgoing," "partier," "regular person," "well respected," "fun to be with," "cares about appearances."

We asked them to use the same list of words and describe a user of a plain package of cigarettes. The words that came out here were quite negative, things like "wimpy," "gross," "boring," "a goody-goody," which is a very bad thing, "buys the cheapest," "geeky," "will try anything." Those were our words. The words the kids added were "loser," "dirty," "old," "out of it," "a '50s type person" -- I don't see anything wrong with that -- "nerd"; even "fat" came out as a descriptor, and "stupid," "no life," "desperate," "strange," "uninteresting." Very strong differences in the perceptions of users of these two different packages, and we were very clear in saying: "It's the same product inside the two packages. We're only interested in the package."

We also asked them to give us their direct reactions to the plain packages. All of the groups strongly disliked them. They saw the buff colour as even worse than white because buff says old or antique and white has a bit of a crisper look to it. They preferred the white to the buff, although we didn't show them packages in white. We only had this one version of the plain pack.

People also reported that it makes the product look more serious and that it increases the prominence of the health warning on the package. On the other hand, the brand packages were reported to make cigarettes and smoking look like fun.

We also put the two beside various different brands of cigarettes, in plain and brand packs, and asked them to indicate which they would least like to be seen with. Between 80% and 97% said they wouldn't want to be seen with this one; they'd prefer to be seen with this one.

1630

These were focus groups of six to 10 kids that we did, 20 focus groups, 129 people in total. The results were very consistent across groups. Some of the kids were younger groups, 12- to 14-year-olds, and some of the kids were older groups, 16- and 17-year-olds: the same results. Smokers and non-smokers, same results; males, females, same results.

Our main conclusion from this research was that current packaging of tobacco reinforces the positive images of smoking by linking smoking to images of independence, fun and attractiveness, and those kinds of images are projected through promotional strategies. The package is a key link that allows these marketing strategies to succeed. If it was plain, if it did not include colours and fonts, the connection to this event-advertising that tobacco companies are using to promote their product would not be made.

Youth are also more influenced by these marketing tactics than adults because they're more image-driven. Also, youth are more likely to be in transitional stages of smoking, in other words, thinking about starting or experimenting, whereas adults are either confirmed smokers or confirmed non-smokers. Our research showed, particularly through the expert interviews, that this kind of packaging is likely to have a bigger impact on young people than it will on adults for those reasons.

Accordingly, to reduce the appeal of smoking to youth, we recommend that regulations under section 5 of Bill 119 require that tobacco be packaged in plain packages with black printing, standard fonts and no use of colour. We also recommend that Bill 119 tighten controls on tobacco company sponsorship of sporting and cultural events -- that's the other half of the equation -- by banning the practice of using look-alike names, colours and fonts in advertising for these events.

Just a word on making tobacco less available. That was the appeal side. We can do something about making it less appealing for young people by changing the package. Cost is one of the factors making it available or unavailable to young people, but there are other controls as well as cost to make it less available to young people; specifically, effective controls on selling of tobacco to minors.

In the same study that I've been speaking of, over two thirds of the smokers we interviewed bought their own cigarettes, the most common location being a convenience store. Although retailers are breaking the law when they sell cigarettes to anyone under the age of 18, none of the people we interviewed had any trouble buying their own cigarettes.

We support Bill 119 in its proposition to increase the legal age of purchase to 19. We support banning all tobacco sales from vending machines. We support requiring proof of age to purchase cigarettes. We also urge you in Bill 119 to require licensing of retail outlets with enforcement and revocation of licence for selling to minors. We also encourage you to set a minimum package size of 20 cigarettes. Kiddie packs of 15 and even 5-packs have recently come on the market, and that makes smoking more affordable to our young people. This practice needs to be stopped.

The Chair: Thank you for bringing the results of your study to us. We'll have time for a few questions.

Mrs Haslam: I'd like to congratulate you because you're one of the few who have come to see this as an overall Ontario tobacco strategy and to see the piece of legislation as fitting into that overall strategy. I think people coming before us forget that it's a piece in an overall strategy. I also am pleased to see that you are of the opinion that it's only going to be as effective as its regulations and enforcement, because I fully agree with that. It's the enforcement that will make or break the success of any piece of legislation.

Regarding those points on page 1, and that's where I'd like to go to now, when you're looking at packaging, you know that we're going to have to be working with the federal government in an overall national strategy. I'll ask my questions in one fell swoop and maybe give you some time.

The Chair: The Chair favours fell swoops.

Mrs Haslam: The Chair favours fell swoops. Good. I'm so pleased.

Number one in my fell swoop is what role Ontario should play with the federal government in a national strategy for packaging.

The second thing is to look at tightening controls on the advertising of tobacco companies supporting -- that would come under regulations. It could prove difficult and I'm open to hearing some suggestions. Coming from a ministry of culture, I know that in reduced times of money availability to theatres and to artistic groups, they welcome that support. Would that support still be there if they couldn't do some of the font work, or do you think the support should still be there, and what would you recommend in how that support could be there and how you would take out some of the font work?

On the third point, you're requiring all retailers who sell tobacco to be licensed. Do you agree with the present model in the proposed legislation whereby we look at it under a ticketing process?

The last thing I wanted to ask is on study 3. When will the findings be in for that last study?

Ms d'Avernas: I'll try to address your questions to the best of my ability, the four or five that you've asked.

The role that Ontario should play in the national strategy: I think tobacco is a provincial issue as well as a federal or a national issue. Clearly, there has to be collaboration between the different levels of government, but I would hope that Ontario can provide some leadership in tobacco control. I don't think we're going to see it from the federal government, given what I've been reading in the papers over the last few weeks. I think Ontario can play a leadership role in tobacco control.

If we can maintain a strong Bill 119 and if we can demonstrate some effect of Bill 119 in combination with the comprehensive tobacco strategy under way in Ontario, the other provinces and the federal government will have to look at what's happening in Ontario. I hope that we will give the federal government and other provinces an opportunity to look at Ontario as a model for things they may do in the future.

In terms of tightening controls on sponsorship, will removing fonts and colours cause tobacco companies to withdraw from sponsorship? I don't feel that I can answer that question. I'm sorry.

Mrs Haslam: Would you still recommend it?

Ms d'Avernas: I would still recommend it even if funding was withdrawn. Yes, absolutely. I think that is one of the key links to the ability of tobacco companies to advertise at this time.

Number three, licensing: Do we support a ticketing system proposed in the bill? I would prefer a system where retail outlets are required to have a licence to sell tobacco and that licence can be taken away if they are caught selling to a minor so that the disincentive for them to do so is loss of revenue from being able to sell tobacco.

The findings from study 3: We just heard about funding for the study last week. It's beginning. Next week is our first advisory committee meeting, and we anticipate the results will be ready in December.

Mr Jim Wilson: Thank you very much for your presentation. Obviously, you spoke at great length about the need for plain or generic packaging and you gave the committee a description of what that packaging should look like. I think that's needed, because with all the media reports on this legislation, I can't figure out for the world why it got so much attention, this piece of legislation. If it wasn't for the pharmacy thing and perhaps the vending machine aspect, there's nothing new here.

Mr Martin: You wouldn't do it.

Mr Jim Wilson: Well, it's already the law of the land, most of this stuff. All they've done is boost the age by one year.

Mrs Cunningham: Do your research, Tony.

1640

Mr Jim Wilson: We don't know what the regulations are, and I don't know if you were in the room when I asked the government whether they were prepared to move in the packaging section, to tell us what in the world they envision there. They must know or you wouldn't ask for regulatory authority, I would hope.

It's a leading question, but would you agree that unless the government comes forward with its regulatory intentions, this bill doesn't really set us too far down the track of reducing consumption in Ontario? It sounds great. I read in the paper that they were going to ban kiddie packs, but I can't find it in the bill.

Ms d'Avernas: I think the strength of any legislation lies in its regulations and in its enforcement.

Mr Jim Wilson: So your preference would be that the government spell out as much as it can in this legislation so we actually know. If we're going to give it credit for a bill, we need to know more than just that every page says, "We're asking for regulatory authority to do X, Y and Z," but doesn't tell us whether they're actually going to do X, Y and Z, or if they do it, how they're going to do it or what it's going to look like.

Ms d'Avernas: My response to that is that I certainly support the spirit of the bill and I have some confidence that the government will put in regulations that equally support the spirit that's being reflected in the bill.

Mrs Cunningham: Could I just ask a question on the position of licensing? To license a retailer, which has been raised today, where do you see that taking place in the bill? Do you see it as part of the legislation or part of the regulations?

Ms d'Avernas: It's not in the legislation right now, so I guess I was seeing it as part of the regulations.

Mrs Cunningham: It's not in the legislation and we're in the position of making amendments. That's why I'm asking the question. It's got to be legislation, I think.

Ms d'Avernas: I would suggest that it be put right in the legislation in that case.

Mrs Cunningham: That's why we're having public hearings, to make recommendations for change. We don't expect it's going to look like this at the end of public hearings, or what's the purpose of the public hearings? I'm the eternal optimist or I wouldn't be doing this job.

Ms d'Avernas: Yes, I would support licensing.

The Chair: There's a sense of optimism in the hall as we move to the parliamentary assistant for a final thought.

Mr O'Connor: On the area of sponsorship, of course that falls under the federal legislation, Bill C-51. I'm sure you're quite aware of the Tobacco Products Control Act, and as you know, it's tied up in the courts right now. Would you like to comment -- you've been involved in some of this earlier on -- on the Trade-marks Act, which falls under federal legislation. I don't know whether you're a lawyer or not or whether it would help for you to comment on the fact that the Trade-marks Act would also be a problem. It is federal legislation, which is why the packaging has to be dealt with from a federal level.

Ms d'Avernas: I can't respond to that. I'm not a lawyer. I'm a researcher. I can respond to questions in terms of the expected impact of these things. I can't answer on that.

Mr O'Connor: Fair enough. It's federal legislation, and I was just wondering.

The Chair: Thank you again for coming and sharing the results of your research with us.

The Chair: Our final witness today will be the representatives from the Wellington-Dufferin-Guelph Health Unit. We invite them to come forward.

Mr McGuinty: While they're settling themselves here, the parliamentary assistant raises a good issue and I wonder if the researcher might assist us in this regard, to tell us the connection between the federal regulatory authorities and the provincial with respect to packaging and perhaps some of the history associated with it -- I gather there was a court case which said that somebody had gone too far at some level, whether it was the province of Quebec or something -- just so that we have a bit more information regarding that. I'd find that helpful.

The Chair: Perhaps research could have a look at just what's involved in terms of what would be possible to bring to members prior to clause-by-clause.

Mr McGuinty: Yes.

WELLINGTON-DUFFERIN-GUELPH HEALTH UNIT

The Chair: Welcome to the committee. What's the old phrase? Last but not least. We're delighted to see you, delighted that you have come from Wellington-Dufferin-Guelph. If you would just introduce yourselves and then please go ahead.

Dr Douglas Kittle: Since this is lighten up day, I thought maybe you might have a bit of appreciation of my red nose. At 4:30 in the afternoon, I'm sure you're pretty fed up hearing all kinds of discussion on this topic.

Interjections.

Dr Kittle: Great, but since it does wonders for my post-nasal drip, I think I'll remove it at this stage.

My name is Douglas Kittle and I'm the medical officer of health for the health unit, Wellington-Dufferin and the city of Guelph. On my right is Helen Kelly who is the program manager for the tobacco prevention program that we offer at that health unit. I'm sure, since I saw on the agenda that a number of other medical officers have already spoken to you today, that you have an appreciation of the work that we're in the business of carrying out.

I've been in Wellington-Dufferin for about two and a half years. Prior to that, I was the medical officer in Haldimand-Norfolk, which you are also probably well aware is one of Ontario's principal tobacco-growing areas. I don't know if anyone from the flue-cured tobacco association has spoken to you. I didn't see it on the agenda, but I anticipated that they would have done a presentation today as well.

Mrs Haslam: They do it in other ways.

Dr Kittle: They're doing it in other ways, okay.

I would like to congratulate the NDP government, the two opposition parties, and in our situation, Mr Ted Arnott from north Wellington and David Tilson from Dufferin-Peel, both opposition MPPs, as well as Derek Fletcher -- we've been in touch with all three of them and they're all soundly supporting this bill as it's coming forward -- plus the Health minister, Ruth Grier, for tabling this most important piece of public health legislation. In fact, I would say that after legislation on pasteurization of milk back in the 1930s, this probably is the second most significant piece of legislation for public health since that time.

In the words of Dr Schabas, and I'm sure you've heard many of his words this afternoon: "Tobacco accounts for an enormous burden of illness and disability.... Tobacco-related diseases are the province's number one public health problem."

I am pleased to see many of the provisions in Bill 119 which directly affect young people's ability to gain access to tobacco products, and these include the introduction of controls on the availability of tobacco, including vending machines and pharmacies; raising of the legal age for buying tobacco to the legal drinking age, which is 19, as you all know; the banning of cigarette sales by licensed health care professionals, pharmacies and other health care institutional settings; opening the door for plain packaging, thereby eliminating the advertising vehicles of the tobacco industry, and that was well put forward to you by the previous speaker; increasing penalties for violations; and eliminating environmental tobacco smoke in many places.

I am delighted to see the inclusion of pharmacies as a place where tobacco does not belong. We are responsible in Wellington-Dufferin for the carrying out of this tobacco prevention program. In Wellington county, we now have 43% of our pharmacies which do not sell tobacco products; in Dufferin county, 58% are in that position.

During national non-smoking week, our Council for a Tobacco-Free Wellington-Dufferin presented awards to all the pharmacies which did not sell tobacco products. Many interesting comments came from pharmacists who either had never sold tobacco products or had stopped selling tobacco.

Bob Baxter of the city of Guelph's Kortright Pharmacy said, "First and foremost, I'm in the health profession and I don't find it good practice to promote sickness as opposed to health."

Don Sproule of Sproule's IDA Drug Store in Orangeville spoke about his tobacco-free move and had these words to say:

"I received recognition from my peers and other organizations.... I also received positive responses from my customers. However, I did not see as often many of my die-hard cigarette smokers who were going to quit when I stopped selling.... Positively, I gained many new customers in the store.... I have a small pharmacy and by not selling smokes, I have freed up many linear feet of shelf space on which I can display and sell other products, almost all of which have higher margins. For example, my profit on a carton of cigarettes which sold for about $45 was about a 5% markup. Also, I was able to divert several thousands of dollars to more profitable items.

"After I stopped selling tobacco the insurance company added on a premium for any store selling tobacco, and also a cap on the amount of loss they would pay for tobacco loss. I think this was about $10,000. As we all know, making an insurance claim is very time-consuming, and one has to wait many months for their money. It has been almost two years since my store became tobacco-free. I know I made a correct decision. Everyone knows of the new legislation banning tobacco sales in drug stores. I feel tobacco should be banned from all retail stores."

When we actually asked him about follow-up on that, he was in favour of the licensing of retail stores.

1650

I believe that the debate over tobacco in pharmacies is really a conflict between the practice of pharmacy and the marketing interests of large corporations, which have little interest in health or in the wellbeing of the pharmacy profession.

I have difficulty comprehending that a pharmacist would knowingly sell a product which kills when used exactly as intended and dispense medication over the counter to help the individual quit smoking. We must ask, is this ethical? What is the message this sends to our youth? The message it sends is clearly unethical, and it says that money is the most important issue, not ethics and health.

I am concerned that the term "pharmacy" is not clearly defined in Bill 119, which will lead to some problems. In addition, "retail establishment" is also not clearly defined. I would recommend that the definition of pharmacy read as follows:

"Premises in or in part of which prescriptions are compounded and dispensed for the public or drugs are sold by retail, as well as all contiguous retail space, whether under common ownership or otherwise, within the premises and whether used for the sale of health care products or otherwise."

Omissions, and these are omissions which I would like the panel to consider if you are looking at changes to the current legislation: Although we have congratulated the government for its introduction of Bill 119, there are several omissions that need to be included in any comprehensive tobacco control legislation. These include the following. Now, I did put the first one on there, but chewing tobacco is mentioned in the bill, so I'll skip that and go to the next one.

There is no ban on the so-called "kiddie packs"; that is, packages of cigarettes containing fewer than 20 cigarettes, although it appears that a decision to ban kiddie packs could be made under the packaging regulations.

Here's a kiddie pack which I happened to pick up behind the Centre Wellington District High School in Fergus just on Saturday -- it's an empty package -- when I was walking the dog. For any of you who haven't seen it, I suggest that you pass it around and maybe when it gets to the end, it could be put in the ashtrays outside, because I have no further use for it.

There is no ban on the advertising and promotion of tobacco products. This is where plain packaging plays a very important role, and this could be done under the packaging regulation.

Public space restrictions on smoking do not go far enough to ensure that the public is protected from the effects of environmental tobacco smoke.

There is no attempt to improve the Ontario government's largely ineffective workplace smoking legislation. This is a glaring deficiency and one that the government has not indicated it will address.

There is no regulation in the bill regarding the storage of tobacco products at retail sites in order that they are inaccessible to the public until the time of sale. Countertop displays are an incentive both to purchase and to shoplift.

In conclusion, our tobacco prevention team, the Council for a Tobacco-Free Wellington-Dufferin, and I believe that the inclusion of these measures and the enactment of a strong Bill 119 will set a world precedent and send a strong, clear message to everyone that tobacco is a hazardous, addictive substance and that the government of Ontario does not want the youth of this province to be victims to tobacco.

A strong Bill 119 will strengthen the credibility of the Ontario government, as it will further its promised commitment to preventive health care. Legislation like Bill 119 goes hand in hand with education and strengthens the message of all health agencies.

As a health agency which is predominantly in the business of giving out messages, we cannot do this alone. We need the assistance of this legislation and legislation like this. This is important from all angles. Municipal governments are telling us that they will not adopt a smoking bylaw because the federal and provincial governments are not doing their part. A strong Bill 119 will change this.

Our tobacco prevention team has been to the communities of Mount Forest, for example, and to the Fergus town council, where we have attempted to bring forward smoking prevention bylaws for the towns, and they have not had them previously. In both those places we were turned down, and we were turned down primarily because the politicians at the town councils and at the municipal level said: "What's the province doing? What are the feds doing? This is out of our jurisdiction." We recognize that these local bylaws are not out of their jurisdiction, but they're watching you very closely and looking for leadership.

Your support of this very important piece of public health legislation will send a clear sign to our young people and will greatly increase the chances for young Ontarians to be smoke-free.

Mrs O'Neill: I'm looking at page 4. It certainly is a page that contains an awful lot of information. I think it's important that as the last presenter of the day, you have very specifically pointed out a lot of weaknesses in the bill. I think in many ways the bill is not what some people think it is and I'm very happy that you were as concise as you were in pointing out the weaknesses. I hope some of these will be considered deeply in the regulations.

I wanted to ask you, just so I would be sure I understand, about the definition you've chosen for "pharmacy." That includes all of the chains and it would include Wal-Mart and A&P and K mart, those kinds of setups.

Dr Kittle: And Zehrs and Loblaws.

Mrs O'Neill: I just wanted to be sure of that. I might say to you that two or three municipalities, mine being one of them, have been mentioned in the course of the hearings as municipalities that have taken a very strong stand.

This is a municipal election year. I really think, particularly with Bill 119, which I think needs to be strengthened -- I don't think the bill's a strong bill, I really don't; I think it needs to be strengthened if it's going to achieve it's objectives -- it's time to put this on the political agenda and it's time to put it on the municipal election agenda, because you're right that there is leadership that is needed within the municipalities to accompany this bill. This bill is not going to achieve everything, and particularly the workplace and the secondhand smoke issues are being left totally as sidelines. We know how ineffectual those pieces of legislation are at the present time.

The Chair: Do you wish to comment, sir?

Dr Kittle: No, I agree with Ms O'Neill.

Mrs Cunningham: Thank you very much Dr Kittle and Ms Kelly. You're right, some of your colleagues have been here today.

Dr Kittle: Did they wear a red nose?

Mrs Cunningham: No, they didn't, but they had a good sense of humour just like yourself. I suppose that's important to your job from time to time.

Dr Heimann from the Windsor-Essex County Health Unit -- I'm not sure whether you've met each other.

Dr Kittle: I know him, yes.

Mrs Cunningham: I would ask you to get a copy of his brief, and I'm certainly going to be referring yours to him. Maybe we'll take care of that ourselves.

He went a step further with regard to the plain packaging and the availability. He said that retailers should be licensed to sell so that there would be some responsibility on them to certainly get identification from young people who are purchasing cigarettes as to their age etc.

He also said that the responsibility should be on youth, that if in fact they're not to sell products to young people under the age of 19, then there should be some sanction on young people who purchase them, such as a fine or whatever. He did really take a very strong stand. I think in his area of the province, they're quite fed up with the lack of response from their municipalities and others with regard to what you refer to as a need for some legislation in the province with regard to workplace smoking, secondhand smoke and whatnot.

I just wondered what you felt about licensing retailers, meaning that they have to have a license, and that there be certain restrictions and sanctions if they don't follow the law, and also with regard to the young people. How do you think your community would respond to that?

Dr Kittle: It's difficult to say how the community would respond, because I truly can't speak for the community. But I can say that I would agree with Allen, as it's interpreted through you, that we're dealing here with a deadly product and licensing for the retailer would be appropriate as it is for alcohol at the present time. If you're caught with a six-pack and you're under the page of 19, there are repercussions, because you are expected to have the responsibility for owning up to the fact that you're holding it. The same could apply for cigarettes as well.

Mrs Cunningham: I suppose it's up to us then, since we're not seeing either of these examples of strength in the legislation.

Dr Kittle: It could be added to it.

Mrs Cunningham: We'll have to make some amendments to it during that part on behalf of some of the presenters. We've already asked the government if it would come forward with its intended regulations. If we haven't, I'm certainly asking it now, because this is my first day on the committee. It's easy to pass the buck to the federal government or to the provincial government on behalf of all levels of government, but I think we have a responsibility to show the lead here in Ontario.

Dr Kittle: I agree wholeheartedly and I'm very pleased to see that we're taking a good, giant step towards that lead. Let's not lose the momentum.

Mrs Cunningham: I'll pass your accolades on to Mr Tilson and Mr Arnott.

The Chair: We want to thank both of you and the red nose for coming before the committee. It was a good way to end the day's hearings.

Dr Kittle: Thank you, Mr Beer, and thank you for listening.

The Chair: Members of the committee, for those who are returning to Toronto on the bus, it awaits you. May I, on your behalf, thank everyone here at the hotel in London for making our stay a very enjoyable one. Perhaps Mrs Cunningham and Mr Winninger would pass that on within their constituency.

The committee stands adjourned until 10 o'clock tomorrow morning at Queen's Park.

The committee adjourned at 1703.