Canada’s patchwork of government policies and programs addressing tobacco cessation should align in order to reduce the number of Canadians who smoke and lead them towards less harmful approaches to nicotine use.
Tobacco use is the leading preventable cause of premature disease and death in Canada. More than 47,000 Canadians die each year and the costs to the Canadian economy total $12 billion (B) annually. Still, 12.9% of Canadians — or 4.2 million (M) — still smoked in 2020.
With the goal to reduce the number of people who use tobacco in Canada to less than five per cent by 2035, Health Canada launched the Tobacco Control Strategy in 2018.
Source: Health Canada
In a 2019 study, more than half of Canadians who smoked tobacco daily had not attempted to quit over the previous 12 months, while 20 per cent had attempted to quit at least 2-3 times. Tobacco use costs Canadians billions annually. In 2017, costs attributed to tobacco use totaled $12.3 B.
Costs attributable to tobacco use, 2015-17
The strategy to wean Canadians off smoking
Canada’s Tobacco Control Strategy is a $330 M (over five years) commitment to reduce the harms of nicotine addition and protect Canadians from the dangers of tobacco use. The strategy takes a cessation and harm reduction approach – helping those who can’t or won’t quit using nicotine to identify less harmful options, such as vaping or nicotine replacement therapy. Below are the strategy’s four pillars.
Source: Health Canada
Global Advantage Consulting Group was tasked by Health Canada to develop “Canada’s Tobacco Cessation Ecosystem Map” which identified and pinpointed the cessation programs that exist across the country and their relative impact in the ecosystem.
Governments assist with funding, providing services and generating knowledge
GACG found that in tobacco cessation, the federal government is responsible for tobacco control policy development, knowledge generation and project funding. Two departments – Health Canada and Public Health Agency of Canada – are the regulators and policy makers in tobacco cessation. In total, there are 13 tobacco cessation programs and initiatives across federal departments.
However, relatively little investment in the Tri-Agencies is being directed towards research related to tobacco cessation. The Tri-Agencies awarded $1.54 M to 16 tobacco cessation projects in 2019-20. Canadian Institutes of Health Research was responsible for the majority of this investment.
Provincial/Territorial (P/T) governments take on a service provider role. GACG identified 24 cessation programs across 14 P/T departments. P/T governments provide quitline services and drug benefit programs. P/T governments also enact legislation to regulate tobacco. Regulations take the form of setting minimum purchase ages, designated smoking areas, minimum sale prices, and restricting the displays of tobacco products in retail settings.
Regional Health Authorities are primarily providers of services, for example, counselling, free nicotine replacement therapy, cessation medication and cancer treatment. Municipal governments, on the other hand, mobilize resources, such as online educational tools for quitting smoking.
Achieving targets for harm reduction
To help achieve the Tobacco Control Strategy target, there are opportunities for government departments to align their strategies to monitor and regulate new and emerging products, explore best practices and fix the policy patchwork.