Canada’s latest anti-smoking push is a first — but global effort is lagging behind

As Canada takes a novel approach to reducing cigarette smoking, some experts are concerned that the rest of the world still has a long way to go to catch up.

“If we don’t do something more globally, we’re going to have many hundreds of millions of deaths on our hands from this epidemic, as the World Health Organization calls it,” said Jeff Drope, a research professor at the University of Illinois Chicago.

Earlier this week, a fresh set of smoking label regulations came into effect from Health Canada. These regulations will require warning labels on individual cigarettes, not just cigarette packs.

The warnings will be written in English and French, on the paper around the filter. They range from warnings about harming children to causing impotence and cancer.

“We want to have these messages have as much reach as possible to be a constant reminder — and these warnings are going to be ones that you simply cannot ignore,” said Rob Cunningham, a senior policy analyst for the Canadian Cancer Society. 

Manufacturers have until the end of July 2024 to ensure the warnings are printed on all king-size cigarettes sold. Those requirements will extend to regular-size cigarettes, and little cigars with tipping paper and tubes, in April 2025.

The move, which was announced earlier this year, makes Canada the first country in the world to take that step.

“It’s a great way to reach smokers every day with every cigarette, with every puff during every smoke break in every community across the country,” Cunningham told The Current guest host Catherine Cullen. 

Cunningham said it’s too early to quantify just how effective the approach will be, but the statistics show Canada may be heading in the right direction. According to research from the University of Waterloo, 10 per cent of Canadians over 15 smoked cigarettes in 2020, down from nearly 24 per cent in 2000.

But while there’s been significant progress made in Canada, Drope said there’s still a lot more work to do to curb smoking globally.

“We have nearly a billion smokers in the world, and then several hundred million more people that use other tobacco products,” he told Cullen.

Looking at the trends

Drope is the lead author of the Tobacco Atlas, an annual report that looks at the state of smoking around the world.

He said that, on the one hand, global smoking trends are “excellent.”

“We have very clear downward trends over the last 15 years,” he said. According to the Tobacco Atlas, the number of smokers globally declined by 22.7 per cent in 2007 to just under 20 per cent in 2019. “That’s actually great, great progress,” Drope said. 

But on the other hand, there are regions like the eastern Mediterranean and parts of Africa, where smoking is becoming more common.

In his work with Tobacco Atlas, Drope has tried to get governments in low- and middle-income countries to adopt anti-smoking policies. But he says part of the challenge is just getting officials to listen.

“I think in a lot of countries, there are a lot of challenges coming at governments at the same time — and I get that and I’m actually very empathetic to it,” he said. 

“On the other hand, this one’s a no-brainer. There really is no question here that this is preventable death and disease and economic cost, and these are things that really with a very, very clear menu of policies that can be implemented, they can reverse this trend quite readily.”

Powerful tobacco companies

Another challenge is dealing with tobacco companies. Drope said tobacco industries have led effective marketing efforts which have particularly hit young populations in developing countries.

Drope said companies have used social media to advertise “very effectively,” to the point that some children below a smoking age can identify tobacco brands quite readily.

In a statement to The Current, the Canadian affiliate of Philip Morris International — Rothmans, Benson & Hedges (RBH) — said in part the company is “unwavering” in its commitment to preventing youth from using any products containing nicotine.

“We can protect youth while still finding a way to help existing smokers, such as improving access to information about smoke-free products; both are achievable,” the statement continued. 

“No nicotine containing product — whether cigarettes or smoke-free alternatives — should ever be in the hands of youth or non-nicotine users.”

A smoke-free world?

Canada is not the only country making strides to combat smoking prevalence. New Zealand’s current government has set a goal of becoming smoke-free by 2025 — and to do that, it wants to ban the sale of cigarettes to anyone born after Jan 1, 2009.

“What we’d rather do is create a cohort of young people who never have the opportunity to purchase tobacco and so essentially grow it out of the population over time,” said Chris Bullen, a professor of Public Health at the University of Auckland. 

But following New Zealand Prime Minister Jacinda Arden’s resignation earlier this year, Bullen is concerned about the determination of a potentially new government to fulfill the goal.

“We have the likelihood of a change of government at the end of this year,” he said. “I’m nervous that the incoming government might take a softer stance and not drive things as hard as our current government under our present minister.”

What he isn’t concerned about is the potential of a black market of cigarettes, which he said already exists but is “relatively small and it’s relatively easy to manage.”

“We’re surrounded by over a thousand kilometres of water from the nearest country,” he said. “So we’re dealing with postal smuggling, we’re dealing with container loads of other products concealing tobacco products. But the gains for the people involved are not that great at the moment.”

Though some countries like New Zealand are trying to go completely smoke-free, Drope doesn’t see a global smoke-free community emerging “anytime soon, unfortunately.”

“I do see a world where we see more rapid trend downward than we’ve been seeing over the last 15 years — and I think, really, the best way to tackle that is through higher taxes,” he said.

“People are responsive to price. So if we could raise taxes measurably high around the world, we would see that huge decline that we would like to see.”