Next steps to reduce use of tobacco
By Dr. Charles Gardner
Normally in public health we do not speculate about the outcome of an imaginary situation. Sometimes, though, it becomes irresistible to consider what might be prevented if certain unhealthy behaviours were eradicated.
Consider for example if there were no such thing as tobacco.
Each year in Simcoe Muskoka about 500 people would continue to live because they were not victims of their addiction to smoking. People would not suffer from tobacco-related mouth, lung or other cancers, heart disease, or chronic obstructive pulmonary disease. On average, life expectancy in Ontario would be three years greater. Those who currently smoke would live on average 10 more years.
However, tobacco’s addictive ingredient, nicotine, is too powerful to dream away. Regulations are necessary to give Ontario residents a fighting chance to win against nicotine’s tug.
For the last 10 years, the Smoke-Free Ontario Act, or SFOA, has introduced supports to help save lives and reduce health care costs.
It began in 2006, with a ban on smoking in enclosed workplaces and public places, reducing the hazard of second-hand smoke. Further damage to our most vulnerable age group was alleviated in 2009 when it became illegal to smoke in vehicles with children under the age of 16. Last year smoking was banned on bar and restaurant patios and at playgrounds and sports fields.
In 2008 a new control on tobacco marketing was achieved with a ban on the “tobacco power wall” displays in stores. Last year the sale of tobacco products was banned on post-secondary campuses. In 2010, the sale of flavoured cigarillos was banned; this year that has been extended to a ban on all flavoured tobacco products, removing a pernicious ploy by the industry to recruit young tobacco addicts.
In 2011 the thorny issue of the tobacco black market was addressed with strengthened controls on the growth and import of raw leaf tobacco.
The smoke-free Ontario strategy is paying off. Local youth smoking rates are now below 10 per cent. Our free quit smoking workshops are well attended by people tired of the burden of tobacco. The Institute for Clinical Evaluative Sciences has shown that between 2004 and 2013, Ontario avoided $4.9 billion in health care costs through a reduction in unhealthy behaviours; the vast majority of that reduction came from people who stopped smoking.
The spirit of the SFOA has spread to the community, with landlords now starting to develop smoke-free policies in their multi-unit dwellings. Health care providers routinely advise their patients to quit tobacco.
I have championed tobacco controls throughout my public health career, knowing that it is one of the top preventable causes of disease and mortality. Celebrating the 10th anniversary of the Smoke-Free Ontario Act is deeply satisfying. Still, there are those tragic 500 deaths every year from smoking. There is still more that can be accomplished by continued regulation, education, and cessation support.
Dr. Gardner is the Simcoe Muskoka Medical Officer of Health.