uestion… What are Canadians smoking?

1. Q uestion… What are Canadians smoking?

2. Over the last hundred years some things haven’t changed much…

3. And some things have…

4. How can awareness of the trends benefit you in your business?

5. Get paid faster!

6. Cigars • Composed primarily of a single type of tobacco with a tobacco wrapper. • Usually smoke is not inhaled.

7. Cigars • Size matters: • Little cigars • Same size and shape as cigarettes (often sold in packs of 20). • Contain about 1 gram of tobacco (about the same as a cigarette). • May have a filter since smoke is often inhaled.  • Cigarillos • A little bigger than little cigars and cigarettes. • Contain about 3 grams of tobacco. • Does not have a filter. • Large cigars • 7+ inches in length. • Contain between 5 and 20 grams of tobacco. • Does not have a filter.

8. Cigars • How many Canadians are smoking cigars? • Overall population (ages 15+) - 4% • Ages 15 – 19 – 6% • Ages 20 – 24 – 9% • Teenagers prefer little cigars which are often flavoured.

9. Cigars • More harmful than cigarettes? • Higher levels of cancer-causing substances. • More tar. • Higher level of toxins. • The larger the size, the longer the smoking time, the higher the exposure to the toxic substances. • What if you don’t inhale? • Most cigar smokers don’t inhale. • Lower rates of lung cancer, coronary heart disease and lung disease than smokers but still higher rates than non-smokers. • Similar oral and esophageal cancer risks for cigar and cigarette smokers.

10. NRT (nicotine replacement therapy) • Most common forms of nicotine replacement therapy are patches and gum. No prescription required. • Works by giving the user some of the nicotine they would get from cigarettes. • Helps smokers quit by easing the nicotine withdrawal symptoms. • Initial dose is based on the number of cigarettes smoked each day. • Dose is slowly lowered as body adjust to being smoke-free.

11. NRT (nicotine replacement therapy) • NRT patches slowly release nicotine into the bloodstream. • NRT gum gives the user an immediate hit of nicotine. • Both are considered nicotine products. • NRT users = Smoker.

12. Hookahs • Hookah (or waterpipes) originated in the Middle East and India in the 16th century. • Waterpipes burn charcoal to heat tobacco or herbs, producing smoke. The pipe bubbles the smoke through water to cool it before it is inhaled.

13. Hookahs • In Ontario in 2012, more grade 7 – 12 students smoked hookahs than cigarettes (close to 10% versus 8.5%) • Increasing in popularity as a social activity among young people. • Doesn’t currently fall under Smoke-Free legislation. • Hookah bars.

14. Hookahs • Potentially more dangerous than cigarettes. • The charcoal used to heat the herbs or tobacco emits high levels of carbon monoxide, metals and cancer causing chemicals. • Users take an average of 200 puffs during a typical 1-hour hookah session, equivalent to smoking 10 cigarettes. • Exposure to second-hand smoke is a danger.

15. E-cigarettes • Introduced in US in 2007. • Looks like a cigarette but doesn’t contain tobacco. • Heats up liquid nicotine which turns into vapor that is inhaled. • Can also heat up propylene glycol liquid – “fog” at concerts and can be fused with liquid nicotine or flavourings • Considered by some to be a smoking-cessation tool. • Safe and effective? • Legal or illegal in Canada? Health Canada has refused to approve the sale or imp ort of devices or refills containing nicotine

16. E-cigarettes • E-cigarettes are considered nicotine products. • E-cigarette users = Smoker. • Replicates the activity of smoking. Can increases the risk of returning to smoking cigarettes. • Flavoured – how is this seen by underwriters?

17. Medical-marijuana • Medical-marijuana usage in Canada: • In 2001, there were approximately 100 Canadians authorized to possess marijuana for their own medical use. • By 2014 that number increased to almost 38,000 users. • By 2024, that number is projected to increase to 450,000. • Currently 12 licensed marijuana growers in Canada – the first six growers had a production capacity greater than 30,000 kilograms!

18. Medical-marijuana • “Can you write me a prescription for that?” • Patients must get a doctor to approve their usage and “write a prescription” for the Authorization to Possess marijuana. • Only 7% of all physicians and 14% of family doctors support medical-marijuana. • Health Canada: “Dried marijuana is not an approved drug or medicine in Canada. The GOC does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a physician”.

19. Medical-marijuana • Medical conditions that are claimed to benefit from medical-marijuana include:

20. Medical-marijuana • In the news. • Not an approved drug in Canada. • Home grown VS licensed grower: • Medical-marijuana patients who grew their own as of September 30, 2013 can continue to do so. (approximate cost: $0.50/gram) • New patients must purchase dried marijuana directly from a licensed grower. (cost ranges from $5 to $13.50/gram) • Danger of home grow-ops. • Potential for abuse.

21. Zero Tolerance • Intentional or unintentional non-disclosure of material information (medical, financial or lifestyle) on insurance applications is considered fraud. • The most common area of intentional fraud is the answer to “Are you a smoker?”

22. Zero Tolerance • The result? • The claim will not be paid, even after the contestability period. • Beneficiaries could sue the advisor and the insurance company. • Don’t put your reputation at risk. • Good to know: • Ask your clients when they last smoked or used a nicotine-related product. • Give them examples of what could be considered “smoking”. A client using a nicotine patch but not smoking may believe they are a non-smoker. • If in doubt, or the client insists they are a non-smoker, submit a pre-assessment with full disclosure of their smoking activity. • “Smoking amnesia”. What is it? How to avoid it?

23. Non Disclosure • Recent study of smoking statistics: 12.9% Of applicants denied their “love affair” with tobacco 5.8% Of applicants who are former smokers suffered some form of “smokers amnesia”

24. Cotinine • Underwriters will test for cotinine. • Cotinine is only produced when nicotine is metabolized. • Tested for in a urine sample or saliva sample. • Test reveals tobacco use or exposure to tobacco smoke. • Non-smoker = smoke free for 1 year.

25. Not in Good Order (NIGO) • Full and correct disclosure of health history • All questions answered (and reflexive questions) • Handwriting, signatures complete and readable • Speeds up time to issue with U/W • QUS: Electronic paramedicals

26. Now that you know more……

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30. Q • Questions?