New Directions in Tobacco Control

1. New Directions in Tobacco Control Presentation to alPHa February 25, 2010

2. Purpose • To outline major components of the New Directions in Tobacco Control • To highlight next steps

3. Tobacco control is a strategic focus for MHP • Tobacco use continues to be a leading cause of preventable disease and death in Ontario. • Over 1.7 million Ontarians still smoke. • Theeconomicimpactof tobaccouse in Ontario isan estimated $6.1 billion. • Tobacco use is highly correlated with other chronic diseases including: heart, pulmonary and respiratory diseases, diabetes and cancer. • Smoking rates remain high among certain populations: • 61% of First Nations girls and 47% of Aboriginal boys age 15 – 17 smoke • Prevalence of tobacco use is higher among young adults than any other age group in Ontario • Prevalence among blue collar workers in Ontario is more than twice that of white-collar workers • The tobacco industry estimates contraband represents approx. 23% -50% of market. Contraband/illegal cigarettes market has an impact on accessibility.

4. New Directions in Tobacco Control:Why a Renewed Strategy? • New Targets: Ontario risks losing ground.Need new targets/plan. • Economic and health benefits: Billions of dollars in direct health care costs and lost productivity, measurable impacts on related conditions (diabetes, asthma, heart disease). • Smoking rates have leveled off: A new approach is needed to achieve further reductions. • Some populations are at increased risk: e.g., Aboriginal, low SES, young males. • Smoking Cessation: Cessation programs reach only 4% of smokers annually, although 600,000 smokers in Ontario plan to quit in next 30 days. Need integrated and sustainable system. • Contraband: The rising use of low-cost illegal tobacco has removed tobacco tax increases from the tobacco control toolkit, fuelling increased tobacco use in the most price-sensitive segments (e.g., youth).

5. New Directions in Tobacco Control Objectives: • Develop a comprehensive 5-year government-wide strategy • Engage stakeholders and partners in its development and implementation A Government-wide strategy will allow Ontario to: • Better coordinate tobacco control interventions. • Develop a more comprehensive/integrated cessation system • Maximize the outcomes of MHP’s current investments and leverage new investments. Better link tobacco control with other government commitments including chronic disease prevention and other relevant government strategies. • Better coordinate messaging and communications.

6. Strategy Development • Reviewing the evidence • Ontario Agency for Health Protection and Promotion has been contracted by MHP to convene Scientific Advisory Committee (SAC) to provide a report on scientific and technical input/evidence to inform new strategy • Report will feature results of consultations led by SAC with tobacco stakeholders • Report will be provided to MHP on March 31 • Ontario Tobacco Research Unit (OTRU) providing statistics and other research support

7. Strategy Development continued… 2. Input from stakeholders/working groups • MHP has established a Tobacco Strategy Advisory Group (TSAG) to provide advice in strategy development. • Will review/discuss changes in tobacco control environment since the original SFO Strategy was initiated, evidence-based findings of the Scientific Advisory Committee, and, where appropriate, the work undertaken by other related working groups or advisory groups • Short-term committee (one year) • Made up of NGOs (eg: Heart and Stroke Foundation of Ontario), health HR organizations (eg: Registered Nurses Association of Ontario, Ontario Medical Association), research organizations (eg: OTRU), TCANs and Health Units (Dr. Robert Kyle and Dr. Hazel Lynn represent COMOH). • Co-Chaired by Jean Lam (MHP) and Dr. George Pasut (Cancer Care Ontario)

8. Strategy Development continued… 3. Involving other Ministries • ADMs’ Inter-Ministerial Committee on Tobacco Control (ICTC): • Members: • Ministry of Health Promotion (Chair) • Ministry of Health and Long-Term Care • Ministry of the Attorney General (Litigation) • Ministries of Revenue, Finance (Contraband strategy, taxation) • Ministry of Agriculture, Food and Rural Affairs (Conversion of tobacco growers) • Ministry of Labour (workplace) • Ministry of Education (youth, prevention) • Ministry of Aboriginal Affairs • Ministry of Government Services (Services available to OPS employees) • Ministry of Municipal Affairs and Housing

9. Strategy Development continued… 4. Development of New Directions in Tobacco Control Strategy • Input from Ontario Agency for Health Protection and Promotion/Scientific Advisory Committee, Ontario Tobacco Research Unit, Tobacco Strategy Advisory Group, ADM’s Inter-ministerial Committee on Tobacco Control and other working groups will inform development of Strategy • Project team policy staff reviewing tobacco control goals and strategies of other jurisdictions, enforcement activities, possible information gaps in work of SAC and TSAG that will need to be addressed • Target date for Strategy to be developed for government’s consideration: June 2010