Why Tobacco Control is Still Important

Simon Barton

Reprinted from "Tobacco" issue of Visions Journal, 2007, 3 (4), pp. 4-5

Recent headlines might have you thinking the most pressing public health concern is obesity or a lack of physical activity. If you live in the Lower Mainland, you might think it’s illegal drug use. All are important issues, but the leading cause of preventable death in British Columbia is tobacco-related illness. As you’ll see, the numbers really do speak for themselves.

While we can hold our heads up high because we have the lowest smoking rate (15% in 2005) in Canada (for people ages 15+), BC still has over 600,000 daily and occasional smokers. An argument could be made that we have achieved great success by reducing the overall smoking rate from around 45% to 15% in the last 40 years. However, we have only reduced the actual number of smokers by an estimated 200,000.

Even though the overall provincial smoking rate looks promising, some populations still have a long way to go. There has been a very high rate of tobacco use (45% in 1997) among Aboriginal populations in BC.1 This includes smoking rates of 41% for those ages 12 to 18 and 61% for those ages 19 to 24.1 For young gay men, the smoking rate is twice the rate of other men in BC.2

For people with mental illness and/or addictions, tobacco use rates can exceed 70%.3 Since socializing in treatment centres often involves tobacco, it is common for individuals to enter as non-smokers and exit as smokers. Clearly, there is more work to be done to support this population.

Tobacco use is expensive. The Canadian Centre on Substance Abuse has estimated that the cost associated with tobacco use for British Columbia was approximately $2.3 billion in 2002. This includes $605 million for overall health care costs.4

Sadly, most of us know someone whose life has been cut short by smoking. The smoking-attributable mortality (SAM) rate in British Columbia is more than 6,000 individuals each year (6,027 in 2004), or approximately 16 smokers every day5—twice as many as those who die from all other drugs, motor vehicle accidents, suicides, homicides and HIV/AIDS combined. These SAM figures don’t even begin to capture the quality of life lost for many smokers.

Most British Columbians have protection at work as a result of the 2001 WorkSafe BC regulation that restricts smoking in the workplace. The provincial government recently announced legislation that will make school grounds tobacco free, and designated smoking rooms a thing of the past. A recent tour of some of the nightclubs in downtown Vancouver with smoking rooms reinforced that there is still much work to be done.

More than 300 non-smokers die in Canada each year from causes related to second-hand smoke.6 Sadly, Heather Crowe was one of them:6 she never smoked a day in her life, but worked in a smoky restaurant and banquet hall. In our province between 100 and 140 people will die from passive smoking this year.7

On a positive note, we have the lowest provincial rate of children exposed to second-hand smoke at home (5%), which is 7% lower than the national average. While some people think exposure to second-hand smoke is just an issue for infants and children and feel it is simply a nuisance for the rest of us, exposure to second-hand smoke should be an important issue for everyone.

A recent survey by BC Stats revealed strong support for smoke-free public spaces: 85% agree that non-smokers have a right to a smoke-free environment. In this same survey, over 70% agreed that smoking is dangerous to those around the smoker.8 While these results tell us there is still work to do educating the public on the harms caused by second-hand smoke, there is clear support for smoke-free public spaces. We know there are many patrons waiting for their opportunity to enjoy sitting out on a restaurant patio in a smoke-free environment.

If there were no new smokers, we could simply stand back and watch the smoking rates decline as a result of the health impacts of smoking and old age. Unfortunately, young people start to smoke despite best efforts from parents and health educators. Currently, about 27% of young adults ages 20 to 24 in BC are smokers.8 This is the highest smoking rate of any age group in the province. It doesn’t help that the tobacco industry spent over $100 million in 2005 promoting their products with retailers, a dramatic increase from $74 million in 2001.9 We have found that approximately half of all underage smokers get their tobacco products from their friends, family and even strangers.10 It’s hard to believe that a friend or parent would consciously contribute to an addiction that can cost another person’s life.

So when we are asked why we still need to invest in tobacco control, the answers are clear:

  • Over 6,000 smokers and between 100 and 140 non-smokers are expected to die in the next year in British Columbia, and many more will have their health compromised.

  • Tobacco use impacts the health care system

  • At-risk populations have smoking rates that greatly exceed the provincial average.

  • Many youth and young adults will start to smoke in the next year.

  • Tobacco products are widely available throughout the province.

  • If we let our guard down, smoking rates will increase.

 
About the author

Simon is Manager of the BC Ministry of Health Tobacco Control Program, where he has been the lead on each of the core program areas of cessation, prevention, protection and enforcement. He has also worked on prevention programming for the Stopping the Violence Branch and has supported self-care projects such as the BC NurseLine

Footnotes:
  1. Heart and Stroke Foundation of BC & Yukon. (1997). Tobacco Use in BC 1997 (Survey). Vancouver: Author. www.healthservices.gov.bc.ca/tobacrs/index.html

  2. Lampinen, T.M., Bonner, S.J., Rusch, M. et al. (2006). High prevalence of smoking among urban-dwelling Canadian men who have sex with men. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 83(6), 1143-1150.

  3. Johnson, J.L., Macdonald, S., Reist, D. et al. (2006). Tobacco reduction in the context of mental illness and addictions: A review of the evidence (Report). Victoria: Provincial Health Services Authority.

  4. Rehm, J., Baliumas, D., Brochu, S. et al. (2006). The costs of substance abuse in Canada 2002. Ottawa: Canadian Centre on Substance Abuse.

  5. BC Vital Statistics Agency. (n.d.). Smoking-attributable mortality in British Columbia 2004 (Table 42). In Selected vital statistics and health status indicators: Annual report 2004. Victoria: Author. www.vs.gov.bc.ca/stats/annual/2004/index.html

  6. Illing, E.M.M. & Kaiserman, M.J. (2004). Mortality attributable to tobacco use in Canada and its regions. Canadian Journal of Public Health, 95(1), 38-44.

  7. Health Modernization Branch, Knowledge Management and Technology (KMT), Ministry of Health, 2006. KMT supplied this range of figures, citing their sources as the Canadian Centre for Substance Use (100) and the BC Vital Statistics Agency (140).

  8. BC Stats, Ministry of Labour and Citizens’ Services. (2007). Summary of smoking rates for BC: December 2005 through November 2006. www.bcstats.gov.bc.ca/data/ssa/reports/tobacco/smokingstats_20052006.pdf

  9. Provided by Health Canada based on reports pursuant to the Tobacco Reporting Regulations.

  10. Context Research. (2005). Youth access to tobacco project: Final report. Victoria: Ministry of Health, Tobacco Control Program.

 

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