Government Delays Tobacco Control Legislation

Following an extensive debate in the House of Assembly on Friday [Dec 4], Minister of Health, Seniors and Environment Jeanne Atherden said she would “rise and report” on the Tobacco Control Act 2015, which means the legislation will be delayed.

The Bill seeks to make a number of changes including, but not limited to, prohibiting the sale of individual cigarettes, prohibiting the sale of flavoured tobacco products and prohibiting smoking in various places.

Minister Atherden says she will “rise and report”

According to the Act, places in which smoking will be prohibited include health facilities, residential care facilities, educational facilities, day care facilities and preschools, public conveyances, office buildings, hotels, public transportation terminals, vehicles owned by an employer and used by employees in the course of employment, sports facilities and recreational facilities, theatres and cinemas, night clubs, shopping malls, bars and restaurants, retail establishments, and any other facilities accessible by the public.

One of the MPs who expressed concern about the Bill was Derrick Burgess who acknowledged the health issues of smoking, but said the Bill is “over regulation of people’s behaviour” and could “make criminals from law abiding citizens.”

Mr Burgess said if you go to a cricket game “people will go inside and get a drink, and then come outside to have a cigarette on the veranda looking at the cricket game, and then a policeman is going to tell them they cannot smoke out there?”

MP Derrick Burgess speaks on the Bill:

“Any policeman can go to a club and if someone is smoking, can ask them to put it out or arrest them.”

“You know who is going to Court first,” said Mr Burgess. ”They are not going around the yacht club to see if they are smoking there.

“They will go Western Stars, or Bailey’s Bay, or Hamilton Parish Club. That is where they will go first, they will never go around the yacht club. That is what will happen.”

Mr Burgess mentioned that he was recently at a club and someone went outside to have a cigarette.

“If this law was passed, that would be an offence,” he added. “He wasn’t bothering anyone, he was coming outside as he cannot do it inside.”

The Health Minister interrupted to say that Mr Burgess was “misleading the House”, and Mr Burgess replied that “the Bill is quite clear.”

“We cannot support this Bill, it will make criminals out of law abiding citizens, and I would ask this Government to withdraw this Bill,” said Mr Burgess.

The Minister’s full brief follows below:

Mr. Speaker and Honourable Members of the House, the Tobacco Control Bill 2015 was tabled on the 13th November, 2015.

Mr. Speaker, this Act replaces the Tobacco Products [Public Health] Act 1987 and is intended to protect children from tobacco products, strengthen provisions controlling smoking and to control the sale and use of e-cigarettes and cigarette rolling papers in order to protect human health and in particular reduce exposure to chronic disease risk factors in Bermuda.

In considering this Bill, we must all remember that smoking is the most significant cause of preventable death world-wide, and that the economic burden caused by death and disability due to tobacco use and nicotine addiction is staggering and avoidable.

Mr. Speaker, The World Health Organisation [WHO] has set voluntary targets of 30% reduction in the prevalence of current tobacco use by 2025. According to the STEPS survey 2014, 14% of Bermuda residents are smokers and one quarter of our population reports being exposed to second-hand smoke once a week or more in any environment. In order to meet the WHO goal, we aim to reduce the prevalence of smoking in Bermuda to less than 10% of the population in the next decade.

Mr. Speaker, the Tobacco Control Bill 2015 implements obligations from the WHO Framework Convention on Tobacco Control [FCTC]. The overall intent of the Convention is to reduce demand for tobacco products because their use is the leading cause of preventable premature death in the world. In the last decade international efforts to control these known carcinogens have escalated, and it is proposed that Bermuda’s existing tobacco control laws be updated to meet our WHO commitments.

Mr. Speaker, smokers have markedly increased risk of multiple cancers, particularly lung cancer; and smokers are at far greater risk of heart disease, stroke, chronic obstructive pulmonary disease, and diabetes. I recently learned that it is also a risk factor for Alzheimer’s.

The U.S. Surgeon General confirms that nicotine causes an addiction as powerful as that of cocaine or heroin. STEPS data tells us that 45% of Bermuda’s established smokers are trying to quit and I recognize the real challenge they face in kicking their habit. Many of these habits were formed while they were still minors.

Our intent is to prevent initiation of smoking, and enable environments that support persons who are trying to quit, because cases of chronic disease, facilitated by smoking, add millions of dollars to the existing financial burden on Bermuda’s healthcare system and ruin the quality of life for so many.

Mr. Speaker, The Report of the Survey of Students on Knowledge and Attitudes of Drugs and Health 2012 by the Department of National Drug Control [NDC] stated that children in Bermuda first start using cigarettes, on average, when they are 8 years old. Respondents in Youth Tobacco Surveys have stated that no one had refused to sell them cigarettes because of age.

Cigarettes can be purchased individually or in small packages in local stores, making them more affordable for children. Furthermore, there is no age restriction on the sale of cigarette rolling papers. Cigarette advertising and sale is featured at points of sale in local retail establishments, sometimes in close proximity to displays of children’s toys.

Middle and high school survey participants reported that cigarettes were being offered locally as a promotion for them to try, and that they were in possession of cigarette branded tee shirts, pens, and backpacks. Flavourings [like strawberry, apple and grape] increase the appeal of tobacco products among children, providing a gateway to tobacco product consumption.

Mr. Speaker, the Tobacco Control Act 2015 is intended to make smoking less available and attractive to children. Flavoured tobacco products are attractive to and are used by a greater proportion of youth and young adults compared to adults. The candy and fruit flavoured tobacco products for smoking and for use in hookahs are novel products intended to not only be eye catching but also to appeal to the sweet tooth of young persons.

Research has shown that flavoured product use is higher among 18 to 24 year-olds than 25 to 34-year-olds, and that sugar preference is strongest among youth and young adults and declines with age. Such findings indicate that flavoured product use may influence tobacco-use patterns in young adulthood, a critical period when lifelong patterns of tobacco use are often established.

Mr. Speaker, The recent invention of e-cigarettes, also known as Electronic Nicotine Delivery Systems [ENDS], meant that these novel products were not adequately controlled by existing legislation; for example no statutory minimum age of purchase for ENDS was established. ENDS packaging is often devoid of health warnings, so minors may mistakenly assume that they are a “healthy” alternative to cigarettes. Indeed, anecdotally, I can see that many people of all ages do seem to hold this mistaken perception.

In fact, Mr Speaker, E cigarettes contain liquid nicotine, which is poisonous and widely used as a pesticide. They are not healthy alternatives at all and, on the contrary, they are a risk to the smoker and to others.

Vaping inhalants contain many harmful chemicals, in addition to the highly toxic and addictive nicotine. Vaping in others’ presence presents similar risks as smoking, due to passive inhalation of second nicotine vapour. As such, the Bill will control vaping or smoking of e-cigarettes in enclosed public and enclosed workspaces to preserve existing smoke-free policies.

Furthermore, Mr Speaker, e-cigarettes are considered gateway products for tobacco use. They form the same hand to mouth muscle-memory and habit as smoking cigarettes. The policy intent is to protect children from smoking. Other jurisdictions [including the US] are similarly regulating e-Cigarettes in conjunction with tobacco products.

Nevertheless, it is recognized that smoking cessation can be aided by appropriate use of e-cigarettes as well as other nicotine replacement therapies. For this reason, e-cigarettes will be available through pharmacies, which highlights their therapeutic use.

Under the new Act, nicotine will continue to be primarily regulated under the Pharmacy and Poisons Act; a consequential amendment will enable e-cigarettes to be sold by a pharmacist over the counter and obtained without a prescription. This move represents a relaxation in the existing law to increase access but in a controlled way, in order to allow e-cigarettes to be used in smoking cessation.

The policy intent is to promote the therapeutic or medicinal use of nicotine and to deter recreational use of nicotine. Sale by pharmacist is considerably safer than allowing unfettered access to liquid nicotine preparations with the intent of promoting safety – especially of children who have been poisoned by nicotine exposure in other countries.

Mr. Speaker, The Tobacco Products [Public Health] Act 1987 previously required tobacco products to carry health warnings stating the content or amount of tar. The need for these descriptors has been removed from the Tobacco Control Bill 2015 because it is now accepted that smoking in all forms, regardless of the tar content, is harmful to health. As explained, Mr Speaker, this applies to smoking and vaping.

Mr. Speaker, in summary this new legislation will:

• a] remove the requirement in the Act for health warnings to state the amount of tar contained by cigarettes;
• b] introduce further controls of tobacco products, tobacco product sales and promotions to prevent children from obtaining and using tobacco products and to ensure that tobacco product advertising that is attractive to children is adequately controlled;
• c] give inspectors the authority to seize and forfeit any products, items or objects that contravene the Act.
• d] introduce controls for the use of electronic cigarettes by including them as a cigarette product; and
• e] designate cigarette rolling papers as tobacco products.

Mr. Speaker, the responsibility for enforcing the Bill rests upon inspectors who will be designated by the Minister responsible for Health. Inspectors will assure prohibitions on smoking, and enforce controls on sale, advertising, promotion and access to tobacco products. Inspectors will follow a compliance policy and will focus on enabling compliance with the new provisions.

Advice and guidance will be issued to stakeholders early in 2016. Consultation has already taken place to inform the Guidance needed. The Director of the Department of Health, who has been designated the Tobacco Focal Point for Bermuda by the Pan American Health Organisation, will give oversight to the inspectors and the registration of tobacco wholesalers.

Mr. Speaker, the Tobacco Control Bill 2015 addresses concerns for health related to smoking in Bermuda, with particular emphasis on protecting children, preventing the initiation of smoking, and helping smokers who want to quit. One concern that was raised by stakeholders at consultation was that businessmen would have their access to premium cigars restricted by the Act, which would be detrimental to the business climate. Mr Speaker, an examination of the clauses indicates that this is not the case.

In Clause 2 [definitions], entry level cigars [like Gombey Brand cigarillos] that are composed of shredded tobacco will be treated as cigarettes and whole leaf premium cigars will be treated as tobacco products. Cigarettes will be required to be sold in their original packs of 20 whereas premium cigars can be displayed in humidors in their original boxes and sold individually, as is the present practice.

Observed retailing practices involved attendant staff opening the humidors and requirements [via signage and locks] for staff assistance with purchases, as would be expected with these valuable commodities. Some premium cigars are $30 each! The clause prohibiting counter top displays and handling prior to purchase perpetuates from the 1987 Act, and is intended to prohibit self-service and unfettered access to tobacco by children.

In addition cigarettes will have to be sold in their original packaging in cartons or in packs of 20 going forward, and will not be able to be sold individually. “Kiddie packs” of 10 cigarettes will not be allowed.

Mr. Speaker, in conclusion, it gives me great pleasure to introduce the Tobacco Control Bill 2015 to this honourable House on behalf of the Ministry of Health, Seniors and Environment.

Thank you, Mr. Speaker.

The Tobacco Control Act 2015 follows below [PDF here]:

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