Smoking

Smoking

Smoking is a universal health hazard. All forms of TOBACCO smoking are risky. Canadian consumption of cigarettes has been declining since the monitoring of smoking began in 1965, when an estimated 50% of adults smoked. In 1981 smoking prevalence had dropped below 40%. A second milestone was reached in 1994, when the rate of smoking reported was below 30%. By 2004 that number had dropped to 24%. Today, slightly more than 20% of the population aged 15 years and older smoke.

The 1965 statistics showed that daily smokers consumed an average of 20.6 cigarettes per day. That figure declined to 15.2 per day by 2004. Since then, the Canadian Tobacco Use Monitoring Survey (CTUMS) reports smaller increments in the decline in smoking, which may signify that Canadian smokers have become somewhat inurred to efforts to deter them from smoking.

Consumption levels for daily smokers have declined for both men and women, but the decline has been more marked for men. Men historically have smoked more cigarettes per day, and they continue to smoke more than women, an average of 16.4 cigarettes per day for men compared to 13.8 for women. These statistics do not tell the whole story; while the number of men who smoke has been decreasing, the number of women who have taken up smoking has increased since 1978. However, it must be noted that smokers generally under-report tobacco consumption, so statistics may not reflect population trends accurately. Certainly consumption figures tend to be lower than cigarette sales reported for the same period.

Provincial smoking prevalence rates are within 4% to 5% of the national average, with the highest rate (24%) in Québec and the lowest (15%) in British Columbia. The prevalence rate is higher in the territories - 41% in the Northwest Territories and Nunavut. Smoking among Aboriginal populations tends to be higher than among other populations, in some cases by almost 50%. Cigarette smoke contains more than 3000 substances, many of which have a deleterious effect on biological systems. Included among the immediate undesirable consequences of smoke inhalation are contraction of the airways of the lung, an increase in heart rate, a generalized constriction of blood vessels, and an elevation of blood pressure and heart rate. Carbon monoxide in the blood of smokers deprives tissues of oxygen, a fact of potential critical importance for individuals with severe HEART DISEASE. Chronic elevation of blood carbon monoxide contributes to the gradual narrowing of arteries (arteriosclerosis). The inhalation of cigarette smoke by pregnant women subjects the circulation of the fetus to the same stresses as the smoker, which leads to a higher rate of certain obstetrical complications, perinatal mortality, and the birth of slightly smaller, less mature infants.

In addition to vascular diseases, there are 2 other serious long-term effects from smoking. The first is emphysema (commonly found in older smokers), a disease in which the air sacs of the lung break down. This disease and chronic bronchitis account for the symptoms of cough, sputum production and shortness of breath in most long-term smokers.

The second is lung CANCER, the major cause of death from smoking and the leading cause of cancer death for both men and women. Cigarette smoking is the leading cause of lung cancer, accounting for approximately 80% of all new cases of lung cancer in women and 90% in men. Lung cancer is difficult to detect in an early stage and only a small minority of cases are curable. The age-corrected incidence of lung cancer in Canada averages 56 per 100 000 for the population, which represents approximately 64 per 100 000 in males and 49 per 100 000 in females annually, according to the CANADIAN CANCER SOCIETY. The increase has been greater in women, as the proportion of smokers who are female increases. Cancers of the tongue, pharynx, larynx, esophagus and even remote organs such as the bladder are all more common among smokers than nonsmokers. The hazards of exposure to carcinogenic substances, such as asbestos, uranium and certain industrial products, are enormously increased for smokers. Most smokers are strongly habituated or addicted, and the heaviest smokers are least likely to quit smoking. Those smokers wishing help can be assisted by a variety of educational, psychological and pharmacological techniques.

Studies have shown that switching to low-tar cigarettes, or reducing consumption, is ineffective because smokers tend to unknowingly compensate for the reduction by altering their smoking techniques.

Pipe smoking and the substitution of smokeless tobacco in the form of snuff or chewing tobacco have been decreasing in Canada since 1998, in contrast to cigar consumption, which has been increasing markedly since 2004. These products also constitute a major health risk of cancerous and noncancerous oral conditions, and can also result in nicotine dependence and addiction.

A general awareness of the consequences of involuntary or passive smoking has led to the development of powerful antismoking groups among the public. Concerns raised by such groups and the scientific community have resulted in legislation controlling smoking in public places and prohibit it at specific areas outdoors, the worksite and on public transportation, including aircraft flights. Initiatives taken by federal, provincial and municipal governments have included imposing restrictions on all forms of tobacco advertising; introducing legislation to discourage tobacco sales to minors and to ensure that responsibility for their products rests with the tobacco companies and to require warnings on the inside as well as on the outside of cigarette packages; and enacting legislation that removes "power walls" (cigarette displays) from businesses where cigarettes are sold.

The first municipality to restrict smoking in public places was Toronto in 1999; in 2000 Vancouver implemented the first smoking ban in all public places, although designated smoking rooms were permitted. Several provinces and some municipalities have banned smoking in private vehicles in which children are present. The provinces and territories have passed smoking by-laws with the exception of the Yukon, where the only smoking bans are in Whitehorse (as of 2008).

These laws have varied from one province to another in their application. The first provincial ban was imposed by British Columbia in May 2002, followed by Prince Edward Island in December of that year. Both New Brunswick and Manitoba banned smoking in public places in 2004.

The smoking ban in Prince Edward Island applied to public places, with venues such as bars permitted to build separately ventilated rooms for smokers. Newfoundland's law was introduced in 2005 and applied to indoor and outdoor areas of restaurants and bars but permitted employees to smoke in separately ventilated rooms.

Nova Scotia banned smoking in 2002 in most public places, with prohibitions lifted in restaurants and bars after 9 pm. In 2006 these laws were strengthened to ban smoking in bars, restaurants and patios where food is served.

In Québec, smoking in indoor workplaces including bars and restaurants was banned in 2006, although separately ventilated rooms for employees were permitted. Ontario enacted smoking laws in 2005 to ban smoking in all workplaces. The law was strengthened in 2006 to ban smoking in all indoor and roofed outdoor restaurants and bars.

Laws in Saskatchewan were passed in 2005 to ban smoking in public places including bars, restaurants and casinos with employee smoking rooms in workplaces exempted.

Alberta's provincial smoking law was enacted in 2008, several years after most municipalities had prohibited smoking in public places. Okotoks was the first municipality to ban smoking in vehicles in which children are present (2008).

British Columbia's law in 2000 required all workplaces to be smoke-free. The regulations were weakened in 2001 to allow restaurants to construct separate smoking rooms, staffed only by waitpersons willing to serve patrons in those rooms.