Parliamentary Research Branch

PRB 98-8E

When Europeans first explored the New World, they found the Aboriginal inhabitants smoking tobacco leaves, and apparently deriving therapeutic benefits and pleasure from this activity. By the 17th century, European physicians were prescribing tobacco in various forms for medicinal purposes. Even after it was realized that these "cures" were ineffective, tobacco grew in popularity. In the 20th century, cigarettes and pipes came to be associated with sophistication, leisure and affluence; films and advertisements helped to popularize smoking and to develop its connotations of glamour. While smoking was traditionally associated with masculinity, in the past several decades advertisers began to court the female market successfully. Only recently, when its links with various health problems were discovered, did smoking begin to decline in popularity in western industrialized countries.

Reports linking cigarette smoking with cancer began to appear in the 1920s, but it was not until after World War II that deaths from lung cancer became so numerous that systematic follow-up studies were initiated. Researchers’ efforts to establish causation were constrained by the fact that the most serious ill-effects of cigarette smoking may take 10 years or more to appear. By the early 1960s, however, the risks of lung cancer were found to be substantially higher for cigarette smokers than for non-smokers, as were the risks of coronary disease and stroke. The accumulating evidence of the ill-effects of smoking was publicized by the Royal College of Physicians in London in 1962, Health and Welfare Canada in 1963, and the Surgeon General of the United States in 1964.

Over the past few decades, four separate concerns have driven the anti-tobacco lobby: the dangers of smoking for the smoker; the dangers of second-hand smoke for those who must live or work in the vicinity of tobacco smoking; costs of smoking-related illness to the public health system; and, increasingly, youth smoking and the resulting creation of a new generation of smoking-related diseases.

The health dangers of tobacco have become increasingly well known. For example, smoking can cause lung cancer and various lung diseases that seriously impair breathing, as well as other cancers and heart damage. Although the reported rates of smoking-attributable diseases and death can vary with the methodology used, a 1995 study published by Health Canada reported that the total number of smoking-related deaths in Canada in 1991 was 45,064 and suggested that the number of such deaths in the year 2000 would be 46,910.(1)

After research results confirming the negative effects of second-hand smoke became public, perceptions of smoking changed considerably. The social costs of illnesses caused by second-hand smoke and the lost work time from smoke-related ailments were publicized and there were a growing number of complaints to workers’ compensation boards and human rights commissions about smoke in the work environment. Smoking became increasingly viewed as socially unacceptable and many felt that it should be the object of government intervention and regulation as a serious health risk.

The research on the effects of passive smoking remains controversial, however; a 1995 Congressional Research Service Report pointed out that, though the Office of the Surgeon General and the Environmental Protection Agency believe evidence shows that exposure to passive smoke brings a small, but real, risk of lung cancer, this conclusion is questioned by industry, some researchers, and others.(2)

As the estimates of smoking-related deaths and illness rose, increasing attention was paid to the costs of smoking to society. In the United States, this led a number of state governments, as well as the Blue Cross and Blue Shield, to bring lawsuits against the tobacco companies in an attempt to recover the costs of public health care necessitated by cigarette smoking. At least one provincial government has enacted legislation allowing for similar action.(3)

As with most aspects of cigarette smoking, estimates of what it costs the public health care system vary widely. Health Canada, in a 1997 study,(4) found that in Canada 1991 costs attributable to smoking were: $2.5 billion for health care, $1.5 billion for residential care, $2 billion due to workers’ absenteeism, $80 million due to fires and $10.5 billion due to loss of future income as a result of premature death. However, as other commentators note, individuals contribute to the health system through taxes long before a smoking-related illness appears and premature deaths attributable to smoking will actually reduce some government expenditures that would otherwise be necessary.(5)

Increasingly, societal concern has focused on youth smoking, which is widely accepted to be rising, especially among teenage girls; research suggests that nicotine addiction becomes more difficult to break the earlier one starts smoking. The focus of anti-tobacco legislation has increasingly shifted to preventing teenage smoking through education, higher prices and restrictions on "life-style" advertising.

1670: New France’s Sovereign Council imposes duties on tobacco.

1676: New France’s residents are prohibited from smoking or carrying tobacco on the streets.

1739: Canada exports tobacco to France.

1858: Macdonald Tobacco is established in Montreal.

1878: House of Commons defeats resolution to abolish tobacco taxes.

1891: British Columbia prohibits the sale of tobacco to minors, followed by Ontario and Nova Scotia in 1891, New Brunswick in 1893, and Northwest Territories in 1896.

1906: Federal Department of Agriculture establishes the Tobacco Branch.

1908: The Tobacco Restraint Act makes it illegal to sell tobacco products to anyone under 16 years of age.

1912: Imperial Tobacco, established in 1908 through a merger of the American Tobacco Company and the Empire Tobacco Company, is incorporated.

1914: House of Commons Select Committee on Cigarette Evils conducts public hearings.

1927: First Canadian advertisement showing a woman smoking a cigarette appears in Montreal Gazette.

1950: Large-scale epidemiological studies showing a statistical association between lung cancer and smoking are published.

1952: Federal government reduces tobacco taxes in response to a rise in cigarette smuggling.

1954: Canadian Medical Association issues first public warning on the hazards of smoking.

1957: Ontario Flue-cured Tobacco Growers’ Marketing Board is established.

1961: Results published of major Health and Welfare study, initiated in 1954, on the effects of smoking on Canadian war veterans; 60% more deaths among cigarette smokers than non-smokers are reported, and an association is made between cigarette smoking and an increase in lung cancer and heart disease.

1962: Report of the Royal College of Physicians in London, England, provides research evidence of the harmful consequences of smoking.

1963: Federal Minister of Health and Welfare, Judy LaMarsh, drew attention to the link between cigarette smoking and lung cancer, coronary heart disease, and chronic bronchitis.

Canadian Tobacco Manufacturers Council is established.

1964: Report of the Advisory Committee to the United States Surgeon General concludes that lung cancer and chronic bronchitis are medical consequences of smoking.

Canadian tobacco industry adopts first voluntary code on marketing practices.

1965: Federal Department of National Health and Welfare commissions national survey on smoking.

1967: Federal Cabinet approves preparation of legislation to require statements of tar and nicotine levels on cigarette packages and in advertising; however, no bill is introduced.

1969: A report by the House of Commons Committee on Health, Welfare and Social Affairs (Isabelle Report) contained recommendations on restricting the advertising and promotion of tobacco products.

1970: In its first anti-smoking resolution, the World Health Assembly calls upon governments to act against smoking as an avoidable cause of death.

1971: The government introduces Bill C-248 to ban advertising of tobacco products; however, the bill is not debated. Instead, the tobacco industry and the government agree to voluntary guidelines.

1974: The Canadian Council on Smoking and Health and the Non-smokers’ Rights Association are founded.

1976: City of Ottawa passes first municipal bylaw restricting smoking in public places.

1978: Imasco acquires Shoppers Drug Mart.

1979: Nicotine gum is made available in Canada on a prescription basis.

1985: National Strategy to Reduce Tobacco Use is established with representation from federal, provincial and territorial governments and eight health organizations.

Physicians for a Smoke-Free Canada is established.

Treasury Board announces voluntary guidelines for federal public servants on workplace smoking.

(3) "Tobacco Facts: B.C. Fights Back," at http://www.tobaccofacts.org/govt-legalteam.html.

(4) Murray J. Kaiserman, "The Cost of Smoking in Canada, 1991, 18 Chronic Diseases in Canada (1997)," at http://www.hc-sc.gc.ca/hpb/lcdc/publicat/cdic/cdic181/cd181c_e.html.

(5) Jane G. Gravelle and Dennis Zimmerman, "Cigarette Taxes to Fund Health Care Reform: An Economic Analysis," 8 March 1994, at http://www.forces.org/.