Proposed changes to smoking and vaping laws in Ontario: the Smoke-Free Ontario Act, 1994 and the Electronic Cigarettes Act, 2015
The Registered Nurses' Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners and nursing students in Ontario. RNAO has voiced support for the Smoke-Free Ontario Act, 1994 (SFOA) in the past and continues to support the government's efforts to strengthen smoking laws. RNAO welcomes this opportunity to provide feedback in response to the Ontario Ministry of Health and Long-Term Care's (MOHLTC) public consultation paper entitled Strengthening Ontario’s Smoking and Vaping Laws: Proposed changes to regulations made under the SFOA and Electronic Cigarettes Act, 2015.
RNAO’s history of leadership and advocacy in tobacco cessation and control
RNAO supports the regulation of tobacco and electronic cigarette promotion, sale, and use as part of an overall control and cessation strategy in Ontario. Despite decreases in tobacco use in recent years, it remains a well-known and completely avoidable cause of illness and death, causing significant health risks for both tobacco users and non-users. In Ontario, 13,000 people die annually from tobacco-related causes, resulting in $1.6 billion dollars per year in direct health system costs. In addition, given that medical marijuana is legal in Canada, RNAO respects it as a clinical option for practitioners and patients to lawfully consider and applauds the government for pro-actively taking steps to regulate its use in public spaces as we are concerned about potential risks of exposure to second-hand smoke.
Nurses play a key leadership role in empowering Ontarians to achieve and maintain optimal health through their work in tobacco prevention, tobacco cessation, and advocacy for healthy public policy. RNAO supports nurses in building their capacity to engage in tobacco cessation interventions with clients through our best practice guideline and our multi-pronged province-wide Tobacco and Nicotine Intervention (TNI) Initiative. To learn more about RNAO's extensive leadership in this area, please see the attached document (Appendix A).
- Proceed with proposed amendments to the SFOA and Ontario Regulation 48/06 to expand the rules that apply to the smoking of tobacco to include the smoking of medical marijuana. This is a preventative measure to protect the public from the potential adverse effects of exposure to second-hand marijuana smoke.
- Immediately remove current exemptions under Section 9(7-10) of the SFOA that allow tobacco smoking in designated indoor spaces. Both tobacco and medical marijuana smoking should be banned in all indoor public spaces in the interest of protecting employees and the public from the potential harms of second-hand smoke.
- Proceed with the proposed amendments to Ontario Regulation 337/15 under the ECA that would allow parents, guardians and caregivers to supply eligible minors with electronic cigarettes for the purpose of lawfully consuming medical marijuana.
- Amend provincial regulations to permit NPs to prescribe controlled substances, including the authorization of medical marijuana.
- Proceed with the proposed amendments to Ontario Regulation 337/15 under the ECA to prohibit the use of electronic cigarettes in all enclosed public places, enclosed workplaces, and other specified outdoor areas. RNAO supports this regulatory change with no exemption for specific substances being vaped, including medical marijuana.
- Amend Ontario Regulation 337/15 under the ECA to immediately revoke the authority of hospitals and psychiatric facilities, as well as certain provincial government buildings, to designate vaping areas on their outdoor grounds in order to render these properties free of electronic cigarette vapour.
- Proceed with the proposed regulatory changes to expand the current definition of "electronic cigarette" to include "e-substance". Under this revised definition, any substance that is made or sold for use in an electronic cigarette is included under the ECA.
- Regularly review the ECA and its regulations to ensure they reflect up-to-date evidence.
- Proceed with proposed amendments to Ontario Regulation 337/15 under the ECA to prohibit the sale of electronic cigarettes in schools, post-secondary campuses, child care centers and Ontario government buildings. This would align with existing rules under the SFOA that currently limit where tobacco can be sold.
- Proceed with proposed limits under Ontario Regulation 337/15 under the ECA regarding the sale and promotion of electronic cigarettes, as well as the size and format of promotional signs.
RNAO supports the Ontario government's efforts to strengthen healthy public policy in Ontario. We applaud the provincial government for its efforts to strengthen smoking and vaping laws, and we urge you to implement the above legislative and regulatory changes with our recommendations incorporated. We believe these practical and achievable measures are in the best interest of Ontarians, and will continue to move us towards our shared vision of a healthier Ontario. Thank you for giving us the opportunity to present our analysis. We look forward to ongoing collaboration on this important issue.
See the full submission with references below.