Issue
The recent legalization of cannabis and passing of the new Smoke-free Ontario Act 2017 necessitates the updating of previous Smoke-Free Outdoor Spaces Resolutions passed by the Windsor-Essex County Board of Health to reflect changing legislation, emerging smoking products, and the new landscape of smoking behaviour across the country and locally in Windsor and Essex County.
The Windsor-Essex County Board of Health previously supported two resolutions related to creating additional smoke-free outdoor spaces: the first, Banning Smoking at Outdoor Sport and Recreation Areas in Windsor-Essex County in January of 2011, endorsed prohibiting smoking at outdoor sport and recreation areas, and the second, Smoke-Free Outdoor Spaces (Appendix A) in November 2014 which encouraged further smoke-free policy development in outdoor spaces in alignment with new regulations. Since the passing of these resolutions, the Windsor-Essex County Health Unit has supported eight local municipalities including the City of Windsor in the development, approval, and implementation of Smoke-free bylaws in addition to supporting workplaces and the Essex-Region Conservation Authority in passing policies which restrict smoking in outdoor public spaces.
These actions extend regulations beyond those which are offered under the previous Smoke-free Ontario Act (2006) and the recently passed Smoke-free Ontario Act 2017 providing better protections for residents against the harms associated with second-hand tobacco smoke. These resolutions however did not explicitly outline recommendations for municipalities and policy makers on prohibiting products like electronic cigarettes in public spaces and were passed in advance of the legalization of cannabis on October 17, 2018.
Preliminary research on cannabis consumption after legalization shows increases in the first quarter of 2019 with 18.0% of Canadians aged 15 years and older reporting that they used cannabis in the last three months compared to 14.0% in the same time period in 2018, in addition 6.0% of those surveyed indicated they use cannabis “daily” or “almost daily” (Statistics Canada, 2019).
Although the smoking behaviours and habits differ between the two products, the prevalence of cannabis users is comparable to the national smoking rate when considering that 16.2% of Canadians 12 years of age and older report being daily or occasional smokers (Canadian Community Health Survey, 2017). Similar to other legal but harmful products like tobacco and alcohol, cannabis consumption can have serious negative health implications for users, including impacts on both physical and mental health.
Cannabis smoke contains similar toxins to those found in tobacco smoke which are associated with cancer, heart, and respiratory disease (Smoking and Health Action Foundation (SHAF), 2018) in addition to psychoactive components which can lead to mental illness or other mental health issues with early or heavy use. Both the physical and psychological effects of cannabis use are concerning not only for the one consuming cannabis, but also those who are exposed to environmental smoke or vapour from cannabis consumption over the long or even short-term. As a result, exposure to cannabis smoke should be limited, especially for children who face an increased risk for dependence and long-term mental health or learning issues.
Regarding vaping and the use of e-cigarettes, results of the Ontario Student Drug Use and Health Survey indicate that in 2017, 21.6% of students in Grades 7-12 reported use of a vaping product in their lifetime (Boak et al, 2017). In fact, youth (15 to 19 years) and young adults (20 to 24 years) have the highest rates of vaping uptake among the total population Canada-wide (Health Canada, 2018) and between 2015 and 2017 youth use of vaping products increased by 30% per year in Canada (University of Waterloo, 2017). While the health effects of vaping and second-hand vapour exposure are not well-understood given the recent introduction of these products to the consumer marketplace, linkages have already been made between use of these e-cigarettes and increased risk for tobacco smoking uptake, as well as increased frequency and intensity of subsequent tobacco smoking (Ontario Agency for Health Protection and Promotion (Public Health Ontario), 2018).
Experts within the field of tobacco control have also warned about the potential for increases in exposure. In addition, the normalization of smoking behaviour associated with products like e-cigarettes or cannabis in public settings, has the potential to undermine decades of tobacco control efforts which have been effective in dramatically reducing tobacco smoking rates across the country.
Background
The federal government introduced Bill C-45, including the Cannabis Act, in April of 2017 with the goal of legalizing access to non-medical (i.e., recreational) cannabis in Canada. This Act set a foundation of regulations on which provincial/territorial governments could develop more specific controls for how cannabis is grown, distributed, and sold in their provinces and territories. In May 2018, the federal Tobacco and Vaping Products Act (TVPA) was passed which allowed for nicotine in vaping products and placed restrictions on the ways in which these products could be promoted through advertisements. The provincial Smoke-free Ontario Act 2017 (SFOA 2017) builds upon these federal regulations to apply restrictions to where cannabis and vaping products can be consumed as well as how vaping products can be displayed in stores. The SFOA 2017 further prohibits the sale or supply of vaping products to anyone under the age of 19 and is enforced at the local level by WECHU Tobacco Enforcement Officers. These provincial regulations came into force on the same day that cannabis was legalized federally, October 17, 2018.
Under the SFOA 2017, the smoking of medical or non-medical cannabis and use of vaping products is prohibited in all areas where individuals cannot smoke tobacco, most notably in indoor workplaces and public places. The Act also prohibits the use of these products in certain outdoor spaces, including on and within 20m of playgrounds, sport fields, adjacent spectator areas, and recreational facility property, on and within 20m of school property, and on an within 9m of bar and restaurant patios. Any additional spaces, such as parks without playgrounds, beaches, trails, marinas are not covered under the provincial Act. As a result, if municipalities do wish to prohibit the use of cannabis or vaping products their only means to do so, would be through municipal bylaw development. Since the passing of the Smoke-Free resolutions in 2011 and 2014, eight municipalities in Windsor-Essex have passed smoke-free outdoor space by-laws. The Essex Region Conservation Authority has also passed a smoke-free outdoor space policy for conservation areas, which was updated in November of 2018 to include cannabis use and new language around the use of vaping products. In addition to more extensive areas of coverage, such as parks, beaches, trails, and municipal property, there has been an increase in the types of tobacco and smoking related products prohibited within these types of policies. Examples of prohibited items now include smokeless tobacco (e.g., chew) and other lighted or heated smoking equipment such as hookah.
Provincially, municipalities have updated municipal by-laws to expand on prohibited outdoor spaces and products. Recently, there have been some instances in which municipalities and organizations throughout Ontario moved towards more extensive protections including some municipalities which have passed bylaws prohibiting the use of cannabis in all public places, examples of these types of regulations include those which have recently passed in the City of Markham, Richmond Hill, and City of Brantford (Appendix B).
The legalization of cannabis and vaping products in Canada may increase access, normalization and exposure to smoking behaviour, rates of use, and exposure to second-hand smoke. Further research is needed to understand the health effects of long-term exposure to second hand smoke/vapour. Given the potential harms of health effects of cannabis and vapour use and exposure, it is recommended to align cannabis and vaping policies with tobacco policies. Due to the importance of this issue it is recommended that the Board of Health expand on its smoke-free outdoor spaces resolution encouraging municipalities to adopt more restrictive smoke-free outdoor space bylaws explicitly including cannabis and vapour products and consider the expansion of prohibitions of public cannabis smoking in additional spaces.
Proposed Motion
Whereas, the legalization of cannabis came into effect October 17, 2018 and the addition of vapour products and cannabis to the Smoke-Free Ontario Act, 2017, and
Whereas, outdoor sport and recreation areas, parks, beaches, trails, and playgrounds are intended to promote the health and well-being for all Windsor-Essex County residents, and
Whereas, entrances/exits of municipal buildings, and transit shelters/stops, are other areas of exposure to second-hand smoke, cannabis and vaping, and
Whereas, second-hand smoke has proven to be harmful in particular for vulnerable populations such as youth, and
Whereas, youth are increasingly susceptible to the influence of social normalization, and
Whereas, youth uptake of vaping and exposure to cannabis consumption is increasing.
Now therefore be it resolved that the Windsor-Essex County Board of Health encourages municipalities to prohibit the smoking or vaping of any substance on all municipally owned outdoor sport and recreation properties, as well as parks, beaches, trails, playgrounds, at minimum, 9m from entrances/exits of municipal buildings, transit shelters, and transit stops.
Further, that the Windsor-Essex County Board of Health encourages all Windsor-Essex municipalities to update and adopt smoking by-laws to explicitly prohibit the use of cannabis in public spaces including streets and sidewalks.