1. THE FUTURE OF TOBACCO CONTROL IN ONTARIO PRESENTATION TO COMMUNITY MEDICINE RESIDENTS/ MOHS/AMOHS October 25, 2002 Michael Perley Director Ontario Campaign For Action On Tobacco

2. Session Learning Objectives At the end of this session, participants should be able to: Discuss Ontario's experience in developing and gaining adoption of provincial legislation and regulations, and municipal by-laws governing tobacco use. Discuss further opportunities that might pursued to strengthen Ontario's tobacco-use legislation, regulations, and by-laws. Discuss the challenges faced in Ontario to facilitate the enactment of effective tobacco-use legislation, regulation, and by-laws. Discuss tobacco control initiatives implemented in jurisdictions outside of Ontario (e.g., California) and their potential applicability to Ontario.

3. THE FRAMEWORK Tobacco Control Act Smoking in the Workplace Act Municipal Act/Municipal By-laws Occupational Health and Safety Act WSIB

4. EXPERIENCES AND CHALLENGES PROVINCIAL: Political/ideological inertia; anti-regulatory/red tape agenda; presence of tobacco industry and allies; tax revenue MUNICIPAL: Jurisdictional argument; economics; rights and freedoms; alternatives (ventilation, DSRs, proprietors’ choice); exceptions and exemptions (bingo, Legions, patios, etc.)

5. A COMPREHENSIVE TOBACCO CONTROL PROGRAM California experience (heart disease and lung cancer reductions) CDC Witmer Expert Panel OTS Steering Committee Report

6. THE FUTURE Critical mass of local by-laws Making the cost argument Continuing exposure of industry Involvement of non-health sector advocates