Advancing smoke-free public spaces: the challenge of water-pipe in the Canadian context

摘要

Background and challenges to implementation: Canada once led the way with smoke-free public spaces and as a result, most Canadians are protected from second-hand smoke through legislation at multiple levels of government. However water-pipe tobacco, which is growing in use, has presented a challenge in existing regulation. While some jurisdictions have revised legislation to restrict water-pipe use in public spaces, there has been much opposition to such from small business owners, retailers, middle-eastern community and tobacco control industry. Intervention or response: As a result of concerted advocacy efforts, water-pipe tobacco has since been embedded within existing smoke-free public space legislation in a variety of settings. Advocates continue to strive for comprehensive legislation across Canada. Results and lessons learnt: A variety of arguments and tactics were used on both sides to further each cause. Water-pipe supporters: The cultural lens was often applied from supporters of water-pipe. Experts on history or anthropology were leveraged to give credibility to cultural arguments. Small business owners from bars and restaurants pleaded on economic grounds, citing loss of revenue and jobs. Water-pipe products were portrayed to be tobacco-free and without risk. Tobacco control community: Protection of workers was a strong counter-frame. Heath experts and scientists put together a narrative demonstrating risk and trends. Public health experts highlighted tobacco content in water-pipe products, inaccurately labeled as tobacco-free. Advocates leveraged the frame of protecting youth to secure quick adoption. Conclusions and key recommendations: In recent years, Canada has made great strides in securing further protection with regard to water-pipe tobacco. The battle is not yet over, and large communities within Canada continue to be without regulation. Cases from across Canada can serve as useful lessons to make progress in the rest of the country and in the global context.