Building a Smoke-Free Canada is Ottawa Life Magazine’s year-long editorial series examining how Canada is tackling tobacco-related harm. Each article explores policy, innovation, and public health efforts shaping the future of nicotine use.
Canada has made remarkable strides in public health over the past half-century. From seatbelt laws to food labelling, from vaccination programs to clean air initiatives, the country has often led the way in protecting its citizens. Yet one challenge remains stubbornly persistent: tobacco use. Despite decades of education campaigns, regulatory reforms, and cessation efforts, millions of Canadians still smoke. And while smoking rates have declined, the emergence of new nicotine products—vapes, pouches, heated tobacco—has complicated the landscape in ways that demand fresh thinking.
This is the starting point for Ottawa Life Magazine’s new series, Building Smoke-Free Canada. Over the coming months, we’ll explore the policies, science, and social dynamics shaping Canada’s tobacco and nicotine environment. We’ll speak with health experts, regulators, industry voices, and everyday Canadians. Our goal is not to promote any single solution, but to offer a clear-eyed, fact-based look at how Canada might reduce tobacco-related harm while navigating the tensions between innovation, regulation, and public trust.
According to Health Canada’s 2022 Canadian Tobacco and Nicotine Survey, 10.9 percent of Canadians aged 15 and older—roughly 3.5 million people—still smoke cigarettes. Of those, 8.2 percent smoke daily. Among youth aged 15 to 19, 4.2 percent reported current smoking, and 59 percent said they believed it would be “fairly easy” or “very easy” to obtain cigarettes if they wanted them. These numbers reflect both progress and persistent gaps. In 1965, nearly half of Canadian adults smoked. Today, that figure has dropped dramatically, but the plateauing of decline and the rise of vaping among youth have raised new alarms.
The health consequences of smoking are well documented. Lung cancer, chronic obstructive pulmonary disease (COPD), and coronary heart disease remain among the leading causes of death linked to tobacco use. According to a review of epidemiological studies from British American Tobacco, smoking is associated with a wide range of serious illnesses, including stroke, aortic aneurysm, and cancers of the throat, bladder, and kidneys. Public health authorities have long emphasized that there is no safe level of exposure to tobacco smoke, and second-hand smoke continues to pose risks to non-smokers, especially children and pregnant women.
Yet the conversation around tobacco is no longer just about cigarettes. In recent years, a wave of alternative nicotine products has entered the market, offering smokers new options that do not involve combustion. Vaping devices, nicotine pouches, and heated tobacco products are now widely available, though their regulation varies dramatically across provinces. British Columbia, for example, restricts flavoured vape products to specialty shops and imposes a 20 percent tax. Quebec has banned all non-tobacco flavoured vapes and raised the minimum purchase age to 21. Alberta, by contrast, allows flavoured products at age 18 with fewer restrictions.
This patchwork of provincial rules creates confusion for consumers and enforcement challenges for regulators. It also raises questions about equity and access. In some regions, adult smokers seeking alternatives may find themselves with limited legal options, while illicit markets flourish. Health Canada has warned that unauthorized products—often sold online or imported illegally—can bypass safety standards and pose unknown risks.
One of the most closely watched developments in Canada’s harm reduction landscape is the emergence of nicotine pouches. In October 2023, Imperial Tobacco Canada launched ZONNIC, a tobacco-free nicotine pouch authorized by Health Canada as a nicotine replacement therapy (NRT). The product delivers a controlled dose of nicotine—under 4 mg per pouch—without tobacco or combustion. It functions similarly to gums or lozenges but offers a slower, steadier release. For some smokers, this may represent a more discreet and manageable way to reduce or quit smoking.
However, in August 2024, a federal ministerial order reclassified ZONNIC, requiring it to be dispensed behind the counter in pharmacies under pharmacist supervision. While the intent was to ensure safe use and prevent youth access, the change significantly reduced convenience for adult smokers trying to quit. Nearly 20 percent of Canadian postal codes lost easy access to the product. This has prompted calls from some public health experts and retail associations for a review of the policy to ensure that accessibility and safety are balanced appropriately.
The tension between harm reduction and youth protection is at the heart of Canada’s tobacco and nicotine debate. Flavoured products, for instance, are often cited as both a gateway for youth and a tool for adult smokers seeking to switch. Dr. Andrew Pipe of the Ottawa Heart Institute has noted that “flavours may help adult smokers switch—but they also attract youth,” underscoring the delicate balance policymakers must strike.
Globally, countries like Sweden, New Zealand, and Japan have shown that thoughtful harm reduction strategies can yield dramatic results. Sweden, for example, has achieved smoking rates below 5 percent, aided in part by the availability of alternative nicotine products and strong public education campaigns. New Zealand has pursued a bold endgame strategy, aiming to phase out smoking entirely for future generations. Japan has seen a rapid shift from cigarettes to heated tobacco products, though concerns remain about long-term health impacts.
Canada’s federal structure adds complexity to any national strategy. Health Canada sets baseline regulations through the Tobacco and Vaping Products Act (TVPA), but provinces control key aspects of implementation—such as age limits, retail access, and product restrictions. This decentralized approach allows for regional tailoring but can also lead to fragmentation and inconsistency. For example, a product authorized federally may be banned provincially, creating confusion for consumers and challenges for manufacturers.
Moreover, public understanding of nicotine products remains uneven. Many Canadians are unaware that only Health Canada–authorized products are legally available, and that provincial rules may further restrict access. This lack of clarity can undermine trust and fuel misinformation. Advocacy groups like Physicians for a Smoke-Free Canada have called for stronger public education efforts, emphasizing the need to distinguish between combustible tobacco and non-combustible alternatives.
Industry players have a role to play. While some companies have faced criticism for past marketing practices, others are now investing in science-based product development and regulatory compliance. British American Tobacco, for example, has published extensive research on the risks of smoking and the potential benefits of transitioning to smokeless alternatives. Its Omni™ initiative outlines a vision for helping smokers who would otherwise continue to smoke shift toward less harmful products. Similarly, PMI Science has developed a robust research platform focused on smoke-free innovation and harm reduction, which can be explored at pmiscience.com. As these efforts show, building a smoke-free Canada depends on knowledge sharing and high standards of integrity—not corporate messaging alone. This editorial engages with the evidence on those terms.
As Canada looks ahead, several key questions emerge: How can policymakers ensure adult smokers have access to safer alternatives without compromising youth protection? What role should pharmacists, retailers, and educators play in shaping public understanding? How can enforcement be strengthened to combat illicit sales and ensure product safety? And perhaps most importantly, how can stakeholders—government, industry, health advocates, and the public—work together to build a coherent, evidence-based strategy?
Building Smoke-Free Canada will explore these questions in depth. Each instalment will focus on a specific theme: global harm reduction models, youth prevention strategies, consumer rights, enforcement success stories, and innovative cessation tools. We’ll highlight the voices of those on the front lines—doctors, regulators, researchers, and individuals navigating their own quit journeys.
This is not a series about absolutes. It’s about nuance, trade-offs, and the pursuit of better outcomes. Tobacco-related harm remains one of Canada’s most pressing public health challenges. But with thoughtful policy, informed debate, and a commitment to collaboration, progress is possible.
The future may not be smoke-free yet—but it’s within reach.
Photo: iStock
