INTEGRATING TOBACCO TREATMENT INTO ADDICTION SERVICES

1. INTEGRATING TOBACCO TREATMENT INTO ADDICTION SERVICES Mike DeVillaer Provincial Services, CAMH Department of Psychiatry & Behavioural Neurosciences, McMaster University Addictions Ontario Conference May 31 2011

2. Coordinating Team Mike DeVillaer, Provincial Services, CAMH Peter Selby, Addictions Program, CAMH Barney Savage, Public Policy, CAMH JF Crepault, Public Policy, CAMH Norma Medulun, Addictions Ontario Ian Stewart, Ontario Federation of Community Mental Health and Addiction Programs Survey Research Associate: Natalie MacLeod, CAMH Project Partner: ConnexOntario

3. Funding The CAN-ADAPTT Project Tobacco Control Programme Health Canada

4. Buy In ? Imagine that you are not at an addictions conference but rather at an investment seminar, and I am attempting to get you to invest in a particular business enterprise. The first thing I tell you is that most of the states south of the border have already sued us for harm done by our product and we have settled out of court for billions of dollars. And that almost all provinces in Canada are also in various stages of doing the same and we expect to settle out of court for more billions of dollars. Oh yes, and you should also know that the number of people who use our product has gone through unprecedented declines in the last decade or two, and we have no reason to believe that interest in using our product will increase in the coming years, particularly since most governments are spending millions advising people not to use our product. The best we can hope for, as an industry, is to replace some of our current customers as they die prematurely from using our product. In some cases their families have successfully sued us for millions for dollars. I also tell you that it is very difficult for us to get new customers because very few people begin to use our product once they get in their twenties, and so we have a very limited window for engaging our key market. Of course, in most places it’s illegal for us to advertise our product, and where we can, advertising to young people is generally frowned upon. But we do it anyways – in subtle ways – even though we will never publicly admit it. And now our product is being produced for blackmarket distribution and sells for much less than we sell our product for. So, given all this, how many people would be willing to invest your hard-earned dollars in such a seemingly perilous enterprise ? Of course, you have all figured out by now that I’m talking about the tobacco industry, but I haven’t got to the punch line yet. The punch line is that most tobacco companies, despite all these horrendous perils and liabilities, continue to prosper financially. This is the brutally frustrating reality that you face when you work in tobacco control. It’s the mother of all power imbalances. Imagine that you are not at an addictions conference but rather at an investment seminar, and I am attempting to get you to invest in a particular business enterprise. The first thing I tell you is that most of the states south of the border have already sued us for harm done by our product and we have settled out of court for billions of dollars. And that almost all provinces in Canada are also in various stages of doing the same and we expect to settle out of court for more billions of dollars. Oh yes, and you should also know that the number of people who use our product has gone through unprecedented declines in the last decade or two, and we have no reason to believe that interest in using our product will increase in the coming years, particularly since most governments are spending millions advising people not to use our product. The best we can hope for, as an industry, is to replace some of our current customers as they die prematurely from using our product. In some cases their families have successfully sued us for millions for dollars. I also tell you that it is very difficult for us to get new customers because very few people begin to use our product once they get in their twenties, and so we have a very limited window for engaging our key market. Of course, in most places it’s illegal for us to advertise our product, and where we can, advertising to young people is generally frowned upon. But we do it anyways – in subtle ways – even though we will never publicly admit it. And now our product is being produced for blackmarket distribution and sells for much less than we sell our product for. So, given all this, how many people would be willing to invest your hard-earned dollars in such a seemingly perilous enterprise ? Of course, you have all figured out by now that I’m talking about the tobacco industry, but I haven’t got to the punch line yet. The punch line is that most tobacco companies, despite all these horrendous perils and liabilities, continue to prosper financially. This is the brutally frustrating reality that you face when you work in tobacco control. It’s the mother of all power imbalances.

5. Economic Costs of Drug Problems in Ontario, 2002 = $14,300 million