The participants at a major international conference on tobacco control in Uruguay this week will receive a pamphlet from the Canadian Cancer Society that says Canada is losing its status as a world leader in smoking cessation.
The pamphlet, titled Cigarette Package Health Warnings: International Status Report, comes two months after the federal government told the provinces it has abandoned a six-year project to update Canadian cigarette packages with new and more graphic photos.
It will be distributed at a meeting of the 172 parties who have signed the World Health Organization's Framework Convention on Tobacco Control that is taking place all this week in Puente del Este.
"Package warnings are very important and Canada was the first country to acquire picture warnings [in 2001]and now we're falling behind," said Rob Cunningham, a senior policy analyst with the Canadian Cancer Society.
"We want Canada to regain international leadership. Whereas Canada used to have the biggest warnings in the world, it has now fallen to 15th, tied with 18 other countries and territories."
Even small countries like Uruguay and Mauritius require bigger warning labels than Canada does on tobacco package.
"By documenting that other countries are leap-frogging over Canada, we hope that that provides impetus to Health Canada to announce its own warnings," said Mr. Cunningham.
An editorial published last week by the Canadian Medical Association Journal harshly criticized the government for its decision not to update the package warning, saying it was a "senseless" and "ill-conceived" policy change, and even questioned whether it was a result of the government bowing to pressure from the tobacco industry.
The government says it remains committed to reducing youth smoking, helping Canadians to quit smoking, and addressing the pressing issue of contraband tobacco.
"Health Canada continues to examine the renewal of health warning messages on tobacco packaging but is not ready to move forward at this time," said Jenny Van Alstyne, a spokeswoman for Health Minister Leona Aglukkaq
The department continues to review available research, including international best practices, on health warning messages, said Ms. Van Alstyne. "As well, the impact and possible effectiveness of any new messages on the smoking behaviour of Canadians needs to be determined before new messages are considered."
Health Canada had been reviewing the warnings for tobacco products for several years and was considering new labels that would have been larger and, in many cases, much more graphic than the originals until the project was suddenly halted earlier this year.
One of the most powerful new labels that received a strong reaction in Health Canada focus groups was the image of Barb Tarbox, one of Canada's best-known anti-tobacco advocates, emaciated and dying from smoking-related illnesses.
The U.S. Food and Drug Administration started a consultation last week around a number of proposed warnings that could appear on updated U.S. cigarette packages. One of them featured Ms. Tarbox.
"Wouldn't it be ironic if the Americans end up having Barb Tarbox on cigarette packages before Canada does?" asked Mr. Cunningham.
The fact that Canadian cigarette packages have not been changed for 10 years is frustrating, said Mr. Cunningham. There is extensive proof that the graphic pictures on cigarette packages play a role in getting smokers to quit, he said.
"A picture says a thousand words and, if you can see that picture of Barb Tarbox, that brings to life what lung cancer is really like. It has a lot more emotional impact than just what text can say," he said.
"And if it didn't work, the tobacco companies wouldn't lobby against it."