Doctors and tobacco experts are calling on Ottawa to step up anti-smoking efforts. They say the Romanow report failed to outline specific measures, but that the government needs to start working harder to encourage Canadians to butt out.

"Our message to the prime minister and to the minister of health is to deal with the epidemic of death and disease caused by tobacco," Dr. Paul McDonald of the University of Waterloo told a news conference in Ottawa Monday.

"Tobacco is the only legal product that, when used as directed, causes death," McDonald said.

Tobacco experts from various agencies have gathered in Ottawa this week for a conference on smoking and health in Canada.

"What we do in our offices cannot substitute for policies that will turn back this epidemic," Dr. David Esdaile, vice-president of Physicians for a Smoke-Free Canada, told reporters.

The group estimates that cigarette smoking causes 45,000 deaths in Canada every year, five times the number of deaths caused by car accidents, suicides, drug abuse, murder and AIDS combined.

Smoking accounts for 30 per cent of the heart disease cases in Canada and 80 per cent of lung disease.

In a report on the future of health care in Canada released last week, former Saskatchewan premier Roy Romanow said deaths could be prevented if doctors were able to identify risk factors such as smoking early on.

"We already do that," Esdaile says. "This view is far too simplistic."

John Garcia, president of the Canadian Council for Tobacco Control, calls the number of tobacco deaths "a major, preventable problem."

"Just to put things in perspective, the government spends $200 million on tobacco control and $2.5 billion treating tobacco-related disease," Garcia told reporters.

Garcia praised Romanow's report in intent, but said it only "takes us part way there."
"It contains no road map" for eliminating smoking-related deaths, Garcia said.

"When it comes to tobacco, the evidence is very clear, yet Mr. Romanow has failed to make specific recommendations based on that evidence," said McDonald.

"We know that a coordinated and comprehensive program can and has made a difference. Now is the time to act," McDonald said.

Experts are calling on Ottawa to raise taxes on tobacco, to clamp down on promotional efforts by cigarette companies and to improve access to services designed to help people quit smoking.

"We've known for 20 years that people do not start to smoke or quit smoking on their own," Esdaile said.

"Inevitably success in prevention will be affected more by what the prime minister and health minister do than by anything physicians do in their office."