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The provinces are in mediation with three tobacco companies – Imperial Tobacco Canada, Rothmans, Benson & Hedges Inc. and JTI Macdonald Corp. – to reach a settlement agreement.Jeff Chiu/The Associated Press

Three major health organizations have published an open letter to the premiers, urging them to ensure that any settlement reached in the years-long court battle with tobacco companies include clear measures to reduce smoking and change industry behaviour.

The Canadian Cancer Society, the Canadian Lung Association and the Heart and Stroke Foundation say the provinces’ settlement with the companies should require that at least 10 per cent of funds go toward an independent fund aimed at reducing tobacco use; a complete end to all tobacco promotion; penalties if tobacco reduction targets aren’t met; and public disclosure of all secret internal tobacco industry documents.

“We appeal to your leadership to stop Big Tobacco and counter its wrongdoing, thus benefitting generations to come,” states Monday’s letter, signed by the heads of the three health organizations.

The provinces are in mediation with three tobacco companies – Imperial Tobacco Canada, Rothmans, Benson & Hedges Inc. and JTI Macdonald Corp. – to reach a settlement agreement. The $500-billion legal saga stretches back more than two decades, when B.C. became the first Canadian jurisdiction to sue the industry for health costs tied to treating tobacco-related disease.

The companies involved in the litigation have been in creditor protection since 2019, after the Quebec Court of Appeal upheld an earlier judgment ordering them to pay about $15-billion in damages to 100,000 smokers who developed tobacco-related diseases.

The companies will come out of creditor protection if a settlement agreement is reached, or be forced into bankruptcy if they don’t. The health organizations behind the letter say this gives the provincial governments leverage to insist on strong measures aimed at reducing tobacco use.

The settlement negotiations are taking place behind closed doors, meaning it’s impossible to predict when an agreement will be reached.

Rob Cunningham, senior policy analyst with the Canadian Cancer Society, said money from the settlement can’t simply go to general provincial budgets.

“We have a once-in-a-lifetime opportunity to have better controls on the tobacco industry,” Mr. Cunningham said. “That’s exactly what provinces should prioritize in the negotiations.”

He said many of the elements the health organizations are asking for were included in the landmark settlement agreement reached between Big Tobacco and U.S. governments in 1998.

Andrew Pipe, a smoking cessation expert and past chair of Heart and Stroke, said provinces should make it a priority to direct settlement funds to bettering public health.

“We have a health care system across the country that’s in crisis, and the sums that are in play here could make very substantial contributions to addressing some of the elements of that crisis,” Dr. Pipe said.

Cynthia Callard, executive director of Physicians for a Smoke-Free Canada – which was not involved with the open letter – wants the provinces to go even further by ending the availability of nicotine-based products.

“The settlement should be an orderly dismantling of the tobacco business and a phase-out of the nicotine use in Canada,” Ms. Callard said.

Earlier this year, New Zealand became the first country in the world to outlaw the sale of tobacco products to anyone born on or after Jan. 1, 2009. But Ms. Callard said the country’s decision to exempt vaping products is a mistake, as many young people use them – fuelling addiction in a new generation.

About 48,000 people in Canada die every year as a result of tobacco use, making it the leading cause of preventable death.

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