The recent Quebec court decision that ordered three tobacco companies to pay $15 billion in damages could be a catalyst for more aggressive actions to reduce smoking rates in Canada, activists hope.

While the companies have vowed to appeal the decision, others who want to see fewer Canadians lighting up see the ruling as a potential spur toward further action at a time when the number of smokers seems to have plateaued at about 20 per cent of the population over age 12.

"We hope that it's going to be an impetus for federal and provincial governments to regulate the tobacco industry much more aggressively," says Rob Cunningham, a senior policy analyst with the Canadian Cancer Society.

Tobacco use is the leading preventable cause of disease and death in Canada, he says, and is responsible for the death of an estimated 37,000 Canadians each year.

And while "tremendous progress" has been made, Cunningham still sees the need for a "more robust, comprehensive strategy to drive smoking rates down by as much as possible as fast as possible."

That there are fewer Canadians lighting up these days is not in question. In the mid-1960s, smoking was allowed pretty much everywhere and about half of Canadians picked up a pipe or a cigarette.

For men alone, that rate was around 61 per cent, according to a report by the Propel Centre for Population Health Impact at the University of Waterloo.

By 2013, however, that overall rate was down to 19.3 per cent, or roughly 5.7 million Canadians aged 12 and older, according to Statistics Canada.

Legal changes

The factors in that reduction all boil down to government policies that have been introduced over the years, says Francois Damphousse, director of the Quebec office of the Non-Smokers' Rights Association.

Lise Blais holds up a photograph of her husband, Jean-Yves Blais, who died from lung cancer developed from smoking. (Paul Chiasson/Canadian Press) He quickly rattles off a long list: "Banning the advertising and sponsorship of tobacco products, implementing health warnings on tobacco packages, getting rid of tobacco displays, regulating or banning the use of tobacco products in workplaces and public places."

Still, the number of smokers seems to have plateaued for the past five or six years, says Dr. Peter Selby, chief of the addictions division at the Centre for Addiction and Mental Health in Toronto.

Those remaining smokers tend to have less education and be poorer, Selby says.

At the same time, those who are making the public policy decisions today tend to be in the upper socio-economic classes and just aren't seeing their friends and family members smoking.

Often they think smoking is no longer an issue of concern, Selby says. But you don't have to look very far to know that is not the case "because of the impacts," he adds, noting there is more work to do at both the public health and clinical levels, particularly as the tobacco industry seeks ways to find so-called replacement smokers.

"There's a perception this is simply about personal motivation, and everybody just needs to pull up their socks and they'll be fine," he says. "Unfortunately it's a bit more complicated than that."

Flavoured tobacco bans

Across Canada, some provinces are introducing a variety of new regulations. A ban on flavoured tobacco products, including menthol products, came into force in Nova Scotia on May 31. Legislation has also been brought forward in Alberta, Ontario, Quebec and New Brunswick, Cunningham notes.

"Health Canada and provincial governments are crucial to implement new measures that are badly needed to make a difference."

From the federal government, Cunningham would like to see plain packaging mandated for tobacco products.

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Research has indicated that plain packages, meaning those without branding, make the products less appealing and help back up health messages, which would still be included, the BBC reported earlier this year.

Tobacco companies have opposed plain packaging, saying, among other arguments, that it violates intellectual property rights and devalues trademarks.

Health Canada wouldn't comment on the recent court decision, but in an email the department says it continues to review research on plain packaging, and is closely monitoring plain packaging proposals in other countries, along with its implementation in Australia.

Current tobacco product labels in Canada include what the department describes as 16 "graphic health warning messages" that cover 75 per cent of the front and back of packages and information about a Canada-wide quit line.

The federal Tobacco Control Strategy for 2012-2017 includes a national marketing campaign aimed at getting smokers aged 20-24 talking about quitting smoking and staying smoke-free.

In March, the government also announced proposed regulatory amendments to the Tobacco Act "to further restrict flavours used to market cigars that appeal to youth," the department said.

Funding has also been provided to support projects that aim to reduce smoking rates in First Nations and Inuit communities.

Known risks

After the court decision was released last week, the three named tobacco companies — Imperial Tobacco, Rothmans Benson & Hedges and JTI-MacDonald — quickly said they would be appealing.

"This judgment fails to recognize that governments and adult smokers, consumers, have been aware of the risk for decades," says Nadine Bernard, manager of corporate affairs for Imperial Tobacco Canada.

Any legislation that is implemented across Canada should be based on facts and evidence and be pragmatic, she says.

"When we look at the Nova Scotia ban with the menthol ban we believe it was not based on facts and evidence."

Bernard understands that there are a lot of people who "would like to see smoking disappear."

"But at the same time it's a legal business when it does operate under a legal framework and the government gets a lot of taxes, a lot of money out of this industry and we understand that."