Here’s a simple way to end cigarette smoking in a generation

Normally, when people have worked together to do something they know will inevitably result in many deaths, they are prosecuted for murder or conspiracy. When a product is found to be unsafe, such as tainted meat, it is immediately recalled and destroyed. When something is discovered to be carcinogenic, like asbestos, we stop producing it and remove it from the environment.

But we have known for 60 years now that smoking tobacco kills people, and yet Canada still has 4.6 million smokers, who purchased 29,478,234,315 cigarettes in 2014.

As a physician specializing in anesthesiology, I have a front-row seat to the damage caused by tobacco. It is my job to get smokers safely through their cancer surgery, their lung resections and their amputations with as little pain and suffering as possible. I wish I could eliminate the cause of their problems, so they could avoid surgery in the first place.

Most smokers start as teenagers – 19.8% of 18 to 19-year-olds smoke. The solution must lie in preventing people from getting addicted to cigarettes as teenagers because once people start smoking, it is very difficult for them to quit. I have seen a man who has had both legs and eight fingers amputated due to smoking, puffing on a cigarette held between his two remaining fingers!

The best way to compensate for our historical error is to ban people who are now too young to smoke from ever smoking in the future. This policy was proposed by Deborah Khoo and a group from Singapore in 2010. She suggested increasing the legal age for buying tobacco by one year, every year. Those born after a specific date (for example 2005, children who are now age ten or under) would never be old enough to smoke legally. By 2030, only people over 25 would be able to buy cigarettes. Few teens can pass for 25, and most of them would not have friends old enough to buy tobacco for them. By 2050, smoking would be restricted to those over 45, making it look uncool to teenagers, and eliminating the problem of mothers who smoke during pregnancy. At the end of the century, there would be no one legally smoking in Canada.

This simple law, phasing in a new generation of non-smokers, would cause minimal disruption. Current adult smokers could continue to smoke. Businesses that currently depend on selling tobacco would only experience a small decline in sales each year. Tobacco companies would have time to diversify. Governments would find ways to make up for the loss of tax revenue on tobacco products – which currently stands at $8.1 billion.

A survey by Khoo and colleagues showed that 73% of non-smokers and 60% of smokers supported the idea, which has not yet been taken up by Singapore’s government. Canada could lead the way by actually passing this law.

Smoking is the number one cause of preventable deaths, killing more Canadians than AIDS, traffic accidents, suicide, murder, fires, and accidents combined. If one hundred people died in a plane crash or a terrorist attack, it would make headlines. There would be investigations to find the cause and inquiries to try to prevent such a tragedy from happening again. Smoking kills over a hundred Canadians every single day (including two non-smokers due to secondhand smoke), but this is considered normal and acceptable.

In order to be financially sustainable, tobacco companies must constantly lure new, young customers as older customers die. It’s time to put a stop to this business model, to protect our children from death and disability due to smoking. Within a generation, the lethal business of growing tobacco and selling cigarettes could become history.

The comments section is closed.

  • Rudy says:

    Agree completely that the answer is in preventing future generations from establishing the nicotine addiction. I wonder though if the law needs to be heavier handed – not preventing underage persons from buying tobacco, but making it illegal for underage people to smoke. In Ontario, it is currently illegal to purchase tobacco if under age 19, yet we have many smokers under that age.
    Right now, underage smoking is perfectly legal.

  • Elaine says:

    I liked this article and feel this is a very proactive plan to prevent smoking. I am a non smoker. 27 Yrs ago I was living in a basement apartment and one night there was a housefire that caused three deaths. One adult and two children, aged 4 and 18 months old. The cause was a single cigarette burning in a couch in the main floor of the house. The family above and my roommates and I were left homeless. The experience impacted me so much that I started travelling and moved away to Canada. I am an RN and was recruited to a Toronto hospital. I have worked with thoracic ca surgeries and respirology.

  • Mark Taylor says:

    I agree with the notion that it is unconscionable that the scourge of tobacco still exists. Unfortunately, this is the type of proposal that the tobacco industry would support. They have long been in favor of criminalizing the purchase of tobacco by young people. Anyone who has spent any time on this issue knows that the best indicator of the effectiveness of a measure is how strongly the industry fights against it. Criminalizing tobacco purchase by minors would eliminate the responsibility of the industry for the harms their products cause. Surely the criminals should be the sellers, not the buyers. As others have noted, criminalizing users has not worked well for other substances.

    Most of those who have dedicated years to fighting tobacco would argue that the measures that have been shown to be effective at discouraging young people from smoking are high prices, the complete elimination of advertising including plain packages and hidden displays, reduction of points of purchase, strong health warnings on packages, the elimination of smoking in public places, the banning of flavourings, severe punishments for sale to minors, and effective health education. In roughly that order, those are the measures that research has shown to be most effective at prevention the initiation of tobacco use.

  • Nancy says:

    This is a great idea. Young people don’t realize that it only takes a few cigarettes to start a life long addiction that will take their money and their health. Most youth don’t plan on smoking for the rest of their life but many find it so difficult to quit are never able to escape the addictive grip of nicotine. It would be great if the younger generation never started. The babies who yet to be born would not be exposed before birth!

  • Sue says:

    This is soooo true!! BC has the lowest smoking rates in Canada followed by Manitoba. Sadly Ontario has fallen to number 3….why? What does BC have that we don’t??

  • K says:

    I love the idea!! I was skeptical before reading, but it is a great idea.

  • Alexander Walter says:

    Oh, I understand!
    This has worked perfectly well with other toxic substances!
    Clever idea…


John Oyston


Dr. John Oyston, MBBS FRCA FRCP(C), is a retired assistant professor at the University of Toronto and Chief of Anesthesiology at The Scarborough Hospital. He has been an advocate for tobacco control for many years. He has been funded by the University of Catania for research into the health effects of vaping. Serna paid him as a consultant on curriculum development related to vaping. The Canadian Vaping Association commissioned him to write a report to support its legal case against a ban on flavours in vaping products. PMI has paid him to deliver lectures on “Safer nicotine products for people who smoke” to medical audiences. He ran a smoking cessation program called “Quit by Vaping.”

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