Pharmacists reject tobacco giant's argument for more retail access to nicotine pouches

Winnipeg Free Press

5 days ago

Canada's largest tobacco company is ratcheting up efforts to rescind a federal government order last year requiring that nicotine pouches be sold behind the counter at pharmacies.
Imperial Tobacco's public relations campaign says that the ministerial order has made its Zonnic nicotine-replacement therapy pouches more difficult for smokers to access.
Pharmacists — 'front-line health professionals who are already time-squeezed and over-burdened' — are 'increasingly disgruntled by the new demands of this order,' it said.
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An advertisement in a convenience store that sells Zonnic, a nicotine replacement product to help adults quit smoking that is not authorized to be sold to anyone under the age of 18.
Users place the pouches between their upper lip and gum for up to 60 minutes, releasing nicotine that temporarily curbs cravings and nicotine withdrawal symptoms, Imperial Tobacco says on its Zonnic website.
The association representing Manitoba pharmacists called that 'very, very strange.'
'There's no pharmacist being disgruntled or frustrated about the need to have people access these products in pharmacies,' said Britt Kural, pharmacy practice adviser with Pharmacists Manitoba.
'This is what we do — we do it really well.' She said pharmacists are among the most accessible health-care providers and able to help people find the right product to help them stop smoking.
'Pharmacists are experts in smoking cessation and we want to help people find the best options to help them in that journey,' Kural said Friday.
The pharmacy 'is exactly the right spot' for nicotine pouches that Imperial Tobacco and the government have classified as nicotine replacement therapy (NRT).
'We appreciate being able to have them available to consider for people when they want to stop smoking,' she said.
Not every pharmacist appreciates being 'the gatekeeper and policing an NRT product that has been approved by Health Canada,' said Imperial Tobacco's vice-president of corporate and regulatory affairs. Eric Gagnon said the company has heard concerns raised by pharmacy groups about it increasing their workload.
'I wouldn't say that everybody's on the same page,' he said from Montreal.
'The Neighbourhood Pharma Association has raised concern about moving (nicotine replacement therapies) behind the pharmacy counter,' said Gagnon. That could place an 'additional burden on pharmacy professionals,' he said.
'We hosted an event in Western Canada with pharmacists a few months ago, and they also raised some concerns.'
When the federal order was issued last August, Zonnic could no longer be sold where smokers regularly purchase cigarettes, and the flavours were restricted to mint and menthol. At the time, Gagnon accused the federal health minister of 'singling out' Imperial Tobacco, while giving pharmaceutical companies a pass.
'All smoking cessation products should be regulated in the same way,' Gagnon said in an Aug. 22, 2024 press release. 'This is not how good public health policy is made.'
When Zonnic tins — containing 24 pouches — were sold in convenience stores, there was an accelerated decline in cigarette sales, said Gagnon, adding that they've helped 'many thousands' quit smoking.
Nearly a year later, moving nicotine pouches behind the counter hasn't helped those trying to quit smoking, or Canada in meeting its stated goal of attaining a smoking rate of below five per cent by 2035, he said.
'We're concerned that either people will start smoking again or, as we have seen, people will start buying illegal nicotine products which often contain a lot more than the four milligrams that has been approved by Health Canada.'
He said specialty and online shops are illegally selling products that contain six, nine or even 15 milligrams of nicotine.
The push to get pouches sold over the counter alongside cigarettes comes after the settlement of a class-action lawsuit by provinces including Manitoba. Big Tobacco companies — including Imperial — are to cough up billions in after-tax profits solely from tobacco sales over the next 20 years.
'They need to get as many people addicted to alternative products — which includes pouches — as possible, for survival,' said the head of the Manitoba Tobacco Reduction Alliance. Cynthia Carr predicted after the tobacco settlement was announced in March that the companies would push for easier access to highly addictive nicotine pouches to grow their customer base.
'Not only are they handing over $6 billion or so, cash in hand, to start, they then have to start providing up to 85 per cent of their after-tax profits from tobacco. So if they only have a tiny portion left, of course they're going to sell every other product they can,' said Carr, a Winnipeg epidemiologist.
The federal government cracked down on the colourful packaging and flavours of nicotine pouches after studies showed youths were attracted and increasingly using them, Carr said Friday.
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'The company was marketing this to that younger audience, making them fun, fancy flavours — cool designs that were really meant to appeal to a younger population,' said Kural.
'There can be some serious health consequences to underage individuals using these types of nicotine products or any nicotine product,' the pharmacist said. 'That younger population may not understand the consequences that nicotine can have on their overall health and especially in the growth stage of their health.'
Kural said she doesn't think that pharmacists — or any health-care practitioner — would support returning nicotine pouches to over-the-counter sales.
'We're trying to prevent this from falling into the hands of people who shouldn't be using it,' she said.
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Carol SandersLegislature reporter
Carol Sanders is a reporter at the Free Press legislature bureau. The former general assignment reporter and copy editor joined the paper in 1997. Read more about Carol.
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