Item - 2019.HL3.3

The Board of Health:

1.  Urged the Government of Canada to:

a.  Enhance existing and develop new tools for monitoring, data collection, and reporting to better understand cannabis consumption rates and the full range of potential health impacts (negative and positive) of all cannabis products, including information on unintended consequences of the introduction of non-traditional methods of cannabis consumption;

b.  Prioritize research, in collaboration with public health and other subject matter experts, to establish low-risk consumption limits for cannabis;

c.  Focus public education efforts on establishing youth-protective, healthy practices related to the consumption of cannabis products, as they represent new forms of consumption for many people;

d.  Prohibit edible cannabis products that are particularly appealing to children due to colour or shape (i.e., gummy bears, lollipops, etc.);

e.  Prohibit youth-friendly flavours of cannabis vaping products, such as desserts, candy, or soft drinks;

f.  Require edible cannabis products in a single package/container to reflect traditional consumption portions of similar products without cannabis;

g.  Prohibit the marketing, promotion, and display of vaping devices that may be used to consume cannabis in places where youth have access, regardless of whether or not the product or advertising medium represents an association with cannabis;

h.  Establish a maximum limit for total available Delta-9-tetrahydrocannabinol amounts in one-time use (i.e., disposable) vaping devices and require cannabis vape cartridges and vaping devices to include a mechanism to limit the maximum quantity/dosage of Delta-9-tetrahydrocannabinol inhaled in a single "puff" or inhale;

i.  Require cannabis product labelling to include:

A.  Dosing information for vape cartridges, vape devices, and edible cannabis products;

B.  Warnings on cannabis vape cartridges that the product has high Delta-9-tetrahydrocannabinol content; and

C.  Health warning messages, including avoiding co-consumption of edible cannabis with alcohol and/or highly-caffeinated drinks.

j.  Prohibit cannabis topical products that mimic food or drink, including the appearance of the immediate packaging or container to resemble food packaging; and

k.  Prohibit the marketing and promotion of cannabis use in movies, video games, and other media accessible to youth.

2.  Directed that its decision and the report (February 12, 2019) from the Medical Officer of Health be forwarded to all Toronto school boards and Toronto-based Members of Parliament and Members of Provincial Parliament.

On October 17, 2018, the Cannabis Act, 2017 came into force, legalizing the use of cannabis for non-medical purposes. This federal legislation regulates cannabis cultivation, production, packaging, labelling, and promotion of dried and fresh cannabis, cannabis oil and seeds, and cannabis accessories. The Government of Canada has committed to amending the Cannabis Act by October 17, 2019 to include additional cannabis products. In preparation, Health Canada is conducting consultations on proposed amendments to the existing Cannabis Regulations to regulate edible cannabis, cannabis extracts, and topicals.

Toronto Public Health supports a public health approach to the legalization and regulation of cannabis products. Cannabis is a psychoactive substance with potential harms to health. Drug-impaired driving, early initiation of cannabis use, and frequent use are among the main public health concerns related to cannabis. The Board of Health has supported a range of actions directed at the federal and provincial governments to protect health and reduce harms from cannabis use.

This report provides comments based on a review of the proposed amendments to the federal Cannabis Regulations. The proposed amendments include the production and sale of cannabis vaping products, edibles, and other products, such as skin products prepared with cannabis as an ingredient. The recommendations in this report provide regulatory actions the federal government can take to prevent youth exposure to cannabis products that encourage initiation of use, reduce accidental ingestion of cannabis products, reduce consumption of high-potency cannabis products, and highlight the need to collect information on the public health impact of cannabis legalization.