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Q. uestion… What are Canadians smoking?. Over the last hundred years some things haven’t changed much…. And some things have…. How can awareness of the trends benefit you in your business?. G et paid faster!. C igars.
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Q uestion… What are Canadians smoking?
Over the last hundred years some things haven’t changed much…
How can awareness of the trends benefit you in your business?
Cigars • Composed primarily of a single type of tobacco with a tobacco wrapper. • Usually smoke is not inhaled.
Cigars • Size matters: • Little cigars • Same size and shape as cigarettes (often sold in packs of 20). • Contain about 1 gram of tobacco (about the same as a cigarette). • May have a filter since smoke is often inhaled. • Cigarillos • A little bigger than little cigars and cigarettes. • Contain about 3 grams of tobacco. • Does not have a filter. • Large cigars • 7+ inches in length. • Contain between 5 and 20 grams of tobacco. • Does not have a filter.
Cigars • How many Canadians are smoking cigars? • Overall population (ages 15+) - 4% • Ages 15 – 19 – 6% • Ages 20 – 24 – 9% • Teenagers prefer little cigars which are often flavoured.
Cigars • More harmful than cigarettes? • Higher levels of cancer-causing substances. • More tar. • Higher level of toxins. • The larger the size, the longer the smoking time, the higher the exposure to the toxic substances. • What if you don’t inhale? • Most cigar smokers don’t inhale. • Lower rates of lung cancer, coronary heart disease and lung disease than smokers but still higher rates than non-smokers. • Similar oral and esophageal cancer risks for cigar and cigarette smokers.
NRT (nicotine replacement therapy) • Most common forms of nicotine replacement therapy are patches and gum. No prescription required. • Works by giving the user some of the nicotine they would get from cigarettes. • Helps smokers quit by easing the nicotine withdrawal symptoms. • Initial dose is based on the number of cigarettes smoked each day. • Dose is slowly lowered as body adjust to being smoke-free.
NRT (nicotine replacement therapy) • NRT patches slowly release nicotine into the bloodstream. • NRT gum gives the user an immediate hit of nicotine. • Both are considered nicotine products. • NRT users = Smoker.
Hookahs • Hookah (or waterpipes) originated in the Middle East and India in the 16th century. • Waterpipes burn charcoal to heat tobacco or herbs, producing smoke. The pipe bubbles the smoke through water to cool it before it is inhaled.
Hookahs • In Ontario in 2012, more grade 7 – 12 students smoked hookahs than cigarettes (close to 10% versus 8.5%) • Increasing in popularity as a social activity among young people. • Doesn’t currently fall under Smoke-Free legislation. • Hookah bars.
Hookahs • Potentially more dangerous than cigarettes. • The charcoal used to heat the herbs or tobacco emits high levels of carbon monoxide, metals and cancer causing chemicals. • Users take an average of 200 puffs during a typical 1-hour hookah session, equivalent to smoking 10 cigarettes. • Exposure to second-hand smoke is a danger.
E-cigarettes • Introduced in US in 2007. • Looks like a cigarette but doesn’t contain tobacco. • Heats up liquid nicotine which turns into vapor that is inhaled. • Can also heat up propylene glycol liquid – “fog” at concerts and can be fused with liquid nicotine or flavourings • Considered by some to be a smoking-cessation tool. • Safe and effective? • Legal or illegal in Canada? Health Canada has refused to approve the sale or imp ort of devices or refills containing nicotine
E-cigarettes • E-cigarettes are considered nicotine products. • E-cigarette users = Smoker. • Replicates the activity of smoking. Can increases the risk of returning to smoking cigarettes. • Flavoured – how is this seen by underwriters?
Medical-marijuana • Medical-marijuana usage in Canada: • In 2001, there were approximately 100 Canadians authorized to possess marijuana for their own medical use. • By 2014 that number increased to almost 38,000 users. • By 2024, that number is projected to increase to 450,000. • Currently 12 licensed marijuana growers in Canada – the first six growers had a production capacity greater than 30,000 kilograms!
Medical-marijuana • “Can you write me a prescription for that?” • Patients must get a doctor to approve their usage and “write a prescription” for the Authorization to Possess marijuana. • Only 7% of all physicians and 14% of family doctors support medical-marijuana. • Health Canada: “Dried marijuana is not an approved drug or medicine in Canada. The GOC does not endorse the use of marijuana, but the courts have required reasonable access to a legal source of marijuana when authorized by a physician”.
Medical-marijuana • Medical conditions that are claimed to benefit from medical-marijuana include:
Medical-marijuana • In the news. • Not an approved drug in Canada. • Home grown VS licensed grower: • Medical-marijuana patients who grew their own as of September 30, 2013 can continue to do so. (approximate cost: $0.50/gram) • New patients must purchase dried marijuana directly from a licensed grower. (cost ranges from $5 to $13.50/gram) • Danger of home grow-ops. • Potential for abuse.
Zero Tolerance • Intentional or unintentional non-disclosure of material information (medical, financial or lifestyle) on insurance applications is considered fraud. • The most common area of intentional fraud is the answer to “Are you a smoker?”
Zero Tolerance • The result? • The claim will not be paid, even after the contestability period. • Beneficiaries could sue the advisor and the insurance company. • Don’t put your reputation at risk. • Good to know: • Ask your clients when they last smoked or used a nicotine-related product. • Give them examples of what could be considered “smoking”. A client using a nicotine patch but not smoking may believe they are a non-smoker. • If in doubt, or the client insists they are a non-smoker, submit a pre-assessment with full disclosure of their smoking activity. • “Smoking amnesia”. What is it? How to avoid it?
Non Disclosure • Recent study of smoking statistics: 12.9% Of applicants denied their “love affair” with tobacco 5.8% Of applicants who are former smokers suffered some form of “smokers amnesia”
Cotinine • Underwriters will test for cotinine. • Cotinine is only produced when nicotine is metabolized. • Tested for in a urine sample or saliva sample. • Test reveals tobacco use or exposure to tobacco smoke. • Non-smoker = smoke free for 1 year.
Not in Good Order (NIGO) • Full and correct disclosure of health history • All questions answered (and reflexive questions) • Handwriting, signatures complete and readable • Speeds up time to issue with U/W • QUS: Electronic paramedicals
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QUS can help! • Education and preparation are key to a good paramedical with the applicant • Client preparation guides and simple to understand services – in 16 languages • Most CE presentations of any paramedical company in Canada • Materials are reviewed with Chief U/W’s – input for NIGO’s and speeding up time to issue • 800+ Health Professionals coast to coast • Electronic paramedicals – speed up time to issue • We put the SERVE in SERVICE!
Q • Questions?
