Tofino has a drinking problem.
The town’s council adopted a Municipal Alcohol Policy in 2021 after two years of consultations stemming from a 2019 presentation from local doctor Dr. Carrie Marshall and Medical Health Officer Dr. Paul Hasselback, warning that alcohol had become the district’s top health concern.
Despite the district’s actions since then, alcohol continues to top the local health concern list and Medical Health Officer Dr. Charmaine Enns urged council to do more to tackle the issue during a presentation last month.
“We have an issue and it’s not going away. In fact, I expect it to get worse because as consumption goes up so does harm,” Enns said during council’s Aug. 20 regular meeting.
“Especially through enacting alcohol control policies…as a local government, you actually are very powerful…You’re very powerful in terms of the impacts on the health of the public.”
She explained that Tofino General Hospital is seeing an alarming and rising number of alcohol related hospitalizations that were 33 times higher than opioid hospitalizations in 2023. The rest of Vancouver Island saw alcohol hospitalizations 2.4 times higher than opiods.
“We have, in this community, hospitalization rates for alcohol that are almost 2.5 times higher compared to any other area on Vancouver Island,” she said.
She added that “opioid hospitalizations have been very stable, even over the toxic drug crisis, but alcohol is on the rise in terms of hospitalizations.”
She said hospital admissions linked to alcohol in the Alberni-Clayoquot region have surpassed tobacco and are 1.6 times higher than the rest of Vancouver Island and 2.1 times higher than British Columbia. Alcohol hospitalizations in the region have increased 1.4 times since 2007. Alberni-Clayoquot has a substance use disorder rate of 630.7 per 100,000, nearly two times higher than B.C.’s rate of 348.
“This is largely driven by alcohol,” she said, adding alcohol hospitalizations are over 700 per 100,000 while tobacco is around 600 and opioids are under 100.
She added that the death rate from alcohol in the Alberni - Clayoquot region is 50.1 per 100,000, eclipsing the Island’s rate of 37.6 and B.C.’s rate of 33.6.
She said the average alcohol consumption for Alberni-Clayoquot residents over 15 years old has reached 16.8 standard drinks a week, while the Island’s average is 10.3.
“We now know in increasing evidence and body of knowledge that the more drinks that are consumed, the more likely there are to be individual harms. The new guidance in Canada is that seven or more standard drinks a week will result in harm,” she said. “Alcohol is a carcinogen and we haven’t done a good job in our society of making the public aware of that as they consume. The risks from alcohol are not to be diminished.”
She suggested steps must be taken to denormalize drinking and decrease consumption.
“Consume less. There’s no magic number, but consume less because the less you drink the less harm there’s going to be to the individual, but also in terms of society,” she said.
Enns lives in Tofino, but had not presented to the town’s municipal council in a professional capacity before as her designated area for the past 21 years has been the North Island and she’s currently filling an interim role in Tofino’s jurisdiction.
“I have a duty to monitor and report on the health of the population and specifically to report to you as an elected government,” she said. “I actually have to advise in an independent manner, that’s my job. I’m not here to be difficult or to cause waves. I’m actually doing my job and then your job, conversely in our relationship, is to hopefully receive and consider it. You don’t have to do anything with it, but you have a responsibility in governing to receive the independent advice and to consider and, I hope, use it.”
She acknowledged that Tofino’s economy is driven by tourism, but argued against the perception that alcohol has an important role to play in vacations.
“We’re a tourist town, I get that. I’ve lived here a long time. We have small producers, restaurants and tourism. It’s kind of counter intuitive to me that we’d want to further normalize alcohol in an area that has spectacular beauty and outdoors that is unmeasurable compared to most of the world,” she said. “We, as community members, have a job to do too. We need to speak up for what’s important for us and how we want to have, I would hope, a life in our community that’s denormalizing alcohol and doesn’t need alcohol to have an enriched and meaningful community experience.”
She added that the negative impacts of alcohol outweigh the economic benefits, explaining that alcohol sales in B.C. generate about $2 billion in revenue, but cost $2.81 billion in terms of harms in healthcare, lost productivity and criminal justice.
“There is an argument that this is a boost to the economy and it’s a price we’re willing to pay. I’d like to just challenge that by saying, in fact, this is a loss for us in terms of the economy in B.C.,” She said. “We were in the hole $768 million in 2020 from alcohol and that’s without many of the societal and other impacts that aren’t measurable in terms of dollars and cents.”
She suggested every time someone has an alcoholic beverage, it costs British Columbians more than 30 cents in impacts.
“We have to pay for that as a tax base…Somebody has to pay for the harms and the alcohol sales aren’t covering it,” she said.
“As we consider what this means for Tofino, I would propose that it needs to be balanced against the community harms and safety and also I would propose we challenge some of the industry narrative. Let’s not be shy about challenging some of that narrative…We can dispel a lot of that industry narrative if we can just engage in conversation.”
She reiterated that council has significant power to decrease alcohol sales and consumption through limiting the amount of businesses where alcohol is sold and the hours those businesses are able to operate.
“I don’t mean just liquor stores. I mean hours of sales where there’s liquor distribution or liquor sales. You can control that through bylaw,” she said. “It is in your power.”
She suggested enforcement could include revoking business licences, increasing bylaw enforcement of business licences, establishing a new business licence category and surveillance.
In terms of denormalizing alcohol, Enns suggested the district could launch public campaigns around health and safety messaging and restrict alcohol at events.
She acknowledged the district was one of the first communities in B.C. to implement a Municipal Alcohol Policy in 2021, but suggested that policy be updated and a Community Alcohol Strategy be looked at as alcohol related harms go beyond the individual who consumes.
She added Island Health has created a new policy department that could help Tofino upgrade its alcohol policies.
“The priority within the unit is alcohol,” she said.
Coun. Al Anderson asked how consumption is measured to prove Tofino residents are drinking more, noting the town has a high number of tourists as well as a transient population of seasonal workers that could be skewing the numbers.
Enns acknowledged that “this is not a precise measurement” and is based on sales, but suggested the numbers are likely not affected much by visitors.
“It’s the local population that is the bedrock for the data and it doesn’t change with the season,” she said.
Coun. Duncan McMaster pointed out that Enns is an employee of the provincial government, which controls the distribution and sales of alcohol.
“I just wonder what response you get from your bosses at the provincial government,” he said.
Enns responded that the province is in “a conflicted position” on the issue.
“I’m here to give you my independent medical advice as a public health physician. I’m not a politician. The province though has the responsibility to tax the product and also pay for healthcare and legal system and criminal justice. They’re in a bit of a pickle I would say,” she said.
“The issue of my ability and conflict is very real as it relates to the conversation on alcohol…It’s not an easy path, but we can’t ignore it because other people have a vested interest and benefit.”
She suggested the province could face liabilities for the sales of carcinogens not labelled as carcinogens and noted Coun. Tom Stere’s efforts to launch a new labelling system for alcoholic beverages, similar to the warnings on cigarette packs.
Coun. Stere spoke about council’s efforts to tackle alcohol consumption and said Tofino’s Municipal Alcohol Policy is set for review this year or early 2025 and said the district would likely reach out to Island Health for advice on updating it.
“It is in the community charter very clearly that it is our responsibility,” Stere said.
