175-497: The Northern Territories Alcohol Labels Study ( NTAL study ) was a scientific experiment in Canada on the effects of alcohol warning labels . It was terminated after lobbying from the alcohol industry , and later relaunched with industry-advocated experimental design changes: omitting the "Alcohol can cause cancer" label, not labelling some alcohol products, and shortening the time period (from eight to four-and-a-half months). Enough data
350-451: A high nominal per capita income globally and its advanced economy ranks among the largest in the world by nominal GDP , relying chiefly upon its abundant natural resources and well-developed international trade networks . Recognized as a middle power , Canada's strong support for multilateralism and internationalism has been closely related to its foreign relations policies of peacekeeping and aid for developing countries . Canada
525-514: A multi-disciplinary evaluation is necessary to assess each of the four key features for assessment. Generally, a trained physician will determine growth deficiency and FAS facial features. While a qualified physician may also assess central nervous system structural abnormalities or neurological problems, usually central nervous system damage is determined through psychological , speech-language , and occupational therapy assessments to ascertain clinically significant impairments in three or more of
700-467: A parliamentary system within the context of a constitutional monarchy —the monarchy of Canada being the foundation of the executive, legislative , and judicial branches. The reigning monarch is also monarch of 14 other sovereign Commonwealth countries and Canada's 10 provinces . The monarch appoints a representative, the governor general , on the advice of the prime minister , to carry out most of their ceremonial royal duties. The monarchy
875-421: A population of just over 41 million people, it has widely varying population densities, with the majority residing in urban areas and large areas of the country being sparsely populated. Canada's capital is Ottawa and its three largest metropolitan areas are Toronto , Montreal , and Vancouver . Indigenous peoples have continuously inhabited what is now Canada for thousands of years. Beginning in
1050-547: A "large enough font size to be actually readable". All of these factors have been shown, in lab and online studies, to make labels more effective. Three labels were planned to rotate, as this has been found to make other warning labels more noticeable than always using the same label. The number of rotating labels was later reduced to two by industry intervention. The yellow central background and red borders were intended to make them stand out in contrast to any container. Label design work lasted four years, according to Tim Stockwell,
1225-646: A 10-metre (33 ft) cross bearing the words, "long live the King of France", and took possession of the territory New France in the name of King Francis I . The early 16th century saw European mariners with navigational techniques pioneered by the Basque and Portuguese establish seasonal whaling and fishing outposts along the Atlantic coast. In general, early settlements during the Age of Discovery appear to have been short-lived due to
1400-435: A chart with pictograms; they favoured large labels. Previous surveys generally found a majority of Canadians support alcohol warning labels, with one exception. While there has been a lot of research on how people react after seeing alcohol labels in lab and online studies, and what they say about their future intentions, there is much less research on how people change their behaviour in response to real-world warnings. Most of
1575-508: A child may appear 'normal' at birth, intellectual disabilities caused by alcohol before birth may not appear until the child begins school. More broadly, alcohol use during pregnancy is also associated with: Alcohol can also harm the fertility of women who are planning for pregnancy. Adverse effects of alcohol can lead to malnutrition, seizures, vomiting and dehydration. The mother can suffer from anxiety and depression which can result in child abuse/neglect. It has also been observed that when
1750-625: A combination of the harsh climate, problems with navigating trade routes and competing outputs in Scandinavia. In 1583, Sir Humphrey Gilbert , by the royal prerogative of Queen Elizabeth I , founded St John's, Newfoundland , as the first North American English seasonal camp . In 1600, the French established their first seasonal trading post at Tadoussac along the Saint Lawrence. French explorer Samuel de Champlain arrived in 1603 and established
1925-554: A constitutional amending formula and the Canadian Charter of Rights and Freedoms . The Charter guarantees basic rights and freedoms that usually cannot be overridden by any government; a notwithstanding clause allows Parliament and the provincial legislatures to override certain sections of the Charter for a period of five years. Canada's judiciary interprets laws and has the power to strike down acts of Parliament that violate
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#17328876411472100-593: A continuum of long-lasting molecular effects that are not only timing specific but are also dosage specific; with even moderate amounts being able to cause alterations. Additionally, ethanol may alter fetal development by interfering with retinoic acid signaling as acetaldehyde can compete with retinaldehyde and prevents its oxidation to retinoic acid. Different body systems in the infant grow, mature and develop at specific times during gestation. The effect of consumption of alcohol differs during each of these developmental stages: Fetal alcohol spectrum disorders encompass
2275-493: A diagnosis of ARND or static encephalopathy: Growth or height may range from normal to minimally deficient. Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) is the spectrum-wide term for the psychiatric, behavioral, and neurological symptoms of all FASDs. It was introduced into the DSM-V as a "condition for further study" and as a specified condition under, "other specified neurodevelopmental disorders" as
2450-591: A diagnosis of FAS, but also allows a "complex pattern" of functional anomalies for diagnosing PFAS and ARND. The "4-Digit Diagnostic Code" and CDC guidelines allow for a positive CNS finding in any of the three areas for any FASD diagnosis, but functional anomalies must measure at two standard deviations or worse in three or more functional domains for a diagnosis of FAS, PFAS, and ARND. The "4-Digit Diagnostic Code" also allows for an FASD diagnosis when only two functional domains are measured at two standard deviations or worse. The "4-Digit Diagnostic Code" further elaborates
2625-570: A diagnosis of Partial FAS: Growth or height may range from normal to deficient. Alcohol-related neurodevelopmental disorder (ARND) is the specific diagnosis of the non-dysmorphic type of FASD, where a majority of the symptoms are witnessed. The diagnosis was initially suggested by the Institute of Medicine to replace the terms FAE (fetal alcohol effects). It focuses on central nervous system damage, rather than growth deficiency or FAS facial features. The Canadian guidelines also use this diagnosis and
2800-506: A distinguishing element of Canada's political culture. Peace, order, and good government , alongside an Implied Bill of Rights , are founding principles of Canadian federalism . At the federal level, Canada has been dominated by two relatively centrist parties practising "brokerage politics": the centre-left leaning Liberal Party of Canada and the centre-right leaning Conservative Party of Canada (or its predecessors ). The historically predominant Liberals position themselves at
2975-1130: A global first. At the time of the study, South Korea warned consumers specifically about liver cancer , and allowed manufacturers to choose between three labels, one of which did not mention cancer. No other country had alcohol-cancer warning labels. Ireland introduced mandatory cancer-risk labelling in 2018, after the study was launched. As of 2020, no other countries had implemented cancer warning labels on alcohol. As of 2020, 47 countries mandate alcohol warning labels, mostly warnings against drinking while pregnant and driving while drunk . Eight required labelling of "standard drink" serving sizes , and none mandate information on drinking guidelines, although such knowledge has been shown to reduce drinking. The NTAL study cost CA$ 700,000. Despite selling alcohol, governments in Canada lose $ 3.7 billion net per year in healthcare costs to it. Each year, alcohol kills 18,300 Canadians and causes 105,000 hospitalizations and 700,000 emergency room visits (as of 2017). Adding government losses due to criminal justice and productivity costs raises
3150-423: A label that says this can give you cancer." The modified study did find that people who had been exposed to the labels were more likely to know that alcohol causes cancer. People it surveyed also said they drank less alcohol because of the cancer warning label. Sales of products declined when the warning labels were added to them. In this case, Beer Canada president Luke Harford wrote that "'Alcohol can cause cancer'
3325-451: A multi-disciplinary team of professionals. The main criteria for diagnosis of FASD is nervous system damage and alcohol exposure, with FAS including congenital malformations of the lips and growth deficiency. FASD is often misdiagnosed as or comorbid with ADHD. Almost all experts recommend that the mother abstain from alcohol use during pregnancy to prevent FASDs. As the woman may not become aware that she has conceived until several weeks into
3500-469: A national alcohol strategy that recommended contains-[number]-standard-drinks labels, but later opposed such labels. Industry lobbyists did not object to the NTAL study standard-drink labels as strongly as they did to the cancer warning, but they wanted to redesign them. Luke Harford of Beer Canada suggested that the reduced-risk drinking guidelines might be interpreted as a safe amount to drink and drive, asking if
3675-469: A range of physical and neurodevelopmental problems which can result from prenatal alcohol exposure. Diagnosis is based on the signs and symptoms in the person and evidence of alcohol use. These diagnoses of fetal alcohol spectrum disorders are currently recognized: As of 2016, the Swedish Agency for Health Technology Assessment and Assessment of Social Services accepts only FAS as a diagnosis, seeing
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#17328876411473850-521: A researcher working on the study. Before the study started, consumers were surveyed, and strongly approved of putting more information on alcohol containers. Preparatory lab studies with local volunteers were used to choose the content for the labels, so that they would contain the information consumers wanted to know. Yukon and the Northwest Territories (NWT) had both brought in mandatory small stick-on post-manufacturer labels in 1991, well before
4025-418: A study putting labels on your alcohol containers about possible health effects' ...[and] they would say, 'no, you are not going to do that — we are going to stop you, and we will use all means at our disposal to stop that information getting out'". He thought that industry lobbyists would immediately have gone to all the relevant ministers, and threats would have been made, ending the study before it could get off
4200-431: A temperate climate, with a mild and rainy winter. On the east and west coasts, average high temperatures are generally in the low 20s °C (70s °F), while between the coasts, the average summer high temperature ranges from 25 to 30 °C (77 to 86 °F), with temperatures in some interior locations occasionally exceeding 40 °C (104 °F). Much of Northern Canada is covered by ice and permafrost . The future of
4375-467: A third of drinking-age Canadians report not drinking at all in the past year (35.5% as of 2016). Yukon is the region of Canada with the highest per-capita alcohol sales and one of the highest cancer rates. The Chief Medical Officer of Health said that, in the Yukon, alcohol use probably caused more harm than the use of any other substance, and it had comparatively high rates of alcohol-related violence. He called
4550-527: A trained physician with the Lip-Philtrum Guide, a five-point Likert scale with representative photographs of lip and philtrum combinations ranging from normal (ranked 1) to severe (ranked 5). Palpebral fissure length (PFL) is measured in millimeters with either calipers or a clear ruler and then compared to a PFL growth chart, also developed by the University of Washington. Ranking FAS facial features
4725-459: A way to better study the behavioral aspects of all FASD disorders. In terms of FASD, growth deficiency is defined as significantly below average height , weight or both due to prenatal alcohol exposure and can be assessed at any point in the lifespan . Growth measurements must be adjusted for parental height, gestational age (for a premature infant ), and other postnatal insults (e.g., poor nutrition ), although birth height and weight are
4900-525: A weaker but similar effect. Learning that alcohol causes heart disease may or may not change drinking intentions; the evidence is mixed. Major industry strategies for fighting public knowledge of the link between alcohol and cancer have been categorized as deny, distort, and distract: It is common for alcohol industry spokespeople to assert that "alcohol causes cancer" statements are inaccurate, misleading, unproven, incomplete, and/or overreach. These assertions are often quoted in news media, sometimes without
5075-416: A wide variety of terminology to describe an individual's FASD condition, as the nomenclature is still evolving. Most individuals with deficits resulting from prenatal alcohol exposure do not express all features of FAS and fall into other FASD conditions. The Canadian guidelines recommend the assessment and descriptive approach of the "4-Digit Diagnostic Code" for each key feature of FASD and the terminology of
5250-730: Is a country in North America . Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean , making it the world's second-largest country by total area , with the world's longest coastline . Its border with the United States is the world's longest international land border. The country is characterized by a wide range of both meteorologic and geological regions. With
5425-474: Is a false and misleading statement" and said that it was "way too complex an issue to be discussed on the label". Jan Westcott of the Association of Canadian Distillers called the cancer-risk labels "alarmist and misleading". Such claims were widely quoted in media coverage of the NTAL study, though not as widely as in media coverage of some other efforts to label alcohol. Researchers, public health officials, and
Northern Territories Alcohol Labels Study - Misplaced Pages Continue
5600-449: Is a real risk". The Yukon Liquor Corporation put out a written statement saying that, "the liquor industry indicated a possibility and/or likelihood of legal action", and Matt King, its president, said that the cancer labels had been removed due to "the potential for protracted litigation". The Yukon had a population of about 40,000 people at the time of the study, and a gross domestic product of about C$ 3 billion (about one-seventh of
5775-399: Is a set of researchers that approached us to do a study here in the Yukon and the Northwest Territories and we agreed... We did encourage them to talk directly with the producers and largely I want to say, we left that in their hands". Tim Stockwell, a lead author, argued that consulting with industry would have been pointless. "Our conversation would go something like this: 'We're thinking of
5950-438: Is also increased-risk. While there is no safe level of alcohol consumption, drinking more is more harmful (people who drink less are healthier than those who drink more, and people who don't drink at all are healthiest). In earlier online studies, exposure to similar labels made drinkers better at estimating how much they'd drunk and how much alcohol would exceed the reduced-risk limits. The alcohol industry in Canada once approved
6125-418: Is complicated because the three separate facial features can be affected independently by prenatal alcohol. A summary of the criteria follows: Central nervous system (CNS) damage is the primary feature of any FASD diagnosis. Prenatal alcohol exposure, which is classified as a teratogen , can damage the brain across a continuum of gross to subtle impairments, depending on the amount, timing, and frequency of
6300-433: Is determined by comparing head circumference (often called occipitofrontal circumference, or OFC) to appropriate OFC growth charts. Other structural impairments must be observed through medical imaging techniques by a trained physician. Because imaging procedures are expensive and relatively inaccessible to most people, diagnosis of FAS is not frequently made via structural impairments, except for microcephaly. Evidence of
6475-554: Is divided into 15 terrestrial and five marine ecozones . These ecozones encompass over 80,000 classified species of Canadian wildlife , with an equal number yet to be formally recognized or discovered. Although Canada has a low percentage of endemic species compared to other countries , due to human activities, invasive species , and environmental issues in the country , there are currently more than 800 species at risk of being lost . About 65 percent of Canada's resident species are considered "Secure". Over half of Canada's landscape
6650-779: Is estimated to be at least 1 in 20. The rates of alcohol use, FAS, and FASD are likely to be underestimated, because of the difficulty in making the diagnosis and the reluctance of clinicians to label children and mothers. Some have argued that the FAS label stigmatizes alcohol use, while authorities point out that the risk is real. The condition has appeared in several works of fiction. The key signs of fetal alcohol syndrome (FAS) required for diagnosis include: Popova et al. identified 428 ICD-10 conditions as co-occurring in individuals with FAS. Excluding conditions used in FAS diagnosis, co-occurring conditions with 50% prevalence or greater include: Other FASD conditions are partial expressions of FAS where
6825-1019: Is intact and relatively free of human development. The boreal forest of Canada is considered to be the largest intact forest on Earth, with approximately 3,000,000 km (1,200,000 sq mi) undisturbed by roads, cities or industry. Since the end of the last glacial period , Canada has consisted of eight distinct forest regions . Approximately 12.1 percent of the nation's landmass and freshwater are conservation areas , including 11.4 percent designated as protected areas . Approximately 13.8 percent of its territorial waters are conserved, including 8.9 percent designated as protected areas. Canada's first National Park , Banff National Park established in 1885 spans 6,641 square kilometres (2,564 sq mi). Canada's oldest provincial park, Algonquin Provincial Park , established in 1893, covers an area of 7,653.45 square kilometres (2,955.01 sq mi). Lake Superior National Marine Conservation Area
7000-740: Is often printed in a colour that is similar to the background colour, and the warning is often placed on the back of the container. Tim Stockwell described this evidence as "pretty moot because the labels are so bad". Research suggests that the current American fetal warnings aren't very effective. Many people don't notice them. The messages chosen by alcohol providers as part of voluntary warning label schemes tend to be unhelpful (they are thought to be unlikely to change knowledge, intentions, or behaviour). Some may even be counterproductive; adolescents become less opposed to drunkenness when exposed to “please drink responsibly ” messages. Strong evidence that alcohol labels change behaviour in real life, as well as in
7175-454: Is part of multiple international organizations and forums . While a variety of theories have been postulated for the etymological origins of Canada , the name is now accepted as coming from the St. Lawrence Iroquoian word kanata , meaning "village" or "settlement". In 1535, Indigenous inhabitants of the present-day Quebec City region used the word to direct French explorer Jacques Cartier to
Northern Territories Alcohol Labels Study - Misplaced Pages Continue
7350-457: Is poorly understood. Aggravating factors may include advanced maternal age , smoking , poor diet, genetics, and social risk factors. The risk of FASD increases with amount consumed, the frequency of consumption, and longer duration of alcohol consumption during pregnancy. Blood alcohol concentration has been identified as a relevant factor. All forms of alcohol, such as beer, wine, and liquor, pose similar risk. Binge drinking increases
7525-476: Is required for a diagnosis of FAS, and the four diagnostic systems essentially agree on criteria for fetal alcohol syndrome (FAS). However, there are differences among systems when full criteria for FAS are not met. Prenatal alcohol exposure and central nervous system damage are the critical elements of the spectrum of FASD, and a positive finding in these two features is sufficient for an FASD diagnosis in all FASD systems. But different researchers and systems may use
7700-634: Is solely a federal responsibility and is uniform throughout Canada. Law enforcement, including criminal courts, is officially a provincial responsibility, conducted by provincial and municipal police forces. In most rural and some urban areas, policing responsibilities are contracted to the federal Royal Canadian Mounted Police . Canadian Aboriginal law provides certain constitutionally recognized rights to land and traditional practices for Indigenous groups in Canada. Various treaties and case laws were established to mediate relations between Europeans and many Indigenous peoples. The role of Aboriginal law and
7875-478: Is spreading the awareness needed for successful prevention efforts; "Intervention is Prevention". Many social determinants of health impact the effects of PAE: Women can experience serious symptoms that accompany alcohol withdrawal during pregnancy. According to the World Health Organization, these symptoms can be treated during pregnancy with brief use of benzodiazepine tranquilizers . Currently,
8050-399: Is the second-largest country . By land area alone, Canada ranks fourth , due to having the world's largest area of fresh water lakes . Stretching from the Atlantic Ocean in the east, along the Arctic Ocean to the north, and to the Pacific Ocean in the west, the country encompasses 9,984,670 km (3,855,100 sq mi) of territory. Canada also has vast maritime terrain, with
8225-512: Is the source of sovereignty and authority in Canada. However, while the governor general or monarch may exercise their power without ministerial advice in rare crisis situations , the use of the executive powers (or royal prerogative ) is otherwise directed by the Cabinet , a committee of ministers of the Crown responsible to the elected House of Commons and chosen and headed by the prime minister,
8400-416: Is the underlying cause of these disorders, which requires a different treatment paradigm than typical mental health disorders. While other FASD conditions may not yet be included as an ICD or DSM-IV-TR diagnosis, they nonetheless pose significant impairment in functional behavior because of underlying brain damage. Many indications of fetal alcohol spectrum disorders are developmental. Therefore, although
8575-545: Is the world's largest freshwater protected area, spanning roughly 10,000 square kilometres (3,900 sq mi). Canada's largest national wildlife region is the Scott Islands Marine National Wildlife Area which spans 11,570.65 square kilometres (4,467.45 sq mi). Canada is described as a " full democracy ", with a tradition of liberalism , and an egalitarian , moderate political ideology. An emphasis on social justice has been
8750-644: The Canada Elections Act limits this to four years with a "fixed" election date in October; general elections still must be called by the governor general and can be triggered by either the advice of the prime minister or a lost confidence vote in the House. The 105 members of the Senate, whose seats are apportioned on a regional basis, serve until age 75. Canadian federalism divides government responsibilities between
8925-672: The Dominion Lands Act to regulate settlement and established the North-West Mounted Police to assert authority over the territory. This period of westward expansion and nation building resulted in the displacement of many Indigenous peoples of the Canadian Prairies to " Indian reserves ", clearing the way for ethnic European block settlements . This caused the collapse of the Plains Bison in western Canada and
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#17328876411479100-473: The Alcoholic Beverage Labeling Act . The most current advocacy perspectives encourage people and systems to approach FASD with interventions and support for individuals who are already living with FASD. Focusing on prevention often only further stigmatizes individuals with FASD and their birth parents. Advocates say, if a person is supporting people currently living with FASD then that person
9275-746: The Battle of the Scheldt in 1944. Canada provided asylum for the Dutch monarchy while that country was occupied and is credited by the Netherlands for major contributions to its liberation from Nazi Germany . The Canadian economy boomed during the war as its industries manufactured military materiel for Canada, Britain, China , and the Soviet Union . Despite another Conscription Crisis in Quebec in 1944, Canada finished
9450-602: The COVID-19 pandemic in Canada began on January 27, 2020, with widespread social and economic disruption. In 2021, the possible graves of hundreds of Indigenous people were discovered near the former sites of Canadian Indian residential schools . Administered by various Christian churches and funded by the Canadian government from 1828 to 1997, these boarding schools attempted to assimilate Indigenous children into Euro-Canadian culture . By total area (including its waters), Canada
9625-628: The Canada Act 1982 , the patriation of Canada's constitution from the United Kingdom, concurrent with the creation of the Canadian Charter of Rights and Freedoms . Canada had established complete sovereignty as an independent country under its own monarchy . In 1999, Nunavut became Canada's third territory after a series of negotiations with the federal government. At the same time, Quebec underwent profound social and economic changes through
9800-783: The Canadian Shield , the interior plains , the Great Lakes-St. Lawrence Lowlands , the Appalachian region , the Western Cordillera , Hudson Bay Lowlands , and the Arctic Archipelago . Boreal forests prevail throughout the country, ice is prominent in northern Arctic regions and through the Rocky Mountains , and the relatively flat Canadian Prairies in the southwest facilitate productive agriculture. The Great Lakes feed
9975-731: The Meech Lake Accord failed in 1990. This led to the formation of the Bloc Québécois in Quebec and the invigoration of the Reform Party of Canada in the West. A second referendum followed in 1995, in which sovereignty was rejected by a slimmer margin of 50.6 to 49.4 percent. In 1997, the Supreme Court ruled unilateral secession by a province would be unconstitutional, and the Clarity Act
10150-668: The Oka Crisis of 1990, the first of a number of violent confrontations between provincial governments and Indigenous groups. Canada joined the Gulf War in 1990 and was active in several peacekeeping missions in the 1990s, including operations in the Balkans during and after the Yugoslav Wars , and in Somalia , resulting in an incident that has been described as " the darkest era in the history of
10325-602: The Parliament of Canada and the commissioners represent the King in his federal Council , rather than the monarch directly. The powers flowing from the Constitution Act, 1867 , are divided between the federal government and the provincial governments to exercise exclusively and any changes to that arrangement require a constitutional amendment , while changes to the roles and powers of the territories may be performed unilaterally by
10500-539: The Quiet Revolution of the 1960s, giving birth to a secular nationalist movement. The radical Front de libération du Québec (FLQ) ignited the October Crisis with a series of bombings and kidnappings in 1970, and the sovereigntist Parti Québécois was elected in 1976, organizing an unsuccessful referendum on sovereignty-association in 1980. Attempts to accommodate Quebec nationalism constitutionally through
10675-758: The St. Lawrence River (in the southeast) where the lowlands host much of Canada's economic output. Canada has over 2,000,000 lakes—563 of which are larger than 100 km (39 sq mi)—containing much of the world's fresh water . There are also fresh-water glaciers in the Canadian Rockies , the Coast Mountains , and the Arctic Cordillera . Canada is geologically active , having many earthquakes and potentially active volcanoes . Average winter and summer high temperatures across Canada vary from region to region. Winters can be harsh in many parts of
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#173288764114710850-736: The Surgeon General of the United States , the Centers for Disease Control, the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics , the World Health Organization , the United Kingdom's National Institute for Health and Clinical Excellence , and many others. In the United States, federal legislation has required that warning labels be placed on all alcoholic beverage containers since 1988 under
11025-453: The Westminster tradition . The country's head of government is the prime minister , who holds office by virtue of their ability to command the confidence of the elected House of Commons and is appointed by the governor general , representing the monarch of Canada , the ceremonial head of state . The country is a Commonwealth realm and is officially bilingual (English and French) in
11200-499: The displacement of Indigenous populations , and a process of increasing autonomy from the United Kingdom. This increased sovereignty was highlighted by the Statute of Westminster, 1931 , and culminating in the Canada Act 1982 , which severed the vestiges of legal dependence on the Parliament of the United Kingdom . Canada is a parliamentary democracy and a constitutional monarchy in
11375-441: The head of government . To ensure the stability of government, the governor general will usually appoint as prime minister the individual who is the current leader of the political party that can obtain the confidence of a majority of members in the House. The Prime Minister's Office (PMO) is one of the most powerful institutions in government, initiating most legislation for parliamentary approval and selecting for appointment by
11550-471: The 10th to 20th week of gestation. Refinements in diagnostic criteria since 1975 have yielded three distinctive and diagnostically significant facial features which distinguish FAS from other disorders with partially overlapping characteristics. The three FAS facial features are: Measurement of FAS facial features uses criteria developed by the University of Washington . The lip and philtrum are measured by
11725-501: The 16th century, British and French expeditions explored and later settled along the Atlantic coast. As a consequence of various armed conflicts , France ceded nearly all of its colonies in North America in 1763. In 1867, with the union of three British North American colonies through Confederation , Canada was formed as a federal dominion of four provinces. This began an accretion of provinces and territories resulting in
11900-564: The 1713 Treaty of Utrecht and Canada and most of New France came under British rule in 1763 after the Seven Years' War. The Royal Proclamation of 1763 established First Nation treaty rights, created the Province of Quebec out of New France, and annexed Cape Breton Island to Nova Scotia. St John's Island (now Prince Edward Island ) became a separate colony in 1769. To avert conflict in Quebec ,
12075-445: The 2010s and early-2020s showed that most did not know that alcohol causes cancer. Results varied by location and form of question (true/false or open-ended questions), but showed awareness generally below 50%, and sometimes below 1-in-7 (12.9%) unprompted. Less than a quarter of Yukon alcohol purchasers believed that alcohol caused cancer, when surveyed before the intervention started. The Northern Territories Alcohol Labels (NTAL) study
12250-685: The British Parliament passed the Quebec Act 1774, expanding Quebec's territory to the Great Lakes and Ohio Valley . More importantly, the Quebec Act afforded Quebec special autonomy and rights of self-administration at a time when the Thirteen Colonies were increasingly agitating against British rule. It re-established the French language, Catholic faith, and French civil law there, staving off
12425-529: The CDC use the 10th percentile as a cut-off to determine growth deficiency. The "4-Digit Diagnostic Code" allows for mid-range gradations in growth deficiency (between the 3rd and 10th percentiles) and severe growth deficiency at or below the 3rd percentile. Growth deficiency (at severe, moderate, or mild levels) contributes to diagnoses of FAS and pFAS, but not ARND or static encephalopathy. The "4-Digit Diagnostic Code" from 2004 ranks growth deficiency as follows: In
12600-729: The Canadian military ". Canada sent troops to Afghanistan in 2001 , resulting in the largest amount of Canadian deaths for any single military mission since the Korean War in the early 1950s. In 2011, Canadian forces participated in the NATO-led intervention into the Libyan Civil War and also became involved in battling the Islamic State insurgency in Iraq in the mid-2010s. The country celebrated its sesquicentennial in 2017, three years before
12775-565: The Chief Medical Officer of Health. Robert Solomon also said that since the Yukon Liquor Corporation sells alcoholic drinks, it has a legal duty of care to warn consumers of potential risks, and "it doesn't matter if the manufacturer isn't convinced by the evidence". He also said that anyone manufacturing or supplying alcohol in Canada (such as brewers and stores selling it) have a duty to inform consumers of these risks, and
12950-485: The Crown the governor general, lieutenant governors , senators, federal court judges, and heads of Crown corporations and government agencies. The leader of the party with the second-most seats usually becomes the leader of the Official Opposition and is part of an adversarial parliamentary system intended to keep the government in check. The Parliament of Canada passes all federal statute laws. It comprises
13125-696: The FDA has approved three medications—naltrexone, acamprosate, and disulfiram—for the treatment of alcohol use disorder (AUD). However, there is insufficient data regarding the safety of these medications for pregnant women. American Psychiatric Association guidelines recommend that medications not be used to treat alcohol use disorder in pregnant women except in cases of acute alcohol withdrawals or other co-existing conditions. Instead, behavioral interventions are usually preferred as treatments for pregnant women with AUD. Medications should only be used for pregnant women after carefully considering potential risks and harms of
13300-499: The Fetal Alcohol Syndrome Society Yukon expressed concern. Five focus groups done in the Yukon, before the labelling phase of the study began, found strong support for warning labels, with participants focussing on consumer's right to know about health harms, including cancer and fetal alcohol syndrome . Participants also wanted standard drink (SD) information, national low-risk drinking guidelines presented as
13475-732: The First Nations to education, government and legal rights. Because Britain still maintained control of Canada's foreign affairs under the British North America Act, 1867, its declaration of war in 1914 automatically brought Canada into the First World War . Volunteers sent to the Western Front later became part of the Canadian Corps , which played a substantial role in the Battle of Vimy Ridge and other major engagements of
13650-522: The IOM in diagnostic categories, excepting ARBD. The most severe condition is called Fetal Alcohol Syndrome (FAS), which refers to individuals who have a specific set of birth defects and neurodevelopmental disorders characteristic of the diagnosis. The following criteria must be fully met for an FAS diagnosis: FAS is the only expression of FASD that has garnered consensus among experts to become an official ICD-9 and ICD-10 diagnosis. Partial FAS (pFAS)
13825-777: The Liquor Corporation ( see § External links , below ). The study was started by university researchers from the Canadian Institute for Substance Use Research , with support from Health Canada , Public Health Ontario , the Chief Medical Officer of Health of the Yukon Brendan Hanley , and the Yukon Liquor Corporation . In the Yukon as in most of Canada, there is an alcohol monopoly , where only
14000-627: The Métis' grievances ignited the Red River Rebellion and the creation of the province of Manitoba in July 1870. British Columbia and Vancouver Island (which had been united in 1866) joined the confederation in 1871 on the promise of a transcontinental railway extending to Victoria in the province within 10 years, while Prince Edward Island joined in 1873. In 1898, during the Klondike Gold Rush in
14175-406: The NTAL study a major opportunity to fulfill the Yukon Liquor Corporation's social-responsibility mandate, because it would improve knowledge of the real-world effects of health warning labels on alcohol, making the Yukon a world leader in this research. The intervention site (where the labels were changed) was Whitehorse , the capital of the Yukon, and the experimental control site (where nothing
14350-532: The Norse built a small short-lived encampment that was occupied sporadically for perhaps 20 years at L'Anse aux Meadows on the northern tip of Newfoundland . No further European exploration occurred until 1497, when seafarer John Cabot explored and claimed Canada's Atlantic coast in the name of Henry VII of England . In 1534, French explorer Jacques Cartier explored the Gulf of Saint Lawrence where, on July 24, he planted
14525-636: The Northwest Territories, Parliament created the Yukon Territory. Alberta and Saskatchewan became provinces in 1905. Between 1871 and 1896, almost one quarter of the Canadian population emigrated south to the US. To open the West and encourage European immigration, the Government of Canada sponsored the construction of three transcontinental railways (including the Canadian Pacific Railway ), passed
14700-862: The Parliament of Canada. Foetal alcohol syndrome Fetal alcohol spectrum disorders ( FASDs ) are a group of conditions that can occur in a person who is exposed to alcohol during gestation . FASD affects 1 in 20 Americans, but is highly mis- and under-diagnosed. The several forms of the condition (in order of most severe to least severe) are: fetal alcohol syndrome (FAS), partial fetal alcohol syndrome (pFAS), alcohol-related neurodevelopmental disorder (ARND), and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE). Other terms used are fetal alcohol effects (FAE), partial fetal alcohol effects (PFAE), alcohol-related birth defects (ARBD), and static encephalopathy , but these terms have fallen out of favor and are no longer considered part of
14875-621: The Saint Lawrence River. Following the British conquest of New France , this area was known as the British Province of Quebec from 1763 to 1791. In 1791, the area became two British colonies called Upper Canada and Lower Canada . These two colonies were collectively named the Canadas until their union as the British Province of Canada in 1841. Upon Confederation in 1867 , Canada
15050-485: The Ten Brain Domains. Prenatal alcohol exposure risk may be assessed by a qualified physician, psychologist , social worker , or chemical health counselor. These professionals work together as a team to assess and interpret data of each key feature for assessment and develop an integrative, multi-disciplinary report to diagnose FAS (or other FASD conditions) in an individual. A positive finding on all four features
15225-682: The United Kingdom. The delay underscored Canada's independence. The first Canadian Army units arrived in Britain in December 1939. In all, over a million Canadians served in the armed forces during the Second World War . Canadian troops played important roles in many key battles of the war, including the failed 1942 Dieppe Raid , the Allied invasion of Italy , the Normandy landings , the Battle of Normandy , and
15400-617: The United States in 1846 ended the Oregon boundary dispute , extending the border westward along the 49th parallel . This paved the way for British colonies on Vancouver Island (1849) and in British Columbia (1858) . The Anglo-Russian Treaty of Saint Petersburg (1825) established the border along the Pacific coast, but, even after the US Alaska Purchase of 1867, disputes continued about
15575-622: The Yukon Liquor Corporation took legal responsibility for that, or laid it on the supplier, who had not seen the label in advance. The standard drink labels also encourage readers to plan two or more alcohol-free days per week. The Association of Canadian Distillers, Beer Canada and the Canadian Vintners Association alleged that the Yukon government had no legislative authority to add the labels, and would be liable for defamation, defacement, damages (including damage to brands), and packaging trademark and copyright infringement, because
15750-591: The Yukon Liquor Corporation, controlled by the government, can sell alcohol. The Yukon Liquor Corporation was the only liquor retailer in Canada willing to take part in the study. Erin Hobin of Public Health Ontario, a lead researcher on the study, praised the Yukon for its courage at the project launch. She said that the study's main aims were to find out whether the labels improved knowledge of health risks, or changed behaviour, and that this information could be used to develop better public health policy. The cancer labels were
15925-400: The Yukon government all strongly defended the truth of the statement. The researchers said that the fact that alcohol causes cancer has been well known to researchers since the 1990s, and would be well known to the public were it not for industry interference and obfuscation. Alcohol industry representatives also repeatedly stated that the link between alcohol and cancer was too complex to tell
16100-466: The abortive Rebellions of 1837 . The Durham Report subsequently recommended responsible government and the assimilation of French Canadians into English culture. The Act of Union 1840 merged the Canadas into a united Province of Canada and responsible government was established for all provinces of British North America east of Lake Superior by 1855. The signing of the Oregon Treaty by Britain and
16275-408: The alcohol industry, stigmatize it, and damage its reputation, often mentioning small/craft breweries and/or distilleries. The researchers acknowledged that the results of their research could be bad for alcohol sales. A few days after the labels came out, Tim Stockwell said an angry reaction from industry was only to be expected: "Nobody would want a product they make so much money from to suddenly have
16450-417: The annual estimated loss to $ 16.6 billion. Also as of 2017, Canadians spent $ 22.1 billion on alcohol per year: $ 9.2 billion on beer, $ 7 billion on wine, $ 5.1 billion on distilled spirits, and about $ 800 million on alcoholic ciders, coolers and other alcoholic drinks. This bought just over 229 bottles of beer, 24 bottles of wine, and 7 bottles of spirits for each Canadian who is over the legal drinking age. Over
16625-453: The central nervous system shows clinical deficits. In these other FASD conditions, an individual may be at greater risk for adverse outcomes because brain damage is present without associated visual cues of poor growth or the "FAS face" that might ordinarily trigger an FASD evaluation. Such individuals may be misdiagnosed with primary mental health disorders such as ADHD or oppositional defiance disorder without appreciation that brain damage
16800-707: The centre of the political scale. Five parties had representatives elected to the Parliament in the 2021 election —the Liberals, who formed a minority government; the Conservatives, who became the Official Opposition ; the New Democratic Party (occupying the left ); the Bloc Québécois ; and the Green Party . Far-right and far-left politics have never been a prominent force in Canadian society. Canada has
16975-536: The chances and severity of FASD to such an extent that Svetlana Popova has stated that "binge drinking is the direct cause of FAS or FASD". Small amounts of alcohol may not cause an abnormal appearance, however, small amounts of alcohol consumption while pregnant may cause behavioral problems and also increases the risk of miscarriage. Quasi-experimental studies provide moderately strong evidence that prenatal alcohol exposure causes detrimental cognitive outcomes, and some evidence of reduced birthweight, although no study
17150-548: The constitution. The Supreme Court of Canada is the highest court, final arbiter, and has been led since 2017 by Richard Wagner , the Chief Justice of Canada . The governor general appoints the court's nine members on the advice of the prime minister and minister of justice . The federal Cabinet also appoints justices to superior courts in the provincial and territorial jurisdictions. Common law prevails everywhere except Quebec, where civil law predominates. Criminal law
17325-511: The context of the scientific evidence. Industry-made public relations materials tend to have much more complex messages about alcohol and cancer. They stress that alcohol is not the only thing that causes cancer, and that there are many types of cancer which have not been linked to alcohol (also true of tobacco), and point out that it is not yet fully understood how alcohol causes cancers. These statements are true, but irrelevant. Industry materials also make or suggest untrue statements: for instance,
17500-509: The continent during the North American fur trade . These early European interactions with First Nations would change from friendship and peace treaties to the dispossession of Indigenous lands through treaties . From the late 18th century, European Canadians forced Indigenous peoples to assimilate into a western Canadian society. Settler colonialism reached a climax in the late 19th and early 20th centuries. A period of redress began with
17675-499: The country and consists of written text and unwritten conventions. The Constitution Act, 1867 (known as the British North America Act, 1867 prior to 1982), affirmed governance based on parliamentary precedent and divided powers between the federal and provincial governments. The Statute of Westminster, 1931 , granted full autonomy, and the Constitution Act, 1982 , ended all legislative ties to Britain, as well as adding
17850-421: The country, particularly in the interior and Prairie provinces, which experience a continental climate , where daily average temperatures are near −15 °C (5 °F ), but can drop below −40 °C (−40 °F) with severe wind chills . In non-coastal regions, snow can cover the ground for almost six months of the year, while in parts of the north snow can persist year-round. Coastal British Columbia has
18025-439: The degree of CNS damage according to four ranks: Structural abnormalities of the brain are observable, physical damage to the brain or brain structures caused by prenatal alcohol exposure. Structural impairments may include microcephaly (small head size) of two or more standard deviations below the average, or other abnormalities in brain structure (e.g., agenesis of the corpus callosum , cerebellar hypoplasia ). Microcephaly
18200-492: The disabilities of FASD than the neurobehavioral sequelae to the brain damage. Canadian guidelines updated in 2016 deleted growth as a diagnostic criterion. Several characteristic craniofacial abnormalities are often visible in individuals with FAS. The presence of FAS facial features indicates brain damage , although brain damage may also exist in their absence. FAS facial features (and most other visible, but non-diagnostic, deformities) are believed to be caused mainly during
18375-429: The drawing board. He also argued that consultation would be unethical: "We don't want to compromise the accuracy of the information that is put out to consumers because the people who are making a profit from the product are concerned". He said it would be against research ethics guidelines to discuss warning label design with people who have vested commercial interests in increasing alcohol sales. Canada Canada
18550-486: The duty is stronger if the risks are not widely known to the public, the product is mass-marketed to vulnerable consumers, the harms are more severe or probable, and the product is eaten or drunk. Jacob Shelley, director of the health ethics, law and policy lab at the University of Western Ontario , agreed, and pointed out that manufacturers can make money by increasing alcohol consumption, an interest that conflicts with their legal duty to warn of its dangers. Solomon said that
18725-577: The early 1930s saw an economic downturn, leading to hardship across the country. In response to the downturn, the Co-operative Commonwealth Federation (CCF) in Saskatchewan introduced many elements of a welfare state (as pioneered by Tommy Douglas ) in the 1940s and 1950s. On the advice of Prime Minister William Lyon Mackenzie King , war with Germany was declared effective September 10, 1939, by King George VI , seven days after
18900-624: The emergence of a new Canadian identity , marked by the adoption of the maple leaf flag in 1965, the implementation of official bilingualism (English and French) in 1969, and the institution of official multiculturalism in 1971. Socially democratic programs were also instituted, such as Medicare , the Canada Pension Plan , and Canada Student Loans ; though, provincial governments, particularly Quebec and Alberta, opposed many of these as incursions into their jurisdictions. Finally, another series of constitutional conferences resulted in
19075-524: The evidence as inconclusive with respect to other types. The agency feels it is unclear if identifying a FASD-related condition benefits the diagnosed individual. Presently, four FASD diagnostic systems that diagnose FAS and other FASD conditions have been developed in North America: Each diagnostic system requires an assessment of four key features: growth, facial features, central nervous system, and alcohol exposure. To determine any FASD condition,
19250-426: The evidence on real-world warnings is based on the small text-based labels required by the 1988 US Alcoholic Beverage Labeling Act . These labels have been widely criticized. The text is long and hard to read. It warns only about not drinking under specific circumstances, with a message about impaired driving and fetal alcohol spectrum disorders . There is only one message (not multiple messages that rotate). The text
19425-478: The exact biological mechanisms for the development of FAS or FASD are unknown. However, clinical and animal studies have identified a broad spectrum of pathways through which maternal alcohol can negatively affect the outcome of a pregnancy. Clear conclusions with universal validity are difficult to draw, since different ethnic groups show considerable genetic polymorphism for the hepatic enzymes responsible for ethanol detoxification. Genetic examinations have revealed
19600-663: The exact demarcation of the Alaska–Yukon and Alaska–BC border. Following three constitutional conferences, the British North America Act, 1867 officially proclaimed Canadian Confederation on July 1, 1867, initially with four provinces: Ontario , Quebec, Nova Scotia, and New Brunswick. Canada assumed control of Rupert's Land and the North-Western Territory to form the Northwest Territories , where
19775-485: The exposure as well as genetic predispositions of the fetus and mother. While functional abnormalities are the behavioral and cognitive expressions of the FASD disability, CNS damage can be assessed in three areas: structural, neurological, and functional impairments. All four diagnostic systems allow for assessment of CNS damage in these areas, but criteria vary. The IOM system requires structural or neurological impairment for
19950-434: The father's sperm. Almost all experts recommend that the mother abstain from alcohol use during pregnancy to prevent FASDs. A pregnant woman may not become aware that she has conceived until several weeks into the pregnancy, so it is also recommended to abstain from alcohol while attempting to become pregnant. The recommendations of abstaining from alcohol during pregnancy and while attempting to become have been made by
20125-416: The federal government and the 10 provinces. Provincial legislatures are unicameral and operate in parliamentary fashion similar to the House of Commons. Canada's three territories also have legislatures, but these are not sovereign, have fewer constitutional responsibilities than the provinces, and differ structurally from their provincial counterparts. The Constitution of Canada is the supreme law of
20300-488: The federal jurisdiction. It is very highly ranked in international measurements of government transparency, quality of life, economic competitiveness, innovation, education and human rights. It is one of the world's most ethnically diverse and multicultural nations, the product of large-scale immigration . Canada's long and complex relationship with the United States has had a significant impact on its history , economy , and culture . A developed country , Canada has
20475-422: The fetal alcohol syndrome labels were removed when the other labels were put on, to keep the total label size down. Tim Stockwell said that the original study design had included a pregnancy warning on the experimental labels, "but the (Yukon) Liquor Corporation kept insisting that the labels should be smaller, smaller, smaller and then in two languages, and there was just no room". After the study had been cancelled,
20650-534: The first permanent year-round European settlements at Port Royal (in 1605) and Quebec City (in 1608). Among the colonists of New France, Canadiens extensively settled the Saint Lawrence River valley and Acadians settled the present-day Maritimes , while fur traders and Catholic missionaries explored the Great Lakes , Hudson Bay , and the Mississippi watershed to Louisiana . The Beaver Wars broke out in
20825-493: The formation of a reconciliation commission by the Government of Canada in 2008. This included acknowledgment of cultural genocide , settlement agreements , and betterment of racial discrimination issues, such as addressing the plight of missing and murdered Indigenous women . It is believed that the first documented European to explore the east coast of Canada was Norse explorer Leif Erikson . In approximately 1000 AD,
21000-541: The fur trade, conflicts with the colonial authorities and settlers, and the loss of Indigenous lands to settlers and the subsequent collapse of several nations' self-sufficiency. Although not without conflict, European Canadians ' early interactions with First Nations and Inuit populations were relatively peaceful. First Nations and Métis peoples played a critical part in the development of European colonies in Canada , particularly for their role in assisting European coureurs des bois and voyageurs in their explorations of
21175-518: The gross revenues of the alcohol industry in Canada). Researchers initially hoped that a third party might offer funding (or just advice and confidence) to allow the Yukon to fight a legal challenge, as the Bloomberg Foundation did when Uruguay faced deeper-pocketed litigation over plain packaging for tobacco. Robert Solomon, a Canadian law professor specializing in drug and alcohol policy, called
21350-473: The growth of an independence movement in contrast to the Thirteen Colonies. The Proclamation and the Quebec Act in turn angered many residents of the Thirteen Colonies, further fuelling anti-British sentiment in the years prior to the American Revolution . After the successful American War of Independence, the 1783 Treaty of Paris recognized the independence of the newly formed United States and set
21525-416: The idea that alcohol only causes cancer in subgroups (like binge drinkers, heavy drinkers, smokers, people with nutritional deficiencies or taking HRT ), or even that alcohol might protect smokers against cancer. They often incorrectly say that there is no cancer risk from light or moderate drinking. The evidence doesn't support these claims. Industry statements often mix correct and incorrect information. In
21700-741: The in-store and radio messaging never happened. News coverage of industry intervention to shut down the study may have had some similar effects, effectively acting as an awareness campaign. But the news coverage affected both sites: the intervention site (where the new warning labels were added, and a new awareness campaign was planned), and the control site (where nothing was supposed to change). Learning that alcohol causes cancer causes most people to strongly support putting cancer warnings on alcohol containers. Knowing makes drinkers, including heavy drinkers, decide to consume less alcohol. They also become more likely to support other alcohol-related public health measures, like minimum unit pricing . Surveys from
21875-403: The industry could sue the Yukon government", despite the lack of merit to its case. The researchers also thought the alcohol industry, having actively intervened to conceal the health harms of their products from consumers, were opening themselves up to litigation for both the human suffering and recovery of healthcare costs. Lobbyists complained that they had not been consulted on or consented to
22050-455: The initial studies that described FAS, growth deficiency was a requirement for inclusion in the studies; thus, all the original people with FAS had growth deficiency as an artifact of sampling characteristics used to establish criteria for the syndrome. That is, growth deficiency is a key feature of FASD because growth deficiency was a criterion for inclusion in the study that defined FAS. Growth deficiency may be less critical for understanding
22225-509: The introduction of European cattle farms and wheat fields dominating the land. The Indigenous peoples saw widespread famine and disease due to the loss of the bison and their traditional hunting lands. The federal government did provide emergency relief, on condition of the Indigenous peoples moving to the reserves. During this time, Canada introduced the Indian Act extending its control over
22400-430: The lab, makes it easier for governments to require labels. The more evidence there is that the labels will improve awareness and public health, the less likely alcohol lobbyists are to win lawsuits against the labels. Broader awareness campaigns were planned to run during the study: in-store signage and handouts, a website, a toll-free helpline, and radio spots to augment the label messages. Industry intervention meant that
22575-483: The labelled alcohol container contained, and gave the pre-existing Canadian reduced-risk drinking limits (in terms of numbers of standard drinks). These Canadian Centre on Substance Use and Addiction limits have since been revised downwards. As of January 2023, the CCSA says 0 drinks is safest, ≤2 drinks per week is likely lower-risk, 3-6 is increased-risk, >6 significantly increases risk, and more than two drinks per occasion
22750-467: The labels had been added without their consent. In interviews with the New York Times , the lobby groups denied threatening legal action, while the minister said he had stopped the study because he feared legal action. The minister said that they had had conversations around legislative authority, label placement, trademark infringement, and defamation, and "those terms leave us thinking that litigation
22925-536: The labels had been added without their consent. They also claimed that the labels violated their freedom of expression . Partly because cigarette-package warning labels had already been ruled legal, these claims were not considered to have merit. Lobby groups denied threatening legal action. John Streicker , the Yukon Minister Responsible for the Yukon Liquor Corporation , stopped the study just before Christmas. He did not believe lobbyists' claims about
23100-468: The legal threats "without merit", and characterized them as an attempt to keep consumers unaware of the health costs of alcohol. He said it was clear that the Yukon government had the legal right to add the labels, because of the Supreme Court of Canada 's past rulings on cigarette-package warning labels. As the warnings were neither untrue nor malicious, there was no case for defamation , and no case for forced speech. The statements were clearly attributed to
23275-479: The lobbying against the NTAL study, the strongest industry objections were to the "Alcohol can cause cancer" labels. Minister John Streicker said that "I think the preference of the producers is to not have labels, period, and not to have a label study. I think I've heard that from them, but I think it's also fair to say that the thing they were most concerned about was the cancer label." Industry representatives told media that cancer labels would hurt and disadvantage
23450-761: The main front in the War of 1812 between the United States and the United Kingdom . Peace came in 1815; no boundaries were changed. Immigration resumed at a higher level, with over 960,000 arrivals from Britain between 1815 and 1850. New arrivals included refugees escaping the Great Irish Famine as well as Gaelic -speaking Scots displaced by the Highland Clearances . Infectious diseases killed between 25 and 33 percent of Europeans who immigrated to Canada before 1891. The desire for responsible government resulted in
23625-473: The medical facts and instead believed his chief medical officer of health that the labels were truthful. He stopped the study because he did not wish Yukon to risk a long and expensive lawsuit and thought leadership should be taken by the federal government after the COVID-19 pandemic . Initially, the Yukon Liquor Corporation declined to identify the lobbyists who had contacted them, but an access to information request later published e-mails between lobbyists and
23800-436: The medications versus the benefits of alcohol cessation. After a pregnant woman consumes alcohol, the alcohol crosses through the placenta and umbilical cord to the developing fetus. Alcohol metabolizes slowly in the fetus and remains for a long time when compared to an adult. A human fetus appears to be at triple risk from maternal alcohol consumption: Although alcohol is known to be a teratogen (causing birth defects),
23975-659: The mid-17th century over control of the North American fur trade. The English established additional settlements in Newfoundland in 1610 along with settlements in the Thirteen Colonies to the south. A series of four wars erupted in colonial North America between 1689 and 1763; the later wars of the period constituted the North American theatre of the Seven Years' War . Mainland Nova Scotia came under British rule with
24150-672: The monarch, the House of Commons, and the Senate . While Canada inherited the British concept of parliamentary supremacy , this was later, with the enactment of the Constitution Act, 1982, all but completely superseded by the American notion of the supremacy of the law . Each of the 338 members of Parliament in the House of Commons is elected by simple plurality in an electoral district or riding. The Constitution Act, 1982 , requires that no more than five years pass between elections, although
24325-630: The name of the national holiday was changed from Dominion Day to Canada Day . The first inhabitants of North America are generally hypothesized to have migrated from Siberia by way of the Bering land bridge and arrived at least 14,000 years ago. The Paleo-Indian archeological sites at Old Crow Flats and Bluefish Caves are two of the oldest sites of human habitation in Canada. The characteristics of Indigenous societies included permanent settlements, agriculture, complex societal hierarchies, and trading networks. Some of these cultures had collapsed by
24500-552: The permafrost is uncertain because the Arctic has been warming at three times the global average as a result of climate change in Canada . Canada's annual average temperature over land has risen by 1.7 °C (3.1 °F), with changes ranging from 1.1 to 2.3 °C (2.0 to 4.1 °F) in various regions, since 1948. The rate of warming has been higher across the North and in the Prairies. In
24675-570: The preferred measurements. Deficiencies are documented when height or weight falls at or below the 10th percentile of standardized growth charts appropriate to the population. Prenatal or postnatal presentation of growth deficits can occur, but are most often postnatal. Criteria for FASD are least specific in the Institute of Medicine (IOM) diagnostic system ("low birth weight..., decelerating weight not due to nutrition..., [or] disproportional low weight to height" p. 4 of executive summary), while
24850-413: The pregnancy, it is also recommended to abstain while attempting to become pregnant. Although the condition has no known cure, treatment can improve outcomes. Treatment needs vary but include psychoactive medications, behavioral interventions, tailored accommodations, case management, and public resources. Globally, one in 10 women drink alcohol during pregnancy, and the prevalence of having any FASD disorder
25025-473: The pregnant mother withdraws from alcohol, its effects are visible on the infant as well. The baby remains in an irritated mood, cries frequently, does not sleep properly, weakening of sucking ability and increased hunger. In 2019, a study found that individuals with FASD have a higher risk of hypertension independent of race/ethnicity and obesity. Fetal alcohol spectrum disorders are caused by alcohol exposure during gestational development. If an individual
25200-488: The provinces collect more revenue than the federal government, equalization payments are made by the federal government to ensure reasonably uniform standards of services and taxation are kept between the richer and poorer provinces. The major difference between a Canadian province and a territory is that provinces receive their sovereignty from the Crown and power and authority from the Constitution Act, 1867 , whereas territorial governments have powers delegated to them by
25375-568: The provinces could also sue alcohol manufacturers for not warning, as they had previously sued tobacco companies, and a large class-action lawsuit was only a matter of time. Solomon later co-published a paper with the NTAL study's public-health researchers, comprehensively examining and rejecting the legal threats. It disputed the idea that there was any ground for legal action, and said that the government might be at more legal risk for not warning about known dangers, but said that "given that individuals are generally permitted to sue anyone for anything,
25550-432: The public about on a small label; this talking point has also been used in other cases. The NTAL study found that people who remembered the "Alcohol can cause cancer" label were more likely to think that alcohol could cause cancer. It did not report any evidence that people misunderstood the simple message. Jan Westcott said that the cancer labels came off as scare messages, because people rightly "freak out" if you mention
25725-807: The rights they support were reaffirmed by section 35 of the Constitution Act, 1982 . These rights may include provision of services, such as healthcare through the Indian Health Transfer Policy , and exemption from taxation. Canada is a federation composed of 10 federated states , called provinces, and three federal territories . These may be grouped into four main regions : Western Canada , Central Canada , Atlantic Canada , and Northern Canada ( Eastern Canada refers to Central Canada and Atlantic Canada together). Provinces and territories have responsibility for social programs such as healthcare , education , and social programs , as well as administration of justice (but not criminal law). Although
25900-608: The risk of giving birth to a child with FASD is about 15%, and to a child with FAS about 1.5%. Drinking 2 standard drinks a day, or 6 standard drinks in a short time, carries a 4.3% risk of a FAS birth (i.e. one of every 23 heavy-drinking pregnant women will deliver a child with FAS). Furthermore, alcohol-related congenital abnormalities occur at an incidence of roughly one out of 67 women who drink alcohol during pregnancy. Among those mothers who have an alcohol use disorder, an estimated one-third of their children have FAS. The variance seen in outcomes of alcohol consumption during pregnancy
26075-659: The same criteria. While the "4-Digit Diagnostic Code" includes these criteria for three of its diagnostic categories, it refers to this condition as static encephalopathy . The behavioral effects of ARND are not necessarily unique to alcohol however, so use of the term must be within the context of confirmed prenatal alcohol exposure. ARND may be gaining acceptance over the terms FAE and ARBD to describe FASD conditions with central nervous system abnormalities or behavioral or cognitive abnormalities or both due to prenatal alcohol exposure without regard to growth deficiency or FAS facial features. The following criteria must be fully met for
26250-540: The same data sources. The definition of low alcohol consumption varies significantly among studies and often fails to incorporate all aspects of timing, dose, and duration. Recall bias and socioeconomic and psychosocial factors have been controlled for in most studies, but it is likely that residual confounding due to missing factors and variation in methods still exists and is larger than any observed effects. Fathers who consume alcohol prior to conception may contribute to FAS through long term epigenetic modification of
26425-740: The southeast. Canada is also home to the world's northernmost settlement, Canadian Forces Station Alert , on the northern tip of Ellesmere Island —latitude 82.5°N—which lies 817 kilometres (508 mi) from the North Pole. In latitude, Canada's most northerly point of land is Cape Columbia in Nunavut at 83°6′41″N, with its southern extreme at Middle Island in Lake Erie at 41°40′53″N. In longitude, Canada's land extends from Cape Spear , Newfoundland, at 52°37'W, to Mount St. Elias , Yukon Territory, at 141°W. Canada can be divided into seven physiographic regions:
26600-485: The southern regions of Canada, air pollution from both Canada and the United States—caused by metal smelting, burning coal to power utilities, and vehicle emissions—has resulted in acid rain , which has severely impacted waterways, forest growth, and agricultural productivity. Canada is one of the largest greenhouse gas emitters globally , with emissions increased by 16.5 percent between 1990 and 2022. Canada
26775-493: The spectrum. Not all infants exposed to alcohol in utero will have detectable FASD or pregnancy complications. The risk of FASD increases with amount consumed, the frequency of consumption, and the longer duration of alcohol consumption during pregnancy, particularly binge drinking . The variance seen in outcomes of alcohol consumption during pregnancy is poorly understood. Diagnosis is based on an assessment of growth, facial features, central nervous system, and alcohol exposure by
26950-463: The study began (see images). Both warn against drinking during pregnancy; the NWT label also warned of impaired ability to operate machinery and unspecified health problems. No other Canadian jurisdiction had any mandated alcohol warning labels at the time. The study's new experimental label designs were changed before the study began. The Yukon Liquor Corporation gave the researchers label-size limitations. So
27125-402: The study. These criticisms were echoed by the Yukon Liquor Corporation. When cancelling the study, it said it was unfortunate that the study "did not have the consent of label owners". John Streicker, the minister responsible for the Yukon Liquor Corporation, appeared to blame the researchers for not consulting with industry, saying "One of the things to understand first and foremost is that this
27300-438: The terms of peace, ceding British North American territories south of the Great Lakes and east of the Mississippi River to the new country. The American war of independence also caused a large out-migration of Loyalists , the settlers who had fought against American independence. Many moved to Canada, particularly Atlantic Canada, where their arrival changed the demographic distribution of the existing territories. New Brunswick
27475-446: The time European explorers arrived in the late 15th and early 16th centuries and have only been discovered through archeological investigations. Indigenous peoples in present-day Canada include the First Nations , Inuit , and Métis , the last being of mixed descent who originated in the mid-17th century when First Nations people married European settlers and subsequently developed their own identity. The Indigenous population at
27650-446: The time of the first European settlements is estimated to have been between 200,000 and two million, with a figure of 500,000 accepted by Canada's Royal Commission on Aboriginal Peoples . As a consequence of European colonization, the Indigenous population declined by forty to eighty percent. The decline is attributed to several causes, including the transfer of European diseases , to which they had no natural immunity, conflicts over
27825-554: The vice-president of research at the University of Victoria , saying the labels bore "false, misleading and potentially dangerous information". They asked if the study had received approval from a research ethics board (it had been approved by both the Research Ethics Board at Public Health Ontario (identification number: 2017-010.04) and the Human Research Ethics Board at the University of Victoria (Protocol 17–161), and had been given research licenses by both territorial governments). The other two labels explained how many standard drinks
28000-410: The village of Stadacona . Cartier later used the word Canada to refer not only to that particular village but to the entire area subject to Donnacona (the chief at Stadacona); by 1545, European books and maps had begun referring to this small region along the Saint Lawrence River as Canada . From the 16th to the early 18th century, Canada referred to the part of New France that lay along
28175-423: The war with a large army and strong economy. The financial crisis of the Great Depression led the Dominion of Newfoundland to relinquish responsible government in 1934 and become a Crown colony ruled by a British governor. After two referendums , Newfoundlanders voted to join Canada in 1949 as a province. Canada's post-war economic growth, combined with the policies of successive Liberal governments, led to
28350-428: The war. The Conscription Crisis of 1917 erupted when the Unionist Cabinet's proposal to augment the military's dwindling number of active members with conscription was met with vehement objections from French-speaking Quebecers. In 1919, Canada joined the League of Nations independently of Britain, and the Statute of Westminster, 1931 , affirmed Canada's independence. The Great Depression in Canada during
28525-434: The warning labels reduced alcohol sales and consumption: remembering the labels made people more aware of the alcohol-cancer link, and that awareness made people decide to drink less. Industry interference in the study brought international attention. In November 2017, "Alcohol can cause cancer" warning labels (and two other designs) were added to alcoholic products at the only liquor store in Whitehorse , Yukon . The study
28700-652: The word cancer . He said that the labels needed to mention some health benefits of alcohol. Erin Hobin disagreed, criticizing the evidence for such benefits. Westcott later said that the Association of Canadian Distillers was not denying that "excessive" drinking could cause "certain types" of cancer, but "We're just not sure that putting the word 'cancer' on a label is the most effective way to convey that information". He suggested advertising, and retailers having conversations with consumers, instead. Typical industry-funded "public health" ads have been shown to be ineffective to counterproductive. The BC Craft Brewers Guild wrote to
28875-410: The world's longest coastline of 243,042 kilometres (151,019 mi). In addition to sharing the world's largest land border with the United States —spanning 8,891 km (5,525 mi) —Canada shares a land border with Greenland (and hence the Kingdom of Denmark ) to the northeast, on Hans Island , and a maritime boundary with France 's overseas collectivity of Saint Pierre and Miquelon to
29050-427: Was adopted as the legal name for the new country at the London Conference and the word dominion was conferred as the country's title. By the 1950s, the term Dominion of Canada was no longer used by the United Kingdom, which considered Canada a "realm of the Commonwealth". The Canada Act 1982 , which brought the Constitution of Canada fully under Canadian control, referred only to Canada . Later that year,
29225-452: Was fully rated at low risk of bias and quantity of studies was limited. The evidence is inconsistent and contradictory regarding the effects of low-to-moderate drinking, for example less than 12 grams of ethanol per day. Many studies find no significant effect, but some find beneficial associations, and others find detrimental associations, even on the same outcomes. Summarizing studies by country shows some similarity in results, due to using
29400-419: Was gathered to show that all of the labels used in the study were simple, cheap, and effective, and it recommended that they should be required worldwide. Researchers felt that the lobbyists' changes diluted the scientific value of the study and feared the weakened study might not give clear results. While the shortened study did not provide enough evidence to answer some of the research questions, it showed that
29575-507: Was in turn split from Nova Scotia as part of a reorganization of Loyalist settlements in the Maritimes, which led to the incorporation of Saint John, New Brunswick , as Canada's first city. To accommodate the influx of English-speaking Loyalists in Central Canada, the Constitutional Act of 1791 divided the province of Canada into French-speaking Lower Canada (later Quebec ) and English-speaking Upper Canada (later Ontario ), granting each its own elected legislative assembly. The Canadas were
29750-486: Was not exposed to alcohol before birth, they will not have FASD. However, not all infants exposed to alcohol in utero will have detectable FAS, FASD, or pregnancy complications. No safe level of fetal alcohol exposure has been established. Because alcohol is a known teratogen , it is considered unethical to do randomized controlled trials on pregnant women to determine the precise toxicity effects of alcohol. Among women who consume any quantity of alcohol during pregnancy,
29925-430: Was passed by Parliament, outlining the terms of a negotiated departure from Confederation. In addition to the issues of Quebec sovereignty, a number of crises shook Canadian society in the late 1980s and early 1990s. These included the explosion of Air India Flight 182 in 1985, the largest mass murder in Canadian history; the École Polytechnique massacre in 1989, a university shooting targeting female students; and
30100-423: Was planned to run for eight months. Alcohol industry lobbyists stopped the study after four weeks. The Association of Canadian Distillers , Beer Canada and the Canadian Vintners Association alleged that the Yukon government had no legislative authority to add the labels, and would be liable for defamation, defacement, damages (including damage to brands), and packaging trademark and copyright infringement, because
30275-423: Was previously known as atypical FAS in the 1997 edition of the "4-Digit Diagnostic Code". People with pFAS have a confirmed history of prenatal alcohol exposure, but may lack growth deficiency or the complete facial stigmata. Central nervous system damage is present at the same level as FAS. These individuals have the same functional disabilities but "look" less like FAS. The following criteria must be fully met for
30450-470: Was supposed to change) was Yellowknife , the capital of the Northwest Territories , which similarly has a single liquor store. When interviewed in May 2017, Erin Hobin hoped to eventually expand the study to rural areas. The rural Yukon was also compared to Whitehorse. The researchers thought that past alcohol warning labels had not been very well-designed. They designed the labels used in the study to have bright, attention-getting colours, clear messages, and
30625-489: Was the first to look at the effects of cancer warning labels in the real world, but lab and online studies have previously tested their effects. Cancer warnings have been shown to be more effective than warnings about liver damage, diabetes, mental illness and heart disease. People seem to already know that alcohol causes liver damage ; but if they learn that alcohol causes cancer, they make a decision to drink less. Learning that alcohol causes diabetes and mental illness has
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