A letter to the editor published in the Toronto Star on July 7, 2019.

Most of us are aware that cigarette butts are the by far and away the leading source of litter, either by number or weight, both in Canada and worldwide, where trillions are littered daily. In addition to being unsightly, non-biodegradable and toxic to marine and terrestrial environments, they are also a leading cause of destructive fires. Although they are increasingly getting the attention that they deserve as an environmental concern, little thought to them has been given in the context of Canada's recently proposed single-use plastics ban.  

So what exactly is a cigarette butt? Doesn't the filter make smoking safer? They are made up of mostly cellulose acetate–a type of plastic. According to Historian Allen Brandt's "The Cigarette Century" , while initially introduced in the 1950s in response to growing health concerns about smoking (at a time when the industry was still claiming there were none), it soon became clear that they do not make smoking any less dangerous, (and make actually contribute to it's mortality via making smoking less irritating, easing initiation and increasing amounts smoked). They quickly became a marketing tool for the industry- pH was intentionally manipulated to ensure the filters darkened upon smoking, providing the reassuring illusion of filtration.
In addition to dwarfing other sources of plastic waste in number, cigarette butts also differ in a couple of other very significant ways. Firstly ,all other sources of plastic waste, from straws to plastics bags, initially serve an undeniably positive purpose to their user.  The cigarette butt start off as the only product available today that, when used exactly as intended, eventually ends up killing over half it's users, more than 7 million annually, the world's (and also still Canada's) leading cause of preventable death. While banning cigarette filters may have some beneficial indirect effects on smoking rates, much greater benefits would result from measures including raising the age for purchase of all smoked or vaped substances to 21 (currently happening in many States), eliminating kid-friendly flavours and advertising, dramatically increasing cigarette taxes (in line with Australia) and anti-tobacco government spending (now only about one per cent of tobacco tax revenue), and banning smoking in multi-unit dwellings and outdoor gathering areas.
Secondly,  other sources of plastic waste are later usually at least attempted to be disposed of in an environmentally-friendly manner.  Despite decades of unsuccessful educational campaigns, estimates are that at least half of all cigarette butts are disposed of via littering. This means that unlike other sources of plastic waste which enter the environment en-masse through landfills and various means of industrial waste mismanagement,  trillions of toxic cigarette butts each enter the environment individually, leading to much more widespread damage. Therefore implementing a single-use plastics ban without including cigarette filters would be at best a half-measure, and would represent a major lost opportunity to eliminate one of our greatest environmental scourges.
Are there other options for dealing with cigarette waste? Yes, but none that are nearly as good. On a provincial level, Physicians for a Smoke-Free Canada still strongly supports a cigarette deposit-return program, however, while it would be very effective and cost-neutral, this would require significant infrastructure involvement and so far consecutive BC governments have been resistant. Municipally, we would support  the mandatory requirement of having a portable private ashtray and showing such to the sales clerk in order to be allowed to purchase a pack of cigarettes. The stores would be on board as anyone without one would be forced to purchase one from them along with their cigarette purchase. While helpful, and easily implemented, the magnitude of benefit from such a program would be much lower than either of the above. We are opposed to public ashtrays, given that they have not only been proven to be ineffective, but also send the wrong public health message. Several governing agencies have given lip-service to including the tobacco industry under Extended Producer Responsibilities. Beyond providing an image win to the tobacco industry, this would really only provide funding (ultimately via another "tax" on the cost of cigarettes- not a bad thing in itself)  for attempts at difficult after-the-fact clean-up. The ineffectiveness of such with regards to single-use plastics is of course the raison d'etre for proposing the SUP ban in the first place.
Proposing a ban on cigarette filters is not new. UCSD Emeritus Professor Thomas Novotny has long been advocating for this. However it could only succeed in a large jurisdiction. Our federal government's proposal for a sweeping single-use plastics ban gives us this opportunity. We call on not only the government, but on Canada's many health and environmental groups to make sure that the King of the Single-Use Plastics does not escape the reckoning that appears to be coming for his Henchmen.

Stuart H. Kreisman, MD