Sport, Smoke, Drugs... And Public Policy: An Advocacy Journey

Abstract:

"The health of the people is really the foundation upon which all their happiness and all their powers as a state depend." 

Benjamin Disraeli, 1877

The importance of the development of appropriate ‘healthy public policy’ cannot be emphasized enough. Such policies are of particular importance when they support the development of approaches and environments which optimize public and personal health. Policies which regulate or oversee commercial activities involving products demonstrably injurious to health are critical.

Since the late 1960’s the enormous, detrimental impact on societal health of tobacco products has been clearly understood. Yet the development of public policy to regulate the tobacco industry has too often been woefully neglected – typically in the face of strenuous, lavishly financed lobbying activities by that industry.

The role of physical activity, of which sport can be a central component, has long been recognized and found worthy of public support. An involvement in sport, frequently at the elite level which has been in direct receipt of government funding, led to the recognition of glaring inconsistencies in governmental policies and support.  Such recognition led to significant engagement in advocacy activities to illuminate and redress such inconsistencies and demonstrates the ongoing challenges in confronting ‘Corporate Determinants of Health’ (CDH) as corporations and their harmful products evolve.

The value of sport to the community warrants careful, thoughtful stewardship. The use of artificial means of enhancing sport performance (e.g. doping) erodes trust in the integrity of sport and calls for particular advocacy at many levels with sport organizations, professional organizations and governments. The organization and support of sport must also reflect the need to ensure that the entire community benefits from the opportunities that sport and physical activity afford.

Health-care professionals, it will be argued have particular advocacy responsibilities and it is important that such are recognized as being in keeping with the highest standards of their professions – and may make contributions to public health in excess of what is possible through the optimal expression of personal professional skills. In this discussion of a career-based journey through sport, opportunities for, and the necessity of, advocacy will be highlighted.

Dr. Andrew Pipe (CM, MD, LLD (Hon), DSc (Hon), FRCSPS(Hon), Dip Sport Med) is a graduate of Queen's University (a profoundly average member of the Queen’s Soccer Team while a student) and was formerly Chief of the Division of Prevention and Rehabilitation at the University of Ottawa Heart Institute. He continues as a clinician-scientist in that setting and has a significant record of academic publications, citations and international presentations.

Now Professor Emeritus in the Faculty of Medicine at the University of Ottawa, Dr. Pipe has been extensively involved in Sport and Sport Medicine throughout his career and is an acknowledged global expert on anti-doping matters. He has served as Team Physician to four Canadian national teams; as the Chief Medical Officer for Canadian teams at Olympic, PanAmerican and Commonwealth Games and is a past-president of the Canadian Academy of Sport and Exercise Medicine (CASEM) and the Commonwealth Games Association of Canada. Formerly a Vice-Chair of ParticipACTION he is a member of the Canadian Olympic Hall of Fame (Builder). In the aftermath of the 1988 Seoul Olympic Games scandal, Dr. Pipe led the development of Canada’s national anti-doping programme and served as its Chair for 8 years and participated actively in the creation of the World Anti-Doping Agency (WADA).

The founding-Chair of Physicians for a Smoke-Free Canada, Dr. Pipe has been a tireless advocate for appropriate tobacco-control policies and has been instrumental in their development and application – beginning with a successful campaign to remove tobacco sponsorship from sport.

Previously Chair of the Heart and Stroke Foundation of Canada he has been a prominent advocate for the healthy public policies that might prevent cardiovascular disease. Dr. Pipe has received honourary degrees from Queen's University, Brock University and the University of Guelph. In 2002 he was named to the Order of Canada. In 2024 Dr. Pipe was appointed to the Future of Sport in Canada Commission – tasked with examining issues relating to ‘Safe Sport’ and the structure of sport in Canada – its final report was delivered in March 2026.

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