Smoking in Canada: An Overview

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Introduction

The Canadian Tobacco Use Monitoring Survey (CTUMS) was developed to provide Health Canada and its partners with timely, reliable, and continual data on tobacco use and related issues. The survey's primary objective is to track changes in smoking status and amount smoked, especially for 15-24 year-olds, who are most at risk for taking up smoking.

These findings are based on interviews conducted by Statistics Canada between February and December 2003. This fact sheet provides an overview of findings on various topics addressed in the survey questionnaires for 2003 and includes the latest trends in smoking.

All CTUMS fact sheets and supplementary tables, representing four full years of data collection since February 1999, are available on Health Canada's Tobacco Control Programme website.

Trends in Smoking

According to CTUMS, 21% of Canadians (about 5.3 million people) aged 15 and over were current smokers in 2003. An estimated 17% were daily smokers, while the remaining 4% were occasional smokers. The prevalence of smoking was 23% for men and 18% for women.

In 2003, a majority of the Canadian population (53%) were classified as never-smokers, and another 26% were classified as former smokers.

For youth aged 15-19, the prevalence of smoking, at 18%, was slightly less than the overall rate. The prevalence of smoking among females aged 15-19 (20%) continued its recent pattern of being slightly higher than the rate among males (17%).

The smoking rate among young adults aged 20-24 remained the highest across all age groups (30%), with little difference between male and female rates.

Over age 24, smoking rates tended to decrease with age. More specifically, the prevalence of smoking in 2003 was 27% for Canadians aged 25-34, 24% for those aged 35-44, 22% for persons aged 45-54, and only 12% for those aged 55 and over.

As shown in Figure 1, smoking prevalence has decreased significantly since 1985 in all age groups, with overall prevalence falling by 14 percentage points. This includes a drop of 8 percentage points for youth aged 15-19 and 12 percentage points for young adults aged 20-24.

Provincial Trends

In 2003, British Columbia continued to have the lowest smoking prevalence (16%) among the provinces. The rate of smoking among the other provinces ranged between 20% (in Alberta and Ontario) and 25% (in Quebec).

All provinces have experienced a large drop in smoking prevalence since 1985 (Figure 2). Prince Edward Island had the largest decrease in the prevalence of smoking (22 percentage points) and Saskatchewan had the smallest (7 percentage points).

Consumption of Cigarettes

Not only are fewer Canadians smoking as compared with 1985, but they are also smoking fewer cigarettes. In 2003, daily smokers averaged 15.9 cigarettes per day as compared with 20.6 cigarettes per day in 1985.

Figure 3 presents several consumption trends. Male daily smokers consumed more cigarettes per day than did female daily smokers (17.3 versus 14.0). The amount smoked by daily smokers increased with age - from an average of 12.3 cigarettes per day for those aged 15-19 to 18.0 for those aged 45 and over. Finally, the amount smoked by daily smokers varied across the provinces, from a low of 14.6 cigarettes per day in Alberta to a high of 16.8 in Quebec.

"Light" and "Mild" Cigarettes

Fifty-eight percent of Canadian smokers usually smoked "light" or "mild" cigarettes, including "extra" and "ultra" versions.

Smokers of light or mild cigarettes were asked about their beliefs regarding the relative health impacts of smoking such cigarettes. They seemed to have little conviction that there were any positive health consequences from smoking light or mild cigarettes. More specifically, 88% did not believe that smoking these cigarettes reduced the risks of smoking without having to quit, 83% did not believe that smoking these cigarettes reduced the health risks as compared with smoking regular cigarettes, and 78% did not believe that smoking such cigarettes reduced their exposure to tar.

Nicotine Dependence

One measure of nicotine dependence is the Heaviness of Smoking Index, which combines time from waking to smoking the first cigarette of the day and number of cigarettes smoked per day into a scale with three categories of nicotine dependence: light, moderate and heavy.

According to this measure, 43% of daily smokers in Canada were classified as having a light nicotine dependency, 44% had a moderate dependency, and 13% were heavily dependent. The level of nicotine dependency was higher among older smokers, male smokers, and those who smoked regular strength cigarettes.

Use of Alternative Forms of Tobacco

In addition to cigarettes, CTUMS also monitors the use of alternative forms of tobacco. In 2003, only 3% of Canadians had smoked cigars or cigarillos in the previous 30 days. Even fewer had smoked a pipe or used chewing tobacco, pinch, or snuff.

Youth Access to Tobacco

Under the federal Tobacco Act, it is illegal to furnish (for example, sell) tobacco products to young persons aged under 18 in a public place. However, six provinces (Newfoundland, Prince Edward Island, Nova Scotia, New Brunswick, Ontario, and British Columbia) have passed legislation increasing this age limit to 19.

The 2003 smoking rate for 18-year-olds was 16% in the provinces where it is illegal to sell to 18-year-olds. In the remaining four provinces (where 18-year-olds can legally obtain cigarettes), the smoking rate for 18-year-olds was much higher (35%).

How do young persons over age 15 but under the legal age to purchase cigarettes usually obtain their cigarettes? A majority (52%) purchased them from retail sources, especially from small grocery stores (47%). Forty-eight percent of minors obtained their cigarettes from social sources such as a friend or relative (either by taking, buying, or being given them). Twenty-nine percent reported that they were usually given cigarettes by a friend or non-family member.

Starting to Smoke

One measure of smoking experimentation is the age at which the first cigarette was smoked. Among smokers aged 25 and over, 22% had consumed their first cigarette before reaching their teens. By age 15, 62% of these smokers had smoked their first cigarette, and this proportion reached almost 90% by the end of their teens. There was little difference between male and female smokers aged 25 and over in the age they started to smoke.

Smoking and Main Activity/Occupation

In 2003, CTUMS asked respondents about their main activity over the previous 12 months and, for those who reported being employed, additional questions were asked about their occupation.

As compared with an overall smoking rate of 21%, the prevalence of smoking was higher for persons looking for work (31%) and for employed persons (24%). Smoking rates were lower for retirees (11%) and for students (18%).

The 57% of respondents who reported their main activity as "working at a job" were then asked for their occupation. Smoking rates were highest among trade, transport, or equipment operators (36%); workers in processing, manufacturing, or utilities occupations (35%); and those in sales or service (30%). The lowest prevalence of smoking was found among professionals (16%) and workers employed in the administrative, financial, or clerical sectors (18%).

Smoking Restrictions at Work

About two thirds (66%) of employed respondents reported that smoking was completely banned at their place of work (Figure 4). Only 9% said that there were no restrictions at all.

Total restrictions on smoking at the workplace were highest for professionals (81%) and administrative, financial, or clerical workers (76%) and lowest for those in farming, forestry, fishing, or mining occupations (31%). Provincially, the highest rates of complete restrictions at the workplace were in Ontario (72%) and British Columbia (69%), whereas the lowest rates were in Saskatchewan (47%) and Alberta (54%) (Figure 4). Slightly over half (53%) of current smokers reported a total ban on smoking in their workplace as compared with about 70% of former and never-smokers.

Attitudes About Smoking in Restaurants and Bars

In 2003, half of Canadians aged 15 and over felt that smoking should not be allowed anywhere in restaurants. Almost all others favoured some sort of restrictions on smoking in restaurants. These results were much the same regardless of age group or sex. Support for a complete ban on smoking in restaurants was highest among never-smokers (59%) and lowest among current smokers (33%).Nevertheless, fully 95% of smokers agreed that there should be some sort of restriction on smoking in restaurants. Only 29% of Quebecers supported a complete ban on smoking in restaurants. In all other provinces, approval rates for complete smoking restrictions in restaurants were at least 46% and ranged up to a high of 68% in Newfoundland and Labrador.

About 76% of Canadians agreed that there should be some sort of restriction on smoking in bars and taverns, with 34% favouring no smoking at all. Support for a ban on smoking was highest among older Canadians and never-smokers. Provincially, the pattern was much the same as that for smoking in restaurants, with the highest approval rate for no smoking in bars occurring in Newfoundland and Labrador (45%) and the lowest in Quebec (20%).

Second-hand Smoke at Home

In 2003, there was no regular smoking (either by family members or others) in 82% of Canadian households. This proportion ranged from a low of 73% in Quebec to a high of 89% in British Columbia. In 86% of the households with one or more children aged under 12, there was no regular smoking at home.

Survey Methods

Objectives: The Canadian Tobacco Use Monitoring Survey (CTUMS) was initiated in 1999 to provide Health Canada with reliable data on tobacco use and related issues. The primary objective is to track changes in smoking status and amount smoked, especially for those aged 15-24, who are most at risk for taking up smoking.

Population Coverage: The target population for CTUMS is all persons aged 15 and older living in Canada, excluding residents of Yukon, Nunavut, and the Northwest Territories, and full-time residents of institutions. In addition, because this was a telephone survey, the 3% of Canadians without telephones are not included.

Data Collection: The results in this fact sheet are based on data collection that took place between February and December 2003. Statistics Canada conducted computer-assisted interviews by telephone; only direct reports (i.e., not third-party) with selected persons were accepted.

Survey Design: To allow provincial comparisons of approximately equal reliability, the overall sample size for the survey was divided equally across all 10 Canadian provinces. Information about household composition and second-hand smoke in the home was collected in 47,982 households. In half of these households, someone aged 15 or older was selected to provide information on smoking habits. This amounted to 21,300 individuals in 2003, about half of whom were aged 15-24. With this sampling frame, it is possible to estimate the smoking prevalence of Canadians aged 15 and older within about ±0.9% each year. The margin of error will increase when estimating the prevalence of tobacco use for subgroups. A few questions were added to the questionnaire in July 2003, and the sample size for these was 10,741. The topics included age at which daily smoking began and use of marijuana.

The overall response rate, which takes into consideration the participation of both households and individuals, was 76% for the 2003 CTUMS data collection. Every telephone number called by Statistics Canada was fully accounted for in order to calculate the survey's response rate accurately and to properly weight the data to represent the Canadian population.

Microdata: A microdata set containing the results of the survey is available for purchase from Statistics Canada. The public release of the data was announced on August 9, 2004, in Statistics Canada's The Daily.

Terminology: View the definitions of the main terminology used in this fact sheet.