Peer Crowd Analysis and Segmentation for Vaping and Tobacco

Health Canada commissioned Phoenix SPI to conduct public opinion research with Canadian youth and young adults aged 13 to 24 on issues related to vaping products and tobacco use. The research consisted of 1) a literature review and secondary analysis of current evidence-based studies on youth and young adults’ risk behaviours, motivations to engage in risky behaviour, core values, and interests; 2) a series of eight in-person focus groups and eight in-person triads; and 3) an online survey of 3,004 Canadians aged 13 to 24. The focus groups were held in Toronto (English) and Montreal (French) February 12 and 13, 2018 and the triads were conducted in Toronto (English) on February 24 and June 2, Montreal (French) on February 24, and Ottawa (English and French) on June 2. The fieldwork for the online survey was conducted between March 26 and April 24, 2018. More details on the methodology can be found in the Methodology section of the Introduction and Annex 3.

The main objective of the research was to generate results for Health Canada to use to better reach those Canadians with the highest susceptibility of smoking/vaping and to encourage them to make informed choices. The results are intended to increase the Department’s knowledge base and contribute to future public awareness and education campaigns.

Youth and young adults aged 16 to 24 were segmented into seven distinct groups based on their psychographic, behavioural and attitudinal characteristics. Several analytical techniques were used: a factor analysis, a decision tree analysis and a regression analysis. The seven segments, and their proportion of the population, are:

With this in mind, the main target audiences for anti-smoking and anti-vaping messages are likely the four segments at medium to high risk of starting to smoke or vape: “Defiant Partiers”, “Outsiders”, “Thrill Seeking Rule Breakers”, and “Irreverent Risk Takers”. Majorities of the members of these segments consume alcohol, and with one exception—“Outsiders”—also use cannabis.

When it comes to smoking cessation messages, “Irreverent Risk Takers” present the most immediate need for intervention given that members of this segment are significantly more likely to smoke or vape. Members of this segment are also more likely to be older (20-24 years of age), to characterize their friends as “hip hop”, to listen to hip-hop/rap, and to spend their leisure time attending concerts, going to bars, and hanging out a friends’ houses.

Introduction

Phoenix Strategic Perspectives (Phoenix SPI) was commissioned by Health Canada to conduct public opinion research with Canadian youth and young adults aged 13 to 24 on issues related to vaping products and tobacco use.

Background and Objectives

Vaping products, such as e-cigarettes, were virtually unheard of in 2007. By 2015, the Canadian Tobacco, Alcohol and Drugs Survey found that 26% of youth aged 15 to 19 (or 534,000) and 30% of young adults aged 20 to 24 (or 743,000) had tried an e-cigarette. With high prevalence rates among these segments of the Canadian population, it is important to reach such high-risk groups with appropriate messages and programs.

In addition, smoking remains the leading preventable cause of disease and premature death in Canada, killing 45,000 Canadians each year.^{Footnote 3} Although national smoking rates (13%) are decreasing, they are still highest among young adults (18%) and there has been no change in prevalence amongst this segment of the population since 2013.^{Footnote 4} To help protect and enhance awareness of the harms and risks associated with tobacco and vaping product use, Health Canada is developing a public education and outreach strategy to deliver targeted intervention messaging and activities to directly influence positive behaviour in high-risk groups.

In support of this strategy, the Department commissioned public opinion research to better understand youth (13 to 19 year olds) and young adults (20 to 24 year olds)^{Footnote 5} with regard to their psychographic and behavioural characteristics, as well as their values and interests. The main objective of the research was to generate results for Health Canada to use to better reach those Canadians with the highest susceptibility of smoking/vaping and to encourage them to make informed choices.

The results are intended to increase the Department’s knowledge base and contribute to future public awareness and education campaigns.

Methodology

To meet the objectives, qualitative and quantitative research were conducted as follows: 1) a literature review and secondary analysis of current evidence-based studies on youth and young adults’ risk behaviours, motivations to engage in risky behaviour, core values, and interests; 2) a series of eight in-person focus groups and eight in-person triads; and 3) an online survey of 3,004 Canadians aged 13-24. Phoenix SPI ensured that all steps in the research complied with Government of Canada Public Opinion Research Standards and market research industry standards and guidelines, including those of the Marketing Research and Intelligence Association (MRIA).

1. Literature Review

A literature review and secondary analysis of current evidence-based studies on youth and young adults’ risk behaviours, motivations to engage in risky behaviour, core values, and interests was conducted to inform the qualitative and quantitative research. The studies consulted can be found in Annex 1: Literature Review.

2. Qualitative Research

In total, eight focus groups and eight triads were conducted in Toronto (English), Montreal (French), and Ottawa (French and English) as follows:

In each focus group and triad, there was a mix of participants by gender, age and education (as relevant given the age parameters). Within the smoker/vaper groups, there was also a mix of participants by smoking status (occasional and daily) and use of cigarettes and e-cigarettes.

3. Quantitative Research

An online survey was administered to 3,004 Canadian youth and young adults between March 26 and April 24, 2018. The survey averaged 15 minutes to complete. The sample was drawn from the Asking Canadians panel of online Canadians. Panellists were invited to participate in the survey through an email invitation which contained a password-protected URL to access the survey. Parental permission was obtained for youth 13 to 15 years of age. Panellists were rewarded for taking part in the survey per the panel’s incentive program, which is structured to reflect the length of survey and the nature of the sample. Survey data was weighted by region, age and gender to reflect the demographic composition of the target population. Surveys that use samples drawn from online panels cannot be described as statistically projectable to the target population. Because the sample is based on those who initially self-selected for participation in the panel, no estimates of sampling error can be calculated.

Notes to Reader

Detailed Findings

1. Topline Results

The main purpose of this research is the segmentation of youth and young adults according to their likelihood of adopting risk behaviours and their perspectives on a range of related issues. Accordingly, most of the report focuses on the segmentation and the opportunities it presents Health Canada. The purpose of this section is to present the topline results to provide context for the segmentation.

Profile of Respondents

Prevalence of Smoking and Vaping

Profile of Respondents by Age
Age	% to survey sample (weighted)
13-15	4%
16-19	42%
20-24	54%

Profile of Respondents by Gender
Gender	% to survey sample (weighted)
Male	50%
Female	48%
Other	1%
Prefer not to answer	1%

Profile of Respondents by Region
Region	% to survey sample (weighted)
Atlantic Canada	6%
Quebec	21%
Ontario	40%
Prairies	18%
British Columbia	13%
Territories	<1%
Prefer not to answer	1%

Profile of Respondents by Employment Status
Employment Status	% to survey sample (weighted)
Working full-time	18%
Working part-time	26%
Unemployed, but looking for work	5%
A student attending school full-time	67%
A student attending school part-time	4%
Other	2%
Prefer not to answer	1%
(multiple responses accepted)

Profile of Respondents by Education
Education	% to survey sample (weighted)
Less than high school	19%
High School diploma or equivalent	38%
Registered Apprenticeship or other trades certificate or diploma	2%
College, CEGEP or other non-university certificate or diploma	12%
University certificate or diploma below bachelor's level	6%
Bachelor's degree	17%
Post graduate degree above bachelor's level	3%
Prefer not to answer	3%

Profile of Respondents by Language Spoken at Home
Language Spoken at Home	% to survey sample (weighted)
English	70%
French	21%
Other	7%
Prefer not to answer	1%

Profile of Respondents by Household Income
Household Income	% to survey sample (weighted)
Under $20,000	13%
$20,000 to just under $40,000	12%
$40,000 to just under $60,000	13%
$60,000 to just under $80,000	9%
$80,000 to just under $100,000	10%
$100,000 to just under $150,000	11%
$150,000 and above	8%
Prefer not to answer	23%

Profile of Respondents by Characteristics
Characteristics	% to survey sample (weighted)
A member of a visible ethno-cultural group	16%
Part of the LGBTQ2 community	9%
An Indigenous person (First Nation, Métis or Inuit)	3%

Fifteen percent of Canadian youth and young adults vape (6%), smoke (6%), or do both (3%).^{Footnote 7} The vast majority (85%) do neither.

In addition, the likelihood of smoking was higher among those in the survey sample who use cannabis daily or occasionally (46% versus 4% of non-users).

The subgroup differences for vapers are similar to those of smokers. Those in the survey sample who vape were more likely to be from Saskatchewan or Manitoba (19%), male (11%), working full time (13%), and to have more than three people in their social circle who vape or smoke (14%). When it comes to cannabis use and alcohol consumption among vapers, the pattern is the same as that evident among smokers. Specifically, the likelihood of vaping was higher among those who use cannabis daily or occasionally (37% versus 4% of non-users) and those who consume alcohol frequently than those who drink infrequently (18% versus 10%).

Table 1: Incidence of smoking and vaping
Q7. Do you….?	All respondents (n= 3,004)
Vape only	6%
Smoke only	6%
Vape and smoke	3%
Non-smoker/non-vaper	85%

Table 2: Incidence of smoking and vaping by age
Q7. Do you….?	Youth (n= 1,682)	Young Adults (n= 1,322)
Vape only	6%	5%
Smoke only	3%	9%
Vape and smoke	2%	3%
Non-smoker/non-vaper	88%	83%

Table 3: Proportion of the survey sample that smokes or vapes
Q7. Do you….?	All respondents (n= 3,004)
Vape only	9%
Smoke only	9%
Non-smoker/non-vaper	85%

For those who smoke or vape, smoking appears to be a regular activity whereas vaping appears to be more situational.

Smoking is a daily activity for just over four in 10 (43%) youth and young adults who smoke cigarettes whereas vaping is done on a daily basis for one-quarter (24%) of those who use a vaping device or e-cigarette (i.e., vapers). The proportion of youth and young adult smokers who smoke on a weekly basis (11%) is slightly higher than vapers, with only 8% saying they vape weekly.

About one in five (19%) non-daily or occasional smokers have smoked cigarettes in the past 30 days compared to nearly three in 10 (29%) non-daily or occasional vapers who have vaped at least once during the same timeframe.

Fewer smokers have not smoked in the past 30 days in comparison to vapers. This suggests that vaping may be a recreational activity.

Smokers who use cannabis daily or occasionally were more likely than smokers who do not use cannabis to smoke cigarettes daily (65% versus 32%).

Table 4: Frequency of smoking and vaping
Q8. Which of the following best describes how often you smoke cigarettes? Q9. Which of the following best describes how often you use e-cigarettes or vaping devices?	Smoking (n= 193)	Vaping (n= 209)
Daily	43%	24%
Weekly	11%	8%
A couple times a week	7%	8%
Weekends only	2%	5%
At least once in past 30 days	19%	29%
Not in past 30 days	13%	24%

A minority of those who say they are not smokers or vapers have actually tried one or the other in the past.

Of those who consider themselves non-smokers, exactly one in five (20%) have smoked at least once in the past. Of those who identify as non-vapers, more than one-quarter (28%) have vaped at least once.

Among current non-smokers, the likelihood of having ever smoked cigarettes increased as the number of smokers or vapers in a young person’s life increased (from 8% of those who have no smokers or vapers in their life to 28% of those who have more than three different types of people in their social circle). In addition, the likelihood of having ever smoked cigarettes was higher among:

Of those who are current non-vapers, the likelihood of having ever tried an e-cigarette or vaping device increased as the number of smokers or vapers in a young person’s life increased (from 9% of those who have no smokers or vapers in their life to 39% of those who have more than three in their social circle). In addition, the likelihood of having ever vaped was higher among:

Table 5: Non-users' smoking and vaping
Q16. Have you ever smoked cigarettes? Q17. Have you ever tried an e-cigarette or vaping device?	Yes	No
Non-Smokers (n= 2,808)	20%	79%
Non-Vapers (n= 2,794)	28%	71%

Smoking and/or vaping are pursued about equally amongst friends and classmates, but smoking is far more prevalent than vaping amongst co-workers, family members and parents/guardians.

Approximately four in 10 youth and young adults reported that they have friends who vape (41%) and/or smoke (39%). Slightly higher proportions indicated that classmates smoke (45%) and/or vape (42%). The prevalence of smoking was highest among co-workers, with more than half (58%) of youth and young adults who are employed saying their co-workers smoke. Fewer (29%) have co-workers who vape.

Both activities—smoking and vaping—are less prevalent amongst family members. One-third (34%) of youth and young adults said they have a family member who smokes and only one in 10 (11%) have a member of their family who vapes. Even fewer parents and guardians engage in either activity, with 18% smoking and 4% vaping.

The following table presents the number of different types of people (i.e., friends, co-workers, family members, etc.) youth and young adults have in their life who smoke and/or vape:

Table 6: Smoking and vaping among social circle
Q6. Do any of the following people in your life smoke cigarettes or use an e-cigarette/vaping device?	Smoke cigarettes	Vape	Neither	Don't Know
Friends (n= 3,004)	39%	41%	38%	7%
Classmates (n= 3,004)	45%	42%	23%	20%
Co-workers (n= 1,271)	58%	29%	20%	17%
Family members (n= 3,004)	34%	11%	58%	4%
Parents or guardians (n= 3,004)	18%	4%	78%	2%

Number of Different Types of Smokers and Vapers	Percentage (%)
No smokers or vapers in their social circle	15%
One type of smoker or vaper in their social circle	15%
Two	22%
Three	20%
Four	17%
Five or more types of smokers or vapers in their social circle	26%
[Multiple responses accepted]

For those who vape, fluids containing nicotine are used almost as often as those that are nicotine-free. Very few vape cannabis-based fluids exclusively.

Youth and young adults who vape choose nicotine-based fluids almost as frequently as they choose those that are nicotine-free. Specifically, two-thirds said they sometimes (43%) or always (24%) choose fluids with nicotine, while seven in 10 sometimes (50%) or always (20%) choose nicotine-free fluids. In contrast, approximately three in 10 (31%) never vape fluids with nicotine and about the same proportion (28%) never vape nicotine-free fluids.

While over half (57%) of youth and young adults never vape cannabis-based fluids, just over one-third (36%) choose to do so sometimes. For a minority (5%), cannabis-based fluids are the fluids they always vape.

The likelihood of saying they never use fluids containing nicotine was higher among vapers (31%) than smokers (15%).

Table 7: Types of vaping fluids used
Q9b. How often, if at all, do you use the following in your e-cigarette or vaping device?	Vapers (n = 210)
Fluids containing nicotine	31%	43%	24%
Nicotine-free fluids	28%	50%	20%
Fluids containing marijuana/cannabis/THC	57%	36%	5%

Six in 10 say their parents/guardians are or may be aware of their smoking or vaping.

Six in 10 youth and young adults who smoke or vape say their parents or guardians are aware (47%) or may be aware (13%) of their smoking or vaping. In contrast, just over one-third (36%) believe their parents/guardians are not aware they do either activity.

The likelihood of saying their parents or guardians are aware of their smoking or vaping was higher among: daily smokers (71%) and vapers (72%) than occasional smokers (40%) and vapers (41%); and those who use cannabis daily or occasionally (67% versus 45% of non-users).

Tenure, Frequency of Use and Reasons for Starting to Smoke or Vape

Table 8: Parents'/guardians' awareness of smoking or vaping
Q29. Do your parents or guardians know that you smoke cigarettes or use e-cigarettes or a vaping device?	Smokers and Vapers (n= 344)
Aware	47%
Not aware	36%
May be aware	13%
Don't know	5%

The majority of youth/young adults who smoke have been doing so for three years or less while half of those who vape have been doing so for less than a year.

Youth and young adult smokers are relatively new to smoking and vaping: six in 10 (61%) smokers and nine in 10 (92%) vapers said they have been doing so for three years or less. That said, nearly half of vapers (49%) have been using an e-cigarette or vaping device for less than a year compared to just 18% of smokers.

At the other end of the spectrum, approximately one-third (32%) of youth and young adult smokers have been smoking for four or more years. This stands in stark contrast to the tenure for youth and young adults who vape; only five percent have been vaping for at least four years.

Table 9: Length of time smoking or vaping
Q13. How long have you been smoking cigarettes? Q14. How long have you been vaping?	Smoking (n= 196)	Vaping (n= 210)
Less than 1 year	18%	49%
1-3 years	43%	43%
4-5 years	15%	4%
Over 5 years	17%	1%

Once they start, the frequency of use between smokers and vapers is similar.

Once youth and young adults start smoking or vaping, the frequency of use is similar with nearly three in 10 smoking (28%) or vaping (29%) more than when they started, one-third smoking (34%) or vaping (35%) about the same amount as when they first started, and one-third smoking (36%) or vaping (33%) less.

Among youth and young adults who smoke and vape (i.e., “dual users” or respondents who engage in both activities) (n=62), approximately half (53%) smoke less now than they did when they first started smoking cigarettes. The rest were more likely to report no change in the frequency of their smoking (33%) than to say it has increased (14%). When it comes to vaping: 36% vape more, 32% vape less, and 32% reported no change.

Of those that smoke, 16 to 19 year olds in the survey sample were more likely than 20 to 24 year olds to smoke more now than they did when they first started smoking (40% versus 23%). Of those that vape, 16 to 19 year olds were more likely to have not changed the frequency of their vaping than those 20 to 24 years of age (43% versus 28%). Compared to occasional smokers and vapers, those who do these activities daily were more likely to smoke and vape more now than before.

Table 10: Frequency of smoking or vaping over time
Q26. Since you first started smoking cigarettes, do you now smoke more or less than before? Q27. Since you first started vaping, do you now vape more or less than before?	Smoking (n= 196)	Vaping (n= 210)
More than before	28%	29%
No change	34%	35%
Less than before	36%	33
Don't know	2%	3%

Most smokers started smoking due to peer group behaviour followed by product availability and stress relief.

More than half (56%) of youth and young adults who smoke started because their friends were smoking. This was followed, at a distance, by cigarettes being offered to them (32%) and smoking to relieve stress (28%).

Reasons for starting cited less frequently included: the attractiveness of smoking (17%) and the fact that a parent smokes (8%). The potential influence of siblings who smoke played almost no role in their reasons for starting to smoke.

Daily and occasional cannabis users in the survey sample were more likely than non-users to say they started smoking cigarettes because their friends were: 59% versus 34%.

Table 11: Top reasons smokers started to smoke
Q19. Why did you first start smoking cigarettes?	Smokers (n= 196)
Friends were smoking	56%
It was offered	32%
Stress relief	28%
Looked fun and exciting	17%
Parent(s) smoke	8%
Sibling offered it	1%
Other	3%
Can't recall	8%

Most vapers started vaping because friends were vaping and/or they liked the flavours/aroma.

Youth and young adults were most likely to point to two reasons to explain why they started vaping: their friends were vaping (44%) and they liked the flavour and smell of vape fluids (39%). Following this, approximately one in five started because vaping products were offered to them (20%) and because it looked fun and exciting (19%). The perceptions that vaping is less harmful than smoking (14%), is a possible way to quit or reduce using cigarettes (13%) and is not addictive (9%) were cited less frequently.

The role of parents and siblings as potential influencers for vaping uptake is low.

The following survey respondents were more likely to say they started vaping because their friends were vaping:

Table 12: Top reasons vapers started to vape
Q20. Why did you first start vaping?	Vapers (n= 210)
Friends were vaping	44%
Liked the flavours and smell	39%
It was offered	20%
Looked fun and exciting	19%
Not harmful like cigarettes	14%
To quit/reduce use of cigarettes	13%
Didn’t think it was addictive	9%
Parent(s) vape	6%
Sibling offered it	1%
Other	1%
Can’t recall	3%

Select social situations are the main drivers of behaviour for occasional and infrequent vapers.

For these occasional and infrequent vapers, social activities such as being around friends who vape (70%), at a party or bar (34%) and drinking alcohol (28%) tend to drive their vaping behaviour. In addition, 44% pointed to simple boredom as a situation in which they vape. For others, situations in which they vape cited less often include when stressed (26%) and when nervous (19%).

Survey respondents 16 to 19 years of age were more likely than 20 to 24 year olds to say they vape when they are around friends who vape (87% versus 55%) and when they are at a party or bar (47% versus 21%). However, 20 to 24 year olds were more likely than 16 to 19 year olds to say they vape when they are bored (52% versus 36%).

Additionally, females in the survey sample were more likely than males to vape when they are at a bar or party (52% versus 23%), when they are drinking alcohol (48% versus 17%), and when they are stressed out (37% versus 20%).

Possible Pathways to Use and Likelihood to Start Using

Most (81%) of those who smoke and vape said they started smoking first. In contrast, 14% started vaping first.

Table 13: Situations when occasional and infrequent vapers vape
Q12. In which of the following situations do you vape?	Occasional and infrequent vapers (n= 164)
When around friends who vape	70%
When bored	44%
When at a party or bar	34%
When drinking alcohol	28%
When stressed	26%
When nervous	19%
Other	2%

Table 14: Which did you try first?
Q18. Which did you try first?	Those who smoke and vape (n= 62)
Vaping first	14%
Smoking first	81%
Can't recall	4%

The vast majority of non-smokers and non-vapers do not think it’s likely they will start either activity.

Among youth and young adults who do not vape, the vast majority said they are not likely to start: 75% are not at all likely and 17% are not very likely to start. In addition, a very small number of youth or young adult non-smokers said it is possible they may start smoking; almost everyone in this group saying they are not at all likely (88%) or not very likely (9%) to start smoking.

Youth in the survey sample between the ages of 13 and 15 were less likely than older respondents to say it is not at all likely that they will start smoking: 77% versus 89% of those age 16 and older. Those 20 to 24 years of age were more likely than 16 to 19 year olds to say it is not at all likely that they will start vaping (78% versus 70%). In addition, those who are not part of the LGBTQ2 community were more likely to say it is not at all likely that they will start smoking cigarettes or vaping: 89% versus 82% of those who identify as part of the LGBTQ2 community, and 76% versus 64%, respectively.

Those unlikely to start vaping were asked why this is the case. Respondents in this group were most likely to mention health-related reasons to explain why they will not start vaping. This included the belief that it is not healthy (59%), not wanting to get addicted (21%), the perception that it is not safe (16%), concern that it will hurt their throat (2%), and an existing health condition (asthma; less than 1%).

In addition to health-related factors, non-vapers pointed to the perception that vaping is generally unappealing (53%). This was followed by the smell (they do not like it), the cost, the stigma associated with vaping (negative perceptions from others), lack of convenience, and religious beliefs.

Those in the survey sample 13 to 15 years of age were less likely than older respondents to say it is unlikely they will start vaping because it is unappealing to them (34% versus 54% of those age 16 and older). In contrast, these respondents are more likely to attribute their lack of desire to start vaping to not wanting to get addicted (32% versus 20% of those age 16 and older).

Table 15: Likelihood of non-users starting to vape or smoke
Q21. How likely is it that you will ever start….	Very likely	Likely	Somewhat likely	Not very likely	Not at all likely
Smoking (n= 2,736)	0%	0%	1%	9%	88%
Vaping (n= 2,699)	1%	1%	5%	17%	75%

Table 16: Top reasons to not vape
Q24. Why are you not likely to start vaping?	Those unlikely to start vaping (n= 2,472)
Not healthy	59%
Generally unappealing	53%
Don't want to get addicted	21%
Not safe	16%
Don't like the smell	11%
Costs too much	11%
Negative perceptions from others	7%
Not convenient	5%
Using it will hurt throat	2%
Have asthma	0%
Religious beliefs	0%
Other	0%
Don't know	1%

Current non-vapers who said they might be likely to start vaping cited factors like flavour/aroma and curiosity most often.

Very few non-vapers (7%) said they are likely to start vaping. The top reason they might start to vape is liking the product flavours and aroma. Nearly half (48%) mentioned this as a reason they are likely to start vaping. Smaller proportions cited the curiosity of wanting to try it (30%), the belief that it is healthier than cigarettes (25%), the perception that it looks fun and exciting (22%), the fact that their friends vape (16%), and the ease of access to e-cigarettes/vaping products (10%). Seven percent said that a desire to quit smoking cigarettes is the reason they are likely to start vaping.

Perceptions about Social Acceptance, Addiction and Risks

Youth and young adults were asked to rate the extent to which they agree or disagree with the following statements:

Table 17: Top reasons to start vaping
Q25. Why are you likely to start vaping?	Those likely to start vaping (n= 197)
Like the flavours and smell	48%
Want to try it	30%
Healthier than cigarettes	25%
Looks fun and exciting	22%
Friends vape	16%
Easy to get	10%
Want to quit smoking cigarettes	7%
Other	2%
Don't know	6%

Agreement was widespread and strong among those who do not currently smoke or vape that if they started, people close to them would be upset. Almost nine in 10 (89%)^{Footnote 12} agreed that people close to them would be upset if they started smoking, including more than three-quarters (77%) who strongly agreed that this would be the case. A smaller majority (71%) agreed that those close to them would be upset if they started vaping, including 50% who strongly agreed.

Almost six in 10 (57%) non-smokers and non-vapers agreed that smoking is not socially acceptable and just over half (54%) agreed that vaping is embarrassing or not cool. Those who did not agree with these statements were more likely to be ambivalent than to disagree with them. In addition, more than four in 10 (45%) non-smokers and non-vapers share the view that vaping is a big deal. In contrast, one in five (21%) agreed that vaping is not a big deal. The plurality, however, was ambivalent, neither agreeing nor disagreeing with the statement that vaping is not a big deal.

Even those who currently smoke or vape stigmatize smoking more than vaping—and to a greater degree.

Seven in 10 (72%) youth and young adults who currently vape agreed that people close to them would be upset if they smoked, with more than half (58%) strongly agreeing that this would be the case. In addition, almost half of those who currently smoke (49%) believe people close to them are upset that they smoke. These youth and young adults also see vaping as less of an issue than current non-smokers and non-vapers. Specifically, about two in 10 (22%) smokers agreed that people close to them would be upset if they vaped, and a smaller, but similar proportion of vapers (19%), agreed that those close to them are upset that they vape.

Smokers and vapers also see vaping as more acceptable than non-smokers and non-vapers, with four in 10 (40%) agreeing that “vaping is not a big deal” (compared to 21% of non-smokers and non-vapers). Views on smoking cigarettes were more mixed than among non-smokers and non-vapers. Roughly four in 10 (39%) smokers and vapers agreed that smoking is not socially acceptable (compared to 57% of non-smokers and non-vapers), while nearly three in 10 (29%) agreed that vaping is embarrassing or not cool (compared to 54% of non-smokers and non-vapers). Notably, smokers are more likely to disagree that “smoking cigarettes is not socially acceptable” (31% compared to 19% of vapers and 14% of non-smokers/non-vapers).

Table 18: Attitudes towards smoking and vaping [non-users]
Q30. To what extent do you agree or disagree with the following statements?	All non-smokers and non-vapers (n= 2,660)
People close to me would be upset if I smoked	77%	12%	6%	1%	2%
People close to me would be upset if I vaped	50%	21%	16%	5%	3%
Smoking cigarettes is not socially acceptable	32%	25%	26%	10%	4%
Vaping is embarrassing/ not cool	33%	21%	29%	8%	5%
Vaping is not a big deal	8%	13%	31%	24%	21%

Table 19: Attitudes towards smoking and vaping [users]
Q30. To what extent do you agree or disagree with the following statements?	All smokers and vapers (n= 344)
People close to me would be upset if I smoked	58%	14%	17%	3%	5%
People close to me are upset at my smoking	26%	23%	28%	10%	8%
Vaping is not a big deal	18%	22%	40%	11%	6%
Smoking cigarettes is not socially acceptable	19%	20%	33%	15%	11%
Vaping is embarrassing/not cool	13%	16%	40%	15%	14%
People close to me would be upset if I vaped	12%	10%	37%	11%	22%
People close to me are upset at my vaping	8%	11%	42%	16%	19%

Non-smokers and non-vapors believe smoking is addictive but hold less negative views about vaping.

Youth and young adults who do not smoke or vape were asked to rate the extent to which they agree or disagree with the following statements:

More than 9 in 10 (91%)^{Footnote 14} non-smokers and non-vapers agreed that smoking is addictive, with fully 79% agreeing strongly with this statement. Virtually no-one (1%) disagreed. In addition, there was strong and widespread agreement that nicotine is a toxic chemical that should be avoided. More than three-quarters (78%) of non-smokers and non-vapers agreed with the statement, including 57% who agreed strongly.

Table 20: Perceptions of health effects of smoking and vaping [non-users]
Q47. To what extent do you agree or disagree with the following statements about the health effects of smoking and vaping?	All non-smokers and non-vapers (n= 2,660)
Cigarette smoking is addictive	79%	12%	5%	1%	1%
Nicotine is a toxic chemical that should be avoided	57%	21%	12%	2%	1%
Vaping is addictive	31%	25%	21%	4%	1%
Vaping can help smokers quit or reduce smoking	14%	34%	25%	7%	5%
Vaping is no healthier than smoking cigarettes	24%	20%	24%	14%	4%
Vaping will lead to smoking regular cigarettes	11%	17%	28%	18%	7%
Vaping is not addictive	2%	6%	18%	26%	32%

More than half also believe that vaping is addictive^{Footnote 15} (a considerably smaller proportion than the 91% who believe cigarette smoking is addictive). While more than four in 10 (44%) say vaping is no healthier than smoking cigarettes, close to five in 10 (48%) also see vaping as a potential means to help smokers quit or reduce smoking. Youth and young adults were divided when it came to whether or not vaping leads to smoking cigarettes (28% agreed that vaping will lead to smoking cigarettes; 25% disagreed that it will; 28% were neutral).

Smokers and vapers also see cigarettes as addictive but hold generally less negative views about vaping.

Youth and young adults who smoke or vape were asked to rate the extent to which they agree or disagree with the same set of statements. More than eight in 10 (82%)^{Footnote 16} smokers and vapers agreed that cigarette smoking is addictive, with two-thirds agreeing strongly that this is the case. Among non-smokers and non-vapers, agreement was higher—91%. In addition, just over half (57%) of smokers and vapers agreed that nicotine is a toxic chemical that should be avoided—versus 78% of non-smokers and non-vapers.

Table 21: Perceptions of health effects of smoking and vaping [users]
Q47. To what extent do you agree or disagree with the following statements about the health effects of smoking and vaping?	All smokers and vapers (n= 344)
Cigarette smoking is addictive	66%	16%	9%	2%	5%
Vaping can help smokers quit or reduce smoking	32%	29%	24%	5%	5%
Nicotine is a toxic chemical that should be avoided	29%	28%	27%	10%	4%
Vaping is addictive	22%	19%	35%	7%	9%
Vaping is no healthier than smoking cigarettes	16%	17%	32%	15%	14%
Vaping is not addictive	14%	11%	24%	22%	23%
Vaping will lead to smoking regular cigarettes	9%	12%	29%	19%	26%

Compared to non-users, more smokers and vapers see some benefit associated with vaping. Six in 10 (61%) agreed that vaping can help smokers quit or reduce smoking (versus 48% of non-smokers and non-vapers). Vapers are more likely to agree with this than smokers (69% versus 56%). Fewer than half believe that vaping is addictive^{Footnote 17} (compared to more than half of non-smokers and non-vapers),^{Footnote 18} only one-third (33%) see vaping as no healthier than smoking cigarettes (compared to 44% of non-smokers and non-vapers), and the plurality disagreed that vaping leads to smoking cigarettes (45% versus 25% of non-smokers and non-vapers). For the measure, “vaping is no healthier than smoking cigarettes”, vapers were more likely to disagree with the statement compared to smokers and non-smokers/non-vapers (37% versus 24% of smokers and 18% of non-users).

When it comes to perceptions of the health effects of smoking and vaping, the following subgroup differences are noteworthy:

Regardless of whether they currently smoke or vape, youth/young adults strongly believe that smoking on a regular basis carries serious risks. Vaping is seen as less risky.

All youth and young adults were asked to rate the extent to which they think people risk harming themselves when they do each of the following activities:

Non-smokers and non-vapers see serious risks with using nicotine regularly. More than nine in 10 (96%) believe smoking cigarettes on a regular basis is at least slightly harmful, with the vast majority (88%) saying it poses a great risk. While not seen as risky, vaping nicotine is still viewed as harmful: 52% believe it presents a great risk, 34% a moderate risk, and 5% a slight risk.

Infrequent smoking is also seen as carrying risk, although the risk is more likely to be considered slight (16%) or moderate (48%) than great (30%). While still carrying some risk, vaping nicotine once in a while is seen as less risky than vaping nicotine on a regular basis: 25% believe it poses a slight risk, 44% a moderate risk and 21% a great risk. Regular or infrequent nicotine-free vaping are seen as the least risky activities.

Similar to non-smokers and non-vapers, youth and young adults who smoke or vape agree that using nicotine on a regular basis carries risk. More than nine in 10 (96%) believe smoking cigarettes on a regular basis is at least slightly harmful, with the majority (71%) saying it poses a great risk. Beyond that, the way each group of youth and young adults views risk starts to differ. While they both believe infrequent nicotine use and vaping in general offer potential harm, smokers and vapers associate lower levels of risk with these activities.

Smokers and vapers believe vaping nicotine on a regular basis is potentially harmful, but they see it as less risky compared to non-smokers and non-vapers: 28% view it as a great risk (versus 52% of non-smokers and non-vapers), 43% as a moderate risk (versus 34% of non-users) and 20% a slight risk (versus 5% of non-users).

Not surprisingly, smokers and vapers believe that smoking and vaping nicotine once in a while are less risky than non-smokers and non-vapers. They also view vaping non-nicotine products regularly and occasionally as posing less risk than their counterparts who do not smoke or vape.

When it comes to perceived risks of smoking and vaping, the following subgroup differences are noteworthy:

Cannabis and Alcohol Use

Ten percent of the youth and young adults surveyed smoke and/or vape and have tried both cannabis and alcoholic beverages.

Table 22: Perceived risks of smoking and vaping [non-users]
Q48. How much do you think people risk harming themselves when they do each of the following activities?	All non-smokers and non-vapers (n= 2,660)
Smoke cigarettes on a regular basis	88%	7%	1%	0%	4%
Vape nicotine on a regular basis	52%	34%	5%	1%	8%
Smoke cigarettes once in a while	30%	48%	16%	1%	4%
Vape nicotine once in a while	21%	44%	25%	3%	7%
Use a nicotine-free vaping device on a regular basis	20%	33%	30%	6%	11%
Use a nicotine-free vaping device once in a while	10%	27%	39%	14%	9%

Table 23: Perceived risks of smoking and vaping [users]
Q48. How much do you think people risk harming themselves when they do each of the following activities?	All smokers and vapers (n= 344)
Smoke cigarettes on a regular basis	71%	18%	7%	3%	1%
Vape nicotine on a regular basis	28%	43%	20%	3%	6%
Smoke cigarettes once in a while	19%	46%	28%	5%	2%
Vape nicotine once in a while	13%	39%	36%	7%	5%
Use a nicotine-free vaping device on a regular basis	12%	29%	38%	15%	6%
Use a nicotine-free vaping device once in a while	8%	26%	34%	27%	5%

Just over one-third of youth/young adults claim to have used cannabis at least once.

Just over one-third (36%) of youth and young adults have tried cannabis or a cannabis-related product. The frequency of using cannabis varies: 11% report having used cannabis in the past 30 days, 17% have used it but not in the past 30 days, and 8% have used cannabis once only. Of those who use cannabis more frequently, 3% use it at least once weekly while another 3% say they use it daily.

The likelihood of having tried cannabis is higher among the following subgroups of respondents:

The likelihood of using cannabis daily or weekly was higher among vapers and smokers (26% versus 4% of non-smokers/non-vapers).

Seven in 10 youth and young adults have tried an alcoholic beverage at least once, with approximately half (52%) saying they have consumed alcohol at least once in the past 30 days. In contrast, 18% have had an alcoholic beverage, but not in the past 30 days. Of those who use alcohol more frequently, one in five (19%) use it weekly while another 1% say drink alcoholic beverages daily.

The likelihood of saying they never drink alcohol increased as age decreased, from 15% of 20 to 24 year olds, to 42% of 16 to 19 year olds, to 82% of 13 to 15 year olds, and it was higher among males (32% versus 26% of females). In addition, it was higher among survey respondents in Ontario (36%), Alberta (33%) and British Columbia (31%) than among those in Quebec (16%) and Saskatchewan or Manitoba (18%).

Smokers and vapers were more likely than non-smokers/non-vapers to say they drink alcohol daily or weekly (21% and 17%, respectively versus 7% of non-smokers/non-vapers) as were youth and young adult respondents who identified as LGBTQ2 (15% versus 7%).

Sources of Health-related Information

Table 24: Frequency of using cannabis
Q31. Have you ever used or tried marijuana? When we use the term marijuana, we mean the use of marijuana, hashish, hash oil or any other preparation of the cannabis plant. Q32. How often do you use marijuana?	All respondents (n= 3,004)
Daily	3%
Once a week, but not daily	1%
A couple times a week	1%
Weekends only	1%
Less than weekly, but at least once in past 30 days	5%
Have used it, but not in past 30 days	17%
Once only	8%
Never; don't use cannabis	63%

Table 25: Frequency of drinking alcoholic beverages
Q33. How often do you tend to drink alcoholic beverages?	All respondents (n= 3,004)
Daily	1%
Once a week	7%
A couple times a week	6%
Weekends only	6%
Less than weekly, but at least once in past 30 days	32%
Have used it, but not in past 30 days	18%
Never; do not drink	29%
Other	0%

While youth/young adults get health-related information from physicians/other medical professionals and their parents, the Internet is also a significant source of information.

Physicians and medical professionals top the list of sources youth and young adults count on for health-related information—nearly half (48%) would consult a physician or medical professional. This was followed by their parents (40%) and Google (39%). In terms of online or digital sources, in addition to Google, respondents mentioned social media (18%), online news outlets (17%), online forums (9%), and Pubmed/Google Scholar (9%) as sources from which they get health-related information. Notably, approximately one in 10 (13%) would consult government.

A variety of other information sources were mentioned much less often and are depicted in the graph.

Social Media Use and Potential Influencers

Table 26: Sources of health-related information
Q49. From which of the following sources do you get health-related information?	All respondents (n= 3,004)
Physicians/ medical professionals	48%
Parents	40%
Google	39%
Research institutes/ universities	28%
Friends	27%
Social media	18%
Online news outlets	17%
Teacher/ Coach	15%
Government	13%
Online forums	9%
Pubmed/Google Scholar	9%
Newspapers/ magazines	7%
Co-workers	5%
Testimonials	3%
Other	1%
I don't get health-related information	2%
Don't know	1%

Youth/young adults focus their daily social media use mainly on Facebook, Instagram, YouTube and Snapchat. They tend to follow primarily their friends and family members – with friends being followed more by a wide margin.

Youth and young adults use the major social media channels on a daily basis with similar frequency: Facebook (72%), Instagram (65%), YouTube (61%) and Snapchat (61%). In contrast, 22% use Twitter on a daily basis, 12% Pinterest, and 7% Tumblr. On average, respondents use three different social media channels.

Two percent do not use social media and 5% do use social media, but not on a daily basis.

The likelihood of using Facebook increased with age, from 41% of 13 to 15 year olds to 63% of 16 to 19 year olds, to 81% of 20 to 24 year olds, and was highest among survey respondents in Quebec (86%). In addition, those using Instagram, Snapchat, YouTube and Twitter were more likely to be 16 to 19 years of age. Regionally, use of Instagram, Snapchat and Twitter was lower in Quebec than elsewhere in the country. The likelihood of using Facebook, Instagram, Snapchat and Pinterest was higher among female respondents while males were more likely to use YouTube. There are no significant difference in social media use among smokers and vapers.

Friends and family are the main influencers youth and young adults follow, with friends being the most followed group—85% compared to 67% for family members. Compared to smokers and vapers, non-smokers and non-vapers were more likely to mentioned friends (86% versus 80%) and family members (69% versus 60%).

Followed less widely, but still by significant minorities, are select individuals within the music culture (47%), YouTubers (45%), and people in the public sphere (44%). Smaller and similar proportions (from 28% to 31%) also follow retail brands, athletes, news sites, athletes, Hollywood stars, and comedians. In addition, one-quarter (24%) follow social causes and one in five (21%) follow bloggers.

Other influencers on social media were mentioned by very small proportions of youth and young adults.

The following respondents were more likely to follow their friends on social media:

The likelihood of following family members is higher among survey respondents from Atlantic Canada (79%) and Saskatchewan or Manitoba (78%), females (78% versus 57% of males), and non-smokers/non-vapers (69% versus 60% of smokers/vapers).

When asked to rate the importance of different influencers when they want to keep on top of trends, youth and young adults were most likely to attribute importance to their friends. Nine in 10 (91%) rated their friends as at least somewhat important (scores of 3-5), including 37% who said they are very important. The likelihood of attributing importance to their friends is higher among 13 to 15 years (83% versus 73% of 16 to 19 year olds and 74% of 20 to 24 year olds).

Following their friends, just over three-quarters (76%) said they view their family members as at least somewhat important. Approximately six in 10 view brands (63%), public figures (63%), and musicians (60%) as important although few see them as very important sources (a score of 5). Less important sources of trend information include YouTubers (53%) and athletes (49%).

Majorities indicated that bloggers (54%) and Hollywood stars (52%) are not important sources of trend information.

Leisure Activities and Peer Groups

Table 27: Use of social media
Q36. Which social media, if any, do you use on a daily basis?	All respondents (n= 3,004)
Facebook	72%
Instagram	65%
YouTube	61%
Snapchat	61%
Twitter	22%
Pinterest	12%
Tumblr	7%
Reddit	1%
VSCO	0%
Other	1%
Use social media, but not daily	5%
Not on social media	2%

Table 28: Influencers followed on social media
Q37. Who do you follow on the social media that you use?	Those who use social media (n= 2,827)
Friends	85%
Family members	67%
Musicians/singers/groups	47%
YouTubers	45%
Public figures	44%
Retail brands	31%
News sites	30%
Athletes	29%
Hollywood stars	28%
Comedians	28%
Social causes	24%
Bloggers	21%
Meme pages	0%
Artists	0%
Authors	0%
Other	1%

Table 29: Importance of different influencers
Q38. When you want to keep on top of new trends, how important are each of the following?	All respondents (n= 3,004)
Friends	37%	37%	17%	4%	3%
Family members	29%	26%	21%	13%	9%
Brands	10%	25%	28%	16%	19%
Public figures	8%	23%	32%	17%	17%
Musicians	9%	23%	28%	18%	18%
YouTubers	8%	21%	24%	18%	26%
Athletes	6%	17%	26%	18%	29%
Hollywood stars	6%	15%	24%	19%	33%
Bloggers	5%	13%	23%	18%	36%

Youth/young adults spend most of their leisure time online, listening to music, with their family, and watching TV.

Youth and young adults pursue a wide range of individual and social activities in their spare time, such as surfing the Internet (80%), listening to music (78%), spending time with family (70%), watching TV (69%) or movies (68%), and spending time with friends by text/Facetime/Skype (65%) or hanging out at each others’ houses (63%).

Other popular pursuits include going to a shopping mall/shopping online (56%), spending time outdoors (53%), playing video games (48%), going to a gym or playing a sport (46%), posting on social media (43%), spending time in a coffee shop (42%), and going to school or campus events (40%).

The graph below depicts the full range of activities youth and young adults do in their spare time.

Smokers and vapers were more likely than non-smokers and non-vapers to say they go to bars and dance clubs (31% versus 21%) as well as parties (46% versus 31%) in their spare time. The likelihood of engaging in many of the other activities tended to be higher among non-smokers and non-vapers than among smokers and vapers.

Respondents 16 to 19 were more likely to surf the Internet (84% versus 77% of 20 to 24 year olds) and listen to music (83% versus 75% of 20 to 24 year olds and 71% of 13 to 15 year olds) in their spare time. Young adults were more likely to spend time outdoors (57% versus 49% of 16 to 19 year olds and 45% of 13 to 15 year olds) and go to bars/dances (32% versus 12% of 16 to 19 year olds), whereas 13 to 15 year olds were more likely to play video games (66% versus 50% of 16 to 19 year olds and 45% of 20 to 24 year olds).

Table 30: Leisure activities and interests
Q34. In your spare time, which of the following do you do?	All respondents (n= 3,004)
Surf the Internet	80%
Listen to music	78%
Spend time with family	70%
Watch TV	69%
Go to see movies/watch movies online	68%
Text/facetime/skype friends	65%
Hang out at friends' houses	63%
Go to a shopping mall/shop online	56%
Spend time outdoors	53%
Play video games	48%
Go to the gym/do training or play a sport	46%
Post on social media	43%
Go to a coffee shop	42%
Go to school/campus events	40%
Go to a bookstore/read	34%
Go to parties	33%
Volunteer	30%
Attend concerts	26%
Go to sporting events (professional, amateur)	23%
Go to bars/dance clubs	22%
Art/drawing/theatre	20%
Go to church	16%
Go to museums	16%
Do computer programming	11%
Go to live theatre	10%
Go hunting/fishing	8%
Use 4wheelers/ATVs	7%
Play music	0%
Dance	0%
Other	1%

In addition, 13 to 15 year olds and 16 to 19 year olds were more likely than young adults to say they do the following: art/drawing/theatre (27% and 23% of 13 to 15 year olds and 16 to 19 year olds versus 17% of 20 to 24 year olds)and watching TV (77% and 71%^{Footnote 19} vs. 67%).

The likelihood of going to parties was higher among youth and young adults in Saskatchewan or Manitoba (41%) and Quebec (38%) and the likelihood of spending their spare time hunting/fishing (20%) and using 4wheelers and ATVs (18%) was higher among youth and young adults in Saskatchewan or Manitoba.

Respondents who identified as LGBTQ2 were more likely to surf the Internet, listen to music, shop, play video games, post on social media, go to coffee shops and bookstores, engage in art, drawing, or theatre, as well as go to live theatre and museums in their spare time.

With only a few exceptions, females were more likely than males to engage in most of the activities. Exceptions include the following: playing video games (66% versus 28% of females), going to sporting events (26% versus 21%), doing computer programming (16% versus 6%), going fishing or hunting (12% versus 5%), and using 4wheelers and ATVs (10% versus 5%).

Youth/young adults listen to pop music by a wide margin, but hip hop/rap and rock are also popular.

As a whole, youth and young adults largely prefer mainstream musical genres including popular music (69%), hip hop/rap (51%) and rock music (43%), as well as R&B/soul (34%), alternative (31%) and dance (30%). In addition, 28% listen to electronic music, 26% to indie, 26% to country, and 22% to classical music. Other genres were also mentioned, but not nearly as often, as can be seen in the graph below (on the next page).

There were noteworthy differences in musical preferences based on smoking and vaping behaviour. Specifically, non-smokers and non-vapers are more likely to listen to pop music (71% versus 58% of smokers and vapers). In contrast, the likelihood of listening to hip hop/rap and reggae is higher among smokers and vapers than among non-smokers and non-vapers (66% versus 49% and 22% versus 9% respectively).

There are a number of differences in music preferences by age. Noteworthy variations include the following:

Table 31: Preferred types of music
Q35. What type of music do you listen to?	All respondents (n= 3,004)
Pop (Popular music)	69%
Hip Hop / Rap	51%
Rock	43%
R&B / Soul	34%
Alternative	31%
Dance	30%
Electronic	28%
Indie Pop	26%
Country	26%
Classical	22%
Jazz	16%
Easy Listening	15%
Folk	15%
Latin	11%
Reggae	11%
Blues	10%
Inspirational (incl. Gospel)	10%
New Age	7%
Metal	2%
K-Pop	1%
Movie soundtracks	0%
Musical theatre / showtunes	0%
Punk rock	0%
Bollywood	0%
Other	2%

Youth/young adults tend to ‘hang out’ with friends they view as academically-oriented/gifted but some also identify with friends they describe as athletically-oriented.

By a wide margin, youth and young adults describe their friends as “academically-oriented” (44%) compared to friends described as “athletically-oriented” (26%). Mentioned less frequently are friend groups described as “preppy” or “popular” (21%), as “gamers” (20%), and as kids that have an interest in the arts (15%).

All other friend groups were cited by one in 10 or fewer youth and young adults, as depicted in the graph below.

Psychographics and Values

Table 32: Friend Groups
Q40. There are many different ways in which people can describe their group of friends. Which of the following best describes the group(s) you spend time with?	All respondents (n= 3,004)
Academic/gifted kids	44%
Sporty/athletic kids/jocks	26%
Popular/preppy	21%
Gamers	20%
Arts kids - drama, art, band	15%
Outsiders	10%
Hipsters	7%
Country	5%
Hip Hop	4%
Chill / normal / average	2%
Skaters	2%
Punks/emos	1%
Christian / religious	0%
Funny	0%
Outdoorsy	0%
Other	1%

Youth/young adults tend to describe themselves as trusting/considerate, though describing themselves as analytical or careful is also popular.

Youth and young adults were asked to rate how much they agree or disagree on a scale of one to five where one meant strongly disagree and five meant strongly agree that various personality traits describe them. The personality traits included:

More than eight in 10 youth and young adults (82%)^{Footnote 20} agreed that “trusting” or “considerate” describes them. Following this, seven in 10 felt that “analytical” or “careful” describes them. Majorities also agreed that “dutiful” or “rule follower” (59%), “creative” or “imaginative” (56%), “curious” or “daring” (55%), and “sociable” or “outgoing” (50%) describes their personality. Youth and young adults were less likely to view themselves as a “leader” or “trendsetter” (43%) and as “anxious” or “insecure” (43%).

The likelihood of agreeing that “curious” or “daring” describes their personality is higher among smokers (70%) than among vapers (56%) and non-smokers/non-vapers (54%). Smokers and vapers (60%) are more likely than non-smokers/non-vapers (49%) to agree that “sociable” or “outgoing” describes them. In contrast, non-smokers/non-vapers are more likely than smokers and vapers to agree that “reserved” or “quiet” (53% versus 44%), “careful” or “analytical” (73% versus 58%), and “dutiful” or “rule follower” (61% versus 45%) describes them.

Table 33: Personality Traits
Q41. For each of the paired words in the table below, please rate the extent to which you agree or disagree that the words describe you?	All respondents (n= 3,004)
Trusting, considerate	47%	35%	12%	3%	1%
Analytical, careful	31%	39%	20%	6%	2%
Dutiful, rule follower	25%	34%	27%	10%	4%
Creative, imaginative	24%	32%	27%	12%	4%
Curious, daring	19%	36%	28%	12%	4%
Sociable, outgoing	18%	32%	28%	15%	5%
Reserved, quiet	23%	29%	25%	16%	7%
Leader, trendsetter	13%	30%	33%	16%	6%
Anxious, insecure	17%	26%	24%	18%	13%

Youth and young adults are more likely to use positive attributes to describe themselves.

Three-quarters (75%)^{Footnote 21} of youth and young adults have friends in their life who are older than them. Majorities say their friends get good grades (73%), that they follow the rules almost all the time (68%), that being accepted by peers is important to them (61%) and that they listen to their parents (60%). In addition, majorities say they do not skip school regularly (67%), do not attend religious services (67%), and are not the first of their friends to wear a fashion trend (57%).

Non-smoker and non-vapers were more likely than smokers and vapers to agree that their friends get good grades (75% versus 58% of smokers and vapers), that they follow the rules (72% versus 42%), that being accepted by their peers is important (63% versus 53%), that they listen to their parents (63% versus 43%), and that they frequently attend religious services (21% versus 14%).

Conversely, smokers and vapers were more likely than non-smokers/non-vapers to agree with the statements “I am rebellious and like to test boundaries” (40% versus 17%) and “I am usually the first among my friends to have the latest technology or gadget” (28% versus 19%) or “…wear the latest fashion trend” (21% versus 14%). In addition, smokers and vapers were more likely to say that they have friends older than them (81% versus 71%), that most of their friends drink alcohol (75% versus 55%), and that they regularly skip/skipped classes in school (34% versus 13%).

Table 34: Personality Attributes
Q42. To what extent do you agree or disagree with the following statements?	All respondents (n= 3,004)
Most of my friends get good grades	33%	40%	20%	4%	1%
I follow the rules almost all the time	27%	41%	22%	7%	2%
I listen to what my parents tell me to do	20%	40%	28%	8%	3%
I have friends in my life who are older than me	41%	34%	13%	7%	3%
Being accepted by my peers is important to me	23%	38%	26%	8%	4%
Most of my friends drink alcohol	31%	26%	17%	10%	13%
I am usually the first among my friends to try new things	9%	22%	38%	20%	10%
Developing my own style of art/music/dance is important to me	14%	20%	29%	16%	19%
I would describe myself as brand-conscious	9%	22%	27%	18%	21%
I am rebellious and like to test boundaries	6%	14%	28%	28%	23%
I'm usually the first of my friends to have the latest technology	7%	13%	24%	27%	27%
I'm usually the first of my friends to wear the latest fashion trend	4%	10%	25%	24%	33%
I frequently attend religious services	12%	8%	12%	13%	54%
I regularly skip/skipped classes in school	6%	10%	16%	18%	49%

Wanting to explore new places is the most common risk-taker attribute among youth/young adults, followed at a distance by wanting to take a trip with no pre-planned routes or timetables and getting restless when too much time is spent at home.

With regards to risk-taking, most youth and young adults (85%) agreed that they would like to explore new places, including 59% who strongly agreed^{Footnote 22} with this statement. Approximately half the youth and young adults surveyed agreed that they would like to take a trip with no pre-planned routes or timetables (51%) and that they get restless when they spend too much time at home (49%). Meanwhile, half disagreed with the statement “I like wild parties” (49%).

Non-smokers and non-vapers were more likely than smokers and vapers to agree that they would like to explore new places (87% versus 76%), that they would like to take off on a trip with no preplanned route (59% versus 49%), that they get restless if they spend too much time at home (55% versus 48%), that they like new experiences even if they have to break the rules (54% versus 34%), that they like wild parties (51% versus 24%), that they like to do things that frighten them (39% versus 27%), and that they prefer friends who are unpredictable (35% versus 20%).

Table 35: Risk-taker Attributes
Q43. To what extent do you agree or disagree that the following statements describe your personality?	All respondents (n= 3,004)
I would like to explore new places.	59%	26%	10%	3%	1%
I would like to take a trip with no pre-planned routes/timetables.	29%	22%	20%	15%	13%
I get restless when I spend too much time at home.	24%	25%	23%	15%	12%
I would like to try bungee-jumping.	26%	19%	17%	13%	23%
I like new/exciting experiences, even if I have to break the rules.	13%	24%	31%	20%	11%
I like to do things that frighten me	9%	20%	30%	23%	18%
I like wild parties.	12%	16%	22%	19%	30%
I prefer friends who are unpredictable.	6%	16%	35%	26%	14%

Taking a stand against smoking is seen as more important than taking a stand against vaping.

Non-smokers and non-vapers place great value on living a healthy tobacco-free or drug-free lifestyle. Roughly nine in 10 (92%) feel that this is at least somewhat important (scores of 3-5 on the 5-point scale), with 62% saying it is very important. Following this, eight in 10 (81%) attributed importance to taking a stand against smoking, and nearly two-thirds (63%) said this about taking a stand against vaping.

Similar to non-smokers and non-vapers, those who smoke or vape also value living a healthy tobacco-free, drug-free lifestyle, though in smaller proportions. Two-thirds (66%) placed importance on this value (scores of 3-5 on the 5-point scale), but only 19% said it is very important. Additionally, taking a stand against smoking (60%) ranked higher in importance than taking a stand against vaping (37%).

Non-smokers and non-vapers were more likely than smokers and vapers to say the following are very important:

Youth and young adults were asked to think about the future and rank the following life goals in terms of importance to them:

While a majority of youth and young adults attributed importance to all of these life goals, views of the following were nearly unanimous: 97% rated having a fulfilling job as at least somewhat important (scores of 3-5 on a 5-point scale), 96% said this about finding purpose and meaning in life as well as being close to family and friends. Respondents were least likely to view as important having a family—89% consider it important.

The likelihood of attributing importance to the following was higher among non-smokers/non-vapers: being close to friends and family (89% versus 81%), contributing to society (76% versus 68%), and having a family (75% versus 68%). In addition, 13 to 15 year olds were more likely than respondents aged 16 and older to view having lots of money as important (83% versus 64%).

Table 36: Values vis-à-vis vaping and smoking [Non-smokers and non-vapers]
Q44. How important, if at all, are the following to you?	All non-smokers and non-vapers (n= 2,660)
Living a healthy tobacco-free, drug-free lifestyle	62%	18%	12%	3%	3%
Taking a stand against smoking	31%	29%	21%	9%	7%
Taking a stand against vaping	15%	16%	32%	15%	18%

Table 37: Values vis-à-vis vaping and smoking [Smokers and vapers]
Q44. How important, if at all, are the following to you?	All smokers and vapers (n= 344)
Living a healthy tobacco-free, drug-free lifestyle	19%	20%	27%	16%	17%
Taking a stand against smoking	17%	16%	27%	14%	25%
Taking a stand against vaping	10%	7%	20%	17%	44%

Table 38: Future life goals
Q45. When you think about the future, how important, if at all, are the following possible life goals?	All respondents (n= 3,004)
Having a fulfilling job	67%	24%	7%	1%	0%
Finding purpose and meaning in life	60%	27%	9%	2%	1%
Being close to family and friends	65%	23%	9%	2%	0%
Travelling	49%	30%	15%	4%	1%
Contributing to society	40%	35%	18%	4%	1%
Having lots of money	28%	37%	26%	6%	2%
Having a family	52%	22%	15%	6%	3%

Youth/young adults believe a university education and looking after the environment are important social values.

Nearly three-quarters of youth and young adults agreed that a university education (74%) and looking after the environment (73%) are important (scores of 4-5 on a 5-point scale). Following this, six in 10 agreed that it is important to follow government and public affairs and approximately half (51%) would pay more for an environmentally friendly product. Fewer than half—roughly four in 10, or 42%—strive to follow religious/ family traditions and customs.

Non-smokers and non-vapers were more likely than smokers and vapers to attribute importance to a university education (75% versus 66%), to looking after the environment is important (76% versus 59%), and to following what is going on in government and public affairs (62% versus 47%). In addition, they were more likely to say they would pay more for an environmentally friendly product (52% versus 44%).

2. Segmentation Results

There were several components to the segmentation analysis: the factor analysis, the cluster analysis and decision tree modelling, as well as a regression analysis. These are described in this section of the report, along with the resulting segments.

Factor Analysis

A wide variety of items were included in the questionnaire to explore attitudes about smoking, vaping and other risk behaviours. In order to synthesize the large amount of information and present it in a cohesive and comprehensible way, a factor analysis was performed. A factor analysis is a technique used to group together a large number of questions into similar themes or “factors”. This also paved the way for the segmentation analysis to follow.

To locate underlying dimensions—or factors—and limit redundancy in the measurement variables, most of the scale-based questions in the survey were included in the factor analysis. As a result of this analysis, 12 factors were identified. They are presented below together with the questions that comprise each factor.

The table below presents the mean scores for the 12 factors as well as the questions that comprise each factor, broken out by smoking and vaping status. The factors in which the differences between non-smokers/non-vapers and smokers/vapers are greatest are:

In addition, selected variables within a number of the factors revealed significant differences between non-smokers/non-vapers and smokers/vapers. These variables are identified in the table with asterisk.

Once the factor analysis was complete, the results were used to support the segmentation work. Both cluster analysis and decision tree modelling were used to explore potential segments or mutually-exclusive, homogenous and interpretable groups of individuals defined by their attitudes and behaviours with respect to smoking and vaping as well as related issues. In the end, the segments were developed via decision tree modelling. Correlation analyses were done to determine which factors were the best predictors of smoking and vaping.

Regression Analysis

In addition to the factor analysis, a logistic regression model was developed to determine the best predictors of smoking and vaping. Regression is a statistical technique used to assess the influence of selected variables (the independent variables) on another variable (the dependent variable)—in this case, the likelihood of smoking or vaping. The factors and sociodemographic variables included in the segmentation were the independent variables used for the modelling. In the end, the following factors and variables were included in the model:

The coefficients for the variables in the model are provided in the table below. If there was no impact, the coefficient would be 1.0. A 10% increase in the odds ratio would be a coefficient of 1.1, and a 10% decrease would be a coefficient of 0.9.

Table 39: Social values
Q46. To what extent do you agree or disagree with the following statements?	All respondents (n= 3,004)
A university education is important.	46%	28%	17%	4%	4%
Looking after the environment is important to me.	36%	37%	19%	4%	2%
It's important to follow government and public affairs.	23%	37%	28%	7%	3%
I would pay more for an environmentally friendly product.	19%	32%	31%	10%	6%
I strive to follow religious/family traditions and customs.	15%	27%	32%	14%	11%

Figure 40: Factors
Factor	Non- smoker/ Non-vaper n= 2,660	Smoker / Vaper n=344
1. Thrill Seeking	3.3	3.5
I like to do things that frighten me	2.8	3.1
*I like new and exciting experiences, even if I have to break the rules	3.0	3.6
I would like to take off on a trip with no pre-planned routes or timetables	3.3	3.7
I would like to try bungee-jumping	3.1	3.3
I prefer friends who are unpredictable	2.7	3.1
I would like to explore new places	4.4	4.3
I get restless when I spend too much time at home	3.3	3.6
I see myself as: curious, daring	3.5	3.7
2. Meaningful Life and Social Bonds	4.4	4.3
How important is: Having a fulfilling job?	4.6	4.5
How important is: Finding purpose and meaning in life?	4.5	4.4
How important is: Being close to family and friends?	4.6	4.4
How important is: Having a family?	4.2	4.0
How important is: Travelling?	4.3	4.2
3. Rule Follower	3.7	3.2
*I follow the rules almost all the time.	3.9	3.3
I see myself as: Dutiful, rule follower	3.7	3.3
I listen to what my parents tell me to do.	3.7	3.3
*I am not rebellious and do not like to test boundaries	3.6	2.9
4. Anti-smoking/vaping Activist	3.7	2.7
*Taking a stand against vaping?	2.9	2.2
*Taking a stand against smoking?	3.7	2.8
*Living a healthy tobacco-free, drug-free lifestyle?	4.3	3.1
5. Social Responsibility and Engagement	3.9	3.6
I would pay more for an environmentally friendly product	3.5	3.3
Looking after the environment is important to me	4.1	3.7
It is important to follow what's going on in government, public affairs	3.8	3.5
How important is: Contributing to society	4.1	3.9
6. Early Adopter / Conspicuous Consumer	2.6	2.8
I’m usually the first to have the latest technology or gadget.	2.4	2.7
I am usually the first among my friends to wear the latest fashion trend.	2.2	2.5
I would describe myself as brand-conscious.	2.8	2.8
I am usually the first among my friends to try new things.	3.0	3.2
7. Extravert / Introvert	3.0	3.2
I do not see myself as reserved or quiet	2.5	2.8
I see myself as: sociable, outgoing	3.4	3.7
I do not see myself as anxious, insecure	2.8	2.7
I see myself as: leader, trendsetter	3.3	3.4
8. Anti-smoking/Vaping Peer Pressure	4.0	3.2
People close to me would be upset if I smoked	4.6	4.2
*People close to me would be upset if I vaped	4.1	2.8
*Vaping is embarrassing/not cool	3.7	3.0
*Smoking regular cigarettes is not socially acceptable	3.7	3.2
9. Importance of Family and Friends	3.8	3.8
To keep on top of new trends, how important are: Friends	4.0	4.0
To keep on top of new trends, how important are: Family members	3.5	3.5
10. Creative Independence	3.3	3.3
I see myself as: Creative, imaginative	3.6	3.6
Developing my own style of art/music/dance is important to me.	3.0	2.9
11. Religious Values	2.7	2.5
I frequently attend religious services.	2.1	1.9
I strive to follow traditions / customs handed down to me	3.2	3.1
12. Wild Child	3.0	3.8
*Most of my friends drink alcohol	3.5	4.2
*I like wild parties	2.5	3.5

Figure 41: Predictors of smoking and vaping
Predictor	Increase/Decrease in Odds Ratio of Smoking/Vaping
Gender (Female)	0.484	0.548
Factor 3: Rule Follower	0.838*	0.41
Factor 4: Anti-smoking/vaping Activist	0.581*	0.61*
Vaping is not a big deal (Q30B)	1.313*	2.003
Factor 8: Anti-smoking/vaping Peer Pressure	0.167	0.456
Factor 12: Wild Child	2.925	2.486
*The influence of these individual factors in the model was not significant.

The estimated probability of smoking and vaping was generated from this model for each respondent age 16 and older.^{Footnote 23} The risk estimates ranged from just over 1% to nearly 67%. The sample was grouped into the following six risk categories:

The table below presents the proportion of 16 to 24 year olds who fall into each risk category by smoking and vaping.

Based on this model, approximately half the 16 to 24 year olds represent a low risk of starting to smoke (51%) or vape (47%). One-third (32%) pose a medium risk of starting to smoke and four in 10 pose a medium risk of starting to vape. Seventeen percent represent a high risk of starting to smoke and 13% of starting to vape.

Segments

The decision tree analysis resulted in seven segments, dividing youth and young adults (age 16 to 24 years^{Footnote 24}) according to their likelihood of smoking and vaping, as well as their orientations toward a range of related issues. The seven segments, and their proportion of the population, are:

In terms of current smoking and vaping, they do so in the following proportions:

In total, 7% of 16 to 24 year olds are members of this group. While this group exhibits the highest incidence of smoking and/or vaping (58% do so: 23% vape and 50% smoke) as well as cannabis use (67%), it is also the smallest segment. Alcohol consumption among members of this group is second only to “Defiant Partiers”, with 92% having had an alcoholic beverage. This segment is also more likely to present a high risk when it comes to starting to smoke (58% high and 40% medium versus 2% low) and a medium risk when it comes to starting to vape (53% medium and 41% high versus 6% low). This group is defined by its risk behaviour and susceptibility for starting to smoke or vape, as well as the apparent lack of anti-smoking or vaping influences in their lives. It scored lowest on the Rule Follower factor, the Anti-smoking/vaping Peer Pressure and Activist factors, second highest on the Wild Child factor (behind “Defiant Partiers”), and higher than average on the “rule breaker” measure^{Footnote 25}.

In addition to what is shown in the box above, members of this segment also scored higher than average on the following factors:

They scored lower than all other segments on the Social Responsibility/Engagement and Religious Values factors.

In terms of peer groups, this segment was the most likely to characterize their friends as hip/hop. They were also more likely than average to describe their friends as popular or preppy, outsiders, arts kids, and gamers. Members of this segment were the least likely to say they hang around with academic or gifted kids.

Regarding their lifestyle, like “Thrill Seeking Rule Breakers”, members of this segment were more likely than average to attend concerts, go to bars, dance clubs and parties, and hang out at their friends’ houses. In addition, they were more likely than average to hunt or fish and use four wheelers/ATVs. They were the least likely of all the segments to spend time with their family, go to school/campus events, and to volunteer.

Musically, members of this segment were the most likely of all the segments to listen to hip hop/rap, electronic, folk, R&B/soul and reggae music, and the least likely to listen to pop music. They were also more likely than average to listen to music from the following genres: country, dance, indie pop, and rock.

With the exception of YouTube, members of this segment were more likely than average to use popular social media channels and the least likely of all segments to point to friends and family as important influencers. Notably, “Irreverent Risk Takers” were the most likely of all the segments to follow Hollywood stars and comedians on social media, and the least likely to follow social causes.

In total, 25% of 16 to 24 year olds are members of this group. In terms of risk behaviours, 25% vape and/or smoke (15% vape; 14% smoke), 57% have used cannabis, and 87% have consumed alcohol. The incidence of smoking or vaping as well as cannabis use is second highest among this segment. While alcohol consumption is higher than the average among youth and young adults in this segment, it is not as high as it is among “Defiant Partiers” and “Irreverent Risk Takers”. In addition, this segment is more likely to present a medium to high risk when it comes to starting to smoke (49% medium and 47% high versus 4% low) and vape (55% medium and 34% high versus 11% low). The key defining characteristics of this group is that it scored higher than average on the Wild Child and Thrill Seeking factors, as well as on the “breaking rules” measure^{Footnote 26}. In addition, members scored lower than average on the Anti-smoking/vaping Peer Pressure and Activist factors.

Members of this segment also scored higher than average on the Early Adopter factor and Extravert (behind “Defiant Partiers” and “Irreverent Risk Takers”) factor.

They scored lower than average on the Social Responsibility/Engagement, Social Bonds, and Religious Values factors and second lowest on the Family and Friends factor (behind “Outsiders”).

The age split is fairly even—members of this segment are similarly likely to be 16-19 years of age and 20-24 years of age.

In terms of peer groups, this segment was the most likely after “Defiant Partiers” to characterize their friends as athletic or “jocks”. They were also more likely than average to describe their friends as “popular” or “preppy” and less likely than average to say they hang around with academic or gifted kids.

Regarding their lifestyle, members of this segment were more likely than average to attend concerts, go to bars, dance clubs and parties, and hang out at their friends’ houses. They were less likely than average to spend time with their family and to volunteer.

Musically, members of this segment were the most likely of all the segments to listen to alternative music. They were also more likely than average to listen to music from the following genres: dance, electronic music, country music, hip hop/rap, indie pop, R&B/soul, reggae and rock. With the exception of Facebook, “Thrill Seeking Rule Breakers” were more likely than average to use popular social media channels and the most likely of all segments to follow musicians on social media.

In total, 16% of 16 to 24 year olds are members of this group. In terms of risk behaviours, 15% vape and/or smoke (11% vape; 7% smoke), 53% have used cannabis, and 93% have consumed alcohol. The incidence of youth and young adults in this segment smoking or vaping is consistent with the average. However, this segment’s use of cannabis and alcohol is significantly higher than the average. In addition, this segment is more likely to present a medium risk when it comes to starting to smoke (54% medium, 46% low) and vape (61% medium, 33% low, 7% high). The key defining characteristics of this group is that it scored highest on the Thrill Seeker, Wild Child and Social Bonds factors and higher than average on the Anti-smoking/vaping Peer Pressure and Activist factors.

Members of this segment also scored higher than average on the following factors:

They scored lower than average on the “rule follower” measure and Religious Values factor.

In contrast, they are less likely to be living in the Prairies (14% versus 18%).

In terms of peer groups, this segment was the most likely to characterize their friends as popular or preppy and as athletic or “jocks”.

Regarding their lifestyle, members of this segment were the most likely of all the segments to play sports and go to a gym, attend concerts and sporting event, go to bars, dance clubs and parties, hang out at their friends’ houses and post on social media. They were also more likely than average to watch TV and movies.

Musically, members of this segment were the most likely of all the segments to listen to dance music. They were also more likely than average to listen to music from the following genres: electronic music, country music, and hip hop/rap. “Defiant Partiers” were the most likely to use Facebook and Instagram on a daily basis, and to follow friends and family on social media.

In total, 12% of 16 to 24 year olds are members of this segment. In terms of risk behaviours, 12% vape and/or smoke (7% vape; 8% smoke), 21% have used cannabis, and 53% have consumed alcohol. The incidence of smoking, vaping, using cannabis and consuming alcohol is lower among this segment than the average. That said, this segment is more susceptible to starting to smoke or vape than “Rule Followers”, “Creative Conformists”, and “Dutiful Partiers”—specifically, 71% are a medium risk of smoking (14% are low and 15% are high) and 56% are a medium risk of vaping (33% are low and 11% are high). The key defining characteristics of this group is that it scored lowest on the Extravert/Introvert, Friends and Family, Social Bonds, and Early Adopter/Conspicuous Consumer factors, second lowest on the Anti-smoking/vaping Peer Pressure factor (ahead of only “Irreverent Risk Takers”), and lower than average on the Wild Child factor.

“Outsiders” also scored lower than average on the Thrill Seeking, Creative Independence, Social Responsibility, and Religious Values factors.

In terms of peer groups, this segment was more likely than average to characterize their friends as academic or gifted, as arts kids and as gamers (but less so than members of “Creative Conformists”), and less likely than average to say their friends are popular or preppy and sports or jocks. The youth and young adults were the most likely of all the segments to say their friends are outsiders.

Regarding their lifestyle, members of this segment were more likely than average to spend time surfing the Internet, playing video games, and reading or going to bookstores. Conversely, they were less likely than average to engage in social activities, such as posting on social media, hanging out with friends, going to bars, dance clubs, concerts, parties, etc.

Members of this segment were more likely than average to listen to alternative and electronic music and were the most likely of all the segments to use YouTube on a daily basis. When it comes to influences, members of this segment were the least likely of all the segments to follow retail brands, musicians, athletes, and Hollywood stars on social media. Following the segment, “Creative Conformists”, youth and young adults in this segment were most likely to follow YouTubers.

In total, 18% of 16 to 24 year olds are members of this group. This group exhibits the third lowest incidence of smoking and/or vaping (4% do so) as well as average cannabis use (36%) and higher than average alcohol use (81%). They also are low risk in terms of starting to smoke or vape: 97% and 77% respectively. The key defining characteristics of this group is that it scored higher than average on the Rule Follower factor (behind “Rule Followers” and “Outsiders”), the Anti-smoking/vaping Peer Pressure and Activist factors (behind “Rule Followers” and “Creative Conformists”), and the Social Responsibility and Engagement factor (behind “Rule Followers”). On the Wild Child factor, “Conscientious Activists” rank in the middle: they scored slightly higher than average, but below “Defiant Partiers”, “Thrill Seeking Rule Breakers”, and “Irreverent Risk Takers”.

“Conscientious Activists” also scored higher than average on the Friends and Family factor, and lower than average on the Thrill Seeking, Extravert, and Religious Values factors.

In terms of peer groups, this segment was more likely than average to characterize their friends as academic or gifted, less likely than average to say their friends are popular or preppy (but more so than “Rule Followers”), and slightly more likely than average to say the people they spend time with are gamers, country and hipsters.

Regarding their lifestyle, members of this segment were most likely to spend time watching TV and movies, and more likely than average to spend time outdoors, with their family or friends, or computer programming. They were less likely than average to attend parties.

Members of this segment were less likely to listen to hip hop/rap, electronic music, and R&B/soul. In addition, youth and young adults in this segment were more likely than average to be on Facebook and Instagram, and more likely than average to follow their friends on social media.

In total, 9% of 16 to 24 year olds are members of this group. Behind “Rule Followers”, this group exhibits the second lowest incidence of smoking and/or vaping (4%) as well as cannabis (16%) and alcohol use (45%). They also do not present a high risk in terms of starting to smoke or vape: 99% are low risk for starting to smoke and 71% are low risk for starting to vape. The key defining characteristics of this group is that it scored higher than average on the Anti-smoking/vaping Peer Pressure and Anti-smoking/vaping Activist factors (second only to Rule Follower), highest on the Creative Independence factor, and second lowest (behind Rule Followers) on the Wild Child factor.

“Creative Conformists” also scored higher than average on the Social Responsibility factor, and lower than average on the Thrill Seeking, Social Bonds, Extravert, Friends and Family, Early Adopter, and Religious Values factors.

In terms of peer groups, this segment was more likely than average to characterize their friends as academic or gifted, arts kids or outsiders and less likely than average to say their friends are popular or preppy. In contrast, they were most likely of all the segments to say the people they spend time with are gamers.

Regarding their lifestyle, members of this segment are less likely than average to spend their leisure time at a gym or playing sports (and significantly less likely to do so than “Rule Followers”), attending concerts or sporting events, going to bars, dance clubs or parties, and hanging out at friends’ houses or with their parents. In contrast, members of this segment are more likely to spend time volunteering, playing video games, computer programming, and keeping in touch with their friends through text, Facetime or Skype.

The musical profile of this segment is similar to that of “Rule Followers” with a few noteworthy differences: they are less likely to listen to classical music and more likely to listen to alternative and hip hop/rap. In addition, youth and young adults in this segment are least likely to listen to country music, most likely to listen to jazz, and more likely than average to listen to pop music.

With the exception of YouTube, members of this segment are less likely than average to use popular social media channels, and more likely than average to follow their friends, news sites, YouTubers, public figures, and social causes.

In total, 15% of 16 to 24 year olds are members of this group. This group exhibits the lowest incidence of smoking and/or vaping (1% do so) and the least risk in terms of starting to smoke (100% are low risk) and vape (98% are low risk). In addition, they are the least likely to have used cannabis (5% have used cannabis), and their alcohol use is lower than the average (45% have had an alcoholic beverage at least once). The key defining characteristic of this group is that it scored the highest on the Rule Follower factor and the lowest on the Wild Child and Thrill Seeker factors as well as on the measure “breaking the rules”.

Members of this segment scored higher than members of all other segments on the following factors:

In terms of peer groups, this segment was most likely to characterize their friends as academic or gifted, more likely than average to describes their friends as arts kids, and less likely than average to say the people they spend time with are popular or preppy.

Regarding their lifestyle, “Rule Followers” are less likely to spend their leisure time attending concerts, going to bars, dance clubs or parties, hanging out at friends’ houses, and posting on social media. In contrast, members of this segment are most likely to spend time with their family. They are also more likely than average to spend time at school, surf the Internet, volunteer, text, Facetime or Skype with their friends, go to a bookstore, as well as attend church.

Musically, members of this segment are more likely than average to listen to music from the following genres: classical music, inspirational gospel and pop. Conversely, they were less likely than average to listen to alternative, dance, electronic, hip hop/rap, R&B/soul and rock music.

Members of this segment are more likely than average to report that they do not use social media on a daily basis. In terms of influencers on social media, “Rule Followers” are more likely than average to mention their family and less likely to point to Hollywood stars, musicians, comedians, bloggers, YouTubers, and public figures. When it comes to health-related information, “Rule Followers” are the most likely of all the segments to say they would turn to their parents.

Few 13 to 15 year olds in the survey sample smoke or vape—2% or nine respondents. In addition, 13 to 15 year olds were more likely than average to not consume alcohol or to use cannabis. In terms of smoking/vaping influences in their life, 13 to 15 year olds are more likely than older youth and young adults to have no-one in their life who smokes or vapes. While some of the people in their life do smoke or vape, the likelihood of 13 to 15 year olds saying their friends neither smoke nor vape is higher compared to older youth and young adults.

Looking ahead, 13 to 15 year old non-vapers are less likely than older youth and young adults to say it is unlikely they will start vaping because it is unappealing to them. Indeed, for some, vaping is appealing. Triad participants who vape said it is fun and entertaining when asked why they vape. They enjoy the “vape tricks” they can do when using an e-cigarette or vaping device. A few triad participants who do not vape acknowledged that this might be something they try in the future. When asked why, curiosity was mentioned coupled with the perception that vaping is not as harmful as smoking cigarettes. Triad participants (vapers and non-vapers) also pointed to impressions that vaping is fun and less dangerous than smoking to explain why they think the number of people their age who vape is increasing.

In contrast, 13 to 15 year olds are more likely to attribute their lack of desire to start vaping to not wanting to get addicted. This is not surprising given the strong views 13 to 15 year olds have on the health effects of smoking, their attitudes toward smoking and vaping, their perceptions of the risk associated with smoking, and their overall lack of knowledge about the effects of vaping.

Specifically, 13 to 15 year olds are more likely to agree that vaping is no better than smoking cigarettes, that nicotine is a toxic chemical that should be avoided, and that vaping is addictive and will lead to smoking cigarettes. As well, 13 to 15 year olds are more likely than older youth and young adults to agree that smoking cigarettes is not socially acceptable, to believe that vaping is a big deal as well as embarrassing, and to acknowledge that people around them would be upset if they ever vaped.

In addition, 13 to 15 year olds are more likely than 16 to 24 year olds to say that they do not know what risk is posed by vaping non-nicotine fluids. Similar attitudes were expressed by non-vapers in the triads. Regarding the latter point (i.e., risks posed by vaping), vapers in the triads were also of the opinion that the difference between vaping and smoking is not that the former is safer but rather that its adverse effects on health are as yet unknown. Indeed, when asked specifically about the health effects of vaping, a couple of vapers identified popcorn lungs and feeling ‘winded’.

Turning to social media, 13 to 15 year olds are less likely to use Facebook, and more likely to attribute importance to their friends as influencers. When it comes to leisure activities, 13 to 15 year olds set themselves apart from older youth and young adults. They are less likely to surf the Internet and listen to music in their spare time, and more likely to play video games, do art/drawing/theatre, do computer programming, and watch TV. Triad participants (vapers and non-vapers) also emphasized these types of activities, particularly video games.

3. Conclusions

The research findings suggest the following conclusions for Health Canada’s consideration:

Whereas views of smoking are well established among youth and young adults, views of vaping are mixed. Specifically, there is a greater social stigma associated with smoking than with vaping. Youth and young adults think smoking is addictive, not socially acceptable, and carries serious risks. Not surprisingly, anti-smoking peer pressure is strong, with many youth and young adults believing people close to them would be upset if they started smoking (or are upset that they smoke).

Vaping, however, is seen as less risky. Youth and young adults, whether they smoke, vape or do neither, see vaping as more acceptable and less harmful to one’s health compared to smoking cigarettes. Notably, youth and young adults were less likely to think that people close to them would be upset if they started to vape than if they started to smoke. When asked why they think vaping is on the rise, participants from the qualitative research pointed to the fact that vaping is trendy, that it is more convenient than smoking because it can be done indoors, that the smell and taste are more pleasant, and the belief that vaping is a better alternative to smoking cigarettes.

The vast majority of non-smokers and non-vapers do not think it is likely they will start either activity. However, more youth and young adults think it is possible that they may try vaping. When participants from the qualitative research were asked why, curiosity was mentioned coupled with the perception that vaping is not as harmful as smoking cigarettes.

The estimated probability of smoking and vaping generated from a regression model found that young adults (20-24 year olds) present a higher risk of starting to smoke or vape than youth aged 16 to 19. That said, while youth are more likely to present a low risk when it comes to starting to smoke cigarettes or vape, a greater proportion are high risk when it comes to vaping (as opposed to smoking). In other words, while youth non-smokers present a low risk of engaging in either activity, the risk is higher for vaping.

Youth, and to a lesser extent young adults, are susceptible to vaping, are less aware of the health effects and risks associated with vaping than they are about cigarettes, and view vaping as more socially acceptable than smoking cigarettes. In addition, vape products are believed to be more accessible than cigarettes (at the time of this study) and are thought to be a smoking cessation aid.

》 Youth and young adults who vape and/or smoke are more likely to engage in other risk behaviours.

The research indicates that the likelihood of smoking or vaping was higher among youth and young adults who also use cannabis and consume alcohol. The three segments most likely to currently smoke or vape—“Defiant Partiers”, “Thrill Seeking Rule Breakers”, and “Irreverent Risk Takers”—are more likely than average to also use cannabis and consume alcohol.

》 Online is an important source of information for youth and young adults.

While youth and young adults get health-related information from physicians/other medical professionals and their parents, the Internet is also a significant source of information—specifically, Google. Youth and young adults are less likely to go to an organization’s website for health-related and more likely to enter terms in a Google search.

In terms of likelihood of smoking or vaping, “Rule Followers”, “Creative Conformists” and “Conscientious Activists” are low risk and almost no-one in these segments currently smokes or vapes. While health promotion messages are always important, these segments present a lower priority for communications.

In contrast, “Outsiders”, “Defiant Partiers”, and “Thrill Seeking Rule Breakers” who do not smoke or vape present a medium risk of starting to do so, while up to one-quarter currently do vape or smoke. “Irreverent Risk Takers”, the smallest segment, present a high risk of starting smoking and a medium risk of starting vaping. Almost six in 10 members of this segment smoke cigarettes or vape—notably, members of this segment were twice as likely to smoke than to vape.

With this in mind, the main target audiences for anti-smoking and anti-vaping messages are the four segments at medium to high risk of starting to smoke or vape: “Defiant Partiers”, “Outsiders”, “Thrill Seeking Rule Breakers”, and “Irreverent Risk Takers”. Members of these segments are more likely to be male, and with one exception—“Outsiders”, to live in Quebec or the Prairies provinces. Majorities of the members of these segments consume alcohol, and with one exception—“Outsiders” again—majorities also use cannabis. These segments score low on the anti-smoking/vaping peer pressure and activism factors (the exception is “Defiant Partiers”) and the research suggests that these factors differentiate smokers/vapers from non-smokers/non-vapers.

When it comes to smoking cessation messages, “Irreverent Risk Takers” present the most immediate need for intervention given that members of this segment are significantly more likely to smoke or vape. Members of this segment are also more likely to be older (20-24 years of age), to characterize their friends as “hip hop”, to listen to hip-hop/rap music, and to spend their leisure time attending concerts, going to bars, and hanging out a friends’ houses.

Appendix

Annex 1: Literature Review

B. Conclusion

The literature consulted suggested that interventions targeting peer crowds may be an effective way to reach those Canadians with the highest susceptibility of smoking/vaping and to encourage them to make informed choices.

Annex 2: Research Instruments

Qualitative: Recruitment Screener

Screener 1: 13-15 year olds

INTRO: Hello/Bonjour, my name is [RECRUITER]. I’m calling from CRC/Research House, a Canadian research company. We are looking for a group of young people to take part in a study that is being done for the Government of Canada.

Would you prefer that I continue in English or French? / Préférez-vous continuer en en français ou anglais?

RECRUITER NOTE: FOR ENGLISH GROUPS, IF PARTICIPANT WOULD PREFER TO CONTINUE IN FRENCH, PLEASE RESPOND WITH, "Malheureusement, nous recherchons des gens qui parlent anglais pour participer à ces groupes de discussion. Nous vous remercions de votre intérêt."

Is there anyone in your household who is currently 13 to 15 years of age?

Yes CONTINUE
No THANKS/DISCONTINUE

IF ADULT: Are you the parent or guardian for that teen*?

Yes CONTINUE
No ASK TO SPEAK TO ADULT
REINTRODUCE/CONTINUE

*IF THE INDIVIDUAL VOLUNTEERS THAT THERE IS MORE THAN ONE TEEN IN THE HOUSEHOLD, NOTE THIS AND CONTINUE.

IF CHILD: May I speak to your parent or guardian?

[PARENT CONSENT] We are conducting a research study for Health Canada that includes youth 13 to 15 years of age. The study is being conducted to help the department develop public education campaigns to enhance awareness of the health hazards associated with tobacco use. For this study, we’re organizing small discussion groups which are scheduled to run for 1 hour on a Saturday. The sessions involve a small number of teens, three to be exact, who will be asked to share their opinions with others in the group. All opinions will remain anonymous and participation is voluntary. Those who take part will receive $100 for their time. The information collected will be used for research purposes only and handled according to the Privacy Act of Canada. More information about the handling and use of your child’s personal information will be provided by email in advance of the research. The full name of your child will not be provided to the government or any other third party.

IF ASKED ONLY: The personal information you/your child provide to Health Canada is governed in accordance with the Privacy Act and is being collected under the authority of section 4 of the Department of Health Act. The information you provide will not be linked with your name on any document including the consent form or the discussion form. In addition to protecting your/your child personal information, the Privacy Act gives you the right to request access to and correction of your/your child personal information. For more information about these rights, or about our privacy practices, please contact Health Canada's Privacy Coordinator at 613-948-1219 or privacy-vie.privee@hc-sc.gc.ca. You also have the right to file a complaint with the Privacy Commissioner of Canada if you think your personal information has been handled improperly. The final report written by Phoenix will be available to the public from Library and Archives Canada (http://www.bac-lac.gc.ca/).]

May we have your permission to ask your child* some questions to see if s/he qualifies for the discussion group which will take place on [INSERT DATE] at [TIME]?

Yes CONTINUE
No THANKS/DISCONTINUE

*IF MORE THAN ONE TEEN IN THE HOUSEHOLD, ADJUST LANGUAGE: “ONE OF YOUR CHILDREN, THE ONE WHO MOST RECENTLY CELEBRATED A BIRTHDAY”.

Thank you. Before I speak with your child, I have a few more questions for you.

Q1A. We have been asked to speak to participants from all different ages. May I have your child’s age please? RECORD AND CLASSIFY. GET MIX.

Under 13 THANK/DISCONTINUE
13 years
14 years
15 years
16 and older SEND TO 16-24 YEAR SCREENER

Q1B: The discussion group will be video-recorded. These recordings are used to help analyze the findings and write the report. The results from the discussions will be grouped together in the research report, which means that individuals will not be identified in anyway. Neither your child’s name nor his/her specific comments will appear in the research report. Is this acceptable?

Yes CONTINUE
No THANKS/DISCONTINUE

Q1C: There may be some people from Health Canada who have been involved in this project observing the session in-person or remotely via a webcam set-up. They will not take part in the discussion and they will not know your child’s name. Is this acceptable?

Yes CONTINUE
No THANKS/DISCONTINUE

Q1D. Do you, or any member of your immediate family, work for …? READ LIST

…a marketing research, public relations, or advertising firm?
…the media (radio, television, newspapers, magazines, etc.)?
…the federal or provincial government?
…a tobacco or electronic cigarette/vaping company?
…a smoking cessation company?
…a legal or law firm?

Yes THANK/TERMINATE IF YES TO ANY
No CONTINUE

Q1E. Has your child ever attended a discussion group or taken part in interview on any topic that was arranged in advance and for which s/he received money for participating?

Yes
No GO TO Q1H

Q1F. When did your child last attend one of these discussion groups or interviews?

Within the last 6 months THANK/TERMINATE
Over 6 months ago

Q1G. Thinking about the groups or interviews that your child has taken part in, what were the main topics discussed?

RECORD: _______________
THANK/TERMINATE IF RELATED TO TOBACCO OR VAPING/E-CIGARETTES

Q1H. How many discussion groups or interviews has your child attended in the past 5 years?

Fewer than 5
Five or more THANK/TERMINATE

Q1I. What is your child’s name?

RECORD: _______________

Q1J. RECORD GENDER.

Thank you. Now I would like to speak to [INSERT NAME OF CHILD] to make sure [SHE/HE] feels comfortable about taking part in a group discussion. Once I’ve done that, I would like to speak to you again.

[YOUTH INTRO] Hi [INSERT NAME OF CHILD], I'm [RECRUITER] of CRC/Research House, a Canadian research company. Your mother/father/guardian gave me permission to talk to you about a research study. We are conducting research with young people ages 13 to 15 for Health Canada, to help the department develop public education campaigns to enhance awareness of the health hazards associated with tobacco use.

Q2. At the present time, do you… RECORD YES/NO

Use an electronic cigarette, also know as an e-cigarette? [VAPER]
Smoke cigarettes? [SMOKER]
IF ‘YES’ TO BOTH [VAPER+SMOKER]
IF ‘NO’ TO BOTH [NON-SMOKER/NON-VAPER]

I'd like to tell you a little bit about the study to see if you might be interested in taking part. For this study, we’re organizing small discussion groups, each of which is scheduled to run for 1 hour on a Saturday. The discussion groups involve three teens (you and two others) who will be asked to share their opinions. All opinions will remain anonymous and participation is voluntary. Those who take part will receive a cash gift for their time and light refreshments will be served. The information collected will be used for research purposes only and handled according to the Privacy Act of Canada. The full names of participants will not be provided to the government or any other third party. More information about the handling and use of your personal information will be provided to your parent/guardian by email in advance of the research. Would you be interested in taking part in this study?

Yes CONTINUE
No THANK/DISCONTINUE

IF ASKED: The personal information you provide to Health Canada is governed in accordance with the Privacy Act and is being collected under the authority of section 4 of the Department of Health Act. The information you provide will not be linked with your name on any document including the consent form or the discussion form. In addition to protecting your personal information, the Privacy Act gives you the right to request access to and correction of your personal information. For more information about these rights, or about our privacy practices, please contact Health Canada's Privacy Coordinator at 613-948-1219 or privacy-vie.privee@hc-sc.gc.ca. You also have the right to file a complaint with the Privacy Commissioner of Canada if you think your personal information has been handled improperly. The final report written by Phoenix will be available to the public from Library and Archives Canada (http://www.bac-lac.gc.ca/).]

Before we invite you to attend, I need to ask you a few questions to make sure we are getting a good mix of people for each discussion group. This will take 5 minutes. May I continue?

Yes CONTINUE
No THANK/DISCONTINUE

ASK SMOKERS:

Q3. Do you smoke cigarettes every day or occasionally?

Every day [DAILY SMOKER]
Occasionally [OCCASIONAL SMOKER]

DAILY SMOKERS GO TO DEMOGRAPHICS UNLESS THEY VAPE.

ASK VAPERS:

Q4. Do you vape every day or occasionally?

Every day [DAILY VAPER]
Occasionally [OCCASIONAL VAPER]

THE FOLLOWING GO TO DEMOGRAPHICS:
DAILY VAPERS
DAILY SMOKERS WHO VAPE

ASK OCCASIONAL SMOKERS:

Q5. In the past 30 days, did you smoke any cigarettes?

Yes [OCCASIONAL SMOKER]
No [NON-SMOKER/NON-VAPER; UNLESS THEY VAPE]

THE FOLLOWING GO TO DEMOGRAPHICS:
OCCASIONAL SMOKERS WHO DO NOT VAPE

ASK OCCASIONAL VAPERS:

Q6. In the past 30 days, did you use an e-cigarette or vape?

Yes [OCCASIONAL VAPER]
No [NON-SMOKER/NON-VAPER; UNLESS THEY SMOKE]

NOTE: FOR THE SMOKER/VAPER TRIADS, NO MORE THAN 1 PARTICIPANT WHO IS AN OCCASIONAL SMOKER/VAPER.

THE FOLLOWING GO TO DEMOGRAPHICS:
OCCASIONAL VAPERS
OCCASIONAL SMOKERS WHO OCCASIONALLY VAPE

ASK NON-SMOKERS/NON-VAPERS:

Q7. Does anyone in your household, or do any of your friends, use tobacco products? This could be cigarettes, electronic cigarettes, also known as e-cigarettes, cigars, pipes, or tobacco water pipes, such as a hookah.

Yes [AT RISK; NO MORE THAN 2 PER TRIAD]
No

Q8. Have you ever tried smoking a cigarette or using an e-cigarette? [READ OPTIONS]

No
Once only [AT RISK; NO MORE THAN 2 PER TRIAD]
Tried a few times [AT RISK; NO MORE THAN 2 PER TRIAD]

NON-SMOKERS/NON-VAPERS GO TO DEMOGRAPHICS

Screener 2: 16-24 year olds

INTRO: Hello/Bonjour, my name is [RECRUITER]. I’m calling from CRC/Research House, a Canadian research company. We are looking for a group of young people ages 16 to 24 to take part in a study that is being done for the Government of Canada.

Would you prefer that I continue in English or French? / Préférez-vous continuer en en français ou anglais?

Is there anyone in your household who is currently 16 to 24 years of age? If so, may I speak with this individual?

Yes CONTINUE
No THANKS/DISCONTINUE

REPEAT INTRODUCTION WHEN INDIVIDUAL COMES TO THE PHONE.

RECORD GENDER BY OBSERVATION. [50/50 SPLIT]

Q1. We have been asked to speak to participants from all different ages. May I have your age please? RECORD AND CLASSIFY. GET MIX WITHIN EACH AGE SEGMENT.

Under 16 THANK/DISCONTINUE
16 years 16-19 YEAR OLDS
17 years 16-19 YEAR OLDS
18 years 16-19 YEAR OLDS
19 years 16-19 YEAR OLDS
20 years 20-24 YEAR OLDS
21 years 20-24 YEAR OLDS
22 years 20-24 YEAR OLDS
23 years 20-24 YEAR OLDS
24 years 20-24 YEAR OLDS
25 and older THANK/DISCONTINUE

Q2. At the present time, do you… RECORD YES/NO

Use an electronic cigarette, also know as an e-cigarette? [VAPER]
Smoke cigarettes? [SMOKER]
IF ‘YES’ TO BOTH [VAPER+SMOKER]
IF ‘NO’ TO BOTH [NON-SMOKER/SMOKER/NON-VAPER]

FOR SMOKER/VAPER GROUPS, GET A MIX OF SMOKERS AND VAPERS. SOME WILL DO BOTH AND THAT IS FINE.

We are conducting a research study for Health Canada, a department of the Government of Canada, to help them develop public education campaigns to enhance awareness of the health hazards associated with tobacco use. I'd like to tell you a little bit about the study to see if you might be interested in taking part. For this study, we’re organizing discussion groups which are scheduled to run for 2 hours in the evening. The discussion groups involve a small number of [FOR 16-19 YEAR OLDS: young people / FOR 20-24 YEAR OLDS: people] who will be asked to share their opinions with others in the discussion group. All opinions will remain anonymous and participation is voluntary. Those who take part will receive a cash gift for their time and light refreshments will be served. The information collected will be used for research purposes only and handled according to the Privacy Act of Canada. The full names of participants will not be provided to the government or any other third party. More information about the handling and use of your personal information will be provided by email in advance of the research. Would you be interested in taking part in this study?

Yes CONTINUE
No THANK/DISCONTINUE

Q3. Do you, or any member of your immediate family, work for …? READ LIST

…a marketing research, public relations, or advertising firm?
…the media (radio, television, newspapers, magazines, etc.)?
…the federal or provincial government?
…a tobacco or electronic cigarette/vaping company?
…a smoking cessation company?
…a legal or law firm?

Yes THANK/TERMINATE IF YES TO ANY
No CONTINUE

ASK SMOKERS ONLY:

Q4. Do you smoke cigarettes every day or occasionally?

Every day [DAILY SMOKER]
Occasionally [OCCASIONAL SMOKER]

DAILY SMOKERS GO TO DEMOGRAPHICS UNLESS THEY VAPE.

ASK VAPERS:

Q5. Do you vape every day or occasionally?

Every day [DAILY VAPER]
Occasionally [OCCASIONAL VAPER]

THE FOLLOWING GO TO DEMOGRAPHICS:
DAILY VAPERS
DAILY SMOKERS WHO VAPE

ASK OCCASIONAL SMOKERS:

Q6. In the past 30 days, did you smoke any cigarettes?

Yes [OCCASIONAL SMOKER]
No [NON-SMOKER/NON-VAPER; UNLESS THEY VAPE]

THE FOLLOWING GO TO DEMOGRAPHICS:
OCCASIONAL SMOKERS WHO DO NOT VAPE

ASK OCCASIONAL VAPERS:

Q7. In the past 30 days, did you use an e-cigarette or vape?

Yes [OCCASIONAL VAPER]
No [NON-SMOKER/NON-VAPER; UNLESS THEY SMOKE]

NOTE: FOR THE SMOKER/VAPER TRIADS, NO MORE THAN 1 PARTICIPANT WHO IS AN OCCASIONAL SMOKER/VAPER.

THE FOLLOWING GO TO DEMOGRAPHICS:
OCCASIONAL VAPERS
OCCASIONAL SMOKERS WHO OCCASIONALLY VAPE

ASK NON-SMOKERS/NON-VAPERS:

Q8. Does anyone in your household, or do any of your friends, use tobacco products? This could be cigarettes, electronic cigarettes, also known as e-cigarettes, cigars, pipes, or tobacco water pipes, such as a hookah.

Yes [AT RISK; NO MORE THAN 4 PER GROUP]
No

Q9. Have you ever tried smoking a cigarette or using an e-cigarette? [READ OPTIONS]

No
Once only [AT RISK; NO MORE THAN 4 PER GROUP]
Tried a few times [AT RISK; NO MORE THAN 4 PER GROUP]

NON-SMOKERS/NON-VAPERS GO TO DEMOGRAPHICS

Demographics Questions

ASK QD1 OF THOSE 18 YEARS OF AGE AND OLDER:

QD1. Could you please tell me what is the last level of education that you have completed? [READ LIST; GET MIX]

Some high school
Completed high school
Some college/technical school/CEGEP
Graduated college/technical school/CEGEP
Some university
Graduated university
Graduate studies

GO TO INDUSTRY QUESTIONS, UNLESS UNDER 16. 13-15 YEAR OLDS GO TO INVITATION TO PARTICIPATE.

13-15 YEAR OLDS, GO TO INVITATION TO PARTICIPATE.
16 AND OLDER, GO TO INDUSTRY QUESTIONS.

Industry Questions

*ONLY ASK PARTICIPANTS AGE 16 AND OLDER.

QI1. Have you ever attended a discussion group or taken part in an interview on any topic that was arranged in advance and for which you received money for participating?

Yes
No GO TO QI5

QI2. When did you last attend one of these discussion groups or interviews?

Within the last 6 months THANK/TERMINATE
Over 6 months ago

QI3. Thinking about the groups or interviews that you have taken part in, what were the main topics discussed?

RECORD: _______________
THANK/TERMINATE IF RELATED TO TOBACCO

QI4. How many discussion groups or interviews have you attended in the past 5 years?

Fewer than 5
Five or more THANK/TERMINATE

QI5. Participants will be asked to look at some items, write out short comments and voice their opinions in front of others? Do you feel comfortable doing this?

Yes CONTINUE
No THANK/TERMINATE

QI6: The discussion group will be video-recorded. These recordings are used to help with analyzing the findings and writing the report. The results from the discussions will be grouped together in the research report, which means that individuals will not be identified in anyway. Neither your name nor your specific comments will appear in the research report. Is this acceptable?

Yes CONTINUE
No THANK/TERMINATE

QI7: There may be some people from Health Canada who have been involved in this project observing the session in-person or remotely via a webcam set-up. They will not take part in the discussion and they will not know your name. Is this acceptable?

Yes CONTINUE
No THANK/TERMINATE

GO TO INVITATION TO PARTICIPATE

Invitation to Participate

Thank you. We would like to invite you to attend one of the discussion groups, which will be lead by a researcher from the national public opinion research firm, Phoenix SPI. The group will take place on [DAY OF WEEK], [DATE], at [TIME] at [FACILITY]. It will last [FOCUS GROUPS=two hours; TRIADS=1 HOUR], and we ask that you arrive 15 minutes early. Following your participation, you will receive $100 to thank you for your time.

Are you willing to attend?

Yes CONTINUE
No THANK/TERMINATE

13-15 YEAR OLDS GO TO SECTION B.

Section A: 16 AND OLDER ONLY

May I have your email address so that we can also send you an email message with the address where the group will be held?

Yes: ENTER EMAIL ADDRESS: ____________________
No: That’s fine. Do you have a pen handy so that I can give you the address where the group will be held? It will be held at [INSERT FACILITY ADDRESS] at [TIME] on [DATE].

At the facility, you will be asked to produce photo identification, so please remember to bring something with you (for example, a driver’s license). In order to participate, you will also be asked to read and sign a consent form when you arrive at the facility.

If you use glasses to read, please bring them with you.

As we are only inviting a small number of people to attend, your participation is very important to us. If for some reason you are unable to attend, please call us so that we can get someone to replace you. You can reach us at [INSERT NUMBER] at our office. Please ask for [INSERT NAME].

Someone from our company will call you the day before to remind you about the session. To do that, we need to have your contact information.

PARTCIPANT
First name:	________________________________________
Last Name:	________________________________________
Daytime phone number:	________________________________________
Evening phone number:	________________________________________
Email:	________________________________________

Thank you!

Section B: 13-15 YEAR OLDS ONLY

In the next few days, we will be sending your parent or legal guardian a letter by email. The letter will have instructions on what you need to do for the discussion group, as well as a consent form that your [HE/SHE] must sign and return to us in advance of the group. Now I need to talk to your parent/guardian again. Would you please put [HER/HIM] back on the phone?

Thank you for allowing me to speak with [INSERT NAME OF CHILD]. [SHE/HE] would like to participate in the study. Here are a few other details about the group discussion:

》 The discussion will last 1 hour, starting at: [INSERT TIME].
》 We ask that participants arrive 15 minutes early, that is by [INSERT TIME].
》 Following their participation, [INSERT NAME OF CHILD] will be given $100.
》 The discussion group will be held at: [FACILITY NAME + ADDRESS]

In the next few days, we would like to send you a letter by email. The letter will have instructions on what your child needs to do for the discussion group, as well as a consent form that you must sign and return to us in advance of the group. To send the letter, may we please have your contact information?

PARENT/GUARDIAN
First name:	________________________________________
Last Name:	________________________________________
Daytime phone number:	________________________________________
Evening phone number:	________________________________________
Email:	________________________________________

One last thing. Someone from our company will call your child the day before to remind [HIM/HER] about the session.

Thank you!

Qualitative: Focus Group and Triad Guides

Introduction (5 minutes)

Introduce moderator and welcome participants to the focus group.
- Thanks for attending/value your being here.
- Tonight, we’re conducting research on behalf of Health Canada.
- We will be seeking your opinion on various aspects of tobacco use and vaping.
- The discussion will last approximately 2 hours.
- If you have a cell phone or other electronic device, please turn it off.
Describe focus group.
- A discussion group is a “round table” discussion.
- My job is to facilitate the discussion, keeping us on topic and on time.
- Your job is to offer your opinions.
- There are no right or wrong answers. This is not a knowledge test.
- Everyone’s opinion is important. We want you to speak up even if you feel your opinion might be different from others.
Explanations.
- Comments treated in confidence.
  - Please note that anything you say during these groups will be held in the strictest confidence. We do not attribute comments to specific people. Our report summarizes the findings from the groups but does not mention anyone by name. Please do not provide any identifiable information about yourself.
- The session is being audio-video recorded. The recordings remain in our possession and will not be released to anyone, even to the Government of Canada, without your written consent.
  - Recording is for report writing purposes / verify feedback.
- Observers.
  - There are observers from the Government of Canada who will be watching behind the one-way mirror and online.
  - Purpose: oversee the research process and see your reactions first-hand.
Any questions?
Roundtable introduction: Please tell us your first name and a hobby you have.

1. Non-Smokers/Non-Vapers

Contextual Issues and General Impressions (20 minutes)

To start, do any of you have friends or acquaintances who smoke cigarettes or use e-cigarettes? GET HANDOUT COUNTS BY TYPE OF TOBACCO USE AND BY ACQUAINTANCE / FRIEND.
For those of you who have friends who use tobacco or vape: [MODERATOR: VAPERS MAY OR MAY NOT USE A VAPING FLUID THAT CONTAINS NICOTINE; WHETHER OR NOT NICOTINE IS USED, IS NOT RELEVANT.]
Do they smoke cigarettes or vape around you? How does this make you feel and why?
PROBES (IF NEEDED): concerned / indifferent
And how, if at all, does your friends’ smoking or vaping affect what you do when you hang out together? In order words, does their smoking or vaping influence the types of activities you do, the places you go, or things like that?
And, for those of you who don’t have friends or acquaintances who smoke cigarettes or use e-cigarettes,
Do you notice people your age smoking or vaping? Tobacco use is prohibited in a lot of places, so where do you tend to notice people smoking or vaping?
For all of you,
What’s your general impression … do you think the number of people your age who smoke cigarettes or vape is increasing or decreasing and why? Let’s start with cigarettes…now what about vaping?
Why do you think some people your age smoke or vape, whether daily or occasionally? USE FLIPCHART. [MODERATOR: PAY ATTENTION TO DIFFERENCES BY TYPE OF TOBACCO USE: CIGARETTES VS. E-CIGARETTES.]
PROBES (IF NEEDED):
- fun/pleasurable
- cool
- relaxing/calming
- keeps alert/increases concentration
- curbs appetite/helps maintain/lose weight
- social bonding/experience
What words or adjectives would you use to describe someone your age who smokes or vapes? PROBE FOR REASONS WHY.
And, do you think you would ever start smoking cigarettes or using e-cigarettes? Why/why not? If so, which… smoking or vaping? Why?
What do you see as the difference between smoking cigarettes and vaping? Is there a difference? Why/why not? IF NOT MENTIONED: What about the health effects of smoking cigarettes and vaping? Are they the same? If not, why not?

Peer Groups and Other Influencers (30 minutes)

Now I want to talk about different groups of people your age. Teens often form groups or cliques starting in school [ADD FOR 20-24 YEAR OLDS: and these groups or cliques tend to influence your sense of self as you enter your twenties.]

What type of groups do/did you find in your school? RECORD ON FLIPCHART.
PROBES (IF NEEDED):
- Athletes/kids who are on school teams
- Kids who do well in school/are academically inclined
- Kids who are artistically focused (i.e. music, drama, visual arts, etc.)
- Kids who cut classes/skip school/get in trouble
- Kids with a reputation for being leaders, involved in student council or other activities/concerned about image/involved in lots of activities
- Kids who rebel against norms/attempt not to conform to social ideals
- Kids who keep to themselves and do not belong to any particular peer group
FOR EACH OF THE GROUPS IDENTIFIED, ASK:
What are the characteristics of someone you would describe as belonging to this group [INSERT GROUP]? By characteristics, I mean their appearance, their academic performance, their attitudes or values, their school or extra-curricular activities, their interactions at school, the type of music they listen, and other things like this. Why do you say that?
In your experience, how much are/were members of these groups liked or disliked by others? Why do you say that? GO THROUGH THE GROUPS IDENTIFIED ONE AT A TIME AND PROBE FOR EXAMPLES.
Which of these groups is/was more likely to smoke cigarettes or vape and why?
To what extent, if at all, is/was identifying as belonging to one of these groups important to people your age? Why/why not?
How would you describe your circle of friends? Which of these types of groups do they mostly belong to?
Does/did your circle of friends include people from more than one of these different groups? If so, from which groups?
FOR 20-24 YEAR OLDS ONLY, ASK:
Thinking about your circle of friends now, do these types of groups or cliques still exist? If not, how have they changed or what has replaced them? PROBE FOR BRIEF DESCRIPTIONS OF EACH GROUP.
EVERYONE:

Switching topics,
When you want to keep on top of new trends among people your age, who would you look to first? By this, we mean people who influence the way you think about things—your opinions or your behaviour? Why? [MODERATOR: IF ASKED WHAT IS MEANT BY ‘TRENDS’ EXPLAIN THAT IT COULD REFER TO ANYTHING, FROM FASHION TO MUSIC TO HEALTH AND FITNESS, FOR EXAMPLE.]
PROBES (IF NEEDED): musicians, actors, celebrities, bloggers, peers/friends
Do these sources of influence have a bigger impact on how you see or think about things than other sources, such as friends or family, experts, news or information from credible organizations? In other words, would a celebrity endorsement of a certain product trump independent reviews of this same product? Why/why not?

Activities (20 minutes)

Changing the focus somewhat, I want to talk about what you do in your spare time and I’d like to start with the types of electronic devices use and the content you consume.

What kinds of electronic devices do you use on a daily basis? KEEP BRIEF
PROBES (IF NEEDED):
- Smartphone
- Tablet
- Laptop/PC
- TV/Smart TV
- E-reader
And which social media platforms do you use? Which one is most important to you and why?
PROBES (IF NEEDED):
- Facebook
- Instagram
- Twitter
- YouTube
- Snapchat
- Tumblr
What about apps? What are some of the apps that you use on a daily basis?
And when it comes to TV shows and movies, or listening to music…do you stream this kind of entertainment?
In a typical week, what do you spend money on?
PROBES (IF NEEDED):
- Food/eating out
- Clothes/cosmetics
- Sports equipment
- Gym membership
- Entertainment – sports events, movies
- Transportation – Uber, transit pass
- Alcohol
Where are the places you go, or events you attend, in your spare time? Think broadly here, giving consideration to the different seasons. RECORD ON FLIPCHART.
PROBES (IF NEEDED):
- Mall
- Library
- Sporting event
- Gym or playing sports
- Coffee shop
- Bookstore
- Beach
- Camping
- Skiing/snowboarding
- Concert
- Bar/dance club
- Friend’s house
- Campus/school event
- Movies
- Cycling/Running
What activities or events, if any, do you associate with smoking or vaping and why? REFER TO ITEMS RECORDED ON FLIP CHART.
Now I want you to think about the most well-known or “popular” people in your school or community who hang out where you do, how many of them smoke cigarettes or use e-cigarettes?
Do you think smoking and vaping among people who hang out where you hang out is increasing, decreasing or staying the same? Why do you say that?

Knowledge and Social Values (25 minutes)

Changing topics one more time, I’d like you to think about some past quitting smoking messages or campaigns that you have encountered.

Can anyone recall any anti-smoking or quit smoking campaigns? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
And does anyone recall any campaigns about vaping? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
Thinking about your peers who smoke or vape, who would this campaign appeal to? Why?
What sort of messages would you suggest to get the attention of smokers/vapers and convey the health effects of tobacco use and risks of vaping?
To what extent is living a healthy tobacco-free, drug-free lifestyle important to you personally? And what about to your friends?
Is taking a stand against smoking and vaping important to you personally? And what about to your friends?
Have any of you ever thought about becoming involved (or are involved) with some type of non-smoking/non-vaping campaigns or initiatives, whether big or small ones?
Do you think that vaping is better than smoking regular cigarettes when it comes to the health effects? Why?
When you think about the future, what are important life goals? That is, what types of things do you want to achieve?
PROBES (IF NEEDED):
- having lots of money
- contributing to society
- finding purpose and meaning in life
- being close to family and friends
- bucket list
- travelling
- Marriage

Risk Behaviours and Information Sources (15 minutes)

So far, we’ve been talking mainly about smoking and vaping. Now I’d like to focus more broadly and include other health-related risk behaviours, such as alcohol and drug use, in addition to smoking and vaping.

Why do you think some young people engage in risk behaviours, and others do not?
PROBES (IF NEEDED):
- peer pressure
- rebellion/test boundaries
- mental health issues
- to get attention
- escape an unhappy situation
And, what do you think they get out of engaging in these risk behaviours?
At what point do you think risky behaviour becomes a problem? Why do you say that?
Now still thinking about risky behaviours, but also more broadly about health issues,
If you wanted this type of information, where would you go?
Which of these sources do you view as being must trustworthy when it comes to providing health-related information? Why?

Conclusion (5 minutes)

We’ve covered a lot tonight and I really appreciate you taking the time to come and share your opinions. I’m going to leave the room now to check with the observers to see if there are any last questions for you. When I come back, I’m going to ask whether any of you has last thoughts that you want to share with the Government of Canada about anything we’ve talked about tonight.

MODERATOR WILL LEAVE THE ROOM AND CHECK WITH OBSERVERS TO SEE IF THERE ARE LAST QUESTIONS.

Does anyone have any last thoughts or feedback to share with the Government of Canada about what we’ve talked about tonight?

Thank you very much for your time. This concludes the discussion group.

2. Smokers/Vapers

Contextual Issues and General Impressions (25 minutes)

What you all have in common, and part of the reason you are here, is that you smoke cigarettes or vape. Some of you probably or may do both.

To start, how many of you smoke? And how many of you vape? [HAND COUNT]
How many of you smoke or vape on a daily basis? [HAND COUNT] For those who don’t, how often do you smoke or vape?
How long have you been smoking or vaping? [RECORD SEPARATELY; ADJUST IF PARTICIPANTS DO BOTH] What kind of tobacco products do you use? What type of device do you use to vape?
PROBES (IF NEEDED):
- Cigarettes, cigars, cigarillos, chew, hookah, pipe
- Vapers:
  - Rechargeable vs. disposable,
  - Cig-a-likes, pen devices, RDA, RTA
  - Nicotine or nicotine-free liquid
What were the circumstances or situation in which you first tried a cigarette/e-cigarette?
Why do you smoke or vape…that is, what do you get out of it? [RECORD SEPARATELY; ADJUST IF PARTICIPANTS DO BOTH]
PROBES (IF NEEDED):
- fun/pleasurable
- relaxing/calming
- keeps alert/increases concentration
- curbs appetite/helps maintain/lose weight
- social bonding/experience
Has anyone here ever tried to quit smoking or vaping? [HAND COUNT; RECORD SEPARATELY]
For those who have,
How many times have you tried and for how long (on average) were you tobacco-free? Why do you think your quit attempts didn’t stick? [MODERATOR: PAY ATTENTION TO VAPERS AND WHETHER THOSE WHO SMOKE AND VAPE TRIED VAPING AS A SMOKING CESSATION AID].
What’s the most important reason someone might want to quit smoking or vaping? Why?
PROBES (IF NEEDED):
- health; physical fitness
- smell (on clothing, hair)
- high cost
- stop premature aging/wrinkles
- most of my friends don’t smoke
- partner doesn’t smoke
What’s your general impression … do you think the number of people your age who smoke cigarettes or vape is increasing or decreasing and why? Let’s start with cigarettes…now what about vaping?
How do you think your peers who don’t smoke or vape view those who smoke or vape? What’s one word or adjective they might use to describe someone who smokes or vapes? Why? [MODERATOR: WHAT FOR DIFFERENCES BETWEEN SMOKERS AND VAPERS].

Peer Groups and Other Influencers (30 minutes)

What type of groups do/did you find in your school? RECORD ON FLIPCHART.
PROBES (IF NEEDED):
- Athletes/kids who are on school teams
- Kids who do well in school/are academically inclined
- Kids who are artistically focused (i.e. music, drama, visual arts, etc.)
- Kids who cut classes/skip school/get in trouble
- Kids with a reputation for being leaders, involved in the student council or other activities/concerned about image/involved in lots of activities
- Kids who rebel against norms/attempt not to conform to social ideals
- Kids who keep to themselves and do not belong to any particular peer group
FOR EACH OF THE GROUPS IDENTIFIED, ASK:
What are the characteristics of someone you would describe as belonging to this group [INSERT GROUP]? By characteristics, I mean their appearance, their academic performance, their attitudes or values, their school or extra-curricular activities, their interactions at school, and other things like this. Why do you say that?
In your experience, how much are/were members of these groups liked or disliked by others? Why do you say that? GO THROUGH THE GROUPS IDENTIFIED ONE AT A TIME AND PROBE FOR EXAMPLES.
In your experience, which of these groups is/was more likely to smoke cigarettes or vape and why?
To what extent, if at all, is/was identifying as belonging to one of these groups important to people your age? Why/why not?
How would you describe your circle of friends? Which of these types of groups do they mostly belong to?
Does/did your circle of friends include people from more than one of these different groups? If so, from which groups?
FOR 20-24 YEAR OLDS ONLY, ASK:
Thinking about your circle of friends now, do these groups or cliques still exist? If not, how have they changed or what has replaced them? PROBE FOR BRIEF DESCRIPTIONS OF EACH GROUP.
EVERYONE:

Switching topics,
When you want to keep on top of new trends among people your age, who would you look to first? By this, we mean people who influence the way you think about things—your opinions—
or your behaviour? Why? [MODERATOR: IF ASKED WHAT IS MEANT BY ‘TRENDS’ EXPLAIN THAT IT COULD REFER TO ANYTHING, FROM FASHION TO MUSIC TO HEALTH AND FITNESS, FOR EXAMPLE.]
PROBES (IF NEEDED): musicians, actors, celebrities, bloggers, peers/friends
Do these sources of influence have a bigger impact on how you see or think about things than other sources, such as friends or family, experts, news or information from credible organizations? In other words, would a celebrity endorsement of a certain product trump independent reviews of this same product? Why/why not?

Activities (20 minutes)

Changing the focus somewhat, I want to talk about what you do in your spare time and I’d like to start with the types of electronic devices use and the content you consume.

What kinds of electronic devices do you use on a daily basis? KEEP BRIEF
PROBES (IF NEEDED):
- Smartphone
- Tablet
- Laptop/PC
- TV/Smart TV
- E-reader
And which social media platforms do you use? Which one is most important to you and why?
PROBES (IF NEEDED):
- Facebook
- Instagram
- Twitter
- YouTube
- Snapchat
- Tumblr
What about apps? What are some of the apps that you use on a daily basis?
And when it comes to TV shows and movies, or listening to music…do you stream this kind of entertainment?
In a typical week, what do you spend money on?
PROBES (IF NEEDED):
- Food/eating out
- Clothes/cosmetics
- Sports equipment
- Gym membership
- Entertainment – sports events, movies
- Transportation – Uber, transit pass
- Alcohol/cigarettes/vape fluids
Where are the places you go, or events you attend, in your spare time? Think broadly here, giving consideration to the different seasons. RECORD ON FLIPCHART.
PROBES (IF NEEDED):
- Mall
- Library
- Sporting event
- Gym or playing sports
- Coffee shop
- Bookstore
- Beach
- Camping
- Skiing/snowboarding
- Concert
- Bar/dance club
- Friend’s house
- Campus/school event
- Movies
- Cycling/Running
What activities or events, if any, do you associate with smoking or vaping and why? REFER TO ITEMS RECORDED ON FLIP CHART.
Now I want you to think about the most well-known or “popular” people in your school or community who hang out where you do, how many of them smoke cigarettes or use e-cigarettes?
Do you think smoking and vaping among people who hang out where you hang out is increasing, decreasing or staying the same? Why do you say that?

Knowledge and Social Values (20 minutes)

Changing topics one more time, I’d like you to think about some past quitting smoking messages or campaigns that you have encountered.

Can anyone recall any anti-smoking or quit smoking campaigns? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
And does anyone recall any campaigns about vaping? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
What sort of messages would you suggest to get the attention of smokers/vapers and convey the health effects of tobacco use and vaping?
To what extent is living a healthy, drug-free, tobacco-free lifestyle important to you personally? And what about to your friends?
PROBE: Reasons why/why not
Do you foresee yourself stopping smoking or vaping? Why/why not?
Do you think that vaping is better than smoking regular cigarettes when it comes to the health effects? Why?
When you think about the future, what are important life goals? That is, what types of things do you want to achieve?
PROBES (IF NEEDED):
- having lots of money
- contributing to society
- finding purpose and meaning in life
- being close to family and friends
- bucket list
- travelling
- Marriage

Risk Behaviours and Information Sources (15 minutes)

Why do you think some young people engage in risk behaviours, and others do not?
PROBES (IF NEEDED):
- peer pressure
- rebellion/test boundaries
- mental health issues
- to get attention
- escape an unhappy situation
And, what do you think they get out of engaging in these risk behaviours?
At what point do you think risky behaviour becomes a problem? Why do you say that?
If you wanted information on the risks or benefits to your health when it comes to smoking and vaping, where would you go?
Which of these sources do you view as being must trustworthy when it comes to providing information about health-related risks or benefits? Why?

Conclusion (5 minutes)

We’ve covered a lot tonight and I really appreciate you taking the time to come and share your opinions. I’m going to leave the room now to check with the observers to see if there are any last questions for you. When I come back, I’m going to ask whether any of you has last thoughts that you want to give the Government of Canada about discussion topic.

MODERATOR WILL LEAVE THE ROOM AND CHECK WITH OBSERVERS TO SEE IF THERE ARE LAST QUESTIONS.

Does anyone have any last thoughts or feedback to share with the Government of Canada about the topic?

Thank you very much for your time. This concludes the discussion group.

Introduction (3 minutes)

Introduce moderator and welcome participants to the triad.
- Thanks for attending/value your being here.
- Today, we’re conducting research on behalf of Health Canada.
- We will be seeking your opinion on various aspects of tobacco use and vaping.
- The discussion will last approximately 1 hour.
- If you have a cell phone or other electronic device, please turn it off.
Describe focus group.
- A discussion group is a “round table” discussion.
- My job is to facilitate the discussion, keeping us on topic and on time.
- Your job is to offer your opinions.
- There are no right or wrong answers. This is not a knowledge test.
- Everyone’s opinion is important. We want you to speak up even if you feel your opinion might be different from others.
Explanations.
- Comments treated in confidence.
  - Please note that anything you say during these groups will be held in the strictest confidence. We do not attribute comments to specific people. Our report summarizes the findings from the groups but does not mention anyone by name. Please do not provide any identifiable information about yourself.
- The session is being audio-video recorded. The recordings remain in our possession and will not be released to anyone, even to the Government of Canada, without your written consent.
  - Recording is for report writing purposes / verify feedback.
- Observers.
  - There are observers from the Government of Canada who will be watching behind the one-way mirror and online.
  - Purpose: oversee the research process and see your reactions first-hand.
Any questions?
Roundtable introduction: Please tell us your first name and a hobby you have.

1. Smokers/Vapers

Contextual Issues and General Impressions (15 minutes)

What you all have in common, and part of the reason you are here, is that you smoke cigarettes or vape. Some of you probably or may do both.

To start, how many of you smoke? And how many of you vape?
How many of you smoke or vape on a daily basis?
How long have you been smoking or vaping? [RECORD SEPARATELY; ADJUST IF PARTICIPANTS DO BOTH] What kind of tobacco products do you use? What type of device do you use to vape?
PROBES (IF NEEDED):
- Cigarettes, cigars, cigarillos, chew, hookah, pipe
- Vapers:
  - Rechargeable vs. disposable,
  - Cig-a-likes, pen devices, RDA, RTA
  - Nicotine or nicotine-free liquid
What were the circumstances or situation in which you first tried a cigarette/e-cigarette?
Why do you smoke or vape…that is, what do you get out of it? [RECORD SEPARATELY; ADJUST IF PARTICIPANTS DO BOTH]
PROBES (IF NEEDED):
- fun/pleasurable
- relaxing/calming
- keeps alert/increases concentration
- curbs appetite/helps maintain/lose weight
- social bonding/experience
Has anyone here ever tried to quit smoking or vaping? [RECORD SEPARATELY]
For those who have,
How many times have you tried and for how long (on average) were you tobacco-free? Why do you think your quit attempts didn’t stick? [MODERATOR: PAY ATTENTION TO VAPERS AND WHETHER THOSE WHO SMOKE AND VAPE TRIED VAPING AS A SMOKING CESSATION AID].
What’s the most important reason someone might want to quit smoking or vaping? Why?
PROBES (IF NEEDED):
- health; physical fitness
- smell (on clothing, hair)
- high cost
- stop premature aging/wrinkles
- most of my friends don’t smoke
- partner doesn’t smoke
What’s your general impression … do you think the number of people your age who smoke cigarettes or vape is increasing or decreasing and why? Let’s start with cigarettes…now what about vaping?
How do you think your peers who don’t smoke or vape view those who smoke or vape? What’s one word or adjective they might use to describe someone who smokes or vapes? Why? [MODERATOR: WHAT FOR DIFFERENCES BETWEEN SMOKERS AND VAPERS].

Peer Groups and Other Influencers (15 minutes)

Now I want to talk about different groups of people your age. Teens often form groups or cliques starting in school.

What type of groups do/did you find in your school?
PROBES (IF NEEDED):
- Athletes/kids who are on school teams
- Kids who do well in school/are academically inclined
- Kids who are artistically focused (i.e. music, drama, visual arts, etc.)
- Kids who cut classes/skip school/get in trouble
- Kids with a reputation for being leaders, involved in the student council or other activities/concerned about image/involved in lots of activities
- Kids who rebel against norms/attempt not to conform to social ideals
- Kids who keep to themselves and do not belong to any particular peer group
FOR EACH OF THE GROUPS IDENTIFIED, ASK:
What are the characteristics of someone you would describe as belonging to this group [INSERT GROUP]? By characteristics, I mean their appearance, their academic performance, their attitudes or values, their school or extra-curricular activities, their interactions at school, and other things like this. Why do you say that?
In your experience, which of these groups is/was more likely to smoke cigarettes or vape and why?
How would you describe your circle of friends? Which of these types of groups do they mostly belong to?
Switching topics,
When you want to keep on top of new trends among people your age, who would you look to first? By this, we mean people who influence the way you think about things—your opinions—
or your behaviour? Why? [MODERATOR: IF ASKED WHAT IS MEANT BY ‘TRENDS’ EXPLAIN THAT IT COULD REFER TO ANYTHING, FROM FASHION TO MUSIC TO HEALTH AND FITNESS, FOR EXAMPLE.]
PROBES (IF NEEDED): musicians, actors, celebrities, bloggers, peers/friends
Do these sources of influence have a bigger impact on how you see or think about things than other sources, such as friends or family, experts, news or information from credible organizations? In other words, would a celebrity endorsement of a certain product trump independent reviews of this same product? Why/why not?

Activities (10 minutes)

Changing the focus somewhat, I want to talk about what you do in your spare time and I’d like to start with the types of electronic devices use and the content you consume.

What kinds of electronic devices do you use on a daily basis? KEEP BRIEF
PROBES (IF NEEDED):
- Smartphone
- Tablet
- Laptop/PC
- TV/Smart TV
- E-reader
And which social media platforms do you use? Which one is most important to you and why?
PROBES (IF NEEDED):
- Facebook
- Instagram
- Twitter
- YouTube
- Snapchat
- Tumblr
What about apps? What are some of the apps that you use on a daily basis?
PROBE: If you were thinking of quitting smoking, would you be interested in an app to help you do this? If so, what feature(s) would you expect or want the app to have?
And when it comes to TV shows and movies, or listening to music…do you stream this kind of entertainment?
In a typical week, what do you spend money on?
PROBES (IF NEEDED):
- Food/eating out
- Clothes/cosmetics
- Sports equipment
- Gym membership
- Entertainment – sports events, movies
- Transportation – Uber, transit pass
- Cigarettes/vape fluids
Where are the places you go, or events you attend, in your spare time? Think broadly here, giving consideration to the different seasons. PROBES (IF NEEDED):
- Mall
- Library
- Sporting event
- Gym or playing sports
- Coffee shop
- Bookstore
- Beach
- Camping
- Skiing/snowboarding
- Concert
- Bar/dance club
- Friend’s house
- Campus/school event
- Movies
- Cycling/Running
What activities or events, if any, do you associate with smoking or vaping and why?

Knowledge and Social Values (10 minutes)

Changing topics one more time, I’d like you to think about some past quitting smoking messages or campaigns that you have encountered.

Can anyone recall any anti-smoking or quit smoking campaigns? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
PROBE: Break it off
And does anyone recall any campaigns about vaping? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
What sort of messages would you suggest to get the attention of smokers/vapers and convey the health effects of tobacco use and vaping?
To what extent is living a healthy, drug-free, tobacco-free lifestyle important to you personally? And what about to your friends?
PROBE: Reasons why/why not
Do you foresee yourself stopping smoking or vaping? Why/why not?
When you think about the future, what are important life goals? That is, what types of things do you want to achieve?
PROBES (IF NEEDED):
- having lots of money
- contributing to society
- finding purpose and meaning in life
- being close to family and friends
- bucket list
- travelling
- Marriage

Risk Behaviours and Information Sources (5 minutes)

Why do you think some young people engage in risk behaviours, and others do not?
PROBES (IF NEEDED):
- peer pressure
- rebellion/test boundaries
- mental health issues
- to get attention
- escape an unhappy situation
And, what do you think they get out of engaging in these risk behaviours?
At what point do you think risky behaviour becomes a problem? Why do you say that?
If you wanted information on the risks or benefits to your health when it comes to smoking and vaping, where would you go?
Which of these sources do you view as being must trustworthy when it comes to providing information about health-related risks or benefits? Why?

Conclusion (2 minutes)

I really appreciate you taking the time to come and share your opinions. I’m going to leave the room now to check with the observers to see if there are any last questions for you. When I come back, I’m going to ask whether any of you has last thoughts that you want to give the Government of Canada about discussion topic.

MODERATOR WILL LEAVE THE ROOM AND CHECK WITH OBSERVERS TO SEE IF THERE ARE LAST QUESTIONS.

Does anyone have any last thoughts or feedback to share with the Government of Canada about the topic?

Thank you very much for your time.

2. Non-Smokers/Non-Vapers

Contextual Issues and General Impressions (15 minutes)

As I mentioned, we’re going to be discussing tobacco use and vaping.

To start, do any of you have friends or acquaintances who smoke cigarettes or use e-cigarettes?
For those of you who have friends who use tobacco or vape: [MODERATOR: VAPERS MAY OR MAY NOT USE A VAPING FLUID THAT CONTAINS NICOTINE; WHETHER OR NOT NICOTINE IS USED, IS NOT RELEVANT.]
Do they smoke cigarettes or vape around you? How does this make you feel and why?
PROBES (IF NEEDED): concerned / indifferent
And how, if at all, does your friends’ smoking or vaping affect what you do when you hang out together? In other words, does their smoking or vaping influence the types of activities you do, the places you go, or things like that?
And, for those of you who don’t have friends or acquaintances who smoke cigarettes or use e-cigarettes,
Do you notice people your age smoking or vaping? Tobacco use is prohibited in a lot of places, so where do you tend to notice people smoking or vaping?
For all of you,
What’s your general impression … do you think the number of people your age who smoke cigarettes or vape is increasing or decreasing and why? Let’s start with cigarettes…now what about vaping?
Why do you think some people your age smoke or vape, whether daily or occasionally? [MODERATOR: PAY ATTENTION TO DIFFERENCES BY TYPE OF TOBACCO USE: CIGARETTES VS. E-CIGARETTES.]
PROBES (IF NEEDED):
- fun/pleasurable
- cool
- relaxing/calming
- keeps alert/increases concentration
- curbs appetite/helps maintain/lose weight
- social bonding/experience
What words or adjectives would you use to describe someone your age who smokes or vapes? PROBE FOR REASONS WHY.
And, do you think you would ever start smoking cigarettes or using e-cigarettes? Why/why not? If so, which… smoking or vaping? Why?
What do you see as the difference between smoking cigarettes and vaping? Is there a difference? Why/why not? IF NOT MENTIONED: What about the health effects of smoking cigarettes and vaping? Are they the same? If not, why not?

Peer Groups and Other Influencers (15 minutes)

Now I want to talk about different groups of people your age. Teens often form groups or cliques starting in school.

What type of groups do/did you find in your school?
PROBES (IF NEEDED):
- Athletes/kids who are on school teams
- Kids who do well in school/are academically inclined
- Kids who are artistically focused (i.e. music, drama, visual arts, etc.)
- Kids who cut classes/skip school/get in trouble
- Kids with a reputation for being leaders, involved in student council or other activities/concerned about image/involved in lots of activities
- Kids who rebel against norms/attempt not to conform to social ideals
- Kids who keep to themselves and do not belong to any particular peer group
FOR EACH OF THE GROUPS IDENTIFIED, ASK:
What are the characteristics of someone you would describe as belonging to this group [INSERT GROUP]? By characteristics, I mean their appearance, their academic performance, their attitudes or values, their school or extra-curricular activities, their interactions at school, the type of music they listen, and other things like this. Why do you say that?
Which of these groups is/was more likely to smoke cigarettes or vape and why?
How would you describe your circle of friends? Which of these types of groups do they mostly belong to?
Switching topics,
When you want to keep on top of new trends among people your age, who would you look to first? By this, we mean people who influence the way you think about things—your opinions or your behaviour? Why? [MODERATOR: IF ASKED WHAT IS MEANT BY ‘TRENDS’ EXPLAIN THAT IT COULD REFER TO ANYTHING, FROM FASHION TO MUSIC TO HEALTH AND FITNESS, FOR EXAMPLE.]
PROBES (IF NEEDED): musicians, actors, celebrities, bloggers, peers/friends
Do these sources of influence have a bigger impact on how you see or think about things than other sources, such as friends or family, experts, news or information from credible organizations? In other words, would a celebrity endorsement of a certain product trump independent reviews of this same product? Why/why not?

Activities (10 minutes)

Changing the focus somewhat, I want to talk about what you do in your spare time and I’d like to start with the types of electronic devices use and the content you consume.

What kinds of electronic devices do you use on a daily basis? KEEP BRIEF
PROBES (IF NEEDED):
- Smartphone
- Tablet
- Laptop/PC
- TV/Smart TV
- E-reader
And which social media platforms do you use? Which one is most important to you and why?
PROBES (IF NEEDED):
- Facebook
- Instagram
- Twitter
- YouTube
- Snapchat
- Tumblr
What about apps? What are some of the apps that you use on a daily basis?
And when it comes to TV shows and movies, or listening to music…do you stream this kind of entertainment?
In a typical week, what do you spend money on?
PROBES (IF NEEDED):
- Food/eating out
- Clothes/cosmetics
- Sports equipment
- Gym membership
- Entertainment – sports events, movies
- Transportation – Uber, transit pass
Where are the places you go, or events you attend, in your spare time? Think broadly here, giving consideration to the different seasons.
PROBES (IF NEEDED):
- Mall
- Library
- Sporting event
- Gym or playing sports
- Coffee shop
- Bookstore
- Beach
- Camping
- Skiing/snowboarding
- Concert
- Bar/dance club
- Friend’s house
- Campus/school event
- Movies
- Cycling/Running
What activities or events, if any, do you associate with smoking or vaping and why?

Knowledge and Social Values (10 minutes)

Changing topics one more time, I’d like you to think about some past quitting smoking messages or campaigns that you have encountered.

Can anyone recall any anti-smoking or quit smoking campaigns? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
PROBE: Break it off
And does anyone recall any campaigns about vaping? If so, what do you recall about what you saw/read/heard? What was your impression of the campaign(s)? Would you characterize it as “cool” or “believable”? Why/why not?
Thinking about your peers who smoke or vape, who would this campaign appeal to? Why?
What sort of messages would you suggest to get the attention of smokers/vapers and convey the health effects of tobacco use and risks of vaping?
To what extent is living a healthy tobacco-free, drug-free lifestyle important to you personally? And what about to your friends?
PROBE: Reasons why/why not
Is taking a stand against smoking and vaping important to you personally? And what about to your friends?
PROBE: Reasons why/why not
Have any of you ever thought about becoming involved (or are involved) with some type of non-smoking/non-vaping campaigns or initiatives, whether big or small ones?
When you think about the future, what are important life goals? That is, what types of things do you want to achieve?
PROBES (IF NEEDED):
- having lots of money
- contributing to society
- finding purpose and meaning in life
- being close to family and friends
- bucket list
- travelling
- Marriage

Risk Behaviours and Information Sources (5 minutes)

Why do you think some young people engage in risk behaviours, and others do not?
PROBES (IF NEEDED):
- peer pressure
- rebellion/test boundaries
- mental health issues
- to get attention
- escape an unhappy situation
And, what do you think they get out of engaging in these risk behaviours?
At what point do you think risky behaviour becomes a problem? Why do you say that?
Now still thinking about risky behaviours, but also more broadly about health issues,
If you wanted this type of information, where would you go?
Which of these sources do you view as being must trustworthy when it comes to providing health-related information? Why?

Conclusion (2 minutes)

I really appreciate you taking the time to come and share your opinions. I’m going to leave the room now to check with the observers to see if there are any last questions for you. When I come back, I’m going to ask whether any of you has last thoughts that you want to share with the Government of Canada about anything we’ve talked about today. MODERATOR WILL LEAVE THE ROOM AND CHECK WITH OBSERVERS TO SEE IF THERE ARE LAST QUESTIONS.

Does anyone have any last thoughts or feedback to share with the Government of Canada about what we’ve talked about today?

Thank you very much for your time. This concludes the discussion group.

Qualitative: Online Survey

Landing page
Please select which language you wish to complete the survey in.

English
French

[NEXT]

Intro Page for 13-15 year olds

As a parent of or legal guardian to a youth living in your household, we are requesting your permission for your teenager to participate in an important survey being conducted for Health Canada.

Background information

This research is being conducted by Phoenix Strategic Perspectives (Phoenix SPI), a Canadian public opinion research firm on behalf of Health Canada.

The purpose of this online survey is to collect opinions and feedback from youth and young adults that will be used by Health Canada in the development of public education campaigns to increase awareness of the health hazards associated with tobacco use and vaping.

How does the online survey work?

Your child is being asked to offer his/her opinions.
We anticipate that the survey will take up to 15 minutes to complete.
Your child’s participation in the survey is completely voluntary.
Your decision on whether or not to allow your child to participate will not affect any dealings you may have with the Government of Canada.

What about your child’s personal information?

Your child’s views, opinions and feedback are his/her personal information.
Your child’s personal information will be collected by Phoenix SPI in accordance with the applicable provincial privacy legislation or the Personal Information Protection and Electronic Documents Act (PIPEDA).
The personal information your child will provide to Health Canada is governed in accordance with the Privacy Act and is being collected under the authority of section 4 of the Department of Health Act in accordance with the Treasury Board Directive on Privacy Practices. For more information, click here.
Please be assured that all opinions will remain anonymous and will not be attributed to your child in any way.

What happens after the online survey?

The final report written by Phoenix SPI will be available to the public through Library and Archives Canada (www.bac-lac.gc.ca/).

If you have any questions about the survey, you may contact Phoenix SPI at research@phoenixspi.ca.

Since privacy is important while respondents answer this survey, we request that your child be able to complete the survey in a setting where his/her answers will not be seen by others. All answers will remain anonymous and confidential.

Would you allow your teen to continue?

Yes NEXT SCREEN
No TERMINATE

Thank you for your support of this important research. Before hitting the continue button, please have your teen available to begin answering the following questions.

[CONTINUE—SEND YOUTH TO SURVEY INTRO PAGE]

Survey Intro Page

Thank you for agreeing to take part in this short survey. We anticipate that the survey will take up to 15 minutes to complete and it is registered with the *National Survey Registration System*.

This research is being conducted by Phoenix Strategic Perspectives (Phoenix SPI), a Canadian public opinion research firm, on behalf of Health Canada.

The purpose of this online survey is to collect opinions and feedback from youth and young adults that will be used by Health Canada to develop public education campaigns to increase awareness of the health hazards associated with tobacco use and vaping.

How does the online survey work?

Your participation in the survey is completely voluntary.
Your decision on whether or not to participate will not affect any dealings you may have with the Government of Canada, now or in future.

What about your personal information?

Please be assured that all opinions will remain anonymous and will not be attributed to you personally in any way.
The personal information you will provide to Health Canada is governed in accordance with the Privacy Act and is being collected under the authority of section 4 of the Department of Health Act in accordance with the Treasury Board Directive on Privacy Practices. For more information, click here.
Your personal information will be collected by Phoenix SPI in accordance with the applicable provincial privacy legislation or the Personal Information Protection and Electronic Documents Act (PIPEDA).

What happens after the online survey?

The final report written by Phoenix SPI will be available to the public through Library and Archives Canada (www.bac-lac.gc.ca/).

If you have any questions about the survey, you may contact Phoenix SPI at research@phoenixspi.ca.

Your help is greatly appreciated, and we look forward to receiving your feedback.

[CONTINUE]

PROGRAMMING NOTES:

*HYPERLINK NATIONAL SURVEY REGISTRATION SYSTEM. TEXT:

The registration system has been created by the survey research industry to allow the public to verify that a survey is legitimate, get information about the survey industry or register a complaint. The registration system’s toll-free phone number is 1-800-554-9996. Click **here if you wish to verify the authenticity of this survey.

**HYPERLINK:

SECTION TITLES SHOULD NOT APPEAR ON SCREEN FOR RESPONDENTS. DO NOT PRESENT QUESTION NUMBERS ON SCREEN FOR RESPONDENTS. INCLUDE A PROGRESS BAR.
ALL QUESTIONS ARE MANDATORY, BUT INCLUDE A DON’T KNOW OPTION

Screening

What is your age?
[TEXT BOX]

TERMINATE IF UNDER 13 OR OVER 24

TERMINATION MESSAGE:
Thank you very much for your interest in completing this survey. Unfortunately you are not eligible for this survey.
In the previous 30 days, which, if any, of the following have you participated in?
Select all that apply
- A Government of Canada survey TERMINATE
- A survey about smoking cigarettes or e-cigarettes TERMINATE
- None of the above
TERMINATION MESSAGE:
Thank you very much for your interest in completing this survey. Unfortunately you are not eligible for this survey.
Are you….?
- Male
- Female
- Other
- Prefer not to answer
Where do you live?
- Alberta
- British Columbia
- Manitoba
- New Brunswick
- Newfoundland and Labrador
- Northwest Territories
- Nova Scotia
- Nunavut
- Ontario
- Prince Edward Island
- Quebec
- Saskatchewan
- Yukon Territory
Which of the following describes your current employment status? Are you…
Select all that apply
- Working full-time, that is, 35 or more hours per week?
- Working part-time, that is, less than 35 hours per week?
- Unemployed, but looking for work?
- A student attending school full-time?
- A student attending school part-time?
- Other – [Do not specify]
- Prefer not to answer
QUOTA TERMINATION

Thank you very much for your willingness to complete this survey. We’re sorry, but at this time we’ve already received a sufficient number of completed surveys from people with a similar profile to yours.

Smoking Status and Behaviours

Do any of the following people in your life smoke cigarettes or use an e-cigarette/vaping device?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Friends
2. Classmates
3. Co-workers
4. Family members
5. Parents or guardians
[COLUMNS]
- Smoke cigarettes
- Vape
- Neither
- Don’t know
PROGRAMMING NOTE: Hyperlink e-cigarette/vaping device – description -- E-cigarettes are battery-powered devices which are sometimes designed to look and feel like regular cigarettes. Using an e-cigarette is often called “vaping”. “Vape” means using an e-cigarette/vaping device.
Do you…?
Select all the apply
- Use an e-cigarette or vaping device [VAPER]
- Smoke cigarettes [SMOKER]
- None of the above [NON-SMOKER/NON-VAPER]
- IF BOTH [SMOKER+VAPER]
[SMOKER]
Which of the following best describes how often you smoke cigarettes?
- I smoke cigarettes every day [DAILY]
- I smoke cigarettes at least once a week, but not daily [OCCASIONAL]
- SHOW IF ONCE A WEEK:
  - A couple times a week
  - Weekends only
  - Other (SPECIFY)
- I smoke cigarettes less than weekly, but at least once in the past 30 days [OCCASIONAL]
- I have smoked cigarettes, but not in the past 30 days [INFREQUENT]
[VAPERS]
Which of the following best describes how often you use e-cigarettes or a vaping device?
- I use them every day [DAILY]
- I use them at least once a week, but not daily [OCCASIONAL]
- SHOW IF ONCE A WEEK:
  - A couple times a week
  - Weekends only
  - Other (SPECIFY)
- I use them less than weekly, but at least once in the past 30 days [OCCASIONAL]
- I have used them, but not in the past 30 days [INFREQUENT]
9b. How often, if at all, do you use the following in your e-cigarette or vaping device?

[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Vape fluids containing nicotine
2. Nicotine-free vape fluids
3. Vape fluids containing marijuana/cannabis/THC
[COLUMNS]
- Never
- Sometimes
- Always
- Don’t know
[SMOKER+VAPER]
Which of the following best describe how often you…
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Smoke cigarettes
2. Use an e-cigarette or vaping device
[COLUMNS]
- I [use them] / [smoke cigarettes] every day [DAILY]
- I [use them] / [smoke cigarettes] at least once a week, but not daily [OCCASIONAL]
- SHOW IF ONCE A WEEK:
  - A couple times a week
  - Weekends only
  - Other (SPECIFY)
- I [use them] / [smoke cigarettes] less than weekly, but at least once in the past 30 days [OCCASIONAL]
- I have [used them] / [smoked cigarettes], but not in the past 30 days [INFREQUENT]
Cut
[OCCASIONAL + INFREQUENT VAPER]
In which of the following situations do you vape?
Select all the apply
- When I’m around friends who vape
- When I’m bored
- When I’m nervous
- When I’m stressed out
- When I’m at a party or bar
- When I’m drinking alcohol
- Other: Click here to enter text.
[SMOKER]
How long have you been smoking cigarettes?
- Less than 1 year
- 1-3 years
- 4-5 years
- Over 5 years
- Don’t know
[VAPER]
How long have you been vaping?
- Less than 1 year
- 1-3 years
- 4-5 years
- Over 5 years
- Don’t know
[SMOKER+VAPER]
How long have you been doing the following…?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Smoking cigarettes
2. Vaping
[COLUMNS]
- Less than 1 year
- 1-3 years
- 4-5 years
- Over 5 years
- Don’t know
[NON-SMOKER]
Have you ever smoked cigarettes?
- Yes
- No
[NON-VAPER]
Have you ever tried an e-cigarette or vaping device?
- Yes
- No
[SMOKER+VAPER]
Which did you try first?
- E-cigarettes/vaping device
- Traditional cigarettes
- I can’t recall
[SMOKER]
Why did you first start smoking cigarettes?
Select the top 2 reasons

[ROTATE]
- It looked fun and exciting
- My friends were smoking
- It was offered to me
- For stress relief
- My parent(s) smoke
- A sibling offered it to me
- Other: Click here to enter text.
- I can’t recall
[VAPER]
Why did you first start vaping?
Select the top 2 reasons

[ROTATE]
- It looked fun and exciting
- My friends were vaping
- It was offered to me
- I liked the flavours and smell
- It’s not harmful like smoking cigarettes
- Didn’t think I could get addicted
- To quit or reduce my use of cigarettes
- My parent(s) vape
- A sibling offered it to me
- Other: Click here to enter text.
- I can’t recall
[NON-SMOKERS/NON-VAPERS; INCLUDE SMOKERS WHO SAID ‘NO’ AT Q17 FOR Q21B AN INCLUDE VAPERS WHO SAID ‘NO’ AT Q16 FOR Q21A]
How likely is it that you will ever start….
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Smoking cigarettes
2. Vaping
[COLUMNS]
- 1-Not at all likely
- 2-Not very likely
- 3-Somewhat likely
- 4-Likely
- 5-Very likely
Cut
Cut
[1 OR 2 AT Q21: VAPING]
Why are you not likely to start vaping?
Select the top 2 reasons

[ROTATE]
- I know it’s not healthy
- Using it hurt my throat
- I don’t like the smell
- I don’t want to get addicted
- Negative perception from others
- Not convenient for me
- It’s generally unappealing to me
- It’s not safe
- It costs too much
- Other: Click here to enter text.
- Don’t know
[3-5 AT Q21: VAPING]
Why are you likely to start vaping?
Select the top 2 reasons

[ROTATE]
- Because it looks fun and exciting
- Because my friends vape
- Because it’s easy to get
- Because I like the flavours and smell
- Because it’s healthier than smoking cigarettes
- Because I want to quit smoking
- Because I want to try it
- Other: Click here to enter text.
- Don’t know
[IF SMOKER]
Since you first started smoking cigarettes, do you now smoke more or less than before?
- Smoke more than before
- Smoke less than before
- It hasn’t changed
- Don’t know
[IF VAPER]
Since you first started vaping, do you now vape more or less than before?
- Vape more than before
- Vape less than before
- It hasn’t changed
- Don’t know
[IF SMOKER+VAPER]
Since you first started, do you now do the following more or less than before?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Smoking cigarettes
2. Vaping
[COLUMNS]
- More than before
- Less than before
- No change
- Don’t know
[SMOKERS/VAPERS]
Do your parents or guardians know that you smoke cigarettes or use e-cigarettes or a vaping device?
- Yes
- No
- Maybe
- I don’t know
[EVERYONE]
To what extent do you agree or disagree with the following statements?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Smoking regular cigarettes is not socially acceptable.
2. Vaping is not a big deal.
3. Vaping is embarrassing/not cool.
4. [SMOKERS] People close to me are upset at my smoking.
5. [VAPERS] People close to me are upset at my vaping.
6. [NON-SMOKERS] People close to me would be upset if I smoked.
7. [NON-VAPERS] People close to me would be upset if I vaped.
[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree

Lifestyle: Activities and Influencers

[EVERYONE]

Have you ever used or tried marijuana? When we use the term marijuana, we mean the use of marijuana, hashish, hash oil or any other preparation of the cannabis plant.
- Yes
- No SKIP TO Q33
How often do you use marijuana?
- Every day
- Once a week, but not daily
- SHOW IF ONCE A WEEK:
  - A couple times a week
  - Weekends only
  - Other (SPECIFY)
- Less than weekly, but at least once in the past 30 days
- I have used it, but not in the past 30 days
- Once only
How often do you tend to drink alcoholic beverages?
- Every day
- Once a week, but not daily
- SHOW IF ONCE A WEEK:
  - A couple times a week
  - Weekends only
  - Other (SPECIFY)
- Less than weekly, but at least once in the past 30 days
- I have used it, but not in the past 30 days
- Never; I do not drink
In your spare time, which of the following do you do? [ROTATE ITEMS]
Select all that apply
- Go to a shopping mall/shop online
- Go to the gym/do training or play a sport (team or individual)
- Go to a coffee shop
- Go to a bookstore/read
- Attend concerts
- Go to bars/dance clubs
- Go to parties
- Hang out at your friends’ houses
- Go to school/campus events
- Go to see movies/watch movies online
- Watch TV
- Surf the internet (i.e. watching videos)
- Play video games
- Text/facetime/skype friends
- Post on social media
- Listen to music
- Go to museums
- Go to live theatre
- Art/drawing/theatre
- Spend time outdoors
- Spend time with your family
- Go to church
- Go to sporting events (professional, amateur)
- Go hunting/fishing
- Use 4wheelers/ATVs
- Do computer programming
- Volunteer
- Other [TEXT BOX]
What type of music do you listen to? [ROTATE ITEMS]
Select all that apply
- Alternative
- Blues
- Classical
- Country
- Dance
- Easy Listening
- Electronic
- Folk
- Hip Hop / Rap
- Indie Pop
- Inspirational (incl. Gospel)
- Jazz
- Latin
- New Age
- Pop (Popular music)
- R&B / Soul
- Reggae
- Rock
- Other [TEXT BOX]
Which social media, if any, do you use on a daily basis? [ROTATE ITEMS]
Select all that apply
- Facebook
- Instagram
- Twitter
- YouTube
- Snapchat
- Tumblr
- Pinterest
  - I use social media, but not every day
  - I am not on social media
  - Other [TEXT BOX]
IF ANY SELECTED AT Q36
Who do you follow on the social media that you use? [ROTATE ITEMS]
Select all that apply
- Family members
- Friends
- Retail brands
- News sites
- Hollywood stars
  - Who do you follow? [TEXT BOX]
- Musicians/singers/groups
  - Who do you follow? [TEXT BOX]
- Comedians
- Athletes
  - Who do you follow? [TEXT BOX]
- Bloggers
  - Which blogs do you follow? [TEXT BOX]
- YouTubers
  - Which YouTubers do you follow? [TEXT BOX]
- Public figures
  - Who do you follow? [TEXT BOX]
- Social causes
  - Which social causes are you interested in? [TEXT BOX]
- Other [TEXT BOX]
When you want to keep on top of new trends, how important are each of the following?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Family members
2. Friends
3. Brands
4. Hollywood stars
5. Musicians
6. Athletes
7. YouTubers
8. Bloggers
9. Public figures
[COLUMNS]
- 1-Not at all important
- 2-
- 3-
- 4-
- 5-Very important
Cut

Personality and Social Values

There are many different ways in which people can describe their group of friends. Which of the following best describes the group(s) you spend time with?
Select up to 2 responses
- Popular/preppy
- Academic/gifted kids
- Sporty/athletic kids/jocks
- Arts kids – drama, art, band
- Gamers
- Hipsters
- Hip Hop
- Country
- Punks/emos
- Skaters
- Outsiders
- Other [TEXT BOX]
For each of the paired words in the table below, please rate the extent to which you agree or disagree that the words describe you.
[GRID FORMAT; ROTATE ROW ITEMS]

[ROWS]

I see myself as…
1. Curious, daring
2. Reserved, quiet
3. Sociable, outgoing
4. Trusting, considerate
5. Anxious, insecure
6. Leader, trendsetter
7. Dutiful, rule follower
8. Analytical, careful
9. Creative, imaginative
[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree
To what extent do you agree or disagree with the following statements?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. I am rebellious and like to test boundaries.
2. I have friends in my life who are older than me.
3. Being accepted by my peers is important to me.
4. I regularly skip/skipped* classes in school.
5. Most of my friends drink alcohol.
6. I frequently attend religious services.
7. Most of my friends get good grades.
8. I would describe myself as brand-conscious.
9. I am usually the first among my friends to try new things.
10. I am usually the first among my friends to have the latest technology or gadget.
11. I am usually the first among my friends to wear the latest fashion trend.
12. I listen to what my parents tell me to do.
13. I follow the rules almost all the time.
14. Developing my own style of art/music/dance is important to me.
PROGRAMMING NOTES:

*Use past tense if attending school at Q5 is not selected; use present tense if attending school is selected.

[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree
To what extent do you agree or disagree that the following statements describe your personality?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. I would like to explore new places.
2. I would like to take off on a trip with no pre-planned routes or timetables.
3. I like to do things that frighten me
4. I would like to try bungee-jumping.
5. I like wild parties.
6. I like new and exciting experiences, even if I have to break the rules.
7. I get restless when I spend too much time at home.
8. I prefer friends who are unpredictable.
[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree
How important, if at all, are the following to you?
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. Living a healthy tobacco-free, drug-free lifestyle
2. Taking a stand against smoking
3. Taking a stand against vaping
[COLUMNS]
- 1-Not at all important
- 2
- 3
- 4
- 5-Very important
When you think about the future, how important, if at all, are the following possible life goals?
[GRID FORMAT; ROTATE ROW ITEMS]

[ROWS]
1. having lots of money
2. contributing to society
3. finding purpose and meaning in life
4. being close to family and friends
5. travelling
6. having a family
7. having a fulfilling job
[COLUMNS]
- 1-Not at all important
- 2
- 3
- 4
- 5-Very important
To what extent do you agree or disagree with the following statements:
[GRID FORMAT; ROTATE ROW ITEMS]
[ROWS]
1. I would pay more for an environmentally friendly product.
2. Looking after the environment is important to me.
3. I strive to follow the traditions and customs handed down to be me from my family or religion.
4. It is important to follow what’s going on in government and public affairs.
5. A university education is important.
[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree

Risk Perceptions and Attitudes

To what extent do you agree or disagree with the following statements about the health effects of smoking and vaping?
[GRID FORMAT; ROTATE ROW ITEMS]

[ROWS]
1. Vaping is no healthier than smoking regular cigarettes.
2. SPLIT SAMPLE: Vaping is not addictive/vaping is addictive.
3. Cigarette smoking is addictive.
4. Vaping will lead to smoking regular cigarettes.
5. Vaping can help smokers quit or reduce their number of cigarettes
6. Nicotine is a toxic chemical and should be avoided in all forms (or products).
[COLUMNS]
- 1-Strongly disagree
- 2
- 3-Neutral
- 4
- 5-Strongly agree
How much do you think people risk harming themselves when they do each of the following activities?
[GRID FORMAT; ROTATE ROW ITEMS]

[ROWS]
1. Use an e-cigarette/vaping device containing nicotine once in a while
2. Use a nicotine-free e-cigarette/vaping device once in a while
3. Use an e-cigarette/vaping device containing nicotine on a regular basis
4. Use a nicotine-free e-cigarette//vaping device on a regular basis
5. Smoke cigarettes once in a while
6. Smoke cigarettes on a regular basis
[COLUMNS]
- No risk
- Slight risk
- Moderate risk
- Great risk
- Don’t know

Sources of Information

You’re almost finished the survey.

From which of the following sources do you get health-related information?
Select the top 3 sources

[ROTATE]
- Online forums
- Testimonials
- Friends
- Parents
- Co-workers
- Teacher/Coach
- Government
  - DROPDOWN: Can you please specify? [TEXT]
- Google
- Social media
  - DROPDOWN: Which social media? [TEXT]
- Online news outlets
- Research institutes/universities
- Physicians/medical professionals
- Pubmed/Google Scholar
- Newspapers/magazines
- Other: Click here to enter text.
- I don’t get health-related information
- Don’t know

Demographics

These last questions will help us group your answers with others that we will receive in this survey.

[EVERYONE]

What is the highest level of formal education that you have completed?
- Less than high school (no certificate, diploma or degree)
  - DROPDOWN: What grade are you in? [TEXT]
- High School diploma or equivalent
- Registered Apprenticeship or other trades certificate or diploma
- College, CEGEP or other non-university certificate or diploma
- University certificate or diploma below bachelor's level
- Bachelor's degree
- Post graduate degree above bachelor's level
- Prefer not to answer
What language do you speak most often at home?
- English
- French
- Other
- Prefer not to answer
Do you identify as…
Select all that apply
- …an Indigenous person (First Nation, Métis or Inuit)?
- …a member of a visible ethno-cultural group? ASK Q53
- …part of the LGBTQ2 community?
- Prefer not to answer
Are you a member of any of the following visible ethno-cultural groups?
- South Asian (e.g. East Indian, Pakistani)
- Chinese
- Black (e.g. African, Caribbean)
- Filipino
- Latin America
- Arab
- Japanese
- Korean
- Southeast Asian (e.g. Vietnamese, Cambodia, Indonesian)
- West Asian
- Other (specify): _______________
- Prefer not to answer
Which of the following categories best describes your total household income? That is, the total income of all persons in your household combined, before taxes?
- Under $20,000
- $20,000 to just under $40,000
- $40,000 to just under $60,000
- $60,000 to just under $80,000
- $80,000 to just under $100,000
- $100,000 to just under $150,000
- $150,000 and above
- Prefer not to answer
What are the first 3 digits of your postal code?
- Prefer not to answer
SHOW FOR 13-15 YEAR OLDS ONLY:
Would you be willing to participate in a follow-up discussion on these same topics to explore a few areas in greater depth? Participants will receive an honorarium to thank them for their time. Would you be willing to participate?
- Yes
- No
[IF YES]
May we have your contact information?
- Name: [TEXT BOX]
- Telephone number: [TEXT BOX]
- Email: [TEXT BOX]

Completion Page

That concludes the survey. The results will be available at the Library and Archives Canada website in the coming months. Thank you very much for your thoughtful feedback. It is much appreciated.

Annex 3: Technical Specifications of Research

1. Literature Review

2. Qualitative Research

In total, eight focus groups and eight triads were conducted in Toronto (English), Montreal (French), and Ottawa (French and English) as follows:

Triads were conducted with the 13-15 year olds because the experiences of this youngest segment were judged to be too different from those of youth aged 16 to 19 to include them in the same research group. Using both focus groups and triads maximized the budget, while still providing for multiple groups with each age segment, in both languages, and with each audience.

3. Quantitative Research

All steps of the project complied with market research industry standards and the Standards for the Conduct of Government of Canada Public Opinion Research.

Q9b. How often, if at all, do you use the following in your e-cigarette or vaping device?	Vapers (n = 210)
	Never	Sometimes	Always
Fluids containing nicotine	31%	43%	24%
Nicotine-free fluids	28%	50%	20%
Fluids containing marijuana/cannabis/THC	57%	36%	5%

Q30. To what extent do you agree or disagree with the following statements?	All non-smokers and non-vapers (n= 2,660)
	5 - Strongly agree	4	3 - Neutral	2	1 - Strongly disagree
People close to me would be upset if I smoked	77%	12%	6%	1%	2%
People close to me would be upset if I vaped	50%	21%	16%	5%	3%
Smoking cigarettes is not socially acceptable	32%	25%	26%	10%	4%
Vaping is embarrassing/ not cool	33%	21%	29%	8%	5%
Vaping is not a big deal	8%	13%	31%	24%	21%

Q48. How much do you think people risk harming themselves when they do each of the following activities?	All non-smokers and non-vapers (n= 2,660)
	Great risk	Moderate risk	Slight risk	No risk	Don't know
Smoke cigarettes on a regular basis	88%	7%	1%	0%	4%
Vape nicotine on a regular basis	52%	34%	5%	1%	8%
Smoke cigarettes once in a while	30%	48%	16%	1%	4%
Vape nicotine once in a while	21%	44%	25%	3%	7%
Use a nicotine-free vaping device on a regular basis	20%	33%	30%	6%	11%
Use a nicotine-free vaping device once in a while	10%	27%	39%	14%	9%

Q38. When you want to keep on top of new trends, how important are each of the following?	All respondents (n= 3,004)
	5 - Very important	4	3	2	1 - Not at all important
Friends	37%	37%	17%	4%	3%
Family members	29%	26%	21%	13%	9%
Brands	10%	25%	28%	16%	19%
Public figures	8%	23%	32%	17%	17%
Musicians	9%	23%	28%	18%	18%
YouTubers	8%	21%	24%	18%	26%
Athletes	6%	17%	26%	18%	29%
Hollywood stars	6%	15%	24%	19%	33%
Bloggers	5%	13%	23%	18%	36%

Predictor	Direction	Increase/Decrease in Odds Ratio of Smoking/Vaping
Predictor	Direction	Smoking coefficients	Direction	Vaping coefficients
Gender (Female)		0.484		0.548
Factor 3: Rule Follower		0.838*		0.41
Factor 4: Anti-smoking/vaping Activist		0.581*		0.61*
Vaping is not a big deal (Q30B)		1.313*		2.003
Factor 8: Anti-smoking/vaping Peer Pressure		0.167		0.456
Factor 12: Wild Child		2.925		2.486
*The influence of these individual factors in the model was not significant.

Risk Category	Smoking	Vaping
Low (below 5% risk)	51%	47%
Medium (5% to <20%)	32%	40%
High (20% plus risk)	17%	13%

Segments	Smoke cigarettes	Vape
Irreverent Risk Takers	50%	23%
Thrill Seeking Rule Breakers	14%	15%
Defiant Partiers	7%	11%
Outsiders	8%	7%
Conscientious Activists	1%	4%
Creative Conformists	2%	2%
Rule Followers	1%	0%

Year	Publication Title	Citation/Link	Key Contents^{Footnote 28}
2017	“Why Peer Crowds Matter: Incorporating Youth Subcultures and Values in Health Education Campaigns”	Moran MB, Walker MW, Alexander TN, Jordan JW, Wagner DE. “Why Peer Crowds Matter: Incorporating Youth Subcultures and Values in Health Education Campaigns.” American Journal of Public Health. 2017 Mar; 107(3):389-395.	Explores peer crowd targeting for promoting healthy behaviours among young people. Uses the Fresh Empire campaign in the U.S. (FDA Centre for Tobacco Products) to demonstrate how peer crowd targeting can be used at a national level to create and distribute tobacco prevention messages.
2017	“Evidence to Guide Action: Comprehensive tobacco control in Ontario (2016)”	Smoke-Free Ontario Scientific Advisory Committee, (2017) “Evidence to Guide Action: Comprehensive Tobacco Control in Ontario (2016)”.	Provides an assessment of the tobacco control interventions that may have the greatest impact on reducing tobacco use. Chapter Six focuses on interventions and innovations related to cessation. Youth and young adults comprise one section of the Chapter [Canada]
2016	“Clearing the air: protocol for a systematic meta-narrative review on the harms and benefits of e-cigarettes and vapour devices”	“Clearing the air: protocol for a systematic meta-narrative review on the harms and benefits of e-cigarettes and vapour devices.” MacDonald et al. Systematic Reviews (2016) 5:85.	Meta-narrative review of e-cigarette literature.
2016	“Peer crowd affiliation as a segmentation tool for young adult tobacco use”	Lisha NE, Jordan JW, Ling PM. “Peer crowd affiliation as a segmentation tool for young adult tobacco use” Tobacco Control. 2016; 25: i83–i89.	Tobacco use is not the same across racial/ethnic groups or peer crowds. Concluded that interventions targeted a peer crowds may be an effective way to reach young adults who use tobacco.
2015	“Changing Attitudes Toward Smoking and Smoking Susceptibility Through Peer Crowd Targeting: More Evidence From a Controlled Study.”	Moran, Meghan Bridgid, and Steve Sussman. “Changing Attitudes Toward Smoking and Smoking Susceptibility Through Peer Crowd Targeting: More Evidence From a Controlled Study.” Health communication 30.5 (2015): 521–524.	This study uses a controlled experimental design to test the effect of peer crowd targeting in an antismoking ad on antismoking attitudes and smoking susceptibility. The authors concluded that targeting based on peer crowd is a useful strategy for anti-smoking interventions.
2015	Virginia I-Base Survey Analysis Report	Virginia I-Base Survey Analysis Report. Prepared for: Virginia Foundation for Healthy Youth by: Michael D. Sears and Curtis A. Mildner.	This report presented a practical application of Rescue Agency’s I-Base survey to high school students across the state of Virginia.
2015	“Smoker Identity and Its Potential Role in Young Adults’ Smoking Behavior: A Meta-Ethnography”	Tombor, Ildiko et al. “Smoker Identity and Its Potential Role in Young Adults’ Smoking Behavior: A Meta-Ethnography.” Ed. Anne E. Kazak. Health Psychology 34.10 (2015): 992–1003.	The research synthesizes findings from qualitative studies (17 relevant papers) on smoker identity and potential influences on smoking and smoking cessation.
2014	“Translating the Link between Social Identity and Health Behavior into Effective Health Communication Strategies: An Experimental Application Using Anti-Smoking Advertisements.”	Moran, Meghan Bridgid, and Steve Sussman. “Translating the Link between Social Identity and Health Behavior into Effective Health Communication Strategies: An Experimental Application Using Anti-Smoking Advertisements.” Health communication 29.10 (2014): 1057-1066.	Evidence links social identity to health-related behaviours, including risk behaviours. This study looked at social identity as a target for health campaigns and interventions. Results indicate that peer crowd targeting is a useful strategy for anti-smoking campaigns.
2014	“Using Peer Crowds to Segment Black Youth for Smoking Intervention.”	Lee, Youn Ok et al. “Using Peer Crowds to Segment Black Youth for Smoking Intervention.” Health promotion practice 15.4 (2014): 530–537.	This research uses the studies on peer crowds and applies it to young Black people in Richmond, Virginia. The study concluded that peer crowds can help target campaigns at those who are at the highest risk.
2013	Functional Analysis for Cultural Interventions	Middlesex-London Health Unit Rescue Agency Ontario Tobacco Research Unit	Findings showed that teens in Central West and South West Ontario are influenced by Hip Hop and Alternative peer crowds are at the highest risk for tobacco use. [CANADIAN]
2013	“Psychographic Segments of College Females and Males in Relation to Substance Use Behaviors”	Tiffany Ashley Suragh, Carla J. Berg, and Eric J. Nehl. The Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA. “Psychographic Segments of College Females and Males in Relation to Substance Use Behaviors”. Soc Mar Q. 2013 September; 19(3): 172–187.	Psychographic segmentation was used to group youth adults and inform health campaigns.
2012	Development of adolescents’ peer crowd identification in relation to changes in problem behaviors.	Doornwaard, S. M., Branje, S., Meeus, W. H. J., & ter Bogt, T. F. M. (2012). Development of adolescents’ peer crowd identification in relation to changes in problem behaviors.” Developmental Psychology, 48, 1366–1380.	This study looked at the development of peer crowd identification in relation to changes in problem behaviour among Dutch adolescents. [INTERNATIONAL]
2012	“Multiple Peer Group Self-identification and Adolescent Tobacco Use”	Fuqua, J.L., Gallaher, P.E., Unger, J.B., Trinidad, D.R., Sussman, S., Ortega, E., Johnson, C.A. “Multiple peer group self-identification and adolescent tobacco use.” Subst Use Misuse, 47(6):757-66, 2012.	Looked at peer crowd identification and smoking in Los Angeles among self-identified Rockers, Skaters, and Gamers. Concluded that psychographic targeting could be useful to design relevant smoking prevention messages for those who identify with high-risk peer groups.
2012	“Preventing Tobacco Use among Youth and Young Adults”	U.S. Department of Health and Human Services (2012) Preventing Tobacco Use among Youth and Young Adults: A Report of the Surgeon General. Rockville, MD.	The report notes that in the U.S. nearly one in four high school seniors is a current smoker and that most young smokers become adult smokers. Smoking persists despite targeted prevention programs and advertising of the health effects of tobacco use. The report looks at why smoking rates have not diminished when there is a large body of evidence-based interventions that have been considered effective.
2009	“The challenges of adolescent crowd research: Defining the crowd.”	Cross, J. R., Fletcher, K. L. (2009). The challenges of adolescent crowd research: Defining the crowd. Journal of Youth and Adolescence, 38, 747–764.	This article reviews the various methods used to identify peer crowd membership and suggests that targeted interventions based on peer crowds may not work and contends that additional studies comparing the various self-identification approaches and peer ratings are needed.
2008	“Does This Make Me Look Fat? Peer Crowd and Peer Contributions to Adolescent Girls’ Weight Control Behaviors”	Eleanor Race Mackay and Annette M. La Greca (2008). “Does This Make Me Look Fat? Peer Crowd and Peer Contributions to Adolescent Girls’ Weight Control Behaviors”. J Youth Adolescence (2008) 37:1097–1110.	Association with peer crowds was linked to reported concern and perceived per concern with one’s weight.
2007	Peer crowds in a commuter college sample: The relation between self- reported alcohol use and perceived peer crowd norms.	Sessa, F. M. (2007). Peer crowds in a commuter college sample: “The relation between self- reported alcohol use and perceived peer crowd norms.” Journal of Psychology: Interdisciplinary and Applied, 141, 293–305.	Examined the relation between self-reported alcohol use and perceived peer crowd norms for alcohol use.
2007	Adolescent peer group identification and characteristics: A review of the literature.	Sussman, S., Pallav, P., Ashmore, D., & Brown, B. (2007). Adolescent peer group identification and characteristics: A review of the literature. Addictive Behaviors, 32,1602–1627.	The study identified five general teen peer group categories: elites, athletes, academics, deviants and others.
2002	“Peer Crowd Affiliation and Internalizing. Distress in Childhood and Adolescence: A Longitudinal Follow-Back Study.”	Prinstein, M. J., La Greca, A. M. (2002). Peer crowd affiliation and internalizing distress in childhood and adolescence: A longitudinal follow-back study. Journal of Research on Adolescence, 12, 325–351.	Peer crowds are reputation based and peer crowd affiliation was associated with concept/perceptions of self and levels of internalizing distress.
2001	“Adolescent Peer Crowd Affiliation: Linkages With Health-Risk Behaviors and Close Friendships.”	Annette M. La Greca, Mitchell J. Prinstein, Michael D. Fetter; Adolescent Peer Crowd Affiliation: Linkages With Health-Risk Behaviors and Close Friendships, Journal of Pediatric Psychology, Volume 26, Issue 3, 1 April 2001, Pages 131–143.	Examined adolescents’ peer crowd affiliation and links with health-risk behaviours.
1990	“Peer-group association and adolescent tobacco use.”	Sussman, S., Dent, C. W., Stacy, A. W., Burciaga, C., Raynor, A., Turner, G. E., Cahrlin, V., Craig, S., Hansen, W. B., Burton, D., & Flay, B. R. (1990). Peer-group association and adolescent tobacco use. Journal of Abnormal Psychology, 99, 349 -352.	Looks at the relationship between cigarette smoking/smokeless tobacco use and peer-group identification using a sample from Southern California.
No date	“Young Adult Social Branding: A behavior change model based on culture and influencers to reduce young adult tobacco use”	Rescue Agency: https://rescueagency.com/files/pdf/Young_Adult_Social_Branding.pdf	Background information on peer crowds as done by Rescue Agency

Age group	Montreal	Ottawa	Toronto	Total
13-15 year olds	6	5	14	25
16-19 year olds	16	--	17	33
20-24 year olds	15	--	15	30

Total Sample Used	51,550
Unresolved (U)	41,409
In-scope non-responding units (IS)	2,566
No response	1,296
Partially completed surveys	1,270
Responding units (R)	7,575
Completed survey	3,004
Disqualified – quota filled	1,702
Disqualified – industry	2,869
Response Rate = R/(U+IS+R)	15%

Peer Crowd Analysis and Segmentation for Vaping and Tobacco – Final Report

Table of contents

Figures

Executive summary

Introduction

Background and Objectives

Methodology

1. Literature Review

2. Qualitative Research

3. Quantitative Research

Notes to Reader

Detailed Findings

1. Topline Results

Profile of Respondents

Prevalence of Smoking and Vaping

Tenure, Frequency of Use and Reasons for Starting to Smoke or Vape

Possible Pathways to Use and Likelihood to Start Using

Perceptions about Social Acceptance, Addiction and Risks

Cannabis and Alcohol Use

Sources of Health-related Information

Social Media Use and Potential Influencers

Leisure Activities and Peer Groups

Psychographics and Values

2. Segmentation Results

Factor Analysis

Regression Analysis

Segments

3. Conclusions

Appendix

Annex 1: Literature Review

B. Conclusion

Annex 2: Research Instruments

Qualitative: Recruitment Screener

Demographics Questions

Qualitative: Focus Group and Triad Guides

Qualitative: Online Survey

Annex 3: Technical Specifications of Research

1. Literature Review

2. Qualitative Research

3. Quantitative Research

Annex 4: Tabulated Survey Data

Footnotes