POR Registration #: POR 014-18
Prepared for: Health Canada
Prepared by:
Corporate Research Associates Inc.
Ce rapport est aussi disponible en français.
For more information on this report, please email:
hc.cpab.por-rop.dgcap.sc@canada.ca
Corporate Research Associates
Suite 5001, 7071 Bayers Road
Halifax NS B3L 2C2
www.cra.ca
1-888-414-1336
Supplier Name: Corporate Research Associates Inc.
September 2018
This public opinion research report presents the results of focus groups conducted by Corporate Research Associates Inc. on behalf of Health Canada. The research study entailed a total of sixteen focus groups with Canadian 15 to 24 years old between August 1 and 16, 2018.
Cette publication est aussi disponible en français sous le titre : Évaluation d’énoncés sur les risques relatifs aux produits de vapotage.
This publication may be reproduced for non-commercial purposes only. Prior written permission must be obtained from Health Canada. For more information on this report, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca or at:
Communications Branch
Health Canada
200 Eglantine Driveway
AL 1915C, Tunney’s Pasture
Ottawa, ON K1A 0K9
Catalogue Number:
H14-268/2018E-PDF
International Standard Book Number (ISBN):
978-0-660-27842-1
Related publications (registration number: POR-014-18):
Catalogue Number H14-268/2018F-PDF (Final Report, French)
ISBN 978-0-660-27843-8
© Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2018
The increasing popularity of vaping products in Canada prompted the federal government to pass Bill S-5, which became law in May 2018 in the form of amendments to the Tobacco Act, now renamed the Tobacco and Vaping Products Act (TVPA). The revised Act allows the government to regulate vaping materials as a separate class of products.
Although vaping emissions are less harmful than those of cigarettes, they still carry health risks. As a result, the Act prohibits promotion of vaping in a manner that conveys the idea that it provides a health benefit to users, or that promotes vaping by comparing it with the use of tobacco. At the same time, the Act allows for regulatory exceptions to this prohibition – including the use of select, scientifically-backed statements that compare the health risks of vaping and tobacco products, but that neither mislead the public about the harm of vaping, nor promote vaping among young people and non-smokers.
Health Canada was interested in conducting qualitative research to support the creation of comparative risk statements that could be authorized for use for vaping products. The objective of these authorized statements is that they do not mislead people about the health hazards of vaping and tobacco use, and do not motivate young people and adult non-smokers to use either product. The relative risk statements that were tested were designed to help consumers make informed choices about their health in the context of vaping. With this in mind, the main objective of this research is to evaluate Canadian vapers, smokers, youth and young adults’ perceptions of certain relative risk statements, and potential variations, that may be authorized for use in the commercial promotion of vaping products. Specifically, the relative risk statements were assessed for clarity or messaging, ease of reading, credibility, and inducement risk to youth and young adults who are non-smokers.
The study consisted of a total of sixteen (16) in-person focus groups conducted from August 1st to 16th, 2018. Four English focus groups were conducted in each of Toronto (ON), Vancouver (BC), and Saskatoon (SK), while four French groups were conducted in Montreal (QC). In each location, one group was conducted with each of four audiences: adult vapers (a person that has vaped at least once per week for the last four weeks); adult smokers (a person that has smoked at least once per week for the past four weeks); youth 15 to 19 years old who have never smoked tobacco and have never used a vaping device; and young adults 20 to 24 years old who are not currently smoking or using a vaping device.
Given low participation among youth in Montreal, an online focus group involving a live discussion was conducted with this audience in addition to the in-person focus group. Each focus group included a mix of age, gender, education level (vaper and smoker groups only), household income, as well as various levels of vaping and smoking frequency (among the vaper and smoker groups). All participants lived in their respective markets for at least two years. Across all groups, a total of 124 participants took part in this research.
This report presents the findings from the study. Caution must be exercised when interpreting the results from this study, as qualitative research is directional only. Results cannot be attributed to the overall population under study, with any degree of confidence.
I hereby certify as a Representative of Corporate Research Associates Inc. that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Directive on the Management of Communications. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences, standings with the electorate or ratings of the performance of a political party or its leaders.
Signed ____________________________________________________________________
Margaret Brigley, President & COO | Corporate Research Associates
Date: September 10, 2018
Findings from the Testing of Relative Risk Statements for Vaping Products reveal that most of the seventeen statements tested are effective at communicating that vaping is less harmful than smoking if you are a smoker. Further, with a few exceptions, they do not mislead consumers about the harms of vaping products.
Although the overarching message of the statements appeared clear to participants, the information provided was considered incomplete or insufficient in many instances. This sentiment is likely a result of consumers looking for confirmed and scientifically-proven information on the health risks of vaping products to inform their choices.
In terms of message clarity, it should be noted that the statement ‘switching completely from combustible tobacco cigarettes to e-cigarettes reduces users’ exposure to numerous toxic and cancer-causing substances’, though impactful, it confused some as to whether or not vaping products contained carcinogens. In these instances, participants tended to believe that vaping products were harmful. Confusion was also evident in terms of what causes addiction and cancer in the statement ‘e-cigarettes contain nicotine which is addictive but does not cause cancer like tobacco smoking does’.
The research also revealed that the use of words such as ‘lower’, ‘fraction’, and ‘reduced’, without qualifiers (e.g., ‘significantly’), combined with the use of conditional verbs (e.g., ‘can’, ‘could’, and ‘may’) affected participants’ understanding of the claims made by each statement. For example, saying that ‘vaping can be harmful’ also implies that the opposite is true, (i.e. vaping can not be harmful in some situations). At the same time, saying that ‘vaping is less harmful than smoking’ does not adequately quantify the difference in harms between both, according to participants.
For the most part, the statements do not induce curiosity in vaping products among non-vaper and non-smoker youth and young adults, particularly statements that identify smokers as the intended audience (e.g., using expressions such as ‘switching completely’, ‘completely replacing’, ‘users’, and ‘smokers’), and statements that present vaping as still being harmful. That said, the statements ‘e-cigarettes contain nicotine which is addictive but does not cause cancer like tobacco smoking does’ and ‘except for nicotine, vaping products typically only contain a fraction of the 7,000 chemicals found in tobacco or tobacco smoke, and at lower levels’ minimize the risks or potential harms of vaping products compared to cigarettes, thus suggesting to readers that vaping may not be very harmful at all. These two statements were also the most unclear in specifying the potential harms of vaping products, creating confusion as to what causes cancer and which toxic substances, and how many, are included in vaping products.
Looking at the sentence structures, findings show that short statements that use simple language and present a single idea were considered most effective at clearly communicating the intended message. In terms of specific wording, ‘less harmful’ is preferred and deemed clearer than ‘not harmless’. ‘Significantly lower’ implies a difference of at least half, and is perceived as greater than ‘much lower’ or ‘much less’. ‘Vaping products’ is felt to be more encompassing and broader than ‘e-cigarettes’ in addition to having less of a negative stigma. The terms, ‘emit’ and ‘release’ were considered equally adequate, and, along with ‘exposure’, they speak of second-hand smoke or vape. To qualify the harms of vaping and smoking, ‘toxic substances’ grabs attention and implies a more serious and noteworthy situation than the expression ‘harmful substances’. Both ‘completely replacing’ and ‘switching completely’ suggested a permanent and total switch from smoking to vaping. Finally, while ‘numerous’ is less commonly used than ‘many’, it conjures scientific knowledge and implies a greater number.
Findings suggest that most of the risk statements tested are suitable to alert consumers of the health risks of vaping in comparison to smoking, while not inducing interest in those types of products among non-users.