Smoking Behaviour Journey Map - Executive summary

Prepared for Health Canada

Supplier Name: Environics Research
Contract Number: HT372-184244/001/CY
Contract Value: $99,435.71 (including HST)
Award Date: 2019-02-04
Delivery Date: 2019-03-29

Registration Number: POR 119-18

For more information on this report, please contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca

Ce rapport est aussi disponible en français.

Smoking Behaviour Journey Map
Executive Summary

Prepared for Health Canada by Environics Research

March 2019

Permission to reproduce
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

Cat. No. H14-324/2019E-PDF

ISBN 978-0-660-30843-2

Cette publication est aussi disponible en français sous le titre Parcours du comportement tabagique.

Cat. No. H14-324/2019F-PDF (Rapport en français)
ISBN 978-0-660-30844-9

Executive summary

Background and objectives

Canada's Tobacco Strategy has set the ambitious goal of lowering tobacco use among Canadians to 5% by 2035. To do this, Health Canada needs to both prevent the initiation of tobacco use and support users in their cessation efforts. The department identified a need to gather quantitative and qualitative information about smoking habits and feelings, including, (a) situations smokers typically find themselves in when smoking, and (b) how smokers are feeling at the time they are having a cigarette. This approach combines both the behaviour and the emotion of smoking simultaneously.

This research sought to test the salience of smoking behaviour among Canadians who smoke and the extent to which smoking is an integral part of their identity. Unlike other research that poses questions specifically about smoking, this research used a unique diary approach, exploring respondents' daily activities without specifically raising the topic of smoking until the final day of the journal. This approach was designed to understand, from smokers themselves, how smoking is integrated into their lives, without any bias for or against smoking introduced by the research questions themselves.

Use of the findings of this research. This research will help Health Canada better understand the social aspect of smoking – the extent to which smoking is intertwined with smokers' social interactions, the role it plays (i.e., leading to inclusion or exclusion) and the challenges this creates when smokers have quitting intentions. The research will help Health Canada develop new lines of messaging focused on the experience of smoking (both positive and negative). The findings will assist Health Canada to inform program strategy and communications to better meet the needs of smokers when they are ready to quit, by having a more thorough understanding of their patterns of behaviour.

Methodology

The research comprised two data collection phases:

A quantitative online survey conducted March 7 to 15, 2019, with 510 adult Canadians (recruited from an online panel) who are daily smokers and have been smoking for at least five years. The survey explored their behaviour values and attitudes, to provide insights into who smokers are; a variety of topics were included to avoid indicating to respondents that the main focus was smoking. The online survey also served as the source for recruiting participants to the second, qualitative phase of the research.
A subsample of 80 online respondents participated in a seven-day qualitative journaling exercise. Participants were randomly selected from those who expressed interest in and consented to the journal exercise. The journal took place from March 14 to 20, 2019 and gathered detailed information about the daily lives, habits, emotions and thoughts of daily smokers, and where and how smoking is discussed (or not) in this context.

A more detailed methodology is presented in Appendix A of the full report.

Statement of limitations: Survey respondents were drawn from among panels of individuals who have agreed to participate in online surveys. The data have been weighted to reflect the demographic composition of daily smokers in Canada according to the 2017 Canadian Tobacco Alcohol and Drugs Study (CTADS). Because the sample is based on those who initially self-selected for participation in the panel, no estimates of sampling error can be calculated, and the results cannot be described as statistically projectable to the target population.

Qualitative research provides insight into the range of opinions held within a population, rather than the weights of the opinions held, as would be measured in a quantitative study. The results of this type of research should be viewed as indicative rather than projectable to the population.

Contract value

The contract value was $99,435.71 (HST included).

Key findings

Quantitative phase

The results of the quantitative research demonstrate that there is no single "profile" of smokers. While all respondents to the online survey shared the characteristic of being a daily smoker who has been smoking for more than five years, there is a substantial range in their experiences (outside of smoking), attitudes and values. This is relevant because efforts to engage individuals, and what sorts of messages to use, have been shown to be most effective when framed in (that is, consistent with) the values of the individual.
Their general outlook suggests many are facing substantial challenges in their lives. While majorities of smokers express self-efficacy with respect to their health and to their lives overall, substantial minorities feel they lack control in these areas. They are also experiencing financial concerns, with more than half saying they are just getting by or falling behind on expenses. They express greater skepticism than trust in other people and are as likely to say they have a weak connection to their community as a strong one.
Self-reported health indicators are reasonably positive, although not universally. A majority of smokers surveyed report being in at least good health. Half say they sleep well, but only one quarter say they eat enough fruit and vegetables. Three in ten report their life is stressful and four in ten regularly have trouble sleeping; the majority get less than 30 minutes of exercise a day.
There is considerable energy and thought being devoted to developing healthier habits, even if they are not successful. Over half of daily smokers made improvements to their health in the past year (exercise and diet being top mentions), and close to nine in ten say they should make other changes (notably quitting smoking); lack of willpower is the main barrier. Eight in ten say they want to make changes this year, notably quitting smoking and exercising more.

Qualitative phase

For many participants, the online diary exercise evolved into something more than a daily assignment. It offered an opportunity for self-reflection, a seemingly rare occasion to take time to focus on their feelings, goals and aspirations, and what they feel is holding them back from achieving these goals.
Overall, participants tended to describe their day-to-day lives in a task-oriented way, even when not specifically asked to do so. The average day can be categorized into three stages: getting ready for the day, going to work, and decompressing from work. Daily routines are well-established, which has proven practical and efficient. However, even the habitual can be hectic. Overcoming challenges to the routine is viewed as a success but doesn't seem to change the routine.
No more than a handful of participants referred to smoking (unprompted) in their daily diaries. Generally speaking, smoking appears to be a means to manage or cope with feelings and emotions. When it did come up, it was typically associated with the comfort of routine (and primarily the morning routine), or a moment for relaxation or quiet reflection. It can also have a calming effect when feeling overwhelmed or stressed.
Some participants discussed smoking as something they would like to change about themselves and brought up quitting as an aspiration for the future. However, there is a sense that quitting smoking is a very large challenge that is difficult to overcome, and there was very little evidence of firm plans to quit.
Participants gave two main reasons for rarely mentioning smoking in their diaries. For many, it is something so ingrained in daily life, and has been for decades, that they didn't think to share it. Others appeared very aware of the social stigma of smoking and expressed shame and embarrassment.

Political neutrality statement and contact information

I hereby certify as senior officer of Environics that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada, and Procedures for Planning and Contracting Public Opinion Research. 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.

Sarah Roberton
Vice President, Public Affairs
Environics Research Group
sarah.roberton@environics.ca
613-699-6884

Supplier name: Environics Research Group
PWGSC contract number: 60074-182050/001/CY
Original contract date: 2019-01-03
For more information, contact Health Canada at hc.cpab.por-rop.dgcap.sc@canada.ca