Smokers Panel Baseline Survey 2022

Executive Summary

Prepared for Health Canada

Supplier Name: Environics Research
Contract Number: HT372-215072/001/CY
Contract Value: $249,183.98 (including HST)
Award Date: 2022-01-12
Delivery Date: 2022-05-09

Registration Number: POR 096-21

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

Smokers Panel Baseline Survey 2022 - Final report

Prepared for Health Canada by Environics Research

May 2022

This public opinion research report presents the results of a quantitative research study conducted by Environics Research on behalf of Health Canada, comprising an online survey with 7,248 Canadians aged 15 or older who are current smokers, conducted from March 3 – April 10, 2022.

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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

^©His Majesty the King in Right of Canada, as represented by the Minister of Public Services and Procurement Canada, 2022

Cat. No. H14-417/2022E-PDF
ISBN 978-0-660-45892-2

Cette publication est aussi disponible en français sous le titre Étude longitudinale sur le tabagisme, 2022 - Sommaire

PDF:
Cat. No. H14-417/2022F-PDF
ISBN 978-0-660-45892-2

Executive summary

A. Background and objectives

Canada's Tobacco Strategy has set an ambitious goal of lowering tobacco use among Canadians to 5% by the year 2035. To realize this objective, Health Canada needs to understand factors underlying transitions, be it starting smoking, quitting smoking, relapse smoking, and/or moving on to other nicotine use (e.g., vaping). This information could be used to develop programs that prevent the initiation of tobacco use as well as support users in their cessation efforts to quit tobacco long-term.

The main objective of this research is to understand patterns of use, attitudes, and behaviours at the individual level with respect to cigarette smoking among current Canadian smokers aged 15 years and older. This research will be designed to serve as a baseline, should Health Canada wish to measure changes in smoking behaviour using a return-to-sample methodology in the subsequent two years.

Specific research objectives include, but are not limited to, the following:

• To establish baseline patterns of use among current smokers,
• To understand factors driving changes in smoking status,
• To understand changes in patterns of dual use (vaping and cigarette smoking),
• To measure Canadian current smokers' level of awareness and knowledge around vaping products, and
• To gather information on Canadian current smokers' level of awareness, knowledge and behaviours with respect to smoking cessation products.

B. Methodology

This research study consisted of a national online survey of 7,248 Canadians aged 15 or older and who smoked at least once in the month before the survey (also known as current smokers). The incidence of current smokers among Canadians 15+ is 10.3 percent nationally (per Canadian Tobacco and Nicotine Survey [CTNS] 2020 data). The survey was conducted from March 3 – April 10, 2022. The sample was designed to (a) be as representative as possible of the current smoker population by age, gender, and province, and (b) to maximize the subsample of youth (15-19 years) and young adult (20-24 years) smokers, for adequate analysis in subsequent waves (despite expected attrition).

As this online survey utilized an opt-in panel, it is a non-probability survey, and no margin of sampling error should be calculated. Reported percentages are not generalizable to any group other than the sample studied, and therefore no formal statistical inferences can be drawn between the sample results and the broader target population it may be intended to reflect.

The following completions were achieved:

C. Contract value

The contract value was $249,183.98 (including HST).

Report

This report begins with an executive summary outlining key findings and conclusions, followed by a detailed analysis of the survey data. Provided under a separate cover is a detailed set of "banner tables" presenting the results for all questions by population segments as defined by region and demographics. These tables are referenced by the survey question in the detailed analysis.

In this report, quantitative results are expressed as percentages unless otherwise noted. Results may not add to 100% due to rounding or multiple responses. Net results cited in the text may not exactly match individual results shown in the tables due to rounding. Differences between subgroups are noted based on Z-test results at 95% probability for comparing proportions and based on two-tailed T-test results at 95% probability for comparing means. Comparisons are based on differences between sub-groups, and not on differences compared to the total.

People who smoke, had formerly smoked, and vape are referred to as smokers, former smokers, and vapers, respectively, in the interest of brevity. Likewise, given that participants must have smoked in the past 30 days, any reference to 'smoker' refers to someone that is a current smoker.

Use of findings of the research. Data from this research will allow the Tobacco Control Directorate to understand and contextualize any recent changes in smoking prevalence.

D. Key findings

In this baseline survey of Canadian smokers, there is further confirmation that a plurality initially try cigarettes as a young adult, so this is still very much a target for anti-smoking communications. Although most smokers exhibit low dependence on nicotine, this remains of concern as dependence increases along with age. Further, seven in ten have exhibited at least one health issue that can be attributed to smoking. Just under half of smokers (47%) are current vapers (35% of smokers are also regular vapers and are, thus, dual users as per the Health Canada definition), and, while there is evidence these smokers are using vaping to reduce their cigarette intake, there is a risk they are simply changing nicotine intake methods, as dependence on vaping with nicotine scores higher among this subgroup than dependence on smoking with nicotine in the smoker sample at large. Large proportions of smokers have attempted to quit but have been unsuccessful, despite the use of various methods. Smoking is identified as the most harmful of a range of other activities, including vaping with nicotine, use of cannabis in any form, and junk food.

Specific findings of the research follow:

Frequency, history and heaviness of use

• Two-thirds (66%) of smokers smoke daily; the proportion of daily smokers is higher among adults (69%) than younger smokers (40%), and lower among those who also vape (58%).
• Close to half (48%) first tried smoking between the ages of 15 and 19, with the mean start age being 18. Just over one-quarter (27%) first tried smoking earlier than age 15, and one-quarter tried as either a young adult aged 20-24 (13%) or adult (12%). Starting to smoke before age 15 is notably higher among those who are now daily smokers (31%) than those who are occasional smokers (19%).
• A majority of six in ten (61%) current smokers say they smoke up to 10 cigarettes per day. Broken down, 1 in 10 (10%) smoke only 1, 3 in 10 (29%) smoke 2 to 5, and 2 in 10 (22%) smoke 6 to 10. Then, 3 in 10 (30%) smoke between 11 and 20. The overall average is 10.5. Daily smokers average 13 cigarettes per day, while occasional smokers average 5 cigarettes on the days when they smoke.
• Six in ten current smokers have their first cigarette of the day within half an hour of waking up (18% in the first 5 minutes, 40% from 6 to 30 minutes); one-quarter (25%) wait more than an hour. Daily smokers are far more likely than occasional smokers to have their first cigarette within the first half hour of being awake (715 vs. 30% of occasional smokers on the days they smoke).
• The Heavy Smoking Index (HSI) assigns a score to daily smokers based on two key questions: how many cigarettes they smoke each day, and how soon after waking they usually have their first cigarette. Two-thirds of daily smokers (65%) were found to have a low dependence on nicotine, one-third (34%) have a moderate dependence and one percent have high dependence.
• Just over half (53%) have been smoking at their current rate for 10 years or less. Understandably, length of time smoking at current rate is heavily correlated to age: seven in ten (71%) younger people have been smoking at their current rate for 1 to 10 years, vs. just under four in ten adults (38%). Daily smokers are more likely (57%) than occasional smokers (27%) to have smoked for over 10 years.
• Seven in ten current smokers (69%) get a strong urge to smoke at least daily, and about half of these experience strong cravings multiple times a day. Three in ten (31%) have such urges less often or never. As may be expected, getting strong urges to smoke at least daily is considerably higher among daily smokers (82%) than occasional smokers (42%).
• Smokers were asked to indicate how much they spent in the past month on cigarettes. Responses range broadly, from nothing to $400 or more. The average spend was about $170. Daily smokers spend over double what occasional smokers do ($206 vs. $90).
• One-third (35%) of Canadian smokers say the cigarettes they smoke are unaffordable (score of 1-3 on a 10-point affordability scale). A plurality (44%) are neutral, and two in ten (21%) say they are affordable. Saying their cigarettes are unaffordable is higher among daily smokers (38%) than occasional smokers (29%).
• Of a list of seven health issues that can be attributed to smoking, seven in ten (70%) have experienced at least one, with the most common being dry cough (43%), phlegm (34%) and shortness of breath (29%). The most serious ailments are also the least common: COPD (6%) and lung cancer (3%). Experiencing ill effects from smoking is more common among daily smokers (72% experiencing at least one symptom, vs. 66% of occasional smokers).

Drivers to use and quality of life

• Of a list of seven health issues that can be attributed to smoking, seven in ten (70%) have experienced at least one, with the most common being dry cough (43%), phlegm (34%) and shortness of breath (29%). The most serious ailments are also the least common: COPD (6%) and lung cancer (3%). Experiencing ill effects from smoking is more common among daily smokers (72% experiencing at least one symptom, vs. 66% of occasional smokers).
• Smokers were asked to indicate how many of their friends, parents/guardians, family members, or classmates/coworkers smoke, and, if applicable, if their spouse or partner is a smoker. Youth are the most likely to report most or all of the people in their life smoke, and adults are the least likely, except when it comes to spouse/partner, who they are the most likely to report is a smoker.
• When asked to indicate agreement with statements about the experience of smoking, smokers are most likely to agree (score of 8-10) smoking calms them down when they are stressed or upset (52%), that they smoke when around other smokers (49%) or that they enjoy smoking when having coffee or tea (48%). Agreement is lower that smoking is an important part of their life (26%) or that it helps control weight (20%). Almost half disagree that medical evidence of smoking causing harm is exaggerated (47%).

Vaping status and questions for smokers who are also regular vapers

• Just under half (47%) of smokers are current vapers, having vaped at least once in the previous month. Just under two in ten (16%) vape daily; three in ten (31%) vape occasionally (weekly or less often). Just over half (53%) did not vape in the past 30 days. Note 74 percent of current vapers are regular vapers, that is, smokers who vape at least weekly (and are considered regular vapers in this report to maintain consistency with previous Health Canada public opinion research studies).
• Vaping with nicotine at least weekly was reported by the vast majority (82%) of regular vapers. Almost half (48%) vape without nicotine, and one-third (36%) have vaped products not knowing whether or not it had nicotine.
• Regular vapers are most likely to have begun vaping as an adult (58%), with the average age being 29. About two in ten began vaping as a youth (19%) or young adult (18%), and very few began vaping under the age of 15 (4%).
• Approximately half (51%) of regular vapers vape with nicotine within the first 30 minutes of waking, the other half (49%) begin at 31 or more minutes. Around one in five (19%) wait less than five minutes.
• Pluralities of around four in ten regular vapers say they vape five or fewer times a day, whether with nicotine (36%), without nicotine (39%) or if unsure the vape has nicotine or not (35%); around two in ten vape six to ten times a day regardless of type of liquid.
• The Heavy Vaping with Nicotine Index (HVNI) assigns a score to regular vapers based on responses to two questions: how many times they vape with nicotine per day, and how soon after waking they usually first vape with nicotine. Six in ten (59%) exhibit low dependence, three in ten (30%) express a moderate level of dependence, and just over one in ten (11%) are highly dependent on vaping with nicotine.
• Just under six in ten (56%) smokers who regularly vape have been vaping at their current rate for less than two years. Youth and young adults are more likely than adults to have been vaping for less than a year; adults are the most likely to have been vaping for two years or more.
• Smokers who also regularly vape were asked how they self-identify. Half (50%) indicate they are both a smoker and a vaper, one in three (29%) identify as a smoker, and about one in six (17%) say they are a vaper. Only a very small proportion (3%) do not indicate one of those three descriptions.
• Of six reasons for vaping in addition to smoking, the top response is to reduce smoking (23%), and an additional close to two in ten (18%) indicate it is to try to quit. Two in ten (19%) note it is out of enjoyment, and about one in seven (15%) say it is because they can vape in places where they cannot smoke.
• Two-thirds (65%) of smokers who regularly vape indicate they vape twice a day or more in situations where they cannot smoke; the mean is 6.58 times.

Transitions, cessation, and relapse

• Strong majorities of smokers have previously tried or are currently trying to stop (78%) or reduce (84%) the frequency of their smoking. Half (51%) were currently trying to cut down and three in ten (30%) were currently trying to quit at the time of the survey. Around two in ten (22%) have never tried to quit.
• Among the three-quarters who have ever tried to quit, over eight in ten (84%) indicate they have made a serious quit attempt that lasted more than a full day, working out to 65 percent of all smokers.
• One-quarter (26%) of those who have made a serious attempt to quit indicate their longest quit attempt was less than a week, and an additional one in six (17%) say their longest was between one and three weeks. Three in ten (30%) made it from one month to less than a year, and over one-quarter (28%) had a quit attempt last a year or more.
• Half of smokers who have made a serious attempt to quit in the past have made one attempt in the past year (50%). Two in ten (19%) have tried twice, and just over this (22%) tried three to five times. Nine percent have tried six or more times. The average number of attempts is just under four (3.74).
• Six in ten (63%) who have made a serious attempt to quit have used at least one nicotine replacement method. The most common forms are gum (40%) and patches (36%) (multiple mentions were permitted).
• Nine in ten (90%) who have made a serious attempt to quit smoking have used at least one method of quitting that did not involve a nicotine replacement. The most commonly used of these are going cold turkey (48%) and reducing the number of cigarettes (46%). Just under two in ten each have used vaping (18%), prescription medication (17%), or making a deal with a friend or family member (17%).
• Just over four in ten (44%) of any smoker indicating they have used vaping to reduce or quit smoking say they got information or advice from someone about this; this proportion rises to half (50%) when looking just at regular vapers. From a list of possible sources, the most used by regular vapers are friends/classmates (42%), vape shops (29%), doctors (26%) and co-workers (24%).
• Smokers were asked to indicate their level of confidence that they will quit smoking for good, using a 1-10 scale. Just over one-third (36%) are confident (score 8-10), close to half (48%) are neutral (scope 4-7), and around one in seven (16%) are not confident (score 1-3). The mean is 6.30.
• Just under half of smokers (48%) indicate stopping smoking is an important goal (score of 8 to 10), one in ten rate it as not important (score of 1 to 3), and the remainder are neutral. The mean is 7.00.
• Smokers are most likely to rate it as true that if they stopped smoking it would be because they personally believe it is the best thing for their health (67%), or because they feel they want to take responsibility for their own health (64%). Six in ten (59%) rate it as true that if they quit it would be because they have carefully thought about it and believe it is very important for many aspects of their life. Far fewer indicate their quitting smoking would be from feeing guilt or shame (27%), or due to pressure from others (23%). Just over two in ten (22%) agree they really don't think about stopping smoking.

Cannabis, alcohol and relative harm perceptions

• Seven in ten smokers have tried cannabis in at least one form, usually by smoking it (61%); just over four in ten (44%) have tried edibles, and one-third (32%) have vaped cannabis. Strong majorities of seven in ten or more who have tried cannabis in each form have used it in that form in the past month.
• Just over six in ten each say they have smoked the same amount while vaping (63%) or smoking (62%) cannabis, around three in ten have smoked less in each case, and under one in ten have smoked more while vaping (6%) or smoking (8%) cannabis.
• Close to nine in ten (88%) smokers have ever had a drink with alcohol. This proportion is notably lower among youth, at just under half (47%), but comparable for young adults (87%) and those age 25 and over (89%). In the previous 30 days, just under six in ten (56%) had an alcoholic drink at least once a week, just over one-quarter (28%) have had a drink less often than once a week, and one in seven (16%) have not had any alcoholic beverages.
• Just under six in ten (57%) say they have smoked the same amount while having alcoholic beverages, just under three in ten (28%) have smoked more while drinking, and about one in seven (15%) say they have smoked less.
• Of a list of six substance-related activities, smoking cigarettes is rated the most harmful (64%), followed by vaping with nicotine (48%). Around four in ten rate consuming junk food (43%) or alcohol (40%) as harmful. Cannabis in the forms of vaping or smoking is just under drinking alcohol, at 39% and 36%, respectively.

E. 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, Corporate and Public Affairs
Environics Research Group
sarah.roberton@environics.ca

Supplier name: Environics Research Group
PWGSC contract number: HT372-215072/001/CY
Original contract date: 2022-01-12
For more information, contact Health Canada at: hc.cpab.por-rop.dgcap.sc@canada.ca