New results from surveys on vaping and tobacco issues.

This week two surveys were reported with information on nicotine-related behaviours.  One was by the B.C.-based Research Co, the other by the Toronto-based Centre for Addiction and Mental Health. 

This post reports on these results.

CAMH Student Survey

The  Ontario Student Drug Use and Mental Health Survey  (OSDUHS) [1]  has been conducted by CAMH every second year for an impressive 45 years. The Ontarians who were contemplating high school graduation when it was first in the field in 1977 will now be preparing for retirement! 

Questions on tobacco use were included in the first survey in 1977 and questions on e-cigarette use were added in 2015. Unlike many surveys which use past-month use as the main indicator (e.g. 'current smoking'), this survey focuses on use during the past 12 months.

As would be expected the questions on the survey and the manner of collecting data have evolved over the decades. The impact of COVID-19 restrictions triggered significant changes between 2019 and 2021 and resulted in a drastically reduced response rate. This cycle of the survey had the smallest sample size in the survey's history. The authors warn "because of the significant changes to the methodology in 2021, caution is warranted when comparing these estimates with those from previous OSDUHS cycles." 

In 2019 - 14,142 students in grades 7 to 12 from 992 classes in 263 schools in 47 school boards participated in the survey between November of 2018 and June 2019. [2] 

In 2021 -  2,225 students in grades 7 to 12 from 122 schools in 31 school boards completed the survey online (from any location at any time) between March and June 2021.

The survey found  significant reductions in vaping and dridnking, but not for using tobacco, cannabis or opioids

The caution on comparisons should be kept in mind when reviewing the decline in many indicators of concern. The survey found a statistically significant decrease in vaping and alcohol, but the drop in past-year cigarette smoking (from 5% to 4.1%) and cannabis use (from 22.0% to 17.0%) was not statistically significant. 

The survey found that many Ontario high school students think it is easy to get access to nicotine. 

Just over one-half (56%) of students reported it they thought it is "fairly easy" or "very easy" to get e-cigarettes, and just under one-half (45%) had that view for tobacco.

The survey paints an asymptotic approach to ending  youth tobacco smoking, and a return to higher rates of nicotine use.

Each successive wave of the OSDUHS since 1995 has shown a decrease in the percentage of students in grades 7 - 11 who have smoked in the past year, but the rate of decline is slowing.

Even with the reported declines in vaping behaviour, overall nicotine use in 2021 appears to be greater than it was in 2005, when 14.4% of  high school students smoked cigarettes (and alternative product use, like hookah and cigarillos, had not yet emerged as a measurable problem).

Historic data, shown below, is available for grades 7 to 11 for the years 1977 to 2017 and for grades 7 to 12 for the years 1995 to 2021. [3] 

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RESEARCHco

Research Co has conducted four waves of its survey on vaping:  in August 2018, October 2019, September 2020 and April 2022. The poll was not taken in 2021. The company describes the methods as follows: "Results are based on an online study conducted from April 16 to April 18, 2022, among 1,000 adults in Canada. The data has been statistically weighted according to Canadian census figures for age, gender and region. The margin of error, which measures sample variability, is +/- 3.1 percentage points, nineteen times out of twenty."

This survey found vaping on the rise.

. Like the Ontario student survey, it also identifies past-year behaviour instead of the more usual past-month use. The question asked is: "Have you used an electronic cigarette or e-cigarette (vaping) in the past 12 months?"). 

Research Co found an increase in e-cigarette use in 2022 when compared with 2 years earlier -  in all regions and for all ages except those over 55 years of age. 

Support for regulatory controls remains strong, albeit decreasing with time.

This survey has asked about public support for certain restrictions on vaping marketing, with some questions asked in several years and others asked on only one or two waves. In 2021 the survey found:

* Three times as many Canadians support as oppose restrictions on allowing e-cigarette manufacturers to make relative risk claims. In comparison with earlier survey waves, overall support for such restrictions was lower, largely because a greater number of respondents were "not sure" of their position. Excluding "not sure", in 2021, 74% of respondents agreed with restricting references to e-cigarettes as being  healthier. 

* Social acceptance of e-cigarettes has not much changed. Levels of agreement to the statement "I would  not consider dating a person who used electronic cigarettes" remain much as they were in 2019 (at about half of all respondents and 58% of those who stated an opinion).

* Twice as many support banning flavours as oppose. Levels of agreement to "Banning certain flavours of vaping products, such as cannabis and "confectionery”" were lower in 2022 than when assessed in 2020, but overall agreement among those with an opinion is two-thirds (67%).

* Support for advertising restrictions remains high.  Levels of agreement to "Restricting the use of testimonials and "lifestyle" advertising for vaping products" were slightly lower in 2022 than in 2020, when federal measures were just being implemented. In 2022, three-quarters (76.5%) of those with an opinion expressed agreement with this policy.

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Sources:

[1] CAMH. Findings from the 2021 Ontario Student Drug Use and Health Survey. https://www.camh.ca/-/media/files/pdf---osduhs/2021-osduhs-report-pdf.pdf

[2] CAMH. Detailed Findings from the 2019 Ontario Student Drug Use and Health Survey. https://www.camh.ca/-/media/files/pdf---osduhs/drugusereport_2019osduhs-pdf.pdf?la=en&hash=7F149240451E7421C3991121AEAD630F21B13784

[3] CAMH. Detailed Findings from the 2019 Ontario Student Drug Use and Health Survey. 1977-2017
https://www.champlainpathways.ca/wp-content/uploads/2018/01/Detailed_DrugUseReport_2017OSDUHS.pdf

[4] Tables for Poll conducted by Research Co. on Vaping in Canada - April 26, 2022
https://researchco.ca/wp-content/uploads/2022/04/Tables_Vaping_CAN_26Apr2022.pdf

[5] Tables for Poll conducted by Research Co. on Vaping in Canada - October 2020
https://researchco.ca/wp-content/uploads/2020/10/Tables_Smoking_CAN_27Oct2020.pdf

[6] Tables for Poll conducted by Research Co. on Vaping in Canada - November 2019
https://researchco.ca/wp-content/uploads/2019/11/Tables_Vaping_CAN_13Nov2019.pdf

[7] Tables for Poll conducted by Research Co. on Vaping in Canada - November 2018
https://researchco.ca/wp-content/uploads/2018/11/Tables_Vaping_21Nov2018.pdf