Updates on smoking behaviours from the Canadian Community Health Survey 2022

This post provides information on data collected by the Canadian Community Health Survey (CCHS) during 2022. The 5 figures presented below use data made public on Statistics Canada web-site (Health Characteristics annual estimates), Health Canada's website and the Data Dictionary for the survey which was provided to us by Statistics Canada. A downloadable data sheet  which relates to some of the figures is available.

Background: Canada's national surveys on smoking behaviour

With 65,300 participants, the Canadian Community Health Survey is the largest health survey in Canada, but it is not the only one. 

The Canadian Community Health Survey has been conducted for over 20 years, although several changes have been made over those years. The questions on smoking behaviour were redrafted in 2022 and questions on vaping behaviour were added. Major changes to the way information is collected were made in 2015 (when in-person interviews were reduced), in 2020 (when they were abandoned) and in 2022 (when on-line interviews were added to telephone interviews). As reported here earlier, the method by which data is collected seems connected to peoples' willingness to self-identify as a smoker: people who responded face-to-face were more likely to say they smoked. 

On behalf of Health Canada, since late 2019 Statistics Canada also conducts the Canadian Tobacco and Nicotine Survey, (CTNS) which now also includes questions on cannabis and alcohol use. 12,100 Canadians participated in that survey in 2022, and data from that wave were released by Health Canada this past September. The CTNS was preceded by the Canadian Tobacco Use Monitoring Survey (CTUMS, 1999-2012) and the Canadian Tobacco Alcohol and Drug Survey (2013-2017).  The CTNS collects information on-line, and the previous surveys used telephone interviews.

Figure 1: the gaps between survey estimates are closing

For many years there was a sizeable gap in the estimates of smoking rates produced by the CCHS and CTUMS/CTADS, with the larger survey identifying a million more smokers than the smaller telephone surveys. 

There was very little difference in the estimates for 2022. The CTNS collected in winter 2022-23 found 10.9% of Canadians over 15 years of age smoked daily or on occasion (10.9%), close to the CCHS estimate of 11.6% for Canadians over 12 years of age. 

There was also no difference in the estimates of past-month vaping use between both surveys. Both estimated past-month e-cigarette use at 5.8%. 

Figure 2 : More provincial variation in smoking rates than in vaping rates

With five times as many Canadians participating, the CCHS is better able to provide comparisons of substance use among Canada's smaller provinces than is the smaller CTNS. 

As tested by Statistics Canada, smoking rates are statistically higher than the rest of the country in Newfoundland, Nova Scotia, Saskatchewan and lower in Ontario and British Columbia. Vaping rates are statistically higher in Alberta and lower in Ontario. 

Figures 3a and 3b: Prevention can take the credit for driving smoking rates down.

From 2001 to 2022, the CCHS survey population grew by 7.2 million, the number of smokers fell by 2.8 million, the number of former smokers grew by 1.14 million,  (to on to 33 million), the number of experimenters grew by 0.7 million and the number of Canadians who reported they had never smoked a whole cigarette grew by 8.6 million.

The population growth in Canada during that period reflects the net impact of 1.8 million births, 1.5 million deaths, the net arrival of 1.6 million immigrants and 0.6 million non-permanent residents and the net departure of 0.16 million emigrants. 

The survey results suggest the key role that population turnover is playing in estimates of smoking prevalence. Since 2018, there was a decline both in the number of smokers and the number of former smokers, with a growth in lifetime abstainers that was more than twice as large as the loss of ever smokers.

Figure 4: Cannabis now rivals tobacco for number of users

When considering the total population, the CCHS estimates that many more Canadians have used cannabis in the past month than have smoked cigarettes (4.6 million vs. 3.8 million), with a somewhat smaller difference reported by the CTNS (3.4 million vs. 2.6 million). 

When it comes to daily use, however, cigarettes are more commonly used than cannabis (3 million vs. 2 million Canadians) or vaping (3 million vs. 1 million Canadians).

 

Figure 5: January is a key month for quitting.

In previous years, the CCHS only asked recent quitters about the month in which they quit smoking. In 2022 the information was asked of all former smokers. 

January was most frequently cited as the month in which a smoker quit (19%) followed by June (11%) and September (9%).