New data on how Canadian smokers try (and fail) to quit smoking

What quitting methods are Canadian smokers trying?  And how successful are they?  

Statistics Canada has provided new data to help answer these questions. The 2023 and 2024 waves of the Canadian Community Health Survey (CCHS) included questions on the quit methods recently used by smokers. 

These results have not yet been published on government web-sites, but they can be found in aggregate form in the Data Dictionaries which Statistics Canada makes available. These can be downloaded here: CCHS 2023 and CCHS 2024, with the data assembled on a fact sheet. More information about the CCHS can be found below and elsewhere. 

The survey results indicate that:

• One-half of Canadian smokers have made an unsuccessful quit attempt in the past year 
• Two-thirds of those who try to quit do so without using any cessation aids or methods 
• The vast majority of quit attempts are unsuccessful (85%)
• Failure rates are essentially the same for most popular products and methods (going it alone, NRT, vaping products). Cutting down may be associated with greater chance of failure. 
• Only a small number of smokers use the nicotine pouch or internet programs in their quit attempts, and the survey found few or no individuals who had done so successfully.

One-half of Canadian smokers have made an unsuccessful quit attempt in the past year. 

Each person who said they had smoked in the last month was asked  "In the past 12 months, did you stop smoking for at least 24 hours because you were trying to cut back or quit?" 

Of the estimated 3.6 million Canadian smokers in 2023, 1.8 million had made a failed quit attempt in the previous 12 months (51%). Of the estimated 3.6 million smokers last year, 1.8 million had unsuccessfully tried to quit at least once (54%). This question was asked of all people people who said they had smoked in the past month, including those who had not yet smoked 100 cigarettes and who are usually not included in estimates of smoking prevalence. (Variable CSS_41)  

As evidenced by the fact that this question was only asked of people who were smoking at the time of the interview, these attempts were unsuccessful.

Successful quit attempts were identified elsewhere in the survey (Variables SPU_10 and SPU_25). Those who were identified as having smoked in the past were asked how long ago they had quit. An estimated 429,500 had quit smoking in the past 12 months in 2023 and 414,500 in 2024.  Included in these results are people who smoked fewer than 100 cigarettes before they quit.

Most quit attempts (63%) are made without any aids or methods

The CCHS asked about the stop smoking methods used both by smokers who had tried and failed to quit and those who had stopped smoking in the past 12 months. (Variables SPU_40 and SPU_45)

Eight potential quitting methods were identified in 2023. These were: (a) nicotine replacement products, (b) smoking cessation medications, (c) internet-based programs or apps, (d) vaping devices or e-cigarettes, (e) making a deal with a friend or your family, (f) reducing the number of cigarettes, (g) trying to quit smoking on your own, or (h) an ‘other’ method. People could identify the use of more than one method. An additional method (tobacco-free nicotine pouches) was added to the questionnaire in 2024. These nicotine products were authorized for sale in Canada in the summer of 2023, and were widely available throughout 2024. 

The yearly average of these responses is shown below (results for each survey year are provided in the downloadable data sheet).

Two-in-three Canadians (63%) report that they tried to quit smoking on their own, and almost half of smokers (45%) said they used the self-help method of cutting down.

The most commonly used commercial stop smoking aids (NRT or vaping products) were used by one-third of those making a past-year quit attempts. Smoking cessation medications and "other" unspecified methods were used by one-tenth of such respondents, and other products and services (pouches and internet apps) were used by one-twentieth.

No matter the method or product, the vast majority of quit attempts fail. 

This survey is not designed to assess whether a quit attempt has been successful, and the results cannot be converted into a measure of quitting success. The survey does allow for an estimate of the minimum failure rate of quit attempts.

Modern clinical trials of stop smoking methods do not generally rely solely on self-reported behaviour, and confirm smoking status with physical or biological tests and use standard time periods to measure quitting success, such as 3- or 6-month abstinence. The CCHS do not provide such measures, and those who identify as recently-quit former smokers would include individuals with varying lengths of abstinence. Some could have had their last cigarette only a few days prior to the interview, and others might have quit smoking up to 12 months earlier.

The CCHS can be used to provide estimates of unsuccessful quit attempts Those who say that they have tried to quit in the past year but also say they are smoking at the time they are interviewed have tautologically failed, no matter how long their quit attempt lasted, although some may have been abstinent for longer than the 6 months often used in clinical trials.

The above chart uses "failure rate" to mean the proportion of smokers who have made a quit attempt in the past 12 months and who say they are still smoking when interviewed. Overall, quit attempts using any of the methods failed 8 times out of 10, with failure rates ranging from 79% to 96%.

Vaping products yield little or no improvement over traditional methods (but carry higher risks)

From this population survey, smokers who use e-cigarettes are little or  no more successful than those who used no cessation aid or who used conventional NRT: The aggregate failure rate for these three methods differ by only a percentage point

More than four in five quit attempts using a vaping product did not lead to success. Further analysis of this data (by those with access to the Master Files) could assess whether those failed efforts are associated with the increased risk of dual use, and whether those who succeeded are exposed to the risks of long-term vaping

These results do not suggest cutting down on the number of cigarettes is effective as a quit method.

Almost one half (45%) of past-year quit attempts involved reducing the number of cigarettes smoked. Cutting down is a method still promoted by the Ontario government, Health Canada and others.

These survey results suggest that reducing to quit may be associated with a greater risk of failure. Those who reported a quit attempt using this strategy failed almost all the time (96%). Access to the Master File or PUMF file is needed to establish whether these differences are statistically significant and how the use of more than one quit method affects the results. 

Because these quit methods are not randomly assigned, the self-selection of methods is a consideration (i.e. those who reduce to quit may be inherently more challenged in quitting). 

Very few Canadians used nicotine pouches - and too few succeeded with this method to provide a statistically reliable estimate.

One brand of tobacco-free nicotine pouches (Zonnic) was approved for sale in the summer of 2023 and by January 2024 this brand was widely available across Canada, although sales were limited to pharmacies by late summer 2024. The CCSH began including questions on tobacco-free these products in 2024, with the question phrased in a way that would include the use of authorized and unauthorized pouches. 

The survey estimates that 107,500 smokers used a nicotine pouch in a failed quit attempt. However, when they asked the same question of Canadians whose quitting attempts had not failed, they were unable to find more than 25 individuals who had used these products.

These results suggest that quitting attempts do not explain the size of the nicotine pouch market in Canada, and that unintended use is very high. There are no official reports of legal sales, but Imperial Tobacco identifies that these products are sold in 9,000+ pharmacies across Canada. That company also claims that in addition to the (unstated) volume of its legally-sold pouches, "500 million illegal pouches were sold" in Canada last year. 

The Canadian Community Health Survey 

The Canadian Community Health Survey is Statistics Canada’s largest national survey collecting information related to health status. The survey began in 2001 and has been conducted annually since 2007. In 2023 and 2024 the survey was restricted to individuals 18 years of age or over. The number of respondents in each of those years was 51,600 and 48,300, respectively. More information on the survey can be found here.

Statistics Canada publishes some results from the survey in a number of tables. Examples include Health indicators by visible minority and selected sociodemographic characteristics; Health characteristics, two-year period estimates. The survey estimates that there were 3.56 million Canadians over the age of 18 who had smoked at least once in the past month in 2023 and 3.61 million in 2024.

The Data Dictionaries provide aggregated results, and do not reveal differences by age, sex, income, mental health or other important determinants of smoking behaviour. Nor do they allow for statistical tests to compare associations. Such analyses can only be done using either the CCHS Master Files, which are available to researchers based in government or universities, or the public use PUMF files which are typically not released for several years after survey completion.   

Federal Health Minister pressed to ban flavoured vaping products across Canada during the National Health Ministers’ Conference in Calgary on October 16th and 17th

 Press release

Calgary – Health organizations from across Canada are urging federal Health Minister Marjorie Michel to prohibit flavoured vaping products to protect Canadian youth from nicotine addiction. The appeal comes as federal, provincial and territorial ministers converge in Calgary for two days of deliberations on national health priorities.

The coalition is running high-profile ads in downtown Calgary and at the YYC airport, revealing that over 24,000 youth have started using nicotine vaping products since federal health minister Marjorie Michel took office last spring. The ads are aimed at all the health ministers and their delegations (see ad copy below).

“Over 24,000 youth have started using nicotine vaping products in the last few months since the Minister took office,” said Les Hagen of ASH Canada. “This translates into over 50,000 new youth users annually, which is 50,000 too many. The federal Health Minister needs to respond quickly if she is truly committed to improving public health and protecting youth from tobacco and nicotine companies. We know that the provincial and territorial health ministers agree, and they need to remind her of this urgency during their discussions”.

“The federal government has delayed the approval of regulations to ban flavoured vaping products for over four years,” said Flory Doucas of the Quebec Coalition for Tobacco Control. “We urge Minister Michel to take immediate action, and we encourage her provincial and territorial counterparts to support these efforts. A strong national consensus will pave the way for strong national protection and make it much harder for industry to target kids with appealing flavours that trivialize nicotine addiction”.

Besides the numerous countries that have banned recreational vaping products altogether, a growing number have at least banned flavours other than tobacco, such as Finland in 2016, Lithuania in 2022, Hungary and Ukraine in 2023, the Netherlands and Slovenia in 2024 and Latvia in 2025. Closer to home, the states of California, Massachusetts, New York, New Jersey, Rhode Island and Washington, DC have also banned flavours. In Canada, four provinces and two territories have banned flavoured vaping products. However, the provincial bans are largely being undermined by illegal shipments and online sales from other provinces.

“Federal restrictions on vaping flavours would make it much harder for retailers to offer these enticing, addictive products and would provide effective protection for all Canadian youth”, said Cynthia Callard of Physicians for a Smoke-Free Canada. “The federal government can control borders and oversee international shipments and trade restrictions, and such measures would facilitate enforcement and curb illegal shipments at the source. The lack of federal action is allowing the industry to undermine provincial measures”.

“Just as there is a federal ban on interprovincial sales of cigarettes, a federal flavour ban on vaping products should be accompanied by a ban on online sales, as this would further reduce youth access to vaping products,” added Doucas. “It’s far too easy for youth to order vaping products online and avoid age detection. A ban on online sales will protect more youth from nicotine addiction and potential tobacco use”. 

A recent “umbrella review” of published peer-reviewed health studies revealed that youth who use nicotine vaping products are three times as likely to start smoking. Tobacco and vaping products share the same fundamental health hazard—nicotine addiction. Nicotine is one of the most addictive substances in existence.

“There is no benefit to be derived from 50,000 new youth nicotine users annually”, said Hagen. “Nicotine is a harmful and addictive substance that can lead to tobacco dependency and all its associated health risks. Tobacco is the leading avoidable cause of premature death in Canada, claiming the lives of 46,000 Canadians annually.

“As part of their upcoming two days of discussions, provincial health ministers should call on the federal Minister to strengthen and implement without further delays the vaping flavour additive restrictions that Ottawa originally announced in 2021,” concludes Callard.

The federal government has committed to reducing tobacco use to less than 5% by 2035. About 3.6 million Canadians continue to smoke tobacco products, representing 12% of all people aged 15 and over, according to the 2024 Canadian Community Health Survey. Over 300,000 youth aged 12-17 vaped in the past 30 days in 2024 according to the Canadian Health Survey on Children and Youth.

Action on Smoking & Health (ASH Canada)

Coalition québécoise pour le contrôle du tabac

Physicians for a Smoke-Free Canada

New Canadian Clinical Guidelines for Smoking Cessation Interventions

This week the Canadian Task Force on Preventive Health Care presented its first set of advice for clinicians to help their patients quit cigarette smoking. These guidelines are published today in the Canadian Medical Association Journal in the article "Recommendations on interventions for tobacco smoking cessation in adults in Canada". 

The task force has packaged its advice in a number of formats for different audiences. In addition to the CMAJ article and appendices, it has prepared infographics and discussion tools for physicians and smokers which are available on the Task Force's website. 

These guidelines encourage clinicians to support quit attempts and the use of proven stop-smoking interventions and medications. 

The task force strongly recommends the use of stop-smoking medications supported by clinical trials:  NRT (patch, gum, lozenges, inhaler, spray used alone or together), Varenicline, Bupropion and Cytisine. (The use of nicotine pouches was not included in this review, but may be considered for future updates.) It strongly recommends combind behavioural and pharmacotherapy interventions.

Conditional recommendation is given to on-line support, provided it is accompanied by direct behavioural support. 

The task force strongly recommends against the use of methods which have little to no proven effect, including acupuncture, hypnosis, laser therapy, electric current stimulation, ear acupressure and St. John's wort.

The task force conditionally recommends against the use of e-cigarettes, except for those smokers who have already unsuccessfully tried other interventions, are unwilling to try other interventions, or express a strong preference for e-cigarettes. 

The authors of this review detail their many concerns with respect to e-cigarettes. They cite the potential for long-term harms, the evidence of lengthy continued use of e-cigarettes, the significant rate of dual use following an unsuccessful quit attempt using e-cigarettes and the greater risk of relapse among those who use this method. They also note the absence of an approved e-cigarette with a verified formulation, the wide variability in the design of products on the market, the involvement of tobacco companies in their manufacture and the greater risk than with other NRT of long term nicotine use. 

Although their evidence review did not include population-level studies, the task force was concerned with the societal impact of e-cigarettes being promoted as cessation products. "There are uncertain public health and societal impacts of normalizing e-cigarettes as a population approach to cessation. The task force is concerned that this could, for instance, inadvertently increase uptake of vaping among youths and nicotine addiction in the general population. Given the large increases observed in youth vaping in recent years, the possible impact of recommending e-cigarettes for smoking cessation on this trend is a concern for the task force."

Their recommendations were tempered by the reality of the permissive legal framework for cigarettes and their widespread use. "Many people are already using e-cigarettes to attempt to quit smoking. For these individuals, the choice may be between attempting to quit using e-cigarettes with advice and support of a health care provider versus doing this alone without informed guidance."

About the work of the Canadian Task Force on Preventive Health Care

In developing these guidelines, the Task Force followed the process it had established for all clinical guideline reviews. Research reports on the results of experimental interventions for smoking cessation in clinical settings were collected, screened and reviewed following a research protocol developed more than 6 years ago. The guidelines were based on these research findings and informed by a subsequent review by interested stakeholders and some members of the public.

The Canadian Task Force on Preventive Health Care is a body of experts convened through the Public Health Agency of Canada (PHAC) and tasked with the development of clinical practice guidelines that support primary care providers in delivering preventive health care. Although it is managed through a government agency (and subject to some level of government control), it identifies itself as "an independent, objective, arms-length panel of experts without ties to industry or government." 

Today's issue of the CMAJ also includes an editorial calling for greater institutional and clinical support for smoking cessation and a commentary on ways to modernize the work of the Task Force.

Statistics Canada finds no decrease in smoking or vaping in 2024

This morning Statistics Canada updated its table of "Health indicator statistics, annual estimates" to include the results of the 2024 wave of the Canadian Community Health Survey. This data included estimates of "current" and "daily" cigarette smoking, as well as past-month e-cigarette use.

Although the estimates of prevalence for these behaviours in 2024 were slightly lower than in 2023, in all three cases the agency found that there was no statistically significant decrease in these indicators. 

For 2024 they estimate there are 3.6 million Canadian smokers (of whom 2.7 million smoke on a daily basis) and 1.9 million vapers. 

Otherwise expressed, 11% of Canadians are smokers, of whom 8% smoke on a daily basis and 6% of Canadians have used a vaping product at least once in the past month. This compares with 19% who have had at least one bout of heavy drinking in the past year and 6% who use cannabis daily or almost daily.

Until 2023 the agency included children aged 12 to 17 in the survey, but now only includes those who are 18 years of age or older. This and other methodological issues make it difficult to robustly compare the results after 2023 with those of previous years.

The chart below shows the results of various federal government surveys since 2000.

 

Health Groups call on Federal Health Minister Marjorie Michel to ban vape flavours within her first 100 days.

 PRESS RELEASE

(Ottawa – May 26, 2025) – Deeply concerned with the impact of the previous government’s permissive approach to nicotine vaping products, tobacco control organizations are calling on the new government to quickly align controls on this market with those used for tobacco.

As part of these important reforms, they are asking for regulations to ban flavours in vaping products to be finalized within the Health Minister’s first 100 days in office. Restricting flavours in vaping products was a commitment made by the Liberal Party in the recent federal election.

“Minister Michel has inherited the youth vaping crisis, and her intervention is urgently needed to clean up the mess her predecessors left behind,” said Les Hagen, Executive Director of Action on Smoking & Health. “This will require her to stand up to the tobacco industry and its front groups, and to protect youth from their attempts to undermine health policies.”

“The youth vaping crisis has gone on far too long,” he added. “The past government’s decision to liberalize the sale of vaping products has negatively impacted one-half of Canadian youth without producing any measurable benefit in overall smoking cessation among adults.”

Vaping products became legal for sale and promotion in Canada in May 2018, and were exempted from the marketing restrictions that have been proven to help protect young people from starting to use tobacco products. These measures include large graphic health warnings, plain and standardized products and packaging, bans on flavourings and sweeteners, and controls on accessibility including a ban on interprovincial sales.

“Over the past seven years, parents, teachers and health professionals have struggled to protect kids from the predatory commercial activities which followed,” said Flory Doucas, co-director of the Quebec Coalition for Tobacco Control. “They have waited for meaningful federal government action while hundreds of thousands of children were being recruited to nicotine addiction by an industry sugar-coating a harmful drug with exotic flavours and playful devices.”

Health Canada’s 2023 Canadian Substance Use Survey found that over one million Canadian teenagers aged 15-19 (48%) had tried vaping products, 681,000 (31%) had used them in the past month and that 400,600 (17%) were vaping on a daily basis.

“We cannot afford for this government to sit on its hands or take the same laissez-faire approach to the tobacco and nicotine industry as its predecessor,” said Cynthia Callard, Executive Director of Physicians for a Smoke-Free Canada. “The need for stronger regulations has been recognized by government for years, as the cost of its inaction continues to climb.”

Health Canada proposed several measures to address the youth vaping crisis in the spring of 2019. Only one of these measures has been approved (limiting nicotine concentration), despite ongoing appeals by health organizations and federal and provincial Medical Officers of Health. Four years after draft regulations to restrict flavourings were published, they have still not been finalized despite Ministerial promises to do so.

“The legalization of vaping products has not produced a net public health benefit in Canada,” said Ms. Callard. “Since 2018 there has been no increase in quit attempts or in successful quitting among smokers, and the number of former smokers has actually dropped. Smoking rates are going down at a slower rate than in years prior to the legalization of nicotine vaping products.” 

Opening the vaping market allowed corporate interests to halt the reduction in nicotine addiction. The widespread use of nicotine products among young people means there are as many or more nicotine users in Canada as there were before these products were legalized. Only a minority of Canadian vapers (28%) are former smokers. 

“The previous government’s preference for a poorly regulated vaping market has facilitated the tobacco industry pivoting to other harmful products and launching a new epidemic of nicotine addiction,” said Mr. Hagen.

Health Canada’s Canadian Substance Use Survey found that one in every three young Canadians who had tried vaping even once were using these products on a daily basis. Independent studies of nicotine use among youth report that young vapers find themselves more addicted than do young cigarette smokers. Many studies report that youth who use vaping products are much more likely to start using tobacco products.

In addition to being highly addictive, vaping products present significant risks for cardiovascular disease, lung injury and exposure to toxins, especially given some of the additives used to flavour liquids.

“We are not calling for a ban on vaping products,” said Flory Doucas. “We are calling for the use of proven regulatory controls to prevent industry from enticing young people to experiment with and become addicted to nicotine.”

“At the current rate of initiation, the nicotine industry is set to recruit more than 15,000 school-aged children to vaping during Minister Michel’s first 100 days in office. She is the Canadian with the greatest power and responsibility to bring that number down before the start of the school year this September.”

Backgrounder can be downloaded Here. 

Canada's conservatives give the floor to the tobacco industry

This post reports on the presence this week of tobacco and nicotine interests at the Canada Strong & Free Network (CSFN) Conference held in Ottawa. 

The CSFN is a political advocacy group established twenty years ago by Preston Manning as the Manning Centre for Building Democracy, but was given a new name in 2025.  Its relationship with Canada's Conservative Party is described as "interlocking", with board members including former federal cabinet ministers (Joe Oliver) and political advisors (Ray Novak, Kate Harrison).

The CSFN hosts two networking conferences each year --  billing them as "exchanges of ideas and best practices and fulfilling our mission of facilitating exchanges and stronger relationships amongst the conservative movement’s various components."

This year's conference features presentations by tobacco industry agencies (Frank Silva, Imperial Tobacco), industry-sponsored agencies (Consumer Choice, Maria Papaionnou, Rights4Vapers) and individuals (Ian Irvine) and nicotine apologist (David Sweanor).

On yesterday's agenda, Imperial Tobacco's CEO was scheduled to introduce a talk on "Why Liberalism Failed" shortly after a panel discussion with vaping advocates: "Common Sense Policies that Let Adults Be Adults."

The presence of tobacco-nicotine industry spokespeople and strategists in this spring's conference is noteworthy in the context of the federal election in which the event falls. In previous meetings Imperial Tobacco has sponsored refreshments (October 2024; April 2024) and Rights4Vapers has also sponsored previous meetings,  as has the Vaping Industry Trade Association. This year's agenda appears to be the first in which this industry has been promoted to the front of the room.

The Framework Convention on Tobacco Control imposes requirements on governments to protect public health measures from tobacco industry interference, and offers guidance on how to implement this obligation. Health Canada recently published guidance for federal employees, but has refrained from offering recommendations to political agencies (or other levels of government). 

The Article 5.3 guidelines are based on the principle that there is a fundamental and irreconcilable conflict between the tobacco industry's interests and public health interests.  They call for accountability and transparency on the part of government and the industry. Health Canada has failed to impose on the industry any reporting requirements on political sponsorships or related expenditures. 

The cozying up between nicotine manufacturers and politicians and political advocacy groups that took place this week in Ottawa is not illegal. But it is a discouraging sign for those who have previously relied on pan-partisan support for tobacco control. 

The CFSN has proposed an answer to Canada's Conservative Party on the fundamental political question of  "whose side are you on?" There are 17 days left for this and other parties to provide a clear answer to this question.  

Regulations to implement a regulatory charge are published today

 Today's edition of the Canada Gazette (Part II) included the first public release of the regulations that will require tobacco companies to pay some of the federal governments' costs to manage the industry. These regulations are the Tobacco Charges Regulations SOR/2025-80. The regulations were announced two weeks ago by Ya'ara Saks before the change in prime minister and cabinet. 

Under this new regulation Health Canada, the Public Health Agency and Indigenous Services Canada are required to calculate the amount that it spends in its tobacco regulation and then apportions this cost on manufacturers in proportion to their revenues. Companies are required to provide net sales revenues for each category of tobacco products (e.g. cigarettes, little cigars, heated tobacco, etc.). The charge is not applied to vaping products, nicotine pouches or other nicotine products which do not contain tobacco leaf.

The date that the regulation comes into force is not established. The text provides it to come into force no earlier than May 1, 2025, but leaves an option for the incoming government to cancel the approach merely by not completing the registration process. "11 (1) These Regulations, except section 9, come into force on May 1, 2025, but if they are registered after that day, they come into force on the day on which they are registered."

This charge was a key demand of leading health charities during the last federal election, and was the only tobacco- or nicotine- related measure identified in the mandate letter issued to the Minister of Addictions in 2021. The regulation was adopted by cabinet on March 6 - eight days before the change in government.  (The 2021 mandate letter has been removed from the Prime Ministers website, but is available on the Internet Archive.) 

The Tobacco and Vaping Products Act was amended as part of the 2024 budget bill to authorize the government to recoup certain costs provided that they were related to "the carrying out of the purpose of this Act."  

The TVPA purpose with respect to tobacco is narrowly cast. Other than the generalized intent "to protect the health of Canadians", it identifies the protection of young persons and others from inducements to use tobacco products, to restrict the access of young persons to tobacco products, and to enhance public awareness (and avoid misinformation) about the risks of tobacco use.

Nonetheless, the intent of the department at this time is to use this charge to recoup costs associated with activities that are not clearly embraced by the TVPA purpose. The activities listed in the (non-binding) regulatory impact statement (RIAS) are: "compliance and enforcement activities, laboratory analysis, development and implementation of regulations, public education and awareness on the health hazards of tobacco use, supporting improved services and resources to help people quit smoking, and providing funding to First Nations, Inuit and Métis Nation to develop and implement approaches to reducing commercial tobacco use. The costs to administer the tobacco cost recovery framework will also be included. Activities undertaken in relation to vaping are not included at this time, except if they are for the purpose of helping Canadians quit tobacco."

The weakness of the link between these activities and the legislated purpose of the act were the focus of the concerns we expressed about the proposed fee last summer, and our subsequent recommendations for a revised purpose to the law.  These concerns were not identified in the RIAS published today. 

To date Health Canada has not predicted how much it would recover as a result of this new charge. The RIAS identifies that the regulation will cost the industry $42.54 million per year, including their own reporting and administrative costs. The administrative costs for the federal government to administer the program are estimated at $1.3 million per year.   

The RIAS states that the three departments which will participate in this process currently receive 85% of the $66.2 million annual budget for tobacco control (including vaping and other forms of nicotine use). Information from other sources on federal expenditures on tobacco control can be found on our 2024 fact sheet 

PMI boasts that heated tobacco, vaping and pouches increase nicotine use and profits

Last month Philip Morris International (PMI) talked to investors at the CAGNY conference - an annual event held in Florida to connect manufacturers with investors. PMI used the occasion to report on its experience over the past 10 years on smoke-free products. 

This post identifies some take-away facts from this presentation. The slide deck can be viewed here, and the transcript is available courtesy of Seeking Alpha here. 

Little more than a decade has passed since PMI became the first multinational tobacco company to re-invent its business and to expand its product line to include new nicotine technologies. It's initial focus was on heated tobacco (IQOS was launched in Italy and Japan in 2014 and introduced to Canada in 2017). In 2022 it began selling vaping products (for which Canada was its first market) and in the same year it acquired Swedish Match and began marketing Zyn pouches.

New nicotine products have allowed PMI's profits to grow

Over the past 10 years, PMI's revenues from cigarette sales have fallen somewhat - from $26.6 billion in 2015 to $23.2 billion in 2024. This loss in revenue has been more than made up for by increased revenues from non-combustible products: from a mere $199 million in 2015 to $14.7 billion in 2024.

Last year the company made 38 cents of every dollar of earnings from "smoke-free" products - heated tobacco, vaping or pouches. (slide 37)

New products have allowed PMI to sell more nicotine.

Overo the past 10 years, the number of cigarettes sold by Philip Morris have fallen steadily (because they increased prices, the drop in revenues was not as acute). This loss in volume sales has been largely made up for by an increase in the number of other nicotine products sold. Using "stick equivalent units" to compare sales with traditional cigarettes, the company reports that after 2020 newer product sales allowed them to turn an annual 2% decrease in units of nicotine sole to a 2% annual increase. (Slide 9)

New Nicotine Products are more profitable than traditional cigarettes.

It costs PMI much less to manufacture cigarettes than IQOS (at a global level, an average of $13 per 1,000 cigarettes vs. $26 per 1,000 IQOS devices and sticks), but they nonetheless make much more money from IQOS sales ($54 for 1,000 IQOS vs $23 for cigarettes). 

For Zyn, the profit difference is even more dramatic. In the United States, the company makes $185 on 1000 Zyn pouches, which costs them $30 to manufacture. (Slide 16). 

The global nicotine market is not shrinking as alternative product sales grow. 

As the world observes the 20th anniversary of the Framework Convention on Tobacco Control it is disheartening to hear that PMI estimates that global nicotine sales (86% of which are cigarettes) are not falling and that the "Total nicotine market [is] close to stable". (slide 24)

Ignoring other tobacco products (like bidis, hookah, etc), the company estimates that the for every 6 cigarettes sold world wide, there is one equivalent dose of nicotine sold in the form of heated tobacco, vaping liquids or nicotine pouch. 

The proportion of the nicotine market taken up by traditional cigarettes varies greatly by country. PMI presented separate data only for the United States, where slightly less than half of nicotine products sold are cigarettes. (Slide 25)

Smokers who also use vaping or pouches use nicotine more often than those who only smoke or vape.

PMI reported the results of its consumer research into the volume of use by individuals who use one or more product category. They found that those who used more than two non-combustible products (HNB, vaping and oral) "have substantial higher daily consumption" than do those who use only one product. 

Those who use both cigarettes and non-combustible nicotine also increase the volume of product they use. Individuals who use only heated tobacco use about the same quantity of product as do smokers, but those who only vape use less. (Slide 28) 

In his comments, PMI CEO Jacek Olczak alluded to the role that these products have in overcoming regulatory and social restrictions on smoking. "...We start looking into the nicotine, new nicotine market, the smoke-free market more from the multi-category perspective versus the one because we also see this in the marketplace, then the consumers are not really focused on one product category. They're looking at the smoke-free products from the perspective of the repertoire which satisfies or responds to the different needs or moments or situations they might have during the day."

PMI's new products appeal more to wealthier people.

Included in this investor presentation was information on the age and income brackets of individuals who used PMI's brands of cigarettes, heated tobacco, vaping and nicotine pouches. Globally, most of their customers are in middle or higher income brackets, and this is even more true for the non-cigarette categories. Its vaping products are more likely to be purchased by younger people.

Newly-released data on cigarette sales suggests pockets of increased illicit trade

Last week Health Canada updated the information it provides on tobacco sales in Canada, and transferred this information to the department's consolidated data platform (HealthInfobase.canada.ca). Provincial level information is presented for cigarettes; national level data is shown for other forms of tobacco, but provincial level information is downloadable. 

Tobacco manufacturers are required to report to Health Canada the number of each brand of cigarettes and the number of kilograms of fine-cut tobacco they sell in each province each month. 

This information, together with national estimates of the number of smokers in each province, allows the calculation of the average number of cigarettes legally sold per smoker in each province. 

Differences in these estimates over time or between provinces could suggest:

* changing patterns of nicotine use (if smokers are changing how many cigarettes a day they smoke, and/or substituting cigarettes with vaping products on some occasions).

* changes in survey methods which affect the estimates of smoking behaviour (the survey mode for the Canadian Community Health Survey was modified in 2015, 2020 and 2022).

* changes in purchasing behaviour (if smokers increase or decrease the number of cigarettes they buy which are not included in the manufacturers' reports, such as illicit supply, interprovincial sales and duty-free purchases related to travel).

A data sheet showing cigarette sales per smoker is available here. 

As shown in the figures below (and on the data sheet) this information reveals that:

* Over the last 10 years, the number of reported smokers has decreased by about one-third (37%), but the number of cigarettes legally sold has decreased by half (48%).

* In some provinces, the difference between the drop in sales and smokers is very dramatic. The fall in the number of cigarettes sold was twice as large in Newfoundland and New Brunswick than the drop in the number of smokers (19% vs 69% in Newfoundland; 28% vs 61% in New Brunswick.

* The number of cigarettes legally sold per smoker varies considerably across Canada: from 16 cigarettes per day in Saskatchewan to 9 cigarettes per day in British Columbia and Newfoundland.

Twenty years later, the FCTC needs help

This week marks 20 years since the Framework Convention on Tobacco Control came into force.

You have to have a long memory to recall how extraordinarily ambitious it was dream that countries would agree on an international law on tobacco and to devote your efforts to working on this treaty. And perhaps you have to have been there to fully appreciate the visionary leadership and strategic acumen that was shown by those individuals working within government and non-government systems who made it happen. 

The architects and stonemasons of the FCTC have now largely moved on to new challenges, have moved out to retirement or are sadly no longer with us. Those who have replaced them are facing tobacco control challenges which are no less daunting and require no less skill and commitment to overcome. Nor are the stakes any lower. 

Just as before, the treaty faces the headwinds of tobacco industry interference and the lack of funding. Added to these familiar challenges is the industry's ability to use new nicotine products to sidestep tobacco control measures and to inveigle themselves into tobacco control discussions. 

A commentary published in the Lancet this week reflects on the FCTC at the 20-year mark and offers some advice on how Parties can better meet old and new challenges [Gilmore AB et al. 20th anniversary of the WHO Framework Convention on Tobacco Control coming into force: Gilmore AB et al. 20th anniversary of the WHO Framework Convention on Tobacco Control coming into force: time for a step change in ambition.

The recommendations in this commentary include:

* Ensuring stable financing by moving towards a polluter pay approach in which the industry pays for the harm it causes

* Accelerating implementation among those countries which are behind and adopting forward looking measures (such as those under review by the Article 2.1 Expert Group) among countries which have met the basic implementation objectives

* Responding to new nicotine/tobacco products and tobacco industry disinformation by accepting there is unlikely to be a single approach that fits all countries, but that the FCTC offers regulations that can be applied to all new products and stronger measures are also consistent with the treaty.

* Taking steps to prevent industry interference by developing measures to prevent their involvement in COP delegations, by establishing a legal defence fund, by providing the funding to ensure that independent science is available and by better holding the industry accountable for the harms it causes.

* Increasing data sharing and scientific and other exchanges among governments. 

The aspirations, enthusiasm, stamina and cooperation that were engaged in building the FCTC are badly needed again.

 

Health Canada's 2023 drug survey shows very high rates of youth vaping and smoking. Why is no one talking about it?

On December 27th, during the lull between Christmas and New Year, Health Canada quietly released the results of the Canadian Substance Use Survey. The material produced for this release includes a data sheet summary, a description of the methodology, and a very useful interactive data tool. 

Notably missing from these communications products was a press release or any official statement about the context or impact of these results in the department's view. Also absent over the intervening 6 weeks is any comment or reaction from the federal Minister responsible for addressing the harms of substance use, the Hon. Ya'ara Saks.

This silence is all the more concerning, given the picture this survey provides of harmful substance use among young Canadians, with indicators of early dependence. Among teenagers aged 15-19, 17% vape daily, 12% use cannabis every day or nearly every day and one-in-twenty (5%) already meets the criteria for alcohol dependence. 

This post reports on the findings of this survey with respect to tobacco and nicotine use.

Canadian Substance Use Survey (CSUS) 2023 estimates for cigarette and vaping prevalence

As shown in the figures above, the CSUS estimates that almost as many Canadians were using vaping products as smoking cigarettes:  10% were past month vapers and vs 13% were past-month smokers. They found 1 in 20 Canadians vapes daily (5%), compared with 1 in 12 who smokes cigarettes daily (8%).

When it comes to young Canadians (aged 15 to 24), past month cigarette smoking rates are similar to those in the general population (14% vs 13%). However, vaping rates are significantly higher: in the past month 1 in 3 teenagers (31%) and 1 in 4 young adults (26%) used a vaping device, compared with 1 in 14 adults over 25 (7%).

With respect to daily use of these products, CSUS found that in comparison with adults over 25, young people are much less likely to smoke daily  (3% for 15-19 year olds, 4% for 20 to 24 year olds and 9% for those over 25), but much more likely to vape on a daily basis. About 1 in 6 (17%) teenagers aged 15-19 vapes daily, as do 1 in 7 (15%) young adults,  compared with 1 in 25 adults over 25.

The figures shown above were extracted from the CSUS data tables. It should be noted that, unlike many other government surveys, CSUS includes in their estimate of daily cigarette use those who have smoked fewer than 100 cigarettes in their lifetime.  

The CSUS estimates for overall smoking rates use are aligned with those from other government surveys .... but....

When comparing the estimates of overall population prevalence of cigarette smoking from this survey with those produced by other government surveys, the rates of cigarette use are largely consistent. The wave of the Canadian Community Health Survey (CCHS) conducted in 2023 identified 11.4% Canadians as "current smokers". The CSUS identified 11.8% who met the same criteria.  

The results for other smoking variables were also aligned. CSUS estimates of those who had ever smoked 1 cigarette or who had smoked 100 cigarettes or more, or who had smoked in the past 30 days were very close to those produced by the CCHS (50% vs 52%; 37% vs 41%, 13% vs 12%). CCHS has historically covered the population of people over 12 years of age, but in 2023 was changed to cover only those 18 years and older.

The trend-line produced by CCHS, CSUS and two other Health Canada surveys of smoking are shown below. They do not suggest that there has been a substantial decrease in the rates of cigarette use over the past 4 years.  

...CSUS estimates for smoking rates among youth and young adults are higher than indicated by previous surveys.

For young people, the CSUS produces higher estimates of current and daily smoking than did Health Canada's previous surveys (the Canadian Tobacco Alcohol and Drug Survey, CTADS, and the Canadian Tobacco and Nicotine Survey, CTNS).

The CTNS in 2022 estimated that 4% of youth aged 15-19 were current smokers, and 1% were daily smokers. The CSUS estimates in the following year were 8% and 3% respectively. For young adults aged 20 to 24 the 2022 CTNS estimates were  8% (current) and 3% (daily), which contrasts with the 2023 CSUS estimates of 10% and 4%. Estimates for those aged over 25 were substantially the same.  

The CSUS estimates for vaping in Canada are the highest recorded to date.

Health Canada surveys which monitor vaping began in 2013 (the Canadian Tobacco Alcohol and Drug Survey), and were redesigned in 2019 (The Canadian Tobacco and Nicotine Survey) and then subsumed into other surveys in 2023, including CSUS (15+), the CCHS (18+) and the Canadian Health Survey on Children and Youth (CHSCY, not yet released).  

The rates for ever use, past-month use and daily use of vaping products from available federal government surveys are shown below. Of theses, the CSUS has produced the highest estimates of  youth use:

• half of youth (47%) and young adults (52%) have used an e-cigarette at least once
• one-third of youth (31%) and one-quarter of young adults (26%) have used them in the past month
• one-sixth of youth (17%) and one-seventh of young adults (15%) use them daily. 
• for every three young Canadians who experiment with vaping devices, one has become a daily user.

Differences among surveys:  CSUS vs. CCHS vs. CTNS vs CTADS vs .....

The methods used by the CSUS are not identical to those used in the previous surveys commissioned by Health Canada to assess substance use. 

Because of these differences, the results from one instrument is not not intended to be used to evaluate changes over time in the behaviour. In the information attached to the CSUS release, Health Canada makes this clear:  "The changes to the sampling methodology in 2023 may have impacted estimates of substance use. ... cell phone recruitment and oversampling of youth and young adults with the knowledge that the survey would be asking about substance use, may have resulted in an overestimation of substance use ... we recommend using CSUS 2023 data without comparison to previous iterations."

On this basis, we cannot infer that vaping rates have risen dramatically between 2022 and 2023. But can we infer that are problems with one or other survey sampling methods? 

Of the four surveys identified above, CSUS is the only one which was not conducted by Statistics Canada. The work was contracted to Advanis, the public opinion firm which also manages the Health Canada's cannabis survey (The Canadian Cannabis Survey). This private sector research firm appears to have followed similar recruitment and selection methods in both surveys. 

In the technical notes which accompany these Advanis surveys, a rationale is provided for the decision to supplement traditional telephone recruitment with outreach to young people who participate in on-line panels and also for providing some financial incentives for certain youth respondents. This approach has not been included in the surveys conducted for Health Canada by Statistics Canada.

It seems evident that these sampling methods produced very different results for measuring youth substance use. What is less clear is how to interpret the results.

Implications for public health

Such dramatic differences in the measurements commissioned by Health Canada warrant reflection and action.

If the problem of youth vaping and other substance use is greater than previously thought, there is even more reason for the department to (finally!) step off the brakes and implement measures to stop manufacturers from inducing young people to use harmful and addictive products.

If the Minister and the department do not wish adjust their policies and programs in response to this new information, then they should explain this decision. 

At the very least, there should be greater transparency and openness about how the federal government views the results and methods of its own surveys.

Ottawa should stop profiting from youth vaping and start reducing it.

Weedless Wednesday is an annual occasion to acknowledge the harms of tobacco industry products and to commit to individual and societal action to reduce them.

With the dissolution of Parliament clearly on the horizon, today is an occasion to reflect on the failure of the federal government’s failure to ameliorate the problems they caused when they adopted a free-market approach to vaping products in 2018.

Their reforms invited cigarette companies to expand the nicotine market by selling vaping products. The initial ‘light touch’ regulations adopted by the Trudeau government imposed few conditions on the marketing or design of these devices. It allowed these disreputable companies to reinvent their market and to recruit new generations to nicotine addiction.

This approach reversed decades of progress in protecting young people from experimenting with and becoming addicted to nicotine. Canada has experienced no overall change in rates of nicotine use since the Trudeau government came to power in 2015.

The impact of this federal policy was an immediate spike in youth vaping which continues to persist. More than one in five Canadian  youth are vaping by the time they leave high school (with 13% doing so daily), and by the time they are in their early twenties more than one in four are using some form of nicotine.

At a population level, liberalizing the vaping market did not result in more Canadians quitting smoking. It did result in more young people using nicotine. Health Canada’s surveys show that this change in policy resulted in a much greater increase in vaping among non-smoking youth than it has among smokers trying to quit.

The government was slow to apply brakes to the marketing or nicotine strength of these products, and even slower to implement other measures it proposed to protect youth. Tobacco and nicotine companies continue to lure young people with fun-flavours and gimmicky designs and to allow promotions for these on websites and social media to which young people have access.

Health Canada officials have advanced regulations to restrict vape flavours, to require age-gating of vaping e-retailers and to curb the use of designs. These have lain dormant on Health Canada’s regulatory plan or have been dropped altogether.

Abandoning these reforms was a political choice. Flavour restrictions, for example, were initially drafted in 2021 but preparation of the final version was delayed for over three years. It was scheduled for submission to cabinet last May, but Minister Saks did not push it forward after she met with representatives of the vaping industry in May. Despite her October assurance that the measures would be finalized “as quickly as possible,” she has given no sign that this will happen before the election.

Actions taken by other federal ministers have also failed to protect youth. The federal tax on vaping products was promised as a way to address youth vaping, but failed to contain measures to prevent manufacturers from adjusting their pricing and products to keep prices low. It now costs less than a quarter to inhale a milligram of nicotine.

This government makes money on youth vaping. Last year federal revenues from vaping taxes had more than doubled to $485 million. Young people, who make up 40% of the market, provided $200 million. The $75 million which came from high-school aged children is more than twice as much as Health Canada spent on all activities to reduce smoking or vaping.

The Trudeau government’s vaping policies have already harmed a generation of Canadian kids. Time is running out before this failure becomes their public health legacy.

Feds pocket $74+ million from kids' vaping

As reported here earlier, the federal Public Accounts that were tabled on the last day Parliament sat before Christmas provide details on the excise taxes collected by various federal agencies. This blog reports on the evolving role of vaping taxes as a source of federal revenues and the disproportionate amount provided by young people.

Tobacco tax revenues are down, but new vaping taxes have mostly made up the difference

In the 2023-2024 fiscal period, federal revenues from tobacco were $2.6 billion, down from $3 billion the year before. The introduction of a federal vaping taxes in the fall of 2022  however has helped the federal government to maintain its revenues from nicotine use. Vaping tax revenue grew from $184 million in its first half-year of implementation to $486 million last year. 

The combined federal revenues on nicotine products was just over $3 billion, only a little lower than in recent years.

Kids are paying 15% of federal vaping taxes

The youthfulness of Canadian vapers is documented in federal surveys of smoking and vaping behaviour, such as the last Canadian Tobacco and Nicotine Survey which was conducted into January 2023. 

For every 20 Canadians who vape, 8 are under 25 and 3 are under 19 years of age. This proportion holds with respect to both daily and occasional use, as shown in the table below. By contrast, in the general population, 9 out of 10 Canadians are over 25 years of age. 

In the absence of better data, we can use the age distribution of the vaping population to estimate the share of vaping taxes (and vaping product sales!) that are made by each age group. 

• Children aged 15 to 19 provided $74.302 million in federal vape tax revenues (15.3%)
• Young adults aged 20 to 24 provided $123.7 million (25.5%)
• Adults over age 25 provided $287.9 million. (59.2%)

This crude method likely underestimates the amount of tax paid by children. Children under 15 were not included in the CTNS survey, but some are known to vape, therefor the actual proportion of children who vape will be larger than the survey estimates. Also, the vaping tax is not equally assessed on all vaping products, with a higher rate is placed on those products (pods, disposables) that are favoured by young people.

Vape taxes can be a health intervention only if they affect affordability 

Taxes on harmful products are understood to be an effective and an efficient way of reducing consumption, which is why they are strongly supported by health experts. Tobacco taxes have a convincing history of  helping reduce smoking rates. But it is not the taxes, per se, which impact product use, but rather the resulting increase in product prices that they produce. Tobacco companies have generally increased their prices in response to new taxes, although they sometimes blunt their impact by absorbing some of the tax for a period of time. The belief and expectation that taxes will be passed on to the consumer is one reason that many health economists have not seen it necessary to include price controls with tobacco taxes. 

With vaping taxes, the expectation that prices would proportionately increase has not been met. Since taxes were introduced in Canada, the companies have been able to modify their production costs or product designs in ways that the price of vaping has fallen DESPITE the introduction of new taxes. For this reason, vaping taxes without price controls may prove to be ineffective as a health measure, although effective as a source of government revenue.

The image below displays the tax and price for one mg of deliverable nicotine sold by Imperial Tobacco in Ontario in January 2025.  From a package of 20 cigarettes that costs $14.69, a single cigarette costs $0.73 cents of which $0.37 is tax. This cigarette contains 2.4 mg of deliverable nicotine giving a tax of $0.15 and a price to consumer of $0.31 per mg of deliverable nicotine.

The nicotine in the different VUSE products made by the same company are subject to somewhat different vaping taxes, depending on volume of liquid they contain. The price of a mg of deliverable nicotine in the package of older-fashioned VUSE epods (containing 76 mg of nicotine and subject to $2.24 in taxes) is not so different than its cigarette equivalent. VUSE Pods are taxed at $0.06 cents per mg of nicotine, with a cost to the consumer of $0.26 per mg, which is about ten cents more per mg of nicotine than it was before the vaping tax was introduced. 

The nicotine in the nicotine devices introduced to the market since the federal tax came into force is less than half the price of the Vuse e-pod. The Vuse GO 8000 was introduced this past summer. It contains 300 mg of nicotine and is now subject to $13.44 in taxes. The tax per mg of nicotine  is $0.045 cents and the consumer price per mg is $0.12 cents.

In short, manufacturers were able to overcome the impact of the vaping tax by redesigning their products to deliver nicotine in a less costly way. The first generation of VUSE disposables has been withdrawn from vaping shops, to be replaced by products which have defeated the health benefit of the vape tax.