Smoking in Canada. A statistical snapshot of Canadian smokers. Physicians for a Smoke-Free Canada A Wellington Street Ottawa Ontario K1Y 3A1

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1 Smoking in Canada A statistical snapshot of Canadian smokers 2 Physicians for a Smoke-Free Canada 1226 A Wellington Street Ottawa Ontario K1Y 3A1 A statistical snapshot of Canadian smokers, 2

2 This analysis is based on the public use micro data of the Canadian Community Health Survey, Cycle 3.1, 2. This snapshot was compiled using resources provided by the Tobacco Control Programme of Health Canada. Any opinions expressed or inferred are not necessarily shared by Health Canada. For further information, please contact: Physicians for a Smoke-Free Canada 1226 A Wellington Street Ottawa Ontario K1Y 3A1 Tel: Fax: Physicians for a Smoke-Free Canada

3 A statistical snapshot of Canadian smokers 1. Age 2 2. Smoking in the provinces New and Old Canadians 8 4. Official language proficiency.. 9. Family Circumstances Family income 1 7. Source of income Family structure Marital Status Home ownership Food security Health Status Cognitive functioning Happiness tal health Stress Weight Improvements to health Workplace issues Smoking Work status Work stress Smoking and gambling Smoking and drinking Smoking and pregnancy Education. A statistical snapshot of Canadian smokers, 2

4 Of every 1 smokers... smokers quitters 1 is over 8 years old are in their 7s are in their 6s are in their s are in their 4s are in their 3s are in their 2s are under 2 years of age <1 live in northern territories <1 1 <1 <1 11 live in British Columbia live in Alberta live in Saskatchewan live in Manitoba live in Ontario live in Quebec live in New Brunswic live in Nova Scotia <1 live in Prince Edward Island <1 <1 <1 1 2 live in Newfoundland were born in Canada immigrated to Canada speak English (but not French) speak French (but not English) speak French and English speak neither French nor English 1 < have a family income less than $1, per year have a family income between $1, and $29, per year have a family income between $3, and $49, per year have a family income between $, and $79, per year have a family income over $8, per year live on waged income live on retirement income live on employment insurance or workers compensation benefits have another source of income live by themselves share a house with non family members live with a spouse or partner and no-one else live with a spouse or partner and children are single parents nliving with their child or children are living with a parent are living with both parents are living in some other arrangement don t gamble 1 6 are problem gamblers 4 7 drink alcohol regularly drink alcohol occasionally no longer drink alcohol never drink/drank alcohol Physicians for a Smoke-Free Canada

5 Of every 1 smokers... smokers quitters 38 are married are living common law are divorced, separated or widowed have never been married live in a home owned by a family member live in a rental home have no worries about having enough to eat live with modest food insecurity (but not hungry) 4 live with food insecurity with moderate or severe hunger 16 consider themselves in excellent health consider themselves in very good health consider themselves in good health consider themselves in fair health consider themselves in poor health have no cognitive problems (remembering, understanding) have some cognitive problems (remembering, understanding) consider themselves happy consider themselves somewhat happy consider themselves somewhat unhappy consider themselves very unhappy are in excellent mental health are in very good mental health are in good mental health are in fair mental health are in poor mental health have seen a mental health professional in the past year have not seen a mental health professional in the past year are extremely stressed are quite a bit stressed are a bit stressed are not very stressed are not at all stressed are underweight (using measurement of BMI < 18.) are normal weight (using measurement of BMI between 19 and 2) are over weight (using measurement of BMI between 2 and 3) are obese (using measurement of BMI > 3) think they are underweight think their weight is just about right think they are overweight think they should do something to improve their health think quitting smoking is their most important health improvement of those who work, work where smoking is not at all permitted of those who work, work where smoking is allowed in some areas of those who work, work where there are no on smoking have graduated from college or university have some post secondary training finished high school (but no further) have not graduated from high school A statistical snapshot of Canadian smokers, 2

6 B asic demographics Age smokers smokers F or both men and women in Canada, the age group with the largest number of smokers is 4-44 years of age The average Canadian smoker male and female is around 4 years of age The age profile of Canadian smokers likely reflects several cohort effects, especially variances in birth rates and changes in social attitudes towards smoking l2-14 who are today older than sixty 4, 3, 2, 1, 1, 2, 3, 4, were raised in an era when smoking daily smoker occasional smoker daily smoker occasional smoker among women was socially discouraged. who are today in their 4s to 6s were adolescents or young adults during the 197s when women s social roles were revolutionized and when they were exposed to new tobacco marketing which exploited women s liberation (i.e. you ve come a long way baby ). Prevalence of smoking, women Prevalence of smoking, Modern tobacco control (advertising -4 bans, high taxes and workplace 4-49 smoking ) was 4-44 implemented in the late 198s, somewhat rolled back in the 199s and restored in the late 199s. The first generation to fully benefit would be those born after 199 (currently under 16 years of age). Despite that, 1% of children have smoked before entering high school daily smoker occasional smoker l daily smoker occasional smoker Physicians for a Smoke-Free Canada 2

7 the relatively symmetry for numbers of men and women who currently smoke masks differences in the ever smoking and quit rates between sexes. Former Smokers Former Smokers l Only for generations born after 198 are ever smoking rates the same for men and women Never Smokers Never Smokers l Only for generations born after 196 are rates of successfully quitting the same for men and women The quit ratio (the proportion of former smokers to current smokers) increases significantly for older Canadians as a result of the premature death of smokers. This cold math reflects a reduction in the denominator as well as an increase in the numerator. Quit ratio (former to current smokers) Quit ratio (former to current smokers) men l A statistical snapshot of Canadian smokers, 2 3

8 Shouldering the burden of disease Comparing the percentage of smokers 8+ and the percentage of the population 7-79 for each age group and sex allows us 7-74 to measure the equity of the burden 6-69 of smoking between generations.* Age cohorts which have a higher percentage of smokers than average would have, by this measure, an disproportionate burden of tobaccouse By this measure, higher burdens of tobacco use are found among: Canadians born between 19 and 196. Most in this generation would have started smoking after the harmful effects of smoking were well publicized in the early 196s. They were also the first generation for whom there was a clear government policy to educate children about the harmful effects of smoking Percentage of women smokers Percentage of women in population l Percentage of men smokers Percentage of men in population Canadians born between 197 and 198. This age cohort is at the peak in the life cycle of smoking, when all those who will smoke have already started and a relatively smaller number has started to quit. After age 6, smokers are a relatively lower number of the population, due to the increased quitting rates in those cohorts for men, the reduced onset for those generations of women and the premature mortality (many smokers in those cohorts are now dead). *This analysis is perhaps less helpful used over the life cycle of smoking than in other comparisons between groups of Canadians because of the staggered onset and early death of smokers. Percentage of Canadian smokers in each decade of life The age cohort which has the greatest number of smokers is those in their 4s. One quarter of all Canadian smokers are in this decade of life. (These men and women were born between 194 and 19) yrs 22% 3-39 yrs 19% \ 4- yrs 24% < 2 yrs 7% 8 + yrs 1% 7-79 yrs 3% 6-7 yrs 8% -6 yrs 16% Physicians for a Smoke-Free Canada 4

9 years of age l MEN daily smoker occasional smoker former smoker never smoker Quit ratio WOMEN daily smoker occasional smoker former smoker never smoker Quit ratio years of age Total MEN daily smoker occasional smoker former smoker never smoker Quit ratio WOMEN daily smoker occasional smoker former smoker never smoker Quit ratio years of age l MEN daily smoker 3,4 4,1 112, 21,7 267, 28,6 267, 332,7 occasional smoker 7, 39,1 81,1 126,9 96, 78,7 7,9 8, former smoker 2, 92,4 171, 294,3 31,7 38,3 418,2 71, never smoker 61,7 489,1 69,9 49,8 32,7 361,7 369,6 43,9 646, 66,7 1,61, 1,163,8 1,26,9 1,7,3 1,131,2 1,42,6 WOMEN daily smoker 9,9 4,8 14, 196, 186,2 168, 191,8 274, occasional smoker 1,6 42,9 7,9 17,4 84,7 61,4 68,7 6,8 former smoker 27,3 9,2 171,6 284,6 334,7 37,7 4, 1,6 never smoker 3,2 449,1 69,7 48,3 46, 472, 471,6,1 646, 633, 1,47,7 1,68,2 1,66, 1,9,7 1,137,1 1,361, years of age Total MEN daily smoker 279,9 23,9 17, 129,7 76,9 49,4 2, 18,1 2,428,8 occasional smoker 62,6 37,1 26,7 24,4 1,7 6, 3,9 3,8 726,4 former smoker 67,6 7,2 7,2 496,6 372,6 327,8 27,9 241,3,64,3 never smoker 32, 26,1 197,9 14, 114,3 12,3 62,9 6, 4,77,2 1,23,6 1,99,2 974,8 791,1 74,6 48, 349,8 323,7 13,296,7 WOMEN daily smoker 26,3 21, 14,4 16,1 71,3 49,8 33, 22,6 2,49,8 occasional smoker 4,6,1 24,8 21, 12,9 13, 9, 7,7 668, former smoker 32,4 489,2 4,7 384, 272, 234, 188,7 29,9 4,87,8 never smoker 437, 386,3 39, 264,7 273,4 24,8 22, 32, 6,14,1 1,289,3 1,141,1 989,4 77,8 63,1 38,1 41,1 42,2 13,679,6 A statistical snapshot of Canadian smokers, 2

10 Smoking in Canada s provinces T he variance in smoking rates across Canada can be attributed to differences both in the number of people who start smoking and the proportion of smokers who have successfully quit. Prevalence of smoking status by province and sex In British Columbia, for example, smoking rates are lowest in Canada both because a proportion of smokers have quit (a quit ratio of 2.1 and 2.3 for men and women respectively) and because the never smoking rate is also highest. 4 2 M F M F M F M F M F M F M F M F M F M F M F M F NFLD PEI NS NB QC ON MB SK AB BC TR CDA daily Womn daily Occasional Former Never By contrast, Newfoundland has the same proportion of successful quitters as British Columbia, but because far more Newfoundlanders have smoked, the smoking rates remain slightly above the Canadian average. Smoking rates are substantially higher in the territories than in southern Canada, however the actual number of smokers in all the territories is smaller (at 29,) than the number smokers in relatively small municipal areas, such as Sherbrooke or Kingston. Quit ratio by province and sex M F M F M F M F M F M F M F M F M F M F M F M F NFLD PEI NS NB QC ON MB SK AB BC TR CDA Prevalence of never smoking by province and sex M F M F M F M F M F M F M F M F M F M F M F M F NFLD PEI NS NB QC ON MB SK AB BC TR CDA Physicians for a Smoke-Free Canada 6

11 Number of smokers in Canadian provinces by sex 1,2, 9, 6, 3, 3, 6, 9, 1,2, NF NF PEI NS NS NB QC ON MB SK SK AB daily (men) BC daily (women) occasional Terr daily former never Total daily occasional occasional former never NF 42,9 8, 17,4 6, 219,3 2 4 PEI 12, 2, 2,4 17, 6, NS 72, 19,4 179,7 112,3 383,4 19 NB 62, 1,3 139,9 94, 311,7 2 QC 63,6 176, 1,38, 992, 3,179,1 2 6 ON 926, 284,4 2,9,4 1,839,8,146, MB 76, 23, 189,8 168,7 48, 17 SK 7, 21,1 168,8 121, 386,8 2 AB 271,8 72,7 23,3 478,2 1,346, 2 BC 246,8 1,6 74,6 681,6 1,769, Terr 12,2 2,4 13, 11,2 39, Cda 2,428,8 726,4,64,3 4,77,2 13,296,7 18 NF 42,1 1,2 93,4 83,4 229, 18 4 PEI 8,7 2,9 24,6 24,4 6,6 14 NS 71,8 17, 16,2 16,9 41, NB 3,8 12, 124,4 134,7 32, QC 77, 191,7 1,294,9 1,21,7 3,279, ON 73,1 246,1 1,729,4 2,69,3,314,8 14 MB 73,4 17,3 168,3 21,2 474,2 1 4 SK 71, 19, 14,1 16,9 396,9 18 AB 22,7 63,7 44,6 69,2 1,33,3 1 BC 27,6 84,3 66, 868,6 1,821, 11 Terr 11,2 2,9 11,4 12, 37,4 3 8 Cda 2,49,8 668, 4,87,8 6,14,1 13,679, A statistical snapshot of Canadian smokers, 2 7

12 New and old Canadians A lthough one in five Canadians is an immigrant, only 1 in 7 smokers is. The lower smoking rate among immigrants is due in part to the greater tendency of immigrant women to never smoke, but also to the greater tendency of immigrant men and women smokers to quit smoking. Immigrants who have been in Canada for more than 1 years have higher smoking rates than immigrant women who have lived in Canada for less than 1 years. Immigrant men are less likely to smoke the longer they have been in Canada (possibly because they are aging and more likely to have quit). Prevalence of current smoking among immigrants by length of stay in Canada years 1 + years men women 11 Prevalence by length of stay among immigrants - 9 years 1 + years daily smoker occasional smoker 7 former smoker never smoker Quit ratio Prevalence of current smoking by immigrant status 1 daily smoker occasional smoker former smoker never smoker immigrant non-immigrant Quit ratio men women immigrant non-immigrant immigrant nonimmigrant daily smoker 38,3 1,998,9 2,379, occasional smoker 144,6 6,8 71,4 6 former smoker 1,133, 4,33,3,436, never smoker 1,6,8 3,413, 4,47, Total 2,71,2 1,281,6 12,996, daily smoker 199, 1,816,6 2,1, occasional smoker 98,4 7,9 66,4 4 former smoker 692,7 4,81,4 4,774, 2 39 never smoker 1,814,7 4,127,2,941, Total 2,84,8 1,83,2 13,387, Physicians for a Smoke-Free Canada 8

13 Official language proficiency M ost Canadian smokers report they are able to converse in either English or French in addition to any other languages they may speak. There are only 4, Canadian smokers who identify themselves as not being able to speak either official language. Among those who speak neither English nor French, only 4% of women identify themselves as a smoker. Smoking prevalence for Canadian women who speak French (but not English) is higher than any other language group (24% vs. the Canadian average of 2%). There are 8 times as many smokers who speak English (but not French) as there are those who speak French (but not English) Prevalence of current smoking by ability to converse in official languages English French Eng + French Not Eng or French men women English French Eng + French Not Eng or French 2 Total Total daily smoker occasional smoker 6 6 former smoker never smoker Quit ratio daily smoker occasional smoker former smoker never smoker Quit ratio English French English and French Neither English nor French Total daily smoker 1,8,6 277,1 24,3 3,9* 2,383,3 occasional smoker 47,9 66, 18,8 712,7 former smoker 3,47,6 617,3 1,228,2 1,3,444, never smoker 2,926,1 393,2 1,124, 44, 4,488,2 Total 8,49,2 1,34,2 3,7,8 126,6 13,28,7 daily smoker 1,268,7 323,3 418,7 9,1 2,16,1 occasional smoker 38,3 81,3 191,1 66,2 former smoker 2,979,9 698, 1,8,3 24, 4,782,8 never smoker 3,87,1 61,8 1,27, 26,,966,9 Total 8,4, 1,718,4 2,96,1 239,6 13,422, * current smoking (daily and occasional) A statistical snapshot of Canadian smokers, 2 9

14 F amily Circumstances Family income S moking has long been related to income, but whether it is associated with wealth or poverty depends on the times and on the perspective. In earlier times, tobacco use was reserved for men and for occasions of privilege (i.e. the smoking room in clubs or use by a high-ranking native shaman). In modern times, tobacco use is more prevalent among those whose family income is low. Because incomes in Canada are, by global standards, high and because of distribution of income (with most families, by definition, in the middle ), most smokers are not poor. The results of the CCHS suggest that smoking is more prevalent in poor families, but also that most smokers are not poor. These two seemingly opposing truths result from the differing perspectives that emerge through measuring prevalence (the percentage within a group) and population (the number of people). Smoking prevalence is twice as high for the lowest family income category as for the highest (37% vs. 2% for men and 3% vs. 16% for women) There are three times as many smokers in the highest family income bracket as in the lowest (1,426, vs. 413,) Smoking prevalence by household income, Canada 2. Canadian Community Health Survey, cycle 3.1 For every 2 Canadian smokers: have family incomes under $3, (3 woman, 2 men) 4 have incomes between $3, and $, (2 women, 2 men) 11 have family incomes over $, (including 3 men and 2 women with incomes over $8,). Household Income ($ thousands) < $1k $1k - 29k $3k - $k $k - $79k $8k+ Total daily smoker occasional smoker former smoker never smoker quit ratio daily smoker occasional smoker 6 former smoker never smoker quit ratio Physicians for a Smoke-Free Canada 1

15 Number of smokers by family income category although the measure used here is family income, the higher personal income of men is reflected in higher family incomes for these individuals. As a result, there is an even greater number of male smokers with high incomes compared with women smokers. 1,, 7,, 2, daily (men) daily (women) occasional < $1k $1k - 29k $3k - $ k $k - $79k $8k+ < $1k $1k - 29k $3k - $ k $k - $79k $8k+ Prevalence of smoking by family income categories 4 3 daily (men) daily (women) occasional 2 1 < $1k $1k - 29k $3k - $k $k - $79k $8k+ < $1k $1k - 29k $3k - $k $k - $79k $8k+ Number of Canadian Smokers by household income, Canada 2. Canadian Community Health Survey, cycle 3.1 Household Income ($ thousands) < $1k $1k - 29k $3k - $k $k - $79k $8k+ Total daily smoker 147,8 286,4 489, 9, 69,4 2,127,7 occasional smoker 34,4 68,6 98,3 162, 26,3 629,1 former smoker 167,9 7,6 91,2 1,372, 1,839,1 4,82,4 never smoker 14,8 32,4 697,2 1,66, 1,69,8 3,871,8 daily smoker 187,6 328,7 46, 449, 378, 1,749,2 occasional smoker 43, 7,8 18,8 19, 184,1 71,2 former smoker 236,3 41, 83,1 1,11,9 1,391,2 4,138, never smoker 316, 71,1 976,4 1,298,6 1,84,4 4,89,9 A statistical snapshot of Canadian smokers, 2 11

16 Family income and smoking within age cohorts Because both income and smoking are age related (earnings increase with age, and smoking rates decrease) it is important to look at income and smoking within age cohorts. * Smoking prevalence is highest among those with lowest family incomes and the gap increases with age. There are more smokers in higher income groups and the difference gap increases with age. *The age groups shown are not evenly space in order to illustrate key periods in the smoking history, such as young adulthood) Number of smokers by family income and age cohort 7, 6,, 4, 3, 2, 1, <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + 12 to 19 years 2 to 24 years 2 to 44 years 4 to 64 years over 6 Prevalence of current smokers (daily and occasional) by family income and age cohort <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + 12 to 19 years 2 to 24 years 2 to 44 years 4 to 64 years over 6 Physicians for a Smoke-Free Canada 12

17 Equity of smoking, by age cohort and family income Proportion of population and smoking population by income and age 16 middle income smokers aged Percentage of population have the most disproportionate burden of tobacco use Percentage of smokers high income Canadians aged and all Canadians over 6 have the 4 disproportionate benefit of not 2 smoking (among older Canadians, this may be because smokers in that generation have prematurely died). <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k $8k + <$1k $1k - $29k $3k - $49k $k - $79k 12 to 19 years 2 to 24 years 2 to 44 years 4 to 64 years over 6 $8k + Household Income ($ thousands) daily smoker occasional smoker former smoker never smoker Total 12 to 19 years NO OR <$1, 14,4 7,8 14,4 71,7 18,3 $1,-$29,999 28, 14,4 32, 186,1 261, $3,-$49,999 34,9 17,8,9 336, 444,6 $,-$79,999 34, 39,1 81,9 77,1 732,6 $8, OR MORE 4,1 49, 14, 788,4 986, 2 to 24 years NO OR <$1, 34,4 14, 27,6 47,9 124, $1,-$29,999 6,1 28,1 7,2 9,3 23,8 $3,-$49,999 77,7 32,4 89,1 14,3 344, $,-$79,999 9, 43,1 118,8 23,8 46,3 $8, OR MORE 98,6 77, 176,4 24, 66, 2 to 44 years NO OR <$1, 114,4 3,6 84, 14,6 334,1 $1,-$29, ,4 8, 179, 249,1 76,6 $3,-$49,999 4,2 9,6 499,1 2,7 1,2,6 $,-$79,999 17,2 166,3 928,3 882,1 2,493,9 $8, OR MORE 48,9 27, 1,29,6 1,238,7 3,19,7 4 to 64 years NO OR <$1, $1,-$29, , 2,9 29,1 197,9 77,4 $3,-$49,999 36,7 46,9 638,8 383,2 1,37,6 $,-$79, ,6 6,7 1,17,4 33,1 1,982,9 $8, OR MORE 37,1 11,6 1,498,2 797, 2,77,8 over 6 years of age NO OR <$1, 44,3 6, 146, 137,2 334, $1,-$29, ,6 17,4 34,7 344,1 1,14,8 $3,-$49,999 7, 14,4 48, 26,4 826,8 $,-$79,999 3,2 7,3 342, 169, 3,4 $8, OR MORE 14,6,3 161,2 116,1 297,2 A statistical snapshot of Canadian smokers, 2 13

18 Source of family income A mong the economic circumstances that seem related to smoking is the source of family income. Canadians whose families are supported primarily through wages are less likely to smoke than those whose primary source of income is work-related social transfers (workers compensation and employment insurance benefits). The vast majority of Canadian smokers live in families dependent on wage income. Former smokers are more likely to be supported by seniors benefits, reflecting the tendency of smokers to quit as they become older. Almost one-half of men and women who are supported by workers compensation or EI benefits smoke. But for every smoker in this category, there are 12 smokers who live on waged income. Proportion of smokers by source of income. daily smoker occasional smoker former smoker never smoker daily smoker occasional smoker former smoker never smoker % 2% 4% 6% 8% 1% employment EI/WC senior benefits other Physicians for a Smoke-Free Canada 14

19 Prevalence of smoking by source of income 4 6 men 4 6 women employment EI/WC senior benefits other employment EI/WC senior benefits other daily smoker occasional smoker daily smoker occasional smoker employment income Employment Ins. / workers compensation senior benefits other Numbers daily smoker 1,899,9 127,3 21, 8,8 2,31,4 occasional smoker 611,9 18,4 3,2 18, 683,4 former smoker 3,846,9 89,7 1,11, 176,8,223, never smoker 3,726,8 93,8 314,6 121,3 4,26, Total 1,8, 329,2 1,67,3 374,9 12,464,9 daily smoker 1,47,4 1,9 244, 72,9 1,938,7 occasional smoker 36,3 23,1 1, 2,2 631,1 former smoker 3,316,3 13,2 964,9 17,7 4,, never smoker 4,323,7 133,8 913,1 214,3,84,9 Total 9,646,7 411,1 2,173,9 478, 12,79,7 Prevalence of smoking daily smoker occasional smoker former smoker never smoker Quit Ratio daily smoker occasional smoker former smoker never smoker Quit Ratio A statistical snapshot of Canadian smokers, 2 1

20 Family structure T he Canadian Community Health and mothers who have a parenting Survey establishes 8 categories partner (32% vs. 38%). of household structure (see box at right). These family structures People who are unattached are appears to have a strong association more likely to smoke if they sharing with the smoking behaviour of accommodation with siblings or with Canadians: non-family members than if they live alone. smoking prevalence is almost twice as high for single mothers (34%) Girls/women who live with their and fathers (36%) as for parents parents are much less likely to who live with a partner (18% for smoke than boys/men who live with mothers, 23% for fathers) or who their parents(14% vs. 27%). are in a partner relationship without Boys living with single parents are children (18% and 19%). no more likely to smoke than boys Among mothers who smoke and with two parents (27%), but girls who live with children, there are 9 who live with single mothers are times as many who live with partner much more likely to smoke than than who are single parents. girls who live with two parents (9, vs. 66, (21% vs. 14%). The difference in never smoking is Successful quitting is highest among much lower between single mothers men who live with a partner (quit ratio of 3). Prevalence of smoking by family structure Survey categories: 1 Selected respondent lives alone. (Household size = 1) 2 Unattached individual living with others (Selected respondent lives with others. He/she cannot have a marital/ commonlaw or parental relationship but other relationships such as siblings are allowed) 3 Spouse/partner living with spouse/partner (Selected respondent lives with spouse/partner only. Household size = 2) 4 Parent living with spouse/ partner and children (Selected respondent lives with spouse/partner and one or more children) Single parent living with children (Selected respondent lives with one or more children. No other relationships are permitted) Selected respondent is a child living with a single parent with or without siblings Selected respondent is a child living with two parents with or without siblings. daily (men) daily (women) occasional (Selected respondent lives in a household composition not classified above. Physicians for a Smoke-Free Canada 16

21 Number of smokers by family structure in partnerships living with children (i.e. married dads) are the largest single group of smokers 1,, 7,, 2, ,, 7, 1,, in partnerships living with children (i.e. married moms) are the second largest group of smokers Single moms and Dads are the smallest groups of smokers according to the survey categories. 6 6 daily (men) daily (women) occasional daily occasional former never Total Numbers 1Unattached living alone 361,8 84,6 67,8 343,8 1,397,9 2Unattached living with others 219,4 73,4 22,4 28,3 721,6 3Spouse/Partner (no children) 23,1 132,1 1,993,1 77, 3,4,8 4Parent, spouse and child 69,7 189,4 1,827, 1,197,8 3,91, Parent and child (single parent),6 1, 78,9 43,4 188, 6Child living with parent and/or sibling 64,8 29,2 82, 272, 448,4 7Child with 2 parents 13,6 14,6 277,4 1,222,9 1,73,6 8Other 18, 49,9 294,4 3,2 1,6, 1Unattached living alone 34,4 83,1 7,2 693,2 1,83,9 2Unattached living with others 122,8,3 183,6 2,1 66,7 3Spouse/Partner (no children) 464,9 12,8 1,472,1 1,27,7 3,32, 4Parent, spouse and child 29,6 163,6 1,46,3 1,6,8 3,71,4 Parent and child (single parent) 217,, 282,6 263,8 819,4 6Child living with parent and/or sibling 64,8 29,2 82, 272, 448,4 7Child with 2 parents 13,6 14,6 277,4 1,222,9 1,73,6 8Other 18, 49,9 294,4 3,2 1,6, Prevalence Quit ratio 1Unattached living alone Unattached living with others Spouse/Partner (no children) Parent, spouse and child Parent and child (single parent) Child living with parent and/or sibling Child with 2 parents Other Unattached living alone Unattached living with others Spouse/Partner (no children) Parent, spouse and child Parent and child (single parent) Child living with parent and/or sibling Child with 2 parents Other A statistical snapshot of Canadian smokers, 2 17

22 Marital Status T he relationship between marital and smoking status is similar for both men and women: people who have never been married are less likely to smoke. People who are married are much less likely to smoke than people who live common law or who are widowed, separated or divorced (characterized in these graphs as formerly married. ). who live common law have the highest prevalence of smoking. Successful quitting is highest among married men. People who have never married have the lowest rate of having quit smoking (they also have a lower rate of starting to smoke.) Both marital relationship and smoking are age-related. Nonetheless, the overall pattern between smoking and marital status remains within age cohorts, as illustrated by data for men and women aged married men and women are less likely to smoke than their common-law equivalents, but most smokers are married. differences between successful quitting between married and never married people is reduced, likely reflecting the tendency of younger Canadians to be smokers and unmarried. Marital status of daily smokers aged 4-44 formerly married 1% common law 2% never married 16% married 49% Prevalence of smoking status by marital status men and women aged married common law daily smoker 4 39 married common law formerly married 6 3 never married occasional smoker formerly married never married former smoker aged Prevalence of smoking by marital status all ages married common law formerly married never married married common law formerly married never married married common law formerly married never married daily smoker occasional smoker daily smoker occasional smoker former smoker men former smoker - women Physicians for a Smoke-Free Canada 18

23 Number of smokers by marital status Although men and women who live in common law relationships are more likely to smoke than married men and women, there are more married smokers (both men and women) than in any other category. For every 2 Canadian smokers: 8,, 6,, 4,, 2,, men 8 7 are married 3 4 live common law 2 4 are separated, divorced or widowed 6 have never married For every 2 Canadians who have successfully quit smoking: 8,, 6,, married common law formerly married never married daily smoker occasional smoker former smoker never smoker women are married 2 2 live common law 2 3 are separated, divorced or widowed 3 3 are never married 4,, 2,, married common law formerly married never married daily smoker occasional smoker former smoker never smoker Numbers married common law formerly married never married daily smoker 1,7,8 374,1 278,1 767, 2,427, occasional smoker 27,7 87,4 39,9 327,3 72,3 former smoker 3,63,7 46,6 439, 971,,6,8 never smoker 1,874, 36,4 167,7 2,227,4 4,7,9 Total 6,76,7 1,314, 924,7 4,293,2 13,289,1 daily smoker 742, 37, 41, 14,1 2,47, occasional smoker 231,3 87,8 83,4 26,2 667,7 former smoker 2,68,9 1, 836,7 84,2 4,81,2 never smoker 2,849, 328,6 79,3 2,13,8 6,99,1 Total 6,481,6 1,37,4 2,12,8 3,7,3 13,66,1 Prevalence of smoking daily smoker occasional smoker former smoker never smoker Quit Ratio daily smoker occasional smoker former smoker never smoker Quit Ratio A statistical snapshot of Canadian smokers, 2 19

24 Food Home security ownership H ome ownership is a marker of economic, occupational and social stability as well as a measure of family self-efficacy. Purchasing a home requires, for most Canadians, a stable source of income and may also indicate attitudes of aspiration and long-term personal goal setting. However, the Canadian Community Health Survey asked only whether the home was owned by a member of the household (not necessarily the person answering the survey). For that reason, the relationship of homeownership to personal Those whose families owned their home were more likely to have never smoked. If they did begin smoking, they were more likely to have quit. As a result, there are strong differences in smoking rates between homeowners and non-homeowners (33% to 21% for men and 21 to 17% for women). The relationship between smoking and homeownership is no less striking when family income is controlled for: Prevalence of smoking by family home ownership & income <$1 k $1k - $29k $3k - $49k $k-$79k $8k + Never smoking by family home ownership & income Home owner Not a home owner <$1 k $1k - $29k $3k - $49k $k-$79k $8k + Quit ratio by family home ownership & income Home owner Not a home owner smoking prevalence is 1/3 lower for home owners than for non-homeowners in every income category. the quit ratio for homeowners is twice that of non homeowners in every income group Home owner Not a home owner <$1 k $1k - $29k $3k - $49k $k-$79k $8k + Physicians for a Smoke-Free Canada 2

25 Number of Smokers and Smoking Prevalence by Housing Arrangements Canadian Community Health Survey, cycle 3.1 Percentage of smokers and non-smokers who live in a family-owned home. no 33% Non-Smokers no 2% Smokers Homeowners yes 67% yes 8% Non homeowners Prevalence of smoking status by family home ownership men women current smoker former smoker never smoker current smoker former smoker never smoker Homeowners Non homeowners Yes homeowner No not owner Total Yes homeowner No not owner Total daily smoker 1,77,3 789,8 2,367, occasional smoker 1,9 194,2 7,1 7 former smoker 4,438,1 962,8,4, never smoker 3,42, 9,3 4,447, Quit ratio daily smoker 1,28, 72,2 2,, occasional smoker 442,6 29,9 62, 4 6 former smoker 3,76,3 1,4,6 4,761, never smoker 4,67,3 1,296,1,93, Quit ratio A statistical snapshot of Canadian smokers, 2 21

26 Food security P olicies to keep cigarettes expensive by imposing excise and other taxes have been proven effective at reducing smoking rates and are considered by some policy advocates to be among the most effective public health strategies to reduce smoking. Concerns have been expressed about whether or not high cigarette prices compromise the ability of Canadians who continue to smoke to meet other health needs, including adequate nutrition. The Canadian Community Health Survey has developed an index of food security. The index is based on 18 questions. Although the questions are asked only of Canadians who live in the provinces of Prince Edward Island, Nova Scotia, Quebec, Ontario, Alberta and British Columbia, there is no reason to believe that the results are not reflective of the national situation. Almost all (9%) of Canadians live with food security. One in Canadians lives with food insecurity and some level of hunger. Of those Canadians, more than half smoke. 1% of Canadians are smokers who live with repeated experiences of hunger. 1 in 2 smokers lives (without children) with repeated experiences of hunger. There are more than 1, Canadians in this situation. 1 in 1 smokers lives with a child who repeatedly experiences hunger. There are more than, Canadians in this situation. The CCHS food security index has four categories: 1 Food secure: Household members show no or minimal evidence of food insecurity. 2 Food insecure without hunger: Household members feel anxious about running out of food or compromise on the quality of foods they eat by choosing less expensive options. Little or no reduction in the household members food intake is reported. 3 Food insecure with MODERATE hunger: Food intake for adults in the household has been reduced to an extent that implies that adults have repeatedly experienced the physical sensation of hunger. In most (but not all) food insecure households with children, such reductions are not observed at this stage for children 4 Food insecure with SEVERE hunger: At this level, all households with children have reduced the children s food intake to an extent indicating that the children have experienced hunger. Adults in households with and without children have repeatedly experienced more extensive reductions in food intake Percentage of Canadians who experience food insecurity by smoking status. Smokers (daily and occasional) Non-smokers (former or never smokers) no hunger 6% with hunger 4% no hunger 3% with hunger 1% secure 9% secure 96% Physicians for a Smoke-Free Canada 22

27 Number of Smokers and Smoking Prevalence by Food Adequacy Canadian Community Health Survey, cycle 3.1 Prevalence of smoking by food security No children in the home Children < 12 years of age in the home secure no hunger with hunger Total secure no hunger with hunger Total 3. Quit ratio People who have ever smoked and who live with hunger are much less likely to have successfully quit smoking. no children children secure.7.7 no hunger..4 with hunger Total secure no hunger with moderate or severe hunger secure no hunger with moderate or severe hunger Total No children smoker 3,46, 17, 1,7 3,79, former smoker 6,787,2 128,7 72,6 6,988, never smoker 6,37,9 162,9 76,7 6,47, Quit ratio Children under 12 smoker 1,44, 99,1 48, 1,191, former smoker 1,77,8 72,8 19,8 1,868, never smoker 2,366,3 127,8 49, 2,43, Quit ratio A statistical snapshot of Canadian smokers, 2 23

28 H ealth status S tatistics Canada has asked Canadians to rate the status of their own physical and mental health. Smoking is arguably the largest single health risk that is included in this survey, and differences in health status can be seen in smoking and non-smoking populations. excellent 24% Non-smokers (former or never smokers) poor 2% fair 8% good 27% 63% of non-smokers rate their health as excellent or good, compared with 1% of smokers 1% of non-smokers rate their health as fair or poor, compared with 1% of smokers. very good 39% Smokers (daily and occasional) excellent 16% poor 4% fair 11% very good 3% good 34% poor fair good very good excellent daily smoker 98,8 289,9 871,9 816, 3,7 2,427,2 occasional smoker 1,2 4, 212,2 313,6 14,3 726,4 former smoker 19,7 22,1 1,71,6 2,89,4 1,182,,6,3 never smoker 49,8 212,3 1,1,8 1,83,7 1,31,3 4,72,8 daily smoker 91,9 248,8 72,6 78,3 278, 2,47,6 occasional smoker 14,4 4,9 183, 28,3 144,1 667,6 former smoker 128, 418,3 1,313,2 1,93,9 1,89,9 4,83,8 never smoker 14, 492,1 1,71,3 2,344,9 1,46,2 6,98, Physicians for a Smoke-Free Canada 24

29 Smoking prevalence by self-reported health status Canadian Community Health Survey, cycle Current Smokers poor fair good very good excellent Former Smokers poor fair good very good excellent Never Smokers poor fair good very good excellent poor fair good very good excellent daily smoker occasional smoker former smoker never smoker Quit ratio daily smoker occasional smoker 4 3 former smoker never smoker Quit ratio A statistical snapshot of Canadian smokers, 2 2

30 Cognitive functioning H igher education may be an imperfect indicator of cognitive functioning, and the ability to apply information to health behaviours. The CCHS asked a sub-sample of respondents a series of questions aimed at assessing their ability to remember and to process information. They used six categories of cognition functioning established (1 no cognitive problems, 2 a little difficulty thinking, 3 somewhat forgetful, - 4 somewhat forgetful/a little difficulty thinking, -very forgetful/great deal of difficulty thinking, 6 unable to remember and/ or think). Because there were few respondents in the higher categories, we grouped the last three to create four categories: Prevalence of current smoking by cognitive functioning men women No problem A little difficulty thinking Somewhat forgetful Somewhat or very forgetful, a little or great deal of difficulty thinking or unable to remember and think no problem little difficulty some forgetful forgetful 2 16 Smoking prevalence was higher among those with greater difficulty, but most smokers have no cognitive function impediment. no problem little difficulty some forgetful forgetful difficulty no problem little difficulty some forgetful forgetful difficulty Total Prevalence of Cognition status Smoking prevalence daily smoker occasional smoker former smoker never smoker Total/Quit ratio daily smoker occasional smoker former smoker never smoker Total/quit ratio Physicians for a Smoke-Free Canada 26

31 Happiness I f tobacco is used as a method of coping with emotional distress (and/or if smoking leads to emotional distress), then higher smoking prevalence might be expected among those who identify themselves as unhappy. In a sub-sample of respondents, CCHS used five categories of emotional functioning, the two most extreme unhappy categories for which we have grouped because the number of Canadians who identified themselves as either very unhappy or life is not worth living was very small. Unhappy Canadians are more likely to smoke. One in three smokers is unhappy, compared with 1 in nonsmokers. Prevalence of current smoking by emotional functioning happy somewhat happy Most Canadian smokers are happy. (7%) somewhat unhappy very / extremely unhappy 2 18 Smoking prevalence was almost three times as high for Canadians who considered themselves very or extremely unhappy. happy very/ somewhat somewhat extremely happy unhappy unhappy happy very/ somewhat somewhat extremely happy unhappy unhappy Total Prevalence of Happiness/ Unhappiness Smoking prevalence current former smoker * never smoker * /quit ratio current smoker former smoker * never smoker * /quit ratio * number too small for reliability A statistical snapshot of Canadian smokers, 2 27

32 tal health ost Canadians smokers and non M smokers consider themselves to be in good or excellent mental health. When asked to rate their own mental health, there were some differences in the self-rated mental health of smokers and non-smokers. Prevalence of current smoking by self-rated mental health men women % of non-smokers rated their mental health as excellent or good, compared with 68% of smokers 1 poor fair good very good excellent 8% of smokers rated their mental health as poor or fair compared with 4% of nonsmokers poor fair good very good excellent Number daily smoker 41, 141,8 64,7 828,4 766,3 2,382,7 occasional smoker 4,6 43,1 16,9 26,3 26,3 721,1 former smoker 3,9 189,7 1,124,2 1,97,3 2,117,7,424,9 never smoker 19,8 14, 778,3 1,89,1 1,971,3 4,463,1 daily smoker 48,8 142,4 49,7 714,6 637, 2,34, occasional smoker 7, 31,6 144,7 24, 221, 68,3 former smoker 33, 177,8 981, 1,831,4 1,781,7 4,8, never smoker 48,7 214,2 1,174,6 2,2, 2,297,6,94,2 Prevalence daily smoker occasional smoker former smoker never smoker Quit ratio daily smoker occasional smoker 6 4 former smoker never smoker Quit ratio Physicians for a Smoke-Free Canada 28

33 Self-rating of mental health smokers and non smokers (%) very good 37% Non-smokers (former or never smokers) good 2% fair 3% poor 1% excellent 39% very good 3% Smokers (daily and occasional) good 24% fair 6% poor 2% excellent 33% Prevalence of current smoking by visit to mental health professional in past 12 months n 3 Canadian provinces (Ontario, 4 1 in 2 Canadians has visited a 34 I New Brunswick and Alberta), 3 mental professional in the past respondents were asked whether they 28 year. 3 had consulted a mental health 2 professional in the 12 months. Of the 18 out of 2 Canadian smokers 2 % of Canadians who had done so, has not visited a mental health 1 smoking prevalence was higher than professional in the past year. 1 among those who had not. If the information from these provinces is true throughout Canada: yes no 19 yes no yes no Prevalence of visiting mental Prevalence of smoking daily smoker occasional smoker former smoker never smoker /quit ratio 9 daily smoker occasional smoker former smoker never smoker /quit ratio A statistical snapshot of Canadian smokers, 2 29

34 Number of Smokers by self-reported stress Canadian Community Health Survey, cycle 3.1 Stress is an often cited as a reason that Canadians smoke. Both non-smoking and smoking Canadians reported stress in their lives. Non-smokers (former or never smokers) a bit 41% The prevalence of smoking is highest among Canadians who report stress and lowest among those who report no stress. 28% of smokers report that quite a bit 18% extreme 3% not at all 13% not very 2% they live with quite a bit or extreme stress, compared with 21% of non-smokers. Smokers (daily and occasional) 31% of smokers report that they live with none or little stress, compared with 38% of a bit 41% non-smokers. not very 21% quite a bit 23% extreme % not at all 1% extremely stressed quite a bit stressed a bit stressed not very stressed not at all stressed daily smoker 137,8 12, 977,8 49, 29,3 2,413,3 occasional smoker 2,8 137,3 314, 173,8 67, 718,4 former smoker 162,9 994,7 2,21,8 1,33,2 81,6,1,2 never smoker 11,2 678,7 1,63,4 979, 24,7 3,946, daily smoker 131,4 14, 812,1 46,3 168,1 2,32, occasional smoker 22, 14,8 293,7 14,6 4,1 66,3 former smoker 1, 934,9 2,12,1 1,2,2 11,7 4,813,9 never smoker 181,9 1,9,4 2,381,3 1,33,6 634,9,43,2 Physicians for a Smoke-Free Canada 3

35 Prevalence of smoking by self-reported stress Canadian Community Health Survey, cycle 3.1 Current Smoking (daily and occasional) extreme quite a bit a bit not very not at all extreme quite a bit a bit not very not at all extremely stressed quite a bit stressed a bit stressed not very stressed not at all stressed daily smoker occasional smoker former smoker never smoker Quit ratio daily smoker occasional smoker 3 6 former smoker never smoker Quit ratio A statistical snapshot of Canadian smokers, 2 31