NWT Addictions Report Prevalence of alcohol, illicit drug, tobacco use and gambling in the Northwest Territories

NWT Addictions Report Prevalence of alcohol, illicit drug, tobacco use and gambling in the Northwest Territories December 2010

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EXECUTIVE SUMMARY The aim of this report is to present detailed findings from the 2009 NWT Addictions Survey. Topics covered include the prevalence of alcohol use, tobacco, illicit drugs and gambling activities. The 2009 NWT Addictions Survey included core content from the Canadian Tobacco Use and Monitoring Survey (CTUMS) while the alcohol, illicit drug and gambling items in the questionnaire were derived from the core content of the Canadian Addictions Survey (CAS). This report will help to provide reliable data on alcohol, illicit drug, tobacco use and gambling activities within the NWT. In turn, this data can be used to: 1. Assist government and health professionals understand the current state of substance use in the NWT; and 2. Inform decision-making related to prevention and treatment programming. Alcohol Highlights In the 12 months prior to the 2009 survey, 77% of NWT residents 15 years and over reported they consumed alcohol. 43% of residents surveyed said they typically consume 5 or more drinks on one occasion. This is an increase from 34% since 1996. Among current drinkers in 2009, 64% of 15 to 24 year olds reported consuming 5 or more drinks on a single occasion and one in four engaged in heavy drinking at least once a week. Aboriginal people tend to drink less frequently than non-aboriginal, but tend to consume a larger amount when they do drink. In general, as education levels increase the number of drinks consumed on a single occasion decreases. Although university graduates drink more frequently, they drink lower quantities on a single occasion. Illicit Drugs Highlights The majority of the NWT population reported using cannabis at least once in their lifetime. Overall, the proportion of lifetime users increased from 53% to 59% between 1996 and 2009. At least 11% of the NWT population aged 15 and over are using cannabis on a weekly basis. People who reported trying one of the five types of illicit drugs (cocaine/crack, hallucinogens, speed, ecstasy and heroin) at least once in their life increased from 16% in 2002 to 24% in 2009. The prevalence of past year use of any of the five illicit drugs increased from 2% to 4% between 2002 and 2009 which might be attributed an increased use of hallucinogens (magic mushrooms, PCP or LSD) and ecstasy.

Tobacco Use Highlights In the NWT the proportion of current smokers dropped from 44% in 1996 to 36% in 2009. Between 1996 and 2009, there was a significant increase in the proportion of people who have never smoked: 15 to 24 year olds (27% to 48%); and 25 to 39 year olds (32% to 46%). The prevalence of daily smoking among Aboriginal people 15 years and over declined from 53% in 1996 to 38% in 2009. However, Aboriginal people continue to have higher rates of daily smoking than non-aboriginal (38% vs. 14%). The likelihood of being a daily smoker is lower in Yellowknife than in the regional centers and other communities. In 2009, 22% of women indicated they smoked during pregnancy. Approximately 1 in 10 pregnant women had spouses or partners that smoked around them. Residents of the NWT were also exposed to second-hand smoke in their homes and in vehicles. Twenty percent indicated that at least one family member or visitor smoked inside their home every day or almost every day and 24% were exposed to second-hand smoke in cars at least once a week. Gambling Highlights The prevalence of current gambling declined from 78% to 71% between 1996 and 2009. Males, seniors, Aboriginal people, those with less than a university degree and residents in communities outside of Yellowknife were more likely to gamble at least once a week. In 2009, the average amount spent in a typical week gambling was $40.

TABLE OF CONTENTS Introduction........................................................ 1 Methods........................................................... 1 Alcohol Use......................................................... 4 Illicit Drug Use...................................................... 22 Tobacco........................................................... 30 Gambling.......................................................... 43 Summary.......................................................... 50

LIST OF TABLES Figure 1: Proportion of current drinkers by demographic characteristics among residents aged 15+, NWT 2009 5 Figure 2: Overall trends in the frequency of drinking among current drinkers aged 15+ NWT 1996 2009 6 Figure 3: Frequency of drinking more than once a week by demographic characteristics among current drinkers aged 15+, NWT 2009 7 Figure 4: Overall trends in the usual number of drinks consumed on a single occasion among current drinkers aged 15+, NWT 1996 2009 8 Figure 5: Usual amount of alcohol consumed in a single sitting (5+ drinks) by demographic characteristics among current drinkers aged 15+, NWT 2009 9 Figure 6: Proportion of heavy drinking of least once a month by demographic characteristics among current drinkers aged 15+, NWT 2009 11 Figure 7: Type of drinker among residents aged 15+, NWT 2009 12 Figure 8: Proportion of heavy frequent drinkers by demographic characteristics among residents aged 15+, NWT 2009 13 Figure 9: Harm from own current drinking among current drinkers aged 15+ by type NWT 2004 2009 14 Figure 10: Prevalence of one or more types of harm from own drinking by demographic characteristics among current drinkers aged 15+, NWT 2009 15 Figure 11: Harm from other s drinking among NWT residents aged 15+ by type NWT 1996 2009 16 Figure 12: Prevalence of one or more types of harm from other people s drinking in the past 12 months by demographic characteristics among residents aged 15+, NWT 2009 17 Figure 13: Prevalence of driving within one hour of drinking 2 or more drinks by demographic characteristics among current drinkers aged 15+, NWT 2009 18 Figure 14: Prevalence of drinking during pregnancy among women age 20 to 44 years NWT 2002 2009 19 Figure 15: Frequency and volume of alcohol consumption during pregnancy among women who drank while they were pregnant, NWT 2002 2009 20

Figure 16: Demographic characteristics in AUDIT score 8+ among current drinkers aged 15+, NWT 2009 21 Figure 17: Proportion of cannabis ever tried by demographic characteristics among residents aged 15+, NWT 1996 & 2009 22 Figure 18: Proportion of cannabis use in the past 12 months by demographic characteristics among residents aged 15+, NWT 2009 23 Figure 19: Cocaine/crack, hallucinogens, speed, ecstasy and heroin ever used in lifetime among residents aged 15+, NWT 2002 2009 24 Figure 20: Proportion of cocaine/crack, hallucinogens, speed, ecstasy, and heroin ever used in lifetime by demographic characteristics among residents aged 15+ NWT 2009 25 Figure 21: Prevalence of other illicit drugs ever used in lifetime among residents aged 15+, NWT 1996 2009 26 Figure 22: Cocaine/crack ever used in lifetime by demographic characteristics among residents aged 15+, NWT 2009 26 Figure 23: Hallucinogens ever used in lifetime by demographic characteristics among aged 15+, NWT 2009 27 Figure 24: Harm from own illicit drug use among current users aged 15+ by type NWT 2004 2009 28 Figure 25: Harm from own drug or alcohol use among users aged 15+ by type NWT 2009 29 Figure 26: Smoking status in the past 12 months among residents aged 15+ NWT 1996 2009 30 Figure 27: Demographic characteristics among residents who smoke aged 15+ NWT 1996 & 2009 31 Figure 28: Smoking status in past 12 months by gender, NWT 2009 31 Figure 29: Smoking status in past 12 months by age, NWT 2009 32 Figure 30: Smoking status in past 12 months by ethnicity, NWT 2009 32 Figure 31: Smoking status in past 12 months by highest level of education, NWT 2009 33 Figure 32: Smoking status in past 12 months by community type, NWT 2009 33 Figure 33: Proportion of daily smokers among residents aged 15+, NWT 2009 34 Figure 34: Overall trend in the average number of cigarettes per day among daily smokers aged 15+, NWT 1996 2009 35

Figure 35: Average number of cigarettes per day by demographic characteristics among daily smokers aged 15+, NWT 2009 36 Figure 36: Overall trend in quit rates among ever smokers aged 15+ NWT 1996 2009 37 Figure 37: Quit rates by demographic characteristics among ever smokers aged 15+, NWT 1996 & 2009 37 Figure 38: Smoking during pregnancy among women aged 20 44, NWT 1996 2009 39 Figure 39: Exposure to second-hand smoke inside homes by demographic characteristics among residents aged 15+, NWT 2009 40 Figure 40: Exposure to second-hand smoke in vehicles at least once per week by demographic characteristics among residents aged 15+, NWT 2009 41 Figure 41: Ever used in lifetime and past year use of chewing tobacco among residents aged 15+, NWT 1996 2009 42 Figure 42: Proportion of current gamblers by demographic characteristics among residents aged 15+, NWT 2009 44 Figure 43: Multiple types of gambling in past year among current gamblers aged 15+ NWT 1996 2009 45 Figure 44: Prevalence of gambling in past year among current gamblers aged 15+ by type, NWT 1996 2009 45 Figure 45: Average among of money spent in a typical week of gambling by demographic characteristics among current gamblers aged 15+, NWT 2009 47 Figure 46: Proportion of regular gamblers by demographic characteristics among residents aged 15+, NWT 2009 48 Figure 47: Prevalence of gambling once a week among current gamblers aged 15+ by type, NWT 1996 2009 49

2009 NWT Addictions Report INTRODUCTION The purpose of this study is to present detailed findings from the 2009 NWT Addictions Survey and compare them with previous surveys as part of an ongoing effort to monitor trends and patterns of alcohol, tobacco, illicit drug use and gambling activities in the Northwest Territories. The report will help to understand the current state of substance use in the NWT and inform decision-making related to prevention and treatment programming. Key objectives of the study include: Determine the prevalence and patterns of alcohol and drug use in the NWT; Measure the extent of harms associated with the use of alcohol and drugs; and Provide baseline data for future evaluations and program reviews. METHODS Survey design and methodology 1 The 2009 NWT Addictions Survey was conducted across the NWT between mid-september and October 2009. The NWT Bureau of Statistics was contracted by the Department of Health and Social Services with funding from Health Canada, to conduct the survey. Alcohol and illicit drug questions came from core content of the Canadian Addictions Survey (CAS) and tobacco questions came from The Canadian Tobacco Use and Monitoring Survey (CTUMS). The questionnaire remained fairly similar to previous years with a few additions such as emerging drug issues and quit smoking methods. Telephone surveys were conducted in Yellowknife, Fort Smith, Hay River and Inuvik and face-toface interviews were conducted in smaller communities. Dwellings in 22 different communities in the NWT were randomly sampled as part of the survey. All of the content of the alcohol and illicit drug related questions are the same, with the exception of heavy drinking. In the Canadian Addictions Survey, men were asked how often they consumed five or more drinks on one occasion, while women were asked how often they consumed four or more drinks on one occasion. In contrast, the NWT survey asked both men and women how often they consumed five or more drinks on one occasion. As a result, NWT estimates for the prevalence of heavy drinking among females may be more conservative than those estimated using four or more drinks as an indicator of regular heavy drinking. 1 Further technical details on the methodology can be found in Appendix A. Page 1

2009 NWT Addictions Report Sample design All NWT communities were divided into the following eight strata: Yellowknife, Hay River, Fort Smith, Inuvik, Norman Wells, small north, small south A and small south B. Households in Yellowknife, Hay River, Fort Smith and Inuvik were selected at random using random digit dialing. Households in the other strata were randomly selected using a dwelling list maintained by the NWT Bureau of Statistics. One respondent 15 years or older was randomly selected from each household. Interviews were conducted by telephone in households selected using random digit dialing, and face-to-face interviews were conducted in the other selected households. Weighting The objective is to select a small number of individuals whose behaviour will represent all individuals in the population. Based on that small sample, inferences or predictions can be made about the total population. To help achieve this goal, respondents are given a sample weight, which depends on their sex, age and ethnicity. Sample weights help compensate for unequal probabilities of selection, non-coverage of the population and non-response bias. The sum of the weights over the sample provides an estimate of the population size. Population estimates used for weighting are based on published estimates of the NWT population produced by Statistics Canada and community population estimates produced by the Bureau of Statistics. Demographic indicators The substance use and gambling variables are presented by demographic indicators when possible throughout the report. These include: Demographics Sex Ethnicity Age Highest Level of Education Community Type Categories of the Indicators Male; Female Aboriginal; Non-Aboriginal The age groups reflect categories used to weight the survey results to NWT population estimates: 15 24; 25 39; 40 59; 60+. In some cases, 15 39 and 40+ is used. The latter is used when measures are based on small numbers or when 15 to 39 year olds (high risk group) have similar prevalence. Less than High School - grade 11 or less; High School Diploma high school diploma; Some Post-Secondary trades certificate or diploma, or college certificate or diploma; University Degree. Yellowknife; Regional Centers which include Fort Smith, Hay River & Inuvik; Other Communities Page 2

2009 NWT Addictions Report Limitations The limitations of the 2009 NWT Addictions Survey are those common to large surveys involving self-reported measures. These limitations include potential underreporting and sampling errors. The NWT Addictions Survey deals with sensitive subject matter: people are asked to report on behaviour that may not be socially acceptable and may even be illegal. As a result, it is expected that some underreporting of such behaviour may occur. However, surveys remain the most efficient way to obtain information representative of the population of the NWT. Research also indicates that while an underreporting (or, conversely, over reporting) bias may influence estimates for a single point in time, it likely remains quite stable over time, therefore having less of an impact on impact on estimating change over time. Sampling errors refer to the variations caused by surveying a portion of the population rather than the entire population. For example, conducting telephone interviews (as was done in Fort Smith, Hay River, Inuvik and Yellowknife) assumes that everyone in those populations has a conventional residence with telephones. However, a small proportion of households do not have telephones and therefore would not have been included. With both telephone and face-toface interviews (conducted in smaller NWT communities), people residing in institutions such as hospitals, correctional facilities or long-term care facilities were not included. Homeless people were also not part of the survey due to the sampling frame based on dwellings (e.g. houses, apartments). Nevertheless, since one of objectives of the NWT Addiction Surveys is to generate estimates of the prevalence of substance use as a whole, the relatively small size of these excluded populations should have minimal effect on the reliability of estimates for the broader population. Weighting of the sample reflected the probability of a household being selected in the sample. The NWT Bureau of Statistics 2009 population estimates were used for poststratification weighting by community type, age, gender and ethnic group (Aboriginal/non- Aboriginal). Page 3

2009 NWT Addictions Report ALCOHOL USE This section reports on five measures of alcohol use including current drinkers, drinking frequency, usual consumption, frequency of heavy drinking, heavy drinking, and harmful/hazardous drinking. Also included is information on harm from one s own drinking, harm from someone else s drinking, the prevalence of drinking and driving, as well as drinking during pregnancy. Current drinkers Residents were asked a series of questions about their alcohol use. For the purpose of the survey the word drink means: one bottle or can of beer; one glass of wine or a cooler; one straight or mixed drink with one and a half ounces of hard liquor. Residents were asked two questions: During the past 12 months, have you ever had a drink of beer, wine, liquor or any other alcoholic beverage; and at what age did you have your first drink? The proportion of the population surveyed who were 15 years and over that currently drink has not changed significantly since 1996. 2 However there was a decrease from 87% in 1996 to 75% in 2009 in drinking among 15 to 24 year olds. Those in the 25 to 39 year old age group reported the highest proportion of current drinkers and conversely those 60 years and over are significantly less likely to drink. Additionally, the prevalence of current drinking is higher among males than females (80% vs. 74%). On average NWT residents reported having their first drink at 16 years of age. 2 The report utilizes methods to determine whether the difference between the reference and comparison groups is statistically significant meaning it is highly unlikely that the difference is a result of chance. Note that as these analyses are primarily descriptive in nature, casual interpretations cannot be drawn from any significant trends or differences described throughout the report. See the Appendix for a more detailed description of report methodology including reliability of estimates and significance testing. Page 4

2009 NWT Addictions Report Figure 1: Proportion of current drinkers by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 20% 40% 60% 80% 100% Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities Reference category- basis of comparison for the other categories. Significant difference at the.05 level Frequency of drinking Drinking frequency is derived from the question: During the past 12 months, how often did you drink alcoholic beverages? The answers were recorded in four categories: more than once a week, once a week, 1-3 times a month, less than once a month. The proportion of current drinkers who reported using alcohol more than once a week increased from 25% to 30%. At the same time, those drinking less than once a month decreased from 29% to 25%. The frequency of drinking more than once a week increased among females, 25 to 39 year olds and those with less than high school. Page 5

2009 NWT Addictions Report Youth 15 to 24 years of age were less likely than all other age groups to drink more than once per week (22% vs. 31%, 32% and 41%) and males were more likely to drink alcohol more than once per week than females (37% vs. 23%). Figure 2: Overall trends in the frequency of drinking among current drinkers aged 15+, NWT 1996 2009 35% 30% 25% 20% 15% 10% 1996 2009 5% 0% More than once a week Once a week 1 to 3 times/month Less than once a month Significant difference at the.05 level between 1996 and 2009. Page 6

2009 NWT Addictions Report Figure 3: Frequency of drinking more than once a week by demographic characteristics among current drinkers aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities Reference category- basis of comparison for the other categories. Significant difference at the.05 level Usual amount of alcohol consumed on a single occasion Usual consumption reflected the usual number of drinks the respondent had on the days they consumed alcohol: During the past 12 months, on those days that you drank, how many drinks did you usually have? A second question was also asked: How often in the past 12 months have you had 5 or more drinks on one occasion? Overall, the amount of alcohol consumed on a single occasion increased between 1996 and 2009. The proportion of current drinkers who reported consuming 1-2 drinks or 3-4 drinks declined as the proportion of current drinkers consuming 5 or more drinks on a single occasion increased from 34% to 43%. In 2009, the 15 to 24 age group showed an increase in having 5 or more drinks on a single occasion (64% vs. 44%, 32% and 36%). Page 7

2009 NWT Addictions Report Males were more likely than females (50% vs. 35%) to drink 5 or more drinks on a single occasion. Among education levels, drinking 5 or more drinks on a single occasion was highest among those with less than a high school diploma. In addition, those living in other communities and regional centers were more likely than those living in Yellowknife to consume 5 or more drinks on a single occasion (55% and 48% vs. 35%). Figure 4: Overall trends in the usual number of drinks consumed on a single occasion among current drinkers aged 15+, NWT 1996 2009 Significant difference at the.05 level between 1996 and 2009. Page 8

2009 NWT Addictions Report Figure 5: Usual amount of alcohol consumed in a single sitting (5+ drinks) by demographic characteristics among current drinkers aged 15+, NWT 2009 Total 0% 10% 20% 30% 40% 50% 60% 70% Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities Reference category- basis of comparison for the other categories. Significant difference at the.05 level Frequency vs. volume Those 15 to 24 years of age were less likely to drink more than once per week than all other age groups but they tend to drink larger quantities of alcohol when they do drink. Among current drinkers, 64% of 15 to 24 year olds consume 5 or more drinks when they consume alcohol compared to other age categories. The volume of alcohol consumed on a single occasion also varies by level of education. In general, as education levels increased the number of drinks consumed on a single occasion decreased. Heavy drinking The risk of alcohol-related problems increases in the case of heavy drinking. According to the Centre for Addiction and Mental Health (CAMH) and the Canadian Centre on Substance Abuse heavy drinking is defined as a pattern of alcohol consumption that brings the blood alcohol Page 9

2009 NWT Addictions Report concentration (BAC) level to 0.08% or more. This pattern of drinking usually corresponds to five or more drinks on a single occasion for males and four or more drinks on a single occasion for females, generally within about 2 hours. Respondents were asked how many times in the past year they consumed 5 or more drinks on a single occasion. 3 The proportion of current drinkers who consumed 5 or more drinks at least once per month increased from 41% to 47% between 2002 4 and 2009. In 2009, residents 15 to 24 years of age were more likely to have 5 or more drinks at a single occasion at least once per month. Both male (from 50% to 56%) and female (from 30% to 37%) heavy drinking increased since 2002, with males continuing to engage more often in heavy drinking at least once a month than females. As in past surveys, university graduates were less likely to drink heavily than other education groups and residents living in Yellowknife were less likely to drink heavily than those residing in other communities. 3 In the NWT, males and females were asked the same question. 4 Data for frequent heavy drinking at least once per month and at least once per week is presented for 2002 2009. The 2002, 2004, 2006 and 2009 surveys asked the question of regular heavy drinking with pre-defined categories (e.g. more than once a week, once a week, etc.). In the 1996 Alcohol and Drug Survey, respondents provided an open-ended answer to this question (i.e. the actual number of times they drank in the past 12 months). To address possible issues of recall bias presented by the open-ended answers from the 1996 survey, only data from 2002 2009 is presented. Refer to Tables 7 & 9 in Appendix for all demographic trends. Page 10

2009 NWT Addictions Report Figure 6: Proportion of heavy drinking at least once per month by demographic characteristics among current drinkers aged 15+, NWT 2009 Total Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities 0% 10% 20% 30% 40% 50% 60% 70% Reference category- basis of comparison for the other categories. Significant difference at the.05 level Type of drinker To summarize the above description of alcohol use patterns, the NWT population is subdivided into a drinking/non-drinking typology. The type of drinker is a derived variable based on drinking status, frequency of drinking and the usual amount of alcohol consumed on a single occasion. The categories are as follows: Lifetime abstainer Never drank alcohol Former drinker - Drank, but not in the past 12 months Light infrequent drinker - Drank in the past 12 months, but less than once a week and fewer than five drinks Light frequent drinker - Drank in past 12 months, once a week or more and fewer than five drinks Heavy infrequent drinker - Drank in the past 12 months, less often than once a week and usually five or more drinks Heavy frequent drinker - Drank in the past 12 months, once a week or more and five or more drinks Page 11

2009 NWT Addictions Report In 2009, 7% of the population aged 15 and over abstained from alcohol, 15% were former drinkers, 26% were light infrequent drinkers, 18% were light frequent drinkers, 15% were heavy infrequent drinkers and 19% were heavy frequent drinkers. Figure 7: Type of drinker among residents aged 15+, NWT 2009 Between 2002 and 2009, increases in the proportion of heavy frequent drinkers occurred among all population groups with the exception of 15 to 24 year olds and those with less than high school diplomas. The proportion of female heavy frequent drinkers increased from 7% in 2002 to 13% in 2009. Similarly, the proportion of heavy frequent drinkers rose amongst non-aboriginal people from 9% to 15%. In 2009, residents from the regional centers were also more likely than residents from Yellowknife and other communities to be heavy frequent drinkers (26% vs. 17% and 16%). Page 12

2009 NWT Addictions Report Figure 8: Proportion of heavy frequent drinkers by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% 30% Male Female 15-24 25-39 40-59 60+E Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities E Moderate sampling variability - interpret with caution. Reference category- basis of comparison for the other categories. Significant difference at the.05 level Alcohol-related problems Although most drinking occasions occur without harm, and most people do not have problems with alcohol, adverse personal experiences do occur, especially when they are assessed over the lifetime of the respondents. In the 2004, 2006 and 2009 NWT Addiction Surveys, current drinkers were asked if their drinking had harmful effects on their friendships, physical health, home life/marriage, work/studies or created financial, legal, housing and learning difficulties. In 2009, 23% of current drinkers aged 15 and over reported at least one type of harm as a result of their drinking. Harmful effects on friendships or social life (14%), physical health (10%), and home life or marriage (8%) were the most common types of self-reported harm in the past year. Page 13

2009 NWT Addictions Report Figure 9: Harm from own current drinking among current drinkers aged 15+ by type, NWT 2004 2009 Type (%) 2004 2006 2009 One or more types 22 21 23 Friendships/social life 13 10 14 Physical health 10 10 10 Home life/marriage 10 8 8 Work/studies 7 6 6 Financial position 8 5 5 Legal problems 2 E 2 E 2 E Housing problems F 2 E 2 E Learning problems 2 E 2 E 2 E E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. No significance test due to 2004 to 2009 data only. Fifteen to 24 years old, those with less education and those living in communities other than Yellowknife were more likely to experience harm from their own drinking in the past year than the corresponding reference categories. The likelihood of harm also tends to decrease with education. University graduates and those with some post-secondary had a lower risk of harm from their own drinking than those with a high school diploma or less (11% and 12% vs. 24% and 42%). In addition residents living in smaller communities and those living in regional centers experience more harm from their own drinking than residents living in Yellowknife (43%, 24% and 12%). Page 14

2009 NWT Addictions Report Figure 10: Prevalence of one or more types of harm from own drinking by demographic characteristics among current drinkers aged 15+, NWT 2009 Total 0% 10% 20% 30% 40% 50% Male Female 15-24 25-39 40-59 60+E Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-SecondaryE University Degree E Yellowknife Regional Centers Other Communities E Moderate sampling variability - interpret with caution. Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Harm from someone else s drinking in the past year Respondents were also asked if they experienced any of the following types of harm as a result of someone else s drinking: insults or humiliation, family or marriage problems, being pushed or shoved, serious arguments, verbal abuse or physical assault. The prevalence of harm from someone else s drinking changed little over the past 13 years. By 2009, around 51% of the NWT population aged 15 and over experienced at least one type of harm. The most common types of victimization were insults or humiliation (33%), serious arguments (26%), verbal abuse (24%) and being pushed or shoved from someone who had been drinking (21%). Moreover, 19% of respondents reported family or marriage problems and 10% had been physically assaulted by someone under the influence of alcohol. Page 15

2009 NWT Addictions Report Figure 11: Harm from other's drinking among NWT residents aged 15+ by type, NWT 1996 2009 Type (%) 1996 2002 2004 2006 2009 One or more types 55 53 56 53 51 Insulted/humiliated 40.. 35 33 33 Family/marriage problems 16 19 21 17 19 Pushed/shoved 25 26 27 25 21 Serious arguments 30 34 32 29 26 Verbal abuse.. 38 27 29 24 Physically assaulted 12 15 14 10 10.. Data not available. Significant difference at the.05 level between 1996 and 2009. The prevalence of victimization tends to decrease with age, where 15 to 24 year olds were more likely than all other age groups to be victimized by someone who had been drinking (65% vs. 55%, 44% and 35%). Harm from someone else s drinking also differs by ethnicity, education and community of residence. Aboriginal people were more likely than non-aboriginal to be harmed as a result of someone else s drinking (59% vs. 43%). University graduates were at a lower risk of victimization by someone who had been drinking (38% vs. 59%, 52% and 49%) and residents in communities other than Yellowknife were at a higher risk of experiencing harm (61% vs. 45%). There was no significant difference between Yellowknife and regional centers. Page 16

2009 NWT Addictions Report Figure 12: Prevalence of one or more types of harm from other people's drinking in the past 12 months by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 10% 20% 30% 40% 50% 60% 70% Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Drinking and driving Drinking and driving increases the risk of bodily harm to self and to others. For instance, alcohol was a factor in 22% of all injuries and 55% of all deaths resulting from motor vehicle accidents between 1996 and 2004. Youth and young adults were especially at risk and accounted for about a third of all motor vehicle accident related deaths over that period 5. Current drinkers were asked if they drove a motor vehicle within 1 hour of consuming 2 or more alcoholic beverages within the year prior to the survey. 5 GNWT Department of Health and Social Services. 2004. Injury in the Northwest Territories: A Descriptive Report, pp. 42-50. Page 17

2009 NWT Addictions Report The proportion of residents who drove within an hour of consuming 2 or more drinks declined from 21% in 1996 to 13% in 2009. Significant declines were noted for males, 25 to 39 year olds, 40 to 59 year olds, and those with more than a high school diploma. Despite the downward trend in male prevalence since 1996, males in 2009 were still twice as likely as females to drive within an hour of consuming 2+ beverages (16% vs. 8%). In addition, those with less than a high school diploma were more likely than those with a university degree to drink and drive (20% vs. 11%). Prevalence of drinking and driving did not vary with age or place of residence. Figure 13: Prevalence of driving within one hour of drinking 2 or more drinks by demographic characteristics among current drinkers aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% Male Female E 15-24 E 25-39 40-59 60+F Aboriginal Non-Aboriginal Less than High School High School DiplomaE Some Post-Secondary University Degree Yellowknife Regional CentersE Other Communities E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Page 18

2009 NWT Addictions Report Drinking during pregnancy Women who drink during pregnancy are at risk of having a child with FASD. Fetal Alcohol Spectrum Disorder (FASD) is a broad term describing a range of effects that can occur in an individual whose mother drank alcohol during pregnancy. These effects may include permanent physical, mental, behavioural and learning disabilities. Drinking patterns among women of childbearing age is one of the main risk factors associated with FASD. Thus, information on drinking during pregnancy provides an indication of the proportion of pregnant women who are at a high risk of having a child with FASD. Females aged 20 to 44 years were asked whether they drank alcohol during their last pregnancy (i.e. pregnant within 5 years of the survey) and if yes, how often and how much. In 2009, 9% of females aged 20 to 44 reported drinking during their last pregnancy. Among those who reported drinking during their last pregnancy, the vast majority did so less than once a month and consumed one or two drinks. Figure 14: Prevalence of drinking during pregnancy among women aged 20 to 44 years, NWT 2002 2009 (%) 2002 2006 2009 Total 15 15 E 9 E E Moderate sampling variability - interpret with caution. No significance test due to high sampling variability. In 2009, the prevalence of female respondents, who drank while pregnant at least once a week or 1 to 3 times per month, was suppressed due to the low number of respondents. Where prevalence has been reported, for example drinking during pregnancy at least once per week, the biggest change is probably due to sampling variation, as some categories of the indicators are based on a small number of respondents. To give a more stable estimate of the population value, pooled estimates are also shown. Pooled estimates combine respondents from each survey and give a more reliable estimate of the population. Page 19

2009 NWT Addictions Report Figure 15: Frequency and volume of alcohol consumption during pregnancy among women who drank while they were pregnant, NWT 2002 2009 (%) 2002 2006 2009 Pooled 1 Once a week or more 16 E 34 E F 19 E 1 to 3 times a month 21 E F F 19 E Less than once a month 62 53 E 71 E 62 1 or 2 Drinks 67 83 64 E 69 3 or 4 Drinks 17 E F 0 14 E 5+ Drinks 17 E F F 17 E E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. 1 Pooled proportion combines numbers from 2002 and 2009 to provide a more stable estimate. No significance test due to high sampling variability. Harmful/Hazardous Drinking: Alcohol Use Disorder Identification Test (AUDIT) The Alcohol Use Disorder Identification Test (AUDIT) helps identify hazardous drinking patterns and gives an indication of alcohol dependency. AUDIT is a derived variable based on ten questionnaire items including: drinking frequency, volume, inability to stop drinking after starting, failure to meet expectations because of drinking, need for alcohol in the morning to get going, feelings of guilt after drinking, inability to remember what happened the night before because of drinking, injury as a result of drinking and having someone express concern about drinking. An AUDIT score of eight or more indicates a harmful/hazardous use of alcohol. In 2009, 42% of respondents aged 15 and over scored 8 or higher on AUDIT. Males, 15 to 24 year olds, those with lower levels of education and residents outside of Yellowknife were more likely than the corresponding reference groups to engage in harmful/hazardous alcohol use. While the gap is closing between males and females, 48% of males engaged in harmful/hazardous drinking compared to 34% of females. The gap remains large between Aboriginal and non-aboriginal drinkers with Aboriginal people more than twice as likely to engage in high-risk alcohol use (61% vs. 25%). Residents aged 15 to 24 years were more likely than the other age groups to score 8 and over on AUDIT (62% vs. 42%, 31% and 34%). The harmful/hazardous use of alcohol tends to decrease with levels of education. University graduates were less likely to score 8 and over than all other education groups. Page 20

2009 NWT Addictions Report Harmful/hazardous drinking also tends to decrease with increasing community size. As such, residents from Yellowknife were less likely to score 8 and over than people from the regional centers and other communities (31% vs. 45% and 58%). Figure 16: Demographic characteristics in AUDIT score 8+ among current drinkers aged 15+, NWT 2009 Total 0% 10% 20% 30% 40% 50% 60% 70% Male Female 15-24 25-39 40-59 60+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities Reference category- basis of comparison for the other categories. Significant difference at the.05 level Page 21

2009 NWT Addictions Report ILLICIT DRUG USE In this section, trends of cannabis and other illicit drug use in the NWT are examined. The lifetime and past-year prevalence use and various other concerns related to its use are described. Lifetime prevalence is based on a question asking respondents during your life, have you used or tried..., and past-year prevalence is based on a follow-up question about whether they also used the drug during the past 12 months. Cannabis (ever tried) Respondents were asked whether they had tried cannabis (marijuana or hashish) at least once in their lifetime. In 2009, (59%) of the NWT population reported using cannabis at least once in their lifetime, an increase from 53% in 1996. Significant increases occurred among females, 40 to 59 year olds, those with less than high school as their highest level of education. For all other demographic groups, the proportion of lifetime users remained the same. Figure 17: Proportion of cannabis ever tried by demographic characteristics among residents aged 15+, NWT 1996 & 2009 Total 0% 10% 20% 30% 40% 50% 60% 70% 80% Male Female 15-24 25-39 40-59 60+FE Aboriginal Non-Aboriginal 1996 2009 Less than High School High School Diploma Some Post-Secondary University Degree E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. Significant difference at the.05 level between 1996 and 2009. Page 22

2009 NWT Addictions Report Cannabis (past year use) Respondents were asked if they used cannabis within 12 months prior to the survey. Although there has been a significant increase in past year cannabis use between 1996 and 2009, the prevalence has remained stable at 20% of the NWT population sampled since 2002. Females, those 15 to 59 and those with less than a high school diploma showed an increase in cannabis use in the past 12 months between 1996 and 2009. In 2009, males, 15 to 24 year olds, those with less than high school and residents living in communities other than Yellowknife were more likely to have used cannabis in the past year than the corresponding reference categories. Figure 18: Proportion of cannabis use in the past 12 months by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% Male Female 15-24 25-39 40-59 60+F Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-SecondaryE University Degree E Yellowknife Regional Centers Other Communities E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Page 23

2009 NWT Addictions Report Past year use was higher among those with a high school diploma or less than those with higher levels of education (32% and 24% vs. 11% and 9%). In addition, use of marijuana or hashish in the past year was higher in the regional centers and other communities than in Yellowknife (20% and 32% vs. 13%). In the 2004, 2006 and 2009 surveys, past year users were asked how often they used cannabis within 3 months prior to the survey. In 2009, 94% reported using cannabis within 3 months prior to the survey. Additionally, 53% reported using cannabis at least once a week, while 40% used cannabis monthly or less. In 2009, current users of marijuana or hashish were asked if they drove a motor vehicle within 2 hours after using marijuana or hashish within the year prior to the survey. Approximately 6% of current users indicated they had driven within 2 hours of using cannabis. Other illicit drugs (ever tried and past year use) NWT residents were asked whether they tried any of the following types of drugs at least once in their lifetime: cocaine/crack, hallucinogens (magic mushrooms, PCP or LSD/acid), speed, ecstasy and heroin. They were also asked whether they used any of these drugs in the past 12 months. Figure 19: Cocaine/crack, hallucinogens, speed, ecstasy and heroin ever used in lifetime among residents aged 15+, NWT 2002-2009 30% 25% 20% 15% 10% 5% 0% 2002 2004 2006 2009 Other Illicit Drugs in Lifetime By 2009, the most common drugs used in the NWT at least once were hallucinogens (20%), followed by cocaine/crack (11%), ecstasy (6%) and speed (3%). The ever tried once in a lifetime category of other illicit drugs increased from 16% in 2002 to 24% in 2009. Significant increases occurred among all population groups with the exception of Page 24

2009 NWT Addictions Report those with some post-secondary and university degrees. Ever tried use of other illicit drugs did not vary with age or ethnicity, but significant differences were present for gender, education levels and type of community. Figure 20: Proportion of cocaine/crack, hallucinogens, speed, ecstasy and heroin ever used in lifetime by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% 30% 35% Male Female 15-24 25-39 40-59 60+F Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities F High sampling variability - data was suppressed. Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Page 25

2009 NWT Addictions Report Figure 21: Prevalence of other illicit drugs ever used in a lifetime among residents aged 15+, NWT 1996 2009 Type (%) 1996 2004 2006 2009 Trend Cocaine/Crack 10 12 11 11 Hallucinogens 14 12 12 20 Speed 6 3 E 3 3 Ecstasy.. 3 E 4 6 Heroin 1 E 1 E F 1 - - - E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed... Data not available. Significant difference at the.05 level; not significant; - No significance test. Figure 22: Cocaine/crack ever used in lifetime by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 2% 4% 6% 8% 10% 12% 14% 16% Male Female 15-39 40+ Aboriginal Non-Aboriginal Less than High School High School DiplomaE Some Post-Secondary University Degree Yellowknife Regional CentersE Other Communities E Moderate sampling variability - interpret with caution. Page 26

2009 NWT Addictions Report Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Use in the past 12 months of any of the five illicit drugs increased between 2002 and 2009 from 2% to 4%. Among the population groups, significant changes occurred with males (2% to 6%) and 15 to 39 year olds (2% to 7%). Overall, 1% of NWT residents surveyed indicated they had used cocaine or crack in the past 12 months, while 2% indicated past year use of hallucinogens or ecstasy. Figure 23: Hallucinogens ever used in lifetime by demographic characteristics among residents aged 15+, NWT 2009 Total 0% 5% 10% 15% 20% 25% 30% Male Female 15-39 40+ Aboriginal Non-Aboriginal Less than High School High School Diploma Some Post-Secondary University Degree Yellowknife Regional Centers Other Communities E Moderate sampling variability - interpret with caution. Reference category- basis of comparison for the other categories. Significant difference at the.05 level. Page 27

2009 NWT Addictions Report Harm from use of illicit drugs in the past year In the 2004, 2006 and 2009 NWT Addiction Surveys, respondents who used drugs in the past year were asked if their illicit drug use had harmful effects on their friendships, physical health, home life/marriage, work/studies or created financial, legal, housing and learning difficulties. Overall in 2009, approximately 27% of past year drug users experienced at least one type of harm. The most common types reported were harm to physical health (12%), followed by work or study (11%) and harm to friendships or social life (9%). Figure 24: Harm from own illicit drug use among current users aged 15+ by type, NWT 2004 2009 Any Other Can- Any Other Can- Any Other Can- Type (%) Drug 1 Illicit 2 nabis Drug 1 Illicit 2 nabis Drug 1 Illicit 2 nabis One or more types of harm 39 21 18 26 53 E 21 27 43 E 23 Friendships/social life 17 E 10 10 12 E 36 E 7 E 9 E F 8 E Physical health 21 E 10 9 12 E 28 E 9 E 12 E F 12 E Home life/marriage 11 E 8 8 14 E 32 E 10 E 8 E F 8 E Work/studies 12 E 6 6 8 E F 6 E 11 E 26 E 7 E Financial position 16 E 5 5 12 E 24 E 9 E 8 E F 7 E 1 Includes Cannabis, Cocaine, Hallucinogens, Speed, Ecstasy & Heroin 2 Includes Cocaine, Hallucinogens, Speed, Ecstasy & Heroin E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. No significance test due to 2004 to 2009 data only. 2004 2006 2009 Approximately 23% of past year cannabis users reported at least one type of harm. The most common types of cannabis related harm were physical health (12%), followed by harm to friendships, home life, work and/or finances. For users of other types of illicit drugs, 43% experienced at least one type of harm in the past year. For comparative purposes, other illicit drug users were 1.9 times as likely as both cannabis and alcohol users to experience at least one type of harm (43% vs. 23% and 23%). Cannabis users and drinkers reported similar rates of harm. Page 28

2009 NWT Addictions Report Figure 25: Harm from own drug or alcohol use among current users aged 15+ by type, NWT 2009 Any Other Type (%) Drug 1 Illicit 2 Cannabis Drinking One or more types of harm 27 43 E 23 23 Friendships/social life 9 E F 8 E 14 Physical health 12 E F 12 E 10 Home life/marriage 8 E F 8 E 8 Work/studies 11 E 26 E 7 E 6 Financial position 8 E F 7 E 5 1 Includes Cannabis, Cocaine, Hallucinogens, Speed, Ecstasy & Heroin 2 Includes Cocaine, Hallucinogens, Speed, Ecstasy & Heroin E Moderate sampling variability - interpret with caution. F High sampling variability - data was suppressed. Page 29

2009 NWT Addictions Report TOBACCO This section provides a general descriptive summary of tobacco trends in the NWT between 1996 and 2009. Smoking status Between 1996 and 2009 there was a decline in respondents reporting smoking daily (39% to 25%) and an increase in the proportion of respondents who never smoked (30% to 41%). Figure 26: Smoking status in the past 12 months among residents aged 15+, NWT 1996 2009 Significant difference at the.05 level between 1996 and 2009. Page 30