Summary of results for the Canadian Student Tobacco, Alcohol and Drugs Survey 2016-17

Background

The 2016-17 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), previously called the Youth Smoking Survey (YSS), is the ninth cycle of data collection on student tobacco, alcohol, and drug use. A total sample of 52,103 students in grades 7 to 12 (secondary I through V in Quebec) completed the survey, which ran between October 2016 and June 2017 in nine Canadian provinces^Footnote1. The weighted results represent over 2 million Canadian students. CSTADS 2016-17 collected information on tobacco use, alcohol and drug use, as well as information on bullying, mental health, and school connectedness. Prior cycles of CSTADS collected tobacco-related data from students in grade 6. The results below reflect a reanalysis of the CSTADS 2014-15 data to include only students in grades 7 to 12 for accurate comparison to CSTADS 2016-17 data.

The Summary of Results presents data from the 2016-17 cycle of CSTADS. Detailed tables and definitions are provided.

Cigarette Use

In 2016-17, 18% of students in grades 7 to 12 (approximately 383,000) had ever tried smoking a cigarette, even just a puff. In grades 7 to 9, 9% of students had ever tried smoking a cigarette and in grades 10 to 12, 28% of students reported the same. These results were unchanged from 2014-15.

In 2016-17, 3% of students in grades 7 to 12 (approximately 66,000 students) were current cigarette smokers, with 1% smoking daily and 2% smoking occasionally. The prevalence of current smoking (3%) was unchanged from 2014-15.

The average age at which students in grades 7 to 12 first tried smoking, even just a puff, was 13.6 years, unchanged from 2014-15.

Smoking by Province

In 2016-17, the prevalence of having ever tried smoking a cigarette ranged from a low of 15% in Ontario to a high of 34% in Saskatchewan among students in grades 7 to 12. The prevalence of current smoking ranged from a low of 2% in British Columbia to a high of 8% in Newfoundland and Labrador and Saskatchewan.

Source of Cigarettes

The majority (78%) of Canadian students who smoked in the past 30 days got their cigarettes from social sources rather than retail sources. Social sources include friends, family, and others, regardless of whether the cigarettes were given freely, paid for, or stolen. Accessing cigarettes through social sources was higher among students in grades 7 to 9 (93%) than those in grades 10 to 12 (75%).

Most students in grades 7 to 12 (62%) thought it would be "fairly easy" or "very easy" to get a cigarette if they wanted one.

Electronic Cigarettes

In 2016-17, the prevalence of ever trying an e-cigarette increased to 23% (approximately 470,000 students) from 20% in 2014-15. Ten percent (10%) of students (approximately 206,000) had used an e-cigarette in the past 30 days, an increase from 6% in 2014-15. Prevalence of past-30-day use of e-cigarettes was higher among males (12%) than females (8%) and higher among those in grades 10 to 12 (15%) than students in grades 7 to 9 (5%).

Among students who used an e-cigarette in the past 30 days, 57% had used an e-cigarette on three or fewer days, while 11% reported daily use. Daily use of an e-cigarette in the past 30 days was higher among males (14%) than females (5%). This was a new question for the 2016-17 cycle.

Of the students who had used an e-cigarette in the past 30 days, 17% were current smokers, 12% were former smokers, 35% were experimental smokers or puffers, and 36% indicated that they had never smoked a cigarette, not even a puff.

Thirteen percent (13%) of students (approximately 265,000) in grades 7 to 12 had ever tried both cigarettes and e-cigarettes, unchanged from 2014-15. Among students who had tried both cigarettes and e-cigarettes, 54% tried a cigarette first (approximately 141,000 students), 35% (approximately 92,000 students) tried an e-cigarette first and the remainder could not remember or provided inconsistent answers. The prevalence of trying an e-cigarette first was higher among students in grades 7 to 9 (39%) than in grades 10 to 12 (34%).

Half of students in grades 7 to 12 (53%) thought it would be "fairly easy" or "very easy" to get an e-cigarette if they wanted one, unchanged from 2014-15.

Source of Electronic Cigarettes

For the first time, the 2016-17 cycle of CSTADS included a question on the source of e-cigarettes. Less than one quarter (22%) of students in grades 7 to 12 who used an e-cigarette in the past 30 days got their e-cigarette from a retail source. Retail sources include purchases made in store and/or online. Accessing e-cigarettes through retail sources was higher among students in grades 10 to 12 (24%) than those in grades 7 to 9 (16%) and higher among males (28%) than females (12%).

Perceived risk of harm of cigarettes and e-cigarettes

Students in grades 7 to 12 were asked how much they think people risk harming themselves when they smoke cigarettes or use an e-cigarette.

Smoking cigarettes once in a while was perceived to be a "slight risk" or "moderate risk" by most students (78%). The majority of students (65%) thought there was "great risk" of harm from smoking cigarettes on a regular basis.

Almost one in four students (23%) thought there was "no risk" of harm from using an e-cigarette once in a while, compared to 8% who thought there was "great risk". Using an e-cigarette on a regular basis was thought to pose "no risk" of harm by 10% of students and "great risk" of harm by 26%. One in ten students (10%) were unaware how much a person risked harming themselves by using an e-cigarette once in a while or on a regular basis.

The perception of risk of harm from smoking cigarettes and using e-cigarettes varied by smoking status, with current and former smokers attributing less risk to the use of cigarettes and e-cigarettes than never smokers.

Use of Any Tobacco Product

Students were asked about their use of the following tobacco products: cigarettes (including menthol and roll-your-own), cigars, little cigars or cigarillos, smokeless tobacco, waterpipes, and blunt wraps.

In 2016-17, 23% of students in grades 7 to 12 (approximately 474,000 students) had ever tried at least one of these products. Less than half as many (10% or approximately 204,000 students) had used at least one tobacco product in the past 30 days, down from 12% in 2014-15. Prevalence of past-30-day use of a tobacco product in 2016-17 was higher among males (12%) than females (8%) and higher among students in grades 10 to 12 (16%) than students in grades 7 to 9 (4%).

Cigarettes (18%) were the tobacco products most commonly ever tried by students in grades 7 to 12, followed by little cigars (12%), cigars (9%), waterpipes (9%), smokeless tobacco (5%), roll-your-own tobacco (5%), and blunt wraps (4%). Use of cigarettes (6%) in the past 30 days was more common than use of waterpipes (3%), little cigars (3%), cigars (3%), smokeless tobacco (2%), blunt wraps (2%), and roll-your-own tobacco (2%).

Flavoured Tobacco Use

The 2016-17 cycle of CSTADS included a question on the initiation of flavoured tobacco products. One third (35%) of students who had used a tobacco product (approximately 153,000) reported that the first tobacco product they used was flavoured. A higher percentage of grade 10 to 12 students (37%) than grade 7 to 9 students (28%) reported that the first tobacco product they used was flavoured.

Students were asked if they had used any of the following flavoured tobacco products in the past 30 days: menthol cigarettes, little cigars or cigarillos, cigars, waterpipe tobacco, and smokeless tobacco. Six percent (6% or approximately 121,000 students) of all students in grades 7 to 12 had used a flavoured tobacco product in the past 30 days. Prevalence of use was higher among males (8%) than females (4%). Prevalence of past-30-day use of a flavoured tobacco product was 10% among students in grades 10 to 12 versus 2% among students in grades 7 to 9.

Overall, 3% of students (approximately 51,000 students) had used menthol cigarettes, even just a puff, in the past 30 days, unchanged from 2014-15. The prevalence of using a waterpipe to smoke flavoured waterpipe tobacco in the past 30 days was 2%, a decrease from 2014-15 (3%). At 2%, the prevalence of use of flavoured little cigars or cigarillos in the past 30 days decreased from 4% in 2014-15. The prevalence of use of flavoured cigars in the past 30 days was 2%, a decrease from 2014-15 (3%).

Alcohol

Alcohol remains the substance with the highest prevalence of use by Canadian students in grades 7 to 12.

After decreasing through successive cycles of the survey (from 53% in 2008-09), the prevalence of use of alcohol in the past 12 months by students in grades 7 to 12 increased to 44% (approximately 859,000) from 2014-15 (40%).

On average, students tried their first alcoholic beverage at 13.4 years of age, unchanged compared to a mean age of 13.5 in the previous cycle (2014-15). Females were slightly older when they tried their first drink than males (13.6 years versus 13.2 years).

Just under one quarter of students (24%, approximately 487,000) reported high risk drinking behaviour (i.e., five or more drinks on one occasion) in the past 12 months, which was unchanged from 2014-15.

In 2016-17, 35% of students (approximately 727,000) in grades 7 to 12 reported drinking an energy drink (such as Red Bull^®or Rock Star^®) in the past 12 months. The prevalence of students who reported drinking alcohol and an energy drink on the same occasion (separately or mixed together) in the past 12 months was 16% in 2016-17 (approximately 319,000), which was unchanged from 2014-15.

When students were asked how difficult they thought it would be to get alcohol if they wanted some, 69% (approximately 1.4 million) responded that they thought it would be "fairly easy" or "very easy", which was unchanged compared to last cycle (67%).

Cannabis

Cannabis, which includes marijuana, hash and hash oil, has the highest prevalence of use after alcohol.

In 2016-17, 17% of students in grades 7 to 12 (approximately 340,000) reported using cannabis in the year preceding the survey, unchanged from 2014-15.

Past 12-month use of cannabis by males was 18% and by females was 16%, both unchanged from the previous cycle. However, prior to 2014-15, the prevalence of use by males exceeded that of females.

The results of the 2016-17 survey showed that grade 7 to 12 students were on average 14.2 years old when they first used cannabis, unchanged from the previous cycle. Females were slightly older than males when they first used it in 2016-17 (mean age of 14.4 years and 14.1 years, respectively.)

For the first time, grade 7 to 12 students were asked about their methods of cannabis consumption. Among students who used cannabis, smoking (e.g., a joint, bong, etc.) was the most common method (80%, approximately 340,000), followed by edibles (34%, approximately 143,000), vaping (30%, approximately 123,000), and dabbing (22%, approximately 91,000). Drinking cannabis was the least reported method of consumption among students (14%, approximately 58,000). Approximately 25% of students who use cannabis (approximately 101,000) also reported using another method.

In the 2016-17 survey, students in grades 7 to 12 were asked how much they thought people risk harming themselves when they smoke marijuana or cannabis. Nineteen percent (19%) of the students (approximately 393,000) thought that smoking cannabis once in a while put people at "great risk" of harming themselves, a decrease from 2014-15 (25%). There was an increase from 14% to 18% (approximately 363,000 students) that thought there was "no risk". When asked about smoking cannabis on a regular basis, the prevalence of students who thought that people were at "great risk" of harming themselves decreased from 58% in 2014-15 to 54% (approximately 1.1 million) in 2016-17, while students who thought there was "no risk" increased to 9% (approximately 189,000) compared to 7% last cycle.

Students in grades 7 to 12 were asked how difficult they thought it would be to get cannabis if they wanted it and 39% (approximately 794,000) reported that they thought it would be "fairly easy" or "very easy" to obtain, unchanged from 2014-15 (41%).

Almost 55% of students in grades 7 to 12 (approximately 1.1 million) indicated that they had not used either alcohol or cannabis in the past 12 months, a decrease from 2014-15 (59%). Unchanged from the previous cycle, 16% of the students (approximately 306,000) reported that they had used both substances in the past 12 months. The survey did not include questions about whether the substances were used on the same occasion. Less than 1% of students (approximately 16,000) indicated that they had used cannabis, but not alcohol in the past year, a slight decrease from 2014-15.

Illicit and other drugs

Past 12-month use of synthetic cannabinoids was reported by 3% of grade 7 to 12 students (approximately 68,000), which was unchanged from the previous cycle. There was also no change, compared to last cycle, among males (4%), females (3%), and both grade groupings (grades 7 to 9, 2% and grades 10 to 12, 5%).

Use of salvia in the past year continued to decrease from a high of 5% in 2008-09 to 1.3% in 2014-15, and 0.9% (approximately 18,000 students) in 2016-17^Footnote2.

Problematic Use of Psychoactive Pharmaceuticals

In 2016-17, the prevalence of past year use of psychoactive pharmaceuticals to get high increased from 4% last cycle to 6% (approximately 115,000 students). Psychoactive pharmaceuticals include sedatives/tranquilizers, stimulants and prescription pain relievers.

Among the three classes of psychoactive pharmaceuticals surveyed, the past 12-month use of prescribed pain relievers to get high was 3% (approximately 61,000 students), which was unchanged from last cycle. There was no change in the prevalence of past 12-month use of oxycodone (1%, approximately 24,000 students) or of fentanyl (0.5 %, approximately 10,000 students)^Footnote3 to get high. The prevalence of past 12-month use of other prescribed pain relievers (e.g., morphine, codeine, Tylenol 3^®, etc.) remained unchanged and was reported at 3% (approximately 52,000 students).

In 2016-17, 3% of students in grades 7 to 12 (approximately 71,000) reported using stimulants, including medications used to treat attention deficit hyperactivity disorder (ADHD), to get high over the past 12 months, representing an increase from 2% last cycle. The use of sedatives/tranquilizers to get high over the past 12 months increased from 1% last cycle to 2% (approximately 36,000 students) in 2016-17.

Students in grades 7 to 12 were asked how much they thought people risk harming themselves when they use prescription medication to get high. Forty percent (40%) of students (approximately 819,000) indicated that they thought there was a "great risk" of people harming themselves when they use prescription medication to get high once in a while. The perception of "great risk" was unchanged at 72% (approximately 1.5 million) when students were asked about use on a regular basis. The perception of "no risk" of harm when prescription medication is used to get high either once in a while (5%, approximately 109,000 students) or on a regular basis (5%, approximately 92,000 students) increased from 2014-15 (4% and 3%).

When asked how difficult students felt it would be to get prescription medicine if they wanted it, 25% (approximately 515,000 students) thought it would be "fairly easy" or "very easy" to obtain prescription pain relievers, a decrease from 2014-15 (37%). Twenty-eight percent (28%, approximately 561,000 students) thought the same about the ease of obtaining medicine used to treat ADHD.

Problematic Use of Over the Counter Medications

Dextromethorphan is an active ingredient found in many over-the-counter cough suppressant cold medicines. In 2016-17, the prevalence of past 12-month dextromethorphan use to get high among students in grades 7 to 12 increased to 5% (approximately 108,000) from 1% in 2014-15. The use of sleeping medication available from a drugstore (such as Nytol^®or Unisom^®) to get high also increased from 1% in 2014-15 to 4% (approximately 73,000 students) in 2016-17.

Past 12-month use of Gravol^®to get high, which was measured for the first time in 2014-15, increased to 4% (approximately 83,000 students) in 2016-17 from 1% in 2014-15.

Acknowledgement

Health Canada's Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), was conducted for Health Canada by the Propel Centre for Population Health Impact at the University of Waterloo.

Reference Information

CSTADS was developed to provide timely, reliable and continual monitoring of tobacco, alcohol and drug use in school-aged youth. CSTADS provides essential input to the development of policies and programs. The next survey is expected to be carried out during the 2018-19 school year.

For more information about the survey and/or its results, please contact Health Canada by e-mail (odss-bssd@hc-sc.gc.ca).