Results at a Glance - Evaluation of the Health Portfolio Tobacco and Vaping Activities 2016-17 to 2020-21 – December 2021 - Office of Audit and Evaluation

Program Context

Under Canada's Tobacco Strategy (CTS), Health Canada committed to:

• helping Canadians quit tobacco, and
• protecting youth and non-tobacco users from nicotine addiction.

The Public Heath Agency of Canada (PHAC) contributes to helping Canadians quit tobacco by supporting tobacco cessation and prevention interventions for Canadians with a focus on those facing health inequalities and at highest risk of tobacco use. PHAC and Health Canada also support global tobacco control efforts.

Over five years:

HC: $191M
PHAC: $13M

Evaluation Approach

This evaluation examined the performance and efficiency of Health Canada and PHAC tobacco and vaping activities for the period 2016-17 to 2020-21.

Figure 1 - Text description

Evaluation Approach

• Document and File Review
• Literature Review
• Financial Data Review
• Key Informant Interviews
• Limited Jurisdictional Comparison
• Data Anlysis

What the Evaluation Found

Tobacco prevalence rates have declined from 17.7% in 2015 to 14.8% in 2019. Over the last five years, Health Canada has made significant progress on the development, implementation and enforcement of the Tobacco and Vaping Products Act (TVPA), which was enacted in May 2018. In collaboration with its partners, such as PHAC, Health Canada also developed and implemented the new Canada's Tobacco Strategy (CTS). In addition, Health Canada and PHAC brought Canadian perspectives forward in global discussions and contributed to shaping the international tobacco control agenda.

Although they are not harmless, the CTS recognized vaping products containing nicotine as being a source of nicotine that is a less harmful option than smoking if someone switches completely to vaping, and integrated this view into the broad approach for dealing with tobacco use. The CTS also acknowledged that tobacco use is not equally spread across the population, and makes groups who experience higher rates of smoking a key priority. Health Canada and PHAC have funded a variety of prevention and cessation projects, and performance data available for some of the more mature projects show that they have supported participants to quit smoking. Newer PHAC projects are aiming to reach groups that experience health inequalities and face higher rates of tobacco use than the general population, in line with the CTS priority.

Recent Health Canada and PHAC initiatives, for example new regulations and funded tobacco cessation projects, should help contribute to planned tobacco and vaping outcomes. However, more work is required to move towards the CTS goal of less than 5% tobacco use by 2035 and to address the rapid rise in youth vaping.

Some challenges identified by the evaluation include:

• Health Canada has not communicated a plan for tobacco and vaping activities to external stakeholders in an integrated way, leading to a lack of awareness about Health Canada's contributions to the goal of less than 5% by 2035 and the issue of youth vaping.
• Some Health Canada information technology systems are outdated or non-existent, leading to extra time to process data, and to missed opportunities to collect and analyze information that could inform the program.
• Health Canada's resources were largely focused on vaping activities in recent years, resulting in reduced tobacco activities.
• Health Canada's website includes information regarding health hazards arising from vaping use, and it is important that the most up-to-date information continue to be reflected.

The findings from this evaluation resulted in the four recommendations listed below, all of which are directed to Health Canada. There are no recommendations for PHAC, given that actions to address shortcomings found during the evaluation in terms of knowledge exchange and performance measurement issues are already underway.

Recommendations

1. Communicate to partners and stakeholders, Health Canada's action plan for the Department's contribution to achieving CTS goals and for addressing youth vaping.
2. Enhance information technology systems and data analytics capacity to support program activities.
3. Examine resource distribution between tobacco and vaping activities.
4. Review and update the Health Canada website to reflect the most up-to-date science and public health advice on health risks and benefits of vaping.