Canadian Tobacco Alcohol and Drugs  (CTADS): 2013 summary

Canadian Tobacco, Alcohol and Drugs Survey (CTADS)

Introduction

The Canadian Tobacco, Alcohol and Drugs Survey (CTADS) is a biennial general population survey of tobacco, alcohol and illicit drug use among Canadians aged 15 years and older. It replaces the Canadian Tobacco Use Monitoring Survey (CTUMS) which was conducted from 1999-2012 and the Canadian Alcohol and Drug Use Monitoring Survey (CADUMS) which was conducted from 2008-2012. The CTADS merged the core tobacco content from CTUMS and the core drug and alcohol content from CADUMS resulting in more efficient data collection and providing a tool to monitor and compare the use of multiple products and substances with addictive properties. The CTADS is conducted by Statistics Canada on behalf of Health Canada.

Understanding Canadian trends in tobacco, alcohol and drug use is vital to the effective development, implementation and evaluation of national and provincial strategies, policies and programs.

The following report presents results from the first biennial CTADS data collection, which commenced in February 2013 and ended in December 2013. The results for 2013 are based on telephone interviews with 14,565 respondents across all 10 provinces, representing 29,043,889 Canadian residents aged 15 years and older. The current Summary of Results for 2013 presents data from the latest CTADS. A discussion of the results from CTADS 2013, detailed tables and some definitions used in this report are also provided.

Tobacco Products and E-cigarette Use

According to the Canadian Tobacco, Alcohol and Drugs Survey (CTADS), the overall smoking prevalence in 2013 was 15% (4.2 million smokers), unchanged from 2012 (16%, about 4.6 million smokers), but the lowest national smoking rate ever recorded. Eleven percent (11% or 3.1 million) reported smoking daily, while 4% (1.1 million) reported smoking occasionally. More males (16%) reported smoking than females (13%). Daily smokers smoked an average of 13.9 cigarettes per day, lower than the average cigarettes per day smoked in 2012 (15.0).

Youth Smoking (Aged 15-19 Years)

In 2013, current smoking among youth aged 15 to 19 years was 11% (approximately 225,000 teens). This is the lowest rate of current smoking recorded for this age group since Health Canada first reported smoking prevalence. Five percent (5%) of youth reported smoking daily, and consumed an average of 9.2 cigarettes per day, while 6% of youth reported smoking occasionally. A higher percentage of male than female youths reported currently smoking (13% and 8%, respectively).

In 2013, the smoking rate among youth aged 15 to 17 years was 6% (82,000), the lowest ever recorded. The 2013 current smoking rate was 8% for males and 5% for females. Two percent (2%) of youth aged 15 to 17 smoked daily, a decrease from the rate reported in 2012 (4%). Daily smokers in the age group consumed an average of 8.5 cigarettes per day.

Eighteen percent (18%) of older youth aged 18 to 19 years (143,000) were current smokers in 2013. Ten percent (10%) smoked daily and 8% smoked occasionally. Daily smokers in this age group consumed an average of 9.5 cigarettes per day. There was a higher percentage of male (19%) than female (13%) youth aged 18-19 years who were current smokers.

Young Adult Smoking (Aged 20-24 Years)

The prevalence of smoking among young adults aged 20 to 24 years was 18% (435,000 young adults) in 2013. The current smoking rate for young adult males was 21%, higher than the rate for females, which was 15%.

The rate of daily smoking among young adults in 2013 was 11% a higher percentage of daily smoking among males (13%) than females (8%). Young adults who reported smoking daily consumed an average of 11.8 cigarettes per day.

Adult Smoking (Aged 25 Years and Older)

Fifteen percent (15%) of Canadians aged 25 years and older were current smokers (3.6 million) in 2013. There was no statistical difference between male and female current smoking rates (16% compared to 14%, respectively). The rate of daily smoking was 11% and there was also no difference between males and females (12% of males compared with 11% of females). Males who smoked daily consumed an average of 15.8 cigarettes per day, a higher number than for females (12.7).

Consumption of Cigarettes

Canadian daily smokers aged 15 years and older consumed an average of 13.9 cigarettes per day in 2013, a decrease from the average of 15.0 cigarettes per day reported in 2012. Male daily smokers consumed more cigarettes per day (an average of 15.2) than female daily smokers (an average of 12.5).

Provinces

Provincial current smoking rates for Canadians aged 15 and older ranged from a low of 11% in British Columbia to a high of 20% in New Brunswick. Cigarette consumption ranged from a low of 12.9 cigarettes per day in British Columbia to a high of 15.6 in Quebec.

Cigars: Regular and Little/Cigarillos

Approximately, 3% (1.0 million) of all Canadians aged 15 and older, 5% (104,000) of youths aged 15 to 19, and 7% (172,000) of young adults aged 20 to 24 reported smoking any type of cigar^{Footnote 1} in the past 30 days in 2013.

Five percent (5% or 55,000) of all cigar smokers were under the legal age to purchase tobacco in their province of residence.

Approximately 3% (759,000) of Canadians aged 15 years and older reported smoking little cigars or cigarillos in the past 30 days. Among Canadian youth aged 15 to 19, 4% (91,000 youth) and 6% (147,000) of young adults aged 20 to 24 reported smoking a little cigar or cigarillo in the past 30 days.

Reducing the appeal of little cigars to youth is an important goal of the Tobacco Act as amended in 2009 by the Cracking Down on Tobacco Marketing Aimed at Youth Act. These amendments came into force in 2010. While it may not be possible to fully evaluate the impact of these amendments on youth smoking of little cigars based only on prevalence, it is worth noting that the percentage of youth aged 15 to 19 who reported smoking little cigars in the past 30 days has declined from 8% (183,000) in 2009, to 6% (141,000) in 2010 and most recently to 4% (91,000) in 2013. Of youth aged 15 to 19 who smoked little cigars/cigarillos in 2013, 62% (56,000) smoked flavoured little cigars/cigarillos, while 19% (17,000) of youth smoked both flavoured and unflavoured little cigars/cigarillos.

Water-Pipe Tobacco

In 2013, 10% or 2.8 million Canadians aged 15 years and older reported having ever tried a water-pipe. Fourteen percent (14% or 296,000) of Canadian youth aged 15 to 19 and 29% (694,000) of young adults aged 20 to 24 reported having ever tried a water-pipe.

Less than1% of Canadians 15 years and older (229,000), 3% (63,000) of youth aged 15-19, and 4% (86,000) of young adults aged 20-24 reported smoking a water-pipe in the past 30 days. These results were the same as in 2012 and 2011, the first time past 30 day use of a water pipe was asked.

When Canadians who reported using a water-pipe during the past 30-days were asked about their beliefs regarding the risks and benefits associated with smoking a water-pipe compared to cigarettes, 34% thought that smoking tobacco in a water-pipe was more harmful, 28% thought it was neither more harmful nor less harmful and 38% thought it was less harmful, than cigarettes.

Smokeless Tobacco

In 2013, 8% of Canadians 15 years and older reported having ever tried smokeless tobacco products. Six percent (6%) of youth or 126,000 youth aged 15 to 19 and 10% of young adults (233,000) aged 20 to 24 reported having ever tried smokeless tobacco. The prevalence of smokeless tobacco use within the past 30 days was under 1% for Canadians aged 15 years and older and 1% for both youth aged 15 to 19 and for young adults aged 20 to 24.

Cigarette Sources

According to CTADS 2013, most (58%) current smokers usually bought their cigarettes from a small grocery or corner store and at gas stations (18%). First Nations Reserves were reported as the usual cigarette source for 2% of smokers.

Forty-two percent (42%) of youth smokers aged 15 to 19 obtained their cigarettes from a small grocery store, while 11% got them from a gas station. Thirty-two percent (32%) of youth obtained their cigarettes for free from a family member, a friend or someone else.

Among youth who were too young to purchase cigarettes legally in their province of residence, 34% got their cigarettes from a regular retail source in 2013.

Cheaper Cigarettes

CTADS includes questions about efforts smokers have made in the past 6 months to purchase cigarettes at a cheaper cost. Ten percent (10% or 420,000 Canadians) purchased cigarettes from a First Nations Reserve and 2% (79,000) reported they purchased cigarettes that may have been smuggled. Some smokers reported more than one source, so these numbers should not be added. Fifteen percent (15% or 33,000) of youth aged 15 to 19 and 16% (70,000) of young adults aged 20 to 24 purchased cigarettes from a First Nations Reserve in the past 6 months.

Electronic Cigarettes

CTADS is the first national survey in Canada to include questions about the use of electronic cigarettes (e-cigarettes). Overall, 9% (2.5 million) of Canadians 15 years and older have ever tried an e-cigarette. Twenty percent (20% or 417,000) of youth aged 15 to 19 and 20% (488,000) of young adults aged 20 to 24 have ever tried an e-cigarette.

Past 30 day use of e-cigarettes among Canadians 15 years and older was 2% (521,000 Canadians), 3% (54,000 youth) among youth aged 15 to 19 years and 4% (95,000 young adults) among young adults aged 20 to 24.

Of Canadians who had ever tried an e-cigarette, the majority (55% or 1.3 million) reported that the last e-cigarette they used did not contain nicotine, compared to 26% (or 650,000) who reported using an e-cigarette with nicotine, while 19% (or 466,000) were unsure.

Approximately, one half (51% or 696,000) of current or former smokers who had ever tried an e-cigarette reported using it as a cessation aid in the past two years. CTADS did not include questions about the success of any smoking cessation attempts using e-cigarettes.

Drug Use and Abuse

In 2013, the use of at least one of six illicit drugs in the past 12 months (cannabis, cocaine or crack, speed, ecstasy, hallucinogens or heroin) was reported by 11% of Canadians (3.1 million) and is not different from 2012 (11% or 2.9 million). The reported rate of such use by males (14% or 2.0 million) was higher than that reported by females (8% or 1.0 million), while the rate of use by youth aged 15 to 19 (23% or 473,000) and young adults aged 20 to 24 (27% or 651,000) was approximately 3 times higher than that reported by adults (8% or 2.0 million).

Use of at least one of five illicit drugs excluding cannabis in the past 12 months (cocaine or crack, speed, ecstasy, hallucinogens or heroin) was reported by 2% of Canadians (458,000) and is unchanged from 2012 (2% or 561,000). The reported rate of such use by males (2% or 342,000) was approximately double that reported by females (1% or 116,000), while the rate of use by youth aged 15 to 19 (5% or 86,000) and young adults aged 20 to 24 (6% or 156,000) was substantially higher than that reported by adults (1% or 216,000).

Cannabis Use

The prevalence of past-year cannabis use among Canadians aged 15 years and older was 11% (3.1 million) in 2013, unchanged from 10% (2.8 million) in 2012. The prevalence rate in 2013 among youth aged 15 to 19 (22% or 469,000) and among young adults aged 20 to 24 (26% or 635,000) was higher than that among adults 25 years and older (8% or 1.9 million). Youth initiated use of cannabis at a younger age (15.1 years) than both young adults (16.6 years) and adults (18.3 years).

The prevalence of past-year cannabis use in 2013 was higher among males (14% or 2.1 million), than females (7% or 1.0 million). There was no difference between the sexes in age of initiation (17.8 years for males versus 18.1 years for females).

Provincial prevalence of past-year cannabis use ranged from 8% in Saskatchewan to 13% in British Columbia. Each province's past-year cannabis prevalence was compared with the average prevalence for the nine remaining provinces. Of these, Saskatchewan had a lower than average prevalence, while British Columbia showed a higher than average prevalence.

Other Illicit Drug Use

In 2013, past-year use of the most commonly reported illicit drugs after cannabis was estimated to be less than 1% for each (cocaine or crack (0.9% or 259,000), hallucinogens (0.6% or 163,000), ecstasy (0.4% or 111,000), speed/methamphetamine (0.2% or 48,000)). Past-year use of heroin is not reportable. There were no changes in prevalence of use of any of these drugs individually, between 2013 and 2012.

Past-year use of each of the following illicit drugs for males was at least double that of females (cocaine or crack (1.3% for males versus 0.5% for females), hallucinogens (0.9% for males versus 0.3% for females), ecstasy (0.6% for males versus 0.1% for females), speed/methamphetamine (0.2% for males versus 0.1% for females)).

Use and Abuse of Psychoactive Pharmaceutical Drugs

CTADS includes questions relating to the abuse of three classes of psychoactive pharmaceutical drugs. The three classes of drugs are: opioid pain relievers, stimulants (such as medication prescribed for Attention Deficit Hyperactivity Disorder) and tranquillizers and sedatives. While these drugs are prescribed for therapeutic purposes, they have the potential to be abused due to their psychoactive properties. To provide a baseline on overall use, including therapeutic use and abuse, respondents were asked whether or not they had used opioid pain relievers, stimulants, or sedatives. Among those who had used these drugs, further questions were asked to determine whether the drugs were used for reasons other than for prescribed therapeutic purposes.

The overall rate of psychoactive pharmaceutical use among Canadians aged 15 years and older was 22% (6.4 million) and was no different from 2012 (24% or 6.6 million). The rate of such use among youth aged 15 to 19 and adults aged 20 to 24 (18% or 383,000 and 20% or 486,000, respectively), was lower than for adults aged 25 and older (23% or 5.5 million). Prevalence among females (25% or 3.7 million) was higher than for males (19% or 2.7 million).

In 2013, of Canadians aged 15 years and older who indicated they had used a psychoactive pharmaceutical in the past year, 2% (146,000 Canadians, corresponding to 0.5% of the total population) reported they abused such a drug (i.e. used it for the experience, the feeling it caused, to get high or for "other" reasons). These rates of abuse are lower than in 2012, when 6.3% of users (corresponding to 1.5% of the total population) reported they had abused such a drug. There was no difference in the rates of abuse between males (3% or 75,000) and females (2% or 71,000) who had used these products in the past year. The rates of abuse were higher for youth aged 15 to 19 (10% or 36,000) and young adults aged 20 to 24 (9% or 40,000) compared to adults aged 25 years and older (1% or 70,000).

Opioid Pain Relievers

Of the three categories of pharmaceuticals, opioid pain relievers were the most commonly used in 2013, with one in seven (15% or 4.3 million) Canadians aged 15 years and older reporting their use in the 12 months preceding the survey. There was a decrease in the prevalence of past-year use of opioid pain relievers compared with 2012 (17%).

Among users of opioid pain relievers, 2% (99,000 Canadians representing 0.3% of the total population) reported abusing them, a decrease from 2012 (5% of users or 0.9% of the total population). The prevalence of abuse among opioid users was 3% (52,000) for males, while the rate for females was not reportable. The rate of abuse among youth (aged 15 to 19) who used opioids was 6% (16,000), while the rate of abuse among young adults (aged 20 to 24) and adult (aged 25 years and older) opioid users was not reportable.

CTADS 2013 included a question to determine whether users of opioid pain relievers tampered with their medication prior to use: "During the past 12 months did you ever tamper with a pain reliever product before taking it, for example, crush tablets to swallow, snort or inject?" When tampering was added to the existing definition of abuse, it did not result in any change in pain reliever abuse.

Stimulants

In 2013, 1% (256,000) of Canadians aged 15 years and older used a stimulant in the past 12 months, a decrease from 2012 (2%). Prevalence among youth aged 15 to 19 (3% or 73,000) and young adults aged 20 to 24 (2% or 45,000) was higher than among adults aged 25 years and older (1% or 138,000), while there was no difference in prevalence between males and females (1% or 139,000 for males and 1% or 117,000 for females).

Sixteen percent (16%) of people who used stimulants (or 39,000 Canadians, representing 0.1% of the total population) reported abusing them, a decrease from the rate reported in 2012 (40%) of users (168,000 Canadians, representing 0.6% of the Canadian population). The rate of abuse for youth aged 15 to 19 was 32% (20,000) and 40% (14,000) for young adults aged 20 to 24, while the rate for adults aged 25 and older was not reportable.

Sedatives

The prevalence of past-year use of sedatives by Canadians aged 15 years and older was 10% (3.0 million), no different from the rate reported in 2012 (10% or 2.8 million). There was higher prevalence of such use by females (13% or 2.0 million) compared with males (7% or 1.0 million). The prevalence of past year use of sedatives was 2 to 3 times higher among adults aged 25 years and older (12% or 2.8 million) than for youth aged 15 to 19 (4% or 75,000) and young adults aged 20 to 24 (5% or 114,000). There were too few Canadians who reported abuse of sedatives, measured by use for the experience, the feeling they cause or to get high, for the estimate to be reportable.

Harms Related to Illicit Drug Use

In 2013, 3% (821,000) of Canadians aged 15 years and older reported experiencing at least one harm in the past year due to their illicit drug use, an increase from the rate reported in 2012 (2%). The prevalence of reported harm due to their own illicit drug use was 2 times higher among males (4%or 544,000) than females (2% or 277,000). Youth aged 15 to 19 years (8% or 170,000) and young adults aged 20 to 24 (8% or 204,000) reported harm due to their own illicit drug use at a rate 4 times that of adults aged 25 and older (2% or 447,000). Among current users of any illicit drug and individuals who reported abuse of psychoactive pharmaceuticals, one in five (20% or 636,000) reported having experienced some harm in the past year due to their drug use, unchanged from 2012 (17%).

Alcohol

Prevalence of Alcohol Use

In 2013, 76% (representing 21.9 million) of Canadians reported drinking alcohol in the past year, unchanged from the rate reported in 2012 (78%). A higher percentage of males than females reported past-year alcohol use (81% or 11.5 million versus 71% or 10.4 million, respectively). Sixty percent (60% or 1.3 million) of youth aged 15 to 19, 83% (2.0 million) of young adults aged 20 to 24 and 77% (18.6 million) of adults aged 25 years and older reported past-year drinking.

Provincial rates of current drinking ranged from 73% in Newfoundland and Labrador and Ontario to 83% in Quebec. Each province's past-year alcohol prevalence was compared with the average for the nine remaining provinces. Two provinces had lower than average prevalence (Newfoundland and Labrador and Ontario), while the prevalence of past-year alcohol use in Quebec was higher than average.

Low-risk Alcohol Use

Canada's Low-Risk Alcohol Drinking Guidelines^{Footnote 2} (LRDG), consist of five guidelines and a series of tips. Guidelines 1 and 2, and acute and chronic effects, are explained in the definitions section below. People who drink within the low-risk alcohol drinking guidelines consume no more than the recommended quantity of alcohol within the number of days specified, whereas those who exceed the guidelines consume more alcohol than recommended within the stated timeframe. The basis of the LRDG is reported alcohol consumption in the 7 days prior to the survey.

Among people who consumed alcohol in the past 12 months, 21% (representing 16% of the total population or 4.4 million Canadians) exceeded guideline 1 for chronic effects and 15% (11% of the total population or 3.1 million Canadians) exceeded guideline 2 for acute effects. A higher percentage of males than females drank in patterns that exceeded both guidelines. The chronic-risk guideline was exceeded by 23% (2.6 million) of male drinkers and 18% (1.8 million) of female drinkers, while the acute-risk guideline was exceeded by 18% (2.0 million) of male drinkers and 11% (1.1 million) of female drinkers. The guidelines were exceeded by young adults aged 20 to 24 years at higher rates than among youth aged 15 to 19 and adults aged 25 years and older. Twenty-nine percent (29% or 575,000) of young adult drinkers versus 20% for both youth drinkers (245,000) and adult drinkers (3.5 million) exceeded the guideline for chronic risk, while the acute-risk guideline was exceeded by 23% (457,000) of young adult drinkers compared to 15% (185,000) of youth drinkers and 14% (2.5 million) of adult drinkers.

Reference Information

Statistics Canada conducts CTADS on behalf of Health Canada. The target population for CTADS is all persons 15 years of age and older living in Canada, excluding residents of the Yukon, Northwest Territories and Nunavut.

To allow provincial comparisons of approximately equal reliability, the overall sample size for the survey is divided equally across all 10 Canadian provinces. A sample of about 14,000 respondents (the approximate sample size for a full year of data) consists of 7,000 individuals aged 15-24, and 7,000 individuals aged 25 and older across Canada, with a distribution of 700 individuals in each of the two age groups per province.

CTADS is a random digit dialling survey, where telephone numbers are generated randomly by computer and interviews are conducted over the telephone. The response rate for the 2013 CTADS was 81.8%. For the purposes of this report only univariate and bivariate analyses were conducted, with statistical t-testing for comparisons. The data presented in this report have been weighted to allow the results to be generalized to the Canadian population using the Canadian Census 2011.

For more information about the survey and its results, please write to the Office of Drug Research and Surveillance, Controlled Substances Directorate, Health Canada, Address Locator 0301A, Ottawa, ON, K1A 0K9, or send an e-mail request to odss.bssd@hc-sc.gc.ca.

For information on the public-use microdata file, please contact Statistics Canada's Client Services, Special Surveys Division (1-800-461-9050; 613-951-3321; facsimile: 613-951-4527; ssd@statcan.gc.ca).