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Socio-economic Status and Smoking in Canada, 1999–2006: Has There Been Any Progress on Disparities in Tobacco Use?

  • Quantitative Research 2008 Student Award Winner
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Abstract

Objectives

Comprehensive tobacco control policies implemented in Canada have succeeded in lowering overall smoking prevalence; however, the extent to which they have impacted socio-economic disparities in tobacco use is not known. This study examined smoking rates and related measures across socio-economic groups over a 7-year period in Canada.

Methods

Regression analyses tested associations between smoking-related outcomes (prevalence, frequency, consumption, quit intentions and attempts, quit ratios), education level and time, using data from adults 25 years and older who completed the 1999 to 2006 waves of the Canadian Tobacco Use Monitoring Survey (CTUMS), a repeated cross-sectional survey with nationally representative samples (n=86,971).

Results

Between 1999 and 2006, smoking prevalence, daily smoking, and cigarette consumption decreased, while the proportion of smokers who planned to quit increased, as did the proportion of ever-smokers who had quit. However, significant educational differences were observed: Canadians with less education had greater odds of current smoking (prevalence approximately doubled between the most and least educated groups) and daily smoking, and consumed more cigarettes, compared to university graduates. Highly-educated ever-smokers were also more likely to have quit smoking. These disparities remained stable over the time period studied. Intentions and attempts to quit were not consistently associated with education.

Conclusions

The decline in smoking among Canadians between 1999 and 2006 represents a major public health achievement. However, considerable smoking-related disparities exist between socio-economic groups, and have changed very little. Therefore, while recent programs and policies have succeeded in reducing overall tobacco use, they have not addressed socio-economic disparities.

Résumé

Objectifs

Les politiques de lutte globale contre le tabagisme mises en œuvre au Canada ont réussi à abaisser la prévalence du tabagisme dans l’ensemble; on ignore cependant leur impact sur les disparités socioéconomiques dans l’usage du tabac. C’est pourquoi nous avons examiné les taux et autres mesures du tabagisme dans divers groupes socioéconomiques sur une période de 7 ans au Canada.

Méthode

Au moyen d’analyses de régression, nous avons testé les associations entre les résultats liés au tabagisme (prévalence, fréquence, consommation, intentions et tentatives de renoncement, ratios de renoncement), le niveau d’instruction et la durée des études. Nos données ont été recueillies auprès d’adultes (25 ans et plus) ayant effectué les cycles 1999 à 2006 de l’Enquête de surveillance de l’usage du tabac au Canada (ESUTC), une enquête transversale répétée auprès d’échantillons représentatifs à l’échelle nationale (n=86 971).

Résultats

Entre 1999 et 2006, la prévalence du tabagisme, le tabagisme quotidien et la consommation de cigarettes ont diminué, tandis que la proportion des fumeurs voulant cesser de fumer a augmenté, ainsi que la proportion des gros fumeurs ayant cessé de fumer. Nous avons toutefois observé des écarts significatifs sur le plan de l’instruction: les Canadiens peu instruits étaient plus susceptibles d’être des fumeurs actuels (la prévalence variait du simple au double entre les groupes les plus et les moins instruits), d’être des fumeurs quotidiens et de fumer plus de cigarettes que les diplômés universitaires. Les gros fumeurs très scolarisés étaient aussi plus susceptibles d’avoir cessé de fumer. Ces disparités sont restées stables au cours de la période de l’étude. Les intentions et les tentatives de renoncement au tabac n’étaient pas associées à l’instruction de façon constante.

Conclusion

La baisse du tabagisme chez les Canadiens entre 1999 et 2006 est une grande victoire pour la santé publique. Cependant, les importantes disparités liées au tabagisme entre les groupes socioéconomiques ont très peu changé. Les politiques et les programmes récents ont réussi à réduire le tabagisme dans l’ensemble, mais ne se sont pas attaqués aux disparités socioéconomiques.

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Authors and Affiliations

  1. Department of Health Studies & Gerontology, University of Waterloo, 200 University Ave. W., Waterloo, ON, N2L 3G1, Canada

    Jessica L. Reid MSc, David Hammond PhD & Pete Driezen MSc

Authors
  1. Jessica L. Reid MSc
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  2. David Hammond PhD
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  3. Pete Driezen MSc
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Correspondence to Jessica L. Reid MSc.

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Reid, J.L., Hammond, D. & Driezen, P. Socio-economic Status and Smoking in Canada, 1999–2006: Has There Been Any Progress on Disparities in Tobacco Use?. Can J Public Health 101, 73–78 (2010). https://doi.org/10.1007/BF03405567

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  • DOI: https://doi.org/10.1007/BF03405567

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