Initiation or cessation: what keeps the prevalence of smoking higher in Quebec than in the rest of Canada?

Abstract

Introduction We compared smoking initiation and cessation in Quebec versus the rest of Canada as possible underpinnings of the continued higher cigarette smoking prevalence in Quebec. Methods Data were drawn from the Canadian Community Health Survey (CCHS). We compared average and sex-stratified prevalence estimates of (1) current cigarette smoking in persons aged 15 years and older; (2) past-year initiation of cigarette smoking in those aged 12 to 17 and 18 to 24 years; and (3) past-year cessation in adults aged 25 years and older in Quebec versus the other nine Canadian provinces in each two-year CCHS cycle from 2007/08 to 2017/18. Results The prevalence of current smoking decreased from 25% to 18% among adults aged 15 years and older in Quebec from 2007/08 to 2017/18, and from 22% to 16% in the rest of Canada. Initiation among those aged 12 to 17 years decreased from 9% to 5% in Quebec, and from 7% to 3% in the rest of Canada. Neither initiation among people aged 18 to 24 (at 6% and 7%, respectively) nor cessation among adults aged 25 and older (approximately 8%) changed over time in Quebec or in the rest of Canada. In each two-year CCHS cycle, past-year initiation among those 12 to 17 years of age was consistently higher in Quebec than in the rest of Canada, but there were no substantial or sustained differences in initiation among people aged 18 to 24 or in past-year cessation. Findings were similar when stratified by sex. Conclusion Higher levels of smoking initiation among youth aged 12 to 17 years could be a proximal underpinning of the continuing higher prevalence of smoking in Quebec versus the rest of Canada.

Do demographic and socioeconomic characteristics underpin differences in youth smoking initiation across Canadian provinces? Evidence from the Canadian Community Health Survey (2015–2018)

“…The prevalence of smoking has consistently been higher in Quebec than in the rest of Canada, with differences driven in part by higher youth initiation rates in Quebec. 3 In our study, initiation of a first cigarette among adolescents varied substantially across Canadian provinces, with Quebec's estimate being 79% higher than that of Ontario and 143% higher than that of British Columbia. We examined the extent to which demographic and socioeconomic factors underpinned these differences and observed two key findings.…”

“…for past-year initiation: 5% in Quebec vs. 3% in the rest of Canada in 2017-2018). 3 Several mechanisms could underpin persistent differences in initiation across provinces. Tobacco control policies, including minimum age for legal access, tobacco tax rates and adequate enforcement of legislation, are likely key.…”

Routine Clinically Detected Increased ROS1 Transcripts Are Related With ROS1 Expression by Immunohistochemistry and Associated With EGFR Mutations in Lung Adenocarcinoma

“… 25 Therefore, one of the hypotheses for our low proportion of ROS1-rearranged cases would be a difference in smoker demographics in our cohort. Although the current prevalence of smokers in Quebec (18%) is only slightly higher to that of the rest of Canada (16%) but lower than other countries, including United States (25%) and Japan (21%), 26 , 27 it was for a long time higher than elsewhere in Canada and United States, at 64.2% to 54.9% from 1965 to 1975 (closest being Atlantic provinces at 53.4%–46.8%), 28 and 33% to 36% from 1985 to 1999 (closer to Manitoba, 35.3%–30.1%). 29 Thus, the lower incidence of nonsmoker-associated genetic alterations in NSCLC is likely a consequence of the smoking demographics in the past 5 to 7 decades rather than a reflection of the current smoking demographics in Quebec.…”

Tobacco smoking prevention and control in Canada: where do we go from here?

“…In the current issue, we present two com mentaries-one led by Hagen 2 and one by Melamed 3 -that challenge the past five years of tobacco control and question the complex role of the COVID19 pandemic in future tobacco control efforts. In one of two original research papers, Pelekanakis et al 4 delve into the reasons underpinning continued provincial differences in smok ing prevalence. In the second, Williams et al 5 identify predictors of ecigarette uptake among high school students in Canada.…”