Summary of results: Canadian Student Tobacco, Alcohol and Drugs Survey 2014-15

Background

The 2014-15 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS), previously called the Youth Smoking Survey (YSS), is the eighth cycle of data collection on student tobacco, alcohol, and drug use. A total sample of 42,094 students in grades 6 to 12 (grades 6 to secondary V in Quebec) completed the survey, which ran between October 2014 and May 2015 in the ten Canadian provinces. The weighted results represent over 2.5 million Canadian students. CSTADS 2014-15 collected information on tobacco use from students in grades 6 to 12, while students in grades 7 to 12 were also asked about alcohol and drug use. The 2014-15 cycle also collected information on bullying, mental health, and school connectedness. The current Summary of Results for 2014-15 presents data from the latest CSTADS. Detailed tables and some definitions used in this report are also provided.

All reported increases and decreases in the text below are statistically significant changes (i.e., not likely to have occurred by chance alone). To improve readability, the words "statistically significant" will not be repeated. Similarly, at times the text will state that prevalence is "unchanged" or not different between groups, even though the numbers are not identical. This occurs when the difference between numbers is not statistically significant.

Cigarette Use

In 2014-15, 18% of students in grades 6 to 12 had ever tried smoking a cigarette, even just a puff, down from 24% in 2012-13. In grades 6 to 9, 8% of students (approximately 115,000 youth) had ever tried smoking a cigarette, a decline from 13% in 2012-13. In grades 10 to 12, 29% of students had ever tried smoking a cigarette, down from 37% in 2012-13.

In 2014-15, 3.4%Footnote 1 of students in grades 6 to 12 (approximately 87,000 students) were current cigarette smokers, with 1.6% smoking daily and 1.9% smoking occasionally. The prevalence of current smoking (3%) decreased compared to 2012-13 (4%).

The average age at which students in grades 6 to 12 first tried smoking, even just a puff, was 13.5 years, older than the 13.2 years observed in 2012-13.

Ever Tried Smoking by Province

In 2014-15, the prevalence of having ever tried smoking a cigarette ranged from a low of 14% in Ontario to a high of 27% in Saskatchewan among students in grades 6 to 12. Provincial prevalence of having ever tried smoking a cigarette decreased since 2012-13 in Quebec (to 20% from 31%), Ontario (to 14% from 21%) and Alberta (to 15% from 22%). The prevalence of ever trying a cigarette was unchanged in the provinces of Newfoundland and Labrador (23%), Prince Edward Island (25%), Nova Scotia (21%), Saskatchewan (27%), and British Columbia (19%). The percentage of students who ever tried smoking a cigarette in Manitoba was 25% in 2014-15. Manitoba did not participate in YSS 2012-13, so no comparisons to the previous cycle can be made. CSTADS 2014-15 data cannot be used to produce provincial estimates for New Brunswick due to a low recruitment rate.

Source of Cigarettes

The majority (77%) 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 6 to 9 (89%) than those in grades 10 to 12 (74%).

Most students in grades 6 to 12 (58%) thought it would be "fairly easy" or "very easy" to get a cigarette if they wanted one.

Electronic Cigarettes

The 2014-15 cycle of CSTADS included questions about electronic cigarettes (e-cigarettes) for the first time. In the past 30 days, 6% or approximately 143,000 students had used an e-cigarette, while 18% or 442,000 students had ever tried one. Prevalence of past-30-day use of e-cigarettes was higher among males (7%) than females (4%) and higher among those in grades 10 to 12 (9%) than students in grades 6 to 9 (3%).

More than half-a-million students (approximately 610,000 students or 24%) in grades 6 to 12 ever tried cigarettes, e-cigarettes, or both cigarettes and e-cigarettes. The largest percentage of these students had tried both products (44%), while 28% had only ever used e-cigarettes and 28% had only ever used tobacco cigarettes.

Among the 241,000Footnote 2 students who had ever tried both cigarettes and e-cigarettes and could remember which they had tried first, 27% (approximately 62,000 students) tried an e-cigarette first and 73% (approximately 165,000 students) tried a tobacco cigarette first. More than one in three students (35%) in grades 6 to 9 tried an e-cigarette before a cigarette compared to one in four students (25%) in grades 10 to 12.

Many students in grades 6 to 12 (47%) thought it would be "fairly easy" or "very easy" to get an e-cigarette if they wanted one.

Perceived risk of harm of cigarettes and e-cigarettes

Students in grades 6 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 9% who thought there was "great risk". Using an e-cigarette on a regular basis was thought to pose "no risk" of harm by 12% of students and great risk of harm by 25%. Almost one in six students (16%) 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 if they had ever tried any of the following tobacco products, and if they used them in the past 30 days: cigarettes (including menthol and roll-your-own), cigars, little cigars or cigarillos, smokeless, waterpipe, bidis, and blunt wraps.

In 2014-15, 23% of students in grades 6 to 12, (581,000 youth) had ever tried at least one of these products. Less than half as many, 11% (approximately 262,000 students) had used at least one tobacco product in the past 30 days, down from 12% in 2012-13. Prevalence of past-30-day use of a tobacco product in 2014-15 was higher among males (12%) than females (9%) and higher among students in grades 10 to 12 (19%) than students in grades 6 to 9 (4%).

Cigarettes (18%) and e-cigarettes (18%) were the products most commonly ever tried by students in grades 6 to 12, followed by little cigars (13%), waterpipes (10%), cigars (9%), smokeless tobacco (4%), and roll-your-own tobacco (4%). Use of cigarettes (6%) and/or e-cigarettes (6%) in the past 30 days was more common than use of little cigars (4%), waterpipes (4%), cigars (3%), smokeless tobacco (2%), and roll-your-own tobacco (2%).

Flavoured Tobacco Use

Students were asked if they had tried any of the following flavoured tobacco products in the past 30 days: menthol cigarettes, little cigars or cigarillos, cigars, waterpipe tobacco, and smokeless tobacco. Seventy percent (70%, approximately 183,000) of students who used any tobacco product in the past 30 days used a flavoured product. This corresponds to 7% of all students in grades 6 to 12 who used at least one of these flavoured tobacco products in the past 30 days. Prevalence of use was higher among males (9%) than females (6%). Prevalence of past-30-day use of a flavoured tobacco product was 13% among students in grades 10 to 12 versus 3% among students in grades 6 to 9.

Overall, 3% of students had used menthol cigarettes in the past 30 days, representing approximately 67,000 youth. Past-30-day prevalence of using menthol cigarettes decreased among students in grades 6 to 9 (to 1% from 2% in 2012-13). Prevalence among students in grades 10 to 12 was unchanged at 5%. A higher percentage of males (3%) than females (2%) had smoked a menthol cigarette in the past 30 days.

At 3%, the overall prevalence of using a waterpipe to smoke flavoured waterpipe tobacco in the past 30 days was unchanged from the previous cycle and unchanged for students in grades 6 to 9 (1%). For students in grades 10 to 12, however, prevalence increased to 5% (approximately 55,000 youth) from 4% in 2012-13.

At 3%, the overall prevalence of use of flavoured little cigars or cigarillos was unchanged from the previous cycle. Among students in grades 6 to 9, prevalence of use of flavoured little cigars or cigarillos decreased since 2012-13 (to 1% from 2%), while prevalence by sex (4% among males and 2% among females) and among students in grades 10 to 12 (6%) was unchanged.

At 3%, overall prevalence of use of flavoured cigars was unchanged from the previous cycle, but decreased among students in grades 6 to 9, to 1% from 2% in 2012-13. Prevalence of use was unchanged by sex (4% among males and 1% among females), and among students in grades 10 to 12 (5%).

Alcohol

Alcohol is 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 remained unchanged from 2012-13 at 40% (approximately 831,000 students).

On average, students tried their first alcoholic beverage at 13.5 years of age, a delayed first age of alcohol use compared to a mean age of 13.1 in the previous cycle (2012-13), and 12.8 recorded in 2008-09 and 2010-11. Females tried their first drink at an age slightly older than males (13.6 versus 13.3).

Just under one quarter of students (24%, approximately 500,000 students) reported drinking excessively (i.e., five or more drinks on one occasion) in the past 12 months, continuing a decreasing trend through previous cycles from a high of 39% in 2008-09.

In 2014-15, 31% of students 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 2014-15 (approximately 341,000 students).

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

Cannabis

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

In 2014-15, 17% of students in grades 7 to 12 (approximately 354,000 students) reported using cannabis in the year preceding the survey. This is a decrease from 19% in 2012-13 and previous cycles of the survey, (21% in 2010-11 and 27% in 2008-09).

Past 12 month use of cannabis by males decreased to 17% from 21% in 2012-13. Prevalence of past 12 month use for both males and females has decreased over survey cycles and, historically, the prevalence of use by males has exceeded that of females. The 2014-15 survey marked the first time that there was no difference between the two.

After remaining unchanged for several cycles of the survey, the results of the 2014-15 survey showed that students were on average older when they first used cannabis (14.2 years of age) compared to 2012-13 (14.0) and that females were slightly older than males (mean age of 14.3 compared to 14.1) when they first used it.

In the 2014-15 survey, students in grades 7 to 12 were asked how much they thought people risk harming themselves when they smoke marijuana or cannabis. Twenty-five percent (25%) of the students (approximately 518,000) thought that smoking cannabis once in a while put people at "great risk" of harming themselves while 14% 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 more than doubled to 58% of students (approximately 1.2 million) while those who thought there was "no risk" dropped to 7%.

Students in grades 7 to 12 were asked how difficult they thought it would be to get cannabis if they wanted it and 41% (approximately 870,000) of students reported that they thought it would be "fairly easy" or "very easy" to obtain.

Almost 60% of students in grades 7 to 12 indicated that they had not used either alcohol or cannabis in the past 12 months. While 15% of the students 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. Only a small percentage of students (1%) indicated that they had used cannabis but not alcohol in the past year.

Illicit and other drugs

Synthetic cannabinoids had the third highest prevalence of past 12 month use among Canadian students in grades 7 to 12, after alcohol and cannabis. At 4% (approximately 82,000 students) this was an increase from the 1% that reported use in the previous cycle. An increase was seen in both males (2% to 4%) and females (1% to 4%) and in both grade groupings.

Use of salvia in the past year continued to decrease from a high of 5% in 2008-09 to 1% (approximately 28,000 students) in 2014-15.

Past year use of amphetamines decreased to 1% in 2014-15 from 2% in 2012-13 and 3% in 2008-09.

Abuse of Psychoactive Pharmaceuticals

The prevalence of use of psychoactive pharmaceuticals to get high shared the third highest prevalence of use with synthetic cannabinoids at 4%, exceeded only by the prevalence of use of alcohol and cannabis. This prevalence was unchanged from 2012-13 but a decrease from 6% in 2010-11. Psychoactive pharmaceuticals include sedatives/tranquilizers, stimulants and prescribed pain relievers.

Among the three classes of psychoactive pharmaceuticals surveyed, the abuse of prescribed pain relievers was the highest at 3% (approximately 55,000 students). For the first time, the prevalence of past year abuse of oxycodone (1%) and of fentanyl (0.4%) were measured separately from other prescribed pain relievers (morphine, codeine, Tylenol 3®,..) (2%).

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-one percent (41%) of students (approximately 867,000) 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" increased to 70% (about 1.5 million students) when students were asked about similar use on a regular basis. Less than 4% of students said that there was "no risk" of harm when prescription medication is used to get high either once in a while or on a regular basis.

When asked how difficult students felt it would be to get prescription medicine if they wanted it, 37% (approximately 786,000 students) thought it would be "fairly easy" or "very easy" to obtain prescription pain relievers. Thirty percent (30%) thought the same about the ease of obtaining medicine used to treat ADHD.

Dextromethorphan is an active ingredient found in many over-the-counter cough suppressant cold medicines. The 2014-15 results show a continued decrease in the prevalence of abuse among students in grades 7 to 12, down from a high of 5% in 2010-11 to 1% or about 29,000 students. The abuse of sleeping medication available from a drugstore (such as Nytol® or Unisom®) decreased from 2% in 2012-13 to 1% in 2014-15.

Use of Gravol® to get high was measured for the first time in 2014-15. At 1%, it is the only substance measured in this survey where there was no difference in the prevalence of past 12 month use between students in grades 7 to 9 and those in grades 10 to 12.

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 (grades 6 to 12 for tobacco and grades 7 to 12 for alcohol and drugs). CSTADS provides essential input to the development of policies and programs. The next survey is expected to be carried out during the 2016-17 school year.

For more information about the survey and/or its results, please contact Health Canada by e-mail (cstads_questions_ectade@hc-sc.gc.ca), or by calling the toll-free telephone number (1-866-318-1116).

For information on the public-use microdata file, please contact Propel Centre for Population Health Impact at the University of Waterloo (www.cstads.ca).

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