Canadian Community Health Survey: New data on smoking and on diabetes

2005

Widespread smoking bans in public places appear to have considerably reduced the risk of exposure to second-hand smoke across Canada. Still, millions of Canadians had a regular brush with second-hand smoke last year, according to the Canadian Community Health Survey (CCHS).

The survey, which covered 130,000 people, also showed a substantial decline in the smoking rate, especially among teenagers.

Overall, an estimated 5.9 million people, or 22% of the population aged 12 and older, were smokers last year, down slightly from 23% in 2003 and 26% in 2000/2001. The sharpest decline was among young people aged 12 to 17.

On the downside, about 15% of non-smokers aged 12 and over told the survey in 2005 that they were exposed to second-hand smoke in a public place regularly, that is, every day or almost every day.

This was down from 20% in 2003, but it still represented one out of every seven non-smoking Canadians, or about 3.1 million people.

Rates were highest in Quebec, where 23% of non-smokers reported they regularly inhaled second-hand smoke in a public place. In the health region of Abitibi-Témiscamingue, the proportion reached 31%.

In Alberta, which was second, 18% of non-smokers reported regular encounters. In the province's Northern Lights health region, the rate reached 25%.

Since the survey was taken, several provinces have passed anti-smoking legislation. On January 1, 2006, Alberta banned smoking in public places that anyone under the age of 18 could visit. More recently, both Ontario and Quebec banned smoking in public places on May 31, 2006.

The CCHS provides the latest information on rates of smoking, exposure to second-hand smoke, and the proportion of people living in households and working in places where smoking is completely restricted.

The CCHS also provides a wealth of information on a wide range of other health issues.

Exposure to second-hand smoke declines

As smoking bans in public places have become more widespread, exposure to second-hand smoke among non-smokers has declined. These bans in public places may have spilled over to less exposure to second-hand smoke in other places like homes and cars.

In 2005, the most common type of location for exposure to second-hand smoke was public places, reported by 15% of non-smokers. However, this was down from 20% in 2003, the biggest decline among the three types of location considered by the survey (homes, public places and private vehicles).

Among non-smokers, 9% reported that they were regularly exposed to second-hand smoke at home, down from 11% in 2003. Over the same period, the rate of regular exposure to second-hand smoke in private vehicles fell from 10% to 8%.

All told, 23% of non-smokers reported regular exposure to second-hand smoke in at least one of the three types of location in 2005, down from 29% two years earlier.

Young people are most at risk. About 40% of non-smokers aged 12 to 17 reported being regularly exposed to second-hand smoke in at least one type of location in 2005. This compares with 31% for those aged 18 to 34, 19% for those aged 35 to 64 and 11% for those aged 65 and over.

Sharpest declines in current smoking among young people

The prevalence of smoking has declined among both men and women, and across all age groups.

The sharpest decrease was among young people aged 12 to 17, among whom it fell from 14% in 2000/2001 to 10% in 2003, and to 8% in 2005. The youth smoking rate has declined because increasing numbers of young people never start to smoke.

In 2000/2001, 73% of youth reported that they had never smoked cigarettes. By 2005, the proportion had hit 82%.

This finding is particularly relevant, because smokers generally start smoking before they are 18, and it is relatively rare for adults to take up smoking. As a result, there may be further declines in smoking rates among older age groups as today's youth move into adulthood.

Smoking rates were still highest among both men and women in the age group 18 to 34, although they have fallen. One-third (33%) of men and 26% of women in this age group were current smokers last year.

Smoking rates: Lowest in British Columbia

Smoking rates in 2005 were significantly below the national average of 22% in only two provinces — British Columbia (18%) and Ontario (21%). The rate in Manitoba (21%) was also lower than the national average, but the difference was not statistically significant.

Smoking rates were highest in Nunavut (53%), Northwest Territories (36%) and Yukon (30%).

Between 2003 and 2005, smoking rates fell significantly in New Brunswick, Quebec, Ontario and Manitoba and Nunavut.

Regionally, the health region of Richmond, British Columbia, had the nation's lowest rate of smoking at 12.6%.

In contrast, two health regions (Burntwood/Churchill in Manitoba and Mamawetan/Keewatin/Athabasca in Saskatchewan) had the highest rate. In both, 35% of the population were current smokers.

Bans in households, workplaces on rise

More Canadians are living in homes where smoking is completely restricted, and the proportion of workers who report a total ban on smoking at their workplace has also increased.

In 2005, close to two-thirds (64%) of people aged 12 or older lived in households where smokers were asked not to light up. This was up from 57% two years earlier.

Between 2003 and 2005, this proportion rose significantly in all 10 provinces, as well as in Northwest Territories and Nunavut. In the Yukon, it remained stable.

More than three-quarters (77%) of the population of British Columbia lived in a home where smoking was banned. In fact, 14 of British Columbia's 16 health regions had rates above the national average.

In contrast, only 43% of Quebec's population lived in a home where smoking was banned. Rates in all 16 of Quebec's health regions were well below the national average of 64%. They ranged from 28% in Région Nord-du-Québec to 52% in Région de l'Outaouais.

Similarly in 2005, two-thirds of workers nationally (68%) were employed in a workplace in which smoking was completely restricted.

About 71% of the employed population in Ontario and 76% in Manitoba reported workplace smoking bans, both significantly higher than the national average. Smoking bans were also more frequently reported in workplaces in the North, where Yukon had a rate of 79%, Northwest Territories showed a rate of 83% and Nunavut had rate of 92%.

Diabetes: Rates higher than average in eastern provinces

A separate report from the CCHS provides information on the health practices of individuals diagnosed with diabetes, and the factors that affect appropriate care of diabetics.

Diabetes is currently the seventh leading cause of death in Canada. National CCHS data show that about 1.3 million Canadians aged 12 and over, or 5% of the population, reported that they had been diagnosed with diabetes. Rates were significantly higher than the national average in the eastern provinces.

Individuals with diabetes in five provinces — Newfoundland and Labrador, Prince Edward Island, New Brunswick, Ontario and Manitoba — were asked a set of questions to determine how well guidelines published by the Canadian Diabetes Association for glucose testing and foot and eye examinations were followed.

For example, the guidelines suggest that diabetic individuals should have their level of glycosylated haemoglobin (A1C) measured every three months for purposes of glycemic (blood sugar level) control.

Three-quarters of diabetic patients (74%) had their haemoglobin A1C checked by a health care professional at least once in the year prior to the survey. On average, those who received the test were close to meeting the recommended frequency of every three months.

Still, one in five diabetic individuals in the five participating provinces had not received a test in the previous year.

A key factor associated with regular glucose testing was access to a regular medical doctor. This provides further evidence of the important role that health professionals play in delivering diabetes care.

In addition, the majority of diabetics in the five provinces met the recommended requirements for eye dilation examinations by a health professional. However, only half were meeting suggested requirements for annual foot examinations.

The results clearly indicate that diabetic individuals using insulin were more likely to receive diabetes care compared with those not using insulin. In some cases, insulin use may be a marker for a more progressed or advanced disease or may reflect poor glycemic control.

Definitions, data sources and methods: survey number 3226.

The release is co-ordinated with today's release of Health Indicators, no. 1 (82-221-XIE, free) a project to produce basic health indicators (such as use of health services, smoking and self-rated health) for each health region and for peer groups of health regions.

The publication Your Community, Your Health: Findings from the Canadian Community Health Survey (CCHS): Smoking and Diabetes Care: Results from the CCHS Cycle 3.1, 2005, (82-621-XWE2006002, free) is also now available from the Our products and services page of our website.

For more information, contact Media Relations (613-951-4636), Communications and Library Services Division.