Smoking Frequency, Prevalence and Trends, and Their Socio-Demographic Associations in Alberta, Canada

Article excerpt

Objectives: To determine the numbers of smokers, smoking prevalence and trends, and to examine their socio-demographic associations in Alberta using data from three Canadian national health surveys undertaken between 2000 and 2005.

Methods: The three surveys collected self-reported health data from Canadians aged 12 years and older. The weighted number of smokers and the smoking prevalence by health region and by urban/rural status were determined. The socio-demographic associations of smoking in Alberta were examined using logistic regression analysis.

Results: The numbers of smokers and the smoking prevalence were both higher among men than women, in middle-aged groups (20-39 and 40-59 years) than in younger (12-19 years) and older (≥60 years) groups, and among Canadian-born people than immigrants to Canada. The smoking prevalence tended to 1) increase with the increasing rurality of residence, 2) decrease over the timeframe examined, 3) be inversely proportional to educational level and 4) be inversely proportional to household income. The number of smokers was largest in urban areas and among those who reported the highest education and household income.

Discussion: The new tobacco legislation being introduced in Alberta in 2009 may decrease the smoking prevalence in the province, but additional interventions in the regions with the largest numbers of smokers may help further reduce the smoking population and overall smoking prevalence in Alberta.

Key words: Smoking; prevalence; trend; socio-demographic factors; public health

La traduction du résumé se trouve à la fin de l'article. Can J Public Health 2009;100(6):453-58.

Mots clés : tabagisme; prévalence; tendances; facteurs sociodémographiques; santé publique

Tobacco smoking is one of the most important yet preventable causes of diseases and deaths in the world.1-5 Despite substantial declines over the past few decades in Canada,6 one-fifth of Canadians still smoked in 2006.7 In 2007, the Canadian Federal Tobacco Control Strategy set a new target to further reduce the smoking rate to 12% by 2011.8 Although the strategy has been articulated at a federal level, the provincial/territorial health authorities have an important role to play in achieving this national goal.

In Alberta, regional health authorities (RHAs) have been responsible for making and implementing local public health policies, including those relevant to cigarette smoking. While there are data describing the smoking trends in Alberta,9 there is a paucity of published information concerning the numbers of smokers, and smoking prevalence and trends at the RHA level. Furthermore, the socio-demographic factors that may be associated with smoking in Alberta have not been examined.

The aims of this study were to determine the smoking frequency, prevalence and trends at the RHA level, and to examine their socio-demographic associations in Alberta. Such information will help guide policy-makers in facilitating resource planning and in evaluating the effectiveness of smoking control programs.

METHODS

Three Canadian Community Health Surveys (CCHS: Cycle 1.1, 2000/01; Cycle 2.1, 2002/03; Cycle 3.1, 2004/05) were carried out by Statistics Canada between 2000 and 2005. The surveys collected self-reported health information from a representative sample of Canadians aged 12 years and older, with the exclusion of the population on Indian reserves and Canadian forces bases, in institutions and in some remote areas. The three surveys were designed to provide reliable health estimates at the RHA level across Canada. The sample sizes were, respectively, 130,880, 134,072 and 132,221 for Canada, and 14,456, 13,871 and 11,800 for Alberta. The response rates ranged from 78.9% to 84.7% for Canada and from 81.5 % to 85.1% for Alberta. The survey methodology has been published widely6,10,11 and can also be found on the Statistics Canada website. …