Diapositive 1

1
Youth Social Access to Tobacco Products
Whats happening in Quebec ?
Ann Royer Ph.D. Direction de santé publique de
Québec Quebec Public Health Department
2
Objectives
Objectives

• Describe the current situation of youth access to
  tobacco products in the Province of Quebec

Identify links between age, gender, smoking
intensity, financial ressources, parental smoking
and youth access

• Report on a 2-day consultation meeting on youth
  social access held in Montreal in February 2006

3
Main surveys used
Main surveys used

• Institut de la statistique du Quebec (ISQ).
  Quebec Survey of Tobacco Use in High School
  Students, 2000 and 2002
• ISQ (2005). Survey on tobacco, alcohol and drug
  use, and gambling in Quebec high school students,
  2004
• Health Canada (2002). Canadian Community Health
  Survey 2000-2001 (CCHS)
• Health Canada (2004). Youth Smoking Survey 2002

4
Age at first cigarette
Age at first cigarette

• Average age first cigarette in Canada 11.4
  years
• Average age first cigarette in Quebec 12.3
  years
• No difference between girls and boys as to age of
  initiation

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Smoking Prevalence, Quebec High School Students
Smoking Prevalence, Quebec High School Students

26,2
23,1
22,9
20,1
18,8
14,8
ISQ (2003). Quebec Survey of Tobacco Use in High
School Students 2002 ISQ (2005). Survey on
tobacco, alcohol and drug use, and gambling in
Quebec high school students, 2004
6
Changes in smoking status,2002-2004
Changes in smoking status, 2002-2004
2004
2002
7
Changes in smoking prevalence by grade, 2002-2004
Changes in smoking prevalence by grade, 2002-2004

29,6
22,3
31,3
28,2
18,3
24,7
16,5
21,5
11,7
20,1
ISQ (2003). Quebec Survey of Tobacco Use in High
School Students 2002 ISQ (2005). Survey on
tobacco, alcohol and drug use, and gambling in
Quebec high school students, 2004
8
Changes in smoking prevalence by grade,
2002-2004. Current smokers
Changes in smoking prevalence by grade,
2002-2004. Current smokers

23,6
21,8
20,5
16,2
16,6
12,6
8,9
8,3
5,7
5,2
ISQ (2003). Quebec Survey of Tobacco Use in High
School Students 2002 ISQ (2005). Survey on
tobacco, alcohol and drug use, and gambling in
Quebec high school students, 2004
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Smoking according to sex and grade, 2004
Smoking according to sex and grade, 2004

26,8
16,3
16,9
15,4
10,6
8
9,8
6,2
6,1
4,4
ISQ (2005). Survey on tobacco, alcohol and drug
use, and gambling in Quebec high school students,
2004
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Sources of tobacco products by smoking status
Sources of tobacco products by smoking status
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Number of cigarettes smoked per day over a 30-day
period
Number of cigarettes smoked per day over a 30-day
period
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Differences between gender and access to
cigarettes
Differences between gender and access to
cigarettes

66,3
58,1
24,9
23,1
18,3
8
ISQ (2005). Survey on tobacco, alcohol and drug
use, and gambling in Quebec high school students,
2004
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Proportion of youth acquiring tobacco from social
sources
Proportion of youth acquiring tobacco from social
sources
1. ISQ (2003). Quebec Survey of Tobacco Use in
High School Students 2002 2. ISQ (2005). Survey
on tobacco, alcohol and drug use, and gambling in
Quebec high school students, 2004 3. Health
Canada (2004). Youth Smoking Survey 2002
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Link between smoking parents and youth access
Link between smoking parents and youth access

• Increased risk factor for smoking
• Decreased age of smoking initiation (11,3 c.
  12,3)
• Easy access (no risk)

Source DiFranza Coleman. ( 2001). Tobacco
Control 10323-28.
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Financial autonomy and youth access to tobacco
products
Financial autonomy and youth access to tobacco
products

• The more money youth have , the more likely they
  will prefer purchasing their own cigarettes or
  having someone buy for them
• Those who receive or gain more
• than 31 per week are more likely to
• purchase their cigarettes from retailers
• Younger youth and girls depend on their friends
  and other social sources

ISQ (2003). Quebec Survey of Tobacco Use in High
School Students 2002, Schnebelen. 2004.
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A Few Facts
A Few Facts

• Beginners and occasionnal smokers
• obtain cigarettes from friends and family
• The exchange of cigarettes among peers
• is often for free especially for the beginners
• Youth also purchase and share cigarettes
• Daily or established smokers are more likely to
  obtain their cigarettes from retailers (by buying
  themselves or having someone buy for them
• Girls are more likely to use social sources

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Evolution of purchase or purchase attempts of
tobacco products in retail stores, 2000-2004
Evolution of purchase or purchase attempts of
tobacco products in retail stores, 2000-2004

57,8
54,3
51,1
ISQ (2001). Quebec Survey of Tobacco Use in High
School Students 2000 ISQ (2003). Quebec Survey
of Tobacco Use in High School Students 2002 ISQ
(2005). Survey on tobacco, alcohol and drug use,
and gambling in Quebec high school students, 2004
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Purchase attempts and smoking status, 2004
Purchase attempts and smoking status, 2004

76
54
24
ISQ (2005). Survey on tobacco, alcohol and drug
use, and gambling in Quebec high school students,
2004
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Proportion of youth stating they were refused
puchase of cigarettes
Proportion of youth stating they were refused
puchase of cigarettes

50
21
19
10
ISQ (2005). Survey on tobacco, alcohol and drug
use, and gambling in Quebec high school students,
2004
20
Retailer compliance Sale of tobacco products
to minors
Retailer compliance Sale of tobacco products
to minors

Sources AC Nielsen, report submitted to Health
Canada, february 2004 Corporate Research Group,
report submitted to Health Canada, february 2005
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Facts
Facts

• ? number of purchase attempts of tobacco
  products by youth
• ? number of youth stating they have no
  difficulty in purchasing tobacco products
• ? retailer compliance to the law

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Solutions
Solutions

• Legislation
• Better practices
• Interventions

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Partners
• Quebec Council on Tobacco and Health (NGO)
• Quebec Health Ministry
• Health Canada
• Public Health Departments of Quebec city and
  Montreal

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Objective
• To define an action plan to reduce youth social
  access to tobacco products
• Methodology
• Invite all partners in tobacco control to express
  their concerns, experiences and advice on youth
  access to tobacco products
• Analyze the different aspects of youth access to
  tobacco products (laws, better practices and
  interventions)
• Summarize the exchanges and report on the
  recommendations

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Participants
• About 80 participants from all regions of
  province
• Representatives from

• Representatives from Healthy School
  Programs
• Youth
• Community groups
• Tobacco control NGOs

• Quebec Ministry of Health
• Health Canada
• Public Health Departments
• Researchers
• Health professionals
• Educators

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Main Themes
• Overview of situation in Quebec
• Identify the groups to reach
• Identify the best interventions
• Elaborate an action plan and recommendations for
  future steps

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Groups
• Opponents
• Conditionals
• Initiators
• Integrators

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Opponents
• Participants who questioned the pertinence of
  intervening to reduce social access.
• Their concern stemmed from fact that there is
  little scientific evidence that show effective
  interventions aimed at reducing youth social
  access work.

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Conditionals
• Participants who questioned the pertinence of
  intervening to reduce social access at this time.
• They proposed that other measures in tobacco
  control should be implemented before getting to
  social access measures

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Initiators
• Recognized the importance of youth social access
  and worried about the consequences if no action
  is taken.
• They proposed pilot projects that would target
  specific groups
• Necessity of evaluating pilot projects

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Report on a 2-day consultation meeting on youth
social access
Report on a 2-day consultation meeting on youth
social access

• Integrators
• Participants (including youth) felt it was
  necessary to integrate new interventions on youth
  social access to existing tobacco control
  programs in order to counter the effects of new
  Tobacco Law

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Recommended steps
Recommended steps

• Hold regular discussion and planning meetings
  with all interested in tobacco control
• Continue implementation of proven tobacco control
  measures
• Increase price of tobacco products
• Control of tobacco smuggling
• Legislation and Enforcement of laws forbidding
  tobacco use in public places
• Legislation forbidding promotion and display of
  tobacco products

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Recommended steps
Recommended steps

• Produce anti-smoking media campaigns aimed at
  entire population on a regular and continuous
  basis
• Implement, on a permanent basis, a research group
  capable of ensuring continuity in research
  projects and support the different tobacco
  control projects in Quebec
• Convince medical profession to prescribe NRTs to
  minors
• Develop smoking cessation tools and programs for
  youth

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Recommended steps to deal with youth social
access
Recommended steps to deal with youth social
access

• Put in place working group which will
• Review literature on youth social access
• Conduct qualitative surveys on social norms
  surrounding youth access and purchase
• Recommend pilot projects
• Fund research to better understand youth social
• access in Quebec
• Involve youth in planning and implementation of
• interventions to reduce social sourcing

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Recommended steps to deal with youth social
access
Recommended steps to deal with youth social
access

• Develop pilot projects on social sourcing aiming
  adults
• Integrate interventions to reduce social access
  in already existing tobacco control programs
  especially those where youth and community are
  involved
• Evaluate projects
• Disseminate results

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Conclusion
Conclusion

• Restrictions concerning retailers only do not
  prevent youth from accessing tobacco products
• One must consider youth social access to tobacco
  products as being part of smoking acquisition
• Although it is necessary to make adults aware
  that it is forbidden to give cigarettes to a
  minor, it is also necessary to find a way to
  reduce the social exchange of cigarettes between
  minors

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Final Conclusion
Final Conclusion

• A report of the 2-day consultation was produced
  by the organizing committee.
• It stated the importance of putting into place
  discussion venues for all actors involved in
  tobacco control in order to insure collaboration
  and support for future interventions.

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Acknowledgements
Acknowledgements
The original documents used to produce this
presentation have been made possible by financial
contributions from the Quebec Health Ministry and
the regional Quebec Tobacco Control Program,
Health Canada.
The views expressed herein do not necessarily
represent the official policies of the Quebec
Health Ministry and Health Canada.
Special thanks to Doina Malai (Public Health
Department of Montreal) and Charles Vanasse
(Quebec Council on Tobacco and Health) for their
help in preparing this presentation.