Abstract
One of the main enterprises associated with tobacco control is surveillance, that is, to measure and follow over time the extent of smoking among the Canadian population. While surveillance systems have been in place for more than 50 years, knowing the exact prevalence of smoking in Canada continues to be a complex matter and understanding its estimation requires a critical appreciation of our national surveys’ idiosyncrasies. This commentary describes the two Statistics Canada surveys that are most commonly used to examine smoking prevalence in this country: the Canadian Community Health Survey (CCHS) and the Canadian Tobacco, Alcohol and Drugs Survey (CTADS). It compares estimates of smoking prevalence obtained from each source and examines potential reasons for their noticeable discrepancies. Canadian researchers interested in smoking prevalence should be aware of current and future limitations, and should discuss and analyze these accordingly.
Key Words: Canada, surveys and questionnaires, epidemiology, smoking
Résumé
L’une des principales entreprises associées à la lutte contre le tabagisme est la surveillance, c’est-à-dire la mesure et le suivi de l’ampleur du tabagisme dans la population canadienne. Bien que les systèmes de surveillance soient en place depuis plus de cinquante ans, connaître la prévalence exacte du tabagisme au Canada continue d’être une question complexe. La compréhension de son estimation nécessite ainsi une appréciation critique des particularités de nos enquêtes nationales. Ce commentaire décrit les deux enquêtes de Statistique Canada les plus couramment utilisées pour examiner la prévalence du tabagisme au Canada: l’Enquête sur la santé dans les collectivités canadiennes (ESCC) et l’Enquête canadienne sur le tabac, l’alcool et les drogues (ECTAD). Il compare les estimations de la prévalence du tabagisme obtenues à partir de chaque source et examine les raisons potentielles de leurs divergences. Les chercheurs canadiens qui s’intéressent à la prévalence du tabagisme devraient être plus conscients des limites actuelles et futures de nos données et travailler à les dépasser.
Mots ClÉs: Canada, survols et questionnaires, épidémiologie, tabagisme
Footnotes
Acknowledgements: The author thanks the Interdisciplinary Study of Inequalities in Smoking (ISIS) research group, Jennifer O’Loughlin, Benoît Lasnier and Gerry Veenstra for their help, and acknowledges funding support from a PhD scholarship from the Fonds de Recherche du Québec - Santé (FRQS).
Conflict of Interest: None to declare.
References
- 1.Corsi DJ, Boyle MH, Lear SA, Chow CK, Teo KK, Subramanian SV. Trends in smoking in Canada from 1950 to 2011: Progression of the tobacco epidemic according to socioeconomic status and geography. Cancer Causes Control. 2014;25(1):45–57. doi: 10.1007/s10552-013-0307-9. [DOI] [PubMed] [Google Scholar]
- 2.Ottawa Tobacco Research Unit OTRU. Directory of Public Use Data on Tobacco Use in Canada. 2015. [Google Scholar]
- 3.Statistics Canada. Canadian Community Health Survey (CCHS) 2016. [Google Scholar]
- 4.Statistics Canada. Canadian Tobacco Alcohol and Drugs Survey (CTADS) 2016. [Google Scholar]
- 5.Gilmore J. Report on Smoking in Canada 1985 to 2001. 2002. [Google Scholar]
- 6.Statistics Canada. Table 105-0503. Health Indicator Profile, Age-Standardized Rate, Annual Estimates, by Sex, Canada, Provinces and Territories. 2015. [Google Scholar]
- 7.Hill A, Roberts J, Ewings P, Gunnell D. Non-response bias in a lifestyle survey. J Public Health Med. 1997;19(2):203–7. doi: 10.1093/oxfordjournals.pubmed.a024610. [DOI] [PubMed] [Google Scholar]
- 8.Lahaut V, Jansen H, van de Mheen D, Garretsen H. Non-response bias in a sample survey on alcohol consumption. Alcohol Alcohol. 2002;37(3):256–60. doi: 10.1093/alcalc/37.3.256. [DOI] [PubMed] [Google Scholar]
- 9.Kirst M, Mecredy G, Chaiton M. The prevalence of tobacco use co-morbidities in Canada. Can JPublicHealth. 2013;104(3):210–15. doi: 10.17269/cjph.104.3770. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 10.Zhao J, Stockwell T, Macdonald S. Non-response bias in alcohol and drug population surveys. Drug Alcohol Rev. 2009;28(6):648–57. doi: 10.1111/j.1465-3362.2009.00077.x. [DOI] [PubMed] [Google Scholar]
- 11.Livingstone M, Dietze P, Ferris J, Pennay D, Hayes L, Lenton S. Surveying alcohol and other drug use through telephone sampling: A comparison of landline and mobile phone samples. BMC Med Res Methodol. 2013;13:41. doi: 10.1186/1471-2288-13-41. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 12.Statistics Canada. Residential Telephone Service Survey (RTSS), 2013. 2014. [Google Scholar]
- 13.Smith P, Frank J, Mustard C. Trends in educational inequalities in smoking and physical activity in Canada: 1974–2005. J Epidemiol Community Health. 2009;63(4):317–23. doi: 10.1136/jech.2008.078204. [DOI] [PubMed] [Google Scholar]
- 14.Stephens T, Brown KS, Ip D, Ferrence R. The Future of Household Telephone Surveys on Tobacco: Methodological and Contextual Issues. Toronto, ON: The Ontario Tobacco Research Unit; 2009. [Google Scholar]
- 15.PLoS ONE. 2012.
- 16.Wong SL, Shield M, Leatherdale S, Malaison R, Hammond D. Assessment of validity of self-reported smoking status. Health Rep. 2012;23(1):47–53. [PubMed] [Google Scholar]