10 co o E 01

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ENVIRONICS

RES E ARC H G ROU P

10 co o E ⁰¹

W AVE 3 SURVEYS

THE HEALTH EFFECTS OF TOBACCO

AND HEALTH WARNING MESSAGES ON CIGARETTE PACKAGES

SURVEY OF YOUTH

Prepared for:

Health Canada 1C-01-22

Prepared by:

Environics Research Group Limited

February 2002

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T ABLE OF CONTENTS

1.0 INTRODUCTION 3

2.0

SMOKING STATUS 4

A. Smoking Behaviour and Brands 4

B. Quit Attempts and Potential Quitters 6

3.0

HEALTH EFFECTS OF SMOKING

9

A. General and Top-of-mind Effecrs 9

B. Sources of Information abolit Health Effecrs 12

C. Specifie Healrh Effects Caused by Smoking... 13

D. Specifie Health Effecrs Caused by Second-Hand Smoke 17

E. Health Effecrs Caused by Hydrogen Cyanide 19

4.0

DEATHS FROM TOBACCO USE 20

5.0

QUIT TIPS 22

6.0

HEALTH

W

ARNING MESSAGES 25

A. Recall and Reads Per Day 25

B. Impact of New Messages 31

C. Assessment of New Messages 32

D. Comparison of New and Old Messages 33

7.0 TOXIC SUBSTANCES 35

ApPENDIX

Survey Methods

English and French Questionnaires

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1.0 INTRODUCTION

Environics Research Group Lirnited was

commissioned by Healrh Canada ta conduet a survey of Canadian youth, including yourh smokers and non-smokers. The main objective of the survey was

li

ta provide information to assist in the evaluation of the impact of new health warning messages on robacco packaging on yourh knowledge and

behaviours. The new health warning messages began appearing on the major tabac co brands on

approxirnarely January 1. 2001 and on ail brands as of approximately June 30.

The survey assessed sources of information about the effects of robacco, awareness and knowledge of the healrh effeets of tobacco, the exrenr ta which specific diseases are believed ta be caused by robacco and the number of deaths caused by smoking. The survey also measured awareness and recall of the new labels and their effect on knowledge and behaviours.

Where possible; the results of the new survey will be compared ta the previous baseline survey of yourh, whieh was conducted by Environics in December 2000 prior ta the introduction of the new healrh warning messages into the rnarketplace, and with the survey eonducted in Mareh and April 2001 a few monrhs after the new healrh warning messages were first inrroduced inro the markerplace.

The survey of yourh aged 12 ro 18. which included youth smokers and non-srnokers, is based on a sample size of 1.006. This survey was conducted berween July 9 and August 1. 200l.

A survey based on a sample of 1.006 has a margin of error of approximarely 3.1 percentage points. 19 rimes in 20.

This report summarizes the findings of the research.

Appended ro this report are copies of the English and French questionnaires and a description of the survey rnethods.

ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES - W A VE 3 3

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2.0 SMOKING STATUS

A.

Smoking Behaviour and Brands

From the survey, ten percent of yourh smoke cigaretces every clay and five percent smoke

occasionally. Olcler youth, especially those aged 17 ro 18 years, are more likely than younger teens tO say they smoke cigarettes every clay.

Among non-smoking youth, 33 percent say they have at sorne tirne rried cigarette smoking, which includes just having a few puffs. Among non- smoking youth who have never tried smoking, not even a few puffs, nine percent say they have seriously thought abolit trying smoking. Among non-smoking youth, three percent say they might try smoking wirhin the nexr rnonth.

Of the youth sample, 15 percent are smokers and 84 percent are non-smokers. Of ail youth, 34 percent can be classified as porenrial smokers. Porential smokers inclucle any youth who say they have rried smoking, have seriously thoughr about smoking or think they might rry smoking within the next rnonth,

Almost two in ten Canaclian youth (17%) report having smoked at least 100 cigarettes in their life.

This number is twice as high among older youth, aged 17 tO 18 years.

Cigarette Consumption

DEC MAR-ApR JULY

2000 2001 2001

Every day 11 7 10

Occasionally (Iess th an

every day) 6 6 5

Not at ail 83 87 84

Q.l

At the present time, do yo« smoke cigarettes (manufactured or roll your own) every day, occasionally or not at all?

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - W A VE 3 4

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Among yourh smokers who smoke every day, 27 percent report smoking more than 15 cigarettes per day, which includes four percent who say they smoke more rhan 25 cigarettes per day. Five in ten (49%) say they smoke between ren and 15 cigarettes per day. More than two in ten (25%) report smoking fewer than ten cigarettes per day.

Among youth smokers who smoke occasionally+, 89 percent report smoking fewer than ren cigarettes per day on the days rhat they smoke. Nine percent smoke between ren ra 15 cigarettes per day and no one reports smoking more rhan 15 cigarettes per day.

Among youth smokers, Players Light Regular Size (16%) is most often menrioned as rheir regular brand of cigarettes. Smaller proportions mention

DuMaurier King Size (10%), DuMaurier light Regular Size (10%), DuMaurier Regular Size (9%), Export "A" Regular Size (9%), Export "A" Medium Regular Size (5%) and Players Light King Size (5%).

Twenry-five percent mention sorne other brand and eight percent say they do not have a regular brand.

When yourh smokers are asked if they smoke any other brands of cigarettes, 56 percent say they do not smoke any other brand.

Cigarette Consumption Per Day

Every Day Smokers

DEC MAR-ApR JULY

2000 2001 2001

Less than 10 cigarettes per day 31 35 25

10 ta 15 cigarettes per day 41 40 49

26 or more cigarettes per day 4

Q.6

On average, how many cigarettes do you smoee per day?

Subsamp!e: Smoke every day

Cigarette Consumption Per Day

Occasional Smokers

DEC MAR-ApR JULY

2000 2001 2001

Less than 10 cigarettes per day 92 89 89

16 or more cigarettes per day

dklna 4 2

Q.7

On the days that you smoke, about how many cigarettes do YOII

smoke?

Subsamp!«: Smoke occasiona!!y

1 These nurnbers should be inrerprered wich caution, because of srnall sample sizes.

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B.

Quit Attempts and Potential Quitters

Severi in ren yourh smokers (69%) report having rried to quit smoking; three in ten (31 %) have not tried to quit.

The survey results indicare thar there has been an eight point increase since March-April 2001 in the number of youth who have rried ta quit, and a ten point increase in the number who have tried "once."

Among youth smokers who have tried to quit smoking, ni ne in ten (90%) say they have sropped smoking for a period of 24 hours at least once in the past year, in an attempt ta quit. Only ren percent say they have not attempted to quit smoking in the past year.

Quit Attempts

Smokers

DEC MAR-ApR JULY

2000 2001 2001

Yes 66 61 69 ^~Î

No 33 38 31

dk/na

Q.9

Have yeu euer tried to quit smoking?

Subsample: Smokers

Number of Times Tried to Quit Smoking

Smokers

DEC MAR-ApR JULY

2000 2001 2001

Once 21 15 25

Twice 15 26 19

Three limes 20 10 13

More Ihan three times 27 37 32

Not in the pa si year 15 12 10

dk/na

Q.IO

In the past year, how man) times have you stopped smoking for at least 24 hours becasse yo« were trying to quit Jmokzng?

Subsample: Smokers who have tried to quit smoking

ENVI RON ICS ^HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES ~ WAVE 3 6

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Almosr six in ren yourh smokers (56%) report they are now seriously rhinking of quitring smoking; 44 percent say rhey are not.

The resulrs From the current survey are not

significanrly different From those found in the March- April 200 land December 2000 surveys.

Among yourh smokers who are seriously thinking abour quirring smoking-', alrnosr four in ten (37%) say they will try ro quit wirhin the next 30 days.

Forty-rune percent say they will try ro quit within the next six months. Severi percent say they will not try within the next six months and six percent don't know when they will try to quit.

Potential Quitters

Smokers

Yes No dk/na

DEC

2000

57 42

MAR-ApR JULY

2001 2001

50 56

49 44.

Q.lla

Are you nou/ seriously thinking of qultting smoking?

Subsample: Smokers

Potential Ou itters

Smokers

DEC MAR-ApR JULY

2000 2001 2001

Within the next 30 days 56 41 37

Within the next 6 months 28 50 49

Not within the next 6 months 12 6 7

dk/na 5 ³ 6

Q.llb

When do you think you will try to quit?

Subsample: Smoeers who are senousi y thinking of quitiing smoking

2 These numbers should be inrerprered wirh caution, because of small sarnple sizes.

ENVIRONICS ^HEALTH^EFFECTSOF TOBACCO AND HEALTH WARNING MESSAGES- WAVE 3 7

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Among youth smokers who are seriously thinking about quirting smoking.', more rhan one-half say they will use will power or go cold turkey (54%) to try to quit smoking. More than one in ren say they would chew gum/candy/food (14%). Smaller numbers say they would eut back gradually (8%), use the nicotine patch (7%), do more exercise/get physically fit (7%), use nicotine gum (6%) or avoid other smokers/situations involving smoking (5%).

Ten percent mention sorne other ways or rnerhods and five percent offer no opinion.

Ways to Quit

Smokers

DEC MAR-ApR JULY

2000 2001 2001

Will power/co Id turkey/just stop 54 46 54

Chew gum/candy/food 4 ₃ 14

Cut back gradually 10 16 8

Nicotine patch 9 18 7

More exercise/get physically fit 2 2 ⁷

Nicotine gum 6 8 6

Avoid other srrokers/situations

involving smoking 5 2 5

Distract yourself 9 3

Zyban 6 2 2

Don't start 2

Hypnosis 1

Self-help program 2

Other 4 2 2

None/nothing 2

dk/na 11 5 5

Q. I le

If

you u/ere to quit smoking at sorne point in the future, what ways or metbods do you think you would use?

Subsample: Smoeers who are seriously thinking of qunting smoking

3 These nurnbers should be interprcted wich caution, because of small sample sizes.

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3.0 HEALTH EFFECTS OF SMOKING

A.

General and Top-of-mind Effects

More than eighi: in ten youth (85 %) think thar cigarette smoking is a major health problem in Canada. Anorher 13 percent rhink ir is a rninor problem. Only one percent rhink ir is not a health problem.

The results of the current survey are similar to those found in March-April 2001 and in December 2000.

The view thar smoking is a major health problem is lower among youth smokers.

When asked whac specifie human healrh effects or diseases can be caused by smoking cigarettes, youth are most likely co mentionlung cancer (61%).

Sm aller proportions mention cancer in general (37%), heart attack/disease/angina (19%), oral cancer - tongue, lips, mouth, throar 05 %), lung disease (14%), emphysema 00%), gum disease/roorh loss/

mou th disease (5%), respiratory problems/difficulty breathing/shortness of breath (5%), asthma (5%) and yellow reerh/fingers/effect on appearance (5%).

Twenry-nine percent mention other hum an health effects or diseases.

The current survey finds a decrease since March- April 2001 in the number of youth who mention lung cancer. The results of the currenr survey are similar co chose found in December 2000.

Older youch and yourh smokers are more likely rhan ethers co mention oral cancer and emphysema.

Porential yourh smokers are also more likely to mention oral cancer. Older youth and porential youth smokers are more likely rhanorhers to mention lung cancer. Youth smokers are more likely to mention cancer in general.

Smoking as a Health Problem

DEC MAR-ApR JULY

2000 2001 2001

Major 84 87 85

Minor 13 11 13

Nol a problem 2 1 1

dk/na

Q.I2

In general, do you think that cigarette smoking is a major health problem, a minor health problem or not a health problem in

Canada?

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEAlTH WARNING MESSAGES - WAVE 3 9

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Health Effects of Smoking - Top-of-Mind

DEC

2000

Cancer-Iung 60

Cancer in general 35

Heart attacl<!disease/angina 17

Cancer - oral (tongue, lips, mouth, throat) 13

Lung disease/lungs (unspecified) 16

Emphysema 9

Gum disease/tooth loss/mouth disease 4

Respiratory problems/difficully breathing/shortness of breath 5

M~~ 5

Yellow teeth/fingers/effect on appearance 2

Stroke 2

Brain damage/disease 1

Blood circulation problerns/blood clots 2 Bronchitis/chronic bronchitis

Cancer - other

Impotence/sexual dysfunction

Death/premature death 2

Liver damage/disease

Poor physical condition/loss of energy Bad breath

Etlect on the fetus/unborn child

Smaller babies/reduced growth of babies during pregnancy Preterm birth/premature birth

2

2 2

• Less than one percent

MAR-ArR JULY

2001 2001

68 61

34 37

21 19

14 15

13 14

10 10

6 5

5 5

4 5

4 2

3 2

2 2

1 2

2 2 2

Continued ...

Q.13

What specifie human heafth elfeets or diseases, if any. fan yo« think of that can be caused by smoking cigarettes? Are tbere any ethers?

ENVIRONICS ^{HEAL TH}^EFFECTSOF TOBACCO AND HEAL TH W ARNING MESSAGES - W AVE 3 10

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Health Effects of Smoking - Top-of-Mind

Continued

DEC MAR-ApR JULY

2000 2001 2001

Addiction Cancer - breast Wrinkles/premature aging Coughing

Birth defects/problems with pregnancy Ihroat diseasvprobtems

Eye disease/problems High blood pressure

Air pollution/environmental damage Multiple Sclerosis

Headaches Dizziness/nausea Second-hand smoke Kidney disease/problems Skin irritations/conditions Miscarriages/still births Immune system problems Stomach problems Fire accidents/burns Allergies

Gangrene

Other 2 2 2

None

dk/na 3 4

, Less than one percent

Q.13

What specifie human health effects or diseases,

if

any, can yo« think of that can be caused by smoking cigarettes) Are there any otbers?

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B.

Sources of Information about Health Effects

Wheo asked where they have receody seen or heard ioformatioo which talks about the healrh effects of smoking cigarettes, the largest proportion of yourh mention television (48%). Sm aller nurnbers mention schooi/universiry (40%), cigarette packages (32%), word of mouch/family/frieods (14%) aod magazioes (11 %). Thirty percent mention ether sources of information aod six percent say oowhere.

The results of the currenr survey show thar the oum ber of yourh who have seen or heard information about the health effects of smokiog cigarettes 00

cigarette packages is 19 points higher than in December 2000. The oumber who mention schoo1/

university is lower than thar fouod in December 2000. There has beeo a slight decrease sioce March- April 2001 in the oum ber mentioning television,

Older youth, youch smokers aod porencial youth smokers are more likely ro have seen this ioformatioo

00 cigarette packages. Older youth are also more likely ta mention television aod magazioes. Yourh aged 12 ta 16 are more likely tO mention schoo1/

universi ry.

Sources of Information About Health Effects

DEC MAR-ApR JULY

2000 2001 2001

Television 49 56 48

School/university 48 44 40

Cigarette packages 13 29 32

Ward of mouth/family/friends 11 10 14

Magazines 16 14 11

Newspapers 6 7 6

Billboards 5 6 5

Radio 5 5 5

News 2 2 3

InterneVwebsite 2 3 2

Doctor/doctor's office 3 2 2

Public areas and buildings 2 2

Posters 2

Workplace

Other tobacco product packages Advertising/media - general Health associations/açencies Pamph 1 ets/bro c h ures/flyers Drug/health food stores/stores

in general

Books/scientific journals Bus/public transportation Hospitals/medical clinics

Other 1

Nowhere 8 5 ⁶

dk/na 3 3 3

• Less th an one percent

Q.14

Thinking genera!!y abolit information iobicb ta/ks abolit the heafth eflects of smoking cigarettes, where have YOIi seen or heard any of this kind of information recent/y? Anywhere else?

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c. Specifie Health Effeets Caused by Smoking

In this section of the survey, respondents were read a list of healrh effects and diseases, and were asked the extent ro which they agreed or disagreed that each can be caused by smoking cigarettes.

An overwhelming rnajoriry of youth strongly agree thar lung cancer (95%) can be caused by smoking cigarettes. Large majorities srrongly agree thar smoking can cause heart disease (74%), throat cancer (73%), gum or mouth diseases (72%), asthrna (67%), rnouth cancer (66%) and premature death (64%).

SmaUer majorities strongly agree that smoking can cause smaller babies or reduced growth of babies during pregnancy (54%), chronic bronchitis (50%) and wrinkles and premature aging (50%).

Fewer th an half of youth strongly agree thar smoking can cause stroke (49%), premature birth or preterm birth (42%), emphysema (38%), miscarriages (35%), blood clots (34%), impotence in men (27%), stomach ulcers (22%), infertility (22%) and bladder cancer (l6%). Only abolit one in ten strongly agree thar smoking can cause acne (12%), Multiple Sclerosis (Il %), arrhritis (lI %), Alzheimer' s Disease (lI %), gangrene (9%) and hepatitis (8%).

Specifie Health Effeets Caused by Smoking

OEC MAR-APR JULY

2000 2001 2001

Lung cancer

Stronglyagree 95 97 95

Somewhat agree 4 2 4

Somewhat disagree Strongly disagree dk/na

Heart disease

Somewhat disagree 2 2 3

Strongly disagree 2

dk/na Throat cancer

Strongly disagree 2 1

dk/na 2 2

Gum or mouth diseases

Strongly disagree 4 2 2

dk/na 3 2 2

Asthma

dk/na 2

Q.15

1 am going to read you a !ist of human health effects and diseases that may or may not be caused by smoking cigarettes. Based on what you know or be!ieve p!ease te!! me

if

you strong!y agree, somewhat agree, sometobat disagree or strongly disagree that smoking cigarettes can cause eacb of the follouing . ⁾

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 3 13

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The results of the current survey suggest thar there have been slight declines since the March-April 200 l survey in the proportions of Canadian youth who strongly agree thar throar cancer, heart disease and emphysema can be caused by smoking cigarettes.

Comparison with the baseline survey in December 2000 suggests thar, over this time period, the proportions who srrongly agree thar specific health effects can be caused by smoking have in most cases remained stable, but thar there have been increases in the proportions of Canadian youth who strongly agree thar impotence in men, gum and rnouth diseases, stroke and infertiliry can be caused by smoking.

Among yourh, girls are more like1y th an boys to

strongly agree thar smoking can cause smaller babies or reduced growth of babies during pregnancy, premature birth or preterm birth and chronic

bronchitis. Boys are more like1y than girls ro srrongly agree thar smoking can cause impotence in men and premature dearh, Older youth are more like1y to strongly agree thar smoking can cause emphysema, impotence in men, rnourh cancer, throar cancer, wrinkles and premature aging, infertility, gum or mouth diseases, smaller babies or reduced growth of babies during pregnancy, chronic bronchitis and premature death.

Specifie Health Effects Caused by Smoking

DEC MAR-ApR JULY

2000 2001 2001

Mouth cancer

dl</na 3 3 3

Premature death

Strongly disaçree 4 4 2

dl</na 3 3 4

Smaller babies or reduced growth of babies during pregnancy

dl</na 6 4 6

Chronic bronchitis

dl</na 10 11 17

Wrinkles and premature aging

dl</na 4 3 5

Q.I5

1 am going to read you a list of buman health effects and diseases that may or may not be caused by smoking cigarettes. Based on what YOIi know or belieue p!ease tel! me

if

you strongly agree, somewhat agree, somewhat disagree or strong!y disagree that smoking cigarettes can cause each of the fo!!owing ... )

ENVI RON ICS ^HEALTH ^EFFECTS^OFTOBACCO AND HEALTH WARNING MESSAGES - WAVE 3 14

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Those who have seen, read or heard about the new heal th warning messages on cigarette packages and rhose who have seen rhese messages on cigarette packages are more likely rhan rhose who have not co strongly agree thar smoking can cause emphysema, impotence in men, throar cancer, inferrility, smaller babies or reduced growth of babies during pregnancy and chronic bronchitis. Those who have seen, read or heard about the new health warning messages on cigarette packages are also more likely ro srrongly agree that smoking can cause wrinkles and premature aging, gum or rnouth diseases and premature death.

Potential smokers among yourh are more likely co strongly agree thar smoking can cause impotence in men, asrhrna, throat cancer and chronic bronchitis, but they are more likely to srrorigly disagree thar smoking can cause gangrene and acne. Y outh smokers are more likely than ethers to strongly agree thar smoking can cause emphysema and impotence in men, but they are more likely CO strongly disagree thar smoking can cause arthriris, impotence in men, gangrene, stomach ulcers, miscarriages, bladder cancer, heparitis, wrinkles and premature aging, acne, Multiple Sclerosis and Alzheirner's Disease.

Specifie Health Effects Caused by Smoking

DEC MAR-ApR _JULY

2000 2001 2001

Stroke

dk/na 11 12 13

Premature birth orpreterrn birth

dklna 7 7 8

Emphysema

Strongly agree 37 42 38

dklna 27 28 30

Miscarriages

Strongly agree 34 35 35

dk/na 10 12 14

Blood clots

dklna 10 9 11

Q.15

1 am going to read you a list of human health effects and diseases that may or may not be caused by smoking cigarettes. 8ased on what you know or be!ieve p!ease te!! me if you strongly agree, somewhat agree, somewhat disagree or strong!y disagree that smoking cigarettes can cause each of the Jo!!owing . . ?

ENVIRONICS HEAlTH EFFECTS OF TOBACCO AND HEAlTH WARNING MESSAGES - WAVE 3 15

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Specifie Health Effects Caused by Smoking Specifie Health Effects Caused by Smoking

DEC MAR-ApR _JULY _DEC MAR-ApR _JULY

2000 2001 2001 2000 2001 2001

Impotence in men Multiple Sclerosis

Stronglyagree 14 27 27 Stronglyagree 14 13 11

Somewhat agree 29 27 26 Somewhat agree 27 29 27

Somewhat disagree 18 16 15 Somewhat disagree 21 21 18

Strongly disagree 15 11 9 Strongly disagree 16 13 15

dk/na 24 19 23 dk/na 22 24 29

Stomach ulcers Arthritis

Strongly agree 23 24 22 Stronglyagree 12 12 11

dk/na 13 13 17 dk/na 9 11 13

Infertility Alzheimer's Disease

dk/na 23 20 25 dk/na 13 15 18

Bladder cancer Gangrene

Somewhat dlsagree 26 25 26 Somewhat disagree 19 19 15

dk/na 11 13 14 dk/na 32 31 36

Acne Hepatitis

Somewhat disaqree 30 30 28 Somewhat disagree 27 29 25

dk/na 7 9 10 dk/na 15 15 17

Q.15

1 am going to read you a list of buman heafth effeas and diseases that may or may not be caused by smoking cigarettes. 8ased on what you enoio or belieue please tel! me if you strongly agree, somewhat agree, somewhat disagree or strongly disagree that smoèing cigarettes can cause each of the [allounng ... ?

ENVIRONICS HEAL TH EFFECTS OF TOBACCO AND HEAL TH W ARNING MESSAGES - W A VE 3 16

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D.

Specifie Health Effects Caused by Second- Hand Smoke

In this section of the survey, respondenrs were read a list of health effects in non-smokers, and were asked abolit the exrenr to which they agreed or disagreed thar each can be caused by second-hand smoke.

Majorities of youth srrorigly agree that second-hand smoke can cause asrhrna artacks in children (62%) and lung cancer in non-smokers (52%). Fewer rhan half strongly agree thar second-hand smoke can cause chest infections in children (49%), bronchiris in children (46%), heart disease in non-smoking adules (37%), srrokes in non-smoking adults (22%), srDS (Sudden Infant Death Syndrome) or crib dearh (18%) and ear infections in children (13%). Only about one in ren strongly agree that second-hand smoke can cause arrhriris (10%), Multiple Sderosis (8%) and Alzheimer's Disease (8%) in non-smoking adults.

The results of the current survey suggest thar there have been declines since the March-April 2001 survey in the proportions of Canadian youth who strongly agree thar lung cancer in non-smokers, SIDS, chesr infections in children and bronchitis in children cari be caused by smoking cigarettes.

Comparison with the baseline survey in December 2000 suggests slight declines over this time period in the proportions expressing srrong agreement with resp'ect to lung cancer in non-smokers, SIDS and chest infections in children.

Specifie Health Effects Caused by Second-Hand Smoke

DEC MAR-ApR JULY

2000 2001 2001

Asthma attacks in children

Stronglyagree \ 64 64 62

dl</na 2

Lung cancer in non-smokers

dl</na 2

Chest infections in children

dl</na 3 2 4

Bronchitis in children

dl</na 7 5 8

Heart disease in non-smoking adults

dl</na 3 2 4

Q.I6

Hm is a list ofhealth effects and diseases afficting non-smokers that may or may not be caused by breathing in second-band smoke from cigarettes that otber people are smoking. Based on what you

know or believe please tell me ifyou strongly agree, somewhat agree, somewhat disagree or Jtrongly disagree tbat second-band smoke cati cause eacb of the followil/g ... ?

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Among yourh, girls are more likely rhan boys co

Specifie Health Effeets Caused by

srrongly agree that second-hand smoke can cause

Seeond-Hand Smoke

asrhrna attacks and chest infections, both in children.

Boys are more likely than girls co srrongly agree char OEC MAR-ApR JULY

second-hand smoke can cause strokes in non- 2000 2001 2001

smoking adulrs. Older yourh are more likely than SIOS (Sudden Infant Death Syndrome) or Crib Oeath

orhers co strongly agree that second-hand smoke can Stronglyagree 23 24 18 cause asthma atracks, ear infections, chest infections

and bronchitis, all in children; heart disease in non-

smoking adules; and lung cancer in non-srnokers. Somewhat disagree 16 19 17

Those who have seen, read or heard about the new dk/na 15 15 20

healrh warning messages on cigarette packages and

chose who have seen these messages on cigarette Ear infections in children

packages themselves are more likely to strongly agree Stronglyagree 15 14 13 thar second-hand smoke can cause asrhrna attacks Somewhat agree 24 26 27 and bronchiris in children. Those who have seen, read Somewhat disagree 28 30 26 or heard abolit the new health warning messages on Strongly disagree 24 23 26

cigarette packages are also more likely to strongly dk/na 9 7 8

agree thar second-hand smoke can cause lung cancer in non-smokers and chest infections in children,

Arthritis in non-smoking adults

y ourh smokers are more likely rhan orhers co Strongly agree 7 8 10

strongly disagree thar second-hand smoke can cause Somewhat agree 20 21 21 heart disease, arthriris, strokes, Multiple Sclerosis and Somewhat disagree 34 31 31 Alzheirner's Disease in non-smoking adulrs, ear Strongly disagree 31 32 27

infections in children and SIDS or crib death. dk/na 7 9 11

Multiple Sclerosis in non-smoking adults

Stronglyagree 9

Specifie Health Effeets Caused by Seeond-Hand Smoke

OEC MAR-ApR JULY

2000 2001 2001

Strokes in non-smoking adults

dk/na 10 10 13

Q.76

Somewhat agree 25

Somewhat disagree 25

Strongly disagree 22

dk/na 19

Alzheimer's Oisease in non-smoking adults

Strongly agree 8

Somewhat agree 23

Somewhat disagree 30

Strongly disagree 27

dk/na 11

10 26

8 26

28 24

18 19

18 23

8 8

25 23

29 28

27 26

11 15

Here is a list of health effects and diseases affecting non-smoeers that may or may not be caused by breathing in second-hand smoke from cigarettes that other people are smoking. Based on what you know or belieie please tel! me

if

yeu strongly agree, somewhat agree. somewhat disagree or strong!y disagree that second-band smoee can cause each of the following )

ENVI RON ICs HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 3 18

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E.

Health Effects Caused by Hydrogen Health Effects Caused by Hydrogen Cyanide Cyanide

DEC MAR-ApR JULY

When asked, top-of-rnind, three-quarters of youth 2000 2001 2001

(76%) offer no specifie health effects or diseases thar

Lung disease/cancer 2 5 4

can be caused by hydrogen cyanide. Another 12

percent say hydrogen cyanide does not cause any Cancer - general 1 ₂ ₂ health effects or diseases. Only 16 percent mention Dealh 3 ₂ ₂ specifie healrh effects or diseases. Respiratory problems/loss of brealh 2

Heart disease/aftack 2

The survey finds that the number of youth who say Brain damage/memory loss/stroke hydrogen cyanide does not cause any hcalrh effects or Headache

diseases increased slightly between December 2000 Dizziness and March-April 200 l , but has now declined (by 18 Nausea points). The survey also finds rhar the number who Vertigo offer no opinion decreased slightly between _/ Stomach aches December 2000 and March-ApriI2001, bue has now Weakness increased ^(by17 points).

Damage 10 cells/arleries/blond Throat cancer

Mout cancer/disease Poisoning

Liver cancer/disease Damage to nervous system Pregnancy complications Lung damge

Burning in body/organs

Other 1 1 1

None 24 30 12

dk/na 66 59 76

* Less than one percent

Q.35

What specifie heafth effects or diseases, If any, (an yo« name that (an be caused by hydrogen cyanide?

ENVI RON ICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 3 19

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4.0

DEATHS FROM TOBACCO USE

Respondenrs were asked whether they believe thar

Causes of Oeath

robacco use kills more or fewer numbers of Canadians

[han a number of orher causes of dearh, OEC MAR-ApR JULY

2000 2001 2001

Between half and rwo-rhirds of youth think robacco Suicides use kills more Canadians each year rhan do suicides

More 61 64 67

(67%), murders (60%), alcohol (55%), AIDS (54%),

Fewer 21 19 17

illegal drugs (52%) and car accidents (50%).

About the same number 15 14 15

Between one-rhird and one-half of yourh believe thar

robacco use kills fewer or the same number of dk/na 3 3 2

Canadians each year as these other causes of dearh.

Murders

The current survey suggests a slight decrease since More 57 60 60

March-April 2001 in the number of yourh who think Fewer 25 23 22 tobacco use kills more each year than do illegal About the same number 16 16 16

drugs. Since December 2000 there have been slight dk/na 2 2

increases in the numbers of youth who think thar

tobacco use kills more Canadians each year than car Alcohol

accidents, AIDS, alcohol and suicides. More 51 57 55

Fewer 20 15 18

Boys are more likely chari girls ro rhink thar tobacco

use kills more Canadians each year than do any of

dk/na 2

rhese other causes of dearh. Older yourh are more likely chan ethers ra think cobacco use kills more

each year chan do illegal drugs, AIDS, suicides and AlOS

murders. Those who have seen, read or heard about More 50 51 54

the new health warning messages on cigarette Fewer 26 24 22

packages and chose who have seen chese messages on About the same number 20 21 22

cigarette packages themselves are more likely to dk/na 4 3 2

rhink chat cobacco use kills more Canadians each

year th an most of rhese orher causes of dearh, Illegal drugs

More 52 59 52

Porenrial yourh smokers are more likely to think Fewer 23 20 21

robacco use kills more each year chan do illegal

drugs, car accidents and AIDS. Youth smokers are

dk/na 2

slighdy more likely to rhink tobacco use kills fewer Canadians each year than do illegal drugs, AIDS and

Car accidents murders.

More 46 50 50

Fewer 28 27 25

dk/na

Q.I7

Do you think that tobacco use kills more, jèwer or about the same number of Canadians eacb year as eacb of the Jollowing otber causes of deatb ... ?

ENVI RON les HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES - WAVE 3 20

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A total of 22 percent of youth correcdy believe thar approximately 45,000 Canadians die each year as a resulr of tobacco use. More than four in ten (45%) pick a number lower rhan 45,000 and three in ten (29%) choose a number higher than 45,000.

The survey finds that the number of youth who correctly believe thar approximately 45,000

Canadians die each year as a resulr of tobacco use has increased by four points since the December 2000 survey.

Number of Canadians Who Die Each Year from Tobacco Use

DEC MAR-ApR JULY

2000 2001 2001

1,000 5 3 4

5,000 8 7 8

10,000 1

15,000 11 11 15

20,000 1

25,000 20 17 16

45,000 18 23 22

50,000 2 2

75,000 15 15 15

100,000 15 15 13

Other 3 ⁴ 2

None

dk/na 2 2

Q.18

Which of the fo!!owing do you think is the closest approximation of the number of Canadians who die each year as a result of tobacco use? ls if closest to ... ?

ENVIRONICS ^HEALTH EFFECTS OF TOBACCO AND HEAL TH W ARNING MESSAGES - W A VE 3 21