W AVE 2 SUR VEYS

(1)

ENVIRONICS

RES E ARC H G ROU P

W AVE 2 SUR VEYS

THE HEALTH EFFECTS OF TOBACCO AND HEALTH

W

ARNING MESSAGES

ON CIGARETTE PACKAGES

SURVEY OF YOUTH

fi L E

Prepared for:

Healrh Canada

Prepared by:

Environics Research Group Limired

August 2001

PN4893

(2)

"

IABLE 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-rnind Effects 9

B. Sources of Information about Health Effects ; Il

c. Specifie Healrh Effects Caused by Smoking... 12

D. Specifie Health Effects Caused by Second-Hand Smoke 16

E. Health Effects Caused by Hydrogen Cyanide 18

4.0

DEATHS FROM TOBACCO USE 19

5.0

QUIT TIPS 21

6.0

HEALTH WARNING MESSAGES 22

A. Recall and Reads per Day 22

B. Impact of New Messages , 27

c. Assessment of New Messages 28

D. Comparison of New and Old Messages 28

7.0

ToxIC SUBSTANCES 29

8.0

TELEVISION ADVERTISING 31

A. Awareness and Recall 31

B. Sponsorship of Ads 32

c. Effectiveness of Ads 32

D. Recall and Use of Communication Channels 33

ApPENDICES

Survey Methods

English and French Questionnaires

(3)

1.0 INTRODUCTION

Environics Research Group Limired was

commissioned by Health Canada to conduct a survey of Caoadiao youth, including youth smokers and non-smokers. The main objective of the survey was ro provide information to assist in the evaluation of the impact of new health warning messages on tobacco packaging on yourh knowledge and

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

approximately January 1,2001.

The survey assessed sources of information about the effects of tobacco, awareness and knowledge of the health effects of tobacco, the exrenr to which specifie diseases are believed ro be caused by tobacco and the number of dearhs caused by smoking. The survey also measured awareness and recall of the new labels and their effect on knowledge and behaviours and awareness and recall of television advertising about the new labels.

Where possible, the results of the new survey will be compared ro the previous baseline survey of yourh, which was conducted by Environics in December, 2000 prior ro the introduction of the new health warning messages into the marketplace.

The survey of youth aged 12 to 18, which included youth smokers and non-srnokers, is based on a sample size of 1,003. This survey was conducted between March 27 and April 9, 2001.

A survey based on a sample of 1,003 has a margin of error of approximately 3.1 percentage points, 19 times in 20.

This report surnmarizes the findings of the research.

Appended to this report are copies of the English and French questionnaires and a description of the survey rnerhods.

ENVIRONICS

3

HEALTH EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES

(4)

2.0 SMOKING STATUS

A. Smoking Behaviour and Brands

From the survey, seven percent of youth smoke cigarettes every day and six percent smoke

occasionally. Older youth, especiaIly chose aged 17 ta

18 years, are more likely than younger teens to say they smoke cigarettes every day.

Among non-smoking youth, 37 percent say they have at sorne rime tried cigarette smoking, which includes just having a few puffs. Among non- smoking youth who have never rried smoking, not even a few puffs, seven percent say they have seriously thought about trying smoking. Among non-smoking youth, three percent say they might try smoking within the next month.

Of the yourh sample, 13 percent are smokers and 87 percent are non-smokers. Of aIl youth, 36 percent can be classified as porenrial smokers. Potentiai smokers include any youth who say they have tried smoking, have seriously thought about smoking or rhink they might try smoking within the next monrh.

More rhan one in ren Canadian youth (14%) report haviug smoked at least 100 cigarettes in rheir life.

This number is twice as high among older yourh, aged 17 ta 18 years.

Cigarette Consumption

DEC 2000

Every day

Occasionally (Iess than every day) Not al ail

11 6 83

MAR-ApR

2001 7 6 87

I-IEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES

ç.i

At the present time, do yoa smoke cigarettes (manufactured or roll your oum) every day, occasionally or no! a! ail?

ENVI RON les 4

(5)

Among yourh smokers who smoke every clay*, 25 percent report smoking more than 15 cigarettes per day, which includes one percent who say they smoke more than 25 cigarettes per clay. Four in ten (40%) say they smoke between ren and 15 cigarettes per clay. More th an rhree in ren (35%).report smoking fewer than ten cigarettes per day.

Among youth smokers who smoke occasionally*, 89 percent report smoking fewer than ten cigarettes per day on the days that they smoke. Five percent smoke berween ten and 15 cigarettes per day and only one percent smoke more th an 15 cigarettes per clay.

Among youth smokers, Players Light Regular Size (23%) is most often mentioned as rheir regular brand of cigarettes. Small proportions mention DuMaurier Regular Size (9%), Export "A" Medium Regular Size (6%), DuMaurier King Size (6%), DuMaurier Light King Size (6%), Export "A" Regular Size (5%) and DuMaurier Light Regular Size (5%). Twenty-eight percent mention sorne ether brand.

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

* These nurnbers should be interprered wieh caution, because of small sample sizes.

Cigarette Consumption Per Day

Every Day Smokers

DEC MAR-ApR

2000 2001

Less than 10 cigarettes per day 31 35

10 to 15 cigarettes per day 41 40

16 to 20 cigarettes per day 12 12

21 ^to25 cigarettes per day 14 12

26 or more cigarettès per day 1

Q.6

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

Subsample: Smoke every day

Cigarette Consumption Per Day

Occasional Smokers

DEC MAR-ApR

2000 2001 Less than 10 cigarettes per day

10 ^to15 cigarettes per day 16 or more cigarettes per day dk/na

92 7

89 5

4

Q.7

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

Subsampie: Smoke occasional!y

ENVIRONICS

5

HEALTH EFFECTS OF TOBACCO AND HEALTH WARN1NG MESSAGES

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B.

Quit Attem.pts and Potential Quitters

Six in ten yourh smokers (61 %) report having tried ra quit smoking; abolit four in ten (38%) have not tried to quit.

Among yourh smokers who have tried to quit smoking*, almost nine in ten (88%) say they have stopped smoking for a period of 24 hours at least once in the past year, in an attempt ro quit. Only 12 percent say they have not attempted ro quit smoking in the past year.

* ^These^numbers ^should be incerprered with caution, because of small sample sizes.

Quit Attempts

Smokers

DEC MAR-ApR

2000 2001

Yes No dk/na

66 33

61 38

Q.9

Have you cucr tried to quit smoking?

Subsample: Smokers

Number of Times Tried to Quit Smoking

Smokers

DEC MAR-ApR

2000 2001

Once 21 15

Twice 15 26

Three times 20 10

More than three times 27 :J

Not in the past year 15 12

dk/na

Q.IO

In the past year, bou: many timesbave you stopped smoking for at

!east 24 hours because YOIi were trying to quit smoking?

Subsample: Smokers who have tried to quit smoking

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

(7)

-.

Five in ten youth smokers (50%) report they are now seriously thinking of quitting smoking; 49 percent say they are not.

Among yourh smokers who are seriously thinking about quittiog smoking*, four in ten (41%) say they will try to quit within the next 30 days. Fifty percent say they will try to quit wirhin the next six monrhs.

Six percent say they will not try within the next six months and three percent don't know when they will try to quit.

* These numbers should be interpr e ted wirh camion, because of srnall sample sizes.

Potential Quitters

Smokers

DEC MAR-ApR

2000 2001

Yes 57 50

No 42 49

dk/na

Q.lla

Are yuu 7J1JU/ seriously thinking of quitting smoking?

Subsample: Smokers

Potential Quitters

Smokers

DEC MAR-ApR

2000 2001

Within the next 30 days 56 41

Within the next 6 months 28 50

Not within the next 6 months 12 6

dk/na 5 3

Q.llb

When do you think JOU will try to quit?

Subsample: Smokers who are seriously thinking of qui/ting smoking

ENVIRONICS

7

HEALTI-l EFFECTS OF TOBACCO AND HEALTH WARN1NG MESSAGES

(8)

Among yourh smokers who are seriously thinking about quitting smoking*, almost one-half say they would use will power or go cold turkey (46%) to try ro quit smoking. About two in ten say they would use the nicotine patch (18%) or eut back gradually (16%). About one in ten say they would distract rhemselves (9%) or use nicotine gum (8%). Eleven percent mention other ways or methods and five percent offer no opinion.

* These nurnbers should be mterpreted with camion, because of small sample sizes.

Ways ta Quit

Smokers

Will power/cole turkey/just stop Nicotine patch

Cut back gradually Distract yourself Nicotine gum Chew gum/candy/food Zyban

Avoid other smokers/situations involving smoking

More exercise/get physically fit None/nothing

Other dklna

DEC MAR-ApR

2000 2001

54 46

9 18

10 16

9

6 8

4 3

6 ₂

5 2

2 2

9 2

11 5

Q.Ilc

If you uiere to quit smoking at sorne point in the future, what ways or methods do you think you wou/d use?

Subsample: Smokers who are seriously thinking of quiiting smoking

ENVI RON les ^HEALTH ^EFFECTS OF TOBACCO AND I-lEALTl-I WARNING MESSAGES 8

(9)

3.0 HEAlTH EFFECTS OF SMOKING

A.

General and Top-of-mind Effects Smoking as a Health Problem

Almost ni ne in ren youth (87%) rhink thar cigarette smoking is a major healrh problem in Canada.

Another Il percent rhink ir is a minor problem.

Only one percent think it is not a healrh problem.

Major Minor Nol a ^problem dk/na

DEC MAR-ApR

2000 2001

84 87

13 11

2 1

The current survey finds a slight increase since December in the number of youth who think that cigarette smoking is a major health problem in Canada.

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

Q.12

ln general, do you think that cigarette smoking is a major health problem, a minor hea/th problem or no! a heafth prob/em in

Canada?

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTI-l WARNING MESSAGES 9

(10)

When asked what specifie human healrh effects or diseases can be caused by smoking cigarettes, youth are most likely ro mention lung cancer (68%).

Smaller proportions mention cancer in general (34%), heart attack/disease/angina (21 %), oral cancer - tongue, lips, mouth, throat (14%), lung disease 03%), emphysema 00%) gum disease/roorh loss/

rnourh disease (6%) and respirat?ry problemsl difficulty breathing/shortness of breath (5 %). Forry percent mention other human health effects or diseases.

The current survey finds increases since December in the number of youth who mention lung cancer and heart attack/disease/angina and a slight decrease in the number who mention lung disease.

Older youth and youth smokers are more likely than ethers to mention emphysema. Youth smokers are also more likely than ethers ta mention heart attack/

disease/angina. Older yourh are also more likely to mention oral cancer.

Health Effects of Smoking - Top-of-Mind

~, ","'~'. --':;, •• ,:;"-"~t-h';>;,_'i~ __ ·,'v.,~,.", ..• _._"_.,_,,_,,_;,~~,,,,,",,,' ô' ... - .. x;-.< "''''"".,' ;w;;, .'~_ •• ' __ " ~.; ... _.- __ ;<'~"

DEC MAR-ApR

2000 2001

Cancer - Iung 60 68

Cancer in general 35 34

Heart atack/disease/anqina 17 21

Cancer - oral (tongue, lips, mouth, throat) 13 14

Lung disease/lungs (unspecilied) 16 13

Emphysema 9 10

Gum disease/tooth loss/mouth disease 4 6 Respiratory problems/dilticulty

breathing/shortness 01 breath 5 5

Asthma 5 4

Stroke 2 4

Yellow teeth/lingers/eltect on appearance 2 4

Brai n damage/disease 3

Liver damage/disease 2

Blood circulation problems/blood clots 2 2 Poor physical condition/loss 01 energy 2 2

Bronchitis/chronic bronchitis 2

Cancer - other 2

Bad breath 2

Impotence/sexual dyslunction 2

Eltect on the tetus/unborn child (general) Smaller babies/reduced growth of

babies during pregnancy 2

Premature birth/preterm birth 2

Death/premature death 2

Addiction Cancer - breast Wrinkles/premature aging Second-hand smoke High blood pressure

Air pollution/environmental damage Allergies

Coughing Gangrene None

Other 4 3

dl</na 3

• Less than one percent Q.13

WhClt Jpectfic hurnan bealtb efforts or diseases,

if

cmy, can you thini: of tbat tan be caused by smoking cigarettes? Are there Clny otbers?

ENVIRONICS ^HEALTH ^EFFECTS OF TOBACCO AND HEALTH W ARNING MESSAGES 10

(11)

B.

Sources of Information about Health Effects

When asked where they have recendy seen or heard information which talks about the health effects of smoking cigarettes, the largest proportion of youth mention television (56%). Sm aller numbers mention school/university (44%), cigarette packages (29%), magazines 04%) and word of mouth/family/friends 00%). Twenty-eight percent mention other sources of information and five percent say nowhere.

The current survey finds a considerable increase since December in the number of youth who have seen or heard information about the health effects of smoking cigarettes on cigarette packages (up 16 points) and a smaller increase in the number who have seen this information on television. There have been slight decreases in the numbers who mention school/university and who say they have not seen this information anywhere.

Older yourh, youth smokers and potential yourh smokers are more Iikely to have seen this information on cigarette packages. Oider youth and porential youth smokers are also more likely ro mention television. y ounger youth, aged 12 ro 14 years, are more likely to mention school/university.

Sources of Information About Health Effects

>;iA_"_"'·"".'i',:t-w,',~,"'i<-·' __ ~_-'.'-·<-vV~-'''''''''-:i'<,;' ._~", _,' q>-. ,,·- ___ 'r~?6·~''''~.~,~·=,_·'''''., '-" "'i"'.

DEC MAR-ApR 2000 2001

Television 49 56

School/university 48 44

Cigarette packages 13 29

Magazines 16 14

Word 01 mouth/lamily/lriends 11 10

Newspapers 6 7

Billboards 5 6

Radio 5 5

InterneVwebsite 2 3

Doctor/doctor's office 3 2

News 2 2

Public areas and buildings 2

Workplace

Other tobacco product packages

Other 6

Nowhere 8 5

dkina 3 3

* Less than one percent

Q.14

Thinking generally about information which ta/ks ab~ut the health efficts of smoking cigarettes, u/here have you seen or heard any afthis kind of information recent/y? Anytobere else?

ENVIRONICS

HEALTl-I EFFECTS OF TOBACCO AND I-lEALTH WARNING MESSAGES Il

(12)

c Specifie Health Effects Caused by Smoking

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

Large majorities of youth strongly agree thar lung cancer (97%) can be caused by smoking cigarettes.

Large majoriries also strongly agree thar smoking can cause heart disease (78%), throat cancer (77%), gum or mouth diseases (73%), asthma (70%), rnouth cancer (69%) and premature death (67%). Sm aller majorities strongly agree that smoking can cause smaller babies or reduced growth of babies during pregnancy (55 %), wrinkles and premature aging (52%), chronic bronchitis (52%) and stroke (51 %).

Fewer than half of youth strongly agree that smoking can cause emphysema (42%), premature birth or preterrn birrh (41%), blood clots (36%), miscarriages (35%), impotence in men (27%), stomach ulcers (24%), infertility (23%) and bladder cancer (19%).

Only about one in ren strongly agree that smoking can cause multiple sclerosis (13%), arthritis (12%), Alzheirner's Disease (12%), acne (11 %), hepatitis (10%) and gangrene (9%).

Specifie Health Effects Caused by Smoking

.... ,_o~·v'''.,_- __ ,~.~''''·,,··~v_,_,,~'-··_ ... '.'{'''',>=;;,;, ',."z .... x~'""'..:', .... ,..~.:~~, ·-····'_·~-,·,'"';;,·'~".·_''to''''''' __ F;_·'''_·.··_''' '.··~,y, ... ~.Vy'. ,-,_

DEC MAR-ApR

2000 2001

Lung cancer

Strongly agree 95 97

Somewhat agree 4 2

Somewhat disagree Strongly disagree dk/na

Heart disease

Somewhat agree 21 18

Somewhat disagree 2 2

Strongly disagree 2

dk/na

Throat cancer

Strongly disagree 2

dk/na '2

Gum or mouth diseases

Stronglyagree 66 73

Strongly disagree 4 2

dk/na 3 2

Asthma

Stronglyagree 67 70

dk/na 1

• Less than one percent

Q.15

1 am going to read you a list of human health effeas and diseases that may or may not be caused by smoking cigarettes. 8ased on what you know or believe please tell me if you strongly agree, somewhat agree, somewhat disagree or strongly disagree that smoking cigarettes can cause each of the fol/owmg ... )

ENVIRONICS ^HEALTH^EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES 12

(13)

In general, rhere have been increases since December in the numbers of youth who strongly agree thar smoking can cause a number of thèse health effects, particularly impotence in men (up 13 points), stroke (up seven points) and gum or mouth diseases (up seven points).

Among youth, girls are more likely th an boys to strongly agree thar smoking can cause miscarriages, wrinkles and premature aging, gum or mouth diseases, sm aller babies or reduced growth of babies during pregnancy, premature birrh or preterm birth and chronic bronchitis. Older youth are more Iikely to strongly agree that smoking can cause

emphysema, impotence in men, asthma, mouth cancer, throat cancer, wrinkles and premature aging, infertility, gum or mouth disease and chronic

bronchitis. Younger youth are more likely ta strongly agree that smoking can cause bladder cancer and hepatitis.

Specifie Health Effects Caused by Smoking

DEC MAR-ArR 2000 2001 Mouth cancer

Stranglyagree Somewhat agree Somewhat disagree Strongly disagree dk/na

Premature death Strongly agree Somewhat agree Somewhat disagree Strongly disagree dk/na

Smaller babies or reduced grawth of babies during pregnancy

Somewhat agree Somewhat disagree Strongly disagree dk/na

Chranic branchitis Strongly agree Samewhat agree Somewhat disagree Strongly disagree dk/na

51 30 7 2 10

66 21

6 4 3

69 21

4 3 3

Wrinkles and premature aging Stronglyagree

50 25 12

9 4 63 23 7 4 3

67 21

5 4 3

29 7 7 6

29 8 4 4

52 28 5 3 11

52 25 12

9 3

Q.15

[ am going to read you a list of human health effects and diseuses that may or may nol be caused by smoking cigarettes. Based on what yos know or believe please tell me

if

you strong!y agree, somewhat agree, someuibat disagree or strongly disagree that smoking cigarettes can cause eacb of the fo!lowing ... ?

ENVI RON les

13

HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES

(14)

Those who have seen, read or heard about the new healrh warning messages on cigarette packages and those who have seen these messages on cigarette packages themselves are more likely to strongly agree thar smoking can cause emphysema, impotence in men, mourh cancer, gum or mouth diseases and chronic bronchitis.

Potential smokers among yourh are more likely ro strongly agree that smoking can cause throat cancer and chronic bronchitis. y outh smokers are more likely th an others ta strongly agree thar smoking can cause emphysema, impotence in men and chronic brouchitis but they are more likely to srrongly disagree thar smoking can cause blood clots, arrhritis, impotence in men, stomach ulcers, miscarriages, bladder cancer, hepatitis, wrinkles and premature aging, acne, multiple sclerosis, Alzheimer's Disease and premature dearh.

Specifie Health Effects Caused by Smoking

':~~i~M;';'i;';':""'":-J'<:"'>M,~i'''_'''''.'-'''·''' ., '<A'>'~·;:··"_"''''''''-:''''~,·~#·'h_~)i~-;N.''~-1''.,W"'·,"''''''X:,%,«~;,o,_";>,-_;;"<"""_'*"""v..~,,,;:,'_"'_.X_,)<i'X~·V~· ."'-;;-;

DEC MAR-ApR

2000 2001

Stroke

Stronglyagree 44 51

dk/na 11 12

Emphysema

dk/na 27 28

Premature birth or preterm birth

dk/na 7 7

Blood clots

dk/na 10 9

Miscarriages

dk/na 10 12

Q.15

1 am going ta read you a list of buman health effeas and diseases that may or may not he caused by smoking cigarettes. Based on what yo« know or believe please tel] me

if

yo« strongly agree, somewhat agree, someu/hat disagree or strong!y disagree that smoking cigarettes can cause each of the foliouung ... )

ENVIRONICS ^HEALTH ^EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES 14

(15)

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

,"~"~"" ·,·,·';x.>..·'''r_';'~.A··'''<- _ _''''>'-:';':,>._· <, .< ,,;" ... "'" ,~-.,.;" •.. *'- .,,~.',<~ ',v'''-.''''''''~ '<""~"""""'· .. "'i'.V~·p,?<.""."" "'"

DEC MAR-ApR DEC MAR-ApR

2000 2001 2000 2001

Impotence in men Arthritis

Stronglyagree 14 27 Stronglyagree 12 12

Somewhat agree 29 27 Somewhat agree 26 26

Somewhat disagree 18 16 Somewhat disagree 29 29

Strongly disagree 15 11 ^Strongly ^disagree 25 22

dk/na 24 19 dk/na 9 11

Stomach ul cers Alzheimer's Disease

Stronglyagree 23 24 Strongly agree 11 12

Somewhat agree 36 36 Somewhat agree 27 25

Strongly disagree 9 8 Strongly disagree 22 20

dk/na 13 13 dk/na 13 15

Infertility Acne

Somewhat agree 29 31 ^Somewhat^agree 23 24

Strongly disagree 12 9 Strong Iy disagree 29 26

dk/na 23 20 dk/na 7 9

Bladder cancer Hepatitis

dk/na 11 13 dk/na 15 15

Multiple Sclerosis Gangrene

dk/na 22 24 dk/na 32 31

Q,J5

1 am going to read you a list of hurnan health effeas and diseases that may or may not be caused by smoking cigarettes, Based on what you know or believe please tel! me if you strongly agree, somewhat agree, somewhat dùagree or strong!y dùagree that smoking cigarettes can cause each of the fo!!(!wing ... ?

ENVIRONICS HEALTH EfFECTS OF TOBACCO AND HEALTH WARNING MESSAGES 15

(16)

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 about the exrenr to which they agreed or disagreed that each can be caused by second-band smoke.

Majorities of yourh strongly agree thar second-band smoke can cause asthma attacks in children (64%),

lung cancer in non-srnokers (60%), chest infections

in children (53%) and bronchitis in children (50%).

Fewer th an half strongly agree thar second-band smoke can cause heart disease in non-smoking adults (40%), strokes in non-smoking adults (24%), SIDS (Sudden Infant Death Syndrome) or crib death (24%) and ear infections in children (14%). Only about one in ten strongly agree thar second-band smoke can cause multiple sclerosis 00%), Alzheimer's Disease, (8%) and arthritis (8%) in non-smoking adules.

ln general, there have been essentially no changes in the numbers of yourh who strongly agree thar second-hand smoke can cause most of these health effects. However, there have been slight increases in the numbers who think second-band smoke can cause lung cancer in non-srnokers and strokes in non- smoking adults.

Specifie Health Effects Caused by Seeond-Hand Smoke

DEC MAR-ApR

2000 2001 Asthma anacks in children

Stronglyagree Somewhat agree Somewhat disagree Strongly disagree dk/na

Lung cancer in non-smokers Stronglyagree Somewhat agree Somewhat disagree Strongly disagree dk/na

Chest infections in children Strongly agree Somewhat agree Somewhat disagree Strongly disagree dk/na

Bronchitis in children Stronglyagree 'Somewhat agree Somewhat disagree Strongly disagree dk/na

49 34 7 4 7

64 64

25 27

6 4

3 3

2

56 60

31 28

7 6

5 5

54 32 7 3 3

53 35 6 4 2

50 35 7 4 5

40 39 12

7 2

Heart disease in non-smoking adults Stronglyagree

38 38 13

8 3

Q.16

Here is a list

of

health effectJ and diseases affecting non-smokers tba: may or may not be caused by breathing in second-band smoke from cigarettes that ether people are smoking. Based on what you

knoJ// or bel/eve pleaJe tell me ifyou strongjy agree, iomeu/hat agree, someiuhat dùagree or strongl)' dùagree that second-band smaee rail cause each

of

the jo//oJ///ng ... ?

ENVIRONICS 16

(17)

Among yoùrh, girls are more likely than boys ta strongly agree thar second-band smoke can cause asrhrna attacks, chest infections and bronchitis in children. Older yourh are more likely than others ta strongly agree thar second-hand smoke can cause chest infections and bronchitis in children.

Those who have seen, read or heard about the new health warning messages on cigarette packages and those who have seen these messages on cigarette packages themselves are more likely ta strongly agree thar second-hand smoke can cause heart disease in non-smoking adulrs, lung cancer in non-srnokers, and chest infections and bronchiris in children.

Youth smokers are more likely than orhers to strongly disagree thar second-hand smoke can cause arthritis, strokes, multiple sclerosis or Alzheimer's Disease in non-smoking adules, ear infections in children and SIDS or crib dearh,

Specifie Health Effects Caused by Second-Hand Smoke

DEC MAR-ApR

2000 2001

Arthritis in non-smoking adults

Stronglyagree 7 8

dklna 7 9

Q.16

Specifie Health Effects Caused by Second-Hand Smoke

DEC MAR-ApR

2000 2001

Strokes in non-smoking adults

dk/na 10 10

SIOS (Sudden Infant Death Syndrome) or Crib Death

Strongly agree 23

Somewhat agree 31

Somewhat disagree Strongly disagree dk/na

Ear infections in children Stronglyagree Somewhat agree Somewhat disagree Strongly disagree dk/na

Multiple Sclerosis in non-smoking adults Stronglyagree

Alzheimer's Oisease in non-smoking adulls Stronglyagree

8 23 30 27 11

16 15 15

15 24 28 24 9

9 25 25 22 19

24 30 19 11 15

14 26 30 23 7

10 26 28 18 18

8 25 29 27 11

l-lEALTH EHECTS OF TOBACCO AND HEALTH WARNING MESSAGES

Here is a lis!

of

health effects and diseases affeding non-smokers tbat may or may no! be caused f::y breathing in second-band smoke from cigarettes that otber peop!e are smoking. Based on what you know or believe ptease te!! me

if

you strongly agne, somewha/ agree, somewhat disagree or strongly disagree that second-hand smoke can cause each

of

the fo!/olvillg ... ?

ENVIRONICS

17

(18)

E.

Health Effects Caused by Hydrogen Cyanide

Wh en asked, top-of-mmd, six in ren youth (59%) offer no specifie healrh effects or diseases thar can be caused by hydrogen cyanide. Another 30 percent say hydrogen cyanide does not cause any health effects or diseases. Only 17 percent mention specifie healrh effects or diseases.

The current survey finds increases in the numbers of youth who say hydrogen cyanide does not cause any healrh effects or diseases and who offer an opinion.

Health Effects Caused by Hydrogen Cyanide

DEC MAR-ApR

2000 2001

Lung disease/cancer 2 4

Respiratory problerns/loss of breath 3

Cancer - qeneral 1 2

Death 3 2

Heart disease/altack/stroke 2

Headache Stomach aches

None 24 30

Other 6 4

dklna 66 59

* Less thar one percent

Q.34

What specifie hea/th effects or diseases, if any, can you name that can be caused by hydrogen cyanide?

ENVIRONICS ^HEALTH^EFrECTS ^OF^TOBACCO AND HEALTH WARNING MESSAGES 18

(19)

4.0 DEATHS FROM TOBACCO USE

Respondenrs were asked whether they believe thar tobacco use kills more or fewer numbers of Canadians thau a number of other causes of dearh.

Between half and over six in ten of youth think tobacco use kills more Canadians each year than do suicides (64%), murders (60%), illegal drugs (59%), alcohol (57%), AIDS (51%) and car accidents (50%).

Between one-rhird and half of youth believe that tobacco use kills fewer or the same number of Canadians each year as these other causes of death, The current survey finds that rhere have been increases in the numbers of yourh thar think tobacco use kills more Canadians each year than do most of these other causes of dearh.

Boys are more likely than girls ro think thar tobacco use kills more Canadians each year than do aoy of rhese other causes of death. Those who have seen, read or heard about the new health warning messages ⁰⁰cigarette packages are also more Lkely to think thar tobacco use kills more Canadians each year th an do any of these other causes of death.

Older youth, aged 17 to 18 years, are more Iikely th an others to think that robacco use kills more Canadians each year than do illegal drugs, AIDS or murders.

Causes of Death

DEC MAR-ApR

2000 2001

Suicides

More 61 64

Fewer 21 19

About the same number 15 14

dk/na 3 3

Murders

More 57 60

Fewer 25 23

dk/na 2

Illegal drugs

More 52 59

Fewer 23 20

dk/na 2 1

Alcohol

More 51 57

Fewer 20 15

dk/na 2

AlOS

More 50 51

Fewer 26 24

dk/na 4 3

Car accidents

More 46 50

Fewer 28 27

dk/na

Q.17

Do you think that tobacco use ki/ls more,jewer or about the lame number ofCanadians eacbyear as eacb of the Jollowillg other causes of death ... ?

ENVIRONICS

19

HEALTH EFFECTS OF TOBACCO AND HEALTl-I WARNING MESSAGES

(20)

Porenrial youth smokers are more inclined than others to think tobacco use kills fewer Canadians each year th an does AIDS. Youth smokers are slightly more likely th an others to think tobacco use kills fewer Canadians each year than do alcohol, car accidents, suicides and murders.

Only 23 percent of youth correctly believe that approximately 45,000 Canadians die each year as a result of tobacco use. Four in ten 09%) pick a number lower than 45,000 and three in ten (32%) choose a number higher than 45,000.

The current survey finds an increase since December in the number of youth who correcdy believe (hat approximately 45,000 Canadians die each year as a result of tobacco use.

Number of Canadians Who Die Each Year fram Tobacco Use

DEC MAR-ApR

2000 2001

1,000 5 3

5,000 8 7

10,000

15,000 11 11

25,000 20 17

45,000 18 23

50,000 2 2

75,000 15 15

100,000 15 15

None

Other 4 4

dl<jna 2

Q.18

Which of the following do you think is the closest approximation of the number of Canadians who die each year as a resuit of tobacco lise? Is it closest to ... )

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARN1NG MESSAGES 20

(21)

5.0 QUIT TIPS

When youth are asked what tips or advice they are aware of thar might help someone quit smoking, the largest proportions mention medication/patch/

Nicoderm/Zyban/stop smoking pill (29%) and warn ofhealrh effects (22%). Smaller proportions mention will power or cold turkey 04%), Nicotine gum/

Nicorette (11 %), chew gum/candy/food 00%), support groups/counselling/associations/family (6%), eut back gradually (6%), speak to a doctor (5%) and avoid situations where you would normally smoke (5%). Twenty-three percent mention other tips or advice. Eight percent say there is no way to help and 12 percent offer no opinion.

The current survey finds an increase in the number of yourh who mention medication/patch/Nicoderm/

Zyban/stop smoking pill and a slight increase in the number who offer an opinion.

Older youth and youth smokers are more likely than ethers ta mention will power and chew gum/candy/

food. Yourh smokers are also more likely to mention Nicotine gum/Nicorette.

Quit Tips

DEc MAR-ApR

2000 2001

M ed i cati on/patch/N icoderm/

Zyban/stop smoking pill 23 29

Wam of health enects 22 22

Will power/cold turkey/just stop 14 14

Nicotine gum/Nicorette 5 11

Chew gum/candy/food 9 10

Support groups/counsell i ng/assoc iations/larn i Iy 5 6

Cut back gradually 5 6

Speak to a doctor 5 5

Avoid situations where you would normally smoke (e g., telephone/

cottee/bar, etc.) 4 5

Don't start 2 3

Keep active and busy 2 3

More education 3 2

Do something else/disnact yourself 3 2 Be aware of hurting olhers/your chldren 2 2

Exercise 1 2

Waste of rnoney/costs too much 2

Not attractive/yellow fingers/teeth Advertising/media in general

Have a plan 2

Tell others your quit date Drink water

Speak to a pharmacist

Write down reasons you are quitting Delay smoking for ten minutes Take a deep breath or Iwo

None/no way to help 7 8

Other 8 2

dk/na 16 12

Q.19

What tips or advice,

if

any, are you aware of that might belp someone quit smoking? Are tbere any otbers?

ENVIRONICS

21

HEALTH EFFECTS OF TOBACCO AND HEALTH WARN1NG MESSAGES

(22)

6.0 HEALTH W ARNING MESSAGES

A.

Recall and Reads Per Day

An overwhelming number of youth (93%) say they have seen health warning messages on cigarette packages. Youth smokers 000%) express unanimous recall.

The current survey finds a two point increase since December in the number of youth who say they have seen healrh warning messages on cigarette packages.

Seven in ten youth (70%) say they have seen, read or heard about new health warning messages thar are now on sorne brands of cigarette packages in Canada and another four percent say they may have. Almost three in ten (26%) say they have not.

The current survey finds a considerable increase, up 42 points, in the number of yourh who have seen, read or heard about new healrh warning messages.

Older youth, especially rhose aged 17 ro 18 years, youth smokers and potential youth smokers are more likely ro be aware of new health warning messages.

Recal! of Health Warning Messages on Cigarette Packages

DEC MAR-ApR

2000 2001

YES

No

91 9

93 7

Q.20

Have yeu euer seen heafth warning messages on cigarette packages?

Awareness of New Health Warning Messages

Yes Maybe No

DEC MAR-ApR

2000* 2001

28 70

3 4

69 26

Q.21

Have yoa seen, read or heard anytbing about the new health warning messages that are now on some brands of cigarette packages in Canada?

*N(JVember-December 2000 question referred to "hea/th warning messages that might appear on cigarette packages in the near future"

ENVIRONICS HEALTH EFFECTS OF TOBACCO AND HEALTH WARNING MESSAGES 22

(23)

Two-thirds of youth (66%) say they have seen the new health waming messages on cigarette packages themselves. One-third (33%) have nor.

Oider youth, yourh smokers and potential yourh smokers are more likely to say they have seen the new health warning messages on cigarette packages themselves.

Among youth smokers, rhree-quarrers (74%) say they have seen the new health warning messages on their main brand of cigarettes. One-quarter (23%) have not.

Have Se en New Health Warning Messages on Cigarette Packages

March - April 2001

Yes No dk/na

66 33

Q.22

Have you seen any of the new health warning messages on any cigarette packages tbemselues?

Have Seen New Health Warning Messages on Main Brand of Cigarette Packages

Smokers March - April 2001

Yes No dk/na

74 23 3

Q.23

Have yeu sem any of the new health warning messages on {main brand}?

Subsample: Respondents who smoke

ENVIRONICS

23