Tobacco Use Among BC Youth

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Tobacco Use Among BC Youth

• Time for Celebration or Rededication to Tobacco
  Control?
• November, 2004

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Joy Johnson, PhD, RNProfessor and CIHR
InvestigatorCo-Principal Investigator,
NAHBRSchool of Nursing, UBC

• .

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Nursing and Health Behaviour Research Unit (NAHBR)

• A group of researchers interested in determining
  ways to help improve health behaviors of
  individuals, families and communities
• We have conducted a number of studies in the area
  of tobacco use/control
• One arm of our program of research focuses on the
  development of tobacco dependence among youth
• http//www.nahbr.nursing.ubc.ca

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Objectives of this Presentation

• To describe the factors that might explain the
  varying reports of tobacco use among youth in BC
• To report recent research findings regarding
  tobacco use in BC
• To raise questions about how to best report
  tobacco use among youth

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Best Practices in Interpreting Survey Data
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The most dramatic change among B.C. youth is an
18 drop in smoking...The McCreary Centre
Society 2004
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CTUMS- 2003

• The decline in smoking among youth 15-19 years
  continued in 2003 to 18, with 12 reporting
  daily smoking and 7 occasional smoking. This is
  a decrease from 22 in 2002 and is a 10
  percentage point improvement from 28 in 1999,
  when CTUMS was first conducted. Slightly more
  teen girls reported smoking than boys (20 vs
  17). However, among daily smokers, boys smoke
  slightly more cigarettes per day (13.0) than
  girls (11.7).

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Do we have cause to celebrate?

• The reports of a survey such as McCreary and
  CTUMS will depend on
• what questions were asked about smoking
• what schools/people were asked to participate in
  the survey
• how participants are selected
• the participation rates

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Questions to determine smoking status

• CTUMS Determined from the response to the
  question "At the present time do you smoke
  cigarettes every day, occasionally, or not at
  all? Includes daily and nondaily smokers
• McCreary During your life, have you smoked at
  least 100 cigarettes or more? At the present time
  do you smoke cigarettes everyday, occasionally or
  not at all?

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Sampling 101

• the answers we get to our research questions
  depend on who include in our study
• we want the samples we draw to represent the
  populations of interest
• we need to worry about who is not included in the
  survey and why

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The Parts of the Survey Reports We Never Read

• Annual 2003 CTUMS collected data from over
  21,300 respondents from February to December
  2003. The overall margin of error for the smoking
  rate for Canada is /- 0.9. We expect the true
  smoking prevalence for this population to be
  between 20.0 and 21.8, 19 times out of 20

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Two More Word Bites

• 14 School Districts that refused access to their
  schools represent 28 of the student population
  enrolled in grades 7 to 12 in public schools.
• The accurate tracking of trends could be
  affected, if students in persistently
  non-participating school districts exhibited
  changes over time that were vastly different from
  the rest of the provinces students McCreary,
  2003

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BC Youth Survey on Smoking and Health I

• Conducted between October 2001 and May 2002
• Random sample of students enrolled in grades 10
  and 11 in 13 schools
• We sampled 2 school districts of BC Vancouver
  and Prince George
• Response rate was over 80- final sample size
  was 3,280

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The Problem with Population Based Statistics

• You cannot apply population based statistics to
  local setting
• Because population based statistics are based on
  averages they can mask important sub-group
  differences

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Prevalence of Smoking, by Gender and Region in
BCYSOSH I
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Prevalence of Smoking Among Boys, by Ethnicity
and Region in BCYSOSH I
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Prevalence of Smoking Among Girls, By Ethnicity
and Region in BCYSOSH I
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Lessons Learned

• Resist the temptation to rely on overall
  population statistics regarding youth smoking
  rates
• It is difficult to get a representative sample of
  youth
• Rates vary by gender, region, ethnicity, and
  social class
• We need to target programming to those areas
  where there are high rates of tobacco use

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Prevalence of Smoking, by GenderKillarney
Secondary School, East VancouverBCYSOSH I Fall
2001
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BC Youth Survey on Smoking and Health II

• Conducted between January and June 2004
• We surveyed students from 49 schools in 13
  districts of BC targeting students in grades
  8-12.
• Sample included schools from 4 districts not
  sampled by McCreary (Chilliwack, Surrey, Queen
  Charlotte, Nisgaa)
• Where possible we tried to randomly sample
  students within schools
• Response rate was over 75, final sample size was
  8,254
• Because the sample is not representative of all
  youth in BC we report findings by school or
  district.

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Prevalence of Smoking, By GenderHazelton
Secondary School, Hazelton, BCBCYSOSH II -
Spring 2004
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Prevalence of Smoking, By GenderNisgaa
Secondary School, Nisgaa, BCBCYSOSH II Spring
2004
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In 1998, the Northwest part of the province had
the highest rate of youth smokers at 23, which
had dropped to 8 by 2003... The McCreary
Centre Society
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Prevalence of Smoking, By GenderSchool District
74 - Gold Trail BCYSOSH II (Lillooet,
Clinton, Ashcroft, Lytton)
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Prevalence of Smoking, By GenderStanley
Humphries Secondary, Castlegar, BCGrade 11 12
Students BCYSOSH II - Spring 2004
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Prevalence of Smoking, By GenderMount Sentinel
Secondary, South Slocan, BCBCYSOSH II - Spring
2004
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Prevalence of Smoking, By GradeMount Sentinel
Secondary, South Slocan, BCBCYSOSH II (n280)
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Prevalence of Smoking, by GenderSardis Senior
Secondary, Sardis, BCGrade 10, 11 12 Students,
BCYSOSH II
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Prevalence of Smoking, By GenderSardis Senior
Secondary, Sardis, BCGrade 10, 11 12 Students,
BCYSOSH II
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Ethnic Differences in Smoking Prevalence
Examples From Across BC BCYSOSH II
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What does all this mean?

• In relation to youth tobacco use there is some
  good news and some distressing news
• We need to be careful consumers of statistical
  information
• When we read about survey results we need to ask
  about the questions used, the population sampled,
  and the response rate

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A word or two about marijuana

• There is a clear link between marijuana use and
  tobacco use
• Students smoke more when using marijuana
• Some students see marijuana as a healthy
  alternative to tobacco

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Marijuana Use, By Smoking StatusMount Sentinel
Secondary, Slocan, BCBCYSOSH II
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Marijuana Use, By Smoking StatusSardis Secondary
School, Sardis, BCBCYSOSH II
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Marijuana Use, By Smoking StatusNisgaa
Secondary School, Nisgaa, BCBCYSOSH II
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Contact Information about the BCYSOSH

• Rochelle Tucker, Project Director
• rtucker_at_hsph.harvard.edu