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The Prevalence of Tobacco Use Co-morbidities in Canada

  • Quantitative Research
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objectives

Tobacco use co-morbidities, including co-occurring tobacco use, substance use and mental health problems, are a serious public health issue that has implications for treatment and policy. However, not enough is known about the prevalence of various types of tobacco use co-morbidities among the Canadian population. The purpose of this study was to increase understanding of the extent of this issue through an examination of prevalence and correlates of tobacco use co-morbidities in Canada.

Methods

We undertook a series of comprehensive secondary analyses of population survey data from the Canadian Community Health Survey (CCHS) and the Canadian Alcohol and Drug Monitoring Survey (CADUMS). Data were analyzed for 123,846 individuals from the CCHS and 13,581 individuals from the CADUMS. Substance use and mental health variables were compared by smoking status, with chi-square tests. Multivariate logistic regression models were fit to quantify the association between smoking, substance use and mental health issues, adjusting for age, sex, and family income.

Results

Prevalence of problematic alcohol and illicit drug use was significantly higher among current smokers than non-smokers. Co-morbid mental health problems were also elevated among current smokers, and co-morbidities varied by age and gender. While smokers of all ages and genders were more likely to report problematic substance use and poor mental health, the effect of smoking status was significantly larger among youth.

Conclusion

Smoking in Canada is associated with problematic use of alcohol and illicit drugs, as well as co-morbid mental health problems. Youth tobacco use co-morbidities are at a concerning level, especially among young female smokers. More research on this issue in the Canadian context is needed, as well as the development of integrated interventions tailored to treat smokers with co-morbidities, particularly youth.

Résumé

Objectifs

Les comorbidités du tabagisme, dont la concomitance du tabagisme, de la consommation de substances et des troubles de santé mentale, posent un grave problème de santé publique qui a des conséquences sur le traitement et sur les politiques. On n’en sait pas suffisamment long, toutefois, sur la prévalence des diverses comorbidités du tabagisme dans la population canadienne. Le but de notre étude était de mieux comprendre l’envergure de cet enjeu en examinant la prévalence et les corrélats des comorbidités du tabagisme au Canada.

Méthode

Nous avons mené une série d’analyses secondaires globales des données de deux enquêtes en population: l’Enquête sur la santé dans les collectivités canadiennes (ESCC) et l’Enquête de surveillance canadienne de la consommation d’alcool et de drogues (ESCCAD). Nous avons analysé les données de 123 846 répondants de l’ESCC et de 13 581 répondants de l’ESCCAD. Les variables de consommation de substances et de santé mentale ont été comparées selon l’usage du tabac à l’aide d’analyses du khi-carré. Des modèles multivariés de régression logistique ont servi à chiffrer l’association entre le tabagisme, la consommation de substances et les troubles de santé mentale en tenant compte de l’âge, du sexe et du revenu familial.

Résultats

La prévalence de la consommation abusive d’alcool et de drogues illicites était sensiblement plus élevée chez les fumeurs actuels que chez les non-fumeurs. Les troubles de santé mentale concomitants étaient également élevés chez les fumeurs actuels, et les comorbidités variaient selon l’âge et le sexe. Peu importe leur âge et leur sexe, les fumeurs étaient plus susceptibles de faire état d’une consommation abusive de substances et d’une mauvaise santé mentale, mais l’effet de l’usage du tabac était significativement plus grand chez les jeunes.

Conclusion

Le tabagisme au Canada est associé à la consommation abusive d’alcool et de drogues illicites, ainsi qu’à des troubles de santé mentale concomitants. Le niveau des comorbidités du tabagisme des jeunes est inquiétant, surtout chez les jeunes fumeuses. Il faudrait pousser la recherche sur cette question dans le contexte canadien et élaborer des interventions intégrées, adaptées au traitement des fumeurs présentant des comorbidités, tout particulièrement les jeunes.

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Author information

Authors and Affiliations

  1. Population Research Initiative on Mental Health and Addictions (PRIMHA), Ontario Tobacco Research Unit, University of Toronto, 155 College St., Toronto, ON, M5T 3M7, Canada

    Maritt Kirst PhD, Graham Mecredy MSc & Michael Chaiton PhD

  2. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Maritt Kirst PhD & Michael Chaiton PhD

  3. Institute of Clinical Evaluative Sciences, Toronto, ON, Canada

    Graham Mecredy MSc

Authors
  1. Maritt Kirst PhD
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  2. Graham Mecredy MSc
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  3. Michael Chaiton PhD
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Corresponding author

Correspondence to Maritt Kirst PhD.

Additional information

Acknowledgements: This study was partially funded by the Ontario Ministry of Health and Long-Term Care — Health Promotion Division. We thank Robert Schwartz for his comments on an earlier draft of the manuscript.

Conflict of Interest: None to declare.

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Kirst, M., Mecredy, G. & Chaiton, M. The Prevalence of Tobacco Use Co-morbidities in Canada. Can J Public Health 104, e210–e215 (2013). https://doi.org/10.17269/cjph.104.3770

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  • DOI: https://doi.org/10.17269/cjph.104.3770

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