Modifiable Risk Factors – Tobacco Smoking
Key findings
Tobacco smoking rates in Ontario have been declining for at least 2 decades.[1] In 2017, however, nearly one-fifth (17%) of Ontarians ages 20 years and older reported that they were daily or occasional smokers. Smoking rates were significantly higher in men than women, rural residents than urban residents, Canadian-born people than immigrants, lower household income than higher household income, and those with high-school or lower education compared with post-secondary graduates.
Why is this important to Ontarians?
- Modifiable risk factors are behaviours and exposures that can lower or raise a person’s risk of cancer and that can be changed. Evidence confirms strong associations between tobacco smoking and the risk of nearly 20 types of cancer, including lung and colorectal cancers.[2]
- In Ontario, 71.0% of lung cancer cases and 10.7% of colorectal cancer cases can be attributed to smoking tobacco in 2009.[3]
- Reporting on risk factor prevalence in Ontario is important to effectively monitor trends over time, support the development of health promotion and disease prevention strategies, and evaluate outcomes of provincial interventions.
See Modifiable Risk Factors Methodology for technical information.
| Country | Estimates, both sexes (percentage) | Estimates, men (percentage) | Estimates, women (percentage) |
|---|---|---|---|
| New Zealand[4] | 14.9 | 16.4 | 13.3 |
| United States[5] | 17.1 | 18.8 | 15.3 |
| United Kingdom[6] | 17.3 | 19.2 | 15.5 |
| Ireland[7] | 20 | 22 | 17 |
Notes:
- Current tobacco smoking is defined as current daily or occasional smokers.
- There are slight differences in the year, age groups, and/or definitions for each region’s data:
- New Zealand (2017 to 2018 data of individuals ages 15 and older who smoked more than 100 cigarettes in lifetime)
- United States (2017 data of individuals ages 18 and older who smoked more than 100 cigarettes in lifetime)
- United Kingdom (2017 data of individuals ages 16 and older)
- Ireland (2018 data of individuals ages 15 and older)
Results
- The proportion of Ontario adults ages 20 and older who self-reported tobacco smoking remained stable from 2015 (18.5%) to 2017 (17.0%). Men were significantly more likely to be smokers than women.
- From 2015 to 2017, rates of tobacco smoking in Ontario adults ages 25 and older were higher in:
- rural residents (22.1%) compared with urban residents (17.4%)
- the lowest income quintile (26.5% in Q1) than the highest income quintile (12.6% in Q5)
- those with less secondary education and secondary graduates (35.3% and 26.1% respectively) than in post-secondary graduates (13.7%)
- Canadian-born residents (20.9%) compared with immigrants who came more than 10 years ago and recent immigrants (13.3% and 9.2% respectively)
Comparisons
Getting comparable data and measures from multiple jurisdictions is a challenge. Be aware of the different data definitions, methodologies and years used in indicators measured outside Ontario. Jurisdictional comparison is still useful to provide a rough indication of how well Ontario is doing relative to other provinces and countries.
- The prevalence of tobacco smoking in Ontario is higher than the rate in New Zealand (14.9%), and is similar to those in the United States (17.1%) and United Kingdom (17.3%).[4] [5] [6] However, Ontario’s tobacco smoking rate is lower than Ireland’s (20%).[7]
Opportunities
- Exposure to some risk factors is higher in particular social, economic or geographic populations. Populations facing health inequities experience higher incidence and mortality rates for certain cancers.
- The Ontario government has made significant progress in reducing tobacco use through Smoke-Free Ontario. The program aims to prevent youth from starting to smoke, protect people from second-hand smoke and help smokers quit. In 2017, the Ministry of Health and Long-Term Care established the Executive Steering Committee for the Modernization of Smoke-Free Ontario to update the Smoke-Free Ontario strategy. Among the committee’s recommendations was a strategy to work towards reducing the prevalence of tobacco use in the province to less than 5% by 2035. To date, the report’s recommendations have not been implemented.[8]
- Many groups facing health inequities continue to smoke at much higher rates than the rest of the population.[9]
- Universal and targeted interventions are also needed to reduce tobacco use.
- Evidence shows that healthy public policy and community-wide programs are more effective to reduce the prevalence of modifiable risk factors at a population-level than those that focus on changing individuals’ behaviours.
- The Prevention System Quality Index is a series of reports that monitor population-level policies and programs that can reduce cancer risk factors and exposures in the Ontario population. The reports include evidence-based recommendations to strengthen cancer prevention in Ontario.[9]