Baseline Surveys: The Health Effects of Tobacco and Health Warning Messages on Cigarette Packages (disponible en anglais seulement)

3.0 Health Effects of Smoking

A. General and Top-of-mind

Almost nine in ten Canadian adults think that cigarette smoking is a major health problem in Canada. Another ten percent think it is a minor problem. Only two percent think it is not a health problem.

The view that cigarette smoking is a major health problem in Canada is lower among adult smokers, especially those aged 55 and older.

More than eight in ten youth (84%) think that cigarette smoking is a major health problem in Canada. Another 13 percent think it is a minor problem. Only two percent think it is not a health problem.

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

When asked, top-of-mind, what specific human health effects or diseases can be caused by smoking cigarettes, Canadian adults are most likely to mention lung cancer (57%). Smaller proportions mention cancer in general (32%), heart attack/disease/angina (27%), emphysema (23%) and lung disease (18%), asthma (10%) and respiratory problems/difficulty breathing/shortness of breath (8%). Forty-four percent mention a variety of other human health effects or diseases.

Adult smokers are less likely than Canadian adults in general to think that smoking cigarettes causes lung cancer. However, younger adult smokers are as likely as Canadian adults in general to mention lung cancer as a disease caused by smoking cigarettes.

When asked what specific human health effects or diseases can be caused by smoking cigarettes, youth are most likely to mention lung cancer (60%). Smaller proportions mention cancer in general (35%), heart attack/disease/angina (17%), lung disease (16%), oral cancer - tongue, lips, mouth, throat (13%) and emphysema (9%). Forty percent mention other human health effects or diseases.

Older youth, particularly those aged 17 to 18 years, and youth smokers are more likely than others to mention emphysema. Youth smokers are also more likely than others to mention heart attack/disease/angina.

B. Sources of Information About Health Effects

When asked, top-of-mind, where they have recently seen or heard information which talks about the health effects of smoking cigarettes, six in ten Canadian adults (62%) mention television. Smaller proportions mention newspapers (25%), cigarette packages (20%), magazines (18%), radio (11%) and doctor/doctor’s office (9%). Twenty-six percent mention others sources of information and nine percent say nowhere.

When asked where they have recently seen or heard information which talks about the health effects of smoking cigarettes, the largest proportions of youth mention television (49%) and school/university (48%). Small numbers mention magazines (16%), cigarette packages (13%) and word of mouth/family/friends (11%). Thirty percent mention other sources of information and eight percent say nowhere.

C. Specific Health Effects Caused by Smoking

In this section of the survey, respondents were read a list of health 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 Canadian adults strongly agree that lung cancer (94%) and throat cancer (85%) can be caused by smoking cigarettes. Fairly large majorities also strongly agree that smoking can cause heart disease (76%), emphysema (74%), asthma (74%), mouth cancer (73%), chronic bronchitis (71%), premature death (67%), smaller babies or reduced growth of babies during pregnancy (65%) and gum or mouth diseases (63%). Smaller majorities strongly agree that smoking can cause wrinkles and premature aging (56%) and stroke (52%).

Fewer than half strongly agree that smoking can cause premature birth or preterm birth (46%), blood clots (36%), stomach ulcers (31%), miscarriage (29%), impotence in men (20%), bladder cancer (20%) and infertility (19%). Only about one in ten strongly agree that smoking can cause gangrene (13%), Alzheimer™s Disease (11%), acne (11%), multiple sclerosis (10%), arthritis (9%) and hepatitis (8%).

Adult smokers are less likely than Canadian adults in general to strongly agree that smoking can cause most of these human health effects and diseases. However, among smokers, potential quitters are more likely than non- potential quitters (fihard-corefl smokers) to strongly agree that smoking can cause most of these human health effects and diseases. Younger adult smokers are also more likely than smokers in general to strongly agree that smoking can cause some of these health effects and diseases. Female smokers are much more likely than male smokers to strongly agree that smoking can cause chronic bronchitis, wrinkles and premature aging, premature birth or preterm birth and emphysema.

Large majorities of youth strongly agree that lung cancer (95%) can be caused by smoking cigarettes. Large majorities also strongly agree that smoking can cause throat cancer (75%), heart disease (74%), asthma (67%), mouth cancer (66%), gum or mouth disease (66%) and premature death (63%). Smaller majorities strongly agree that smoking can cause chronic bronchitis (51%), smaller babies or reduced growth of babies during pregnancy (51%) and wrinkles and premature aging (50%).

Fewer than half of youth strongly agree that smoking can cause stroke (44%), premature birth or preterm birth (42%), emphysema (37%), blood clots (34%), miscarriages (34%), stomach ulcers (23%), bladder cancer (18%) and infertility (18%). Only about one in ten strongly agree that smoking can cause impotence in men (14%), multiple sclerosis (14%), arthritis (12%), acne (11%), Alzheimer™s Disease (11%), gangrene (9%) and hepatitis (9%).

Among youth, girls are more likely than boys to strongly agree that smoking can cause miscarriages, wrinkles and premature aging, smaller babies or reduced growth of babies during pregnancy, premature birth or preterm birth and chronic bronchitis. Older youth, particularly those aged 18 years, are more likely to strongly agree that smoking can cause emphysema, asthma, mouth cancer, throat cancer, infertility, premature birth or preterm birth and chronic bronchitis. Younger youth, aged 12 to 14 years, are more likely to strongly agree that smoking can cause stroke, arthritis, bladder cancer and acne. Potential smokers among youth are more likely to strongly agree that smoking can cause emphysema and chronic bronchitis. Youth smokers are more likely than others to strongly agree that smoking can cause emphysema but they are more likely to strongly disagree that smoking can cause arthritis, impotence in men, gangrene, bladder cancer, hepatitis, acne, multiple sclerosis and Alzheimer's Disease.

D. Specific Health Effects Caused by Second-Hand Smoke

In this section of the survey, respondents were read a list of health effects in non- smokers, and were asked about the extent to which they agreed or disagreed that each can be caused by smoking cigarettes.

Majorities of Canadian adults strongly agree that second-hand smoke can cause asthma attacks in children (67%), bronchitis in children (60%), lung cancer in non-smokers (59%) and chest infections in children (57%). Fewer than half strongly agree that second-hand smoke can cause heart disease in non- smoking adults (41%), strokes in non- smoking adults (26%), ear infections in children (24%) and SIDS (Sudden Infant Death Syndrome) or crib death (19%). Only about one in ten strongly agree that second-hand smoke can cause Alzheimer™s Disease, (9%), arthritis (8%) and multiple sclerosis (8%) in non-smoking adults.

Adult smokers are less likely than Canadian adults in general to strongly agree that second-hand smoke can cause most of these health effects and diseases in non-smokers. However, potential quitters and younger adult smokers are more likely than smokers in general to strongly agree that second-hand smoke causes most of these health effects and diseases in non-smokers. Female smokers are more likely than male smokers to strongly agree that second-hand smoke causes asthma attacks, ear infections, chest infections and bronchitis in children.

Majorities of youth strongly agree that second-hand smoke can cause asthma attacks in children (64%), lung cancer in non-smokers (56%) and chest infections in children (54%). Fewer than half strongly agree that second-hand smoke can cause bronchitis in children (49%), heart disease in non-smoking adults (38%), SIDS (Sudden Infant Death Syndrome) or crib death (23%), strokes in non-smoking adults (20%) and ear infections in children (15%). Only about one in ten strongly agree that second- hand smoke can cause multiple sclerosis (9%), Alzheimer™s Disease, (8%) and arthritis (7%) in non-smoking adults.

Among youth, girls are more likely than boys to strongly agree that second-hand smoke can cause asthma attacks, chest infections and bronchitis in children. Older youth, especially those aged 18 years, are more likely than others to strongly agree that second-hand smoke can cause lung cancer in non-smokers and chest infections and bronchitis in children. Youth smokers are more likely than others to strongly agree that second- hand smoke can cause bronchitis in children but are more likely to strongly disagree that second-hand smoke can cause arthritis, strokes, multiple sclerosis or Alzheimer's Disease in non- smoking adults.

E. Health Effects Caused by Hydrogen Cyanide

When asked, top-of-mind, four in ten Canadians (43%) cannot name any specific health effects or diseases that can be caused by hydrogen cyanide. Another 31 percent say hydrogen cyanide does not cause any health effects or diseases. Death is the most common response (12%) among those mentioning a specific effect. Twenty-two percent mention some other health effect or disease that can be caused by hydrogen cyanide.

Adult smokers are even less likely than Canadian adults in general to be able to name specific health effects or diseases that can be caused by hydrogen cyanide.

Almost seven in ten youth (66%) offer no specific health effects or diseases that can be caused by hydrogen cyanide. Another 24 percent say hydrogen cyanide does not cause any health effects or diseases. Only 13 percent mention specific health effects or diseases.

Among youth, girls and younger youth, especially those aged 12 to 14 years, are more likely than others to offer no opinion. Boys and older youth, especially those aged 17 to 18 years, are more likely than others to say hydrogen cyanide does not cause any health effects or diseases.