EXAMINING CANADIAN SMOKING RELATED BEHAVIOURS AND ASSOCIATED HEALTH OUTCOMES

Tobacco use is the leading cause of premature death worldwide. To address the growing tobacco epidemic, the World Health Organization introduced the Framework Convention on Tobacco Control. However, there has been an evolution in tobacco products with flavoured tobacco and electronic nicotine delivery systems such as electronic cigarettes (e-cigarettes). Furthermore, the tobacco industry continues to disproportionately target vulnerable populations to recruit new users. As such, it is critical to be aware of paradigm shifts in Canadian smoking behaviours to identify vulnerable populations and to assess the potential harms related to changing smoking behaviours. When examining flavoured tobacco use the prevalence was elevated among Canadian high school students and being males, exposed to peer pressure and having increased weekly spending money were identified as significant determinants of flavoured tobacco use. The lesbian, gay and bisexual (LGB) population is vulnerable to tobacco use due to intrinsic factors, social factors and targeted tobacco advertising. Results of this study showed the prevalence of smoking was higher in the Canadian LGB population compared to national rates. There was a significant association between sexual orientation and smoking status for lesbians and bisexuals compared to heterosexuals, but no significant association between gay and bisexuals and heterosexual males. Health effects of e-cigarettes have not been well characterized. Using the Canadian Community Health Survey, an exploratory study examining the association between past 30-day e-cigarette use and chronic obstructive pulmonary disease (COPD) was examined. A sex-based interaction effect with female e-cigarette users reporting higher rates of COPD compared to males was identified. Furthermore, dual use behaviour was most strongly associated with COPD. In the systematic review and meta-analysis examining if e-cigarette use among baseline never conventional tobacco users predicted tobacco initiation at follow up, the meta-analysis indicated ever e-cigarette users were significantly more likely to initiate tobacco use and current (past 30-day) tobacco use compared to never e-cigarette users