Prevention

Prevention projects investigate the prevalence and predictors of tobacco use and other health risk behaviours among young people during the transition from adolescence to adulthood, the impact of social exposure on youth perspectives about smoking and smoking behavior, and the influence of social networks on the smoking behavior of youth.

A study of electronic cigarettes includes an examination of the role of e-cigarettes as a “gateway” to uptake of traditional cigarettes. A project is also underway to examine gaps in knowledge about effective interventions to reduce the uptake and use of tobacco in Aboriginal communities in Ontario. Additional studies reach across the three pillars of tobacco control to model the impact of policy and program measures including those related to prevention.

Current Prevention Projects

Smoking Co-morbidities during the Transition from High School Post-Graduation: A Scoping Review

Focus Areas: Youth, Tobacco and Other Drugs, Mental Health

Cigarette smoking prevalence rates increase substantially during the transition from adolescence to young adulthood, and many young people initiate smoking after the age of 18. Young adulthood is also a time when co-occurring health risk behaviours and issues, such as problem drinking, illicit drug use, and mental health problems may begin to emerge.

This project undertakes a scoping review of existing evidence on tobacco use co-morbidities among young adults during the transition from high school post-graduation to contribute to a greater understanding of prevalence and predictors of tobacco use co-morbidities, co-use of other substances, and co-morbid mental health problems.

The Social Context of Tobacco Use among Youth (SCOTY): Pilot Study

Focus Areas: Youth, Social Networks

The transition from adolescence to young adulthood is a time of many personal and social role changes, including: leaving home, pursuit of higher education and employment, new social relationships, greater independence and increased responsibility. With this diversity of life changes, youth have more opportunities to experiment and explore, and substance use and other risk behaviours often increase during this time. In particular, cigarette smoking prevalence rates increase substantially during the transition from adolescence to young adulthood. More research on the effects of youth’s social networks and experiences on risk and protective factors during this important developmental and transitional time is important and needed in order to implement interventions and services that will prevent and treat tobacco use among young adults.

Pilot work has been underway to support a funding application for a study to explore social contextual effects, specifically changes in social networks, on tobacco use. If funded, a sample of 500 youth in the final year of high school (age 16-18) from across Ontario will be recruited via social media to participate in the study. All consenting participants will complete an interview during the summer after graduation from high school and a second interview six-months after to gather information on the effects of social network processes on initiation and progression in tobacco use over the course of the transition.

Youth Social and Physical Exposure to Tobacco Use (EMA): Pilot Project

Focus Areas: Youth, Social Exposure

It is increasingly recognized that the more young people see smoking (social exposure), the more likely they are to think that it is acceptable to smoke, especially for those who may be more receptive to taking up smoking. However, there is limited information about how much, where and when youth see smoking in their daily lives. OTRU is studying how youth experience smoking and the impact of this ‘social exposure’ on their perspectives about smoking and smoking behaviour.

In 2014-15 we pilot tested the feasibility of using a mobile smartphone application with GPS (Global Positioning System) technology to collect data on youth social exposure to tobacco use. We recruited a small sample of non-smoking youth who used the application for 5 days to record where and when they saw people smoking cigarettes and other tobacco products (cigarettes, cigars, e-cigarettes and other tobacco-related products), and saw the promotion (including online and media) and exchange (sharing, gifting, purchasing) of tobacco products. An initial interview was used to obtain demographic and background data about participants, and provide training in use of the application. Participants also attended a follow-up interview after the 5-day data collection period to elaborate on settings, identify missing data and provide input on the protocol and application. The results are being analyzed and will be used to leverage additional funding for a larger study of social exposure to tobacco use among susceptible and non-susceptible youth.

RECIG: Research on E-Cigarettes

Focus Areas: Electronic Cigarettes

The Ontario Tobacco Research Unit (OTRU), in partnership with the Centre for Addiction and Mental Health (CAMH), has recently undertaken a multi-component research study of e-cigarettes (RECIG) that will inform the current evidence base, and future provincial policy and legislation. The study will: determine the prevalence of e-cigarette use, particularly among youth, and examine patterns of change over time; review and assess research on health effects and related exposures to nicotine, aerosols and contaminants; explore use of e-cigarettes to reduce, replace or stop smoking traditional cigarettes; and examine the role of e-cigarettes as a “gateway” to uptake of traditional cigarettes.

Methods include: a knowledge synthesis of existing peer-reviewed and grey literature; a survey to determine knowledge of health effects, symptoms and perceived harm, and attitudes of users and non-users about e-cigarettes; an examination of correlates of use and demographic profiles from existing population surveys; analysis of promotional material to understand market segments and motives for purchase; analysis of social media to examine context of use and uptake to tobacco; a randomized clinical trial comparing smoking cessation effectiveness of e-cigarettes and nicotine replacement therapy products, a biomarker study of e-cigarette users to measure concentrations of nicotine and other chemicals and a meeting of an Expert Panel of leading researchers, NGOs, and knowledge users to provide an integrated perspective on e-cigarettes for dissemination to the health community.

Research on Tobacco Reduction in Aboriginal Communities (RETRAC)

Focus Areas: Aboriginal Populations, Cessation Interventions

The prevalence of non-traditional tobacco use among First Nations (on and off-reserve), Inuit and Métis populations in Canada is significantly higher than the general population. High rates of smoking have significance for disproportionately high rates of chronic disease among Ontario Aboriginal communities. This study will address gaps in knowledge about effective interventions to reduce uptake and use of tobacco in Aboriginal communities in Ontario and factors contributing to successful implementation of interventions.

Methods include: a realist informed knowledge synthesis; studies of exemplary communities through site visits and interviews with key informants; in-depth study of seven communities through interviews, focus groups, and community surveys, ongoing knowledge exchange with community partners and a knowledge forum, and seed money and research support for future community projects.

Modelling Interventions and Strategy Effects (SimSmoke)

Focus Areas: Tobacco Control Indicators, Modelling

This cross cutting project continues to refine the Ontario SimSmoke model in order to improve its validity, accuracy and usefulness as a tool to inform policy and program decision making in the province.

Knowledge and Evaluation Support

OTRU responds to the knowledge needs, evaluation and research requests from Ontario’s Public Health Units (PHUs), Tobacco Control Area Networks (TCANs), and other tobacco Transfer Payment Agencies (TPAs) across the three pillars of tobacco control.