Transcript presentation - Canadian Public Health Association

Julie Stratton, Manager, Epidemiology
Peel Public Health
Background
 Self report surveys:
 Most smokers buy their cigarettes legally
 1% of Canadians might have purchased
smuggled cigarettes (CTUMS)
 13% of Canadians buy cigarettes from a
First Nations reserve (23% of Ontarians)
Background
Cigarette Butt Studies
 Canadian Convenience Store Association
 26% in Ontario youth (2008)
 38% in Peel youth (2008)
 Ontario Convenience Store Association
 21% in Ontario residents (2014)
 22% in Brampton residents (2014)
 Post-secondary campuses in Ontario – 14%
Peel Region
• West of
Toronto
• 1.3 million
residents
(20,000 people
added each
year)
•15% of Peel
residents smoke
Research Questions
 What proportion of cigarettes in the Region
of Peel are illicit (untaxed?)
 Are there differences in the proportion of
illicit cigarettes by location of collection?
Methods – Sampling Frame
 4 types of locations within Peel Region
 Regional hospitals (3 locations)
 Regional buildings serving the public (2
locations)
 College campuses (2 locations) and
university campus (1 location)
 Secondary schools (random selection of 10
locations)
Methods – Pilot Study
 Piloted process from one location from each
venue
 Collection
 Identification
Methods – Sample Size
 Required 1,209 butts per venue
 Parameters
 Estimated number of cigarettes smoked per day
 Estimated per cent of contraband based on pilot
study
 Adjustment factor 1/0.7 - 1
 Precision of the estimate = 3%
 Statistical power = 80%
 Type 1 error rate = 5%
 Cigarette butt discard rate based on results of
pilot study
Methods – Collection and
Storage
 Hand collection from the ground or dumped
from cigarette disposal bins
 Collected butts until quota was met
 Collected on non-rainy days
 Stored in a fire proof cabinet in plastic bins
at an off-site location
Classification - Testing
 Brand name or symbol
 Existence of a dry patch within the plug
wrap
 Number of rows and type of ventilation
holes
 Type of filter (acetate or polypropylene)
 Resources: www.cigarettespedia.com
Classification – Brand Name
Examples
 du Maurier
 Player’s
 Matinee
 Viceroy
 Export A
Classification –
Plug Wrap and Dry Patch
Plug
wrap
Dry
patch
(area
with no
glue)
Classification – Ventilation Holes
Electrostatic
Mechanical
Laser
Classification - Filter
 Polypropylene vs acetate
 Some illegal cigarettes use polypropylene
filters
 Do not dissolve in acetone
Classification
 Legal branded
 International
 Legal native
 Contraband (illegal)
 Discards
 Unknown or other
Classification – Legal Native
 Putters
 DKS
 Sago
 Ménage
 Podium
Classification – Contraband
Examples
 Canadian
 Playfair
 Unbranded
Results
Total Collected and Discard Rate
Location
Total
collected
Total
discards
Discard Rate
(per cent)
Hospitals
3,140
449
14.3
Regional
Buildings
2,804
370
13.2
College/university
campuses
4,808
670
13.9
Secondary schools
3,280
562
17.1
14,032
2,051
14.6
TOTAL
Results – Overall Classification
Classification
Legal branded
International
Native legal
Contraband
(Illegal)
Unknown or
other
Number
10,663
144
530
629
Per Cent
89.0
1.2
4.4
5.3
15
0.1
Note: Excludes discards
Results - Native Legal and
Contraband by Venue
Population
Venue
Representing
Per Cent
Native Legal
Per Cent
Contraband
Youth
Secondary
schools
3.1
8.6
Young adult
College/
university
campuses
1.4
2.8
General
population
Hospitals,
Regional
buildings
7.6
5.5
Conclusion
 Lower percentage of contraband cigarette
butts than reported in other studies (5.3%)
 The percentage of contraband cigarette
butts varied by venue (highest in secondary
schools)
 Contraband rates are low - Peel will focus on
other aspects of tobacco control
Implications for Public health
practice
 Collection of cigarette butts to assess
percentage of contraband cigarettes can easily
be replicated in the field
 Peel Health has developed the following
protocols which can be shared:
 Cigarette Butt Study protocol
 Cigarette Butt Collection Protocol
 Cigarette Butt Identification Protocol
 Cigarette Butt Photo Library
For more information
 Julie Stratton, Manager,
Epidemiology,
Peel Public Health,
[email protected]
 Dr. Megan Ward, Associate
Medical Officer of Health,
Peel Public Health,
[email protected]
Limitations
 International and some contraband cigarettes might
have been classified as legal
 Selection of venues