Trends in e-cigarette use in Canada from 2015 to 2021: findings from the nationally representative surveys

E-cigarettes have become increasingly popular worldwide in the last decade. This study examines secular trends and factors associated with self-reported e-cigarette use among the general population and youth across ten Canadian provinces.

This study used data from the 2015 and 2017 Canadian Tobacco, Alcohol, and Drugs Surveys and the 2019-2021 Canadian Tobacco and Nicotine Survey from Statistics Canada. The primary outcomes included self-reported ever, current, and high-frequency e-cigarette use. Weighted multivariate logistic regressions were applied to assess the association between the prevalence of self-reported e-cigarette use and gender, age, cigarette, province, and survey year. Crude and model-estimated provincial prevalence were reported and spatially mapped.

Between 2015 and 2021, self-reported ever, current, and high-frequency e-cigarette use increased by 3.71%, 2.01%, and 2.92%, respectively. In 2021, the proportion of ever-users was lowest in Ontario and highest in Saskatchewan. New Brunswick showed the highest prevalence of current and high-frequency users, while British Columbia and Saskatchewan reported the lowest. Current smokers 35 years and older were more likely to have ever used e-cigarettes than teenage smokers (P < 0.001). Adolescents were significantly more likely to use e-cigarettes than adults (P < 0.001). Females were less likely to be ever or high-frequency users than males (P < 0.05).

This national and provincial analysis provides insights into e-cigarette use in Canada. Public health policies on e-cigarette use may benefit from considering jurisdictional and demographic differences, particularly in relation to use in public spaces.