julie stratton, manager, epidemiology peel public health

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Determining the proportion of illicit (contraband) cigarettes in a local public health jurisdiction Julie Stratton, Manager, Epidemiology Peel Public Health

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Determining the proportion of illicit (contraband) cigarettes in a local public health jurisdiction. Julie Stratton, Manager, Epidemiology Peel Public Health. Background. Self report surveys: Most smokers buy their cigarettes legally - PowerPoint PPT Presentation

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Page 1: Julie Stratton, Manager, Epidemiology Peel Public Health

Determining the proportion of illicit (contraband) cigarettes in a local

public health jurisdiction

Julie Stratton, Manager, EpidemiologyPeel Public Health

Page 2: Julie Stratton, Manager, Epidemiology Peel Public Health

BackgroundSelf 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)

Page 3: Julie Stratton, Manager, Epidemiology Peel Public Health

Background Cigarette Butt StudiesCanadian Convenience Store Association

26% in Ontario youth (2008)38% in Peel youth (2008)

Ontario Convenience Store Association21% in Ontario residents (2014)22% in Brampton residents (2014)

Post-secondary campuses in Ontario – 14%

Page 4: Julie Stratton, Manager, Epidemiology Peel Public Health

Peel Region• West of Toronto

• 1.3 million residents (20,000 people added each year)

•15% of Peel residents smoke

Page 5: Julie Stratton, Manager, Epidemiology Peel Public Health

Research QuestionsWhat proportion of cigarettes in the

Region of Peel are illicit (untaxed?)

Are there differences in the proportion of illicit cigarettes by location of collection?

Page 6: Julie Stratton, Manager, Epidemiology Peel Public Health

Methods – Sampling Frame4 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)

Page 7: Julie Stratton, Manager, Epidemiology Peel Public Health

Methods – Pilot Study

Piloted process from one location from each venueCollectionIdentification

Page 8: Julie Stratton, Manager, Epidemiology Peel Public Health

Methods – Sample SizeRequired 1,209 butts per venueParameters

Estimated number of cigarettes smoked per dayEstimated per cent of contraband based on pilot

studyAdjustment factor 1/0.7 - 1Precision of the estimate = 3%Statistical power = 80%Type 1 error rate = 5%Cigarette butt discard rate based on results of

pilot study

Page 9: Julie Stratton, Manager, Epidemiology Peel Public Health

Methods – Collection and StorageHand collection from the ground or

dumped from cigarette disposal binsCollected butts until quota was metCollected on non-rainy daysStored in a fire proof cabinet in

plastic bins at an off-site location

Page 10: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification - TestingBrand name or symbolExistence of a dry patch within the

plug wrapNumber of rows and type of

ventilation holesType of filter (acetate or

polypropylene)Resources:

www.cigarettespedia.com

Page 11: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification – Brand NameExamplesdu MaurierPlayer’sMatineeViceroyExport A

Page 12: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification – Plug Wrap and Dry Patch

Plug wrap

Dry patch (area with no glue)

Page 13: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification – Ventilation Holes

Page 14: Julie Stratton, Manager, Epidemiology Peel Public Health

Mechanical

Electrostatic

Laser

Page 15: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification - FilterPolypropylene vs acetate

Some illegal cigarettes use polypropylene filtersDo not dissolve in acetone

Page 16: Julie Stratton, Manager, Epidemiology Peel Public Health

ClassificationLegal brandedInternationalLegal nativeContraband (illegal)DiscardsUnknown or other

Page 17: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification – Legal NativePuttersDKSSagoMénagePodium

Page 18: Julie Stratton, Manager, Epidemiology Peel Public Health

Classification – Contraband ExamplesCanadianPlayfairUnbranded

Page 19: Julie Stratton, Manager, Epidemiology Peel Public Health

ResultsTotal 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

TOTAL 14,032 2,051 14.6

Page 20: Julie Stratton, Manager, Epidemiology Peel Public Health

Results – Overall Classification Classification Number Per CentLegal branded 10,663 89.0International 144 1.2Native legal 530 4.4

Contraband (Illegal)

629 5.3

Unknown or other

15 0.1

Note: Excludes discards

Page 21: Julie Stratton, Manager, Epidemiology Peel Public Health

Results - Native Legal and Contraband by VenuePopulation Representing

Venue 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

Page 22: Julie Stratton, Manager, Epidemiology Peel Public Health

ConclusionLower 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

Page 23: Julie Stratton, Manager, Epidemiology Peel Public Health

Implications for Public health practiceCollection 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 protocolCigarette Butt Collection ProtocolCigarette Butt Identification ProtocolCigarette Butt Photo Library

Page 24: Julie Stratton, Manager, Epidemiology Peel Public Health

For more informationJulie Stratton, Manager,

Epidemiology, Peel Public Health, [email protected]

Dr. Megan Ward, Associate Medical Officer of Health, Peel Public Health, [email protected]

Page 25: Julie Stratton, Manager, Epidemiology Peel Public Health

Limitations

International and some contraband cigarettes might have been classified as legal

Selection of venues