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Julie Stratton, Manager, Epidemiology Peel Public Health.

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1 Julie Stratton, Manager, Epidemiology Peel Public Health

2 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)

3 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%

4 Peel Region West of Toronto 1.3 million residents (20,000 people added each year) 15% of Peel residents smoke

5 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?

6 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)

7 Methods – Pilot Study Piloted process from one location from each venue Collection Identification

8 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

9 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

10 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:

11 Classification – Brand Name Examples du Maurier Player’s Matinee Viceroy Export A

12 Classification – Plug Wrap and Dry Patch Plug wrap Dry patch (area with no glue)

13 Classification – Ventilation Holes

14 Mechanical Electrostatic Laser

15 Classification - Filter Polypropylene vs acetate Some illegal cigarettes use polypropylene filters Do not dissolve in acetone

16 Classification Legal branded International Legal native Contraband (illegal) Discards Unknown or other

17 Classification – Legal Native Putters DKS Sago Ménage Podium

18 Classification – Contraband Examples Canadian Playfair Unbranded

19 Results Total Collected and Discard Rate LocationTotal collected Total discards Discard Rate (per cent) Hospitals3,14044914.3 Regional Buildings 2,80437013.2 College/university campuses 4,80867013.9 Secondary schools3,28056217.1 TOTAL14,0322,05114.6

20 Results – Overall Classification ClassificationNumberPer Cent Legal branded10,66389.0 International1441.2 Native legal5304.4 Contraband (Illegal) 6295.3 Unknown or other 150.1 Note: Excludes discards

21 Results - Native Legal and Contraband by Venue Population Representing VenuePer Cent Native Legal Per Cent Contraband YouthSecondary schools 3.18.6 Young adultCollege/ university campuses 1.42.8 General population Hospitals, Regional buildings 7.65.5

22 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

23 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

24 For more information Julie Stratton, Manager, Epidemiology, Peel Public Health, Dr. Megan Ward, Associate Medical Officer of Health, Peel Public Health,

25 Limitations International and some contraband cigarettes might have been classified as legal Selection of venues

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