An international survey shows that about 1 in 4 (23%) Canadian adults (age 18+) reported using cannabis at least once in the past 12 months.
Canada, the only country surveyed by the Commonwealth Fund where cannabis is legal for recreational use, had a higher rate than the 11-country average (9%), although Canada’s rate was similar to that seen in some states in the U.S. where cannabis is legal (20%). Reported rates of cannabis use were highest in the territories and Nova Scotia, followed by Alberta and British Columbia.
How Canada Compares: Results From the Commonwealth Fund’s 2020 International Health Policy Survey of the General Population in 11 Countries, released by the Canadian Institute for Health Information (CIHI), covers a wide variety of topics about health care systems, including mental health, access to health care, barriers to care and virtual care.
The survey took place between March 6 and June 15, 2020, in Canada, with the majority (75%) of interviews occurring in March and April. A detailed analysis shows that survey results were not affected by the COVID-19 pandemic, as most patients recalled experiences with health care systems that happened before it started.
For the first time, the survey included comparable information about behaviours affecting health (use of alcohol, tobacco, vaping, cannabis and other drugs).
Heavy drinking in Canada
A quarter of Canadians reported heavy drinking at least once a month. Heavy drinking is defined as 4 or more drinks for women and 5 or more drinks for men on 1 occasion. Canada’s rate of heavy drinking (27%) was slightly lower than the Commonwealth Fund average (32%).
Canadian men were significantly more likely than women to have a heavy drinking episode at least once a month (32% versus 22%). Heavy drinking was higher among younger Canadians (age 25 to 34) than among those 35 and older.
9% of respondents in Canada who reported heavy drinking had had a discussion with their doctor about alcohol use — the same as the international average (9%). More than twice that number (22%) had spoken to their doctor about their use of cannabis or other drugs like cocaine, amphetamines, heroin or other substances, a rate slightly higher than in other countries (17%).
Vaping in Canada
The survey results show that 5% of Canadians were using vaping devices (e.g., e-cigarettes), compared with 4% in peer countries. Vaping rates were highest among young adults (age 18 to 34) at 11%, compared with 3% among those 35+.
“The Commonwealth Fund’s survey shows that a quarter of Canadians reported using cannabis. Canada is the only country surveyed where cannabis is legal — other than a few states in the U.S. — and it only became legal for recreational use in 2018. It will be important to continue to study Canadians’ cannabis use and see how it affects their health in the future. While we have standards that define heavy drinking — 4 or more drinks for women and 5 or more drinks for men on 1 occasion — there are no standards that define ‘heavy’ cannabis use.”— Tracy Johnson, Director, Health System Analysis and Emerging Issues, Canadian Institute for Health Information
“The Commonwealth Fund’s survey provides an important baseline for substance use in Canada. Since the onset of the pandemic, we have seen some of these numbers increase — especially for those with mental health and substance use concerns. With further lockdowns happening throughout the country, this is something we need to be mindful of as we work to reduce overall health harms in Canada. We encourage people to refer to the low-risk drinking guidelines and to remember the importance of seeking help, lower-risk substance use and positive coping methods as we continue to deal with the effects of the pandemic on our substance use and mental health.”— Rita Notarandrea, Chief Executive Officer, Canadian Centre on Substance Use and Addiction (CCSA)
CIHI’s 2017 report Alcohol Harm in Canada includes more information about alcohol harm, while the Your Health System indicator Hospitalizations Entirely Caused by Alcohol provides data by province and territory.
CCSA’s Canada’s Low-Risk Alcohol Drinking Guidelines provides recommendations for reducing the long-term health risks associated with alcohol, while COVID-19 and Cannabis Smoking and Vaping explains how COVID-19 can affect people who use cannabis products.
Additional analyses of the health of Canadians and Canada’s health systems during the pandemic are in development and will be released in 2021.
About the Commonwealth Fund
Based in the United States, the Commonwealth Fund is a private foundation that aims to promote a high-performing health care system that achieves better access, improved quality and greater efficiency, particularly for society’s most vulnerable populations.
The Commonwealth Fund’s 2020 survey focused on the views and experiences of the general population age 18 and older. For the first time, all 3 Canadian territories were oversampled, allowing their results to be reported alongside provincial results and to be statistically tested against the international average.
Within Canada, funding for an expanded Canadian sample was provided by CIHI, Canada Health Infoway, the ministère de la Santé et des Services sociaux du Québec and Ontario Health, Quality unit (formerly Health Quality Ontario).
The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization dedicated to providing essential health information to all Canadians.
CIHI works closely with federal, provincial and territorial partners and stakeholders throughout Canada to gather, package and disseminate information to inform policy, management, care and research, leading to better and more equitable health outcomes for all Canadians.
Health information has become one of society’s most valuable public goods. For 25 years, CIHI has set the pace on data privacy, security, accessibility and innovation to improve Canada’s health systems.