Sharing our knowledge

The COMPASS Study collects data on a number of youth health behaviours. Using these data, we have created a number of knowledge products. Sharing our findings and producing usable knowledge tools is an important step in working collaboratively to improve youth health. Our knowledge products and resources are provided below:

• Vaping/E-Cigarettes
• Cannabis
• Alcohol
• Obesity

Vaping/e-cigarettes

Link to COMPASS vaping brochure

Changes in the e-cigarette environment

• There have been rapid shifts in the language used to describe e-cigarette use (or vaping) behaviour and in the type of devices used by youth. COMPASS continuously monitors these shifts and revises questionnaire wording to reflect current terminology.
• Shifts in regulation of e-cigarette devices in Canada can impact use among  youth. Devices containing nicotine have been legalized, increasing availability and advertising. COMPASS data can evaluate how changes in these regulations impact e-cigarette use behaviours and reasons for use among participating students.

Trends in e-cigarette use among students in the COMPASS Study

Did you know?

• Among Ontario students participating in COMPASS in 2018/19, 28% of males and 23% of females aged 15-19 have used e-cigarettes at least once in the last 30 days. 
• Current e-cigarettes use has increased from 8% in 2013/14 to 26% in 2018/19 among COMPASS participants in Ontario. 

This figure describes the percent of students who currently use e-cigarettes in Alberta, British Columbia, Ontario, and Quebec from 2013/14 to 2018/19; current use has increased in all provinces over this time.

Current e-cigarette use is defined as any use in the past 30 days 

Source: 2013-14 to 2018-19 COMPASS schools

This figure describes the percent of students who have ever used e-cigarettes in Alberta, British Columbia, Ontario and Quebec from 2015/16 to 2018/19; ever use has increased in all provinces except British Columbia.

Ever use is defined as ever having tried e-cigarettes

Source: 2015-16 to 2018-19 COMPASS schools

This figure describes the percent of grade 9, 10, 11, and 12 students who currently use e-cigarettes from 2013/14 to 2018/19; current use has increased in all grades over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure described the percent of male and female students who currently use e-cigarettes from 2013/14 to 2018/19; use has increased amongst males and females over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure describes the percent of current e-cigarette usage among White, Black, Asian, Aboriginal, and Hispanic students from 2013/14 to 2018/19; current usage has increased across all demographics over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure describes the percent of non-susceptible never smokers, susceptible never smokers, non-current smokers, and current smokers using e-cigarettes between 2013/14 and 2018/19; current use increased across all groups over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

Relating youth smoking to e-cigarette use

• COMPASS results suggest that e-cigarettes are expanding the tobacco market by attracting low-risk youth who would otherwise be unlikely to initiate use of cigarettes. (Aleyan et al, 2019)
• Recent COMPASS findings demonstrate a reciprocal relationship between cigarette and e-cigarette use and e-cigarette use was found to predict subsequent cigarette use. (Aleyan et al, 2018)
• E-cigarette use may contribute to the development of a new population of cigarette smokers. (Aleyan et al, 2018)

Other health behaviours associated with e-cigarette use

• COMPASS findings suggest that e-cigarette use is connected with the use of other substances such as cannabis, tobacco and alcohol (alcohol being the strongest link). (Zuckermann et al, 2019)

• Moreover, e-cigarette use has been found to be an important contributing factor in the use of multiple substances (poly-substance use).(Zuckermann et al, 2019)

Reasons for use among e-cigarette users in 2018/19

This figure describes the reasons students use e-cigarettes: curiosity was the most frequent response, followed by other reasons, the ability to use in places smoking is not allowed, to smoke less, and finally to quit.

Values do not add up to 100% as students could select more than one response

Source: 2018-19 COMPASS schools

Built environment and e-cigarettes

• E-cigarette retailer proximity and density surroundinga school were not significantly associated with thelikelihood of ever or currently using e-cigarettes. (Cole et al, 2019)
• These findings suggest that students are accessing e-cigarettes through other sources. (Cole et al, 2019)
• School-level policies banning the use of e-cigarettes on school property may be effective in reducing e-cigarette use (or preventing it) in their current form. (Milicic et al, 2018)

Cannabis 

Link to COMPASS cannabis brochure

Cannabis legislation in Canada

• In 2018, Canada federally legalized the recreational use of cannabis among adults, with minimum age requirements varying by province. 

• "After a steady decrease in patterns of cannabis use among youth over several years, it appears that there has been a gradual increase in cannabis use among youth following the start of discourse around cannabis legalization, with some populations of youth being at greater risk. " (Zuckermann et al, 2019)

Trends in cannabis use

Did you know?

• Among students participating in COMPASS in 2018/19, 26% have used cannabis at least once in their lifetime, and 13% report using at least monthly. 
• Cannabis use increases with grade and spending money, and use is more common among males and indigenous students.

This figure describes the percent of students who use cannabis in Alberta and Ontario from 2013/14 to 2018/19 and British Columbia and Quebec from 2016/17 to 2018/19; use has largely remained constant with slight changes year to year, except British Columbia which has decreased.

Cannabis use is defined as any use in the past 30 days

Souce: 2013-14 to 2018-19 COMPASS schools

This figure describes frequency of cannabis use among students between 2013/14 and 2018/19, categorized by daily, weekly, monthly, occasional, and non-use; over this time, non-use has decreased, occasional and monthly use has increased, and weekly and daily use has remained constant.

Source: 2013-14 to 2018-19 Ontario COMPASS schools

This figure describes the percent of male and female students who currently use cannabis between 2013/14 and2018/19; use has increased in both genders, and female use has remained consistently lower than male use.

Current cannabis use is defined as any use in the past 30 days. 

Source: 2013-14 to 2018-19 COMPASS Ontario Schools

This figure describes the percent of students in grades 9, 10, 11, and 12 who currently use cannabis between 2013/14 and 2018/19; cannabis use increases by grade, and over time remains steady across most grades, however grade 10 and 12 show slight increases.

Source: 2013-14 to 2018-19 COMPASS Ontario Schools

This figure depicts the use of cannabis between 2013/14 and 2018/19 among White, Black, Asian, Indigenous, and Hispanic students; Indigenous students have the highest frequency of use, followed by Black, White, Hispanic and Asian students. Use among Black and Hispanic students has decreased, use among Indigenous and Asian students has remained the same, and use among White students has increased over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario Schools

This figure describes the percent of students who currently use cannabis based on weekly amounts of spending money between 2013/14 and 2018/19; students with $100+ use the most cannabis, followed by $41-$100, $11-$40, $1-$10, and zero dollars of weekly spending money. Use among all groups has shown slight year to year changes but remain steady overall, except an increase in use among students with $100+ weekly spending money.

Source: 2013-14 to 2018-19 COMPASS Ontario Schools

Cannabis use and mental health

• Students who use cannabis more commonly report symptoms of depression and anxiety and these symptoms increase as cannabis is used more frequently. (Butler et al, 2019)

• The presence of depressive symptoms, and poorer emotional regulation skills were associated with higher rates of cannabis use.(Romano et al, 2019)

• Students who report greater psychosocial wellbeing (e.g. flourishing) are less likely to use cannabis or use at higher frequencies. (Romano et al, 2019; Butler er al., 2019)

Other health behaviours associated with cannabis use

• Polysubstance use, inclusive of cannabis, vaping and alcohol, was reported by 13.5% of Ontario and Alberta students. (Zuckermann et al, 2019)
• Escalation of cannabis use throughout high school was associated with being male, vaping, and low math marks. (Zuckermann et al, 2018)
• Students that engage in healthier behaviours (e.g., meeting screen time and sleep guidelines) are less likely to use cannabis. (Romano et al, 2019)
• Binge drinking, cigarette use, vaping, and opioid use were all associated with higher rates of cannabis use. (Romano et al, 2019)

Modes of use among students who use cannabis in 2018/19

This figure describes the mode of cannabis use among students who use cannabis on an occasional, monthly, weekly, and daily basis, categorized by smoking, vaping, and eating or drinking cannabis. Smoking is consistently the most frequent mode of use, followed by eating or drinking then vaping. The percent of students who consume in any way increases with more frequent use.

Values do not add up to 100% as students could select more than one response. 

Cannabis and school outcomes

• Improving school connectedness is protective against the frequency of cannabis use among students. (Weatherson et al, 2018)
• Students who used cannabis were less likely to attend class regularly, complete their homework, and achieve and value high marks, relative to their peers who abstained from using cannabis. (Patte et al, 2017; Williams et al, 2019)

Alcohol 

Link to COMPASS alcohol brochure

Changes to the alcohol environment

• There have been a number of provincial government-led changes, such as extended hours of sale, and changes to where alcohol can be consumed and purchased, that may shift the social environment surrounding consumption.
• Youth in the jurisdictions exposed to the latest change in LCBO policy authorizing grocery stores to sell alcohol are more likely to transition from abstinence to high-risk regular drinking and high-risk regular drinkers are more likely to maintain their behaviours (Gohari. et al, under review)

Trends in frequency of alcohol use among students in the COMPASS Study

Did you know?

• Among Ontario students participating in the COMPASS study in 2018/10, 41% of males and 37% of females aged 15-19 have had more than a sip of alcohol in the last 30 days.
• Among grade 12 students participating in the COMPASS study in 2018/19, 75% have had more than a sip of alcohol at least once in their lifetime.
• "Male and upper grade students had greater likelihood of engaging in high [risk] level patterns of alcohol consumption." (Gohari et al, 2020)

This figure describes the frequency of alcohol use between 2013/14 and 2018/19; non-use, occasional, and daily use has increased, and weekly and monthly use has decreased over this time.

Alchol use is defined as any use that was more than just a sip in the last 12 months. 

Source: 2013-14 to 2018-19 COMPASS Ontario schools. 

This figure describes the frequency of binge drinking between the years of 2013/14 and 2018/19; non-use has increased, weekly binge drinking has decreased, and occasional, monthly, and daily binge drinking has remained stable over this time.

Binge drinking is defined as consuming 5 drinks of alcohol or more on one occasion in the last 12 months. 

Source: 2013-14 to 2018-19 COMPASS Ontario schools. 

This figure describes the percent of male and female students who currently binge drink between 2013/14 and 2018/19; use has decreased in both genders, and female use has remained consistently lower than male use over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure describes the percent of students in grade 9, 10, 11, and 12 who currently binge drink between 2013/14 and 2018/19; binge drinking increases with each grade, and has decreased in all groups over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure depicts the rates of binge drinking between 2013/14 and 2018/19 among White, Black, Asian, Indigenous, and Hispanic students. Indigenous students have the highest frequency of binging, followed by White, Black and Hispanic, and Asian students. Binge drinking among all students has decreased over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

This figure describes the percent of students who currently binge drink based on weekly amounts of spending money between 2013/14 and 2018/19. Students with $100+ use the most cannabis, followed by those students who value between $41-$100, $11-$40, $1-$10, and zero dollars of weekly spending money. Binge drinking among all groups has decreased over this time.

Source: 2013-14 to 2018-19 COMPASS Ontario schools

Age of alcohol use in initiation among grade 12 students in 2018/19

This figure describes the age of alcohol initiation among grade 12 students; 28% had never drunk, 7% stated at 10 or younger, 1% started at 11, 4% started at 12, 7% started at 13, 15% started at 14, 17% started at 15, 14% started at 16, and 6% started at 17 years or older.

Source: Participating students from 2018-19 COMPASS schools

Health behaviours and early initiation to alcohol consumption

• Early initiation of alcohol consumption increases the likelihood for older students to engage in heavy drinking. (Gohari et al, 2019)
• "Youth engaging in current binge drinking were approximately three times more likely to smoke tobacco and almost eight times more likely to use cannabis." (Butler et al, 2019)
• Students who started binge drinking in grade 10 or 11 had larger body weight and BMI increases in comparison to those who never became binge drinkers. (Vermeer et al, 2019)
• Younger age of first alcohol use was associated with increased Moderate to Vigorous Physical Activity (MVPA) in grade 12. (Williams et al, 2019)

Relating youth binge drinking to other health behaviours and outcomes

• The most common dual use of substances were alcohol and e-cigarettes. (Zuckermann et al, 2019)
• Grade 12 students with higher levels of school connectedness were more likely to use alcohol and binge drink. (Holligan et al, 2019)
• Team sport participation has been shown to be associated with binge drinking among COMPASS student participants. (Butler et al, 2019)
• Among adolescent girls, those who were considered dieters were at increased risk of becoming involved in binge drinking in subsequent years. (Raffoul et al, 2018)
• "Adolescents who initiate binge drinking have a relatively higher risk of poor academic performance, and a lack of preparedness and engagement" (Patte et al, 2017)

Obesity