At least one-fifth of all deaths in London and Middlesex in an average year are attributable to alcohol consumption and smoking tobacco, a report going before the board of health for the Middlesex-London Health Unit on Thursday suggests.
The report references data released last month by Ontario Health and Public Health Ontario, which found that, in an average year, nearly 600 deaths (16.3 per cent) in the region among those 35 and older were attributable to smoking, along with 2,082 hospitalizations (7.9 per cent) and 3,917 emergency department visits (3.2 per cent).
The highest number of smoking-related deaths was from cardiovascular conditions and cancer, the report says. In the region, smoking contributed to one in every five deaths for males, and about one in every eight deaths for females.
The data also showed just over 150 deaths (4.1 per cent), 842 hospitalizations (2.4 per cent) and 6,968 emergency department visits (3.8 per cent) in the region were attributable to alcohol consumption in an average year among those 15 and older.
Cancer was the leading cause of alcohol-attributable deaths, followed by digestive conditions — conditions affecting the gastrointestinal tract, liver and pancreas, the report says. Alcohol consumption contributed to about one in every 16 deaths for males in London and Middlesex, and about one in every 52 deaths for females.
“This type of report is an opportunity for us to take an honest look in the mirror as a community with regards to our substance use, specifically around tobacco and alcohol,” said Dr. Alex Summers, the region’s medical officer of health.
“I think sometimes alcohol, in particular, we forget that it’s a drug. And over the last few decades, there’s been the narrative that a little bit of alcohol … can be actually good for your health. And more and more, we understand that that’s not actually the case.”
The report notes alcohol and tobacco can have significant economic and societal costs in addition to direct health costs, including through injury and premature death, lost productivity, costs related to the criminal justice system, vehicle collisions, family violence and mental health impacts.
Substance use is estimated to have cost Ontario more than $17 billion in 2017, the report says, citing the Canadian Centre on Substance Use and Addiction, with tobacco making up 28 per cent of costs, or $4.8 billion, and alcohol 35 per cent, or $6.2 billion.
Health officials note that the provincial figures are reflective of pre-pandemic conditions, with data about emergency department visits and hospitalizations covering 2015-19 and deaths 2014-18.
Consumption figures, meanwhile, span 2015 to 2017. At least 18 per cent of respondents 20 and older in London-Middlesex reported smoking cigarettes daily or occasionally, while 36.5 per cent of respondents 19 and older said they had two or more drinks per week.
Summers says the odds are strong that those numbers, and numbers related to deaths, hospitalizations and emergency department visits, have increased since the start of the COVID-19 pandemic.
“When we look at alcohol, it’s not a shock to me that use is where it’s at, and we likely did see an increase in use through the pandemic,” he said.
A study released earlier this year using data from the research institute ICES reported a 22 per cent jump in alcohol-related health-care visits in Ontario during the first 14 months of the pandemic, from March 2020 to May 2021.
“Similarly with tobacco, we saw a significant decrease in tobacco use through the ’90s and 2000s with all the increased rules about where you could smoke and where you couldn’t. But for the last decade, those numbers have really plateaued,” Summers said.
“What I’m worried about is that with the increase in vaping amongst youth, we might actually see an increase in subsequent smoking down the line as people become addicted to the nicotine products. So we have to watch these numbers really closely.”
In 2019, roughly 23 per cent of high school students reported having used an e-cigarette in the previous 12 months, up from 11 per cent in 2017, according to the Centre for Addiction and Mental Health’s Ontario Student Drug Use and Health Survey.
As of 2021, the most recent figures from CAMH, 15 per cent of high school students reporting used an e-cigarette in the previous 12 months.
Summers said that regardless if it’s cannabis or tobacco, smoking any substances will cause some type of harm to the lungs.
“This is why smoke-free continues to be an emphasis for us.”
He adds that the health unit will use its upcoming Poisoning Prevention Week to highlight the risk of cannabis exposure to children through the consumption of edibles.
“We’ve seen an increase in poisoning across Ontario as a result of that. The impact of these substances, be it cannabis, alcohol or tobacco, continues to be fairly entrenched in our community, and we’ll continue to try and tell that story,” he said.
“But again, I would highlight (that) these are drugs, they have negative effects on your health, and you need to be informed about the risks that you’re taking on.”
The report comes nearly two months after the Canadian Centre on Substance Use and Addiction unveiled revised recommendations for low-risk alcohol consumption.
The guidelines state that no amount of alcohol is “safe” and that people should drink no more than two standard drinks per week to minimize their risk of cancer and other chronic diseases. Canada’s previous guidelines from 2011 recommended 15 per week for men, or 10 for women.
Roughly 40 per cent of Canadians 15 and older drink more than six standard drinks per week, according to the CCSA. A standard drink is equivalent to a bottle of beer or cider, a glass of wine, or a shot glass of spirits.
A recent Ipsos poll conducted for Global News found that nearly three-quarters of respondents said they were unlikely to change their drinking habits in the wake of the updated CCSA guidelines. Of the respondents, 52 per cent said the lower guidelines were “fearmongering” tactics.
A large age divide was observed in the polling data. Of those aged 18-34, about 36 per cent said they consumed too much and noted its negative impact on their health. Of those 55 and older, only five per cent said the same.
— with files from The Canadian Press
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