Health of Canadians
Health behaviours and substance use

Key findings

• The proportion of Canadians aged 12 and older who met the physical activity guidelines and the proportion of those who reported eating fruits and vegetables five or more times per day declined from 2015 to 2021.
• More than three-quarters (78.3%) of children and youth met the sleep guidelines for their age in 2019.
• Heavy drinking and current cigarette smoking declined from 2015 to 2021.
• The percentage of daily or almost daily cannabis use and current smoking was higher among people with lower incomes, unlike heavy drinking, which was greater among people with higher incomes.
• Yukon had higher rates of exclusive breastfeeding (67.9%) than other provinces and territories (40.7%).

5.0 Health behaviours

Physical activity, nutrition, and sleep

Maintaining a certain level of physical activity, achieving sufficient and good-quality sleep, and maintaining a diet rich in fruit and vegetables contribute to a lower risk of mortality, cardiovascular disease, hypertension, type 2 diabetes, several cancers, anxiety, depression, dementia, and weight gain. They also contribute to improvements in bone health, cognition, quality of life, and physical function.^{Note 48} The recommended amount of physical activity and sleep varies by age group (Table 5.0).^{Note 48}



Physical activity

In 2019, while four in five children aged 5 to 11 (81.8%) were reported to have participated in some moderate-to-vigorous physical activity in the previous seven days, only one-third (34.9%) met the recommendation of at least 60 minutes of such activity per day, on average. Adults aged 18 to 64 were more likely than all other age groups to meet the physical activity guidelines in 2021 (Chart 5.1). In 2021, the proportion of Canadians aged 18 and older who met the physical activity recommendations was 3% lower than in 2015, but the decline was most pronounced among youth aged 12 to 17 (-14 percentage points). Across all ages, more males reported being physically active compared with females.

Did you know?

Parents’ physical activity is associated with that of their children. Results from the Canadian Health Measures Survey show that for every 20-minute increase in a parent’s moderate-to-vigorous physical activity, their child’s moderate-to-vigorous physical activity increased by 5 to 10 minutes.^{Note 37}

Data table for Chart 5.1



Data table for chart 5.1
Table summary
This table displays the results of Data table for chart 5.1 Age group (years), 12 to 17, 18 to 64 and 65 and older, calculated using percent units of measure (appearing as column headers).

	Age group (years)
	12 to 17	18 to 64	65 and older
	percent
2015	59.4	60.6	40.2
2021	45.2	57.8	40.4
Notes: Estimates exclude the territories. Youth (12 to 17 years) meeting the physical activity guidelines have an average of at least 60 minutes per day of moderate-to-vigorous activity; adults (18 to 64 years) and older adults (65 years and older) meeting the physical activity guidelines have at least 150 minutes per week of moderate-to-vigorous activity. Sources: Statistics Canada, Canadian Community Health Survey, 2015 to 2021, Table 13-10-0096-01 Health characteristics, annual estimates.

Sleep

Did you know?

In 2026, Statistics Canada will release the first-ever results of directly measured sleep in Canada. Sleep and physical activity data are being collected using devices called accelerometers in Cycle 7 of the Canadian Health Measures Survey.^{Note 49}

Getting adequate and high-quality sleep supports healthy brain function and maintains physical health.48 Sleep plays an integral role in the health and development of children and youth.^{Note 50} While more than three-quarters (78.3%) of Canadian children and youth met the sleep guidelines for their age in 2019, this decreased with age (Chart 5.2).

A higher proportion of children aged 3 to 11 had the recommended hours of sleep, compared with all other age groups, and this declined by age (Chart 5.2). A higher percentage of youth aged 12 to 17 (37%) reported having difficulty falling and staying asleep compared with all other age groups (Chart 5.2).

Data table for Chart 5.2



Data table for chart 5.2
Table summary
This table displays the results of Data table for chart 5.2 Meeting sleep guidelines and Experiencing trouble falling and staying asleep, calculated using percent units of measure (appearing as column headers).

	Meeting sleep guidelines	Experiencing trouble falling and staying asleep
	percent
3 to 11 years	86.2	19.0
12 to 17 years	66.1	37.0
18 to 64 years	54.6	19.6
65 years and older	31.8	17.3
Sources: Statistics Canada, Canadian Community Health Survey, 2021; and Canadian Health Survey on Children and Youth, 2019.

Did you know?

In 2021, 3.1% of older adults who had difficulty sleeping reported having poor mental health compared with 0.8% of older adults who had no trouble sleeping.^{Note 51}

Did you know?

Feeling tired, fatigued, or sleepy during daytime can be a sign of sleep apnea. In 2016/2017, 6% of Canadians reported having sleep apnea and another 30% were at moderate or high risk of developing sleep apnea based on risk factors such as age, body mass index, and neck circumference.^{Note 52Note 53}

Nutrition

In 2021, 21.8% of Canadians aged 12 and older reported eating fruits and vegetables five or more times per day, down 10 percentage points from 2015 (31.5%). A higher proportion of females (25.5%) met this requirement compared with males (18.0%).

Did you know?

Breastfeeding is an important source of nutrition for infants. Exclusive breastfeeding is recommended for the first six months and up to two years or more, along with age-appropriate complementary feeding.^{Note 54} In 2021, while most females aged 15 to 55 who had a baby in the last five years initiated breastfeeding (93.8%), only 40.7% breastfed exclusively for at least six months.^{Note 55} Breastfeeding exclusivity rates were similar by province or territory, except in Yukon, which had the highest rate (67.9%).^{Note 55Note 56}

6.0 Substance use

Alcohol, tobacco, and cannabis are commonly used substances that could lead to increased risk of chronic disease, including chronic liver disease, chronic respiratory disorders, certain cancers, cardiovascular diseases, and premature death.

Alcohol

Did you know?

New guidance on alcohol consumption was released in 2023 recommending that adults aged 19 and older should consume no more than two standard alcoholic drinks per week to minimize the risk associated with drinking alcohol.^{Note 57} This is a dramatic reduction from previous guidelines.

Heavy drinking is defined as having five or more drinks for males aged 12 and older, or four or more drinks for their female counterparts, on one occasion, at least once a month in the past year.

In 2021,15.6% of Canadians aged 12 and older engaged in heavy drinking, down from 19.2% in 2015 (Chart 6.0). A higher proportion of males (18.7%) reported heavy drinking than females (12.5%), and the prevalence of heavy drinking was highest among men aged 18 to 64 (22.5%). Heavy drinking was higher in the Atlantic provinces, Yukon, and the Northwest Territories than the rest of Canada (Chart 6.1).

Across household income levels, more Canadians in the highest income quintile than in lower income quintiles were heavy drinkers (Chart 6.2).

Tobacco use and vaping

In 2021, 11.8% of Canadians aged 12 and older reported currently smoking cigarettes daily or occasionally, and this has declined since 2015 (Chart 6.0). Males and females aged 35 to 64 had higher rates of smoking than all other age groups. The Northwest Territories and Nunavut had a higher proportion of current smokers compared with the rest of Canada (Chart 6.1). Current smoking was highest in the lowest household income quintile (Chart 6.2).

Did you know?

Tobacco alternatives, such as e-cigarettes, have increased in popularity, particularly among youth aged 12 to 17. In 2021, 15.0% reported vaping daily.^{Note 51} Most vaping products contain nicotine and, like tobacco, can lead to nicotine addiction. Vaping may also increase the risk of exposure to other harmful chemicals.^{Note 58}

Cannabis

In 2018, the Cannabis Act came into force, legalizing and regulating access to cannabis in Canada.^{Note 59} The Canadian Community Health Survey started collecting data on cannabis use in 2019, to monitor and evaluate the impact of the act. In 2021, 5.5% of Canadians aged 12 and older reported using cannabis daily or almost daily (five or more days per week), a share that has remained stable since 2019.

Daily or almost daily cannabis use was reported more often by men and women aged 18 to 34. It was also reported more often by bisexual or pansexual Canadians (15.7%), compared with heterosexual Canadians (5.3%). Cannabis use was higher than the national average in some Atlantic provinces (Prince Edward Island, Nova Scotia, and New Brunswick) and Alberta (Chart 6.1). Like current smoking, the percentage of daily or almost daily cannabis use was higher among people with lower incomes (Chart 6.2).

Daily or almost daily use of cannabis is strongly associated with adverse health outcomes, particularly related to mental health.^{Note 60Note 61}

Data table for Chart 6.0



Data table for chart 6.0
Table summary
This table displays the results of Data table for chart 6.0 Heavy drinking, Current smoking, daily or occasional and Cannabis use, daily or almost daily, calculated using percent units of measure (appearing as column headers).

	Heavy drinking	Current smoking, daily or occasional	Cannabis use, daily or almost daily
	percent
2015	19.2	17.7	Note ..: not available for a specific reference period
2016	19.0	16.9	Note ..: not available for a specific reference period
2017	19.5	16.2	Note ..: not available for a specific reference period
2018	19.1	15.8	Note ..: not available for a specific reference period
2019	18.3	14.8	5.4
2020	16.6	12.9	5.5
2021	15.6	11.8	5.5
.. not available for a specific reference period Notes: Daily smokers are those who reported smoking cigarettes every day (excluding alternative smoking products), while occasional smokers are those who reported smoking cigarettes occasionally. This includes former daily smokers who now smoke occasionally. Questions on cannabis use were added to the Canadian Community Health Survey beginning in 2019. Territorial data are not included in annual estimates. Sources: Statistics Canada, Canadian Community Health Survey, 2015 to 2021, Table 13-10-0096-01 Health characteristics, annual estimates.

Did you know?

In Canada, 4.7% of past-year cannabis consumers had impaired control over their use of cannabis.^{Note 62} Several characteristics independently increased the likelihood of having impaired cannabis control, including being male, being aged 18 to 24, being from a lower-income household, being single or never married, having been diagnosed with anxiety or a mood disorder, or having first tried cannabis at age 15 or younger.^{Note 62} Monitoring the number of Canadians at risk of developing a cannabis addiction is important, as addiction can harm health and negatively affect school performance, work, and financial well-being.^{Note 62}

Data table for Chart 6.1



Data table for chart 6.1
Table summary
This table displays the results of Data table for chart 6.1 Heavy drinking, Current smoking, daily or occasional and Cannabis use, daily or almost daily, calculated using percent units of measure (appearing as column headers).

	Heavy drinking	Current smoking, daily or occasional	Cannabis use, daily or almost daily
	percent
Canada	15.6	11.8	5.5
N.L.	22.8	13.4	5.5
P.E.I.	19.0	14.2	8.8
N.S.	19.4	13.5	8.6
N.B.	18.9	12.4	7.9
Que.	15.9	13.3	3.4
Ont.	14.7	11.6	5.6
Man.	14.6	11.1	5.1
Sask.	16.7	12.6	6.0
Alta.	16.0	11.5	6.7
B.C.	15.1	9.6	6.2
Y.T.	26.1	20.2	Note ..: not available for a specific reference period
N.W.T.	29.0	35.0	Note ..: not available for a specific reference period
Nvt.	23.1	63.1	Note ..: not available for a specific reference period
.. not available for a specific reference period Notes: Provincial data are from the 2021 Canadian Community Health Survey (CCHS), and provinces are compared with the 2021 estimate for the rest of Canada, which excludes the province being compared and the territories (shown). Territorial data are from the 2017 and 2018 CCHS, and territories are compared with the 2017 and 2018 estimate for the rest of Canada, which excludes the territory being compared (not shown). Territorial data for cannabis are not available for the given year. Daily smokers are those who reported smoking cigarettes every day (excluding alternative smoking products), while occasional smokers are those who reported smoking cigarettes occasionally. This includes former daily smokers who now smoke occasionally. Questions on cannabis use were added to the CCHS beginning in 2019. Sources: Statistics Canada, Canadian Community Health Survey (CCHS), 2021, Table 13-10-0096-01 Health characteristics, annual estimates; and CCHS, 2017 and 2018, Table 13-10-0113-01 Health characteristics, two-year period estimates.

Did you know?

While there is a lot of evidence linking health behaviours, such as smoking and physical activity, to health outcomes, fewer studies take a comprehensive look at the combined impact of these factors on outcomes while controlling for other determinants of health. Integrating population health data from the Canadian Community Health Survey with mortality data demonstrated that the largest health behaviour mortality hazards were associated with female heavy smokers in Canada (hazard ratio: 3.36; 95% confidence interval: 2.86, 3.95).^{Note 63}

Data table for Chart 6.2



Data table for chart 6.2
Table summary
This table displays the results of Data table for chart 6.2 Heavy drinking, Current smoking, daily or occasional and Cannabis use, daily or almost daily, calculated using percent units of measure (appearing as column headers).

	Heavy drinking	Current smoking, daily or occasional	Cannabis use, daily or almost daily
	percent
Q1 (lowest)	11.5	16.0	6.8
Q2	12.8	12.8	6.3
Q3	14.7	11.4	6.0
Q4	17.4	10.3	4.1
Q5 (highest)	21.5	8.5	4.1
Notes: Territorial data for cannabis are not available for the given year. Territorial data are not included in annual estimates. Daily smokers are those who reported smoking cigarettes every day (excluding alternative smoking products), while occasional smokers are those who reported smoking cigarettes occasionally. This includes former daily smokers who now smoke occasionally. Questions on cannabis use were added to the Canadian Community Health Survey beginning in 2019. Source: Statistics Canada, Canadian Community Health Survey, 2021.

Opioids, stimulants and illicit drugs

In 2019, 3% of Canadians reported using at least one of six illegal drugs (cocaine or crack, speed or methamphetamine, ecstasy, hallucinogens, heroin, or salvia) and 1% reported problematic use of opioid pain relievers.^{Note 64} The Canadian Wastewater Survey showed that of the 14 drugs measured across five major cities, the levels of fentanyl and methamphetamine significantly increased early in the COVID-19 pandemic.^{Note 65} In both 2019 and 2020, loads of fentanyl per capita were more than four times higher in Vancouver than in any other city, while methamphetamine loads were highest in Edmonton.^{Note 65}

Did you know?

Canada saw a significant jump in opioid-related deaths at the onset of the COVID-19 pandemic, exacerbating the opioid crisis. Emergency department visits because of opioid poisoning have increased in Alberta and Ontario.^{Note 66}

Statistics Canada researchers used machine learning to identify six profiles of individuals who may be at higher risk of opioid overdose. For example, one profile was working-age males who used opioid prescription medications, had high incomes, and were employed primarily in construction.^{Note 67Note 68} Such information can be used by public health authorities to better target and tailor programs and identify points of intervention to support treatment and lessen harms.^{Note 67Note 68}