title: Hardcore smoking among continuing smokers in Canada 2004-2012.
abstract: OBJECTIVE
  Decline in adult smoking prevalence in Canada seems to have slowed, suggesting that smoking rate may have plateaued. It is unclear whether this, at least in part, can be interpreted as evidence that some groups or individuals are becoming less resistant to tobacco control measures. This study examined trends in the prevalence of hardcore smoking in Canada.
  
  
  METHODS
  A nationally representative sample of adult daily smokers was drawn from the Canadian Tobacco Use Monitoring Survey 2004 to 2012 (n = 13,861). Hardcore smokers were defined in two ways: Hardcore 1 comprised those that reported no quit attempt, no quit intention, and smoke their first cigarette within 30 min after awakening and hardcore 2 comprised hardcore 1 plus those smoking 15 or more cigarettes per day. Logistic regression was used to examine associations between hardcore measures and year and socio-demographic variables.
  
  
  RESULTS
  Overall, there was no significant difference in hardcore smoking over time for the periods covered in this study. Analysis examining a single hardcore component, time-to-first cigarette (TTFC) after awakening as a measure of nicotine dependence showed similar results. A clear marked socioeconomic gradient in TTFC was found, those with university education (OR 0.46, 95 % CI 0.37-0.57), college (OR 0.51, 95 % CI 0.42-0.63), secondary (OR 0.68, 95 % CI 0.57-0.82) were significantly less likely to have TTFC ≤ 30 min compared with less than secondary education.
  
  
  CONCLUSIONS
  This study does not support the hardening hypothesis when interpreted as the increase in hardcore smokers over time.
authors.affiliation: Propel Centre for Population Health Impact, Faculty of Applied Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada, sazagba@uwaterloo.ca.
authors.forename: Sunday
authors.initials: S
authors.lastname: Azagba
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult