Canadian Journal of Public Health-Revue Canadienne De Sante Publique最新文献

{"title":"Driving change in Nova Scotia: The lasting impact of Public Health Mobile Units beyond COVID-19.","authors":"Haley Glazebrook, Desiree Gregory, Marie Brown, Beth Gillis, Mary Lewis, Holly Gillis","doi":"10.17269/s41997-026-01210-0","DOIUrl":"https://doi.org/10.17269/s41997-026-01210-0","url":null,"abstract":"<p><strong>Setting: </strong>Amidst the global COVID-19 pandemic, Nova Scotia faced significant gaps and barriers in access to testing, particularly in underserved communities and areas experiencing outbreaks. In the fall of 2020, the Public Health Mobile Units commenced as part of Nova Scotia's provincial emergency response.</p><p><strong>Intervention: </strong>Implementation involved the procurement and development of 10 vans, equipment, staffing, and processes to deliver COVID-19 testing services across the province. The Public Health Mobile Unit composes a collaborative practice model functioning as a provincial team with a focus on geographic zones. These roles include Public Health Nurses, Licensed Practical Nurses, Emergency Support Aides, Drivers, Secretaries with support from leadership, and health promoters.</p><p><strong>Outcomes: </strong>Embracing an equity-based approach, Public Health Mobile Units offered testing in communities not otherwise easily accessed through existing Nova Scotia Health pathways, areas experiencing COVID-19 outbreaks, and priority groups that may be at risk of severe illness. The Public Health Mobile Unit (PHMU) work expanded to include supporting public health's COVID-19 response with immunization, community rapid testing, negative results, and navigating community to COVID-19 resources. Additionally, the rapid services and flexibility of the Public Health Mobile Units supported Nova Scotia during times of need in hurricanes, wildfires, and floods.</p><p><strong>Implications: </strong>The successful evaluation and engagement highlighted the trust and confidence built with the community and partners throughout the pandemic response. Thus, enabling the Public Health Mobile Units to continue delivering preventative health services as the Public Health Mobile Unit has received permanent funding and has continued as a provincial public health program since the fall of 2024.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal shifts in area-level access to cycling infrastructure for equity-deserving groups in three Canadian cities: A descriptive epidemiologic study.","authors":"Hiroshi Mamiya, Benoit Thierry, Zoé Poirier Stephens, Scott Bell, Ehab Diab, Yan Kestens, Meghan Winters, Daniel Fuller","doi":"10.17269/s41997-026-01209-7","DOIUrl":"https://doi.org/10.17269/s41997-026-01209-7","url":null,"abstract":"<p><p>Multi-city investigations of how access to cycling infrastructure changes over time for equity-deserving communities have been absent in Canada and are scarce internationally. In this descriptive epidemiological study, we evaluated how area-level (ecological) access to cycling infrastructure varied by neighbourhood socio-demographic profiles in three Canadian cities (Montréal, Vancouver, and Victoria) across the 2011, 2016, and 2021 census years. For each city and year, we calculated the road network distance to the nearest cycling infrastructure from the population-representative centroids of the census dissemination area as the outcome. The independent variables were the area-level proportions of equity-deserving groups. These were Indigenous people, racialized people, recent immigrants, people in low-income households, tenants, individuals with lower educational attainment, children, and older adults. We employed linear and Bayesian spatial regression methods to examine the relationship between the tertile proportions of each population group and the outcome for each city and census year. Areas with a higher proportion of children had lower proximity to cycling infrastructure, regardless of city or census year. Similar patterns were observed for areas with a higher proportion of older adults, although to a lesser extent. The inequity across the proportion of children narrowed over time in Montréal, but not in Vancouver or Victoria. In contrast, areas with a greater proportion of low-income populations had equal or better access to cycling infrastructure across all cities and time periods. These findings on access to cycling infrastructure are concerning due to the lack of age-friendliness in the implementation of infrastructure in these cities.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Black racism continues to undercut public health and pandemic response: A commentary on the mpox response in Canada.","authors":"Cornel Grey, Jad Sinno, Mackenzie Stewart, Oghenetega Ubor, Carmen Logie, Matthew Numer, Devan Nambiar, Emerich Daroya, Edward Ou Jin Lee, Trevor A Hart, Olivier Ferlatte, Darrell H S Tan, Daniel Grace","doi":"10.17269/s41997-026-01207-9","DOIUrl":"https://doi.org/10.17269/s41997-026-01207-9","url":null,"abstract":"<p><p>This commentary examines how anti-Black racism shaped Canada's public health response to the 2022 mpox outbreak. It explores how racialized and sexualized stigma influenced public discourse and delayed targeted interventions for Black gay, bisexual, and queer men (GBQM). Drawing on critical public health frameworks, we interrogate how colonial narratives framed Blackness as a source of contagion. We also consider how public health institutions were slow to act until mpox appeared in the Global North, reflecting a pattern in global health where outbreaks are not treated as urgent until they affect predominantly white or Western populations. This delay is grounded in a pervasive assumption that infectious disease originates and circulates primarily in the racialized geographies of the Global South. This commentary calls for a transformation of public health infrastructure in Canada to one that centers Black lives in epidemic responses, integrates robust education on Black health through community-engaged expertise, and adopts inclusive, anti-oppressive approaches. In light of Canada's deep ties to global migration and diasporic communities, we underscore the need for timely, globally informed responses to infectious diseases that resist colonial hierarchies which have long treated Black and other racialized lives as less worthy of protection and care.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updating the core competencies for public health in Canada: Feminist community-based study.","authors":"Margaret J Haworth-Brockman, Sarah E Neil-Sztramko, Caralyn Vossen, Alex Henteleff, Hannah Mahar-Klassen, Mandy Walker, Faith Layden, Claire Betker","doi":"10.17269/s41997-026-01206-w","DOIUrl":"https://doi.org/10.17269/s41997-026-01206-w","url":null,"abstract":"<p><strong>Objectives: </strong>The 2008 core competencies for the public health in Canada were used extensively however were outdated. Our objective was to determine and conduct a consultation and engagement process to update the core competencies. This study describes the approach and methods used.</p><p><strong>Methods: </strong>Feminist community-based research informed the multiple methods used to gather explicit and tacit expertise on essential knowledge, skills, and attitudes for the updated competencies. Recommendations from published literature were adapted for project governance, literature reviews, engagement, and integration of feedback on competency statements based on principles of reflection, reflexivity, equity, and transparency.</p><p><strong>Results: </strong>More than 2300 members of the public health community contributed to updating the core competencies via in-person and virtual engagement sessions. Participants were from every province and territory and a range of public health disciplines, roles, and system levels, with a focus on integrating Indigenous and Black Health Leaders' perspectives. Over 2200 comments and edits received informed successive competency drafts.</p><p><strong>Conclusion: </strong>The updated core competencies incorporate timely issues, such as climate change and planetary health, for evidence-informed public health practice and policy. They emphasize the importance of First Nations, Inuit, and Métis approaches and ways of knowing, of integrating Black Health and anti-Black racism, as well as grounding values of health equity, social justice, and accountability in public health practice and policy. This manuscript adds to the international body of knowledge on methods for modernizing core competencies for public health workforce development and training.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying organizational leadership competencies for public health governance in Canada: A modified Delphi study.","authors":"Shinjini Mondal, Kian Rego, Garima Talwar Kapoor, Madelyn P Law, Erica Di Ruggiero","doi":"10.17269/s41997-026-01200-2","DOIUrl":"https://doi.org/10.17269/s41997-026-01200-2","url":null,"abstract":"<p><strong>Objectives: </strong>This research aimed to generate consensus from Canadian public health experts on organizational leadership competencies for public health governance in Canada.</p><p><strong>Methods: </strong>A three-step modified Delphi technique was used to build consensus. It included (1) identifying the list of competencies for organization leadership for public health governance based on a literature review and interviews, (2) conducting a consensus two-round modified Delphi survey with public health experts across Canada, and (3) holding an online deliberative dialogue to finalize the list of competencies and generate pathways for the uptake of competencies. Qualitative responses were analyzed using thematic analysis for Round 1.</p><p><strong>Results: </strong>Sixty-two survey participants participated in Round 1, with a 72.58% retention rate in the second round of the Delphi. Round 3 had 12 public health experts participating in the online consensus dialogue. The Delphi technique generated 20 competencies that were identified across eight domains of systems thinking: policy development, implementation, evaluation; partnership and collaboration; equity and justice; organizational learning; oversight; resource stewardship; and legal authority.</p><p><strong>Conclusion: </strong>This is the first-ever study in Canada to develop organizational leadership competencies for public health governance using a consensus-based approach. The results are relevant to public health and health care organizations interested in adopting or implementing organizational-level competencies. Future research needs to explore implementation and adaptation strategies of these competencies across various public health organizations.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes of Quebec's ban on flavoured vaping products on adolescent electronic cigarette use: a 2022-2024 COMPASS longitudinal analysis.","authors":"Slim Haddad, Richard E Bélanger, Natalia Poliakova, Rabi Joël Gansaonré, Scott T Leatherdale","doi":"10.17269/s41997-026-01199-6","DOIUrl":"https://doi.org/10.17269/s41997-026-01199-6","url":null,"abstract":"<p><strong>Objectives: </strong>Studies evaluating the outcomes of flavoured vaping product sales bans on adolescent vaping remain scarce, often inconclusive, and of limited generalizability, as they rely predominantly on US data. This study examines the short-term outcomes of such legislation implemented in Quebec (Canada) in October 2023.</p><p><strong>Methods: </strong>A pretest-posttest design with a nonequivalent control group was used, drawing on data from the 2022, 2023 (pre-intervention), and 2024 (post-intervention) waves of the COMPASS study. The exposed group included 4540 adolescents from 68 Quebec schools, and the comparison group included 1491 adolescents from 39 Ontario schools. Indicators derived from self-reported current vaping (past-30-days) were analysed: non-use, daily use, initiation, reduction, mean magnitude of reduction, and cessation.</p><p><strong>Results: </strong>Between 2023 and 2024, difference-in-differences analyses revealed no significant between-group differences across all six outcomes examined: non-use (-0.7 percentage point; 95% CI [-2.4, 1.1]), daily use (+ 0.6 point; [-0.2, 1.4]), initiation (+ 1.6 point; [-1.1, 4.3]), reduced use (-9.7 points; [-20.7, 1.3]), mean magnitude of use reduction (+ 0.3 points on the ordinal scale; [-0.1, 0.7]), and cessation (-3.6 points; [-14.9, 7.8]).</p><p><strong>Conclusion: </strong>The results do not provide evidence of short-term outcomes of the Quebec legislation and suggest the need for adjusted approaches. Such adjustments may involve strengthening both the design and implementation of interventions. Future research with longer follow-up periods is needed to identify the most effective measures to protect adolescents.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare utilization and HIV burden among Black communities in Ontario: a matched cohort study.","authors":"Lawrence Mbuagbaw, Fiona Rezene, Wangari Tharao, Winston Husbands, Rita Shahin, Agatha Nyambi, Daeria O Lawson, Medys Kihembo, Muna Aden, Clemence Ongolo-Zogo, Charles Dabone, Sheila Boamah, Fatimah Jackson-Best, OmiSoore Dryden, LaRon Nelson, Geena Verma, Alexander Kopp, Aisha Lofters","doi":"10.17269/s41997-026-01204-y","DOIUrl":"https://doi.org/10.17269/s41997-026-01204-y","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the demographic and health profiles of Black people in the African Caribbean Track Study (A/C Study) who consented to linkage to administrative databases, examine variations in healthcare use, and compare these patterns to those observed in the general population to inform efforts to reduce health disparities.</p><p><strong>Methods: </strong>Using a matched cohort design, participants who consented to administrative data linkage in the A/C Study were matched 1:10 to general population controls based on age (± 5 years), sex, and census metropolitan area. We compared sociodemographic characteristics, HIV prevalence, and healthcare use using descriptive statistics and logistic regression.</p><p><strong>Results: </strong>Of the 1380 A/C Study participants, 309 provided consent and 115 (8.3%) were successfully linked to administrative data and matched to 1150 controls (total N = 1265). A/C Study participants were significantly more likely to reside in areas of higher material deprivation and residential instability. HIV prevalence was substantially higher in the A/C cohort compared to the general population (OR = 29.87; 95% CI, 8.10-110.12). A/C participants also had significantly higher odds of ER use (OR = 2.16; 95% CI, 1.38-3.40). No significant differences were observed in primary care visits, hospitalizations, specialist visits, or UPC index.</p><p><strong>Conclusions: </strong>This study highlights disparities in HIV burden and emergency care use among Black communities in Ontario, underscoring persistent inequities in access to timely, preventive care. These findings demonstrate the value of data linkage for equity-focused health system research and emphasize the need for culturally responsive interventions to improve outcomes among Black populations in Canada.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of a national school food program to reduce dietary inequalities among children in Canada.","authors":"Paul J Veugelers, Nicholas Grubic, Julia Dabravolskaj, Katerina Maximova","doi":"10.17269/s41997-026-01201-1","DOIUrl":"https://doi.org/10.17269/s41997-026-01201-1","url":null,"abstract":"<p><strong>Objectives: </strong>Considering growing food insecurity and diet-related inequalities, Canada has introduced a national school food program (SFP). International studies have shown the benefits of SFPs for student diets, but their potential to reduce differences in dietary intake and diet quality (dietary inequalities) has not been studied. This study examines the associations of existing SFPs with dietary intake and inequalities among elementary students in Canada.</p><p><strong>Methods: </strong>Data from 1442 grade 4-6 students (9-12 years of age) from 26 schools in underserved communities reported foods and beverages consumed in the past 24 h and whether these were provided as part of an SFP, brought from home, or obtained elsewhere. Inequalities in dietary intake (vegetables and fruit, milk and alternatives, free sugars, sodium) and overall diet quality of students who accessed vs. did not access SFPs were quantified using Gini coefficients.</p><p><strong>Results: </strong>Students who accessed SFPs (n = 181) reported consuming more vegetables and fruit, more milk and alternatives, and diets of better quality, compared to their peers who did not access SFPs (n = 1261). These differences were especially pronounced among students from less affluent households. Lower inequalities in the consumption of vegetables and fruit (difference in Gini coefficients = 0.072, 95% CI 0.026-0.116), free sugars (0.055, 95% CI 0.004-0.090), and diet quality (0.019, 95% CI 0.007-0.029) were observed among students who accessed SFPs vs. those who did not.</p><p><strong>Conclusion: </strong>SFPs may play an important role in improving the diets of Canadian children and reducing inequalities in dietary intake, thus highlighting their potential in promoting equitable health outcomes.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in trust in public health authorities, medical care providers, health scientists, and provincial and federal governments in Canada, from before COVID-19 pandemic to May 2024.","authors":"Syed Jafar Raza Rizvi, Sohana Sadique, Daniel A Adeyinka, Khatira Mehdiyeva, Eve Dube, Cory Neudorf, Nazeem Muhajarine","doi":"10.17269/s41997-026-01203-z","DOIUrl":"https://doi.org/10.17269/s41997-026-01203-z","url":null,"abstract":"<p><strong>Objective: </strong>This quantitative study examines the factors predicting changes in trust in governments (federal and provincial/territorial), public health authorities, health scientists, and medical care providers from before the COVID-19 pandemic to May 2024.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among Canadian adults in May 2024. Trust levels before and during the pandemic were assessed using tested and validated items across five domains-provincial and federal governments, public health authorities, health scientists, and medical care providers using Likert scales. A weighted multinomial logistic regression was used to identify factors associated with changes in trust (trust increased, trust decreased). Models were evaluated for goodness-of-fit of predicted versus observed estimates.</p><p><strong>Results: </strong>Adults aged 34-54 were less likely to increase trust in provincial government (RRR = 0.78), and older adults (≥ 55 years) were less likely to increase trust in medical care providers (RRR = 0.36) and more likely to decrease trust in health scientists (RRR = 1.44). Respondents who declared their gender as non-binary or chose not to disclose  were less likely to increase trust in provincial governments (RRR = 0.24). However, individuals with a strong interest in science were more likely to report increased trust in public health authorities (RRR = 1.39) and in health scientists (RRR = 1.69). Vaccine-trusting individuals were more likely to report increased trust across all trust domains.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic significantly impacted public trust in health institutions, with disparities across sociodemographic groups and regions. Trust levels were closely tied to vaccination-attitudes, underscoring the need for transparent, science-based communication and targeted interventions to rebuild trust, particularly among vaccine-hesitant populations.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in higher-risk cannabis use outcomes across Canadian provinces and territories: A cross-sectional study.","authors":"Samantha Goodman, Matthew J Dann, Hanan Abramovici","doi":"10.17269/s41997-026-01202-0","DOIUrl":"https://doi.org/10.17269/s41997-026-01202-0","url":null,"abstract":"<p><strong>Objectives: </strong>In 2018, Canada legalized and regulated the production and sale of cannabis for non-medical purposes. This paper examined the prevalence of 'higher risk' cannabis use outcomes across Canadian provinces and territories (PTs), with rates hypothesized to be lower in Quebec and higher in the territories.</p><p><strong>Methods: </strong>Past 12-month cannabis consumers from the 2023 and 2024 cycles of the Canadian Cannabis Survey were included (n = 7238). A previous study identified 16 higher risk cannabis use outcomes. Logistic regression models tested differences in each outcome by PT (10 provinces; three territories combined) or region (Western Canada, Ontario, Quebec, Atlantic Canada, territories).</p><p><strong>Results: </strong>Newfoundland and the territories had the highest rates of frequent cannabis use, and Alberta had the highest rate of inhalable cannabis extract use. Consumers in Quebec reported among the lowest rates of five 'higher risk' outcomes (including frequent cannabis use, past 12-month use of inhalable cannabis extracts, and use of extracts containing > 30% THC). In contrast, they reported among the highest rates of several other outcomes, including consuming edibles/beverages with > 10 mg THC/unit (despite a provincial limit of 5 mg/unit) and obtaining cannabis from illicit sources. The territories had high rates of frequent cannabis use; however, they did not differ significantly from the provinces on most outcomes.</p><p><strong>Conclusions: </strong>Quebec continues to differ from other PTs in several domains. Differences are likely due to historically lower rates of cannabis use in Quebec, including lower use of extracts, combined with the province's restrictions on product sales, including cannabis products with > 30% THC.</p>","PeriodicalId":51407,"journal":{"name":"Canadian Journal of Public Health-Revue Canadienne De Sante Publique","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}