Consumer Health Products Survey · 2017. 12. 4. · Women, older Canadians (55+), those with at least a college education and those who use consumer health products more frequently

Consumer Health Products Survey

Report Date: 07.18.2016

Consumer Health Products Survey Contract # HT372-152592/001/CY

Produced by TNS Canada

Contract Award Date: March 8, 2016

Report Date: July 18, 2016

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1 Consumer Health Products Survey July 18, 2016

Table of Contents

1. Executive Summary 3

1.1. Research Purpose and Objectives 3

1.2. Summary of Findings 4

1.3. Methodology 6

1.4. Contract Value 7

1.5. Statement of Political Neutrality 7

2. Foreword 8

2.1. Background 8

2.2. Research Objectives 8

2.3. Methodological Overview 9

3. Detailed Findings 10

3.1. Canadians’ Knowledge and Understanding of Consumer Health Products10

3.1.1. Perceived Knowledge of Safety of Consumer Health Products 10

3.1.2. Perceived Knowledge of Effectiveness of Consumer Health Products 13

3.1.3. Categorizing Consumer Health Products 16

3.1.4. How Informed are Canadians when Purchasing Consumer Health Products? 20

3.1.5. Perceived Meaning of Homeopathic Medicine 23

3.1.6. Understanding of Ayurveda 26

3.1.7. Understanding of SPF 28

3.1.8. Awareness of Product Identifiers 29

3.1.9. Perceived Health Canada Responsibilities 31

3.2. Canadians’ Attitudes towards Consumer Health Products 38

3.2.1. Perceptions of Product Safety 38

3.2.2. Attitudes towards Safety 41

3.2.3. Trust in Claims 43

3.2.4. Attitudes towards Claims 45

3.2.5. Product Identifier Perceptions 50

3.3. Selection and Use of Consumer Health Products 52


3.3.1. Frequency of Use 52

3.3.2. Incidence and Frequency of Label Reading 54

3.3.2.1. Natural Health Products 54

3.3.2.2. Non-Prescription Drugs 55

3.3.2.3. Cosmetics 56

3.3.3. Desired Product Information to Make Purchase Decision 57

3.3.4. Determining Safety of Products 66

3.3.5. Determining Effectiveness of Products 72

3.3.6. Where Canadians Look for Product Information 78

3.3.7. Product Preference 82

3.3.8. Reasons for Product Preference 84

4. Survey Methodology 87

4.1. Methodological Overview 87

5. Appendix A: Survey Instrument 90


1. Executive Summary

1.1. Research Purpose and Objectives

The overall objective of this research is to better understand Canadian consumers’ knowledge, attitudes awareness and behaviours as they relate to consumer health products.

More specifically, this research seeks:

• To determine attitudes of Canadians with regard to consumer health products;

• To understand how Canadians select and use consumer health products;

• To understand what information Canadians want to see on consumer health products to assist them in their decision making;

• To assess how and from where Canadians seek information about consumer health products; and,

• To gauge the public’s knowledge and understanding of the various categories of consumer health products and how they are regulated.

The findings will be used by Health Canada:

• To gain more insight into the Canadian public’s views on consumer health products;

• To help ensure that the approach to consumer health products reflects the consumer’s needs.

Health Canada will continue to engage with Canadians as the approach moves forward and evolves.


1.2. Summary of Findings

Canadians’ Knowledge and Understanding of Consumer Health Products

Canadians have low perceived knowledge of the safety and effectiveness of consumer health products. Canadians generally consider themselves more knowledgeable about non-prescription drugs (35%) than cosmetics (25%) or natural health products (19%). They consistently rate their knowledge of the safety and effectiveness of consumer health products higher for non-prescription drugs than natural health products or cosmetics. Canadians also generally feel uninformed when purchasing consumer health products (33-58%). Again, to a lesser extent with non-prescription drugs (33%) than natural health products (58%) or cosmetics (45%).

Women, older Canadians (55+), those with at least a college education and those who use consumer health products more frequently all report higher levels of knowledge regarding the safety and effectiveness of consumer health products in all categories and generally feel more well informed about these products.

Canadians do not categorize consumer health products in the same way Health Canada does. For the most part, Canadians tend to categorize products based on their use rather than the particular ingredients in a product. As such, Canadians tend to categorize products like dandruff shampoo and lip balm with sunscreen into cosmetics rather than non-prescription drugs. Interestingly, perceived level of knowledge and frequency of use do not change the way in which Canadians categorize products. They continue to categorize them based on use rather than ingredients like Health Canada currently classifies and regulates these products.

Awareness and knowledge of homeopathic medicine, Ayurveda and SPF varies substantially. Unprompted, most Canadians (95%) are unable to correctly or even partially define homeopathic medicine. When prompted with a variety of responses, less than half of Canadians (42%) were able to correctly define Ayurveda. Canadians were unable to provide a consistent unprompted definition for SPF 15 however, most (75%) could associate it with “sun protection factor 15”.

Awareness of product identifiers also varies with more than half of Canadians being aware of DINs but much fewer aware of NPNs (15%) or DIN-HMs (10%).

Canadians have a general understanding of Health Canada’s responsibilities but a large portion do not understand the details of exactly what these responsibilities entail. More specifically, around two thirds of Canadians understand Health Canada is responsible for many tasks when it comes to product safety of consumer health products such as making sure products are safe before they hit the shelf, setting safety standards for companies to follow, making sure products contain the ingredients they claim to, etc. There is however, some confusion on what this specifically means. For example, half or more of Canadians believe Health Canada reviews and approves all types of product labels before they hit the shelves and/or test products in the laboratory for all consumer health products. Generally speaking Canadians that perceive themselves to be better informed and have higher perceptions of safety and trust are more likely to believe that Health Canada is responsible for most/all of the tasks presented related to non-prescription drugs and cosmetics. This is not the case for natural health products where only increased trust (not safety) is associated with increased perceptions of Health Canada’s responsibilities.


Attitudes and Perceptions towards Consumer Health Products

Canadians’ attitudes and perceptions about consumer health products are in line with their perceived knowledge and understanding. For the most part, Canadians believe non-prescription drugs are safe (70%), but as seen throughout the research, they are less confident in the safety of cosmetics (60%) and even less so with natural health products (51%). This reflects the finding that Canadians believe more strongly that Health Canada is responsible for ensuring the safety of non-prescription drugs(74%) and less so for cosmetics (65%) and natural health products (67%). More Canadians believe that the government (Health Canada) is primarily responsible for ensuring safety rather than the manufacturers of consumer health products (78% vs 61%).

Attitudes toward claims on labels are another point of interest. Canadians do not trust the claims made on the labels of consumer health products (only 18-36% trusts them). However, even though Canadians claim to be wary of these claims, they also believe these claims are supported by science (66%) and proof from manufacturers (66%). Clearly there is a disconnect with these findings and it is unclear why Canadians lack trust in claims when they also feel they are supported by science and proof from manufacturers.

Perceptions about product identification numbers (DIN, DIN-HM and NPN) tend to be in line with Canadians’ attitudes towards the product categories. These numbers are most associated with product safety and to a lesser extent, being without contamination (there is little association with effectiveness of a product).

Again we see that women, older Canadians (55+), those who use consumer health products and those who feel they are more informed display similar attitudes towards consumer health products. For instance, they are all more likely to believe all consumer health products are safe, more likely to trust the claims on all consumer health product labels and more likely to believe it is Health Canada’s responsibility to ensure a product is safe and claims are supported by science.

Selection and Use of Consumer Health Products

Consumer health product usage varies greatly by category and type of product. Cosmetics are the most frequently used consumer health products, particularly products for hair (79% uses at least once per week) and skin (70% use at least once per week). Natural health products such as vitamins and minerals are also frequently used by a majority (56% uses at least once a week) of Canadians. Seasonal products and specific types of medicines are used by the majority of Canadians (88-92%), however on a less frequent basis. The same is true for sunscreen, antacids and allergy relievers – all used by most Canadians (58-89%), but infrequently. The majority of Canadians never use traditional natural health products (70%) (such as traditional Chinese medicines, or Ayurveda) or homeopathic products (66%).

Incidence and frequency of reading product labels is fairly consistent between the three categories of products. Consistently for each category, dosage and directions are two of the most frequently read portions of the label, while the least commonly read elements are where the product was made and endorsements. The most noticeable difference between categories is that frequency of reading labels is universally higher for non-prescription drugs (23-67%) – all elements are more likely to be viewed at every purchase or at every use, compared to natural health products (23-58%) and particularly cosmetics (20-49%). Brand name is the only product element viewed more frequently on cosmetics than the other two categories.

With regard to information desired to make a purchase decision, directions, ingredients and product warnings are the most important to Canadians. For all three product categories, a strong majority of Canadians want to


have directions on how to use the product (70-77%), ingredients (66-72%), warnings (66-75%) and dosage (71-78%) (with the exception of cosmetics) directly on the product to help them to decide what to buy. Brand name is more important to have on non-prescription drugs and cosmetics than it is on natural health products, while the origin of the product is of higher importance on natural health products. Package inserts and endorsements are the least important package features in the product purchase decision, regardless of category.

Product use plays a role in how much information Canadians’ want for purchase decisions. Frequent users of natural health products such as homeopathic products want more information than infrequent or non-users while frequent users of traditional natural health products want less information than infrequent or non-users. With regard to non-prescription drugs, generally speaking frequent users tend to require less information than infrequent or non-users. Cosmetics users such as hair and skincare products tend to want more information to support their purchase decisions. Furthermore, Canadians who consider themselves informed about non-prescription drugs and Cosmetics also require more information to make purchase decisions.

When it comes to determining the safety and effectiveness of consumer health products, Canadians look to several sources. For natural health products, there are clearly three top sources of information that Canadians look to – asking a health professional or practitioner, researching the product online and reading labels or product inserts. That being said, none of these sources are used by a majority (44-48%). Non-prescription drugs have two sources of information that stand out above the rest – asking a health professional or practitioner and reading labels or product inserts, though only a very slight majority(53-57%) use these sources. For cosmetics, relying on brand name (44-45%) and reading labels or product inserts (43%) are the main sources of information. It is also worth noting that a sizeable portion of the population simply doesn’t think about safety or effectiveness (10-20% and 10-9% respectively); however more think about it for non-prescription drugs (89-90%) than natural health products (86-88%) and cosmetics (79-80%).

Canadians also use a variety of sources to look for product-specific information in each category. While there are no information sources that are used by a strong majority of Canadians, search engines (41-43%) and product labels (43-51%) are two of the most commonly used sources for all three categories. Health care professionals (such as a doctor or a nurse) (53%) are an important source for looking up information on non-prescription drugs. While general internet searches using a search engine are common, specific health-related websites (such as manufacturers’ website, Health Canada’s website, consumer group websites, etc.) are not commonly used by Canadians to look up product information.

As seen with knowledge and attitudes towards consumer health products, selection and usage of these products is predominantly affected by gender and age. Again, women and older Canadians (55+) both display similar tendencies: they are more likely to frequently use most types of products, search for product information about both safety and effectiveness and read several different parts of the labels on product packaging.

1.3. Methodology

An online panel survey was conducted among 2,502 Canadians age 18 years and older. A pre-test consisting of 10 completed English interviews and 10 completed French interviews, was completed before fielding the survey on April 15th, 2016. The survey was in field from April 18th to April 26th, 2016. Respondents for this survey were selected from among those who have registered to participate in the TNS online surveys. The results of such surveys cannot be described as statistically projectable to the target population. The data have


been weighted to reflect the demographic composition of the Canadian population 18 years and older. As this was a panel survey, margin of error does not apply. Surveying was conducted in the respondent’s official language of choice and took an average of 21 minutes to complete. A detailed methodology can be found in Chapter 4.

1.4. Contract Value

The total contract value for this project was $44,547.82 including HST.

1.5. Statement of Political Neutrality

I hereby certify as Vice President, Ottawa Regional Office & Public Sector Practice Lead of TNS Canada Ltd. that the deliverables fully comply with the Government of Canada political neutrality requirements outlined in the Communications Policy of the Government of Canada and Procedures for Planning and Contracting Public Opinion Research. Specifically, the deliverables do not include information on electoral voting intentions, political party preferences and standings with the electorate or ratings of the performance of a political party or its leaders.

David Ang TNS Canada Ltd. Vice President, Ottawa Regional Office & Public Sector Practice Lead


2. Foreword

2.1. Background

Canadians play an active role in managing their own health and using consumer health products responsibly. It is relatively easy for Canadians to do so since they have access to an unlimited amount of health resources and products, many without a prescription or involvement of a health care practitioner. Self-care plays a key role in disease prevention and maintaining public health, as it helps to make the Canadian health care system more sustainable.

Consumer health products can be categorized into three main groups – non-prescription drugs, natural health products and cosmetics. They can range from sunscreens to pain medications, vitamins to homeopathic remedies and toothpastes to skin moisturizing cosmetics. Canadians can easily access these health products in places such as grocery, convenience and department stores, pharmacies, natural health food stores and online.

It is important that Health Canada understand Canadians’ views on consumer health products since it is the federal department responsible for helping Canadians maintain and improve their health. Additionally, it is not always obvious to consumers which category the consumer health product belongs to which can cause consumers to think products are in one category but in fact are in another.

2.2. Research Objectives

The overall objective of this research is to better understand Canadian consumers’ knowledge, awareness, attitudes and behaviours as they relate to consumer health products. This information will be used to support the development of policies relating to these products.

More specifically, this research seeks:

• To determine attitudes of Canadians with regard to consumer health products;

• To understand how Canadians select and use consumer health products;

• To understand what information Canadians want to see on consumer health products to assist them in their decision making;

• To assess how and from where Canadians seek information about consumer health products; and,

• To gauge the public’s knowledge and understanding of the various categories of consumer health products and how they are regulated.


The findings will be used by Health Canada:

• To gain more insight into the Canadian public’s views on consumer health products;

• To help ensure that the approach to consumer health products reflects the consumer’s needs.

2.3. Methodological Overview

An online panel survey was conducted among 2,502 Canadians age 18 years and older. A pre-test consisting of 10 completed English interviews and 10 completed French interviews, was completed before fielding the survey on April 15th, 2016. The survey was in field from April 18th to April 26th, 2016. Respondents for this survey were selected from the TNS online panel. The results of panel surveys cannot be described as statistically projectable to the Canadian population. The data have been weighted to reflect the demographic composition of the Canadian population 18 years and older using age, gender and region. As this was a panel survey, margin of error does not apply. Surveying was conducted in the respondent’s official language of choice and took an average of 21 minutes to complete. A detailed methodology can be found in Chapter 4.

Please note: Analysis was undertaken to establish the extent of the relationship among variables such as age, region, level of education attained, income, differences among caregivers of children and seniors, pregnant and breastfeeding women and those with severe allergies or chronic conditions. Only differences significant at the 95% confidence level are presented in this report. Any differences that are statistically significant between subgroups are highlighted in green in tables throughout the report. As this was a non-probability sample, conclusions from these tests cannot be generalized to any population.

The numbers presented throughout this report are rounded to the closest full number. Due to this rounding, in some cases it may appear that ratings collapsed together are different by a percentage point from when they are presented individually and totals may not add up to 100%. As well, respondents were required to respond to all questions in the survey. Many of the charts in this report present only the top three and bottom three responses on a scale of 7. In instances where the charts do not add to 100% the remaining responses belong to the neutral category or don’t know.


3. Detailed Findings

3.1. Canadians’ Knowledge and Understanding of Consumer Health Products

3.1.1. Perceived Knowledge of Safety of Consumer Health Products

Canadians have low perceived knowledge of the safety of consumer health products.

Before being given any additional information, respondents from across Canada who were recruited from TNS’s online panel (hereinafter referred to as “Canadians”) were asked to rate themselves on their knowledge of consumer health products. Only one third of Canadians (or less) rated themselves as ‘knowledgeable’ (score of 5, 6, or 7 on a 7-point scale) about the safety of the three categories of consumer health products. Canadians are slightly more confident in their knowledge of non-prescription drugs safety (33%), compared to the safety of cosmetics (25%) and natural health products (19%). In fact, at least half of Canadians consider themselves to have poor knowledge (a score of 1, 2, or 3 on a 7-point scale) about the safety of cosmetics (50%) and natural health products (56%).


Frequency of product use plays a role in Canadians’ self-rated knowledge about the safety of consumer health products. More specifically, frequent users of natural health products such as traditional natural health products, natural health products and homeopathic products are more confident in their knowledge about the safety of natural health products than infrequent or non-users. This is also the case for frequent users of non-prescription drugs such as allergy relievers and decongestants, antacids, sunscreens and pain relievers and for cosmetics such as skincare products. Complete details can be found in the table below.

Table 3.1.1.a: Perceived knowledge of safety by frequency of product use

Knowledgeable

(score of 5, 6, or 7) Total

Frequency of use

Frequent Infrequent Never

Base=actual (2,502)

%

(n=varies)

%

(n=varies)

%

(n=varies)

%

Natural health products

Traditional natural health product

19

37 27 14

Natural health product 24 17 10

Homeopathic 39 27 14

Non-prescription drugs

Allergy

33

40 34 28

Cough and cold 41 33 28

Sunscreen 36 32 27

Antacids 41 37 26

Pain relief 42 31 23

Cosmetics

Hair care 25

26 24 22

Skin care 29 18 10

Gender, region and education also play a role in Canadians’ self-rated knowledge about the safety of consumer health products. To this point, women are more confident than men in their knowledge about safety of natural health products (22% vs. 17%), non-prescription drugs (35% vs. 30%) and cosmetics (34% vs. 16%).

Regionally speaking, those residing in British Columbia are significantly more likely than the rest of Canada to rate themselves as ‘knowledgeable’ about the safety of natural health products (24% vs. 16%-20%), while Quebecers are more likely to rate their knowledge higher for non-prescription drugs (36% vs. 29%-34%) and cosmetics (28% vs. 23%-25%).

With regard to education, Canadians with at least a university degree are significantly more likely than those with a high school or less to consider themselves ‘knowledgeable’ about the safety of natural health products (20% vs. 15%), non-prescription drugs (34% vs. 29%) and cosmetics (27% vs. 21%).


Table 3.1.1.b: Perceived knowledge of safety by gender, region and education

Knowledgeable (score of 5, 6, or

7) Total

Gender Region Education

Male Female Atlantic Quebec Ontario Prairies B.C.

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(251)

%

(600)

%

(900)

%

(351)

%

(400)

% (496)

%

(894)

%

(1,062)

%

Natural health products 19 17 22 16 17 20 17 24 15 20 20


33 30 35 29 36 34 29 32 29 34 34

Cosmetics 25 16 34 24 28 25 23 24 21 27 27


3.1.2. Perceived Knowledge of Effectiveness of Consumer Health Products

Canadians have low perceived knowledge of consumer health product effectiveness.

While slightly higher than perceived knowledge of safety, Canadians perceived knowledge of effectiveness is also low. Less than two in five Canadians consider themselves ‘knowledgeable’ (a score of 5, 6, or 7 on a 7-point scale) about the effectiveness of consumer health products. Again, Canadians are slightly more confident about their knowledge of the effectiveness of non-prescription drugs (39%), compared to cosmetics (27%) and natural health products (21%). Around half of Canadians rated themselves as having ‘poor knowledge’ (a score of 1, 2, or 3 on a 7-point scale) about the effectiveness of cosmetics (46%) and natural health products (54%).


Similar to perceived knowledge, frequency of product use plays a role in Canadians’ self-rated knowledge about the effectiveness of consumer health products. More specifically, frequent users of natural health products such as traditional natural health products, natural health products and homeopathic products report higher levels of knowledge about the effectiveness of natural health products than infrequent or non-users. This is also the case for frequent users of non-prescription drugs such as allergy relievers and decongestants, antacids, sunscreen and pain relievers and for cosmetics such as skin and hair care products. Complete details can be found in the table below.

Table 3.1.2.a: Perceived knowledge of effectiveness by frequency of product use

Knowledgeable


Frequency of Use


Base=actual (2,502)

% (n=varies)

%

(n=varies)

%

(n=varies)

%

Natural Health Products


21

40 29 16



Non-Prescription Drugs

Allergy

39

46 40 34


Sunscreen 43 38 34

Antacids 47 43 32


Cosmetics

Hair care 27 29 23 20

Skin care 32 20 10


Similar to perceived knowledge about safety, women are significantly more likely than men to consider themselves ‘knowledgeable’ about the effectiveness of natural health products (23% vs. 19%), non-prescription drugs (41% vs. 37%) and especially cosmetics (36% vs. 18%).

Table 3.1.2.b: Perceived knowledge of effectiveness by gender

Knowledgeable


Gender

Male Female

Base=actual (2,502)

% (1,164)

%

(1,337)

%

Natural health products 21 19 23

Non-prescription drugs 39 37 41

Cosmetics 27 18 36


3.1.3. Categorizing Consumer Health Products

Canadians do not categorize consumer health products in the same way Health Canada does.

Participants were shown images of ten products chosen based on availability in French and English that represent a range of product types and categories of natural health products, non-prescription drugs and cosmetics.

These included:

• Black Radish Ayurvedic product indicated to promote digestion (NPN 80037361) • Centrum Select® 50+ Multivitamin/Mineral supplement (NPN 80005153) • Sedatil Homeopathic medicine indicated for Nervousness hypersensitivity- irritability due to stress

(DIN-HM 80017593) • Extra Strength Non-Drowsy Reactine Allergy 24-hour relief (DIN 02223554) • Nivea Sun SPF 30 lip balm (DIN 02416972) • Neutrogena Ultra Sheer Dry-touch sunscreen SPF 30 (DIN 02377403) • Pepto Bismol cherry flavour (DIN 02097079) • Tylenol Extra Strength (DIN 00559407) • Head & Shoulders dandruff shampoo for Men Old Spice (DIN 02387476) • Pantene PRO-V Clean Rinse Shampoo

Nearly all Canadians (94%-98%) were able to identify that Tylenol, Reactine and Pepto-Bismol are non-prescription drugs. A strong majority were also able to identify Pantene Pro-V Shampoo as a cosmetic (91%) and Black Radish as a natural health product (85%). These are the products that fit most with Canadians’ definitions of these categories.

That being said, Canadians did not categorize several other products presented in the same fashion as Health Canada. The products that Canadians categorized differently tend to be products that are used in a particular way but based on particular ingredients, do not actually belong to the category as defined by Health Canada. For example, dandruff shampoo is used for cleaning one’s hair and is identified as a cosmetic by most Canadians however due to particular ingredients; Health Canada defines it as a non-prescription drug.

Nivea Lip Balm and Neutrogena Sun Screen were also identified as cosmetics by nearly all Canadians (87%-88%). Only a very small proportion correctly categorized them in the same fashion as Health Canada - as a non-prescription drug (6% each), while a similar proportion were equally likely to think they were natural health product (6%-7%).

Natural health products such as Centrum Select and Sedatil were only categorized as an natural health product by one third of Canadians (30%-39%), while the majority (61-68%) identified them as non-prescription drugs. These findings suggest that Canadians do not always categorize products in the same way that Health Canada does.


Interestingly, Canadians’ perceived level of knowledge (how informed they consider themselves to be) and frequency of product use generally do not improve their ability to correctly categorize consumer health products. The exception being Centrum Select, those who considered themselves more informed and those who use traditional natural health products, natural health products and homeopathic products were more likely to identify Centrum Select as a natural health product.

Table 3.1.3.a: Categorizing natural health products by frequency of use


Total

Frequency of Use

Traditional NHP NHP Homeopathic

Knowledgeable (score of 5, 6, or 7) Freq-uent

Infre-quent Never Freq-

uent Infre-quent Never Freq-

uent Infre-quent Never

Base=actual (2,502)

%

(202)

%

(584)

%

(1,767)

%

(1,428)

%

(635)

%

(534)

%

(210)

%

(679)

%

(1,668)

%

Black Radish 85 81 80 86 85 84 83 80 85 85

Centrum Select 39 55 43 35 42 38 31 56 39 37

Sedatil 30 26 29 31 30 30 30 30 31 30


Table 3.1.3.b: Categorizing non-prescription drugs by frequency of use


Total

Frequency of Use

Allergy Cough and Cold Sunscreen





Base=actual (2,502)

%

(362)

%

(1,376)

%

(839)

% (81)

% (2,132)

% (323)

% (812)

% (1,528)

% (281)

%

Reactine 97 94 97 98 81 98 96 96 98 95

Nivea 6 7 6 7 10 6 8 7 6 7

Neutrogena - Ultrasheer 6 6 6 5 12 6 7 6 6 7

Pepto-Bismal 94 91 94 94 76 94 93 94 94 91

Tylenol – Extra Strength 98 96 98 99 85 99 97 99 98 95

Head and Shoulders 6 6 6 6 13 5 8 6 6 6


Total

Frequency of Use

Antacids Pain Relief




Base=actual (2,502)

%

(347)

%

(1,224)

%

(1,022)

% (667)

% (1,823)

% (194)

%

Reactine 97 95 98 98 97 97 95

Nivea 6 6 6 6 7 6 7

Neutrogena - Ultrasheer 6 9 6 5 7 6 6

Pepto-Bismal 94 92 94 94 92 94 91

Tylenol – Extra Strength 98 97 98 99 98 98 97

Head and Shoulders 6 6 6 5 7 5 10


Table 3.1.3.c: Categorizing cosmetics by frequency of use

Cosmetics

Total

Frequency of Use

Skin care Hair care

Knowledgeable (score of 5, 6, or 7) Frequ-ent

Infreq-uent Never Frequ-

ent Infreq-uent Never

Base=actual (2,502)

%

(1,780)

%

(585)

%

(262)

% (1,969)

%

(508)

%

(266)

%

Pantene 91 92 87 84 91 85 87

Table 3.1.3.d: Categorizing Consumer Health Products by perceived level of knowledge

Knowledgeable (score of 5, 6, or 7)

Total

Perceived Level of Knowledge

NHP NPD Cosmetics

Well

In-formed

Not well

In-formed

Well

In-formed

Not well

In-formed

Well

In-formed

Not well

In-formed

Base=actual (2,502)

% (465)

% (1,483)

% (937)

% (808)

% (701)

% (1,155)

%


Black Radish 85 82 84 - - - -

Centrum Select 39 44 35 - - - -

Sedatil 30 31 29 - - - -


Reactine 97 - - 98 96 - -

Nivea 6 - - 6 8 - -

Neutrogena - Ultrasheer 6 - - 6 7 - -

Pepto-Bismal 94 - - 94 92 - -

Tylenol – Extra Strength 98 - - 98 97 - -

Head and Shoulders 6 - - 7 7 - -

Cosmetics

Pantene 91 - - - - 93 89


3.1.4. How Informed are Canadians when Purchasing Consumer Health Products?

Canadians do not feel well informed when purchasing consumer health products.

Canadians do not consider themselves ‘well informed’ when purchasing consumer health products. This is not surprising given how poorly Canadians rated their knowledge of consumer health product safety and effectiveness of these same products. To this point, Canadians rated themselves very poorly in terms of how ‘well informed’ (a score of 5, 6, or 7 on a 7-point scale) they feel when purchasing non-prescription drugs (37% consider themselves ‘informed’), cosmetics (29%) and even less so when purchasing natural health products (19%).

These results, coupled with the low levels of perceived knowledge on safety and effectiveness suggest that Canadians are not well informed consumers.

Frequency of product use plays a role in Canadians’ perceived level of knowledge about consumer health products. Specifically, frequent users of natural health products such as traditional natural health products, natural health products and homeopathic products report feeling more well informed than infrequent or non-users. This is also the case for frequent users of non-prescription drug such as allergy relievers and decongestants, cough cold and flu, antacids, sunscreen and pain relievers and for cosmetics such as skin and hair care products and sunscreen. Complete details can be found in the table below.


Table 3.1.4.a: Perceived level of knowledge by frequency of product use

Perceived level of knowledge (score of 5, 6, or 7) Total

Frequency of Use


Base=actual (2,502)

%

(n=varies)

%

(n=varies)

%

(n=varies)

%



19

37 25 14




Allergy

37

48 38 31


Sunscreen 42 36 31

Antacids 46 41 31


Cosmetics

Skin care 29 33 19 15

Hair care 30 23 24

Gender and education play the biggest role in whether Canadians feel informed when purchasing consumer health products. A consistent theme throughout this research is that women are significantly more likely than men to consider themselves ‘well informed’ when purchasing natural health products (21% vs. 17%), non-prescription drugs (40% vs. 35%) and particularly cosmetics (37% vs. 20%).

With regard to education, Canadians with at least a university degree are significantly more likely than those with a high school diploma to consider themselves ‘well informed’ when purchasing natural health products (20% vs. 15%), non-prescription drugs (39% vs. 34%) and cosmetics (30% vs. 24%).


Table 3.1.4.b: Perceived level of knowledge Canadians perceive themselves to be when purchasing consumer health products by gender and education

Perceived level of knowledge


Gender Education

Male Female High school or less

College/

CGEP University Degree

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(496)

%

(894)

%

(1,062)

%

Natural health products 19 17 21 15 20 19

Non-prescription drugs 37 35 40 34 39 38

Cosmetics 29 20 37 24 30 30


3.1.5. Perceived Meaning of Homeopathic Medicine

Few Canadians understand what homeopathic medicine is.

A mere five per cent of Canadians have even a partial understanding of what homeopathic medicine is and/or the tenants (or origin) behind it. Specifically, the concept of enabling the body to heal itself (1%), like curing (1%), diluted solutions (1%) or low doses(1%) were identified by a very small proportion of Canadians.

Many Canadians (46%) confuse homeopathic medicine for herbal products indicating that it was a natural, plant based or herbal medicine. While others (10%) simply consider it an alternative to traditional medicine such as non-traditional treatment, unconventional medicine or home remedies.

Some Canadians (14%) define it as a medicine that is unproven or does not work while others (12%) consider it unregulated medicine (10%).


Some groups are more likely to have at least a partial understanding of what homeopathic medicine is. In particular:

• Those with more than a high school education are more likely to have at least a partial understanding of homeopathic medicine (5-7% vs 1%).

• Users of natural health products such as traditional natural health products (8-9% vs 4%) or frequent users of natural health products (6% vs 3-4%) are more likely to have at least a partial understanding of homeopathic medicine than non-users of traditional natural health products and infrequent or non-users of natural health products. Interestingly, results were similar among users and non-users of homeopathic products.

Table 3.1.5.a: Perceived Meaning of Homeopathic Medicine by frequency of use

Understanding of Homeopathic Medicine Total

Frequency of Use


Freq-uent




Base=actual (2,502)

%

(202)

%

(584)

%

(1,767)

%

(1,428)

%

(635)

%

(534)

%

(210)

%

(679)

%

(1,668)

%

Natural, plant based or herbal 46 39 48 45 49 47 36 54 58 39

Unproven efficacy, does not work 14 8 8 16 13 12 17 3 7 17

Alternative to traditional medicine 12 11 11 12 13 9 10 11 13 11

Unregulated 10 9 10 10 10 9 7 10 10 9

Partial understanding of homeopathy 5 9 8 4 6 4 3 5 6 5

No side effects/safer than pharmaceuticals 2 5 4 1 2 1 1 5 2 1

Nothing/Don’t know/Refused 21 25 20 20 16 21 28 20 10 25


Table 3.1.5.b: Perceived Meaning of Homeopathic Medicine by education

Understanding of Homeopathic

Medicine Total

Education

High school or less

College/

CGEP University Degree

Base=actual (2,502)

% (496)

%

(894)

%

(1,062)

%

Natural, plant based or herbal 46 49 51 41

Unproven efficacy, does not work 14 9 10 19

Alternative to traditional medicine 12 11 11 13

Unregulated 10 7 10 10

Partial understanding of homeopathy 5 1 5 7

No side effects/safer than pharmaceuticals 2 1 2 2

Nothing/Don’t know/Refused 21 25 19 18


3.1.6. Understanding of Ayurveda

Most Canadians don't understand what Ayurveda is.

When asked which description(s) Canadians would associate with a “product traditionally used in Ayurveda to aid digestion” the majority (58%) answered incorrectly (a drug that aids digestion or a digestive aid made in a place called Ayurveda) or don’t know. Nearly four in ten Canadians were able to correctly associate it with either an herbal digestive aid (31%) and/or with a folk medicine from South Asia to aid digestion (17%)1.

It would appear that Canadians do not have a full understanding of Ayurveda.

1 Note: multiple response so numbers will not add to 100%.


Frequent users of traditional natural health products were more likely to choose an incorrect answer compared to infrequent or non-users (drug: 26% vs 10-15%; place: 18% vs 10-13%).

However, frequent users of natural health products are more likely to understand what Ayurveda is compared to infrequent or non-users (digestive aid: 36% vs 30-19%; folk medicine: 19% vs 10-13%) as are those who consider themselves to be more well-informed about natural health products (digestive aid: 24% vs 14%; folk medicine: 41% vs 26%).

Demographically speaking, women, Canadians under the age of 55 and those with at least a college education are all more likely to understand what Ayurveda is – though still at relatively low levels.

Table 3.1.6.a: Ayurveda associations by gender, age and education

Total

Gender Age Education

Male Female 18-34 35-54 55+

High school or less

College/

CGEP

University Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%

A folk medicine from South Asia to aid digestion

17 15 19 21 17 14 10 14 22

An herbal digestive aid 31 26 36 34 33 27 21 31 36

A medicine (drug) that aids digestion

12 14 10 19 9 9 11 11 13

A digestive aid made in a place called Ayurveda

11 12 11 18 11 6 10 10 13

Don’t know 43 47 40 33 42 53 56 46 35


3.1.7. Understanding of SPF

Canadians associate the term “SPF 15” with sunscreen or protection from the sun.

While Canadian consumers did not come up with a consistent definition to the term “SPF 15”, a large majority (75%) correctly associate it with sunscreen or protection from the sun. The terms “sun protection at lower dosage”, “sun protection factor 15” and “protects from the sun/UV rays” were the most common definitions.


3.1.8. Awareness of Product Identifiers

A small majority of Canadians have heard of a Drug Identification Number.

Just over half (57%) of Canadians have heard of a Drug Identification Number (DIN). However, very few Canadians are aware of Natural Product Number (NPN) (15%) or Homeopathic Medicine Number (DIN-HM).

Not unexpectedly, those who use these types of consumer health products are more likely to be aware of the identification numbers. Users of natural health products such as traditional natural health products and natural health products are more likely to be aware of NPNs (17-20% vs. 6% and 11-12% vs 4% respectively) while users of homeopathic products are more likely to be aware of DIN-HMs (16-24% vs 6%). Users of non-prescription drug such as allergy relievers and decongestants (59-61% vs. 52%), antacids (56-60% vs 52%), sunscreen (60-61% vs 51%) and pain relievers (57-62% vs 42%) are also more likely to be aware of DINs.

Furthermore, Canadians who consider themselves more well informed about natural health products have increased awareness of NPNs (28% vs 11%) and DIN-HMs(22% vs 5%) and those who consider themselves more well informed about non-prescription drugs have increased awareness about DINs(66% vs 47%).


Some demographic groups are more likely than others to have heard about DIN. In particular:

• Women are significantly more likely than men to have heard of a DIN (61% vs. 53%). • Older Canadians (35 and older) are significantly more likely than those under 35 years old to have

heard of a DIN (58%-68% vs. 42%). • Canadians residing in Ontario and the Prairies are significantly more likely than the rest of Canada to

have heard of a DIN (60% and 64%, respectively vs. 47%-55%). • Those with at least a university education are significantly more likely than those with only a high

school education to have heard of a DIN (58%-59% vs. 52%).

Awareness of NPN and DIN-HM are not significantly affected by demographic differences.

Table 3.1.8.a: Awareness of DIN by gender, age and education

Total


Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

% (496)

%

(894)

%

(1,062)

%

Awareness of DIN

57 53 61 42 58 68 52 58 59

Table 3.1.8.b: Awareness of DIN by region

Total

Region

Atlantic Quebec Ontario Prairies B.C.

Base=actual (2,502)

%

(251)

%

(600)

%

(900)

%

(351)

%

(400)

%

Awareness of DIN 57 47 52 60 64 55


3.1.9. Perceived Health Canada Responsibilities

Canadians have a general understanding of Health Canada’s responsibilities but a large portion does not understand the details of exactly what these responsibilities entail.

Regardless of category, Canadians understand Health Canada is responsible for many tasks when it comes to product safety. In particular, at least two thirds of Canadians feel Health Canada is responsible for making sure products are safe before they hit the shelf and setting safety standards for companies to follow.

Even more so than with natural health products and cosmetics, Canadians feel Health Canada is responsible to ensure the safety of non-prescription drug products. This category consistently rates higher on all tasks than the other two, suggesting that Canadians believe Health Canada is more involved with products in the non-prescription drug category as a whole.

While most Canadians believe Health Canada is responsible for a variety of tasks related to safety of consumer health products, more than half do not understand the exact nature of this responsibility. For example, half or more believe Health Canada reviews and approves all types of product labels and/or tests products in laboratories for each category of consumer health product.


Generally speaking Canadians that perceive themselves as better informed and have higher perceptions of safety and higher trust in claims are more likely to believe that Health Canada is responsible for most/all of the tasks presented related to non-prescription drugs and cosmetics. This is not the case for natural health products where only increased trust is associated with increased perceptions of Health Canada’s responsibilities.

Table 3.1.9.a: Perceived Health Canada responsibilities for natural health products by perceived level of knowledge and perceptions of safety and trust in claims.

Natural Health Products Total

Perceived level of knowledge Perceived safety Trust in claims

Well

in-

formed

Not well

in-formed Safe Not safe Trust

Don’t trust

Base=actual (2,502)

%

(465)

%

(1,483)

%

(1,243)

%

(511)

%

(444)

%

(1,321)

%

Making sure a product is safe 67 62 68 69 60 68 67

Setting safety standards for companies to follow 67 65 66 70 61 68 65

Making sure products contain the ingredients they say they do 64 63 62 66 59 67 62

Pulling products that are not safe from the shelves 64 61 65 67 59 63 65

Ensuring products are not contaminated 60 58 60 62 56 60 58

Reviewing the product 58 56 58 61 53 57 57

Making sure a product does what it says it will 55 55 54 56 53 57 55

Approving labels before they hit the shelves 54 53 54 55 52 58 54

Testing products in a laboratory 53 50 53 54 53 52 53

None of these 9 7 10 6 15 5 10


Table 3.1.9.b: Perceived Health Canada responsibilities for non-prescription drugs by perceived level of knowledge and perceptions of safety and trust in claims.

Non-Prescription Drugs Total

Perceived level of knowledge Perceived Safety Trust in Claims

Well

in-

formed

Not well


Don’t trust

Base=actual (2,502)

% (937)

% (808)

% (1,752)

% (241)

% (893)

% (801)

%










None of these 6 4 10 4 16 3 8


Table 3.1.9.c: Perceived Health Canada responsibilities for cosmetics by perceived level of knowledge and perceptions of safety and trust in claims.

Cosmetics Total

Perceived Level of Knowledge Perceived Safety Trust in Claims

Well

in-

formed

Not well


Don’t trust

Base=actual (2,502)

% (701)

% (1,155)

% (1,489)

% (365)

% (523)

% (1,250)

%










None of these 9 8 12 7 14 7 10

Gender and age also play a role with regard to perceived Health Canada responsibilities. Women are more likely to believe Health Canada is responsible for all of the tasks related to natural health products, non-prescription drugs and cosmetics identified in the tables below. The same is true of Canadians who are 55 year or older compared to their younger counterparts where they believe Health Canada is responsible for most tasks.


Table 3.1.9.d: Perceived Health Canada responsibilities for natural health products by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Making sure a product is safe 67 63 71 61 67 72

Setting safety standards for companies to follow 67 61 73 62 64 74

Making sure products contain the ingredients they say they do 64 57 69 60 61 69

Pulling products that are not safe from the shelves 64 60 69 61 63 69

Ensuring products are not contaminated 60 54 65 55 58 64

Reviewing the product 58 55 61 59 55 60

Making sure a product does what it says it will 55 52 58 52 53 59

Approving labels before they hit the shelves 54 50 58 52 54 56

Testing products in a laboratory 53 50 56 47 52 59

None of these 9 11 7 10 10 8


Table 3.1.9.e: Perceived Health Canada responsibilities for non-prescription drugs by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%










None of these 6 7 4 8 6 4


Table 3.1.9.f: Perceived Health Canada responsibilities for cosmetics by gender and age

Cosmetics Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%










None of these 9 11 8 10 9 9


3.2. Canadians’ Attitudes towards Consumer Health Products

3.2.1. Perceptions of Product Safety

For the most part Canadians believe non-prescription drugs are safe, but are not as confident in the safety of cosmetics and natural health products.

The majority of Canadians (70%) feel non-prescription drugs are ‘safe’ (a score of 5, 6, or 7 on a 7-point scale), however, there is less confidence in the safety of cosmetics (60%) and even less with natural health products (51%). These scores reflect Canadians’ perceptions that Health Canada is responsible for ensuring the safety of non-prescription drugs and less so for cosmetics and natural health products.

Product use plays a role in Canadians’ perceptions of safety. Users of natural health products such as traditional natural health products, natural health products and homeopathic products are more likely to think natural health products are safer. Users of non-prescription drugs such as cough and cold, antacids, sunscreen and pain relievers are more likely to consider non-prescription drugs safer and users of cosmetics such as hair and skincare products are more likely to consider cosmetics safer. Furthermore, Canadians who consider themselves informed are also more likely to consider consumer health products safe. Complete details can be found in the table below.


Table 3.2.1.a: Perceived level of safety of consumer health products by product use and perceived level of knowledge

Perceived Level of Safety (score of 5, 6, or 7)

Total

Frequency of Use

Perceived Level of

Knowledge

Frequent Infrequ-ent Never

Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(n=varies)

%

(n=varies)

%



51

63 62 45

77 36 Natural health product 56 52 36



Allergy

70

71 71 68

87 47


Sunscreen 72 72 53

Antacids 74 72 67


Cosmetics

Hair care 60

62 54 50 84 40

Skin care 64 54 47


A couple of demographic differences exist in relation to perceived levels of safety for natural health products and cosmetics. Canadians under 55 years old are significantly more likely to feel natural health products are ‘safe’ compared to older Canadians (55+). With regard to cosmetics, women are significantly more likely than men to feel they are ‘safe’ (64% vs. 56%).

Table 3.2.1.b: Perceived level of safety of consumer health products by gender and age

Safe


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%



Cosmetics 60 56 64 63 59 58


3.2.2. Attitudes towards Safety

Canadians are more likely to believe that responsibility for consumer health product safety lies with government than the manufacturer.

Consistent with findings throughout this report, a solid majority of Canadians (78%) believe (a score of 5, 6, or 7 on a 7-point scale) that Health Canada is responsible for ensuring safety of a consumer products. While not as strongly, most Canadians (61%) also believe it is the responsibility of the manufacturer to ensure the safety of products.

Less than one quarter of Canadians (23%) believe that natural products are safer because they are made of natural ingredients. In fact, more than half (54%) ‘do not believe’ (a score of 1, 2, or 3 on a 7-point scale) this notion. This is consistent with the finding that Canadians have the least amount of trust in natural health products and are least likely to feel Health Canada is responsible for ensuring safety of natural health products.


Gender and age play a role in Canadians’ attitudes towards the perception of safety of consumer health products:

• Women are more likely than men to think that it is Health Canada’s responsibility to ensure product safety (81% vs. 75%).

• Canadians over 55 years old are significantly more likely to believe it is Health Canada’s responsibility to ensure product safety (85% vs. 74%-76%).

• Canadians over 55 years old are also more likely to not believe that natural products are safer because they’re made of natural ingredients (60% vs. 49%-51%).

Table 3.2.2.a: Belief of safety statements towards consumer health products by gender and age

Believe


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

It is Health Canada’s responsibility to ensure a product is safe

78 75 81 74 76 85

Table 3.2.2.b: Disbelief of safety statements towards consumer health products by age

Do not believe


Age

18-34 35-54 55+

Base=actual (2,502)

%

(457)

%

(981)

%

(1,064)

%

A natural product is safer because it is made of natural ingredients

54 49 51 60


3.2.3. Trust in Claims

Canadians are generally sceptical about the claims made on the labels of consumer health products.

The claims that are made on labels of consumer health products are not considered to be trustworthy by the majority of Canadians (64-82% do not explicitly trust them). Only about one third of Canadians (36%) say they ‘trust’ (a score of 5, 6, or 7 on a 7-point scale) the claims made on the labels of non-prescription drugs, while even fewer trust the claims made on cosmetic (22%) and natural health products labels (18%).

These results are in line with the perceived levels of knowledge about effectiveness associated with the same consumer health products (see section 3.1.2).

Product use plays a role in how much Canadians’ trust claims on labels. Users of natural health products such as traditional natural health products, natural health products and homeopathic products are more likely to trust claims on labels of natural health products. Users of non-prescription drugs such as cough and cold, antacids, and pain relievers are more likely to trust the claims made on the labels of non-prescription drugs while users of cosmetics such as hair and skincare products are more likely to trust the claims made on the labels of cosmetics. Complete details can be found in the table below. Furthermore, Canadians who consider themselves informed about natural health products, non-prescription drugs and Cosmetics are also more likely to trust the claims on their respective labels (48% vs 6%, 61% vs 12%, 47% vs 6% respectively), as are


Canadians that consider consumer health products safe: natural health products and Cosmetics (32%vs 2%) and non-prescription drugs (48% vs 4%).

Gender and age affect Canadians’ level of trust in claims made on the labels of consumer health products. As such, women and younger Canadians are more trusting of label claims on natural health products and cosmetics. No demographic differences exist for non-prescription drugs.

Table 3.2.3.a: Trust in label claims by product use

Trust in Claims (score of 5, 6, or 7) Total

Frequency of Use


Base=actual (2,502)

% (n=varies)



18

34 26 14




Allergy

36

42 37 30


Sunscreen 37 37 26

Antacids 41 36 34


Cosmetics

Hair care 22

22 22 15

Skin care 24 17 14

Table 3.2.3.b: Trust in label claims by gender and age

Trust


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%



Cosmetics 22 19 23 24 23 19


3.2.4. Attitudes towards Claims

Canadians believe that scientific support and proof from manufacturers back up the claims on labels.

Two thirds (66%) of Canadians believe (a score of 5, 6, or 7 on a 7-point scale) that claims made on the labels of products must be supported by science, as well as all products claiming to do the same thing need the same level of proof from the manufacturer to support their claim. A small majority (52%) also believe that product claims must be true if they are written on the label. On the contrary, nearly half (54%) of Canadians ‘do not believe’ (a score of 1, 2, or 3 on a 7-point scale) that products with similar claims will do the same thing.


Canadians’ attitudes towards claims are influenced by their perceived level of knowledge (how informed), perceptions of safety and trust in claims. Those who consider themselves more knowledgeable, have higher perceptions of product safety and more trust in label claims are more likely to believe claims are supported by science, manufacturers require similar levels of supporting evidence, product claims must be true and that similar claims will do similar things.

Table 3.2.4.a: Attitudes toward claims for natural health products by how informed, perceptions of safety and trust in claims




Well

in-

formed

Not well


Don’t trust

Base=actual (2,502)

% (465)

% (1,483)

% (1,243)

% (511)

% (444)

% (1,321)

%

It is Health Canada’s responsibility to ensure a product is safe 78 85 77 81 76 88 76

Claims made on the labels of products must be supported by science

66 75 63 69 64 75 64

All products claiming they do the same thing must have the same level of proof provided by the manufacturer to support their claim

66 75 62 70 61 81 62

It is the product manufacturer’s responsibility to ensure a product is safe

61 73 56 67 51 79 53

Product claims must be true if they are written on the label 52 58 49 55 50 67 49

A natural product is safer because it is made of natural ingredients 23 42 14 37 6 61 9

Products with similar claims will do the same thing 20 35 14 28 12 43 14


Table 3.2.4.b: Attitudes toward claims for non-prescription drugs by perceived level of knowledge, perceptions of safety and trust in claims




Well

in-

formed

Not well


Don’t trust

Base=actual (2,502)

% (937)

% (808)

% (1,752)

% (241)

% (893)

% (801)

%



66 77 55 71 52 79 52


66 77 57 70 51 80 53


61 73 51 66 45 75 48





Table 3.2.4.c: Attitudes toward claims for cosmetics by perceived level of knowledge, perceptions of safety and trust in claims

Cosmetics



Well

in-

formed

Not well


Don’t trust

Base=actual (2,502)

% (701)

% (1,155)

% (1,489)

% (365)

% (523)

% (1,250)

%



66 77 61 71 59 78 62


66 76 61 71 58 81 61


61 73 54 67 48 79 53




Canadians’ attitudes towards claims are significantly affected by age. Canadians over 55 years old are significantly more likely than younger Canadians to believe the following:

• Claims on the labels of products must be supported by science (70% vs. 63%-65%). • All products claiming to do the same thing must have the same level of proof provided by the

manufacturer to support their claim (71% vs. 63%).

These same Canadians (55+) are significantly more likely than younger Canadians to not believe the following:

• Product claims must be true if they are written on the label (41% vs. 27%-35%). • Products with similar claims will do the same thing (59% vs. 46%-54%).


Table 3.2.4.d: Belief of claims by age

Believe


Age

18-34 35-54 55+

Base=actual (2,502)

%

(457)

%

(981)

%

(1,064)

%

Claims made on the labels of products must be supported by science 66 65 63 70


66 63 63 71

Table 3.2.4.c: Disbelief of claims by age

Do not believe


Age

18-34 35-54 55+

Base=actual (2,502)

%

(457)

%

(981)

%

(1,064)

%

Product claims must be true if they are written on the label 35 27 35 41

Products with similar claims will do the same thing 54 46 54 59


3.2.5. Product Identifier Perceptions

Product identification numbers are most associated with safety.

After being provided a description for each, the majority of Canadians (52-70%) would consider products with identification numbers to be safe and without contamination, particularly products with a DIN. A small majority of Canadians (55%) would also consider products with a DIN to be effective. That being said, less than half would consider products with a DIN-HM (42%) or NPN (39%) to be effective.

Consistent with other responses, there appears to be increased confidence in non-prescription drugs for safety and effectiveness.


Gender and age play a role in whether Canadians think products with DIN, DIN-HM or NPN are “safe”, “without contamination”, or “effective”. To this point, women and Canadians over 55 years old are significantly more likely than men and Canadians under 55, respectively, to consider products with DIN, DIN-HM and NPN as safe and without contamination.

Table 3.2.5.a: DIN perceptions by age and gender

DIN Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Safe 70 68 73 66 67 77

Without contamination 63 61 65 57 59 71

Effective 55 54 56 49 54 62

Table 3.2.5.b: DIN-HM perceptions by age and gender

DIN-HM Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Safe 60 58 62 55 61 63


Effective 42 42 42 35 42 46

Table 3.2.5.c: NPN perceptions by age and gender

NPN Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Safe 59 57 62 57 59 62


Effective 39 39 39 37 39 41


3.3. Selection and Use of Consumer Health Products

3.3.1. Frequency of Use

Cosmetics are the most frequently used consumer health products.

Most Canadians frequently (at least once per week) use cosmetic products for their hair (79%) and for their skin (70%). Natural health products such as vitamins and minerals are frequently used by over half of Canadians (56%), while about one fifth of Canadians are infrequent users (a few times per month or less) or non-users (never use them).

Seasonal products and specific types of medicines are used by majority of Canadians (68-92%), however, on a less frequent basis. Specific medicines such as cough, cold and flu medicine, as well as pain relievers are used by nearly all Canadians, although presumably on an “as needed” basis, so it is not surprising that they are used infrequently. The same is true for sunscreen, antacids and allergy relievers – all used by most Canadians, but infrequently.

Finally, the majority of Canadians do not use either traditional natural health products (70%) (such as traditional Chinese medicines, or Ayurveda) or homeopathic products (66%).


Gender, age and education all play a role in the frequency of consumer health product use:

• Women are significantly more likely than men to frequently use hair care products (83% vs. 75%), skin care products (88% vs. 53%), natural health products such as vitamins (61% vs. 50%), sunscreen (42% vs. 22%) and pain relievers (28% vs. 22%).

• Canadians 55 year or older are significantly more likely than younger Canadians to frequently use natural health products such as vitamins (64% vs. 47%-54%) and pain relievers (30% vs. 19%-26%).

• Canadians under 55 years old more likely than those 55 years or older to frequently use skin care products (72%-73% vs. 68%), traditional natural health products (9%-12% vs. 6%), homeopathic products (9%-10% vs. 7%) and cold and cough medicine (4% vs. 2%).

• Canadians with a university degree are more likely than those with a high school education to frequently use skin care products (72% vs. 66%), sunscreen (35% vs. 27%), traditional natural health products (11% vs. 7%) and homeopathic products (10% vs. 7%)

Table 3.3.1.a: Frequent users by gender, age and education

Frequent Users (at least weekly) Total


Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

% (1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

% (496)

%

(894)

%

(1,062)

%

Hair care products 79 75 83 82 77 79 77 79 81

Skin care products 71 53 88 73 72 68 66 71 72

Natural health products 56 50 61 47 54 64 54 54 58

Sunscreen products 32 22 42 32 34 30 27 32 35

Pain relievers 25 22 28 19 26 30 33 27 21

Allergy relievers and decongestants

14 14 15 14 16 13 14 14 15

Antacids and laxatives 13 14 13 10 14 15 17 12 13

Homeopathic products 9 8 9 10 9 7 7 8 10

Traditional natural health products

9 9 9 12 9 6 7 7 11

Cough, cold and flu medicines 3 4 3 4 4 2 3 2 5


3.3.2. Incidence and Frequency of Label Reading

3.3.2.1. Natural Health Products

Dosage and directions are the most frequently looked at elements of natural health product labels and packaging.

Dosage and directions on how to use the product are the packaging elements that Canadians are most likely to read every time they use or purchase a natural health product. While still read by most Canadians at some point, elements such as, warnings, brand name, ingredients and package inserts are more commonly read at point of purchase, rather than every use.

The least commonly looked at packaging elements are where the product was made and endorsements. Over one third of Canadians never or are unsure if they read these parts of the labels.


3.3.2.2. Non-Prescription Drugs

Dosage and directions are the most frequently looked at parts of non-prescription drug packaging.

Roughly two thirds of Canadians read the dosage and directions on how to use the product every time they use or purchase a non-prescription drug, highest among the three categories. Brand name is the element most commonly viewed during every purchase, with about half of Canadians doing so. Elements such as warnings about the product, ingredients and package inserts are viewed less frequently and are more commonly looked at during purchase, rather than every use.

As with natural health products and cosmetics, the least commonly looked at packaging elements are where the product was made and endorsements. Over one third of Canadians never or are unsure if they read these parts of labels.


3.3.2.3. Cosmetics

Canadians look at the brand name of cosmetics most frequently.

The brand of cosmetics is most commonly looked at every purchase occasion, however only a small majority (54%) look at this at every purchase or every time they use the product. Dosage, directions on how to use the product and product warnings are the next most frequently looked at packaging elements on cosmetics. However, only a minority of Canadians (39-49%) do so at every purchase or during every use.

Elements such as where the product was made, package inserts or leaflets, ingredients and endorsements are not frequently viewed on cosmetics packaging. Roughly one quarter or less of Canadians looks at these parts of the package at every use or every purchase.


3.3.3. Desired Product Information to Make Purchase Decision

Directions, ingredients and product warnings are the most desired product information to make a purchase decision.

For all three categories, a strong majority of Canadians(66-77%) want to have directions on how to use the product, ingredients, warnings about the product and dosage (with the exception of cosmetics) directly on the product to help them to decide what to buy. Slightly less important, six-in-ten Canadians would also like to see product features on natural health products, non-prescription drugs and cosmetics.

According to Canadians, brand name is more important to have on non-prescription drugs and cosmetics than it is on natural health products, while the origin of the product is of higher importance on natural health products. Package inserts and endorsements are the least important features in the product purchase decision: less than half of Canadians want to have package inserts or leaflets and only about one quarter wants endorsements on the product to help them make a purchase decision, regardless of category.


Product use plays a role in how much information Canadians’ need for purchase decisions of various consumer health products. Generally speaking the type and rank of information remains the same regardless of use. For example, directions and ingredients remain the top two pieces of information desired by Canadians regardless of use. However, the degree to which Canadians want such information tends to vary based on use. Frequent users of natural health products such as and homeopathic products want more information than infrequent or non-users while frequent users of traditional natural health products want less information than infrequent or non-users. With regard to non-prescription drugs, generally speaking frequent users tend to require less information than infrequent or non-users. Cosmetics users such as hair and skincare products tend to want more information to support their purchase decisions. Complete details can be found in the table below.

Furthermore, Canadians who consider themselves informed about non-prescription drugs and cosmetics also require more information to make purchase decisions however the type and rank remain the same. The level of information required to make purchase decisions about natural health products however is similar regardless of the level of perceived knowledge Canadians consider themselves to have in this area. Details can also be found in the table below.

Table 3.3.3.a: Product information needed for natural health products by frequency of use

Product information needed for Natural

Health Products Total

Frequency of Use


Frequ-ent

Infre-quent Never Frequ-

ent Infreq-uent Never Freque

nt Infreq-uent Never

Base=actual (2,502)

% (202)

%

(584)

%

(1,767)

%

(1,428)

%

(635)

%

(534)

%

(210)

%

(679)

%

(1,668)

%

Directions on how to use the product 72 54 65 75 77 67 62 59 73 72

Ingredients in the product 72 55 69 75 77 69 62 62 71 73

Dosage 71 51 66 75 76 68 63 59 72 72

Warnings about the product 70 52 67 73 75 66 61 59 70 71

Product features 60 53 57 61 62 60 53 50 60 60

Brand or product name 53 44 49 56 58 48 47 48 50 55

Where the product was made 51 47 51 51 57 46 40 48 54 49

Package insert or leaflet 44 40 41 45 50 39 36 43 47 43

Endorsements 26 28 29 25 30 25 20 28 28 25


Table 3.3.3.b: Product information needed for non-prescription drugs by frequency of use

Product information needed for Non-Prescription Drugs Total

Frequency of Use

Allergy Cough and Cold Sunscreen

Frequ-ent


ent Infreq-uent Never Freque

nt Infrequ

ent Never

Base=actual (2,502)

%

(362)

%

(1,376)

%

(839)

% (81)

% (2,132)

% (323)

% (812)

% (1,528)

% (281)

%

Dosage 78 72 78 79 44 79 77 78 78 75

Directions on how to use the product 77 71 76 77 39 78 73 75 77 72

Warnings about the product 75 69 74 76 41 75 74 74 75 71

Ingredients in the product 70 63 70 71 42 70 75 73 69 64

Brand or product name 63 61 63 61 50 63 61 62 64 54

Product features 60 54 62 58 36 61 59 59 62 48

Package insert or leaflet 49 52 48 47 36 49 47 52 47 42

Where the product was made 46 44 46 45 30 45 51 50 44 42

Endorsements 25 27 25 25 27 26 23 24 27 20


Table 3.3.3.b: Product information needed for non-prescription drugs by frequency of use…cont’d

Product information needed for Non-Prescription Drugs Total

Frequency of Use

Antacids Pain Relief

Frequ-ent



Base=actual (2,502)

%

(347)

%

(1,224)

%

(1,022)

% (667)

% (1,823)

% (194)

%

Dosage 78 75 80 76 76 79 69

Directions on how to use the product 77 74 78 75 76 77 62

Warnings about the product 75 72 76 73 72 75 69

Ingredients in the product 70 66 72 69 67 71 57

Brand or product name 63 63 63 61 60 63 56

Product features 60 57 60 61 54 61 57

Package insert or leaflet 49 51 52 44 49 48 41

Where the product was made 46 43 49 42 42 46 46

Endorsements 25 24 27 23 24 26 25

Table 3.3.3.c: Product information needed for cosmetics by frequency of use

Product information needed for Cosmetics Total

Frequency of Use

Skin care Hair care

Frequ-ent



Base=actual (2,502

% (1,780)

% (585)

%

(262)

% (1,969)

%

(508)

%

(266)

%

Directions on how to use the product 70 72 61 61 72 63 63

Warnings about the product 66 68 62 55 69 57 61

Ingredients in the product 66 69 58 57 68 63 59

Brand or product name 63 66 58 50 66 54 60

Product features 61 63 56 47 63 53 57

Dosage 53 54 52 45 55 49 46

Where the product was made 43 46 35 34 45 41 37

Package insert or leaflet 35 37 28 31 37 31 27

Endorsements 21 22 20 20 22 21 18


Table 3.3.3.d: Product information needed for natural health products by perceived level of knowledge

Product information needed for Natural

Health Products Total


Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(465)

%

(1,483)

%

Directions on how to use the product 72 69 72

Ingredients in the product 72 76 71

Dosage 71 71 71

Warnings about the product 70 68 69

Product features 60 60 59

Brand or product name 53 54 53

Where the product was made 51 56 47

Package insert or leaflet 44 48 43

Endorsements 26 27 25


Table 3.3.3.e: Product information needed for non-prescription drugs by perceived level of knowledge

Product information needed for Non-

Prescription Drugs Total


Well

in-

formed

Not well

in-formed

Base=actual (2,502)

% (937)

%

(808)

%

Dosage 78 83 71










Table 3.3.3.f: Product information needed for cosmetics by perceived level of knowledge

Product information needed for Cosmetics Total


Well

in-

formed

Not well

in-formed

Base=actual (2,502)

% (701)

%

(1,155)

%






Dosage 53 53 53




Gender and age both play a role with regard to desired product information in making a purchase decision. Women consistently rate significantly higher than men a desire for all types of information (with the exception of endorsements) on all three categories. This is likely tied to women’s higher perceived knowledge on these categories. The same is true of Canadians who are 55 year or older, who also rate their desire for each type of information significantly higher on all three categories than their younger Canadian counterparts (again, with the exception of endorsements).


Table 3.3.3.g: Desired information to make purchase decision on natural health products by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Directions on how to use the product

72 65 78 65 68 81

Ingredients in the product 72 67 78 67 69 80

Dosage 71 66 76 64 68 81

Warnings about the product 70 66 74 63 67 79

Product features 60 57 62 60 59 61

Brand or product name 53 51 55 50 53 57

Where the product was made 51 47 54 43 47 61

Package insert or leaflet 44 36 52 36 43 53

Endorsements 26 26 27 26 26 26


Table 3.3.3.h: Desired information to make purchase decision on non-prescription drugs by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Dosage 78 74 82 69 75 89


77 72 81 67 73 88








Table 3.3.3.i: Desired information to make purchase decision on cosmetics by gender and age

Cosmetics Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%


70 64 75 62 65 80





Dosage 53 55 51 46 48 64





3.3.4. Determining Safety of Products

Canadians look to many different sources to determine the safety of a product.

For natural health products, there are clearly three top sources of safety information that Canadians look to: asking a health professional or practitioner (48%), researching the product online (47%) and reading labels or product inserts (46%). That being said, none of these sources are used by a majority, suggesting Canadians use multiple sources to determine product safety. About one third of Canadians look for Health Canada’s approval number for both natural health products and non-prescription drugs, dropping to one-quarter for cosmetics.

Non-prescription drugs have two sources of safety information that stand out above the rest – asking a health professional or practitioner (56%) and reading labels or product inserts (53%), though only a very slight majority use these sources.

For cosmetics, relying on brand name (45%) and reading labels or product inserts (43%) are the main sources of information. Canadians are also more likely to “not really think about” the safety of cosmetics compared to natural health products and non-prescription drugs (20% vs. 10%-12%).


Canadians who consider themselves knowledgeable about the safety of consumer health products, those who consider themselves well informed in general about consumer health products and those who have higher perceptions about the safety of consumer health products in Canada are more likely than their counterparts to use a variety of sources to help them determine if products are safe.

Table 3.3.4.a: Determining safety of natural health products by perceived knowledge of safety, safety of products and perceived level of knowledge

Determining Safety of Natural Health Products

Total

Perceived Knowledge of Safety

Perceived Safety of Products


High Low Safe Not safe

Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(483)

%

(1,393)

% (1,243)

% (511)

% (465)

% (1,483)

%

Ask health professional or practitioner 48 51 45 50 47 50 45

Research product on the internet 47 57 41 50 44 56 42

Read labels or product inserts 46 50 41 49 44 51 42

Look for Health Canada approval number on the product 34 37 30 36 32 39 31

Rely on brand name/reputation 29 31 28 34 22 31 27

Search advisory, warning or recall information 27 33 23 28 28 32 24

Ask family or friends 24 22 23 26 20 25 22

Assume all products for sale in Canada are safe 21 17 22 26 11 19 20

Don’t really think about it 12 8 15 10 12 8 15

News media 12 13 12 12 12 14 11


Table 3.3.4.b: Determining safety of non-prescription drugs by perceived knowledge of safety, safety of products and perceived level of knowledge

Determining Safety of Non-Prescription Drugs

Total





Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(832)

%

(814)

% (1,752)

% (241)

% (937)

% (808)

%









News media 13 14 12 14 10 14 11



Table 3.3.4.c: Determining safety of cosmetics by perceived knowledge of safety, safety of products and perceived level of knowledge

Determining Safety of Cosmetics

Total





Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(483)

%

(1,393)

% (1,489)

% (365)

% (701)

% (1,155)

%










News media 13 13 13 14 12 16 11

Gender and age both play a role in how Canadians determine safety of products. Women and older Canadians (55+) are both more likely to search for safety information from various sources. For each of natural health products, non-prescription drugs and cosmetics, women are significantly more likely than men to rely on name brand/reputation of a product, reading product labels or inserts and researching online.

For all three categories, Canadians who are 55 year or older are significantly more likely than their younger counterparts to ask a health professional or practitioner, read product labels or inserts, search advisory, warning or recall information and look for the Health Canada approval number on the product.


Table 3.3.4.d: Sources used to determine safety of natural health products by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Ask health professional or practitioner

48 46 51 42 47 55

Research product on the Internet 47 45 50 48 47 47

Read labels or product inserts 46 41 50 37 43 56

Look for Health Canada approval number

34 33 34 25 33 41

Rely on brand name/reputation 29 26 32 29 28 30

Search advisory, warning or recall information

27 26 28 28 23 30

Ask family or friends 24 22 26 31 23 19

Assume all products for sale in Canada are safe

21 21 20 23 20 19

News media 12 11 13 12 11 12

Don’t really think about it 12 14 11 17 13 8


Table 3.3.4.e: Sources used to determine safety of non-prescription drugs by gender and age


Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

Ask health professional or practitioner 56 53 59 48 53 65




Look for Health Canada approval number 36 36 36 29 33 44

Assume all products for sale in Canada are safe 28 29 28 29 30 26

Search advisory, warning or recall information 27 26 29 30 25 28


News media 13 13 13 15 12 12


Table 3.3.4.f: Sources used to determine safety of cosmetics by gender and age

Cosmetics Total

Gender Age

Male Female 18-34 35-54 55+

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%




Ask health professional or practitioner 26 29 23 26 24 29

Look for Health Canada approval number 25 27 24 16 23 34

Assume all products for sale in Canada are safe 26 26 26 29 26 24


Search advisory, warning or recall information 22 21 22 22 19 24

News media 13 12 14 15 12 14



3.3.5. Determining Effectiveness of Products

Canadians use similar sources to determine the effectiveness of a product as with safety.

Similar to when Canadians look for safety information, there are a few sources on effectiveness that stand out for each category. For natural health products Canadians prefer to research the product on the internet (48%) or ask a health professional or practitioner (44%). For non-prescription drugs, the majority of Canadians ask a health professional or practitioner (57%), while others rely on brand name or reputation (43%) or internet research (42%). For cosmetics, relying on brand name (44%) and conducting internet research (41%) are the main sources of information. As seen with determining safety of a product, a sizeable portion of the population does not think about effectiveness; however, more think of it for non-prescription drugs compared to natural health products and particularly cosmetics.

Canadians who consider themselves knowledgeable about the effectiveness of consumer health products, those who consider themselves well informed in general about consumer health products and those who have more trust in label claims are more likely than their counterparts to use a variety of sources to help them determine the effectiveness of the various health products.


Table 3.3.5.a: Determining effectiveness of natural health products by knowledge of effectiveness, trust in claims and perceived level of knowledge

Determining Effectiveness of Natural Health Products

Total

Knowledge of Effectiveness Trust in Claims


High Low Trust Don’t trust

Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(521)

%

(1,371)

% (444)

%

(1,321)

%

(465)

%

(1,483)

%







Assume all products for sale in Canada must do what they say they will do

17 16 16 25 14 17 16


News media 11 13 9 11 10 13 19


Table 3.3.5.b: Determining effectiveness of non-prescription drugs by knowledge of effectiveness, trust in claims and perceived level of knowledge

Determining Effectiveness of Products for Non-Prescription

Drugs

Total




Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(973)

%

(723)

% (893)

% (801)

% (937)

% (808)

%








21 21 22 26 17 22 19

News media 11 12 12 13 11 13 10



Table 3.3.5.c: Determining effectiveness of cosmetics by knowledge of effectiveness, trust in claims and perceived level of knowledge

Determining Effectiveness of Cosmetics

Total




Well

in-

formed

Not well

in-formed

Base=actual (2,502)

%

(671)

%

(1,174)

% (529)

% (1,250)

% (701)

% (1,155)

%









17 20 16 27 14 20 16

News media 12 14 9 16 11 15 9

Gender, age and education all impact how Canadians determine the effectiveness of products. For all three categories, women are significantly more likely than men to research online or to ask friends and family. Men are significantly more likely to not really think about it or assume that all products for sale in Canada must do what they say they do.

Canadians who are 55 year or older are significantly more likely than those under 55 years old to ask a health professional or practitioner, rely on the brand name, search advisory, warning or recall information and look for the Health Canada approval number on the product. Canadians 18-34 years old are significantly more likely to ask family or friends, research online, or to not really think about it.

Finally, with respect to education, Canadians with a university degree are significantly more likely than those with only a high school education to ask family or friends, as well as research the product on the internet. Canadians with a high school education or less are significantly more likely than those with higher education to believe that all products for sale in Canada must do what they say they do.


Table 3.3.5.d: Sources used to determine effectiveness of natural health products by gender, age and education



Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%

Research product on the Internet 48 44 52 51 46 47 41 48 51

Ask health professional or practitioner 44 39 49 35 42 54 45 48 42

Ask family or friends 28 26 30 34 28 22 24 26 30

Rely on brand name/reputation 28 27 30 27 26 32 31 28 29

Look for Health Canada approval number 25 25 24 16 22 34 26 26 23

Search advisory, warning or recall information

21 20 21 18 19 25 18 23 20

Assume all products do what they say they will do

17 18 15 16 17 17 20 15 17

News media 11 11 11 10 10 12 8 13 11

Don’t really think about it 14 16 13 19 13 11 16 15 12


Table 3.3.5.e: Sources used to determine effectiveness of non-prescription drugs by gender, age and education



Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%






Search advisory, warning or recall information 23 23 23 22 21 26 21 23 24

Assume all products do what they say they will do 21 22 19 18 22 21 22 19 21

News media 11 11 12 13 11 10 10 11 12


Table 3.3.5.f: Sources used to determine effectiveness of cosmetics by gender, age and education

Cosmetics Total


Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%






Search advisory, warning or recall information 18 18 17 18 16 20 14 19 18

Assume all products do what they say they will do 17 20 15 17 18 17 23 15 17

News media 12 11 12 12 11 12 10 12 12



3.3.6. Where Canadians Look for Product Information

Canadians use a variety of sources to look for product information.

While there are no information sources that are used by a strong majority of Canadians, search engines and product labels are two of the most commonly used sources for all three categories. Healthcare professionals (such as a doctor or a nurse) are the number one information source for Canadians when looking up information on non-prescription drugs (53%). Far fewer (21-39%) consult a healthcare professional when looking for information on natural health products or cosmetics.

While general internet searches using a search engine are common, specific health-related websites (such as manufacturers’ website, Health Canada’s website, consumer group websites, etc.) are not commonly used by Canadians to look up product information, as only one quarter of Canadians or fewer use any of these types of websites for any of the three categories.

Social media and blogs are not popular information sources and are only used by less than one-in-ten Canadians for all categories.


Gender, age and education all play a role in what sources Canadians use to look up product information. For each category, women are significantly more likely than men to read the product label, ask family or friends, consult the manufacturer’s website and/or use a health magazine or journal.

Canadians who are 55 years or older are significantly more likely than those under 55 to read the product label and ask a health professional. Younger Canadians (18-34 years) are significantly more likely to use internet based research using a search engine, government websites, social media and blogs. They are also significantly more likely to talk to family or friends than older Canadians.

Canadians with a university degree are significantly more likely than those with high school or less to use nearly all of the various sources of information.

Table 3.3.6.a: Product information sources for natural health products by gender, age and education



Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%

Search Engine 43 42 45 45 43 42 36 44 47

Product label 43 40 46 41 40 48 44 42 42

Health care professional 39 36 41 32 36 47 40 41 37

Family or friends 29 27 31 34 30 23 28 29 30

Manufacturers’ website 22 20 24 18 24 23 21 25 20

Health care practitioner 21 19 24 17 22 24 21 24 20

Health Canada website 19 20 18 15 18 24 19 20 18

Health professional website 18 17 19 18 17 19 15 18 20

Health magazine, journal 17 14 19 15 17 18 15 17 17

Consumer group website 13 13 13 13 14 12 9 12 15

GOC website 10 11 9 10 8 12 8 10 11

Social media 8 8 8 13 7 4 6 9 8

Blogs 6 6 7 12 6 2 3 6 9

Other government website 5 6 4 8 5 4 4 5 7


Table 3.3.6.b: Product information sources for non-prescription drugs by gender, age and education



Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%


Product label 50 48 53 45 48 57 52 51 50

Search Engine 42 41 42 46 40 40 33 41 46








GOC website 9 10 8 6 9 12 9 10 9

Social media 6 6 7 11 6 3 6 7 6

Blogs 5 6 4 10 3 2 2 4 6



Table 3.3.6.c: Product information sources for cosmetics by gender, age and education

Cosmetics Total


Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%

Product label 51 45 56 45 48 57 52 51 50

Search Engine 41 39 43 45 41 38 34 41 45









Social media 10 8 13 20 9 4 9 10 11

Blogs 9 7 11 18 9 3 5 8 12

GOC website 6 8 5 5 6 8 6 6 6



3.3.7. Product Preference

There is no strong preference for homeopathic or non-prescription drug for cough and cold products.

Participants were shown images of two products chosen based on availability in French and English that represent a non-prescription product and a homeopathic product indicated as “cough & cold”. The homeopathic product was real Relief cough & cold daytime formula (DIN-HM 8002246). The non-prescription product was Balminil Syrup indicated to relieve dry cough due to colds, antitussive (DIN 00436895).

When asked which product they would be more likely to use, Canadians did not display a strong preference for the homeopathic or non-prescription drug to relieve cough and cold. To this point, roughly half (47%) claimed they would be equally likely to use either product, while about one quarter preferred product A (“Real Relief”, a homeopathic product) (25%) and another quarter preferred product B (“Balminil”, a non-prescription drug) (28%).

Frequent users of natural health products such as traditional natural health products (37% vs 31-22%), natural health products (29% vs 22-17%) and homeopathic products (29% vs 17-22%) were more likely to choose Real Relief.


There are a couple demographic differences when it comes to selecting these products:

• Real Relief was significantly more likely to be chosen by women, Canadians residing in any province other than Quebec and by those with less than a university education.

• Balminil was significantly more likely to be chosen by Canadians under the age of 55, Canadians living in Quebec and by those with at least college education or higher.

• Equal likelihood of choosing Real Relief or Balminil was significantly more likely to be Canadians 55 years of age or older and those with a high school education or less.

Table 3.3.7.a: Product preference by gender, age, region and education

Total


Male Female 18-34 35-54 55+

High school or less

College/

CGEP

Univer-sity

Degree

Base=actual (2,502)

%

(1,164)

%

(1,337)

%

(457)

%

(981)

%

(1,064)

%

(496)

%

(894)

%

(1,062)

%

Equally likely to use Real Relief or Balminil to relieve cough and cold

47 48 45 44 45 50 52 48 43

More likely to use Balminil to relieve cough and cold

28 30 27 33 28 25 21 25 34

More likely to use Real Relief to relieve cough and cold

25 22 28 23 26 25 27 27 23


3.3.8. Reasons for Product Preference

There are many reasons for product preference.

The reasons why Canadians preferred Balminil (a non-prescription drug) or Real Relief (a homeopathic product) vary greatly.

Reasons Canadians selected Real Relief included the details or information on the package (16%), the natural ingredients (15%) and that it relieves or covers more symptoms (15%).

Canadians chose Balminil because it contains medical ingredients (10%), or because they are familiar with the product (10%).

For those who were equally likely to choose either product, the most common response was that they felt that the products were similar to each other (26%). The frequency of use of homeopathic products did not affect the responses on this question, which could mean that consumers are not able to easily identify homeopathic products from non-prescription drugs.

Based on these findings, it would seem Canadians are most likely to choose a brand based on packaging or which has more information on the ingredients or effectiveness of the product.




4. Survey Methodology

4.1. Methodological Overview

Questionnaire Based on the objectives of the research and discussion with the Project Authority, TNS drafted the questionnaire. The resulting survey was 28 questions that were primarily closed-ended. TNS translated the survey into French.

Survey Pretest A pre-test was undertaken on April 15th obtaining 10 English and 10 French completions, including probing questions. The results were reviewed to ensure the survey was working as expected and that the questions were being interpreted as expected. Based on the results of the pre-test, no changes were required for the survey and as such the results of the 20 completes were included in the final data set.

Sample Design and Selection A regionally disproportionate sample of Canadians from the general population aged 18 years and older was drawn to achieve 2,500 completions. The sample was regionally stratified to ensure regional quotas were met.

All sample was obtained from TNS’s proprietary online panel.

Survey Administration An online survey was conducted using computer assisted web interviewing (CAWI) technology. CAWI ensures the interview flows as it should with pre-programmed skip patterns. It also controls responses to ensure appropriate ranges and data validity. Sample is imported directly into the survey to ensure accurate recording of sample variables such as region.

Surveys were conducted in English or French as chosen by the respondent. The survey was conducted from April 18th to April 26th, 2016. In total 2,502 surveys were completed. The average survey length was 21 minutes with the shortest being 5 minutes and the longest being 118 minutes (outliers removed).

All participants were informed of the general purpose of the research. They were also informed of the sponsor and the supplier and that all of their responses would be confidential. As well, the survey was registered with the Survey Registration System.

Margin of Errors As mentioned previously, panel sample was used for this study and as such margin of error does not apply.


Weighting Weighting adjustments were applied to the final edited, clean data to ensure that the data were representative of the 18+ population of Canada based on the 2011 Census. The data were weighted by age within gender and within region to match the Canadian population using 2011 Census Data. The following is the breakdown of actual and weighted completions.

Table 5.1a: Actual

Total Atlantic Quebec Ontario Prairies BC

2,502 251 600 900 351 400

Table 5.1b: Weighted


2,502 179 600 959 429 335

Table 5.1c: Actual


M 18-34 187 12 38 82 28 27

M 35-54 493 20 117 208 75 73

M 55+ 485 58 127 153 72 75

F 18-34 270 27 54 99 36 54

F 35-54 488 46 134 160 71 77

F 55+ 579 88 130 198 69 94


Table 5.1d: Weighted


M 18-34 348 22 81 132 68 45

M 35-54 455 32 108 176 80 59

M 55+ 409 32 102 153 64 58

F 18-34 349 22 81 134 67 45

F 35-54 470 34 108 186 79 63

F 55+ 471 37 120 178 71 65

Completion Rate

A total of 18,500 invitations were sent, of which n=2,502 completed the survey. The overall completion rate achieved for the online study was 13.5%. The following table outlines the sample disposition and response rate as per the MRIA guidelines.

Table 5.1e: Completion rate

Total Invitations Sent 18,500

Completes 2,502

Break Offs 718

Non-Qualifiers 367

Completion Rate 13.5%

Incidence Rate 87.2%

Non-response Bias To address the issue of response bias, data were weighted to be representative of the Canadian population.


5. Appendix A: Survey Instrument

Introduction

Thank you for coming to our site to complete this survey. Today we are conducting a study on behalf of the Government of Canada about the opinions and behaviours of Canadians. This survey will take approximately 15 minutes to complete and is registered with the National Survey Registration System. This survey is anonymous and confidential.

Screener

Do you or anyone in your household work in any of the following fields? (Select all that apply)

• Market research company • Local, provincial/territorial, federal government health agency (for example: Health Canada) • Health care professional (for example: medical doctor/physician, naturopathic doctor, pharmacist,

nurse) • Clinical or academic research on non-prescription drugs, natural health products or cosmetics • Consumer advocacy groups in the area of non-prescription drugs, natural health products or

cosmetics • Non-prescription drug, natural health product or cosmetic industry/trade associations (including

members, executives, associates or other staff) • Manufacturing, packaging, labelling, testing, importing, distributing, marketing, advertising of non-

prescription drugs, natural health products or cosmetics • None of the above <exclusive>

PN: Terminate if response is not none of the above

Consumer Use and Perceptions of Consumer Health Products

PN: Assign random order for product category for each unique respondent but keep consistent throughout the survey.

1. Please drag each product into the category box you think they most belong. Images: 10 images Categories: Natural health products Non-prescription drugs Cosmetics

2. On average, how frequently do you use each of the following products?


Randomize list

• Traditional natural health products such as traditional Chinese medicine or Ayurvedic medicines • Natural health products such as vitamins, minerals, fish oils, probiotics • Homeopathic products • Allergy relievers and decongestants • Cough, cold and flu medicines • Sunscreen products • Antacids and laxatives • Pain relievers • Skin care products (for example: moisturizers, cleansers) • Hair care products (for example: anti-dandruff shampoo, conditioners)

Scale:

Daily A few times a week Once a week A few times per month Once a month Every few months A few times per year Never

3. In general, how would you rate your knowledge about the safety of: Categories: Natural health products Non-prescription drugs Cosmetics Scale: 1 No knowledge at all 2 3 4 5 6 7 Extremely knowledgeable

4. In general, how would you rate your knowledge about the effectiveness (how well they work) of products in these categories: Categories: Natural health products Non-prescription drugs


Cosmetics Scale 1 No knowledge at all 2 3 4 5 6 7 Extremely knowledgeable

5. When you come across a product that says “homeopathic medicine” on the label, what does that mean to you? OPEN

5A. Both of these products have been reviewed and approved by Health Canada. Would you be:

[Two images – to be labelled Product A and Product B]

(a) More likely to use Product A to relieve your cough and cold (b) More likely to use Product B to relieve your cough and cold (c) Equally likely to use Product A or Product B to relieve your cough and cold

5B. Why would you be < insert response from Q5A>?

OPEN

6. Which of the following descriptions would you associate with a “product traditionally used in Ayurveda to aid digestion”? Select all that you think apply.

Randomize list

• A folk medicine from South Asia to aid digestion • An herbal digestive aid • A medicine (drug) that aids digestion • A digestive aid made in a place called Ayurveda • Don’t know

7. When you come across a product that says “SPF 15” on the label, what does that mean to you?

Free-text box (50 words maximum)


DISPLAY:

PN: Use same order as random display selected at the beginning of the survey.

The following survey is about < natural health products, non-prescription drugs and cosmetics>.

Natural health products contain ingredients that originate in nature and include a variety of products such as vitamins and minerals, herbal remedies, homeopathic products, traditional products (such as traditional Chinese medicines), probiotics, and other products like amino acids and essential fatty acids.

Non-prescription drugs are everyday medicines and first-aid products that are available without a prescription, such as allergy and sinus/nasal congestion relievers; cough, cold and flu medicines; fever and pain relievers; eye and ear care drops; antacids and laxatives; children’s medicines; and antiseptic and wound cleansers.

Cosmetics are products used for cleansing, improving or altering the complexion, skin, hair or teeth, such as body wash, facial moisturizer, hair shampoo and conditioner, make-up, deodorant and perfume.

8. In general, how informed do you feel when you buy products in the following categories? Categories: Natural health products Non-prescription drugs Cosmetics Scale 1 Not well informed at all 2 3 4 5 6 7 Extremely well informed

9. How safe do you believe the following products sold in Canada are? Categories: Natural health products Non-prescription drugs Cosmetics Scale 1 Not safe at all 2


3 4 5 6 7 Extremely safe Don’t Know DISPLAY: A product claim is something that a manufacturer says their product will do. The following are a few examples of product claims:

• A stain-removing toothpaste may say “whitens teeth”. • A weight loss product may say “helps you lose weight”. • A cold medicine may say “reduces coughing”. • A body moisturizer may say “helps relieve dry skin”.

10. How much do you trust the claims made on the labels of? Categories: Natural health products Non-prescription drugs Cosmetics Scale 1 Do not trust at all 2 3 4 5 6 7 Trust completely Don’t Know

11. How much do you agree or disagree with the following statements? Scale 1 Completely disagree 2 3 4 5 6 7 Completely agree


• A natural product is safer because it is made of natural ingredients • Products with similar claims will do the same thing • It is the product manufacturer’s responsibility to ensure a product is safe • It is Health Canada’s responsibility to ensure a product is safe • Claims (for example: help you lose weight) made on the labels of products must be supported by

science • All products claiming they do the same thing (for example: relieves sore throat) must have the same

level of proof provided by the manufacturer to support their claim • Product claims (for example: reduces signs of aging) must be true if they are written on the label

Consumer Behaviours

12. Thinking about < insert product category>, which part(s) of the labelling or packaging do you read

and how frequently do you read them? Categories: Natural health products Non-prescription drugs Cosmetics Randomize list

• Brand or product name • Directions on how to use the product (that is, how to take it or apply it) • Warnings about the product (for example: do not use if pregnant, may cause skin irritation,

may have come into contact with allergens) • Ingredients in the product • Dosage (that is, how much of the product to use – for example: take 1 tablet every 4 hours) • Endorsements (as approved by a professional groups or associations, for example: “#1

toothpaste recommended by dentists”) • Where the product was made (country of origin) • Package insert or leaflet (found attached to or inside the product package)

Scale Never Only the first time I buy it About half of the time Every time I buy it Every time I use it Don’t know


13. Which of the following pieces of information do you want to have on a product to help decide what to buy? Categories: Natural health products Non-prescription drugs Cosmetics PN: Anchor other to bottom of list Randomize list

Brand or product name

Directions on how to use the product (that is, how to take it or apply it)

Warnings about the product (for example: do not use if pregnant, may cause skin irritation, may have come into contact with allergens)

Ingredients in the product

Dosage (that is, how much of the product much to use – for example: take 1 tablet every 4 hours)

Endorsements (as approved by a professional groups or associations, for example: “#1 toothpaste recommended by dentists”)

Where the product was made (country of origin)

Package insert or leaflet (found attached to or inside the product package)

Product features

Other

14. How do you determine if the products in these categories are safe? Select all that apply.

Categories: Natural health products Non-prescription drugs Cosmetics Randomize statements, anchor other • Assume all products for sale in Canada are safe • Don’t really think about it • Ask family or friends


• Ask health professional or practitioner • Read labels or product inserts • Rely on brand name/reputation • News media • Search advisory, warning or recall information • Research product on the Internet • Look for Health Canada approval number on the product • Other (please specify) ____________

15. How do you determine if the products in these categories do what they say they will do? Select all that apply. Categories: Natural health products Non-prescription drugs Cosmetics Randomize statements, anchor other • Assume all products for sale in Canada must do what they say they will do • Don’t really think about it • Ask family or friends • Ask health professional or practitioner • Rely on brand name/reputation • News media • Search advisory, warning or recall information • Research product on the Internet • Look for Health Canada approval number on the product • Other (please specify)____________

16. Where do you look for information about products in each of the following categories? Select all that apply.

Categories: Natural health products Non-prescription drugs Cosmetics

Randomize

o Internet (drop down menu) Search Engine (Google, Yahoo, etc.) Health Canada website Government of Canada website Other government website Consumer group website


Health professional website Manufacturers’ website Blogs Social media (Facebook, Twitter, Instagram) Other

o Health magazine, journal, book o Health care professional (Doctor, Nurse, Pharmacist) o Health care practitioner (Homeopath, traditional healer) o Family or friends o Product label o Other (please specify)__________

Role of Health Canada

17. For each of the following categories, which tasks, if any, do you believe Health Canada is responsible for? Categories: Natural health products Non-prescription drugs Cosmetics

Randomize statements

• Reviewing (evaluating) the product before it hits the shelves • Making sure a product is safe before it hits the shelves • Making sure a product does what it says it will before it hits the shelves • Testing products in a laboratory • Ensuring products are manufactured without contamination • Making sure products contain the ingredients they say they do • Approving labels before they hit the shelves • Pulling products that are not safe from the shelves • Setting safety standards for companies to follow • None of these

Product Identifiers

18. Have you ever heard of a:

Drug Identification Number (DIN)

Natural Product Number (NPN)

Homeopathic Medicine Number (DIN-HM)


• Yes • No • Don’t know

DISPLAY

A Drug Identification Number (DIN) is an eight digit number assigned by Health Canada to non-prescription and prescription drugs prior to being sold in Canada. This number tells you that Health Canada has evaluated a product and authorized it for sale in Canada. A Natural Product Number (NPN) or Homeopathic Medicine Number (DIN-HM) is an eight digit number assigned by Health Canada to natural health products or homeopathic medicines prior to the products being sold in Canada. This number tells you that Health Canada has evaluated a product and authorized it for sale in Canada. PN: Ask for each item and randomize DIN, DIN-HM and NPN. Leave discriptions displayed at all times.

19. If a product has a (DIN, DIN-HM or NPN) would you consider it to be: Scale Yes No Don’t know Randomize statements • Safe • Effective (does what it claims to do) • Without contamination

Demographics

Now, we just have a few questions to help us classify your answers. Your responses to these and all other questions will be kept completely confidential.

20. In what year were you born?

21. What is your gender? • Male • Female • Other

22. In which province or territory do you reside?

• Alberta • British Columbia • Manitoba • Newfoundland and Labrador


• New Brunswick • Nova Scotia • Ontario • Prince Edward Island • Quebec • Saskatchewan • Nunavut • Northwest Territories • Yukon

23. What is the highest level of formal education that you have completed?

• Grade 8 or less • Some high school • High school diploma or equivalent • Registered aApprenticeship or other trades certificate or diploma • College, CEGEP or other non-university certificate or diploma • University certificate or diploma below bachelor's level • Bachelor's degree • Post graduate degree above bachelor's level • Prefer not to answer

24. Which of the following categories best describes your total household income? That is, the total

income of all persons in your household combined, before taxes?

• Under $20,000 • $20,000 to just under $40,000 • $40,000 to just under $60,000 • $60,000 to just under $80,000 • $80,000 to just under $100,000 • $100,000 to just under $150,000 • $150,000 and above • Prefer not to answer

25. Are you a parent or caregiver for anyone that is? Select all that apply.

• Under the age of 13 • 13-17 years old • 65 years or older

PN: ONLY ASK TO WOMEN

26. Are you currently? Answer List: Yes, No

• Pregnant • Breastfeeding

27. Do you or anyone in your household have:

• A severe chronic medical condition • A severe or life threatening allergy


Should you wish to learn more about consumer health products, please visit the following websites.

http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php

http://www.hc-sc.gc.ca/cps-spc/cosmet-person/index-eng.php

http://healthycanadians.gc.ca/index-eng.php

http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php

http://www.hc-sc.gc.ca/cps-spc/cosmet-person/index-eng.php

http://healthycanadians.gc.ca/index-eng.php

Documents

Consumer Health Products Survey · 2017. 12. 4. · Women, older Canadians (55+), those with at least a college education and those who use consumer health products more frequently