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Substance use

Learn about substance use among residents of Niagara, with a focus on alcohol, tobacco and cannabis use among youth and adults. The purpose is to share local patterns of substance use across the region to understand how these substances affect our community, increase awareness and inform local planning, prevention and health promotion efforts.

Alcohol consumption

Alcohol consumption is a common behaviour among Niagara residents. Certain patterns of alcohol consumption are associated with increased risk of harm to self and others. More than two standard drinks per week is connected to an increased risk of cancer, and seven or more drinks per week increases risk of heart disease or stroke.

Three people standing next to each other

Adults

  • 59.8% of Niagara residents 19 years or older drink alcohol at least once a month (self-reported, 2021)
  • 34% of Niagara residents 19 years or older are at an increased risk due to consuming three or more standard drinks per week (2019/2020)
Young person with backpack and phone

Youth

  • 42.8% of grade 7 and 8 students reported having at least a sip of alcohol in their lifetimes (2019)
  • 81.5% of secondary students reported having at least a sip of alcohol in their lifetimes (2019)
  • One in three secondary students who reported drinking said they first consumed alcohol in elementary school (2019)

Emergency department visits related to alcohol consumption

Emergency department visits related to alcohol provide an indicator of harms associated with alcohol consumption that require hospital‑based care. These visits include alcohol poisoning, as well as mental health concerns such as alcohol withdrawal. 

In 2024, there were 2,513 emergency department visits for conditions entirely caused by alcohol. Following a decline between 2016 and 2020, rates have remained stable in recent years.  

Overall, males visit the emergency department for conditions entirely caused by alcohol more often than females. Additionally, the rate of emergency department visits for conditions entirely caused by alcohol are highest among residents aged 25 to 64 years.

Rate of emergency department visits related to alcohol consumption per 100,000 population, Niagara, 2015 to 2024

2015

  • Males:764.6
  • Females:425.5
  • All residents:591.1

2016

  • Males:767.4
  • Females:440.0
  • All residents:600.0

2017

  • Males:756.2
  • Females:418.8
  • All residents:584.1

2018

  • Males:670.0
  • Females:388.3
  • All residents:526.6

2019

  • Males:621.0
  • Females:375.0
  • All residents:495.9

2020

  • Males:574.8
  • Females:359.2
  • All residents:465.5

2021

  • Males:580.0
  • Females:354.9
  • All residents:465.8

2022

  • Males:608.3
  • Females:393.9
  • All residents:500.4

2023

  • Males:614.5
  • Females:371.0
  • All residents:491.7

2024

  • Males:552.7
  • Females:370.3
  • All residents:491.0

Rate of emergency department visits related to alcohol consumption per 100,000 population. The overall rate includes all residents and falls between the male and female rates. Since 2015, the overall rate has dropped by 100.1 visits per 100,000.

Tobacco and e-cigarette use

Cigarette

Tobacco

  • 6.8% of secondary students reported smoking a conventional cigarette in the past year (2019)
  • 4.3% of secondary students reported smoking their first cigarette in the past year (2019)
  • 15.1% of Niagara residents 18 years or older reported smoking daily or occasionally in 2023/2024
Vape

E-cigarettes

  • 43% of secondary students reported vaping any type of e-cigarette in the past year (2019)
  • Approximately half of secondary students who reported vaping in 2019 began doing so over the previous year
  • 17% of Niagara residents 18 years or older reported using an e-cigarette or vape at least once

Cannabis use

Three people standing next to each other

Adults

  • 21.6% of Niagara residents 18 years or older reported using cannabis at least once (2023/2024)
Young person with backpack and phone

Youth

  • 25% of students in grades 9 and 10 reported using cannabis at least once in the past year (2019)
  • 45% of students in grades 11 and 12 reported using cannabis at least once in the past year (2019)
  • Just under one-third of secondary students who have used cannabis tried it for the first time in elementary school
  • Another third tried it for the first time in grade 9

Emergency department visits related to cannabis use

Emergency department visits related to cannabis provide an indicator of harms associated with cannabis consumption that require hospital‑based care. These visits include cannabis‑related poisoning and mental health concerns related to cannabis use, including psychotic disorders. 

From 2015 to 2021, the rate of emergency department visits for all cannabis‑related harms increased significantly but have been declined since 2021. In 2024, Niagara had 561 emergency department visits for all cannabis‑related harms. 

Emergency department visits for all cannabis‑related harms are consistently higher among males compared to females and among residents aged 13 to 44 years of age compared to all other age groups. 

Rate of emergency department visits related to cannabis per 100,000 population, Niagara, 2015 to 2024

2015

  • Males:122.6
  • Females:61.1
  • All residents:92.1

2016

  • Males:125.0
  • Females:71.4
  • All residents:98.5

2017

  • Males:152.3
  • Females:89.5
  • All residents:121.3

2018

  • Males:195.6
  • Females:103.8
  • All residents:150.6

2019

  • Males:187.2
  • Females:113.6
  • All residents:150.9

2020

  • Males:213.6
  • Females:134.8
  • All residents:174.8

2021

  • Males:221.3
  • Females:151.7
  • All residents:187.4

2022

  • Males:179.8
  • Females:125.3
  • All residents:152.8

2023

  • Males:135.3
  • Females:103.8
  • All residents:119.8

2024

  • Males:139.3
  • Females:83.4
  • All residents:111.9

Rate of emergency department visits related to cannabis per 100,000 population. The overall rate includes all residents and falls between the male and female rates. The overall rate peaked in 2021 (187.4) and has declined since.

Data notes

Data are based on the most recent available sources and may be updated as new information becomes available. Data are subject to change without notice.

Interpret data points with an asterisk (*) with caution due to moderate sampling variability.

Emergency department visits related to substance use include all Niagara residents, regardless of which emergency department they visit in Ontario, including both suspected and confirmed diagnoses and exclude scheduled emergency department visits.

These visits include conditions entirely attributable to substance use, such as poisonings and mental or behavioural disorders.

Changes in health‑seeking behaviour and access to health services during the COVID‑19 pandemic may have affected trends observed between 2020 and 2023. 

The data includes Niagara specific estimates from two population-based surveys of adult and youth health outcomes and behaviours: the Canadian Community Health Survey and the 2019 Ontario Student Drug Use and Mental Health Survey.  

The Canadian Community Health Survey is collected by Statistics Canada on an annual basis to assess self-reported health behaviours and outcomes of Canadians. The Canadian Community Health Survey does not include individuals living on reserves, full-time members of the Canadian Armed Forces, or individuals who are institutionalized.

The 2019 Ontario Student Drug Use and Mental Health Survey survey was administered in the classroom to randomly selected elementary and secondary schools, limited to students in grade seven to 12.  

Alcohol consumption - Early consumption

  • Canadian Community Health Survey. Statistics Canada, Share File. Ontario Ministry of Health (2019/20, 2021)
  • Ontario Student Drug Use and Health Survey. Centre for Addiction and Mental Health (2019)


Chart 1: Emergency department visits related to alcohol consumption

Chart 2: Emergency department visits related to cannabis use

  • Canadian Institute for Health Information. National Ambulatory Care Reporting System (NACRS). IntelliHealth Ontario. (2024)


Tobacco and e-cigarette use / Cannabis use

Additional information, including data for other substances and Public Health Units, is available through Public Health Ontario’s Substance Use and Harms Tool.

Last updated: June 2026

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