Factors Influencing Smoking Behavior in Hong Kong Primary Schoolchildren: Targets for Prevention

Abstract

The uptake of smoking by children and factors influencing such behavior, although well documented in the West, have not been studied in the Asia-Pacific region. A cross-sectional survey was carried out on 3, 521 children, aged 8-11 years living in two districts of Hong Kong. Knowledge, attitude and behavior related to smoking and sociodemographic data were obtained from questionnaires completed by parents and children. Eleven percent of boys and 5 percent of girls were ever-smokers, 5 percent of all eight-year-olds and 21 percent of 11-year-olds. Believing that parents will not interfere with their smoking (adjusted odds ratio 5.52; 95% confidence interval 2.72, 11.18), living with family members who smoke (1.72; 1.33, 2.23), and having a positive attitude to smoking (4.13; 1.43, 11.98) were factors predictive of ever-smokers. Experimentation with smoking is a major health risk for primary school children in Hong Kong and indicates failure of current smoking prevention programs. Effective culture-specific programs to counteract risk factors and with continuing evaluation are urgently needed; they should be based on information from appropriately-designed epidemiological studies.

Keywords

Asia-Pacific attitude children education health smoking.

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References

1. Lee SH . Department of Health Annual Report 1991/1992. Hong Kong: Government Printer, 1992: 4.

2. Census and Statistics Department, Hong Kong Government. Special Topics Report VII. General Household Survey 1990. Hong Kong: Government Printer 1991.

3. Census and Statistics Department, Hong Kong Government. Special Topics Report I. General Household Survey 1982. Hong Kong: Government Printer, 1983.

4. Li C, Fielding R, Marcoolyn G, Wong CM, Hedley AJ. Health beliefs, expectations and perceived benefits of smoking in Asian women. Tobacco Control (in press).

5. Chung J , Mackay J , Munro C , Tse M . Smoking in Chinese secondary school children in Hong Kong II: Attitudes and knowledge. HK Pract 1989; 11: 159–71.

6. Hertz AZ. Smoking among junior secondary school children in Hong Kong in 1990. A report to the Hong Kong Council on Smoking and Health, 1990:7.

7. Ong SG , Liu J , Wong CM , et al. Studies on the respiratory health of primary school children in urban communities of Hong Kong. Sci Total Environ 1991; 106: 121–135.

8. Seigel S , Castellan NJ . Nonparametric Statistics. New York: McGraw-Hill, 1988:262–272.

9. van Reek J , Adriaanse H , Karaglou A . Smoking among children in the European Community, letter. J Public Health Med 1992; 14: 93–4.

10.

10. van Reek J , Adriaanse H . Smoking by schoolchildren in eleven European countries.In: Durston B , Jamrozik K , editors. Tobacco and Health 1990: The Global War. Perth: Organising Committee of the Seventh World Conference on Tobacco and Health, 1990:301–2.

11.

11. Mendoza R . Tobacco consumption in Spanish school children: Observed tendencies (1986–1990), possible explanatory factors and suggestions for action. Paper presented at the eighth World Conference on Tobacco and Health, 1992:6.

12.

12. Bellew B , Wayne D . Prevention of smoking among schoolchildren: A review of research and recommendations. Health Education Journal 1991; 50: 3–7.

13.

13. Hong Kong 1993. A review of 1992. Hong Kong: Government Printer, 1993: 97.

14.

14. Michell L . Growing up in smoke.In: Durston B , Jamrozik K , editors. Tobacco and Health 1990: The Global War. Perth: Organising Committee of the Seventh World Conference on Tobacco and Health, 1990:550–1.

15.

15. Alexander HM , Callcott R , Dobson AJ , Hardes GR , Lloyd DM , O'Connell DL , Leeder SR . Cigarette smoking and drug use in schoolchildren: IV Factors associated with changes in smoking behavior. Int J Epidemiol 1983; 12: 59–66.

16.

16. de Vries H , Dijkstra M , Grol M , Seelen S , Kok G . Predictors of smoking onset and cessation in adolescents.In: Durston B , Jamrozik K , editors. Tobacco and Health 1990: The Global War. Perth: Organising Committee of the Seventh World Conference on Tobacco and Health, 1990:532–5.

17.

17. McInman AD , Grove JR . The relationship between adolescents' multidimensional self-concept, cigarette smoking, and intentions to smoke.In: Durston B , Jamrozik K , editors. Tobacco and Health 1990: The Global War. Perth: Organising Committee of the Seventh World Conference on Tobacco and Health 1990: 529–31.

18.

18. Reimers TM . Risk factors for adolescent cigarette smoking. AJDC 1990; 144: 1265–72.

19.

19. Peters J , Hedley AJ , Lam TH , Bet-son CL , Wong CM . Factors associated with smoking in primary school children in Hong Kong: Implications for Government action. New Pathways in Epidemiology, 13th Scientific Meeting, Sydney, September 1993:23.

20.

20. The Department of Community Medicine. Air Pollution and Respiratory Health in Primary School Children in Hong Kong 1989–1992. Report presented to the Environmental Protection Department, Hong Kong Government. Hong Kong: Department of Community Medicine, 1993:333.

21.

21. Cheng KK , Hedley AJ , Lam TH , Peters J , Bacon-Shone J , Chan A . A public opinion survey on measures related to the control of smoking in Hong Kong. Hong Kong: Department of Community Medicine, 1993: 12.