Increased Risk of Cigarette Smoking Among Immigrant Children and Girls in Hong Kong: An Emerging Public Health Issue

Abstract

Despite global progress in tobacco control, data are needed for subgroups with increased risk of tobacco use for more effective smoking prevention. Survey data from a random sample of 6,486 youth in grades 7, 8 and 9 were derived from the project Chinese Student Health Survey. Prevalence and hazards of smoking onset were compared by gender and immigrant status. Mediation analysis was used to assess factors that may mediate the impact of immigrant status on smoking. Immigrant students had a much higher risk of hazards of smoking initiation than non-immigrant students. Parental monitoring and parental smoking significantly mediated the effect of immigrant status on early smoking onset. In addition, gender differences in the prevalence of smoking and hazards of smoking onset in our study were smaller than those reported by others targeting non-Hong Kong Chinese youth. Findings of this study imply that immigrant children and girls in Hong Kong are at increased risk to tobacco use. Special attention should be paid to these subgroups for prevention intervention. Prevention intervention for immigrant children should address parental smoking and parental monitoring. Reduced gender difference in smoking among Hong Kong youth suggests an emerging trend for more Chinese girls on the Mainland to smoke along with the rapid socioeconomic development.

Receptivity to Pro-Tobacco Media and Cigarette Smoking among Vocational High School Students in China

“…Findings of this study clearly demonstrate the need for specific tobacco control measures in China, particularly behavioral intervention to reduce adolescents' receptivity and anti-tobacco social marketing to counter-attack tobacco advertising. The high levels of media receptivity reported in our study also support the conclusion by others that the legal measures of banning tobacco advertisement in China are ineffective (Li et al, 2009;Yang et al, 2010;Lau, Chen, & Ren, 2012;Yang et al, 2012). In this case, an alternative approach for the Chinese Ministry of Health to control tobacco would be to strengthen anti-tobacco social marketing, an evidence-based and cost-effective strategy for tobacco control demonstrated in the West (Sutfin, Szykman, & Moore, 2008;Scheier & Grenard, 2010;Buller et al, 2011).…”

“…Data were collected using the Chinese Student Health Behavior Questionnaire (CSHBQ), a paper-and-pencil survey we previously used in China (Zheng, Sussman, Chen, Wang, Xia et al, 2004;Lau, Chen, & Ren., 2012). The participants filled out the questionnaire in their classrooms.…”

“…Although a number of legal measures have been taken to ban tobacco advertising, including the 1991 Tobacco Products Monopoly Law (Article 19), the 1994 Advertisement Law (Article 18), the 1995 Tobacco Advertising Management Regulations (Article 8), and the 2005 ratification of the Framework Convention on Tobacco Control of the World Health Organization (The Ministry of Health of China, 2007), yet, recent studies point to the high levels of exposure to tobacco advertisement in all possible venues including traditional (e.g., radio, television, billboards, and printed media) and new venues (e.g., internet, movies and TV series, event sponsorship, free samples, sale point display) presented by the tobacco industry through direct and indirect methods (Li et al, 2009;Yang et al, 2010;Lau, Chen, & Ren, 2012;Yang et al, 2012Yang et al, ). 2005).…”

Lifestyle and Addictive Behaviors Among Chinese Adolescents in Hong Kong, Macau, Taipei, Wuhan, and Zhuhai—a First Cross-subculture Assessment

“…Although the traditional Chinese culture discourages girls to smoke, relative to mainland China, the low gender ratio or more girls smoking in Hong Kong, Macau and Taiwan may be a reflection that more girls in these cities consider them equal to boys with regard to smoking. Previous research also showed increased smoking among girls in Hong Kong [40].…”

“…Perceived parental monitoring was assessed using a 3-item instrument with 5-point Likert scale (alpha = 0.67) [36,40]. Scale scores were derived by summing up individual items such that higher scores indicating closer parental monitoring as perceived by youth.…”