A COMPREHENSIVE STUDY OF SMOKING IN PRIMARY-SCHOOL CHILDREN IN HONG-KONG - IMPLICATIONS FOR PREVENTION

Study objective-To identify factors associated with smoking behaviour in primary school children in Hong Kong. Design-A cross sectional surv ey in which both children and parents completed questionnaires. The ma in outcome measure was the smoking status of the children; and risk fa ctors (knowledge of and attitude to smoking and demographic and socioe conomic background) were identified as predictors of ever/never smokin g. Setting and subjects-Altogether 9598 primary school children, aged 8-13 years, and attending 27 schools from two districts in Hong Kong p articipated. Main results-The prevalence of ever-smoking was 12% (1119 )-15% (760) in boys and 7% (359) in girls. It ranged from 3% in 8 year old girls to 52% in 13 year old boys. The factors associated with eve r-smoking included the following: being a boy (adjusted odds ratio 2.2 1; 95% confidence interval 1.89, 2.59), increasing age per year (1.48; 1.40, 1.57), living in Kwai Tsing district (1.29; 1.10, 1.50), having one or more smokers at home (2.07; 1.78, 2.39), and having a father w ho was not working (1.41; 1.19, 1.67). Children who were ever-smokers had both seen and approved of their friends' smoking (8.79; 5.33, 14.5 0), had a more positive attitude towards smoking (3.35; 2.21, 5.09), a nd were more successful in recognising cigarette brand names and logos (1.67; 1.42, 1.96), but they lacked confidence (1.78; 1.32, 2.39). Co nclusions-The influences on child smoking are multifactorial and progr ammes in Hong Kong are failing to curb them. The control of these risk factors must be incorporated in the smoking prevention policy of Hong Kong and supported by future enforced legislation.