An exploratory study on the risk behaviours and its associated psychosocial factors in Hong Kong Chinese youth smokers
Dr Li, William Ho Cheung (Principal investigator)
youth, smoking, risk behaviour, Chinese, lifestyle
Block Grant Earmarked for Research (104)
HKU Project Code
Small Project Funding
Tobacco smoking among adolescents is a global concern as it has been described as a "paediatric epidemic" . A worldwide survey in 2003 has shown that the prevalence of tobacco use in youth aged 13 to 15 was greater than 10% and one fourth of them had their first cigarette before reaching the age of 10 years . In England, by the age of 15 years, 11% of youth have reported being regular smokers (usually smoke at least one cigarette per week) . In the US, 10.2% of high school students had ever smoked at least one cigarette every day for 30 days . In Australia, 6.7% of students aged 12 to 17 were current smokers who smoked in past 7 days . In Hong Kong, according to the Census and Statistics Department , the percentage of daily cigarette smokers in the age group of 15 to 19 dropped from 2.5% in 2010 to 2% in 2012. Despite the general low prevalence of smoking, the 84,000 youth who are daily smokers in Hong Kong cannot be overlooked or unconsidered . Most importantly, youth were likely to continue tobacco use into adulthood . Indeed, one out of two smokers will be killed by smoking . Recent medical research has shown that for those who started smoking at young age, two out of three will die from smoking . Nevertheless, quitting at an early age can largely reduce the mortality due to smoking . Therefore, youth smokers should be targeted with smoking cessation interventions to reduce the smoking-attributable diseases and mortality. There is an increasing concern about the risk behaviours, lifestyle and its associated psychosocial factors in youth smokers. There is evidence that lifestyle and behaviour tend to coexist in youth, and hence youth adopting healthy lifestyle in one aspect tend to behave similarly in others. Conversely, involvement in particular risk behaviour can predict involvement of others. For example, youth smokers in Hong Kong were found to be associated with other unhealthy lifestyles, such as high risk sexual behaviours, sleep disorders, depression, and poor self-rated health [13-16]. Nevertheless, a review of the literature reveals that most health education interventions for helping youth to change their unhealthy behaviours were only focused on one particular health problem, whilst the other co-existing unhealthy habits have often been overlooked. It is crucial therefore for healthcare professionals to examine the risk behaviours, lifestyle and its associated psychosocial factors for youth smokers and develop appropriate interventions that can not only help them quit smoking, but also help them adopt a healthy lifestyle. Despite increasing such concerns, information on smoking behaviours and its associated risk factors in youth, particularly in Chinese populations, is scarce. On the other hand, self-esteem, an important driving force and developmental need for youth, which is one of the influential psychosocial factors associated with their smoking [17,18]. A previous study found that youth with high self-esteem have a strong belief in their ability to engage in a healthy lifestyle . According to Carpenito-Moyet , self-esteem derives from a person’s own perceptions, or self-evaluation, about self-competence and efficacy. She also highlights that low self-esteem may be an indicator of susceptibility to depression, consequently affected one’s quality of life. There is some evidence to support the relationships among self-esteem, depression and quality of life , with individuals with low self-esteem would report more depressive symptoms and lower levels of quality of life than those with higher self-esteem [22,23]. A large-scale surveillance on the health risk behaviours of youth conducted in Hong Kong in 2001 revealed that youth with depressive symptoms are more likely to have unhealthy eating habits, smoke, drink alcohol or take illicit drugs . Given these issues, to effectively promote smoking cessation to youth, it is crucial for health care professionals to first identify their self-esteem and then screen those youth who likely to exhibit psychosocial distress or are at high risk of depression. Through understanding such psychological factors in advance, it could enhance the effectiveness of smoking cessation programmes, not only to promote quitting, but also help them lead a healthier life, consequently help improve their quality of life. Nevertheless, there has been so far no study conducted in a Hong Kong Chinese context to examine the relationships among self-esteem, depressive symptoms and quality of life in youth smokers. The aims of this study were: (1) to examine the risk behaviours, lifestyle and its associated psychosocial factors for youth smokers; and (2) to explore the relationships among self-esteem, depressive symptoms and quality of life in youth smokers.