Exposure to anti-smoking media messages and pro-smoking media messages and its association with intention to smoke among adolescents in Hong Kong

Abstract

Background: Even though a series of restrictions aimed at protecting dwellers from being addicted to tobacco are implemented in Hong Kong, the loopholes utilized by tobacco industry can still promote tobacco marketing by various strategies such as sponsorship in movies and charity activities. Therefore, it is still quite necessary to monitor the associations of intention to smoke with exposure to anti-smoking media messages and pro-smoking media messages among adolescents in Hong Kong.

Objectives: Objectives of this study were to investigate exposure to pro- smoking media messages and pro-smoking media messages and their association with intention to smoke among adolescents in Hong Kong.

Methods: This is a cross-sectional study based on secondary data collected from Smoking and Health Survey among Hong Kong Students 2010/11. Data from 61,810 secondary school students were analyzed. Exposure to anti- and pro- smoking media messages among adolescents in Hong Kong was assessed. Logistic regression was conducted to examine the association of intention to smoke with exposure to anti- and prosmoking media messages separately, and then examine the association of intention to smoke with exposure to anti- and pro- smoking media messages with taking exposure to anti- and pro- smoking media messages as a whole. Sub group analysis splitting the sample into never smokers and ever smokers were made throughout logistic regression models above.

Results: In terms of prevalence of exposure to media, higher possibilities of exposure to prosmoking media messages and of exposure to anti-smoking media messages was found among females relative to males (39.9% versus 37.1% and 69.5% versus 68.1% respectively, both p<0.001). Besides, significant higher possibilities of exposure to pro-smoking media messages and of exposure to anti-smoking media messages than those without were detected (43.9% versus 34.4% and 71.9% versus 65.7% respectively, both p<0.001). Statistically significant positive associations were found between exposure to pro-smoking media messages and intention to smoke both among never smokers (OR=1.39, 95% CI: 1.26-1.52, p<0.001) and ever smokers (OR=1.35, 95% CI: 1.24-1.46, p<0.001). And, statistically significant negative associations were observed between exposure to anti-smoking media messages and intention to smoke among never smokers (OR=0.58, 95% CI: 0.53-0.63, p<0.001) and among ever smokers (OR=0.82, 95% CI: 0.76-0.89, p<0.001). In logistic regression models for both anti- and pro- smoking media messages, among never smokers, we found the lowest odd ratio was 0.56 (95% CI: 0.51-0.63, p<0.001), for category with exposure to anti-smoking media messages and no exposure to pro-smoking media messages. And the highest odds ratio was 1.33 (95% CI: 1.11-1.56, p=0.001), for the category with exposure to pro-smoking media messages and no exposure to antismoking media messages. For ever smokers, the lowest odds ratio was 0.82 (95% CI:0.75-0.89, p<0.001), for category with exposure to anti-smoking media messages and no exposure to pro-smoking media messages. And, the hightest odds ratio was 1.35 (95% CI: 1.10-1.66, p=0.004), for the category with exposure to pro-smoking media messages and no exposure to anti-smoking media messages.

Conclusions: In both ever and never smokers, positive associations of intention to smoke with exposure to pro-smoking media messages were observed. However, a negative association of intention to smoke with exposure to anti-smoking media messages was only found for sub group of never smokers.

For both never smokers and ever smokers, the group with exposure to pro-smoking media messages and no exposure to anti-smoking media messages had positively higher increase in the odds of intention to smoke relative to the group with exposure both to anti- and pro smoking media messages.