Association of alcohol consumption patterns with smoking-related intentions and behaviors among Hong Kong adolescents

Abstract

Background: The association of drinking patterns with smoking-related intentions and behaviors has been understudied. This study investigates the relation of specific adolescent drinking patterns with smoking-related intentions and behaviors among Hong Kong secondary school students.

Methods: This cross-sectional study used secondary data from the Youth Smoking Survey, a school-based smoking survey administered in 2010/11 with a sample size of 61,127 students. Dependent variables for this study included ever smoking, current smoking, intensity of smoking, intention to smoke in the next 12 months, quit attempts within the past 12 months and use of tobacco products other than cigarettes. Ever drinking, frequency of alcohol consumption and types of alcohol consumed were manipulated as independent variables. Demographic information of the subjects were identified using descriptive statistics. Cross-tabulations showed the association of drinking behaviors with smoking-related intentions behaviors. Binary logistic and multinomial regression models yielded adjusted odds ratios (AORs). Regression models were adjusted for age, sex, form, socioeconomic status and parental education.

Results: 64.7% of daily drinkers were current smokers, 50% intended to smoke in the next 12 months, 39.4% used tobacco products other than cigarettes and 36.1% smoked more than 20 cigarettes/day. The AORs (95% CI) showed that daily drinkers were 632.82 (439.32-911.55) times as likely to smoke more than 20 cigarettes/day, 93.17 (75.66-114.73) times as likely to be current smokers, 34.52 (28.42-41.93) times as likely to have an intention to smoke in the next 12 months, 29.82 (24.16-36.81) times as likely to be ever smokers, 10.03 (8.27-12.16) times as likely to use tobacco products other than cigarettes and 66% (0.30-0.51) less likely to have attempted to quit smoking in the past 12 months.

Positive associations between the behaviors were also seen among students who drink high alcohol-concentrated drinks. Spirits drinkers were 28.54 (22.53-36.15) times as likely to smoke more than 20 cigarettes/day, 10.81 (9.71-12.03) times as likely to be current smokers, 7.76 (6.96-8.64) times as likely have an intention to smoke in the next 12 months, 6.66 (6.03-7.37) times as likely to be ever smokers and 3.45 (2.96-4.05) times as likely to use other tobacco products.

Conclusions: This is the first study in Hong Kong showing the large, positive associations of alcohol drinking patterns with smoking behaviors and intentions. This association, along with growing prevalence of underage drinking in Hong Kong, suggests that further research should be done into studying these behavioral patterns among adolescents. Policymakers can use more in-depth research on this topic to advocate for stricter regulations on adolescents’ access to and use of alcohol and tobacco. In the long run, these measures can reduce the alcohol- and tobacco-related burden of disease in Hong Kong.