Evaluating the effects of the smoke-free legislation on youth smokers in Hong Kong: perceived social and environmental influence

Abstract

The Hong Kong Government has implemented a comprehensive smoke-free legislation on 1 January 2007, which restricts smoking in indoor workplaces, restaurants, karaokes, public places/park, beaches, and school (both indoor and outdoor). Previous studies showed positive effects of tobacco control policies on changing the smoking behaviour of youth smokers. We examined the differences in perceived social and environmental influence on youth smokers recruited to the Youth Quitline (YQ) before and after the enactment of the smoke-free legislation. Data obtained before (73 weeks) formed the pre- group and after 1 Jan 2007 (78 weeks) formed the post-legislation group. Callers who are ethnic Chinese, aged 12 to 25, smoked ≥ 1 cigarette in the past 30 days and can communicate in Cantonese, were recruited to the YQ for smoking cessation intervention. Chi-square tests compared perceived social and environmental influence on youth smokers in the pre- and post-legislation group, and logistic regression was used to adjust for baseline difference. A total of 254 and 288 youth smokers formed the pre and post-legislation groups. 73% were male, 61% were students, and 61% had mild nicotine dependency level. On average, they were 18 years old, started smoking at 14 years old and consumed 11 cigarettes daily. The post-legislation group were younger (19 vs. 17 years old; p < 0.001), started smoking earlier (14 vs. 13 years old, p = 0.02), and more were students (55% vs. 67%, p = 0.01). Half reported had smoking parents (52% vs. 54%; p = 0.72), at least more than half classmates/colleagues (50% vs. 48%; p = 0.05) and majority of their friends (67% vs. 70%; p = 0.11) were current smokers. More youths in the post-legislation group perceived family members would give support in their quitting plan (57% vs. 68%; p < 0.01), and the difference remains significant after controlling for differences in the three baseline characteristics (AOR, 1.45; 95% CI, 1.01-2.10). The legislation showed a positive effect on youth smokers in their perception of more support from family members on their quitting smoking. However, there seems a minimal difference in their social and environment.