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Increased Risk of Cigarette Smoking Among Immigrant Children and Girls in Hong Kong: An Emerging Public Health Issue

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Abstract

Despite global progress in tobacco control, data are needed for subgroups with increased risk of tobacco use for more effective smoking prevention. Survey data from a random sample of 6,486 youth in grades 7, 8 and 9 were derived from the project Chinese Student Health Survey. Prevalence and hazards of smoking onset were compared by gender and immigrant status. Mediation analysis was used to assess factors that may mediate the impact of immigrant status on smoking. Immigrant students had a much higher risk of hazards of smoking initiation than non-immigrant students. Parental monitoring and parental smoking significantly mediated the effect of immigrant status on early smoking onset. In addition, gender differences in the prevalence of smoking and hazards of smoking onset in our study were smaller than those reported by others targeting non-Hong Kong Chinese youth. Findings of this study imply that immigrant children and girls in Hong Kong are at increased risk to tobacco use. Special attention should be paid to these subgroups for prevention intervention. Prevention intervention for immigrant children should address parental smoking and parental monitoring. Reduced gender difference in smoking among Hong Kong youth suggests an emerging trend for more Chinese girls on the Mainland to smoke along with the rapid socioeconomic development.

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References

  1. Lau, M., & Kan, M. Y. (2010). Prevalence and correlates of problem behaviors among adolescents in Hong Kong. Asia-Pacific Journal of Public Health, 22, 354–364.

    Article  PubMed  Google Scholar 

  2. Lee, A., & Tsang, C. K. K. (2004). Youth risk behaviour in a Chinese population: A territory-wide youth risk behavioural surveillance in Hong Kong. Public Health, 118, 88–95.

    Article  PubMed  CAS  Google Scholar 

  3. Shafey, O., Dolwick, S., & Guindon, G. E. (2003). Tobacco control country profiles (2nd ed.). Atlanta, GA: American Cancer Society.

    Google Scholar 

  4. World Health Organization. (2009). WHO report on the global tobacco epidemic, 2009: Implementing smoke-free environments. Geneva: WHO Press, World Health Organization. Available from http://www.who.int/tobacco/mpower/2009/gtcr_download/en/index.html. Accessed December 22, 2010.

  5. Chen, X. G., Li, Y., Unger, J. B., Gong, J., Johnson, C. A., & Guo, Q. (2001). Hazard of smoking initiation by age among adolescents in Wuhan, China. Preventive Medicine, 32, 437–445.

    Article  PubMed  CAS  Google Scholar 

  6. Chen, X. G., & Unger, J. B. (1999). Hazards of smoking initiation among Asian American and non-Asian adolescents in California: A survival model analysis. Preventive Medicine, 28, 589–599.

    Article  PubMed  CAS  Google Scholar 

  7. Chen, X. G., Unger, J. B., Palmer, P., Weiner, M. D., Johnson, C. A., Wong, M. M., et al. (2002). Prior cigarette smoking initiation predicting current alcohol use: Evidence for a gateway drug effect among California adolescents from eleven ethnic groups. Addictive Behaviors, 27, 799–817.

    Article  PubMed  Google Scholar 

  8. Schneider, S., Mohnen, S. M., & Pust, S. (2008). The average age of smoking onset in Germany—Trends and correlates. Paper presented at the International Journal of Public Health.

  9. Warren, C. W., Jones, N. R., Peruga, A., Chauvin, J., Baptiste, J.-P., de Silva, V. C., et al. (2008). Global youth tobacco surveillance, 2000–2007. Morbidity and Mortality Weekly Report, 57, 1–32.

    Google Scholar 

  10. Malmberg, M., Overbeek, G., Monshouwer, K., Lammers, J., Vollebergh, W. A. M., & Engels, R. (2010). Substance use risk profiles and associations with early substance use in adolescence. Journal of Behavioral Medicine, 33, 474–485.

    Article  PubMed  Google Scholar 

  11. Mao, R., Li, X. M., Stanton, B., Wang, J., Hong, Y., Zhang, H. S., et al. (2009). Psychosocial correlates of cigarette smoking among college students in China. Health Education Research, 24, 105–118.

    Article  PubMed  Google Scholar 

  12. Paul, S. L., Blizzard, L., Patton, G. C., Dwyer, T., & Venn, A. (2008). Parental smoking and smoking experimentation in childhood increase the risk of being a smoker 20 years later: The childhood determinants of adult health study. Addiction, 103, 846–853.

    Article  PubMed  Google Scholar 

  13. Booker, C. L., Unger, J. B., Azen, S. P., Baezconde-Garbanati, L., Lickel, B., & Johnson, C. A. (2008). A longitudinal analysis of stressful life events, smoking behaviors, and gender differences in a multicultural sample of adolescents. Substance Use and Misuse, 43, 1509–1531.

    Article  Google Scholar 

  14. Chen, X. G., Unger, J. B., Cruz, T. B., & Johnson, C. A. (1999). Smoking patterns of Asian-American youth in California and their relationship with acculturation. Journal of Adolescent Health, 24, 321–328.

    Article  PubMed  CAS  Google Scholar 

  15. Chen, X. G., Stanton, B., Fang, X. Y., Li, X. M., Lin, D. H., Zhang, J. T., et al. (2006). Perceived smoking norms, socioenvironmental factors, personal attitudes and adolescent smoking in China: A mediation analysis with longitudinal data. Journal of Adolescent Health, 38, 359–368.

    Article  PubMed  CAS  Google Scholar 

  16. Geckova, A. M., Stewart, R., van Dijk, J. P., Orosova, O., Groothoff, J. W., & Post, D. (2005). Influence of socio-economic status, parents and peers on smoking behaviour of adolescents. European Addiction Research, 11, 204–209.

    Article  Google Scholar 

  17. Grenard, J. L., Guo, Q., Jasuja, G. K., Unger, J. B., Chou, C. P., Gallaher, P. E., et al. (2006). Influences affecting adolescent smoking behavior in China. Nicotine & Tobacco Research, 8, 245–255.

    Article  Google Scholar 

  18. Loke, A. Y., & Wong, Y. P. I. (2010). Smoking among young children in Hong Kong: Influence of parental smoking. Journal of Advanced Nursing, 66, 2659–2670.

    Article  PubMed  Google Scholar 

  19. Weiss, J. W., & Garbanati, J. A. (2004). Relationship of acculturation and family functioning to smoking attitudes and behaviours among Asian-American adolescents. Journal of Child and Family Studies, 13, 193–204.

    Article  Google Scholar 

  20. Li, X. M., Mao, R., & Stanton, B. (2010). Parental, behavioral, and psychological factors associated with cigarette smoking among secondary school students in Nanjing, China. Journal of Child and Family Studies, 19, 308–317.

    Article  Google Scholar 

  21. Shakib, S., Zheng, H., Johnson, C. A., Chen, X. G., Sun, P., Palmer, P. H., et al. (2005). Family characteristics and smoking among urban and rural adolescents living in China. Preventive Medicine, 40, 83–91.

    Article  PubMed  Google Scholar 

  22. Patton, G. C., Hibbert, M., Rosier, M. J., Carlin, J. B., Caust, J., & Bowes, G. (1996). Is smoking associated with depression and anxiety in teenagers? American Journal of Public Health, 86, 225–230.

    Article  PubMed  CAS  Google Scholar 

  23. Lam, T. H., Stewart, S. M., Ho, S. Y., Lai, M. K., Mak, K. H., Chau, K. V., et al. (2005). Depressive symptoms and smoking among Hong Kong Chinese adolescents. Addiction, 100, 1003–1011.

    Article  PubMed  CAS  Google Scholar 

  24. Census and Statistics Department of Hong Kong. (2007). 2006 population by-census thematic report: Persons from the Mainland having resided in Hong Kong for less than 7 years. Hong Kong: Census and Statistics Department, Hong Kong Government.

    Google Scholar 

  25. Ma, Z. D., Lin, G., & Zhang, F. (2010). Examining cross-border marriage in Hong Kong: 1998–2005. In W. S. Yang & M. C. W. Lu (Eds.), Asian cross-border marriage migration: Demographic patterns and social issues. Amsterdam: Amsterdam University Press.

    Google Scholar 

  26. Yau, S. (2006). Family relationships: Cross-border marriage between Hong Kong and Mainland China residents. Journal of Youth Studies, 9, 57–64.

    Google Scholar 

  27. Lohéac, Y., & Page, L. (2006). Princeton or prison? A joint analysis of school achievement and crime rate for children or immigrants. Paper presented at the XX annual conference of the European Society for population economics held on June 22–24, 2006, Verona, Italy.

  28. Molcho, M., Kelly, C., Gavin, A., & Nic Gabhainn, S. (2008). Inequalities in health among school-aged children in Ireland. Dublin: Department of Health and Children.

    Google Scholar 

  29. Census and Statistics Department of Hong Kong. (2006). Needs of persons from the Mainland having resided in Hong Kong for less than 7 years in thematic household survey report no. 28, Census and Statistics Department, Hong Kong Government, Hong Kong.

  30. Siu, H. F. (2009). ‘Hong Kongers’ and ‘new immigrants’, Hong Kong Journal. Available at http://www.hkjournal.org/archive/2009_summer/4.htm. Accessed on January 4, 2011.

  31. Warren, C. W., Jones, N. R., Eriksen, M. P., & Asma, S. (2006). Patterns of global tobacco use in young people and implications for further chronic disease burden in adults. Lancet, 367, 749–753. doi:10.1016/S0140-6736(06)68192-0.

    Article  PubMed  CAS  Google Scholar 

  32. Hong, J. S., Lee, N. Y., Grogan-Kaylor, A., & Huang, H. (2011). Alcohol and tobacco use among South Korean adolescents: An ecological review of the literature. Children and Youth Services Review, 33, 1120–1126.

    Article  Google Scholar 

  33. Tsai, Y. W., Tsai, T. I., Yang, C. L., & Kuo, K. N. (2008). Gender differences in smoking behaviors in an Asian population. Journal of Women’s Health, 17, 971–978.

    Article  PubMed  Google Scholar 

  34. Singleton, R., & Straits, B. C. (2010). Sampling. In R. Singleton & B. C. Straits (Eds.), Approaches to social research (5th ed.). Oxford: Oxford University Press.

    Google Scholar 

  35. Jessor, R. (1992). Reply—Risk behaviour in adolescence: A psychosocial framework for understanding and action. Developmental Review, 12, 374–390.

    Article  Google Scholar 

  36. Centers for Disease Control and Prevention & World Health Organization. Global school-based student health survey (GSHS). Atlanta and Geneva: Centers for Disease Control and Prevention, and World Health Organization. Available from http://www.cdc.gov/gshs/questionnaire/index.htm. Accessed January 3, 2011.

  37. Cox, D. R., & Oaks, D. (1984). Analysis of survival data. London: Chapman and Hall.

    Google Scholar 

  38. Kalbfleisch, J. D., & Prentice, R. L. (1980). The statistical analysis of failure time data. New York: Wiley.

    Google Scholar 

  39. Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  CAS  Google Scholar 

  40. Samet, J. M., & Yoon, S. Y. (2010). Gender, women, and the tobacco epidemic. Geneva: WHO Press, World Health Organization.

    Google Scholar 

  41. Hitchman, S. C., & Fong, G. T. (2011). Gender empowerment and female-to-male smoking prevelance ratios. Bulletin of World Health Organization, 89, 195–202.

    Article  Google Scholar 

  42. Geckova, A. M., van Dijk, J. P., van lttersum-Gritter, T., Groothoff, J. W., & Post, D. (2002). Determinants of adolescents’ smoking behaviour: A literature review. Central European Journal of Public Health, 10, 79–87.

    PubMed  CAS  Google Scholar 

  43. Hong Kong Department of Health, Center for Health Protection. (2010). Smoking: A women’s health perspective. Non-Communicable Diseases Watch, 3, 1–4.

    Google Scholar 

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Acknowledgments

This analysis is one of the research outputs from the project of the Action Health, which is a part of the project Chinese Student Health Survey. Data collection for this study was supported by the Centraline Charity Fund Limited.

Conflict of interest

All authors have no conflict of interests associated with the funding agency.

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Authors and Affiliations

  1. Department of Social Sciences, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, New Territories, Hong Kong Special Administrative Region, China

    Maggie Lau

  2. Action Health, Room 910-911, 9/F, Youth Square, 238 Chai Wan Road, Chai Wan, Hong Kong Special Administrative Region, China

    Maggie Lau

  3. Pediatric Prevention Research Center, Wayne State University School of Medicine, 4707 St. Antoine, Detroit, MI, 48201-2196, USA

    Xinguang Chen & Yuanjing Ren

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  1. Maggie Lau
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Correspondence to Maggie Lau.

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Lau, M., Chen, X. & Ren, Y. Increased Risk of Cigarette Smoking Among Immigrant Children and Girls in Hong Kong: An Emerging Public Health Issue. J Community Health 37, 144–152 (2012). https://doi.org/10.1007/s10900-011-9428-9

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  • DOI: https://doi.org/10.1007/s10900-011-9428-9

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