Thesis (Ph. D.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 156-186).

Thesis (M.Sc.)--Aberdeen University, 2008. / Title from web page (viewed on June 1, 2009). Includes bibliographical references.

published_or_final_version / Community Medicine / Master / Master of Public Health

No description available.

Thesis (M. Phil.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 132-153). Also available in print.

Background: Secondhand smoke exposure (SHS) causes many fatal diseases to children and there is no safe level of exposure. In Hong Kong, around 41%of infants are exposed to household SHS and leading to the additional hospital admissions of the infants. Objectives: To study the effectiveness of a theory-based family intervention delivered by the smoking cessation counselor (SCCs) which aims to reduce household SHS exposure to infants under 18-months, by helping fathers to quit smoking and motivating mothers to establish a smoke-free home . Methods: Families with a smoking father, non-smoking mother and an infant attended the Maternal and Child Health Centres (MCHCs) were invited to join this randomized controlled trial. The family (mother and father) was randomized after the completion of mother’s baseline questionnaire and the collection of saliva samples from mothers and infants. Father was then contacted for telephone baseline interview. Individual interventions were provided to both mothers and fathers at baseline, 1-week and 1-month, and a family session involving both parents was offered to the intervention group. The control group received information on the hazards of SHS and the benefits of smoking cessation. The intervention and control groups were followed-up at 6-and 12-monthsto assess father’s smoking behavior and the execution of a complete no-smoking policy at home. Chi-squares and independent t-tests were used to assess the group differences in father’s smoking behavior and the initiation of a smoke-free home. Generalized estimating equations were used to examine the group changes of mothers’ and infants’ saliva cotinine levels from baseline to 12-month. Logistic regressions were performed to identify the predictors on father’s smoking behavior and the initiation of a smoke-free home. Results: There were 1,158 families randomized. Significantly more fathers in the intervention groupattainedhigher7-day point prevalence quit rate at 6-(8.0% vs 4.1%, p= .007)and 12-months (13.7% vs 8.0%, p= .002)respectively, stopped smoking at home at 12-month (35.7% vs 28.8%, p= .023), higher continuous quit rates at 6-(3.3% vs 0.7%, p= .002) and 12-month (1.8% vs 0.2%, p= .006), reduction of daily cigarette consumption over 50% at 12-month (33.4% vs 23.9%, p= .006), improvement in the stage of readiness to quit smoking at 6-month (13.0% vs 8.9%, p= .04) and more quit attempts (30.9% vs 24.1%, p=.015). No group differences were found in the establishment of the smoke-free home and the changes of saliva cotinine levels of infants and mothers from baseline to follow-ups. Discussion: This theory-based family intervention is effective in reducing household SHS exposure to infants by helping fathers to quit and stopped them to smoking at home, but it is less effective in motivating the mothers to initiate a smoke-free home. Significance: This is the first study testing a theory-based family intervention in reducing household SHS exposure to healthy infants. The family intervention provides a new insight in using ‘family’ as a unit for the intervention to reduce household SHS exposure to healthy infants by improving fathers' household smoking behavior and helping them to quit smoking. / published_or_final_version / Nursing Studies / Doctoral / Doctor of Philosophy

Background: The tobacco epidemic causes a major burden to long-term global public health. Second hand smoke is one of the modifiable exposures causing adverse health effects to children; 40% of children in the world are regularly exposed to second hand smoke and children account for more than a quarter of all deaths from second hand smoke exposure. The global burden highlights the importance of implementation and enforcement of comprehensive smoke-free legislation. Despite smoke-free legislation having been shown to have a positive effect in reducing the prevalence of tobacco consumption and second hand smoke exposure, displacement of smoking from enclosed public places to homes after implementation of smoke-free legislation might increase second hand smoke exposure in children. Objectives: This systematic review aims to investigate the effect of smoke-free legislation on second hand smoke exposure in children and to explore the potential risk factors that may affect its effectiveness. Methods: Studies were searched in online electronic databases, PubMed and EMBASE Classic+ EMBASE 1980-via Ovid (from 1980 to 2014) under the Library website of the University of Hong Kong, by keyword search, hand search of references and Google Scholar for relevant articles published from 2004 to present. Observational studies assessing the effect of smoke-free legislation on second hand smoke exposure in children assessed from cotinine measured before and after the introduction of smoke-free legislation were included. Results: This systematic reviewed identified 8 relevant studies. 3 were assessed as good quality and 5 as average quality. All selected studies reported a decrease in the geometric mean of cotinine concentration after the implementation of smoke-free legislation, but only one of them showed that the reduction in cotinine concentration was significantly reduced from 0.3ng/ml to 0.2ng/ml. An increase in the percentage of cotinine concentrations below the limit of detection and a decrease in the percentage of harmful levels of cotinine concentration were also found. Lower socioeconomic status, more parental smokers and low level of home smoking restriction affected the reduction in second hand smoke exposure after implementation of smoke-free legislation. Conclusion: Smoke-free legislation has a positive effect towards reduction in second hand smoke exposure in children. There is no evidence supporting the possibility that smokers displace tobacco consumption from public areas to their homes after implementation of smoke-free legislation in Western settings. Whether more effort to encourage smoking cessation among parents and other family members living with children would be particularly effective in reducing the public health burden of tobacco consumption should be investigated. Further tobacco control strategies are suggested to work comprehensively with smoke-free legislation to further reduce the global burden of tobacco epidemic. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M. P. H.)--University of Hong Kong, 2006.

Thesis (M. P. H.)--University of Hong Kong, 2007.

Thesis (M. P. H.)--University of Hong Kong, 2006. / Also available in print.