Thesis (M.S.)--West Virginia University, 2002. / Title from document title page. Document formatted into pages; contains vii, 100 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 83-87).

published_or_final_version / Public Administration / Master / Master of Public Administration

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

published_or_final_version / Politics and Public Administration / Master / Master of Public Administration

Background: Although perception predicts behaviours in general, it is less clear whether perceived peer smoking prevalence is associated with smoking among children. Although the harmful effects of smoking and secondhand smoke (SHS) exposure on health are well documented, little is known about the influence of SHS exposure on smoking behaviours, and the effects of smoking on perceived health. Objectives: This thesis aims to investigate the associations of (1) overestimation of peer smoking prevalence and smoking initiation, (2) self-rated health (SRH) with smoking and SHS exposure, and (3) SHS exposure at home with smoking initiation, tobacco addiction and smoking cessation, among an under-studied population of Chinese children in Hong Kong. Methods: A prospective study among primary school students (n = 2171) was conducted in 2006 (baseline) and followed up in 2008. A cross-sectional study on youth smoking (n = 36225) was conducted in 2003/4. Self-administered, anonymous questionnaires were used to collect information on socio-demographic characteristics, smoking status of the subjects, parents, siblings and other family members and SHS exposure at home and outside home. Other detailed information on smoking perceptions and behaviours were recorded among adolescents using standard questions adapted from the Global Youth Tobacco Survey. Self-reported smoking and SHS exposure were validated using hair nicotine tests. Logistic and linear regressions were used to yield adjusted odds ratio (AOR) and β-coefficients for poor SRH, smoking initiation, tobacco addiction and smoking cessation adjusting for socio-demographic characteristics and school clustering effects. Mediation of SHS exposure at home on the associations of smoking family with smoking initiation, tobacco addiction and smoking cessation were evaluated using standard mediation procedures. Results: Experimental smoking, ex-smoking and current smoking were associated with higher AORs for poor SRH than never-smoking among adolescents. Similarly, SHS exposure among never-smoking adolescents was linked to poor SRH. Overestimation of peer smoking prevalence significantly predicted smoking initiation (AOR: 1.79, 95% CI 1.03-3.13) among primary school students after 2 years, although SHS exposure did not predict overestimation. Living in smoking families and SHS exposure at home were significantly associated with smoking initiation and tobacco addiction, and hindered smoking cessation among adolescents (All p<0.05). The association between smoking family and child smoking was mediated by SHS exposure at home. Conclusions: This study provided the first evidence that overestimation of peer smoking predicted smoking initiation among young children, and smoking was associated with poor SRH among Chinese adolescents. The significant associations of SHS exposure at home with smoking behaviours should stimulate further investigations into the underlying psychosocial and physiological mechanisms. Future prospective studies with more comprehensive measurements of smoking and SHS exposure are warranted to confirm these results. Evidence-based interventions to correct misperceptions and promote smokefree homes are needed to protect children from smoking and exposure to SHS. / published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

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. / published_or_final_version / Public Health / Master / Master of Public Health

Introduction Though the associations of general parenting styles and smoking-specific parenting practices with adolescent smoking have received much attention in recent years, important questions remain. Most general parenting studies focused on Caucasian parents but much less in the literature is known about Chinese parents. As for smoking-specific parenting practices in the household, anti-smoking practices have been the focus, with pro-smoking practices seldom being studied. The objectives of the present study were: 1) to examine general parenting styles of Hong Kong fathers and mothers, and their associations with adolescent current smoking; 2) to explore potential effect modifiers of the above associations—age/sex of the adolescent and parental smoking status; 3) to estimate the prevalence of adolescents’ exposure to smoking-specific parenting practices and the coexistence of pro-smoking and anti-smoking practices within a family; and 4) to examine the associations of smoking-specific parenting practices with adolescent current smoking status and their intention to smoke. Methods Data from 2 large-scale school surveys were used. In the Hong Kong Student Obesity Surveillance project (HKSOS), 34,678 secondary students aged 12-17 completed an anonymous questionnaire. Current smoking denoted any smoking in the past 30 days. The parenting style of each parent was classified as authoritative (high care/high control), authoritarian (low care/high control), permissive (high care/low control) or neglectful (low care/low control). Binary logistic regressions generated adjusted odds ratios (AORs) of current smoking for parenting styles, and parental care and control. In the Youth Smoking Survey (YSS) (2003/04), information of adolescent smoking behaviours, their exposure to smoking-specific parenting practices at home and socio-demographic characteristics was collected among 36,612 secondary 1-5 students. Pro-smoking practices included “buy cigarettes/hand cigarettes/light a cigarette/clean the ashtray for family members”, “easily see packages of cigarettes of family members at home”, “exposure to secondhand smoke at home” and “smoking among family members”. Anti-smoking practices were “parent-child communication about harms of smoking” and “anticipated control from father/mother if you were to smoke”. AORs of adolescent current smoking and their intention to smoke for each pro-smoking and anti-smoking practice were calculated. Results In HKSOS, over half of the fathers (51.5%) and mothers (66.2%) were authoritative. Current smoking (3.1%) was associated with lower levels of care both from father and mother, lower levels of maternal control, but higher levels of paternal control. Compared with authoritative fathers, the AORs (95% CI) of adolescent current smoking were 0.74 (0.59-0.93) for permissive, 1.13 (0.87-1.43) for authoritarian, and 0.99 (0.77-1.28) for neglectful. The corresponding AORs for mothers were 1.30 (1.04-1.61), 1.80 (1.34-2.41), and 2.49 (1.90-3.28). In YSS, 9.7% of adolescents were current smokers and 33.2% had the intention to smoke. About half the students (52.7%) reported pro-smoking practices and 87.8% reported anti-smoking practices at home. Anti-smoking practices were associated with lower odds of adolescent current smoking and intention to smoke, whereas pro-smoking practices were linked to higher odds. Conclusions Authoritative mothers and permissive fathers seemed to have protective effects against adolescent smoking. Pro-smoking practices were associated with higher odds of adolescent current smoking and intention to smoke, while anti-smoking practices were protective. / published_or_final_version / Community Medicine / Master / Master of Philosophy

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / abstract / toc / Nursing Studies / Master / Master of Nursing in Advanced Practice