School of Public Health, University of Hong Kong, Hong Kong, China.
School of Nursing, University of Hong Kong, Hong Kong, China.
Nicotine Tob Res. 2019 Jun 21;21(7):949-954. doi: 10.1093/ntr/nty094.
Tobacco industry denormalization (TID) seeks to expose the industry's misconducts. Research on TID beliefs, meaning negative attitudes toward the tobacco industry (TI), may inform TID programs, but was limited to western populations. We investigated TID beliefs and their association with smoking and sociodemographic characteristics in Hong Kong adolescents.
In a school-based cross-sectional survey of 14214 students (mean age 15.0 years, 51.5% boys), TID beliefs were assessed by two questions: (1) whether the TI was respectable and (2) whether the TI tried to get youth to smoke, each with four options from "definitely no" to "definitely yes." Smoking susceptibility and behaviors were also assessed. Sociodemographic characteristics included age, sex, perceived family affluence, highest parental education, numbers of co-residing smokers, and school-level smoking prevalence.
Of all students, 77.6% considered the TI not respectable and 56.6% believed that the TI tried to get youth to smoke. Stronger TID beliefs were inversely associated with smoking susceptibility and behaviors. For example, students considering the TI definitely not respectable (vs. definitely yes) were 56% (95% confidence intervals [CI] = 45% to 66%), 49% (95% CI = 41% to 56%), and 53% (95% CI = 36% to 65%) less likely to be susceptible to smoking (among never-smokers) and be ever- and current smokers, respectively. Of all correlates examined, only younger age and having no co-residing smoker were associated with TID beliefs.
Substantial proportions of Hong Kong adolescents did not hold TID beliefs, but those who did were less likely to smoke. Our results suggest that TID programs may help reduce adolescent smoking.
The TI's misconducts and responsibility for the tobacco epidemic were not well known by Hong Kong adolescents. TID beliefs in this population were inversely associated with smoking. These findings suggest that TID programs in local adolescents may be of value. The investigation into the correlates of TID beliefs found that socioeconomic status and school-level smoking prevalence were not associated with TID beliefs. This suggests that local TID programs targeting adolescents in general, for example, mass-media campaigns, may be more appropriate than those targeting particular schools or selected groups of adolescents.
烟草业去正常化（TID）旨在揭露该行业的不当行为。关于 TID 信仰的研究，即对烟草业（TI）的负面态度，可能会为 TID 项目提供信息，但这些研究仅限于西方国家的人群。我们调查了香港青少年的 TID 信仰及其与吸烟和社会人口特征的关系。
在一项基于学校的横断面调查中，对 14214 名学生（平均年龄 15.0 岁，51.5%为男生）进行了调查，使用两个问题评估 TID 信仰：（1）TI 是否值得尊敬；（2）TI 是否试图让年轻人吸烟，每个问题都有“绝对不”到“绝对是”四个选项。还评估了吸烟易感性和行为。社会人口特征包括年龄、性别、感知家庭富裕程度、父母最高教育程度、共同居住吸烟者人数以及学校吸烟率。
在所有学生中，77.6%的学生认为 TI 不值得尊敬，56.6%的学生认为 TI 试图让年轻人吸烟。更强的 TID 信仰与吸烟易感性和行为呈负相关。例如，认为 TI 绝对不值得尊敬（而不是绝对是）的学生中，分别有 56%（95%置信区间 [CI] = 45% 至 66%）、49%（95% CI = 41% 至 56%）和 53%（95% CI = 36% 至 65%）更不容易吸烟（从不吸烟者中），更不容易成为曾经吸烟者和当前吸烟者。在所检查的所有相关性中，只有年龄较小和没有共同居住的吸烟者与 TID 信仰相关。
相当一部分香港青少年没有 TID 信仰，但那些有 TID 信仰的青少年吸烟的可能性较小。我们的结果表明，TID 项目可能有助于减少青少年吸烟。
香港青少年对 TI 的不当行为及其对烟草流行的责任知之甚少。该人群的 TID 信仰与吸烟呈负相关。这些发现表明，针对当地青少年的 TID 项目可能具有价值。对 TID 信仰相关性的调查发现，社会经济地位和学校吸烟率与 TID 信仰无关。这表明，针对一般青少年的本地 TID 项目，例如大众媒体宣传活动，可能比针对特定学校或特定青少年群体的项目更为合适。
