Smoking and perceived health among primary school students in Hong Kong

Objectives:  To investigate the association between smoking and perceived health among primary school students in Hong Kong.

Methods:  In 2008, primary 2 to 6 students (aged 6 to 14) in 24 randomly selected schools has completed an anonymous questionnaire.  Perceived health in the past 30 days was reported as very good, good, bad or very bad.  Smoking status was categorized as current (at least <1 cig/week), former (smoked any numbers of cigarettes but not any more) and ever (current and former smoker) versus never.  Data were weighted by census school grade distribution.  Logistic regression was used to calculate adjusted odds ratios (ORs) for poor (bad/very bad) vs good (good/very good) perceived health by smoking status adjusting for age, sex, grade, place of birth, socio-econmonic status as represented by the number of bedrooms, parental smoking and secondhand smoke exposure, and taking into account the clustering effect of schools.

Results:  Of 8567 students, 5.8% had ever smoked, including 0.9% current and 4.9% former smokers.  Only 10.4% reported poor perceived health.  Compared with never smokers (9.6%), former (19.7%) and current (24.9%) smokers were more likely to report poor perceived health with ORs (95% CI) of 1.87(1.42-2.47) and 2.13(1.15-3.94), respectively (P for trend<0.001).  Poor perceived health was reported by 20.5% of ever-smokers with OR of 1.89(1.44-2.49) compared with never smokers.

Conclusions:  Even young children smokers were more likely to report poor perceived health than never smokers and stopping smoking seemed to improve perceived health compared with continued smoking.

Funding:  The Hong Kong Council on Smoking and Health.