Association of tobacco industry denormalisation beliefs with smoking cessation and nicotine addiction in adolescent smokers

Abstract

Aim and objective To investigate the associations of tobacco industry denormalisation (TID) beliefs (ie, negative perceptions of the industry) with smoking cessation and nicotine addiction in adolescent smokers. Methods In 2012/13, a cross-sectional survey was conducted in 45857 secondary school students (mean age 14.8 years, 54% boys) in Hong Kong. TID beliefs (score range: 0-6) were measured by two questions: “Do you think the tobacco industry is respectable?” and “Do you think the tobacco industry tries to get youth to smoke?” Each question had 4 options (“probably yes” to “probably no”), which were assigned scores of 0-3, with larger scores indicating stronger TID beliefs. Also measured were smoking status, smoking cessation (yes/no; defined as cessation for ≥4 months), morning smoking (yes/no), cigarettes smoked per day, etc. Associations were examined with adjustment of sociodemographic characteristics, peer smoking, and numbers of co-residing smokers. Results In ever smokers (occasional or daily smoking either now or in the past; n=4544), TID beliefs were associated with an adjusted prevalence ratio (PR) of 1.04 (95% CI 1.02, 1.07; p=0.001) for smoking cessation. In past 30-day smokers (n=3250), TID beliefs were associated with an adjusted PR of 0.98 (0.96, 1.00; p=0.04) for morning smoking and an adjusted β of -0.27 (-0.44, -0.10; p=0.002) for cigarettes smoked per day. Conclusions In Hong Kong adolescents, TID beliefs were associated with smoking cessation in ever smokers, and inversely associated with nicotine addiction in past 30-day smokers. A TID component may strengthen cessation interventions in adolescent smokers. Funding Food and Health Bureau of the Hong Kong Government.

Keywords

• tobacco
• industry
• beliefs
• adolescent