The impact of the smoke-free legislation on smokers' motivation and confidence to quit smoking: A comparison of two sampels in Hong Kong

Abstract

Background: The Hong Kong Government implemented a comprehensive smokefree legislation on 1 January 2007, which restricts smoking in indoor workplaces, restaurants, karaokes, public places/park, beaches, and school (both indoor and outdoor). This study aims to examine the perceived self-efficacy to quit smoking of smokers from two study samples after the smoke-free legislation. Method: Two cross-sectional samples were recruited. The first sample was Chinese youth smokers, aged 12-25, who called the Youth Quitline and received smoking cessation counseling. The second sample was Chinese smoking fathers living with non-smoking mother and a child aged ≤12 years old. We conducted a telephone survey in the two samples, consisted of 4 items on perceived impact of the legislation on self-efficacy to quit smoking and compared the proportions of smoking participants in the two studies by chi-square tests. Results: A total of 288 youth smokers and 608 smoking fathers completed the questionnaires. 75% of the youth smokers were male, 67% were students, a mean age of 17 years, and 62% had mild nicotine dependency. The smoking fathers’ mean age was 39.3 years, 75.1% had secondary education, 95.4% were currently employed, and 62% had mild nicotine dependency. In both samples, about one-third had increased in their motivation to quit smoking (youths vs. fathers) (37% vs. 26%), perceived importance in successful quitting (32% vs. 25%), confidence in quitting (28% vs. 18%); and fewer had perceived difficulty in quitting (11% vs. 6%). While the majority (>60%) remained no change, significant differences were observed in all the 4 variables between the two samples after the legislation (p < 0.001). Conclusion: Although majority of the smoking fathers and youth smokers had little/no change after the legislation, more subjects reported an increase in motivation and confidence to quitting, suggesting the need for more effort from the government to promote smoking cessation. More youth smokers than smoking fathers showed positive changes indicating youth smokers are sensitive to the enactment of the legislation and changes in the overall environment, compared to adult smokers.