Associations of sociodemographic characteristics and conventional cigarette smoking behaviors with poly-tobacco use in Hong Kong Chinese: a population survey

Abstract

Significance Use of alternative tobacco products is increasingly popular in Hong Kong, where the prevalence of daily conventional cigarette smoking is low (10.0%). We examined the associations of sociodemographic characteristics, tobacco addiction, and readiness to quit of conventional cigarettes with poly-tobacco use in current conventional cigarette users. Method A representative sample of 1139 current conventional cigarette users aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015 and 2017. The respondents reported (1) current poly-tobacco use (past 30-day use of electronic cigarettes, waterpipe, cigars, smoking pipe, snus, snuff or self-rolling cigarettes in addition to conventional cigarettes); (2) Heaviness of Smoking Index (HSI) of conventional cigarettes; (3) readiness to quit conventional cigarettes within 30 days (yes/no); and (4) sociodemographic characteristics (age, sex, educational attainment, income). Adjusted odds ratio (AORs) for current poly-tobacco use (versus conventional cigarette use only) in relation to socio-demographic characteristics, HSI and readiness to quit were calculated. Prevalence were weighed by age and sex of current cigarette users in census reports. Results The prevalence (95% CI) of any tobacco products use was 13.4% (11.3-15.3%) for current poly-tobacco, 6.3% (4.8-8.4%) for cigars, 5.6% (4.2-7.4%) for self-rolling cigarettes, 3.8% (2.6-5.6%) for waterpipe, 2.02% (1.1-3.6%) for electronic cigarettes and 2.01% (1.2-3.4%) for smoking pipe. Current poly-tobacco use was associated with being male (AOR 2.00, 95% CI 1.11-3.61) (vs. females), younger age (AORs range from 1.40-4.89, P for trend < .001) and smoker who were less ready to quit (1.94, 1.08-3.49). HSI was not associated with current poly-tobacco products use. Conclusions Being male, younger and less ready to quit were more likely to use poly-tobacco products.