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Purpose The purpose of the study is to investigate the cross-sectional and prospective relation between workplace secondhand smoke (SHS) exposure and respiratory symptoms. Methods Cross-sectional data for workplace SHS exposure and respiratory symptoms were collected by using random digit dialing from 7336 never-smoking Hong Kong workers 15 years or older in 1997 to 1998. In the 2000 to 2001 follow-up, 2213 workers who remained never smoking, had the same SHS exposure status, worked at the same job for at least 2 years, and were not exposed to SHS at home at follow-up were included for prospective analysis. Results Cross-sectionally, SHS was associated significantly with frequent colds, cough and phlegm, throat problems, and the presence of any respiratory symptoms with adjusted odds ratios of 1.89 (95% confidence interval [CI], 1.66–2.15), 1.65 (95% CI, 1.35–2.02), 1.88 (95% CI, 1.63–2.15), and 1.96 (95% CI, 1.75–2.20) at baseline, each having significant linear associations with duration of exposure. SHS was not associated with rhinitis. Prospectively, consistent SHS exposure increased the risk for cough and phlegm and any respiratory symptoms by 48% (12% to 97%) and 54% (13% to 109%), respectively. Conclusions This first non-Western population-based prospective study shows that workplace SHS exposure is associated significantly with frequent respiratory symptoms, both cross-sectionally and prospectively, thus providing strong evidence that the association is causal.

Purpose: Most studies of depressed mood and its correlates in adolescents have been conducted in Western countries. This study examined the relationship between a broad range of stressors and depressed mood in a community sample of Hong Kong adolescents. Methods: Secondary school students ( n = 996) completed the Chinese Beck Depression Inventory (C-BDI), provided demographic information, and indicated their perceptions of family and peer relationships, school function and pressures, and subjective health, and some measures salient to the Hong Kong environment: triad gang pressure, religiosity, and intent to emigrate. The correlation between C-BDI and these variables was assessed in bivariate and multivariate analyses. Results: Hong Kong adolescents reported higher levels of depressive symptoms than a comparison group of Western teenagers. Girls showed more symptoms than boys. All stressors correlated in bivariate analyses with C-BDI, indicating similar influences on depressed mood in Western and Hong Kong teenagers. In multivariate analyses, the stressors contributed cumulatively to the C-BDI score. Perceptions of a lack of parental understanding and peer acceptance appeared as the strongest variables in predicting depressed mood. Conclusions: Depressed mood is highly prevalent among Hong Kong teenagers. Stressors play a cumulative role in their relationship to mood. Our findings point to the importance of broad screening of this vulnerable population.

Study objective: To describe the prevalence of smoking in junior secondary school students in Hong Kong and to analyse the relationship between a range of risk factors and ever-smoking experience, including tobacco advertisements. Methods: Cross-sectional survey using an anonymous standardised self-administered questionnaire. Setting: 61 randomly selected secondary schools in Hong Kong. Participants: 6,304 form 1 to 3 Chinese students from 172 classes (51% girls and 49% boys; 90% were aged 12 to 15 years). Results: The smoking status (95% confidence interval) was: (1) never smoker, 71.1% (70.0%–72.2%), (2) tried only, 15.5% (14.6%–16.4%), (3) used to smoke but not now, 4.2% (3.7%–4.7%), (4) smoked 6 per week, 4.5% (4.0%–5.0%). In a backward stepwise logistic regression model, ever-smoking (including categories 2 to 6 above) was independently associated with thirteen factors, including gender (boys), increasing age, place of birth (outside Hong Kong, mainly China), poor knowledge of the hazards of smoking, positive attitudes to smoking, smoking in family members, participation in tobacco promotional activities, and perception of cigarette advertisements as attractive. Among the strongest associations observed was the youth’s perception of cigarette advertisements as attractive, with the adjusted odds ratio (95% confidence interval) of 2.68 (2.33–3.07). Conclusions: Smoking among young people is an important public health problem. Although the causes are multifactorial, in Hong Kong environmental tobacco advertising is an important risk factor that can be removed by banning all forms of tobacco promotion to young people.