C. L. Betson

A prospective analysis of stress and academic performance in the first two years of medical school

This study provides prospective, longitudinal data on the relationship between stress‐related measures and academic performance during the first two years of medical school.

The correlates of depressed mood in adolescents in Hong Kong

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.

Tobacco advertisements: One of the strongest risk factors for smoking in Hong Kong students

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 < 1 cigarette per week, 2.9% (2.5%-3.4%), (5) smoked 1-6 per week, 1.7% (1.4%-2.0%), and (6) 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 youths 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.

A randomized controlled trial of smoking cessation in Government out-patient clinics in Hong Kong

A review of the smoking cessation pattern in Hong Kong in 1984–90 reveals that the role of doctors remains static. Only 25% of smokers quit on a doctor’s advice (Lam et al., 1994). Very few facilities such as smoking cessation clinics and self-help materials (e. g. booklets and leaflets) are available, and those which are available are limited and their effectiveness has not been evaluated. In addition, the Government clinics in Hong Kong are extremely busy, so that doctors spend an average of 3–5 min with each patient and often see nearly 100 patients a day.

A Smoking Intervention Programme for Primary School Students in Hong Kong

This study was designed to evaluate a smoking prevention programme targeted at primary school children. The objectives were to: 1) assess the feasibility of the programme; 2) increase the children’s awareness of the purposes of tobacco advertising; 3) record any change in attitude towards smoking and 4) measure the effects on the children’s knowledge about the harmful effects of smoking.

Tobacco advertisements were associated with positive attitudes to smoking among children who had never smoked

Many studies have shown that tobacco advertisements and positive attitudes to smoking, as well as other factors such as family smoking and peer influence, are associated with the smoking behaviour of children. In our cross-sectional study on 6304 junior secondary-school students (forms 1–3, aged mainly 12–15 years), we found that the students’ perception of cigarette advertisements as attractive was strongly associated with smoking experience (Lam et al., 1994). Other factors associated with any smoking were knowledge about the hazards of smoking, positive attitudes to smoking and smoking by the family, schoolteachers and peers (Lam et al., 1995). The association was examined in this and other studies by comparing children who smoked with children who did not. All the risk factors, such as attitudes to smoking, were treated as independent variables, whereas smoking (yes versus no) was the dependent variable. Few studies have addressed children who have never smoked and the factors associated with positive attitudes (as the dependent variables). The aim of this study was to examine factors associated with positive attitudes to smoking among children who had never smoked from the above-mentioned data on 6304 students.

Factors Associated with Smoking in Primary Schools in Hong Kong

Hong Kong is the most important commercial gateway to China. It also serves the tobacco industry as an important platform for the promotion and distribution of imported cigarettes. In Hong Kong massive outdoor hoardings and monolithic displays running from ground to roof-tops ofhighrise buildings are prominent features of the environment. Sporting event sponsorship and other promotional activities are commonplace and legal. The Christmas and New Year illuminations have included the Salem Santa Claus in glorious technicolour. Until October 1994 there were no legal restrictions on the sale of tobacco to minors nor on the distribution of cigarettes as gifts or other promotional activities based on exchangeable vouchers for movie shows, discos and other entertainments.