Strengthen Women-oriented Smoking Cessation Services
2014.06.19Hong Kong Council on Smoking and Health (COSH) draws the public attention on women smoking in Hong Kong and advocates the Government for increasing resources on women-oriented smoking cessation services. Lisa LAU, Chairman of COSH says, “The number of daily smokers, including male daily smokers has decreased gradually over the years. However, the number of female daily smokers in 2012 increased by 72.5% as compared with 1990. We deeply concern the prevalence of women smoking.”
According to the Thematic Household Survey Report No. 53 released by the Census and Statistics Department, the smoking prevalence in Hong Kong is 10.7% now which is equivalent to around 645,000 smokers. The smoking rates of male and female were 19.1% and 3.1 % respectively. Though the female smoking prevalence remained at around 3% to 4% in recent years, the number of female daily smokers increased from the record low 56,100 in 1990 to 96,800 in 2012. Female daily smokers aged 30-49 increased drastically (30-39 age group: increased from 2.4% in 1990 to 6.5% in 2012; 40-49 age group: increased from 1.6% to 4.2%). Nearly 60% of female smokers have never tried to quit smoking.
COSH has commissioned the School of Nursing and School of Public Health of The University of Hong Kong to conduct the “Smoking and Health Survey in Hong Kong Women” to understand the trend and characteristics of women smoking in Hong Kong. The survey was divided into two phases. Phase one was a series of qualitative focus group interviews. A total of 73 women participated, comprising 29 never smokers, 24 current smokers and 20 ex-smokers.
The survey shows that emotional problems and stress are some of the most important factors explaining why female smokers start and continue to smoke. The results align with the Thematic Household Survey Report No. 53 which shows that more female smokers failed to give up smoking due to “necessity of easing tension” than male smokers. Dr William LI, Assistant Professor, School of Nursing, The University of Hong Kong elaborates, “Many informants did not realize the female-specific health consequences of smoking like premature skin aging, cervical cancer, osteoporosis and early menopause. They also had misunderstandings on smoking cessation. For example, some were afraid of
gaining weight if they gave up smoking.”
It is well known that smoking causes many fatal diseases. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General published by the United States Department of Health and Human Services in 2014 expanded the list of health consequences causally linked to smoking. The new diseases include liver cancer, colorectal cancer and tuberculosis. Female-related diseases include ectopic pregnancy and congenital defects: orofacial clefts caused by maternal smoking. Prof LAM Tai-hing, Chair Professor of Community Medicine cum Sir Robert Kotewall Professor in Public Health, School of Public Health, The University of Hong Kong explains, “The World Health Organization points out that one out of two smokers will be killed by smoking. Recent medical research indicates that the risk is even higher. Two out of three smokers will die early from smoking-attributed diseases and their life span will be shortened by over 10 years. More than 90% of the extra risk can be avoided if you quit before 40 year-old.”
Phase two of the research was a population-based women survey conducted from 2011 to 2012, interviewing a total of 3,306 female, including 2,032 never smokers, 765 current smokers and 509 ex-smokers. Results show that “curiosity” (44.8%) and “peer influence” (37%) are the key reasons for first smoking attempt among current smokers and ex-smokers. Most current smokers continue to smoke because “smoking becomes a habit” (26.9%) and “craving” (24.3%). It is also found that around 37% of current smokers are occasional smokers and the nicotine dependency of more than half of the daily smokers is mild. It reflects that the quit rate of female smokers in Hong Kong can be enhanced if suitable smoking cessation services are provided. For example, the quit rate of women quitline of The University of Hong Kong is higher than the other cessation services.
Women Quit, the first smoking cessation hotline for female smokers in Hong Kong was established in 2006 by School of Nursing and School of Public Health, The University of Hong Kong. Tailor-made smoking cessation counseling is provided by experienced smoking cessation counsellors. Nearly 1,000 enquires were received and more than half of them received face-to-face or telephone smoking cessation counselling. The self-reported quit rate among the participants was around 30% in 6-month follow-up which is higher than other cessation services (around 20%). It shows that a specially-designed smoking cessation service for women smokers can increase the quit rate.
Ex-smoker Ms WONG Lai-lee, aged 36 and had smoked since 17 year–old with about two packets a day. She stopped smoking when she was pregnant but relapsed afterwards. When she noticed the adverse effects of smoking and secondhand smoke on her children and herself, she decided to kick the habit and seek assistance from the Women Quit in 2010. She has enjoyed a smoke-free lifestyle for two and a half years already.
Antonio KWONG, Vice-chairman of COSH says, “Women smokers have unique characteristics and special needs, tailor-made smoking cessation services with psychological and emotional support to reduce their dependency on smoking are vital.” COSH concerns the prevalence of women smoking in Hong Kong and advocates the Government for formulating long-term tobacco control policies which include setting aside sustainable funding for specially-designed women smoking cessation services, educating the public on gender-specific health hazards of smoking and developing tailor-made marketing strategies to raise the public awareness on the issues of women smoking and promote the smoking cessation services , exerting the influence of female in the community and family, as well as motivating non-smokers as peer support group to women smokers. COSH hopes to lower the number of women smokers in the near future. Let’s strive for a smoke-free family.
COSH advocates the Government for setting aside a sustainable funding for women cessation services, educating the public on gender-specific health hazards of smoking and motivating non-smokers to participate in smoke-free activities.
The number of smokers, including male smokers has decreased gradually while the number of female daily smokers in 2012 increased by 72.5% as compared with 1990.
Ms WONG Lai-lee, who smoked for more than 10 years, gave up smoking with the help of the Women Quit cessation hotline of The University of Hong Kong.