i51 Tob Control: first published as 10.1136/tc.2004.008011 on 27 May 2005. Downloaded from RESEARCH PAPER Smoking behaviour in Taiwan, 2001 C-P Wen, D T Levy, T Yuan Cheng, C C Hsu, S P Tsai ............................................................................................................................... Tobacco Control 2005;14(Suppl I):i51–i55. doi: 10.1136/tc.2004.008011 Purpose: To examine smoking behaviours in Taiwan and compare those behaviours to those in the USA. Methods: Using the National Health Interview Survey (NHIS) of Taiwan (2001), a survey of over 20 000 participants, frequencies were calculated for smoking, ex-smoking, quantity smoked, and exposure to environmental tobacco smoke (ETS). Breakdowns by age, sex, and socioeconomic status were also calculated. Results: The ratio of male to female smoking rates was 10.9 to 1 among adults (46.8%/4.3%), but 3.6 to 1 among underage teenagers (14.3%/4.0%). The proportion of underage to adult smokers was three times higher for girls than for boys. Smoking prevalence substantially increased during and after high school years, and peaked in those aged 30–39 years. Smoking rates of high school age adolescents increased more than threefold if they did not attend school or if they finished their education after high school. Low See end of article for income and less educated smokers smoked at nearly twice the rate of high income and better educated authors’ affiliations ....................... smokers. The smoker/ex-smoker ratio was close to 7. Male daily smokers smoked on average 17 cigarettes/day, and females, 11. Half of the total population, especially infants and women of Correspondence to: childbearing age, were exposed to ETS at home. Chi Pang Wen, National Health Research Institutes, Conclusions: Taiwan has particularly high male smoking prevalence and much lower female prevalence. 35 Keyan Road, Zhunan The low female prevalence is likely to increase if the current sex ratio of smoking by underage youth Town, Miaoli County, continues. The low quit rate among males, the high ETS exposure of females and young children at home, Taiwan 350; Cwengood@ and the sharp increase in smoking rates when students leave school, are of particular concern. These nhri.org.tw observations on smoking behaviour can provide valuable insights to assist policymakers and health ....................... educators in formulating strategies and allocating resources in tobacco control. he proportion of the population who smoke and who In all, 6592 households (23473 persons) were sampled quit, their sociodemographic distribution and character- from the Taiwan area. Development of questionnaires was Tistics, the smoking intensity and the age of smoking based on the Department of Health (DOH) needs of health http://tobaccocontrol.bmj.com/ initiation, and exposure to environmental tobacco smoke indicators and the nature and nurture factors affecting (ETS) vary considerably from nation to nation.1 The extent of health. The final version of the questionnaire was composed these differences has not been carefully studied, particularly of five parts: household interview, individuals older than 12 among non-Western nations,2–5 due to the lack of quality data years interview, individuals younger than 12 years interview, that can provide in depth analysis. Information on these self administered questionnaire for teenagers between 12 and smoking behaviours can form the basis for policy formulation 17 years, and World Health Organization quality of life on tobacco control programmes and serve as important interview for adults aged 20 to 65 years. indicators for their evaluation.6–8 This paper examines the Respondents were first asked whether they had smoked at recent information on smoking behaviours in Taiwan, and least 100 cigarettes in their lifetime, and then asked whether highlights those characteristics that are distinctly different they currently smoked.11 Those who smoked were asked if from those in the USA. they currently smoked everyday, some days or not at all. Current smokers were also asked for the number of cigarettes on October 4, 2021 by guest. Protected copyright. they smoked on an average day. ‘‘Never smokers’’ were those METHODS who had not smoked 100 cigarettes in their lifetime. The data used in this study are from the National Health Individuals who had smoked 100 cigarettes in their lifetime Interview Survey (NHIS) of Taiwan (2001) conducted by the were either a ‘‘current smoker’’ or ‘‘ex-smoker’’. Smokers National Health Research Institutes and Bureau of Health were classified as ‘‘daily smokers’’ if they smoked every day 910 Promotion, Taiwan. This survey incorporated a multi- in the last 30 days, ‘‘occasional smokers’’ if they smoked 1 to staged stratified systematic sampling scheme. It first divided 29 of the last 30 days, and ‘‘ex-smokers’’ if they did not 359 township/districts of Taiwan into seven strata according smoke in the last 30 days. to geographic location and degree of urbanisation. Townships Estimates are also presented on the average number of or districts in each stratum were selected by probability cigarettes smoked per day by daily smokers. Data on the age proportional to their size (PPS). In each selected township/ of initiation were based on the question, ‘‘When did you district, lins (the smallest administrative unit) were selected begin to smoke regularly?’’. Initiation age for smokers age 18 with PPS. Four households were selected randomly from or older was expressed as a median, using a birth cohort each selected lin. Each mentally competent member aged method.12 12 years and above in the selected household was to be When NHIS interviewed 2540 adolescents aged 12–17, they interviewed. The survey was in person and voluntary, with a were also given questionnaires to answer questions on token gift presented at the end of the interview. The response aspects of health risk behaviour. The questionnaires were rate was 94.2%. The survey quality was assured by using self administered in private and with confidentiality assured. experienced interviewers implementing standardised inter- Smoking rates are based on the same definitions as used with view protocols. adults. www.tobaccocontrol.com i52 Wen, Levy, Cheng, et al Tob Control: first published as 10.1136/tc.2004.008011 on 27 May 2005. Downloaded from Table 1 Adult smoking rates by age, education, profession and incomeÀ in Taiwan, 2001 Current smoker n Non-smoker Ex-smoker Total Someday Daily Male Ages 18 years and over (crude) 7967 46.4 (0.56) 7.1 (0.29) 46.5 (0.56) 3.0 (0.19) 43.5 (0.56) Ages 18 years and over (age adjusted)` 46.4 (0.56) 6.8 (0.28) 46.8 (0.56) 3.1 (0.19) 43.7 (0.56) Age 18–19 381 75.3 (2.21) *0.3 (0.28) 24.1 (2.19) 3.1 (0.89) 21.3 (2.10) 20–29 1750 53.8 (1.19) 1.7 (0.31) 44.5 (1.19) 4.2 (0.48) 40.3 (1.17) 30–39 1731 38.4 (1.17) 4.5 (0.50) 57.1 (1.19) 3.4 (0.44) 53.7 (1.20) 40–49 1648 41.5 (1.21) 6.9 (0.62) 51.6 (1.23) 2.9 (0.41) 48.7 (1.23) 50–59 1010 44.9 (1.57) 8.0 (0.85) 47.1 (1.57) 2.7 (0.51) 44.4 (1.56) 60–69 743 45.8 (1.83) 13.3 (1.25) 40.9 (1.80) 2.4 (0.56) 38.5 (1.79) 70 or above 704 46.6 (1.88) 22.9 (1.58) 30.5 (1.74) *0.7 (0.31) 29.8 (1.72) Education (25–64 years old) Elementary (grade 6 or below) 1123 39.8 (1.46) 7.8 (0.80) 52.4 (1.49) 2.0 (0.42) 50.4 (1.49) Middle school (grade 7–9) 1081 27.8 (1.36) 4.4 (0.62) 67.8 (1.42) 2.8 (0.50) 65.0 (1.45) High school (grade 10–12) 1795 36.7 (1.14) 6.1 (0.56) 57.2 (1.17) 3.7 (0.45) 53.5 (1.18) College or above 1616 60.3 (1.22) 5.7 (0.58) 34.0 (1.18) 4.0 (0.49) 30.0 (1.14) Profession (25–64 years old) White collar 2529 49.2 (0.99) 6.0 (0.47) 44.8 (0.99) 4.2 (0.40) 40.6 (0.98) Blue collar 1368 33.4 (1.28) 5.4 (0.61) 61.2 (1.32) 2.8 (0.45) 58.4 (1.33) Service industry 467 39.6 (2.26) 3.9 (0.90) 56.5 (2.29) *2.1 (0.66) 54.4 (2.30) Annual income (NT) (25–64 years old) (240000 (US$6857) 1523 37.4 (1.24) 6.6 (0.64) 56.0 (1.27) 2.4 (0.39) 53.6 (1.28) (480000 (US$13714) 1971 39.3 (1.10) 4.8 (0.48) 55.9 (1.12) 3.2 (0.40) 52.7 (1.12) (960000 (US$ 27428) 1804 47.1 (1.18) 7.2 (0.61) 45.7 (1.17) 3.6 (0.44) 42.1 (1.16) .960000 (US$27428) 287 60.6 (2.88) 4.2 (1.18) 35.2 (2.82) 6.3 (1.43) 28.9 (2.68) Female Ages 18 years and over (crude) 8154 95.3 (0.23) 0.5 (0.08) 4.2 (0.22) 0.6 (0.09) 3.6 (0.21) Ages 18 years and over (age adjusted)` 95.9 (0.22) 0.5 (0.08) 4.3 (0.22) 0.6 (0.09) 3.6 (0.21) Age 18–19 342 95.9 (1.07) *0.3 (0.30) 3.8 (1.03) *1.2 (0.59) *2.6 (0.86) 20–29 1798 95.3 (0.50) *0.2 (0.11) 4.5 (0.49) 0.7 (0.20) 3.7 (0.45) 30–39 1743 96.7 (0.43) *0.6 (0.18) 5.7 (0.56) 1.0 (0.24) 4.7 (0.51) 40–49 1721 95.9 (0.48) *0.2 (0.11) 3.8 (0.46) *0.4 (0.15) 3.4 (0.44) 50–59 1093 95.7 (0.61) *0.4 (0.19) 3.9 (0.59) *0.5 (0.21) 3.5 (0.56) 60–69 822 95.6 (0.72) *1.2 (0.38) 3.2 (0.61) *0.3 (0.19) 2.9 (0.59) 70 or above 635 96.4 (0.74) *1.1 (0.41) 2.5 (0.62) *0.3 (0.22) 2.2 (0.58) Education (25–64 years old) Elementary (grade 6 or below) 1922 95.3 (0.48) *0.4 (0.15) 4.3 (0.46) *0.4 (0.14) 4.0 (0.44) Middle school (grade 7–9) 921 92.9 (0.84) *0.2 (0.15) 6.8 (0.83) *0.9 (0.31) 6.0 (0.78) High school (grade 10–12) 1785 93.8 (0.57) *0.6 (0.19) 5.6 (0.54) 1.1 (0.24) 4.5 (0.49) http://tobaccocontrol.bmj.com/ College or above 1249 98.1 (0.39) *0.4 (0.18) 1.5 (0.35) *0.2 (0.14) 1.3 (0.32) Profession (25–64 years old) White collar 1935 95.6 (0.47) *0.5 (0.16) 3.9 (0.44) 0.7 (0.19) 3.2 (0.40) Blue collar 704 97.9 (0.54) - 2.1 (0.54) *0.1 (0.14) 2.0 (0.53) Service industry 607 91.8 (1.12) *0.8 (0.37) 7.4 (1.06) *1.3 (0.46) 6.1 (0.97) Annual income (NT) (25–64 years old) (240000 (US$6857) 3544 95.1 (0.36) 0.5 (0.11) 4.4 (0.34) 0.6 (0.13) 3.8 (0.32) (480000 (US$13714) 1549 94.5 (0.58) *0.5 (0.18) 5.0 (0.55) *0.5 (0.17) 4.5 (0.53) (960000 (US$27428) 675 95.4 (0.81) *0.3 (0.21) 4.3 (0.78) *1.2 (0.42) 3.1 (0.67) .960000 (US$27428) 71 98.6 (1.40) - *1.4 (1.40) - *1.4 (1.40) *Estimates having an RSE (relative standard error) of more than 30% are indicated.