Introduction: Mobile instant messaging could deliver real-time, personalized, interactive smoking cessation support. Nicotine replacement therapy (NRT) is effective in increasing quit attempts and abstinence but is underused. We assessed the feasibility of mobile chat-based intervention...

Background: Mobile instant messaging (IM) apps (eg, WhatsApp and WeChat) have been widely used by the general population and are more interactive than text-based programs (SMS text messaging) to modify unhealthy lifestyles. Little is known about IM app use for health promotion, including alcohol reduction for university students. Objective: This study aims to explore university student drinkers' perceptions of using IM apps for alcohol reduction as they had high alcohol exposure (eg, drinking invitations from peers and alcohol promotion on campus) and the proportion of IM app use in Hong Kong. Methods: A qualitative study was conducted with 20 Hong Kong Chinese university students (current drinkers) with Alcohol Use Disorder Identification test scores of ≥8 recruited using purposive sampling. Semistructured individual interviews were conducted from September to October 2019. Interview questions focused on drinking behaviors, quitting history, opinions toward IM app use as an intervention tool, perceived usefulness of IM apps for alcohol reduction, and opinions on the content and design of IM apps for alcohol reduction. Each interview lasted approximately 1 hour. All interviews were audio-taped and transcribed verbatim. Two researchers independently analyzed the transcripts using thematic analysis with an additional investigator to verify the consistency of the coding. Results: Participants considered IM apps a feasible and acceptable platform for alcohol reduction intervention. They preferred to receive IMs based on personalized problem-solving and drinking consequences with credible sources. Other perceived important components of instant messages included providing psychosocial support in time and setting goals with participants to reduce drinking. They further provided suggestions on the designs of IM interventions, in which they preferred simple and concise messages, chat styles based on participants' preferences (eg, adding personalized emojis and stickers in the chat), and peers as counselors. Conclusions: Qualitative interviews with Chinese university student drinkers showed high acceptability, engagement, and perceived utility of IM apps for alcohol reduction intervention. IM intervention can be an alternative for alcohol reduction intervention apart from traditional text-based programs. The study has implications for developing the IM intervention for other unhealthy behaviors and highlights important topics that warrant future research, including substance use and physical inactivity. Trial Registration: ClinicalTrials.gov NCT04025151; https://clinicaltrials.gov/ct2/show/NCT04025151?term=NCT04025151

Background: Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method: A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results: Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions: Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

Background: eHealth literacy is important for older adults to be able to seek and evaluate online health information. However, there is a scarcity of large-scale data on their eHealth literacy levels, particularly among the oldest older individuals (aged >75 years) in unique, high-income Asian regions such as Hong Kong. A comprehensive understanding of how eHealth literacy is associated with specific health behaviors, mental well-being, and physical health outcomes in this population is lacking. Objective: This study aims to assess the level of eHealth literacy and its associations with health behaviors and health-related outcomes among older adults in Hong Kong. Methods: We conducted a cross-sectional analysis of baseline data from the Generations Connect Project. This is an ongoing large-scale community-based project, where we trained university students to conduct home visits and assess the health status of older adults (N=6704) in Hong Kong. eHealth literacy was measured using the eHealth Literacy Scale (eHEALS; score: 8‐40). Health behavior measurements included physical activity levels (metabolic equivalent of task minutes per week) and smoking, drinking, and eating habits. Mental well-being was measured using the World Health Organization-Five Well-Being Index (percentage score: 0‐100) and UCLA 3-item Loneliness Scale (score: 3‐9). Physical health was assessed on the basis of self-reported medical diagnosis of noncommunicable diseases (yes/no), including hypertension, diabetes, cardiovascular disease, and stroke. Adjusted unstandardized coefficients (b) and odds ratios (ORs) were calculated to determine the associations between variables. Results: Among the 6704 participants (mean age 77.8, SD 7.0 years), the mean eHEALS score was 18.2 (SD 10.2), and 44.1% (2897/6566) of the participants had inadequate eHealth literacy (score: 8‐15.99). Increasing age (adjusted b −0.32, 95% CI −0.35 to −0.28; P <.001), support from the Comprehensive Social Security Assistance Scheme (adjusted b −1.49, 95% CI −2.04 to −0.95; P <.001), and living in public housing (adjusted b −1.60, 95% CI −2.69 to −0.50; P =.004) were associated with a lower eHEALS score. Participants with moderate eHealth literacy (score: 24‐31.99) were less likely to be current smokers (adjusted OR 0.60, 95% CI 0.38-0.95; P =.04), more physically active (adjusted b 39.83, 95% CI 2.04-77.62; P =.04), more likely to be community health center members (adjusted OR 1.52, 95% CI 1.30-1.77; P <.001) and to have healthy diets (adjusted b 0.034, 95% CI 0.006-0.063; P =.04), and less likely to have a medical diagnosis of diabetes (adjusted OR 0.73, 95% CI 0.62-0.85; P <.001). Moreover, they had a higher score on the World Health Organization-Five Well-being Index (adjusted b 2.89, 95% CI 1.42-4.36; P <.001) and a lower score on the UCLA 3-item Loneliness Scale (adjusted b −0.26, 95% CI −0.37 to −0.15; P <.001). Conclusions: The level of eHealth literacy was low among older adults in Hong Kong. eHealth literacy was associated with positive health behaviors and health-related outcomes. Interventions are warranted to boost their eHealth literacy in the future.

Passive drinking is prevalent in adolescents worldwide, but its prevalence and harm are understudied. Secondary students (n = 5840, grades 7–12) from 23 selected schools in Hong Kong participated in the survey from 2015–16. Students reported the harm of passive drinking, perceived health status (Patient Health Questionnaire-2 and Perceived Stress Scale-4), perceived happiness, and family health, happiness, and harmony in the questionnaire. The associations were analyzed using multivariable logistic regression (odds ratio, OR) and linear regression (unstandardized coefficient, b), adjusted for confounders. It was found that 29.1% (95% CI 27.8 to 30.5%) of students experienced passive drinking in the past 30 days. The past 30-day parental passive drinking was associated with a higher level of depressive symptoms (AOR 1.63, 95% CI 1.26 to 2.10), stress (adjusted b 0.76, 0.42 to 1.10), and lower level of perceived happiness (adjusted b −0.52, −0.72 to −0.33). The past 30-day parental passive drinking was associated with a lower level of family health (adjusted b −1.39, 95% CI −1.66 to −1.11), family happiness (adjusted b −1.36, −1.64 to −1.08), and family harmony (adjusted b −1.40, −1.70 to −1.10). Passive drinking was associated with poorer mental health, family wellbeing, and a lower level of happiness among Hong Kong Chinese adolescents.