We approached 8,687 Chinese adults and identified 7,898 eligible participants during the data collection period. Overall, 2,161 people refused to participate in the study because they were unable to stay for the 20 minutes required to complete the survey, while 5,737 people participated in the study and completed the survey, giving a response rate of 72.6%. Table 2 presents the demographic data of the participants. There were similar numbers of men and women, with a mean participant age of 49.4 ± 13.1 years. The majority of participants (77%) were between 30 and 60 years old. Most participants were married (69.8%) and employed (67.1%); approximately half (44.4%) had completed upper secondary school education, and 54% had a household income above the median. According to the locally adapted classification of BMI for Chinese adults in Hong Kong, 54.6% of the respondents were classified as normal (BMI 18.5 − 23.0), 17.1% as overweight (BMI 23.0 − 25.0), 17.1% as obese (BMI > 25.0) and 11.2% as underweight (BMI < 18.5).
Table 2
Demographic Characteristics of the Participants (N = 5737)
|
Frequency (No./Total No.)a
|
%
|
Age (Years)
|
|
|
30 to 40
|
1930/5737
|
33.6%
|
41 to 50
|
1480/5737
|
25.9%
|
61–70
|
794/5737
|
13.8%
|
71–80
|
384/5737
|
6.7%
|
Sex
|
|
|
Male
|
2867/5737
|
49.9%
|
Female
|
2870/5737
|
50.1%
|
Marital status
|
|
|
Single
|
1359/5346
|
25.4%
|
Married or cohabiting
|
3731/5346
|
69.8%
|
Divorced, separated, or widowed
|
256/5346
|
4.8%
|
Educational Attainment
|
|
|
Primary school or below
|
602/5364
|
11.2%
|
Lower secondary school
|
785/5364
|
14.7%
|
Upper secondary school
|
2383/5364
|
44.4%
|
Tertiary education
|
1594/5364
|
29.7%
|
Household income
|
|
|
HK$<20000
|
727/5737
|
12.7%
|
HK$20000 − 39999
|
1913/5737
|
33.3%
|
HK$40000 − 59999
|
1260/5737
|
22.0%
|
HK$60000 or above
|
1837/5737
|
32.0%
|
Employment status
|
|
|
Unemployed or retired
|
1878/5706
|
32.9%
|
Employed
|
3828/5706
|
67.1%
|
Body mass index classification
|
|
|
Underweight (< 18.5)
|
626/5580
|
11.2%
|
Normal (18.5 to 23.0)
|
3048/5580
|
54.6%
|
Overweight (23.0 to 25.0)
|
954/5580
|
17.1%
|
Obese (> 25)
|
952/5580
|
17.1%
|
Non-Communicable Diseases
|
|
|
3786/5728
|
66.1%
|
|
Diabetes
|
607/5728
|
10.6%
|
Chronic respiratory diseases,
|
173/5728
|
3.0%
|
Cardiovascular diseases
|
1095/5728
|
19.1%
|
Tobacco use
|
|
|
Smokers
|
704/5737
|
12.3%
|
Non-smokers
|
5033/5737
|
87.7%
|
Alcohol use
|
|
|
Drinkers
|
734/5737
|
12.8%
|
Non-drinkers
|
5005/5737
|
87.2%
|
Diet intake
|
|
|
Unhealthy diet intake
|
2353/5737
|
41.0%
|
Healthy diet intake
|
3384/5737
|
59.0%
|
Physical activity
|
|
|
No regular physical activity
|
4330/5737
|
75.5%
|
Have regular physical activity
|
1407/5737
|
24.5%
|
a Sample sizes varied because of missing data on some variables |
Health-risk behaviours
Of the 5,737 participants, 1,909 (33.3%) had one health-risk behaviour; 1,987 (34.6%) had two health-risk behaviours; 598 (10.4%) had three health-risk behaviours and 111 (1.9%) had four health-risk behaviours.
Smoking
Overall, 12.3% (704 of 5,735) of the respondents were current smokers at the time of the survey. Among the current smokers, the vast majority (93.5%; 658 of 704) were daily smokers, and 39.1% (275 of 704) reported smoking at least 11 cigarettes per day.
Alcohol consumption
During the year prior to the survey, 12.8% (734 of 5,737) of the participants consumed alcoholic beverages at least 1 day per week. Among this group, 38.4% (282 of 734) consumed alcohol at least three times per week, and 39.1% (287 of 734) reported that they had engaged in binge drinking (drinking five or more glasses/cans of alcohol on one occasion) during the past month.
Physical activity
During the 7 days prior to the survey, 75.5% (4,330 of 5,737) of the participants had not engaged in the WHO physical activity recommendation of at least 75 minutes of vigorous-intensity or 150 minutes moderate-intensity aerobic physical activity throughout the week.17
Fruit and vegetable consumption
During the 7 days prior to the survey, 2,353 (41.0%) of the participants had consumed less than the WHO recommendation of five servings of fruit and vegetables per day or had a daily intake of less than 400 grams of fruit and vegetables.18
Non-communicable diseases
A total of 33.9% (1,942 of 5,728) of participants reported that they had a NCD; 10.6% (607) had diabetes, 3.0% (173) had a chronic respiratory disease, 1.2% (67) had cancer and 19.1% (1,095) had cardiovascular disease.
Table 3 compares the demographic characteristics of the participants among the four health-risk behaviours. There were significant differences regarding gender. Compared with women, more men (53.9%; 2,484 of 4,605) had at least one health-risk behaviour. In particular, 77.7% (547 of 704) and 78.7% (578 of 734), respectively, of those who regularly smoked or consumed alcohol were men. With the exception of smoking, compared with participants with lower educational attainment, a higher proportion of those with tertiary education regularly consumed alcohol (45.7%, 331 of 725); had an unhealthy diet (40.6%, 947 of 2,330); and were physically inactive (41.8%, 1,792 of 4,289). Additionally, compared with those with lower household income, a higher proportion of participants with higher household income (HK $60,000 or above) were smokers (42.3%, 298 of 704); regularly consumed alcohol (35.7%, 262 of 734); had an unhealthy diet (37.3%, 879 of 2,330); and were physically inactive (31.5%, 1,362 of 4,289). Moreover, compared with participants with other health-risk behaviours, a higher proportion of smokers (50.9%, 358 of 703) and regular alcohol consumers (49.2%, 360 of 733) had NCDs. There were significant differences in NCDs among the four health-risk behaviours, with more smokers having chronic respiratory diseases (8.2%, 58 of 703) and cardiovascular diseases (26.9%, 189 of 703) and more alcohol consumers having diabetes (24.3%, 178 of 733).
Table 3
Demographic Characteristics of the Participants among the four health-risk behaviours (N = 4605)
|
Total
|
Smoking
|
Alcohol consumption
|
Unhealthy
Diet
|
Physical Inactivity
|
Physical Inactivity
|
|
Frequency No (%)
|
Age (Years)
|
(N = 4605)
|
(N = 704)
|
(N = 734)a
|
(N = 2353)
|
(N = 4330) a
|
(N = 4330)
|
30 to 40
|
1693 (36.8)
|
180 (25.6)
|
257 (35.0)
|
923 (39.2)
|
1586 (36.5)
|
1586 (36.5)
|
41 to 50
|
1181 (25.6)
|
210 (29.7)
|
190 (25.9)
|
602 (25.6)
|
1114 (25.7)
|
1114 (25.7)
|
51 to 60
|
768 (16.7)
|
148 (21.0)
|
143 (19.5)
|
374 (15.9)
|
721 (16.7)
|
721 (16.7)
|
61–70
|
586 (12.7)
|
113 (16.1)
|
88 (12.0)
|
269 (11.4)
|
548 (12.7)
|
548 (12.7)
|
71–80
|
275 (6.0)
|
47 (6.7)
|
48 (6.5)
|
133 (5.7)
|
263 (6.1)
|
263 (6.1)
|
81–90
|
102 (2.2)
|
6 (0.9)
|
8 (1.1)
|
52 (2.2)
|
98 (2.3)
|
98 (2.3)
|
Sex
|
(N = 4605)
|
(N = 704)
|
(N = 734)
|
(N = 2353)
|
(N = 4330) a
|
(N = 4330)a
|
Male
|
2484 (53.9)
|
547 (77.7)
|
578 (78.7)
|
1389 (59.0)
|
2293 (53.0)
|
2293 (53.0)
|
Female
|
2121 (46.1)
|
157 (22.3)
|
156 (21.3)
|
964 (41.0)
|
2037 (47.0)
|
2037 (47.0)
|
Marital status
|
(N = 4226) a
|
(N = 698)
|
(N = 729)
|
(N = 2335)
|
(N = 4302) a
|
(N = 4302) a
|
Single
|
1176 (27.6)
|
154 (22.1)
|
179 (24.6)
|
653 (28.0)
|
1084 (25.2)
|
1084 (25.2)
|
Married or cohabiting
|
2885 (67.6)
|
456 (65.3)
|
457 (62.6)
|
1405 (60.1)
|
2726 (63.4)
|
2726 (63.4)
|
Divorced, separated,
or widowed
|
205 (4.8)
|
88 (12.6)
|
93 (12.8)
|
277 (11.9)
|
492 (11.4)
|
492 (11.4)
|
Educational Attainment
|
(N = 4280) a
|
(N = 697)
|
(N = 725)
|
(N = 2330)
|
(N = 4289) a
|
(N = 4289)
|
Primary school or below
|
456 (10.7)
|
63 (9.0)
|
54 (7.4)
|
237 (10.2)
|
601 (14.0)
|
601 (14.0)
|
Lower secondary school
|
604 (14.1)
|
197 (28.3)
|
151(20.8)
|
450 (19.3)
|
659 (15.4)
|
659 (15.4)
|
Upper secondary school
|
1921 (44.9)
|
283 (40.6)
|
189 (26.1)
|
696 (29.9)
|
1237 (28.8)
|
1237 (28.8)
|
Tertiary education
|
1299 (30.3)
|
154 (22.1)
|
331 (45.7)
|
947 (40.6)
|
1792 (41.8)
|
1792 (41.8
|
Household Income
|
(N = 4605)
|
(N = 704)
|
(N = 734)
|
(N = 2353)
|
(N = 4302) a
|
(N = 4330)
|
HK$<20000
|
577 (12.5)
|
14 (2.0)
|
23 (3.1)
|
86 (3.7)
|
|
516 (11.9)
|
HK$20000 − 39999
|
1407 (30.6)
|
185 (26.3)
|
187 (25.5)
|
719 (30.6)
|
|
1343 (31.0)
|
HK$40000 − 59999
|
1197 (26.0)
|
207 (29.4)
|
262 (35.7)
|
669 (28.4)
|
|
1109 (25.6)
|
HK$60000 or above
|
1424 (30.9)
|
298 (42.3)
|
262 (35.7)
|
879 (37.3)
|
|
1362 (31.5)
|
Employment status
|
(N = 4578) a
|
(N = 699)
|
(N = 730)
|
(N = 2337)
|
(N = 4306) a
|
(N = 4306)
|
Unemployed or retired
|
1353 (29.6)
|
206 (29.5)
|
170 (23.3)
|
675 (28.9)
|
1280 (29.7)
|
1280 (29.7)
|
Employed
|
3225 (70.4)
|
493 (70.5)
|
560 (76.7)
|
1662 (71.1)
|
3026 (70.3)
|
3026 (70.3)
|
BMI
|
(N = 4456) a
|
(N = 679)
|
(N = 722)
|
(N = 2275)
|
(N = 4182) a
|
(N = 4182)
|
Underweight (< 18.5)
|
506 (11.4)
|
49 (7.2)
|
44 (6.1)
|
259 (11.4)
|
486 (11.6)
|
486 (11.6)
|
Normal (18.5 to 23.0)
|
2429 (54.5)
|
350 (51.5)
|
349 (48.3)
|
1199 (52.7)
|
2296 (54.9)
|
2296 (54.9)
|
Overweight (23.0 to 25.0)
|
725 (16.3)
|
131 (19.4)
|
138 (19.1)
|
365 (16.0)
|
680 (16.3)
|
680 (16.3)
|
Obese (> 25)
|
796 (17.8)
|
149 (21.9)
|
191 (26.5)
|
452 (19.9)
|
720 (17.2)
|
720 (17.2)
|
Non-Communicable Diseases
|
(N = 4596) a
|
(N = 703)
|
(N = 733)
|
(N = 2347)
|
(N = 4322) a
|
(N = 4322)
|
No
|
3063 (66.6)
|
345 (49.1)
|
373 (50.8)
|
1514 (64.5)
|
2848 (65.9)
|
2848 (65.9)
|
Diabetes
|
495 (10.8)
|
105 (14.9)
|
178 (24.3)
|
280 (11.9)
|
468 (10.8)
|
468 (10.8)
|
Chronic respiratory diseases
|
146 (3.2)
|
58 (8.2)
|
24 (3.3)
|
88 (3.7)
|
142 (3.3)
|
142 (3.3)
|
Cancer
|
43 (0.9)
|
6 (0.9)
|
7 (1.0)
|
19 (0.8)
|
40 (0.9)
|
40 (0.9)
|
Cardiovascular diseases
|
849 (18.5)
|
189 (26.9)
|
151 (20.6)
|
446 (19.1)
|
824 (19.1)
|
824 (19.1)
|
a Sample sizes varied because of missing data on some variables |
Table 4 compares the demographic characteristics of participants with different numbers of health-risk behaviours. There were significant differences regarding gender, with more women having only one health-risk behaviour (56.1%, 1,070 of 1,909) and more men having two or more health-risk behaviours. In particular, of the participants with three or four health-risk behaviours, 78.9% (472 of 598) and 92.8% (103 of 111) were men, respectively. Moreover, of those with three or four health-risk behaviours, a larger proportion were people with higher educational attainment or household income compared with those with lower educational attainment or household income. Additionally, a higher proportion of participants with four health-risk behaviours had NCDs (57.7%, 64 of 111) compared with those with only one health-risk behaviour (28.2%, 537 of 1,907).
Table 4
Demographic Characteristics of the Participants with different numbers of health-risk behaviours (N = 4605)
|
Total
|
One risk
|
Two risks
|
Three risks
|
Four risks
|
|
Frequency No (%)
|
Age (Years)
|
(N = 4605)
|
(N = 1909)
|
(N = 1987)
|
(N = 598)
|
(N = 111)
|
30 to 40
|
1693 (36.8)
|
688 (36.0)
|
787 (39.6)
|
188 (31.5)
|
30 (27.0)
|
41 to 50
|
1181 (25.6)
|
478 (25.0)
|
499 (25.1)
|
176 (29.4)
|
28 (25.3)
|
51 to 60
|
768 (16.7)
|
313 (16.5)
|
321 (16.2)
|
105 (17.6)
|
29 (26.1)
|
61–70
|
586 (12.7)
|
269 (14.1)
|
219 (11.0)
|
81 (13.5)
|
17 (15.3)
|
71–80
|
275 (6.0)
|
115 (6.0)
|
111 (5.6)
|
42 (7.0)
|
7 (6.3)
|
81–90
|
102 (2.2)
|
46 (2.4)
|
50 (2.5)
|
6 (1.0)
|
0 (0.0)
|
Sex
|
(N = 4605)
|
(N = 1909)
|
(N = 1987)
|
(N = 598)
|
(N = 111)
|
Male
|
2484 (53.9)
|
839 (43.9)
|
1070 (53.9)
|
472 (78.9)
|
103 (92.8)
|
Female
|
2121 (46.1)
|
1070 (56.1)
|
917 (46.1)
|
126 (21.1)
|
8 (7.2)
|
Marital status
|
(N = 4226) a
|
(N = 1771)
|
(N = 1846)
|
(N = 547)
|
(N = 102)
|
Single
|
1176 (27.6)
|
478 (27.0)
|
527 (28.5)
|
146 (26.7)
|
25 (24.5)
|
Married or cohabiting
|
2885 (67.6)
|
1231 (69.5)
|
1217 (65.9)
|
369 (67.5)
|
68 (66.7)
|
Divorced, separated,
or widowed
|
205 (4.8)
|
62 (3.5)
|
102 (5.6)
|
32 (5.8)
|
9 (8.8)
|
Educational Attainment
|
(N = 4280) a
|
(N = 1786)
|
(N = 1838)
|
(N = 548)
|
(N = 108)
|
Primary school or below
|
456 (10.7)
|
203 (11.4)
|
187 (10.2)
|
53 (9.7)
|
13 (12.0)
|
Lower secondary school
|
604 (14.1)
|
231 (12.9)
|
234 (12.7)
|
114 (20.8)
|
25 (23.1)
|
Upper secondary school
|
1921 (44.9)
|
879 (49.2)
|
830 (45.2)
|
183 (33.4)
|
29 (26.9)
|
Tertiary education
|
1299 (30.3)
|
473 (26.5)
|
587 (31.9)
|
198 (36.1)
|
41 (38.0)
|
Household Income
|
(N = 4605)
|
(N = 1909)
|
(N = 1987)
|
(N = 598)
|
(N = 111)
|
HK$<20000
|
577 (12.5)
|
520 (27.2)
|
52 (2.6)
|
5 (0.8)
|
0 (0.0)
|
HK$20000 − 39999
|
1407 (30.6)
|
551 (28.9)
|
707 (35.6)
|
127 (21.2)
|
22 (19.8)
|
HK$40000 − 59999
|
1197 (26.0)
|
450 (23.6)
|
478 (24.1)
|
235 (39.3)
|
34 (30.7)
|
HK$60000 or above
|
1424 (30.9)
|
388 (20.3)
|
750 (37.7)
|
231 (38.7)
|
55 (49.5)
|
Employment status
|
(N = 4578) a
|
(N = 1901)
|
(N = 1971)
|
(N = 595)
|
(N = 111)
|
Unemployed or retired
|
1353 (29.6)
|
588 (30.9)
|
583 (29.6)
|
151 (25.4)
|
31 (27.9)
|
Employed
|
3225 (70.4)
|
1313 (69.1)
|
1388 (70.4)
|
444 (74.6)
|
80 (72.1)
|
BMI
|
(N = 4456) a
|
(N = 1852)
|
(N = 1914)
|
(N = 582)
|
(N = 108)
|
Underweight (< 18.5)
|
506 (11.4)
|
235 (12.7)
|
218 (11.4)
|
45 (7.7)
|
8 (11.6)
|
Normal (18.5 to 23.0)
|
2429 (54.5)
|
1036 (55.9)
|
1067 (55.7)
|
280 (48.1)
|
46 (54.9)
|
Overweight (23.0 to 25.0)
|
725 (16.3)
|
293 (15.8)
|
299 (15.7)
|
109 (18.8)
|
24 (16.3)
|
Obese (> 25)
|
796 (17.8%)
|
288 (15.6)
|
330 (17.2)
|
148 (25.4)
|
30 (17.2)
|
Non-Communicable Diseases
|
(N = 4596) a
|
(N = 1907)
|
(N = 1980)
|
(N = 598)
|
(N = 111)
|
No
|
3063 (66.6)
|
1370 (71.8)
|
1316 (66.5)
|
330 (55.2)
|
47 (42.3)
|
Diabetes
|
495 (10.8)
|
176 (9.2)
|
217 (11.0)
|
87 (14.5)
|
15 (13.6)
|
Chronic respiratory diseases
|
146 (3.2)
|
37 (1.9)
|
62 (3.1)
|
37 (6.2)
|
10 (9.0)
|
Cancer
|
43 (0.9)
|
21 (1.1)
|
16 (0.8)
|
5 (0.9)
|
1 (0.9)
|
Cardiovascular diseases
|
849 (18.5)
|
303 (16.0)
|
369 (18.6)
|
139 (23.2)
|
38 (34.2)
|
a Sample sizes varied because of missing data on some variables
|
Table 5 shows the clustering of four health-risk behaviours. Among all health-risk behaviours, smokers had the highest proportion of those with multiple health-risk behaviours (97.6%, 687 of 704). Those who regularly consumed alcohol had the second-highest proportion of having multiple health-risk behaviours, with 94.7% (695 of 734) having more than one health-risk behaviour.
Table 5
The clustering of four health-risk behaviours (N = 4605)
|
One risk behaviour
|
Two risk behaviours
|
Three risk behaviours
|
Four risk behaviours
|
|
Frequency [No./Total No. (%)]
|
Smoking
|
17/704 (2.4)
|
197/704 (28.0)
|
379/704 (53.8%)
|
111/704 (15.8)
|
Alcohol consumption
|
39/734 (5.3)
|
258/734 (35.1)
|
326/734 (44.4)
|
111/734 (15.1)
|
Unhealthy diet
|
141/2353 (6.0)
|
1584/2353 (67.3)
|
517/2353 (22.0)
|
111/2353 (4.7)
|
Physical inactivity
|
1712/4330 (39.5)
|
1935/4330 (44.7)
|
572/4330 (13.2)
|
111/4330 (2.6)
|
Total
|
1909/4605 (41.5)
|
1987/4605 (43.1)
|
598/4605 (13.0%)
|
111/4605 (2.4)
|
The results also revealed clustering patterns of multiple health-risk behaviours. Of the 704 smokers, 231 (32.8%) regularly consumed alcohol. In addition, of the 4,330 respondents who were physically inactive, 2,147 (49.6%) had an unhealthy diet.