Table_1_Parental Knowledge, Attitude, and Practice on Tobacco Use, Smoking Cessation, and Children's Environmental Tobacco Smoke Exposure.DOCX

Background: Environmental tobacco smoke (ETS) exposure in children ranks one of the major public health problems in our time. Poor parental knowledge, attitude, and practice (KAP) on ETS often contribute to worse exposure of the kids. Thus, we aimed to document parental KAP regarding tobacco use, smoking cessation and children's ETS exposure, and to analyse how knowledge and attitude relate to practice.
Methods: Self-administered KAP questionnaires were distributed to smoking parents recruited from the pediatric unit at the Prince of Wales Hospital, which provides pediatric service to a population of 1.2 million in Hong Kong. The 60-item questionnaire had a range of 0–38 for knowledge, 0–44 for attitude, and 0–40 for practice. Descriptive analyses were performed for KAP response, regression analyses were performed for the exploration of associations and identification of predictive indicators.
Results: 145 smoking parents (mean age: 38.0 ± 6.7 yrs.; male: 85.5%) were included. Less than half (39.3%) of them reported a smoke-free policy at home. Among those parents who had private cars, less than half (45.2%) of them had smoke-free policy in their car that they never smoked in the car. Only 25.5% of the participants correctly answered ≥70% of the knowledge questions, and 11.8 % of the participants gave favorable responses to ≥70% of the attitude questions. The total knowledge and the total attitudes score were positively associated (r = 0.49, 95% CI: 0.35–0.79, p < 0.001), yet they were only modestly correlated with parental practice on children's ETS exposure. By multivariate regressions, potential predictive factors for more favorable parental KAP included higher household income, lower parental nicotine dependence level and breastfeeding practice.
Conclusions: Parental KAP related to tobacco use and children's ETS exposure needs improvement to address the significant gap between recommended and actual practice. The weak association between knowledge and practice suggested that parental education alone is not adequate to combat ETS exposure in children.

背景：儿童环境烟草烟雾（Environmental Tobacco Smoke, ETS）暴露是当代主要公共卫生问题之一。家长对ETS的认知、态度与行为（Knowledge, Attitude, Practice, KAP）不足，往往会加重儿童的暴露风险。因此，本研究旨在记录家长针对烟草使用、戒烟及儿童ETS暴露的KAP情况，并分析认知与态度如何影响行为。
方法：本研究向从香港威尔士亲王医院儿科招募的吸烟家长发放自填式KAP问卷；该医院为香港120万人口提供儿科诊疗服务。该问卷共包含60个条目，其中认知维度得分范围为0~38分，态度维度为0~44分，行为维度为0~40分。对KAP问卷结果进行描述性分析，并通过回归分析探索各维度间的关联及识别预测指标。
结果：本研究共纳入145名吸烟家长，平均年龄为38.0±6.7岁，男性占比85.5%。仅39.3%的家长表示家中实施了无烟政策。在拥有私家车的家长中，仅45.2%的人表示车内实施了无烟政策且从未在车内吸烟。仅有25.5%的参与者能正确回答≥70%的认知题目，11.8%的参与者对≥70%的态度题目给出了正向回应。认知总得分与态度总得分呈正相关（r=0.49，95%置信区间：0.35~0.79，p<0.001），但二者与家长针对儿童ETS暴露的行为仅存在中等程度的相关性。通过多变量回归分析发现，家长KAP表现更优的潜在预测因素包括更高的家庭收入、更低的尼古丁依赖程度及母乳喂养行为。
结论：与烟草使用及儿童ETS暴露相关的家长KAP水平有待提升，以弥补推荐行为与实际行为间的显著差距。认知与行为间的弱相关性表明，仅通过家长教育不足以有效防控儿童的ETS暴露问题。