Letters to the Editor
Table 1: Smoke-free home status and smoking
prevalence for persons born in Lebanon living in Sydney
in 1997 and 2001.
Changes in smoke-free home
status in an immigrant
Lebanese community in
Sydney, Australia
1997 telephone 2001 telephone
survey
n=242
%
survey
n=342
%
Smoke-free home status
My home is smoke free (includes
smoking is allowed outside only)
Li Ming Wen, Myna Hua and Chris Rissel
Health Promotion Unit, Central Sydney Area Health
Service, New South Wales
36.4
40.9
22.7
45.6
31.9
22.5
People occasionally smoke
in the house
People frequently smoke
in the house
The smoking prevalence among the Lebanese-born population
in Sydney, Australia, has been reported as significantly higher
than that in the general population (males 42% compared with
27%, and females 28% compared with 21%).1 Similarly, in 1998,
only about one-third (36%) of Lebanese households were smoke-
free, compared with 72% in New South Wales (NSW).2
Chi-square=6.155, df=2, p<0.05
Smoking prevalence
Males
Females
Total
42.5
27.7
34.0
38.7
21.5
27.5
While there is known variation in smoking status in NSW by
country of birth,3 it is unclear if rates of smoking in a particular
non-English speaking community are influenced by national
smoking cessation campaigns in English. There is some evidence
of general effects, with smoking rates in English and non-
English speaking adolescents being highly correlated over time
with relative funding of the Quit campaign during the 1980s and
early 1990s.4
in the “people occasionally smoke in the house” category.
There was also a reduction of smoking rates for both males and
females (see Table 1). However, these changes were not statisti-
cally significant. This could probably be explained by the small
sample size of the surveys, which have only enough power to
detect a 15% change in smoking prevalence among the survey
respondents.
To monitor changes in smoking prevalence and smoke-free
home status among the Sydney Lebanese-born population, tele-
phone surveys were conducted in 1997 and 2001 respectively (in
Arabic or English). The survey participants were randomly se-
lected according to postcodes with a high proportion of people
born in Lebanon and using typical Lebanese surnames identified
in the electronic telephone directory.1 Eligible households were
those with a member of the household aged 18 years and over
born in Lebanon. One eligible person per household was ran-
domly selected in both surveys. The 2001 survey sampling frame
differed only from the previous survey by covering a wider geo-
graphic areas. There were 242 completed interviews in the 1997
survey and 342 completed interviews in the 2001 survey, with
the response rates 74% and 82% respectively. The two samples
did not significantly differ by demographic characteristics.
In both surveys smoking status was assessed with the question:
“Which of the following best describes your smoking status: I smoke
daily, I smoke occasionally, I don’t smoke now but I used to, I have
tried it a few times but never regularly, or I’ve never smoked?”
Smoke-free home status was also assessed with the question:
“Which of the following best describe your home situation: my
home is smoke free, people occasionally smoke in the house, or
people frequently smoke in the house?” Chi-square tests were used
to compare proportions in determining the changes of smoking
status and smoke-free home status between the two surveys.
Compared with the 1997 survey, the proportion of smoke-free
homes significantly increased by almost 10% in the 2001 survey
(see Table 1). This was mainly due to the reduction of responses
The change in individual smoking status is consistent with the
results of the evaluation of the National Tobacco Campaign that
demonstrated a 1.8% reduction in prevalence over 18 months in
November 1998.5 Local tobacco control programs (including
tobacco cessation and smoke-free homes messages6,7) may have
added to the national campaign, but given their small budget could
at best have only had a modest impact. Recall of the national
program (48%) was more than twice as high (22%) as recall of
the local Arabic cessation message, although recall of the local
smoke-free homes campaign was good (53%).7
These data support the hypothesis that national campaigns (at
least tobacco control campaigns) can have a positive impact on
migrant communities.
Acknowledgements
The authors gratefully acknowledge the contributions of the
Smoke Free Home Project Team from the Central Sydney Area
Health Service and the Arabic Tobacco and Health Project Team.
References
1. Rissel C, Ward J, Jorm L. Estimates of smoking and related behaviour in an
immigrant Lebanese community: does survey method matter? Aust N Z J
Public Health 1999;23(5):534-7.
2. Health Status Profile for New South Wales. Sydney: Epidemiology and Sur-
veillance Branch, NSW Health, 1999.
3. Report on the 1997 and 1998 NSW Health Surveys. Sydney: Public Health
Division, NSW Health Department, 2001.
4. Chen J, Bauman A, Rissel C, Tang KC, Forero R, Flaherty B. Substance use
in high school students in New South Wales, Australia, in relationship to
language spoken at home. J Adolesc Health 2000;26(1):53-63.
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AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH
2002 VOL. 26 NO. 1
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