The Prevalence of Multiple Risk Behaviours and Its Association With Health Consequence Among Hong Kong Chinese Adults

Non-communicable diseases (NCDs), including cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, are the most common and preventable causes of morbidity and mortality both globally and locally. According to the World Health Organization (WHO), 41 million (71%) of the 57.7 million global deaths each year are attributed to NCDs. NCDs are often associated with older age groups, but evidence shows that more than 15 million of all deaths attributed to NCDs occur between the ages of 30 and 69 years. The total number of annual deaths of NCDs will further increase to 55 million by 2030 unless urgent preventive measures are taken.

Hong Kong is facing an increasing threat of NCDs, which is compounded by population ageing. In 2016, 25,771 registered deaths (approximately 55%) were attributed to NCDs. In addition, NCDs caused 104,600 potential years of life lost before 70 years of age.

WHO has identified four major behavioural risk factors - tobacco use, harmful use of alcohol, an unhealthy diet and physical inactivity - that contribute substantially to NCDs and can increase the risk of death. Most premature deaths from NCDs are preventable via lifestyle modification. Therefore, helping people adopting healthy lifestyle practices, such as having a balanced diet and engaging in regular physical activity, and quitting health-risk behaviours, such as smoking and harmful use of alcohol can help prevent NCDs and improve quality of life and the overall health of the population. However, many people are unmotivated or find it difficult to modify their risk behaviours, despite their awareness of the associated health hazards. Our previous studies showed that many smokers continued to smoke even after receiving a diagnosis of cancer, diabetes or cardiovascular disease. In addition, health risk behaviours co-occur in clusters and that many people exhibit multiple risk behaviours. A sample of 16,818 adults from the 1998 US National Health Interview Survey revealed that 52% had two or more risk behaviours, including physical inactivity, overweight, cigarette smoking and risky drinking. Our previous study in Hong Kong also found associations between smoking and physical inactivity, an unhealthy diet and alcohol consumption. People with multiple health risk behaviours are usually associated with a higher increased risk of NCDs and face more challenges in the adoption of a healthy lifestyle than those with a single health risk behaviour. A review of the literature reveals that most interventions have been developed and evaluated targeted at people with single risk behaviour rather than multiple risk behaviours. It is crucial therefore to develop and evaluate appropriate interventions that targeting people with multiple risk behaviours with the aim to help them quit health-risk behaviours and adopt a healthy lifestyle, either sequentially or concurrently. First, however, a thorough understanding of the clustering of multiple health risk behaviours and the factors associated with such behaviours are crucial before any appropriate interventions can be developed and evaluated. The aim of the study is to investigate the prevalence of multiple risk behaviours and their association with health consequences among people aged 30 years or above. The objectives of the study are:

1. To investigate the clustering patterns of multiple health risk behaviours;
2. To identify factors associated with multiple risk behaviours; and
3. To find out the association between risk behaviours and non-communicable diseases.