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Title: The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong : a phenomenological study
Authors: Mak, YW 
Leung, D
Loke, AY
Issue Date: 2019
Source: BMC pediatrics, 2019, v. 19, no. 1, 303
Abstract: Background: In Hong Kong, the use of alcohol, tobacco, and other drugs (ATOD) is associated with strong peer influences; frequently absent parents; academic pressures; and a lack of interpersonal skills to cope with stress and conflict. It is posited that this social context alters the nature of the adolescent risk of using ATOD. The study aimed to explore how social interactions in their local context shape experiences of adolescents who smoke or use alcohol with their parents and other significant people (e.g., teachers, peers) in their lives.
Results: The participants consistently indicated that the communication of risk was fundamentally influenced by the attachment between the primary parent(s) and the child. In secure attachments, parents could positively discourage ATOD use by instilling fear or expressing regret or disappointment over its use. However, some parents expressed an overly permissive attitude about ATOD use, or stated that they had a limited ability to influence their child, or that the harm arising from their child's use of ATOD would be minimal. Under these conditions, the authors posited that the potential influence of peers to disrupt parental attachments was stronger.
Conclusions: Descriptive phenomenology was adopted in this study and Colaizzi's method was used to analyse the collected data. Focus group interviews were conducted with 45 adolescents, 11 parents, and 22 school teachers and social workers in two districts in Hong Kong. A secure attachment between a parent and a child enhances the child's sense of self-efficacy in avoiding addictive behaviours such as ATOD use. In contrast, insecure parent-child attachments may trigger children to resist social norms, and disrupt their parental attachments. In these instances, parents may inadvertently convey the message that their children do not need protection from the risks of using ATOD. The key findings suggest that reinforcing secure parental attachments, as well as emphasizing how messages of vulnerability to ATOD are conveyed, may counter balance pressures (including peer influence) to use these substances. Further research is needed to uncover mechanisms of communication that add to the vulnerability of adolescents to using ATOD, and to the negative long-term consequences from ATOD use.
Publisher: BioMed Central
ISSN: 1471-2431
EISSN: 1471-2431
DOI: 10.1186/s12887-019-1678-1
Rights: © The Author(s) 2019. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.
The following publication Mak, Y.W., Leung, D. & Loke, A.Y. The vulnerability to alcohol, tobacco, and drug use of adolescents in Hong Kong: a phenomenological study. BMC Pediatr 19, 303 (2019), is available at
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