Introduction:
The present study aimed to investigate the negative perceptions of paternal and maternal smoking and their associated factors among adolescents in Hong Kong.

Methods:
In a school-based cross-sectional survey in 2010 to 2011, 61,810 Hong Kong secondary school students (mean age 14.6 years, 50.8% boys) reported whether their parents smoked and whether they considered their parents’ smoking unacceptable and minded if their peers knew that their father or mother smoke (indicators of the negative perceptions). Factors associated with negative perceptions of paternal and maternal smoking were explored using multivariable regression models.

Results:
Among students that reported paternal smoking (n=19.184, 29.8%), 50.8% considered it unacceptable, and 21.0% minded if their peers knew of it. Of those reporting maternal smoking (n=3,678, 5.7%), 48.1% considered it unacceptable, and 30.4% minded if their peers knew of it. Generally, the indicators of negative perceptions of parental smoking were associated with younger age, being certain about the harm of smoking and secondhand smoke, no peer smoking, and no secondhand smoke from the respective parent. Considering parental smoking unacceptable was additionally associated with lower family affluence and not living with any smokers apart from the respective parent.

Conclusions:
About half of adolescents in Hong Kong with a smoking parent considered their parental smoking unacceptable, and about a quarter minded if their peers knew of their parent’s smoking. Such negative perceptions were more common in adolescents who were certain about the harm of tobacco, and had fewer co-residing smokers and no smoking peers.