The prevalence of smoking in patients who received anterior cruciate ligament reconstruction in Hong Kong – a retrospective cross-sectional study

Introduction Smokers are known to have inferior outcomes after anterior cruciate ligament reconstruction (ACLR) than non-smokers. Currently, there is no published data on the prevalence of smoking among athletes who receive ACLR in Hong Kong. Methods A retrospective study was conducted in patients who received ACLR between 2007 and 2021 at a regional hospital in Hong Kong. The prevalence of smoking in ACLR patients was compared with the published data of the general population in Hong Kong. Results The prevalence of current daily cigarette smoking in patients who received ACLR between 2007 and 2021 was 16.4%, compared to 11.8%, 10.7%, 10.1%, and 9.5% in 2007, 2012, 2017, and 2021, respectively, for the general population. The daily smoking prevalence for male ACLR patients aged 20–29 years was 21.1%. For male adolescents younger than 20 years old who received ACLR, the prevalence was 5.7%, compared to 1.6% in the general population. Despite a steady decline in the smoking rate in the general population, a progressive drop in the prevalence of daily smoking in patients who received ACLR was only observed in men aged 30–39 years, not in the other age and sex groups. Conclusion The prevalence of current daily cigarette smoking in patients aged under 30 years old who received ACLR in Hong Kong is alarmingly high. There is a pressing need for the government to implement more focused anti-smoking campaigns and cessation support programmes tailored specifically for these young athletes, as there is a common misconception that they do not smoke.