As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Kimberly Orlando of ADDO Investor Relations. Thank you. You may begin.
Thank you. Welcome to Natural Health Trends' first quarter 2018 conference call. During today's call, there may be statements made relating to the future results of the company that are forward-looking statements as defined in the Private Securities Litigation Reform Act of 1995. Actual results, performance, or achievements could differ materially from those anticipated in such forward-looking statements through the result of certain factors, including those set forth in the company's filings with the Securities and Exchange Commission. It should also be noted that today's call will be webcast live and can be found on the investor section of the company's corporate website at naturalhealthtrendscorp.com. Instructions can be found for accessing the archived version of the conference call in today's financial results press release, which was issued at approximately 9:00 A.M. Eastern Time.
At this time, I would like to turn the call over to Chris Sharng, President of Natural Health Trends.
Thank you, Kim. Thanks to everyone for joining us. With me today is Scott Davidson, our Senior Vice President and Chief Financial Officer. Our momentum in the back half of 2017 carried into the first quarter with total revenue of $52.4 million, increasing 14% compared to the fourth quarter of 2017 and decreasing 13% year-over-year. Importantly, the first quarter of 2018 marked our second consecutive quarter of sales growth since the second quarter of 2016. Our improved top-line performance versus the prior quarter is a direct result of the substantial advancements we made during the prior two quarters to revitalize sales. Specifically, we believe that the enhancements made to our commission plan to better incentivize up-and-comers and ease rank advancements along with our effective marketing programs drove the sequential sales growth.
As previously discussed, we began implementing additional enhancements to help direct more resources to lower and mid-level rank members, including a one-time cash bonus for new participants in the International Recognition Program. In January, we held our International Ambassador Academy in Hong Kong, attended by over 5,500 people. This year, the orders generated by promotions directly related to the event exceeded those of the last three years. As part of the occasion, we introduced our new product, Curcumor, producing nearly $600,000 in orders during the quarter, as well as announced various new and exciting programs for the year ahead, which I will discuss in a moment. Our revenue for the quarter improved despite the Chinese New Year and the holiday-related customs shutdown in mid-February.
In anticipation of the closure, we did as much as we could to prepare by working directly with our leaders to pre-ship products and were therefore able to mitigate some, but not all, of this logistic challenge. Our gross profit margin for the first quarter remained strong at 80.5% compared to a record 81.2% in the first quarter of 2017. Through our ongoing proactive expense management to better align our cost structure with current sales levels, we also reported a robust operating income margin of 19.2%, as we stated that we will try targeting our profit margin to be in the high teens compared to 21.7% in the first quarter of 2017. During the quarter, we hosted several excursions with many more plans for the remainder of the year.
The qualification period for our first trip of 2018 ran through the end of 2017, where a group of over 240 traveled to Melbourne and Sydney, Australia in mid-April. The seven-day affair involved phenomenal performances, motivational speakers, coaching, and team-building exercises. Our top qualifiers and global ambassadors enjoy an extended stay in Gold Coast as part of our annual Royal Summit. During this high-profile experience in Australia, where all of our top leaders were present, we announced a two-month qualification for elite members to participate in an exclusive journey to Northern California scheduled for July. Here, they will have the opportunity to take part in targeted training sessions and to share best practices with their North American counterparts. Additionally, the qualification period for Greater China and North American members to travel to South Africa in the fourth quarter concludes in June.
In the Peruvian market, those meeting the criteria are entitled to three separate rewards, either travel to Cartagena, which took place in early April, Hong Kong in August for our 2018 Ambassador Academy, or Cancun this coming September. Not only are these events hugely impactful when it comes to team building and engagement, but they also help to boost order volume and rank advancement in our International Recognition Program. Those that are eligible will also have the opportunity to attend several upcoming Fly High trainings, key to the development and success of those that are considered up-and-comers or for those newer to NHT Global. We already have roughly 1,000 set to participate in May for our Fly High in Chengdu in Southwest China, as well as more than 400 for Seattle in June. Over 2,000 for Malaysia in early July.
We also conducted product roadshows in China and Kuala Lumpur on both StemRenu and ResVator, generating a lot of excitement in those regions. It is clear that the leaders are responding positively to the enhancement we made, and that our efforts to continue strengthening their product knowledge by providing the necessary tool set to expand their business and attract new customers is paying off. Geographical expansion remains a key focus as we continue to concentrate not only on growth in our existing markets, but on entry into new attractive markets to help diversify our presence. In China, we are still in process with our application for a direct selling license, so the timing of obtaining such a license and whether or not we can obtain one remains beyond our control. As communicated previously, we plan to be transparent as material developments arise.
In Germany and in Mexico, while it is still early, we have identified potential leaders in both countries and are continuing to work through the associated product and business registration requirement. In Mexico, we have an event this upcoming weekend with 100 confirmed attendees. In Germany, we recently consulted with local professionals and received a green light on our global marketing plan. We are actively registering dietary and food supplements according to German regulations. Southeast Asia, as a natural expansion to our already significant Greater China market, continues to be a priority for us as well, and we are in the process of product and business registration in Thailand, Indonesia, and Vietnam. Returning capital to our value stockholders remains a priority. We generated $11.1 million in cash flow from operations during the first quarter, as well as paid out $1.5 million in quarterly dividends.
Additionally, following an evaluation of the 2017 Tax Cuts and Jobs Act, our board of directors declared a special dividend in the amount of $20 million, or $1.76 per share. In closing, 2018 is off to a good start, despite the adverse effect that the customs slowdown had in our Hong Kong business. Our leaders remain energized and enthusiastic, and we look forward to more productive incentive trips and targeted training programs in 2018 to drive further progress and growth. With that, I'd like to turn the call over to Scott Davidson, our CFO, to discuss our first quarter financials in detail. Scott?
Thank you, Chris. Total revenue for the first quarter was $52.4 million, a 13% decrease compared to $59.9 million in the first quarter of 2017, and a 14% increase compared to $46.1 million in the fourth quarter of 2017. Sales in Hong Kong, which accounted for 91% of our first quarter revenue, decreased 13% year-over-year to $47.6 million. Outside of Hong Kong, revenue decreased 11% year-over-year to $4.7 million. Our active member base declined slightly to 95,000 at March 31st, from 95,700 at December 31st, and from 114,000 at March 31st last year. Turning to our cost and operating expenses, our gross profit margin for the first quarter remained strong at 80.5%. The prior year margin of 81.2% was higher due to greater event ticket revenue.
Commissions expense as a percent of total revenue increased to 43.9% from 43.4% in the first quarter last year, and is in line with the full year 2017 rate. Selling, general and administrative expenses for the quarter decreased 6% to $9.1 million versus $9.7 million a year ago. As a result, operating income for the quarter totaled $10 million, a decrease of 23% compared to $13 million in the first quarter last year. Our operating income margin was 19.2% compared to 21.7% in the first quarter last year. Our effective tax rate was 14% for the first quarter, compared to 21% in the prior period due to the enactment of the Tax Cuts and Jobs Act. Net income for the first quarter totaled $8.8 million, or $0.78 per diluted share, compared to net income of $10.4 million, or $0.93 per diluted share in the first quarter of 2017.
We generated $11.1 million in cash provided by operations during the quarter, compared to $13.8 million in the prior year quarter. Total cash and cash equivalents of $145.1 million as of March 31st were up from $135.3 million at December 31st. We used our available cash to pay out $1.5 million in dividends during the quarter. On April 17th, 2018, our board of directors declared a quarterly cash dividend of $0.14 per share, representing an 8% increase over the prior quarter dividend, as well as a special cash dividend of $20 million, or $1.76 per share, both of which will be payable on May 25th to stockholders of record as of May 15th. We think our first quarter results represent a good start to the year, we look forward to continuing to revitalize growth and deliver improved financial performance in 2018 and beyond. That completes our prepared remarks.
I will now turn the call back over to the operator to begin the question and answer session. Operator?
Thank you.