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Jetly K, Ismail A, Hassan N, Mohammed Nawi A. Mechanism Linking Cigarette Pack Factors, Point-of-Sale Marketing and Individual Factors With Smoking Intention Among School-Going Adolescents. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00335. [PMID: 39236215 DOI: 10.1097/phh.0000000000001960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2024]
Abstract
CONTEXT Tobacco usage accounts for one of the most preventable causes of death. OBJECTIVE This study aimed to explore mechanisms linking cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents. DESIGN, SETTING, AND PARTICIPANTS This was a cross-sectional study conducted among 6 urban secondary schools. A pretested and validated self-administered questionnaire was used. Data analysis for structural equation modeling was done using SMART-PLS v3.2.8. MAIN OUTCOME MEASURE The main outcome measure was to determine the direct and indirect effects of cigarette pack factors, point-of-sale marketing, and individual factors (psychological reactant trait) to predict smoking intention among school-going adolescents in a theory-based model. RESULTS A total of 386 adolescents fulfilling the inclusion criteria participated. Pictorial warning message reactance (β = .153, P ≤ .001), pack receptivity of conventional pack (β = .297, P = .004), and psychological reactant trait (β = .174, P ≤ .001) were positively related to smoking intention. Pictorial warning negative affect (β = -.153, P = .001) was negatively related to smoking intention. The psychological reactant trait was positively related to message reactance (β = .340, P ≤ .001). However, recall exposure to point-of-sale marketing and pack appraisal of conventional pack was not positively related to smoking intention (β = .038, P = .215 and β = -.026, P = .39, respectively). Pictorial warning message reactance also positively mediates the relationship between psychological reactant trait and smoking intention (β = 0.05, p = .001). The model has strong predictive power. CONCLUSION In conclusion, cigarette pack factors and psychological reactant traits are essential in predicting smoking intention. Hence, policymakers should consider these factors in developing smoking policies.
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Affiliation(s)
- Kavita Jetly
- Author Affiliations: Herbal Medicine Research Centre, Institute of Medical Research, National Institutes of Health, Shah Alam Selangor, Malaysia (Dr Jetly); Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia (Dr Ismail and Nawi); and Non-Communicable Disease Section, Disease Control Division (NCD), Ministry of Health Malaysia, Wilayah Persekutuan Putrajaya, Malaysia (Dr Hassan) Faculty of Public Health, Universitas Sumatera Utara, Indonesia(Dr Ismail)
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Al-Maweri SA, Alhajj MN, Al-Soneidar WA, Shamala A, Alkadasi BA, Amran AG, Abu-Lohom F, Al-Sharani HM, Basalamah MA, Al-Muaalemi Z, Almeslet AS, Abdulrab S, Asiri AA, Kassim S, Halboub E. Tobacco use and khat chewing among adolescents in Yemen: a large-scale school-based cross-sectional study. BMC Public Health 2024; 24:2406. [PMID: 39232711 PMCID: PMC11375828 DOI: 10.1186/s12889-024-19803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/14/2024] [Indexed: 09/06/2024] Open
Abstract
OBJECTIVE The present study sought to assess the prevalence and determinants of tobacco use (cigarette smoking and shisha use) and khat chewing among Yemeni adolescents, and to evaluate their knowledge and attitudes toward these habits. METHODS This school-based cross-sectional study was conducted among 13 to 19-year-old students attending middle/high schools (both private and public) across five main cities in Yemen. Data were collected using self-administered questionnaires comprising questions/items related to sociodemographic data, cigarette smoking, shisha use, khat chewing, and knowledge on and attitudes toward these habits. Bivariate and multivariate analyses were used to explore the most determinant factors. RESULTS A total of 7505 students were recruited from 42 schools across five major cities in Yemen. The prevalence rates of khat chewing, cigarette smoking, and shisha use were 42.4%, 6.8%, and 19.3%, respectively. Compared to females, male subjects reported significantly higher prevalence of khat chewing (51.4% vs. 23.5%, p < 0.001), shisha use (20.3% vs. 17.2%, p < 0.01), and cigarette smoking (8.8% vs. 2.6%, p < 0.001). Male gender, older age, poor knowledge, khat chewing, parents' low education level, and parents' and peers' smoking habits were significant determinants of adolescents' cigarette smoking status. Private education, male gender, older age, poor knowledge, parents' low education level, and parents' and peers' khat chewing habits were significant determinants of adolescents' khat chewing status. The participant's knowledge of and attitudes toward tobacco use and khat chewing were inadequate. CONCLUSION The prevalence of khat chewing, shisha use, and to lesser extent cigarette smoking among Yemeni adolescents is high that needs immediate intervention. The results highlight the urgent need to implement prevention strategies to tackle these habits among the youth in Yemen.
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Affiliation(s)
- Sadeq Ali Al-Maweri
- Department of Preclinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
| | | | | | - Anas Shamala
- Department of Preventive and Biomedical Science, College of Dentistry, University of Science & Technology, Sanaa, Yemen
| | | | | | | | - Hesham Mohammed Al-Sharani
- National Center for Epidemiology and Population Health, ANU College of Health and Medicine, Canberra, Australia
| | | | - Zakarya Al-Muaalemi
- Faculty of Dentistry, Jiblah University for Medical & Health Sciences, Ibb, Yemen
- Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Asma Saleh Almeslet
- Department of Oral Maxillofacial Surgery and Diagnostic Sciences, College of Medicine and Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Saleem Abdulrab
- Alkhor Health Centre, Primary Health Care Corporation, Doha, Qatar
| | | | - Saba Kassim
- Department of Preventive Dental Sciences, College of Dentistry, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Chow CY, Hasan MZ, Kamil AA. Prevalence and Associated Factors Related to Tobacco Consumption Among University Students in Malaysia. Health Psychol Res 2024; 12:94232. [PMID: 38469105 PMCID: PMC10927316 DOI: 10.52965/001c.94232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
Tobacco consumption is one of the major public health concerns worldwide. Moreover, alternative tobacco and nicotine products (ATNPs) are growing in popularity, especially among young adults in the past decade. The study aimed to determine the prevalence and associated sociodemographic factors of tobacco consumption among university students. A cross-sectional study was carried out among 338 university students of a private Malaysian university from March to April 2021. Data was collected using a self-administered online questionnaire with items including sociodemographic information, user status of tobacco consumption and types of tobacco product used. Descriptive statistics, Pearson's chi-square test, Fisher's exact test and simple and multiple logistic regression analyses were performed using the IBM SPSS version 26.0 to analyse the data. The prevalence of tobacco consumption in this study was 8.6% and the main tobacco product used was manufactured cigarettes. In Pearson's chi square test and Fisher's exact test, current use of tobacco was significantly associated with nationality, ethnicity, religion, school, current level of education and parents, siblings and friends use of tobacco (p<0.05). In simple and multiple logistic regression analysis, being non-Malaysian, Indian, Muslim, year 4 student and having parents or siblings who used tobacco, all had statistically significant associations with the current use of tobacco (p<0.05). Findings of this study showed that the use of tobacco among university students is concerning and warrants the need to develop and implement a strategic anti-tobacco program to limit this behaviour among university students.
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Lim KH, Cheong YL, Lim HL, Cheong KC, Hashim MHM, Marine AA, Cheah YK, Lim JH, Mohd Ghazali S. Validity and reliability of the Malay language Perception Towards Smoking Questionnaire (BM-PTSQ) among secondary school adolescents: Further validation using Confirmatory Factor Analysis. Tob Induc Dis 2024; 22:TID-22-25. [PMID: 38268983 PMCID: PMC10807019 DOI: 10.18332/tid/176164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION Perception is an essential factor influencing smoking among adolescents. Thus, a valid tool for measuring perception is a requisite in smoking studies. This study further establishes the validity and reliability of a Malay language version of the Perception Towards Smoking Questionnaire (BM-PTSQ) for assessing the perception of smoking among secondary school-going adolescents in Malaysia. METHODS We administered the BM-PTSQ to 669 secondary school students selected through multistage sampling; 60% of respondents were male (n=398), and 69.9% (n=463) were from rural areas. Respondents were aged 13-16 years, 36.4% (n=241) were 13 years, 40.0% (n=265) were 14 years, and 23.6% (n=156) were 16 years old. We used parallel and exploratory factor analysis (EFA) to determine the domains of the questionnaire. In addition, we also employed EFA, confirmatory factor analyses (CFA), and Cronbach's alpha to evaluate the construct validity and reliability of the BM-PTSQ. RESULTS EFA and parallel analysis identified two domains in the BM-PTSQ that accounted for 62.9% of the observed variance, and CFA confirmed the two-domain structure. The two domains' internal consistency scores ranged from 0.702 to 0.80, which suggested adequate reliability. CONCLUSIONS The BM-PTSQ has acceptable psychometric validity and is appropriate for assessing smoking perception and intention among Malaysian secondary school-aged youth. Researchers should further evaluate this tool's applicability in a more sociodemographically diverse population.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Ministry of Health Malaysia, Johor Bahru, Malaysia
| | - Kee Chee Cheong
- Department of Biostatistics, and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Mohd Hazilas Mat Hashim
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Ali Aman Marine
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Putrajaya Hospital, Putrajaya, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institute of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
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Vakili M, Mirzadeh M, Mirzaei M, Modarresi M, Raei R, Karimi R, Aghakoochak A, Imani AA. Sex differences in high-risk health behaviors among school-going adolescents in Yazd, Iran; a cross-sectional study. Heliyon 2023; 9:e16404. [PMID: 37303572 PMCID: PMC10250580 DOI: 10.1016/j.heliyon.2023.e16404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/14/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Objective Adolescents are exposed to a wide range of high-risk health behaviors. This study aimed to investigate the high-risk health behaviors of adolescents in an Iranian adolescent population and gender differences. Method This cross-sectional descriptive study recruited high school students in Yazd city in center of Iran. Schools were randomly selected. In each school, all selected classes were included. Sampling in each class was census. The study investigated self-reported high-risk health behaviors. Students completed the Global School-based Student Health Survey (GSHS), an anonymous, validated questionnaire. Results 2420 students participated in this study (52.5% male). The age range was 12-19 years. Daily consumption of ≥1 serving of fruit and vegetables per day was reported by 77.4% and 49.5% of respondents, respectively. Adequate physical activity was reported by only 18.4% of adolescents, and significantly less frequently by girls than boys (p < 0.001). 11.8% were current smokers (M/F ratio: 2.6), and 20.5% (M/F ratio: 1.5) were ever used hookah. The prevalence of ever alcohol and substance abuse was 15.5% and 8.8%, respectively. The prevalence of tobacco and substance use was significantly higher in participants' boys than in girls (p < 0.001). Males were over twice more likely to report frequent fighting in the past 12 months than girls. Overall, girls reported more parental supervision than boys (82.1% vs. 73.4%) and parental monitoring (90.6% vs. 86.8%), while boys reported higher levels of awareness over leisure activities than girls (65.8% vs. 58.4%). Conclusions High-risk health behaviors are more common in boys than girls. Health policymakers should use these results in prioritizing and designing health interventions to promote youth health. Further studies are recommended to identify the factors influencing the prevalence of these behaviors.
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Affiliation(s)
- Mahmood Vakili
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahboobahsadat Mirzadeh
- Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mozhgan Modarresi
- Yazd Cardiovascular Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Raei
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reihaneh Karimi
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Aghakoochak
- Health Monitoring Research Center, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Phetphum C, Prajongjeep A, Youngiam W, Thawatchaijareonying K. Susceptibility to smoking and determinants among never-smoking high school students in Thailand. Tob Induc Dis 2023; 21:02. [PMID: 36694667 PMCID: PMC9832328 DOI: 10.18332/tid/156456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION To prevent youth from becoming smokers, it is essential to understand factors contributing to them becoming susceptible to smoking. The aim of this study was thus to estimate the prevalence of smoking susceptibility among neversmoking youth in Thailand and to identify determinants associated with such behavior. METHODS Cross-sectional data for 4572 eighth-grade students (aged 13-15 years) from 120 secondary schools were obtained from a classroom-based survey using a self-administered questionnaire. Using data from never-smoking students (n=3180), simple and multiple logistic regression analyses were performed to identify factors associated with smoking susceptibility. Frequencies and proportions for descriptive statistics are reported along with adjusted odds ratios and 95% confidence intervals for logistic regression models. RESULTS A total of 16.4% of Thai never-smoking youth were susceptible to smoking. Several variables of interest were identified in multivariable analysis as significantly associated with increased susceptibility to smoking: being male (AOR=3.16; 95% CI: 25.4-3.92), having a positive attitude toward smoking - agreeing that smoking displays maturity (AOR=1.49; 95% CI: 1.07-2.09), the perception that smoking helps relieve stress (AOR=1.57; 95% CI: 1.14-2.15), the presence of current smoking peers (AOR=2.04; 95% CI: 1.57-2.66), exposure to secondhand smoking in public (AOR=1.51; 95% CI: 1.17-1.94), exposure to online cigarette and smoking-related advertising occasionally (AOR=1.98; 95% CI: 1.49-2.65), attendance at schools where there are sometimes anti-smoking education activities (AOR=1.57; 95% CI: 1.18-2.07); as well as exposure to anti-tobacco messages rarely (AOR=1.40; 95% CI: 1.05-1.87), occasionally (AOR=1.48; 95% CI: 1.12-1.96) and infrequently (AOR=1.41; 95% CI : 1.07-1.87). CONCLUSIONS Approximately one in six Thai never-smoking youth was found to be susceptible to smoking. Findings suggest it should be useful to supplement relevant tobacco prevention and control efforts by considering such interpersonal and socio-environmental determinants, among vulnerable people to smoke.
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Affiliation(s)
- Chakkraphan Phetphum
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
- Tobacco Control Research Unit, Naresuan University, Phitsanulok, Thailand
| | - Atchara Prajongjeep
- Department of Community Public Health, Sirindhorn College of Public Health Phitsanulok, Phitsanulok, Thailand
| | - Waraporn Youngiam
- Department of Community Health, Faculty of Public Health, Naresuan University, Phitsanulok, Thailand
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Lim KH, Cheong YL, Lim HL, Kee CC, Ghazali SM, Heng PP, Teh CH, Hashim MHM, Cheah YK, Lim JH. Validation of the Malay Version of the Decisional Balance
Inventory (MDBI) among secondary school-going adolescents. Tob Induc Dis 2022; 20:79. [PMID: 36188418 PMCID: PMC9483825 DOI: 10.18332/tid/152409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/05/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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Effendi DE, Nugroho AP, Handayani S, Novita R, Purwoko S, Agustina ZA. Tobacco Consumption Among Young Population in Rural Indonesia: Prevalence and Associated Factors. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: Tobacco consumption among youths is increasing in Indonesia and other middle-income countries. In rural areas, its prevalence is even higher compared to urban settings. Understanding the extent and associated factors of tobacco consumption within this population is essential to inform the formulation of appropriate prevention and control strategies.
Aims: This study aims at analyzing the prevalence and associated factors of tobacco consumption among the young population living in rural Indonesia.
Methods: Data were obtained from Indonesia Family Life Survey wave 5 (IFLS-5). A total of 2,786 responses from respondents aged 15-24 years and living in rural areas were taken into analysis. Binary logistic regression was used to examine the association between tobacco consumption with the predictors.
Results: The prevalence of tobacco consumption among youths in rural Indonesia was 26.5%. Binary logistic regression discovered that factors significantly associated with tobacco consumption among young population were aged 20-24 years (AOR = 4.760, 95% CI: 3.557-6.368), less educated (AOR = 5.988, 95% CI: 3.193-11.229), being married (AOR = 2.484, 95% CI: 1.631- 3.782), and having smoking parent (AOR = 1.346, 95% CI: 1.016-1.783). Young males had a much higher tobacco use prevalence (57.1%). Whereas females had significant negative association with tobacco consumption (AOR = 0.001, 95% CI: 0.000-0.002).
Conclusion: A large portion of youth in rural Indonesia were identified to have tobacco-use behavior. Appropriate prevention and control strategies are needed to address the population groups identified in this study. Policymakers should anticipate challenges that may occur resulting from geographical and cultural differences.
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Lim KH, Cheong YL, Lim HL, Ghazali SM, Kee CC, Cheah YK, Heng PP, Hashim MHM, Tan CV, Lim JH. Correlates of dual/poly tobacco use among school-going
adolescents in Malaysia: Findings from a nationwide school-based
study. Tob Induc Dis 2022; 20:52. [PMID: 35733644 PMCID: PMC9164214 DOI: 10.18332/tid/148247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dual/poly tobacco use is common among youths globally. However, in Malaysia information on dual/poly tobacco use is scarce, thus the present study examines the prevalence and factors associated with dual/poly tobacco users among school-going adolescents in Malaysia. METHODS We derived data on tobacco and e-cigarette use among Malaysian adolescents from a nationwide school-based study conducted in 2016. A total of 13135 adolescents responded in the cross-sectional survey which used multi-stage sampling to select a representative sample of school-going adolescents aged 11–19 years. A standard validated questionnaire was used to obtain the data and multiple logistic regression was conducted to assess factors associated with dual/ poly tobacco use. RESULTS The prevalence of dual/poly tobacco use was 6.5%, more than half of which were both conventional and e-cigarette users. Multivariable logistic regression revealed that the likelihood of dual tobacco use was significantly higher among males (AOR=14.73; 95% CI: 9.11–23.81), secondary school students, those aged 16–19 years (AOR=5.99; 95% CI: 4.04–8.87), natives of Sabah (AOR=7.41; 95% CI: 3.48–15.79), and those never been taught on the health hazards of tobacco at school, exposed to secondhand smoke (SHS) at home, school or other public areas, and had a positive perception of e-cigarettes and lower perception of the harms of tobacco smoking. CONCLUSIONS Although the prevalence of dual/poly users was still low among Malaysian school-going adolescents, proactive measures should be taken to reduce dual tobacco use among youth in Malaysia with focus on the factors identified in this study.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Department of Biostatistics and Data Repository, National Institutes of Health, Shah Alam, Malaysia
| | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Cia Vei Tan
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Jia Hui Lim
- Pharmacy Department, Hospital Putrajaya, Putrajaya, Malaysia
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Heng PP, Daud F, Yusoff MFM, Lim KH. Susceptibility to e-cigarette initiation among tobacco product naïve adolescents in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian adolescents (TECMA). Tob Induc Dis 2021; 19:89. [PMID: 34887718 PMCID: PMC8611510 DOI: 10.18332/tid/142900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Predicting susceptibility to e-cigarette (EC) initiation among adolescents is crucial to optimize preventive measures before the health risk behavior persists through adulthood. The identification of susceptible groups is needed in response to the surge of EC use. This study aimed to determine the prevalence and determinants associated with EC susceptibility among tobacco product naïve (never users of any single tobacco product) school-going adolescents in Malaysia. METHODS Data were derived from the Tobacco and EC Survey among Malaysians (TECMA), which recruited a total of 13162 school-going adolescents aged 10– 19 years from 138 randomly selected schools via a two-stage stratified cluster sampling design. A validated self-administered questionnaire adapted from the Global Youth Tobacco Survey was utilized as the study instrument. The data were analyzed using SPSS version 22.0 descriptively and with multivariable logistic regression to determine the associated factors of EC susceptibility. RESULTS About 15.7% of the tobacco naïve adolescents were susceptible to EC initiation, with the proportion of susceptibility significantly higher among males, mid-adolescents, rural adolescents, those reporting exposure to tobacco advertisement and those not taught in school about the danger of tobacco use. Multivariable logistic regression revealed that the male students (AOR=2.20; 95% CI: 1.86–2.59) from a rural locality (AOR=1.45; 95% CI: 1.23–1.71), those reporting no lessons on the danger of tobacco use at school (AOR=1.66; 95% CI: 1.39–1.99) and those exposed to tobacco advertisement (AOR=1.67; 95% CI: 1.07–2.61), were more susceptible to EC initiation, while no significant association was found between secondhand smoke exposure and EC susceptibility. CONCLUSIONS Comprehensive EC preventive strategies are critically needed together with the implementation of targeted, gender, and culturally impressionable interventions. In addition, future studies should focus on the evaluation of the impacts of the preventive and control efforts to ensure their effectiveness in preventing EC initiation among Malaysian adolescents.
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Affiliation(s)
- Pei Pei Heng
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia.,Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
| | - Faiz Daud
- Department of Community Health, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Kuang Hock Lim
- Institute for Public Health, National Institutes of Health, Setia Alam, Malaysia
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Wahab S, Baharom MA, Abd Rahman FN, A. Wahab K, Zulkifly MA, Azmi AD, Ahmad N. The relationship of lifetime substance-use disorder with family functioning, childhood victimisation, and depression, among juvenile offenders in Malaysia. Addict Behav Rep 2021; 14:100359. [PMID: 34136633 PMCID: PMC8181857 DOI: 10.1016/j.abrep.2021.100359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Adolescent substance use is a multifactorial social issue that leads to detrimental outcomes. The aim of this study is to understand the association of a lifetime history of substance abuse or dependence with family functioning, childhood victimisation, and depression, among adolescent male inmates in a juvenile detention centre in Malaysia. METHODS This study was cross-sectional involving 230 inmates and was conducted in a juvenile detention centre in Malaysia. The mean age of the participants was 16.65 years, with the highest percentage from the Malay ethnicity (87.8% where n = 202). The Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID), Adolescent Alcohol and Drug Involvement Scale (AADIS), Family Adaptability and Cohesion Evaluation Scale (FACES) IV and Juvenile Victimization Questionnaire Second Revision (JVQ-R2) were used as instruments. RESULTS The prevalence of a lifetime history of substance abuse and substance dependence is 72.6% and 58.3%, respectively. A lifetime history of substance abuse and dependence had a significant association with age, race, religion, and peer/sibling victimisation. Further analysis reveals that an increase in age can be a predictor of both lifetime history of substance abuse and dependence while peer/sibling victimisation may predict lifetime history of substance abuse. There was no significant association of lifetime substance-use disorder with family functioning and depression in the juvenile offenders. CONCLUSIONS Adolescents exposed to peer/sibling victimisation might be at a higher risk of developing a substance-use disorder. At-risk groups need to be identified, assessed, and have intervention early to prevent adverse outcomes.
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Affiliation(s)
- Suzaily Wahab
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia
| | | | - Fairuz Nazri Abd Rahman
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia
| | | | - Muhamad Afiq Zulkifly
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia
| | - Amirul Danial Azmi
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia
| | - Norfazilah Ahmad
- Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Cheras, Kuala Lumpur, Malaysia
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Cheah YK, Kee CC, Lim KH, Omar MA. Mental health and risk behaviors among secondary school students: A study on ethnic minorities. Pediatr Neonatol 2021; 62:628-637. [PMID: 34353744 DOI: 10.1016/j.pedneo.2021.05.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 04/24/2021] [Accepted: 05/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities. METHODS The National Health and Morbidity Survey (NHMS) 2017 (n = 8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable. RESULTS Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not. CONCLUSION Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.
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Affiliation(s)
- Yong Kang Cheah
- School of Economics, Finance and Banking, College of Business, Universiti Utara Malaysia, 06010 UUM Sintok, Kedah Darul Aman, Malaysia.
| | - Chee Cheong Kee
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, 40170 Shah Alam, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588 Kuala Lumpur, Malaysia
| | - Mohd Azahadi Omar
- Sector for Biostatistics and Data Repository, National Institutes of Health, Ministry of Health Malaysia, No. 1, Jln Setia Murni U13/52, Seksyen U13, 40170 Shah Alam, Selangor, Malaysia
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Lim KH, Ghazali SM, Lim HL, Cheong YL, Kee CC, Heng PP, Tiunh TY, Mat Hashim MH, Lim JH. Prevalence and factors related to secondhand smoke exposure among secondary school-going adolescents in Malaysia: Findings from Malaysia Global Health School Survey 2012 and 2017. Tob Induc Dis 2021; 19:50. [PMID: 34177412 PMCID: PMC8204740 DOI: 10.18332/tid/136029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/15/2021] [Accepted: 04/22/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Secondhand (SHS) smoke exposure has caused various health problems. Therefore, continuous monitoring of SHS exposure is important to determine the efficacy of various anti-tobacco measure implemented. The study aims to compare the prevalence and factor(s) associated with SHS exposure among secondary school-going adolescents in Malaysia during 2012 and 2017. METHODS We derived data from the Global School Health Survey (GSHS) 2012 and GSHS 2017, which was carried out in Malaysia using multistage sampling to select representative samples of secondary school-going adolescents. Both surveys used similar questionnaires to measure SHS exposure. Descriptive and multivariate logistic regression was used to determine the prevalence and factors associated with SHS exposure. RESULTS Approximately four in ten respondents were exposed to SHS in the past week in both surveys (41.5% in GSHS 2012 and 42.0% in GSHS 2017, respectively). Both surveys revealed a significantly higher SHS exposure among respondents who smoked than among non-smokers and higher among males compared to females. The likelihood of SHS exposure in both surveys was also similar, with a higher likelihood of SHS exposure among smoking adolescents and non-smoking adolescents who had at least one smoking parent/guardian, regardless of their own smoking status. Male adolescents had a higher risk of SHS exposure compared to their female counterparts. Meanwhile, SHS risk also increased with age, regardless of smoking status. CONCLUSIONS Our findings suggested that there were no changes in the prevalence of SHS exposure and recorded only a slight change in the factors associated with exposure to SHS among school-going adolescents in Malaysia between the years 2012 and 2017. A more pro-active, extensive and comprehensive programme should be implemented to address the problem of SHS exposure. Parents should be advised to stop smoking or abstain from smoking in the presence of their children, and smoking cessation interventions are necessary for smoking adolescents and their parents.
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Affiliation(s)
- Kuang Hock Lim
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Sumarni Mohd Ghazali
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Hui Li Lim
- Clinical Research Centre, Hospital Sultan Ismail, Johor Bahru, Malaysia
| | - Yoon Ling Cheong
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Biostatistics and Data Raspatory Sector, National Institutes of Health, Shah Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | - Tsye Yih Tiunh
- Institute for Medical Research, National Institutes of Health, Kuala Lumpur, Malaysia
| | | | - Jia Hui Lim
- Department of Pharmacy and Pharmaceutical Sciences, Monash University Malaysia, Subang Jaya, Malaysia
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Nazarianpirdosti M, Abdi A, Abdi A, Ramazani U. Smoking among High School Students in Iran: A Meta-Analysis Study. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:226-237. [PMID: 34221048 PMCID: PMC8233551 DOI: 10.18502/ijps.v16i2.5823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Cigarette smoking is an important and preventable risk factor, especially for adolescents and high school students. This issue has become one of the challenges for health system. Thus, the present study aimed to investigate the prevalence of smoking among Iranian high school students. Method: This systematic review and meta-analysis study was done by searching PubMed, Scopus, Web Science (WOS), Science Direct, SID, and Google Scholar using the following keywords: “student” and “smoking” from 2000 to March 2018. After initial and critical appraisal, data were entered into a checklist and analyzed by a comprehensive meta-analysis software. Results: The prevalence of smoking was 7.9% by combining the results of 49 articles. Males and females had 10.6% and 4.5% smoking prevalence, respectively. The overall prevalence of smoking was higher in northern areas in Iran (22.4%). Males in the northern (22.4%) and females in western regions (5.3%) were more smokers. There was a significant relationship between the prevalence of smoking with the year of publication, sample size, and age (P < 0.001). Conclusion: In this study, Students' tendency to smoke was different in various regions of Iran, and had a high rate (7.9%). This figure indicates the necessity for planning some coherent educational programs for the public.
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Affiliation(s)
| | - Arsalan Abdi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Uosef Ramazani
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Rodzlan Hasani WS, Saminathan TA, Ab Majid NL, Miaw Yn JL, Mat Rifin H, Abd Hamid HA, Robert Lourdes TG, Ahmad A, lsmail H, Rashid RA, Mohd Yusoff MF. Polysubstance use among adolescents in Malaysia: Findings from the National Health and Morbidity Survey 2017. PLoS One 2021; 16:e0245593. [PMID: 33476329 PMCID: PMC7819602 DOI: 10.1371/journal.pone.0245593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 01/04/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Polysubstance use is defined as the use of more than one non-prescribed licit or illicit substance either concurrently or simultaneously. This study aimed to determine the prevalence of single substance users and polysubstance users and 'their associated factors among adolescents in Malaysia. METHODS This study was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2017, a cross-sectional survey conducted among Malaysian school-going adolescents aged 13 to 17. The NHMS utilised a two-stage stratified cluster sampling. Multivariate Multinomial Logistic Regression analysis was applied. RESULTS The overall prevalence of single substance use and polysubstance use among adolescents were 17.2% and 5.1% respectively. The multinomial model showed a higher likelihood of being single or polysubstance user among male (single user OR = 3.0, poly user OR = 4.6), others Bumiputeras vs Malay (single user OR = 1.7, poly user OR = 5.3), those who live with a single parent (single user OR = 1.2, poly user OR = 1.4), involved in truancy (single user OR = 1.7, poly user OR = 3.6) and being bullied (single user OR = 1.3, poly user OR = 3.4), those who had lack of peer support (single user OR = 1.3, poly user OR = 1.4), poor parental bonding (single user OR = 1.4, poly user OR = 1.8), depression (single user OR = 1.4, poly user OR = 3.2) and those who had no close friend (single user OR = 1.3, poly user OR = 2.7). CONCLUSION Our study highlighted multiple significant associated factors of single and polysubstance use among adolescents in Malaysia. This result can assist in the development of specific intervention and prevention programs targeting high-risk groups.
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Affiliation(s)
- Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
- * E-mail:
| | - Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Nur Liana Ab Majid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Jane Ling Miaw Yn
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Tania Gayle Robert Lourdes
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Ahzairin Ahmad
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Hasimah lsmail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
| | - Rusdi Abd Rashid
- Department of Psychological Medicine, Faculty of Medicine, Center for Addiction Science Studies (UMCAS), University of Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Selangor, Malaysia
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Lim KH, Ghazali SM, Lim HL, Kee CC, Cheah YK, Singh BSGP, Heng PP, Teh CH, Cheong YL, Lim JH. Tobacco use and other aspects related to smoking among school-going adolescents aged 13-15 years in Malaysia: Analysis of three cross-sectional nationally representative surveys in 2003, 2009 and 2016. Tob Induc Dis 2020; 18:80. [PMID: 33013276 PMCID: PMC7528268 DOI: 10.18332/tid/127231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/12/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Periodic surveys on tobacco use patterns and other aspects of tobacco use among school-going adolescents in Malaysia provide information on the effectiveness of anti-smoking measures implemented. However, such information is limited in Malaysia. We investigated the prevalence of smoking and other related aspects among middle-secondary school students in Malaysia from the years 2003-2016 to fill this gap. METHODS We analyzed data from the Global Youth Tobacco Survey (GYTS) 2003, GYTS 2009, and the Tobacco and Electronic Cigarette Survey among Malaysia Adolescents (TECMA) 2016. The surveys employed multistage sampling to select representative samples of adolescents attending secondary school in Malaysia. Data were collected using a pre-validated self-administered anonymous questionnaire adopted from the GYTS. RESULTS Between 2003 and 2016, major changes occurred in which there were reductions in the prevalence of ever smoking, current smoking, and susceptibility to smoking. Reductions were also observed in exposure to SHS in public places and in the home. The proportion of school-going adolescents who support a ban on smoking in public places increased between 2013 to 2016, and there was a significant reduction in the proportion of respondents that were offered 'free' cigarettes by tobacco company representatives. However, there was no difference in the proportion of adolescents who initiated smoking before the age of 10 years and current smokers seeking advice to quit smoking across the time period. CONCLUSIONS Our study indicates that the smoking policies and measures have been effective in reducing smoking prevalence, secondhand smoke exposure, and access to cigarettes, among school-going adolescents in Malaysia. However, measures to reduce smoking initiation and increase smoking cessation need to be strengthened to reduce the burden of smoking-related diseases in Malaysia in the long-term.
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Affiliation(s)
- Kuang H. Lim
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Sumarni M. Ghazali
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Hui L. Lim
- Department of Oncology, Hospital Sulltan Ismail, Johor Bahru, Malaysia
| | - Chee C. Kee
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
- Sector for Biostatistics and Data Repository, National Institute of Health, Shah Alam, Malaysia
| | - Yong K. Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok, Malaysia
| | | | - Pei P. Heng
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien H. Teh
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yoon L. Cheong
- Special Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Jia H. Lim
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Malaysia
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Jabbour N, Abi Rached V, Haddad C, Salameh P, Sacre H, Hallit R, Soufia M, Obeid S, Hallit S. Association between parental separation and addictions in adolescents: results of a National Lebanese Study. BMC Public Health 2020; 20:965. [PMID: 32560706 PMCID: PMC7304209 DOI: 10.1186/s12889-020-09108-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 06/12/2020] [Indexed: 12/02/2022] Open
Abstract
Background Since divorce rates are on the rise in Lebanon (an increase of 101% between 2006 and 2017) and since previous international studies have shown a relationship between divorced parents and adolescents’ addiction to smoking, alcohol, and the internet, assessing the background of the Lebanese situation was deemed necessary. The study objective was to investigate the association between the divorce of parents and smoking, alcohol, and internet addiction among a representative sample of Lebanese adolescents. Methods This study was a cross-sectional, conducted between January and May 2019 using a proportionate random sample of schools from all Lebanese Mohafazat. Out of 2000 questionnaires distributed; 1810 (90.5%) were completed and collected back. Results The mean age was 15.42 ± 1.14 years, with 53.3% females and 74.1% smokers. In addition, 11.9% [95% CI 0.104–0.134] of the adolescents had separated/divorced parents. Divorce in parents was significantly associated with higher alcohol use disorder (Beta = 8.035), higher cigarette dependence (Beta = 2.767) and a higher waterpipe dependence (Beta = 5.263) in adolescents. However, divorce in parents was not associated with internet addiction in adolescents. Conclusion Parental divorce is correlated to higher alcohol and smoking, but not internet addiction among adolescents. Children whose parents are divorced should be subject to continuous follow-up by their parents and by a psychiatrist/psychologist in order not to develop an addiction that could potentially harm them.
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Affiliation(s)
- Nour Jabbour
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Vanessa Abi Rached
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,Université de Limoges, UMR 1094, Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - Pascale Salameh
- INSPECT-LB. Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon.,Faculty of Medicine, Lebanese University, Hadat, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon
| | - Hala Sacre
- INSPECT-LB. Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon
| | - Rabih Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.,Faculty of Medicine, Lebanese University, Hadat, Lebanon
| | - Sahar Obeid
- Research and Psychology Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.,INSPECT-LB. Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon.,Faculty of Arts and Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon. .,INSPECT-LB. Institut National de Santé Publique, Épidémiologie Clinique et Toxicologie - Liban, Beirut, Lebanon.
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Lim KH, Ghazali SM, Lim HL, Cheong KC, Teh CH, Lim KK, Heng PP, Cheah YK, Lim JH. Smoking susceptibility among non-smoking school-going adolescents in Malaysia: findings from a national school-based survey. BMJ Open 2019; 9:e031164. [PMID: 31662384 PMCID: PMC6830643 DOI: 10.1136/bmjopen-2019-031164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE The identification of susceptible non-smoking adolescents is an essential step in reducing smoking initiation among adolescents. The aim of this study was to examine the prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. DESIGN Cross-sectional study. SETTING Primary and secondary schools in Malaysia. PARTICIPANTS 11 246 non-smoking school-going adolescents. OUTCOME MEASURES The prevalence and factors associated with smoking susceptibility among non-smoking school-going adolescents in Malaysia. RESULTS Approximately 14% of non-smokers were susceptible to smoking, and the prevalence of susceptibility was significantly higher among males, ever-smokers and e-cigarette users. The odds of susceptibility to smoking were higher among males, e-cigarette users, those aged 12 years and under and those who had ever smoked or tried cigarettes. Students from schools with educational programmes on the health effects of second-hand smoke (SHS) and who perceived smoking to be harmful were less likely to be susceptible to smoking. CONCLUSION Smoking susceptibility is prevalent among school-going adolescents. A comprehensive approach that enhances or reinforces health education programmes on the adverse health effects of smoking and SHS among school children, that considers multiple factors and that involves all stakeholders is urgently needed to reduce the prevalence of smoking susceptibility among vulnerable subgroups, as identified from the present findings.
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Affiliation(s)
- Kuang Hock Lim
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | | | - Hui Li Lim
- Pathology Unit, Hospital Sultan Haji Ahmad Shah, Mentakab, Malaysia
| | - Kee Chee Cheong
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Chien Huey Teh
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Kuang Kuay Lim
- Occupational Health Center, Institute of Public Health, Setia Alam, Malaysia
| | - Pei Pei Heng
- Special Resource Center, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Yong Kang Cheah
- College of Business, Universiti Utara Malaysia, Sintok, Malaysia
| | - Jia Hui Lim
- School of Pharmacy, Monash University, Malaysia Campus, Bandar Sunway, Malaysia
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Shayo FK, Kalomo MH. Prevalence and correlates of sexual intercourse among sexually active in-school adolescents: an analysis of five sub-Sahara African countries for the adolescent's sexual health policy implications. BMC Public Health 2019; 19:1285. [PMID: 31606038 PMCID: PMC6790023 DOI: 10.1186/s12889-019-7632-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early and unprotected sex with multiple partners among adolescents carries a high risk of acquiring HIV infections, other sexually transmitted infections as well as high rates of teenage pregnancy. Sub-Saharan Africa (SSA) has a higher burden of HIV/AIDS: the leading cause of deaths among adolescents. We estimated the prevalence and examined the correlates of sexual intercourse among in-school adolescents of SSA. The purpose is to inform the public health programs dedicated to tackling the burden of HIV/AIDS. METHODS We did a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from five SSA countries Benin, Mozambique, Namibia, Seychelles, and Tanzania. Our current analysis included a sample of 15,318 in-school adolescents. The primary independent variables were ever had sexual intercourse and sex with multiple partners, while the dependent variables were smoking cigarettes, alcohol use, use of marijuana and amphetamine, and parental connectedness. We performed descriptive statistics, and multivariate logistic regression stratified by gender using SPSS Complex Sample Statistics. A p-value of less than 0.05 was considered statistically significant at 95% confidence intervals. RESULTS Out of 15,318 participants, the overall prevalence of ever had sexual intercourse and sex with multiple partners were 43·5% (6670) and 20·9% (3204), respectively. In overall and across each country, male adolescents had a significantly higher proportion of sex with multiple partners than female adolescents, p < 0·001. The predictors of sexual intercourse with multiple partners in both male and females were smoking cigarettes, alcohol use, and use of marijuana and amphetamine. Female adolescents who smoked cigarettes and used marijuana had a significant likelihood of sex with multiple partners than male adolescents: [aOR 3.6, 95% CI: 2.6-5.1] vs [aOR 2.1, 95% CI: 1.7-2.7] and [aOR 2.4, 95% CI: 1.6-3.7] vs [aOR 1.9, 95% CI: 1·3-2·7], respectively. CONCLUSIONS Adolescents sexual intercourse and more especially sex with multiple partners was prevalent and strongly correlated with substance use. However, the correlation was higher among female adolescents than male adolescents. A customized public health intervention that targets multiple risk factors concurrently may benefit adolescents with clustering of sexual and non-sexual risk-taking behaviors.
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Affiliation(s)
- Festo K Shayo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania.
- Division of Public Health, Department of Global Health Entrepreneurship, Graduate School of Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Mariam H Kalomo
- Department of Non Communicable Disease, Ministry of Health, Community Development, Gender, Elderly, and Children (MoHCDGEC), Dodoma, Tanzania
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Teh CH, Teh MW, Lim KH, Kee CC, Sumarni MG, Heng PP, Mohd Zahari TH, Chan YY, Nuur Hafiza MI, Tee EO, Fadzilah K. Clustering of lifestyle risk behaviours and its determinants among school-going adolescents in a middle-income country: a cross-sectional study. BMC Public Health 2019; 19:1177. [PMID: 31455283 PMCID: PMC6712662 DOI: 10.1186/s12889-019-7516-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/19/2019] [Indexed: 01/07/2023] Open
Abstract
Background Lifestyle risk behaviours such as smoking, alcohol consumption, physical inactivity, sedentary behaviour and low fruit/vegetable intake have been identified as the major causes of chronic diseases. Such behaviours are usually instigated in adolescence and tend to persist into adulthood. Studies on the clustering of lifestyle risk behaviours among adolescents are scarce, particularly in developing countries. Therefore, the present paper aimed to determine the clustering of lifestyle risk behaviours and its determinants among school-going adolescents in Malaysia. Methods Data were extracted from a cross-sectional study, the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study, which was conducted from May to September 2013 across 11 states in Peninsular Malaysia. A two-stage proportionate-to-size sampling method was employed to select a total of 3578 school-going adolescents aged 16–17 years from 20 selected schools in urban and rural settlements, respectively. The MyAHRB study adopted a set of self-administered questionnaires adapted from the Global School-based Student’s Health Survey (GSHS) and the Youth Risk Behaviour Surveillance. Results The results from the analysis of 2991 school-going adolescents aged 16–17 years showed that 16 (in boys) and 15 (in girls) out of 32 combinations of lifestyle risk behaviours clustered. Girls (aOR 2.82, 95% CI: 2.32–3.43) were significantly more likely to have clustered risk behaviours than boys; however, no significant associated factors were observed among girls. In contrast, boys of Malay descent (aOR 0.64, 95% CI: 0.46–0.89) or boys who had at least three friends (aOR 0.65, 95% CI: 0.43–0.99) were less likely to engage in multiple risk behaviours. Conclusion The present study demonstrated the clustering of multiple risk behaviours that occurred in both genders; these results suggest that multiple behaviour intervention programmes, instead of programmes based on siloed approaches, should be advocated and targeted to the high-risk sub-populations identified in the present study.
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Affiliation(s)
- Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia.
| | - Ming Woey Teh
- Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200, Klang, Selangor, Malaysia
| | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Mohd Ghazali Sumarni
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Pei Pei Heng
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Tajul Hassan Mohd Zahari
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Ying Ying Chan
- Institute for Public Health, Ministry of Health, Jalan Bangsar, 50590, Kuala Lumpur, Malaysia
| | - Md Iderus Nuur Hafiza
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
| | - Eng Ong Tee
- Allied Health Science College, Jalan Hospital, 47000, Sungai Buloh, Selangor, Malaysia
| | - Kamaludin Fadzilah
- Institute for Medical Research, Ministry of Health, Jalan Setia Murni U13/52, 40170, Seksyen U13, Bandar Setia Alam, Malaysia
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Shayo FK. Co-occurrence of risk factors for non-communicable diseases among in-school adolescents in Tanzania: an example of a low-income setting of sub-Saharan Africa for adolescence health policy actions. BMC Public Health 2019; 19:972. [PMID: 31331303 PMCID: PMC6647087 DOI: 10.1186/s12889-019-7320-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 07/15/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Childhood lifestyle, health-risk behaviours contribute to two-thirds of non-communicable diseases (NCDs) premature mortality in adult populations. The co-occurrence of risk factors for NCDs is more harmful to health than that of individual risk factor effects when are added independently. The main objective of the present study was to explore the prevalence, sociodemographic distribution, and the co-occurrence of risk factors for NCDs among in-school adolescents. METHODS The present study is based on the secondary analysis of the first nationwide representative sample of the 2014 Tanzania Global School-based Student Health Survey (GSHS). A total sample of 3,793 in-school adolescents was included in the present analysis. The dependent variables were as follows: an unhealthy diet, physical inactivity, tobacco use, excessive alcohol use, and suicide attempt. The analysis involved the Chi squire χ2 test, multinomial and multivariate regression models: to determine the association between the variables of interest. In all analyses, the set level of statistical significance was a p-value of less than 0.05 at 95% confidence intervals. RESULTS The most prevalent combination of risk factors for NCDs were as follows: unhealthy diet and physical inactivity 666 (17.6%); unhealthy diet and suicide attempt 151 (4.0); unhealthy diet and tobacco use 98 (2.8); and unhealthy diet, physical inactivity, and suicide attempt 81 (2.1). In the adjusted regression model; having three 0.60 [0.40-0.91], and a sum of four and five 0.46 [0.28-0.79] risk factors than having no risk factor showed a significant declined with increasing in adolescents age. Primary in-school adolescents than secondary in-school adolescents were significantly more likely to have two 1.81 [1.42-2.32], three 2.40 [1.63-3.54]; and a sum of four and five 2.90 [1.61-5.13] combinations of risk factors. CONCLUSION The co-occurrence of lifestyle health-risk factors for NCDs was prevalent among in-school adolescents: it was significantly higher among younger adolescents. A multi-strategy public health intervention program may be more effective than that of a single risk factor approach: therefore, suitable for resource-limited settings, such as Tanzania.
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Affiliation(s)
- Festo K Shayo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P. O Box 65000, Dar es Salaam, Tanzania.
- Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.
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Nur Atikah AH, Wee LH, Nur Zakiah MS, Chan CMH, Mohamed Haniki NM, Swinderjit JS, Siau CS. Factors associated with different smoking statuses among Malaysian adolescent smokers: a cross-sectional study. BMC Public Health 2019; 19:579. [PMID: 31196055 PMCID: PMC6565528 DOI: 10.1186/s12889-019-6857-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study focused on the associations between socioeconomic status (SES) and adolescent smoking among secondary school students (13 to 17 years) in the Federal Territory of Kuala Lumpur, Malaysia. Our objective was to evaluate the relationships between adolescent demographics, socioeconomic status and smoking status. METHODS The survey data were based on baseline findings from a cross-sectional study (N = 422 adolescents). Chi-square test was used to assess the relationship between demographic characteristics, socioeconomic status (household monthly income and daily allowance) and adolescent smoking status. Exhaled carbon monoxide (CO) reading and the Hooked on Nicotine Checklist (HONC) were used to evaluate adolescent smoking status. A Multivariate Multinomial Logistic Regression (MMLR) was employed to test selected demographic and socioeconomic predictors of smoking status. RESULTS Of the 422 adolescents (M age = 15.58, SD = 1.24), more than half of the participants initiated smoking between 13 to 17 years old (59.0%). A total of 308 (73.0%) were electronic cigarette users, with more than 50% comprising of single users. The mean CO reading was 2.14 ppm with 78.0% of adolescents scoring more than 0 on the Hooked on Nicotine Checklist (HONC). Males and participants aged 15 and 16 years were at increased risks of sole CC smoking. Meanwhile, males, those who are not hooked on smoking and with a non-smoker CO reading were at increased risks of sole EC smoking. Finally, Bumiputeras were at less risk of EC smoking. CONCLUSIONS Demographic variables such as age, gender and ethnicity predicted smoking status predicted smoking risk, but not socioeconomic factors. The findings allow policy makers to target specific high-risk demographic groups when designing smoking cessation programs for adolescents.
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Affiliation(s)
- A H Nur Atikah
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Lei Hum Wee
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia.
| | - M S Nur Zakiah
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Caryn Mei Hsien Chan
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - N M Mohamed Haniki
- Kulliyah of Pharmacy, International Islamic of Malaysia (UIA), Kuala Lumpur, Malaysia
| | - J S Swinderjit
- National Cancer Society Malaysia (NCSM), Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Health Education Program, Community Health Centre, Faculty of Health Sciences, The National University of Malaysia (UKM), Kuala Lumpur, Malaysia.,Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
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23
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Lim HL, Teh CH, Kee CC, Mohd Ghazali S, Pan SA, Lim KH. Exposure to second-hand smoke among secondary school-going adolescents: Findings from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study. PROCEEDINGS OF SINGAPORE HEALTHCARE 2019. [DOI: 10.1177/2010105818789961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it has been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce. Therefore, this article aims to demonstrate the magnitude and factors associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia. Methods: Data were derived from the Malaysian Adolescent Health Risk Behaviour (MyAHRB) study conducted in 2013. A total of 2599 adolescent were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine the risk factors/predictors associated with SHS. Results: More than half of the respondents had been exposed to SHS during the last one week (56.4%), and SHS exposure was significantly higher among respondents who smoked (94.0% vs. 49.9%, p <0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (adjusted odds ratio (aOR) 12.90, 95% confidence interval (CI): 8.01–20.4), had at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41–6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68–2.63). Conclusion: Our findings suggested that the effectiveness of anti-smoking measures implemented in recent years to protect adolescents from the health risks of passive smoking were less evident. Therefore, educational and awareness programmes that emphasize the negative health impacts of SHS exposure on Malaysian adolescents, particularly when among smoking adults, should be intensified to help in preventing adoption of smoking behaviours among adolescents.
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Affiliation(s)
- Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Jalan Maran, Malaysia
| | - Chien Huey Teh
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | - Chee Cheong Kee
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
| | | | | | - Kuang Hock Lim
- Institute for Medical Research, Ministry of Health, Kuala Lumpur, Malaysia
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Kuang Hock L, Hui Li L, Chien Huey T, Yuvaneswary V, Sayan P, Muhd Yusoff MF, Kuang Kuay L, Miaw Yn L, Kee Chee C, Sumarni Mohd G. Support for smoke-free policy among Malaysian adults: findings from a population-based study. BMJ Open 2019; 9:e020304. [PMID: 30760510 PMCID: PMC6377523 DOI: 10.1136/bmjopen-2017-020304] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Public opinion and support can be powerful mandates for smoke-free policy. However, the scarcity of evidence on public opinion among Malaysians necessitates further investigation. Therefore, this study aimed to determine the level of support for smoke-free policy at various public domains and its associated factors among Malaysian adults. DESIGN Data were derived from the Global Adult Tobacco Survey, Malaysia (GATS-M). GATS-M is a nationwide study that employed a multistage, proportionate-to-size sampling strategy to select a representative sample of 5112 Malaysian adults aged 15 years and above. Multiple logistic regression was used to identify factors associated with support for smoke-free policy in selected public domains that is, workplaces, restaurants, bars, hotels, casinos, karaoke centres, public transport terminals and shopping centres. RESULTS The level of support for enactment of a smoke-free policy at selected public domains varied from 37.8% to 94.4%, with the highest support was for gazetted smoke-free domains, namely, shopping centres (94.4%, 95% CI: 93.2% to 95.3%) and public transport terminals (85.2%, 95% CI: 83.3% to 86.9%). Multiple logistic regression revealed that non-smokers were more likely to support smoke-free policy at all domains. In addition, respondents who worked in workplaces with total or partial smoking restrictions were more likely to support a smoke-free policy ((total restriction adjusted OR (AOR): 14.94 (6.44 to 34.64); partial restriction AOR: 2.96 (1.138 to 6.35); non-restriction was applied as a reference). CONCLUSION A majority of the Malaysian adult population supported the smoke-free policy, especially at gazetted smoke-free domains. Therefore, expansion of a total smoking ban to workplaces, restaurants, bars, hotels, casinos and karaoke centres is strongly recommended to reduce exposure to secondhand smoke and to denormalise smoking behaviour.
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Affiliation(s)
| | - Lim Hui Li
- Hospital Sultan Haji Ahmad Shah, Mentakab, Pahang, Malaysia
| | | | | | - Pan Sayan
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | | - Ling Miaw Yn
- Institute of Public Health, Kuala Lumpur, Malaysia
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Lim KH, Teh CH, Heng PP, Pan S, Ling MY, Yusoff MFM, Ghazali SM, Kee CC, Shaharudin R, Lim HL. Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA). Tob Induc Dis 2018; 16:51. [PMID: 31516448 PMCID: PMC6659477 DOI: 10.18332/tid/96297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/17/2018] [Accepted: 09/26/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers. METHODS Our sample consisted of 1348 youth aged 10-17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth). RESULTS Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38-99.8) frequent smokers (AOR=4.41, 95% CI: 2.05-9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41-10.02) and upper secondary (AOR=4.74, 95% CI: 1.72-13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant. CONCLUSIONS The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.
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Affiliation(s)
| | | | - Pei Pei Heng
- Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Sayan Pan
- Jabatan Kesihatan Negeri Perlis, Perlis, Malaysia
| | - Miaw Yn Ling
- Institute of Public Health, Kuala Lumpur, Malaysia
| | | | | | | | | | - Hui Li Lim
- Hospital Sultan Haji Ahmad Shah, Temerloh, Malaysia
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