Abstract
Smoking among Malaysian adolescents remains a public health concern despite concerted efforts in tobacco control. The aims of this study were to examine the prevalence and determinants of current-smoking status in young adolescents. This cross sectional study used the first round of the Malaysian Health and Adolescents Research Team’s prospective cohort study. It was conducted in three States of the Central and Northern regions of Peninsular Malaysia between March and May 2012. The study used the multistage stratified sampling design. A total of 1,342 adolescents of both sexes, aged 12-13 years, were sampled from randomly selected urban and rural national schools. Information on current smoking status and associated factors were collected by a self-administered, pre-tested, validated, structured questionnaire. Seven percent of the samples were current-smokers; the majority (62%) of them started smoking at the age of 11 years or below. The prevalence of current smoking was significantly higher in males (odds ratio [OR] = 2.37; 95% CI: 1.46, 3.84), those who were influenced by smoker friends (OR = 8.35; 95% CI: 4.90, 14.25), who were unaware of the health risks of smoking (OR =1.85; 95% CI: 1.02, 3.36) and who reported a lack of satisfaction about their overall life (OR =3.26; 95% CI: 1.73, 6.12). The study findings provide valuable information to strengthen the existing school-based smoking prevention program through integration of social competence and social influence curricula. The program should empower the young adolescents to refuse tobacco offers, to overcome social influences and to resist peer pressure to avoid starting smoking. Particular focuses to include mental health service to prevent both emotional and behavioural problems are needed.
Highlights
Smoking is a well-established preventable risk factor for non-communicable diseases
The study mainly found that the likelihood of being a current smoker was significantly higher among those young adolescents who were male, were highly influenced by smoker friends and were unaware of the health risks of smoking and who reported a lack of satisfaction about their overall life
Consistent with existing literature [12,13,14], this study found that adolescent boys are significantly more likely to be smokers than girls; smoking prevention programmes mainly need to focus on young male adolescents
Summary
Smoking is a well-established preventable risk factor for non-communicable diseases. While the prevalence of current tobacco use is declining among males aged 15 years and over globally (39% in 2005 and 36% in 2009) and in South-East Asia (39% in 2005 and 30% in 2009), current tobacco use is increasing in younger male adolescents aged 13–15 years globally (16% and 18% in 2007 and 2010 respectively) and in South-East Asia (17% and 21% in 2007 and 2010 respectively). In 2010, within the South-East Asian region, the prevalence of current smoking in young male adolescents (13–15 years old) was higher in Malaysia (35%) and Indonesia (41%) than that of the neighbouring countries (e.g. Philippines 28%, Thailand 24%, and Myanmar 23%) [1,2]. Hypertension, hyperglycemia, overweight and obesity are seen in Malaysian adolescents [6,7,8,9]. It is crucial for the future of the country and region that the major modifiable risk factors for NCDs, including smoking, are tackled within this particular group
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