title: Perceived effects of the Malaysian National Tobacco Control Programme on adolescent smoking cessation: a qualitative study.
abstract: BACKGROUND
  The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined.
  
  
  METHODS
  Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed.
  
  
  RESULTS
  The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation.
  
  
  CONCLUSIONS
  Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.
authors.affiliation: Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
authors.forename: Hizlinda
authors.initials: H
authors.lastname: Tohid
authors.forename: Noriah  Mohd
authors.initials: N
authors.lastname: Ishak
authors.forename: Noor Azimah
authors.initials: NA
authors.lastname: Muhammad
authors.forename: Farah Naaz Momtaz
authors.initials: FN
authors.lastname: Ahmad
authors.forename: Abdul Anis Ezdiana
authors.initials: AA
authors.lastname: Aziz
authors.forename: Khairani
authors.initials: K
authors.lastname: Omar