title: Incidence of adverse transition in smoking stages among adolescents of Kinta, Perak.
abstract: BACKGROUND
  Few local studies have explored the process of adverse transition of smoking stages among adolescents. The present investigation aimed to identify adverse transitions prospectively from the early stages till the escalation of the stages after one year.
  
  
  METHODS
  Data were collected in two waves from a cohort of 2,552 adolescents aged 12-13 years old studying in 15 secondary schools based in Kinta, Perak. A multistage sampling method was used to select the schools and a self-administered structured questionnaire was applied to help categorize the participants into five different smoking stages. Nonsmokers were divided into never smokers and susceptible never smokers. Ever-smokers were categorized as experimenters, current smokers or ex-smokers.
  
  
  RESULTS
  Among the participants 46.8% were Malay, 33.5% Chinese and 17.1% Indians. At baseline, we had 85.3% non-smokers and 14.6% ever smokers. Incidence of adverse transition among all our participants was 24.1%, with a higher value among male participants (16.8%). A higher proportion of susceptible never smokers and experimenters progressed to current smoking stage compared to never smokers.
  
  
  CONCLUSIONS
  This study highlights the changes and patterns of adverse transition among adolescents. Male adolescents, those who are susceptible to smoking and those who had already tried experimenting with cigarettes have a higher chance of escalating to a higher smoking stage.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Malaysia E-mail : premilausm@yahoo.com.
authors.forename: Premila Devi
authors.initials: PD
authors.lastname: Jeganathan
authors.forename: Noran N
authors.initials: NN
authors.lastname: Hairi
authors.forename: Nabilla Al
authors.initials: NA
authors.lastname: Sadat
authors.forename: Karuthan
authors.initials: K
authors.lastname: Chinna
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012574:Schools; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000523:psychology