title: Knowledge, attitude and perception of second-hand smoke and factors promoting smoking in Malaysian adolescents.
abstract: OBJECTIVE
  To identify the relationship between knowledge, attitude and perception regarding environmental tobacco smoke (ETS) and smoking among Malaysian adolescents living in states with complete or partial smoke-free legislation (SFL).
  
  
  METHODS
  A total of 898 respondents aged 13-14 years were randomly selected from 21 secondary schools. The Malay version of the modified Global Youth Tobacco Survey questionnaire was used. Hierarchical logistic regression was performed in examining predictors of smoking attempt among adolescents.
  
  
  RESULTS
  Participants exposed to ETS >5 h/day were more likely to have smoked compared to those exposed to ETS <1 h/day (OR 4.1, 95%CI 1.03-16.0). Living in a state with partial SFL was associated with a two-fold increase in self-reported smoking attempts (OR 1.95, 95%CI 1.10-3.43) compared to living in a state with complete SFL. Negative attitudes and perceptions towards smoking and ETS exposure were linked to lower smoking attempts in states with complete SFL.
  
  
  CONCLUSIONS
  Adolescents with limited ETS exposure who lived in a state with complete SFL were less likely to attempt smoking compared to those exposed more regularly to ETS and living in a state with partial SFL. Preventing adolescents from becoming smokers is the key to reducing national prevalence rates in smoking. There is a need to implement comprehensive smoke-free legislation nationally across Malaysia.
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: N Zainol
authors.initials: NZ
authors.lastname: Abidin
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: A
authors.initials: A
authors.lastname: Zulkifli
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: E Zainal
authors.initials: EZ
authors.lastname: Abidin
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: I
authors.initials: I
authors.lastname: Rasdi
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: S N Syed
authors.initials: SN
authors.lastname: Ismail
authors.affiliation: <label><sup>†</sup></label>Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
authors.forename: A Abd
authors.initials: AA
authors.lastname: Rahman
authors.affiliation: Departments of <label>*</label>Environmental and Occupational Health, Selangor, Malaysia.
authors.forename: Z
authors.initials: Z
authors.lastname: Hashim
authors.affiliation: <label><sup>‡</sup></label>Scottish Centre for Indoor Air, Division of Applied Health Sciences, University of Aberdeen, Child Health, Royal Aberdeen Children's Hospital, Aberdeen, Scotland, UK.
authors.forename: S
authors.initials: S
authors.lastname: Semple
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D010465:Perception; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D014028:Tobacco Smoke Pollution