title: Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?
abstract: BACKGROUND
  This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation.
  
  
  METHODS
  A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire.
  
  
  RESULTS
  The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8).
  
  
  CONCLUSIONS
  Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.
authors.affiliation: Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia E-mail : za_emilia@upm.edu.my.
authors.forename: Aziemah
authors.initials: A
authors.lastname: Zulkifli
authors.forename: Najihah Zainol
authors.initials: NZ
authors.lastname: Abidin
authors.forename: Emilia Zainal
authors.initials: EZ
authors.lastname: Abidin
authors.forename: Zailina
authors.initials: Z
authors.lastname: Hashim
authors.forename: Anita Abd
authors.initials: AA
authors.lastname: Rahman
authors.forename: Irniza
authors.initials: I
authors.lastname: Rasdi
authors.forename: Sharifah Norkhadijah
authors.initials: SN
authors.lastname: Syed Ismail
authors.forename: Sean
authors.initials: S
authors.lastname: Semple
mesh_terms: D000293:Adolescent; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006284:Health Plan Implementation; D006801:Humans; D008296:Malaysia; D008297:Male; D010290:Parents; D011379:Prognosis; D012140:Respiratory Tract Diseases / Q000209:etiology* / Q000517:prevention & control; D012907:Smoking / Q000009:adverse effects / Q000331:legislation & jurisprudence*; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence* / Q000517:prevention & control
chemical_list: D014028:Tobacco Smoke Pollution