title: Risk and Protective Factors for Cigarette Use in Young Adolescents in a School Setting: What Could Be Done Better?
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.
authors.affiliation: Centre for Population Health (CePH), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: M
authors.initials: M
authors.lastname: Dahlui
authors.affiliation: SEACO and School of Medicine and Health Sciences, Monash University Malaysia, Segamat, Malaysia.
authors.forename: N K
authors.initials: NK
authors.lastname: Jahan
authors.affiliation: Centre for Population Health (CePH), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: H A
authors.initials: HA
authors.lastname: Majid
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: M Y
authors.initials: MY
authors.lastname: Jalaludin
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
authors.forename: L
authors.initials: L
authors.lastname: Murray
authors.affiliation: Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom.
authors.forename: M
authors.initials: M
authors.lastname: Cantwell
authors.affiliation: Centre for Population Health (CePH), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: T T
authors.initials: TT
authors.lastname: Su
authors.affiliation: Centre for Population Health (CePH), Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Department of Social and Preventive Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia.
authors.forename: N
authors.initials: N
authors.lastname: Al-Sadat
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D010379:Peer Group; D011446:Prospective Studies; D012307:Risk Factors; D012424:Rural Population; D012572:School Health Services; D012574:Schools / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D000074606:Smoking Prevention; D014505:Urban Population