Smoking among school-going adolescents in selected secondary schools in Peninsular Malaysia- findings from the Malaysian Adolescent Health Risk Behaviour (MyaHRB) study.
BACKGROUND
A multitude of studies have revealed that smoking is a learned behaviour during adolescence and efforts to reduce the incidence of smoking has been identified as long-term measures to curb the smoking menace. The objective of this study was to determine the prevalence as well as the intra and inter-personal factors associated with smoking among upper secondary school students in selected schools in Peninsular Malaysia.


METHODS
A study was carried out in 2013, which involved a total of 40 secondary schools. They were randomly selected using a two-stage clustering sampling method. Subsequently, all upper secondary school students (aged 16 to 17 years) from each selected school were recruited into the study. Data was collected using a validated standardised questionnaire.


RESULTS
This study revealed that the prevalence of smoking was 14.6% (95% CI:13.3-15.9), and it was significantly higher among males compared to females (27.9% vs 2.4%,p< 0.001). Majority of smokers initiated smoking during their early adolescent years (60%) and almost half of the respondents bought cigarettes themselves from the store. Multivariable analysis revealed that the following factors increased the likelihood of being a current smoker: being male (aOR 21. 51, 95% CI:13.1-35), perceived poor academic achievement (aOR 3.42, 95% CI:1.50-7.37) had one or both parents who smoked (aOR 1.80, 95% CI:1.32-2.45; aOR 6.50, 95 CI%:1.65-25.65), and always feeling lonely (aOR 2.23, 95% CI:1.21-4.43). In contrast, respondents with a higher religiosity score and protection score were less likely to smoke (aOR 0.51, 95% CI:0.15-0.92; aOR 0.71, 95% CI 0.55-0.92).


CONCLUSIONS
This study demonstrated that the prevalence of smoking among Malaysian adolescents of school-going age was high, despite implementation of several anti-smoking measures in Malaysia. More robust measures integrating the factors identified in this study are strongly recommended to curb the smoking epidemic among adolescents in Malaysia.
Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
Kuang Hock
KH
Lim
Melaka Manipal Medical College, Jalan Batu Hampar, Kuala Lumpur, 75150 Melaka Malaysia.
Hui Li
HL
Lim
Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
Chien Huey
CH
Teh
Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
Chee Cheong
CC
Kee
Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia.
Yi Yi
YY
Khoo
Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia.
Shubash Shander
SS
Ganapathy
Institute for Public Health, Jalan Bangsar, 50590 Kuala Lumpur, Malaysia.
Miaw Yn
MY
Jane Ling
Institute for Medical Research, Jalan Pahang, 50588 Kuala Lumpur, Malaysia.
Sumarni
S
Mohd Ghazali
Allied Health College, Jalan Hospital, 47000 Sg. Buloh, Malaysia.
Eng Ong
EO
Tee
Adolescent smoking; Interpersonal; Intrapersonal; Peninsular Malaysia; School-going adolescents