According to the Youth Behaviour Risk Factor Surveillance (YBRFSS, 2011) in Malaysia, the
prevalence of smokers nationally among Form 1, 2 and 4 students government secondary school
students was 9.1% (ever smokers) and 8.7% (current smokers). However, there is limited information on the
prevalence of smoking among religious secondary school students and self-esteem as risk factor. Thus, this
study was conducted to determine the prevalence and factors associated with smoking among the religious
secondary school students in Petaling district, Selangor. Methods: A cross-sectional study was conducted
among 899 students. The schools were selected using cluster sampling and self-administered questionnaire
was used. Data was analyzed using chi-square test and multivariate logistic regression to identify the
independent factors for smoking. Results: The response rate was 94%. The prevalence of ever smoking was
10.1%; 3.9% among female and 18.6% among male. The median age (interquartile range) of smoking
initiation was 12.00 (4.01) years. The results showed that independent factors for smoking were: males (OR=
5.47); age group 14-15years (OR=2.82) and 16-17 years (OR=3.63) and having low self -esteem (OR=6.24).
Conclusion: prevalence of ever smokers is higher when compared to YBRFSS, (2011) and it was revealed
that most of the smokers started smoking even before secondary school. The results also revealed the
importance of promoting self-esteem. Efforts in smoking prevention should therefore be focused on curbing
the initiation of the acts and improving students’ self-worth