1.Gender-specific Associations between Tobacco Use and Body Mass Index among School-going Adolescents in Malaysia: Results from the National Health Morbidity Survey 2017
Zamtira Seman ; Jayvikramjit Singh MS ; Ridwan Sanaudi ; Nor Hazimah Yeop Abd Rashid ; Mohd Azahadi Omar
International Journal of Public Health Research 2025;15(1):2157-2166
Tobacco uses and obesity are major global public health concerns, with adolescence being a critical period for the onset of these risk factors. In Malaysia, rising trends in adolescent smoking and obesity necessitate further investigation. This study examined gender-specific associations between different types of tobacco use and body mass index (BMI) among school-going adolescents. Data were derived from the NHMS 2017, a nationwide cross-sectional survey using a two-stage stratified random sampling design (N=27,497). Complex sample logistic regression was employed to assess the odds of past 30-day tobacco use by BMI category (underweight/normal weight, overweight, obese) stratified by gender. Confounders, including age, ethnicity, physical activity, fast food consumption, and mental health, were controlled for in the analysis. Adolescents classified as obese had a significant association with tobacco use, but this was not observed in overweight individuals. Male smokers were significantly less likely to be obese, whereas female smokers had a higher likelihood of obesity (AOR = 1.59, 95% CI: 1.25–2.02). Specifically, female users of e-cigarettes (AOR = 1.86, 95% CI: 1.36–2.56), smokeless tobacco (AOR = 1.66, 95% CI: 1.14–2.43), and other tobacco products (AOR = 1.62, 95% CI: 1.05–2.52) exhibited a higher risk of obesity. No significant association was found among male smokers. Female adolescent smokers showed a greater likelihood of obesity, emphasizing the need for gender-specific interventions. To mitigate these risks, public health efforts should incorporate education, policy measures, and lifestyle promotion. Further research is warranted to explore underlying biological mechanisms
2.Nutritional and Non-Communicable Disease (NCD) Status Association with Fall among Older Persons in Malaysia: Findings from National Health and Morbidity Survey (NHMS) Malaysia 2018
Jayvikramjit Singh ; Mohamad Fuad Mohamad Anuar ; Azli Baharudin ; Suhaila Abdul Ghaffar ; Cheong Siew Man ; Lalita Palineveloo ; Syafinaz Mohd Sallehuddin ; Nur Shahida Abd Aziz ; Norsyamlina Che Abdul Rahim ; Munawara Pardi ; Nur Hamizah Nasaruddin ; Ahmad Ali Zainuddin
International Journal of Public Health Research 2021;11(2):1448-1454
Introduction:
Fall is a health problem for older persons. This study investigates the potential
factors of concern: the nutritional status of older persons and non-communicable
disease association with incidence of falls.
Methods:
This study used data from NHMS 2018, and conducted a cross-sectional design
by applying two-stage stratified cluster sampling. Descriptive statistics such as
the percentage of each variable were done. Factors associated with falls were
determined at both univariate and multivariable levels using simple logistic
regression and multiple logistic regression. The data were presented as standard
values for each analysis and adjusted odds ratios with 95% CI with p values
(<0.05).
Results:
A total of 3,867 from 3,977 elderly (mean age 68.2+ 6.85) were recruited with
the response rate of 97.2%. Factors associated with fall were 70 years old and
above (AOR= 1.34, 95% CI: 1.09, 1.64), obesity (AOR=1.55, 95% CI: 1.21,
1.98), undernutrition (AOR=1.59, 95% CI: 1.30, 1.94), persons with 2 NCDs
(AOR=1.49, 95% CI: 1.15, 1.92) and persons with 3 NCDs (AOR=1.63, 95%
CI: 1.23, 2.16).
Conclusions
Advanced age, malnutrition, obesity, and having two or more NCDs are
associated with falls in the NHMS 2018 study. In conclusion, falls are prevalent
among older persons. There is an urgent need for public health strategies and
programmes to decrease the incidence of modifiable risk factors and early
identification of those at risk. Implementation of fall preventive programs which
includes multifactorial interventions at hospitals and homes can also
significantly reduce incidence of falls among older persons