Modelling an Unhealthy Behaviour Index among School-Going Adolescents in Timor-Leste: A Two-Part Approach IntroductionThe burden of unhealthy behaviours in the adolescent population is a worldwide public health concern. This study develops an unhealthy behaviour index and examines its associated factors within a large sample of adolescents from Timor-Leste.MethodsThe data of 3455 adolescents from a nationally representative sample were analysed. The unhealthy behaviour index was developed based on the number of involvements in unhealthy behaviours (consumption of soft drink and fast food, low intake of fruit and vegetables, physical inactivity, smoking, alcohol drinking, illicit drug use). A two-part model was applied to assess the influences of demographic, environmental, personal and parental factors on the participation decisions of unhealthy behaviours and the unhealthy behaviour index.ResultsParental closeness was associated with participation decisions. Age, being involved in physical fights, suicide attempt and parental connectedness were correlated with unhealthy behaviour index. Bullying victimisation and truancy affected both participation and index. There were interaction effects of gender and loneliness on the unhealthy behaviour index.ConclusionsAdolescents who engage in unhealthy behaviours are more likely to be younger, be involved in physical fights, experience bullying, attempt suicide, play truant and have no parental closeness and connectedness. The specific policy recommendations include discouraging male adolescents who do not encounter loneliness as well as those in lower-secondary education from indulging in unhealthy lifestyles. Additionally, parents should collaborate with educators on monitoring adolescents’ environmental stressors, mental health condition and class attendance, and be prepared to provide support in a timely manner.

Introduction: Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years Methods: The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis Conclusion The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future.

Introduction: Multitude studies have shown perception is an integral factor associated with smoking, However, no such tool was available in Malay language. In this study, we established a Bahasa Malaysia version of PTSQ (BM-PTSQ) and tested the validity and reliability among secondary school adolescents. Methods: The English version of PTSQ originally consists of 12 items. It was translated into Bahasa Malaysia and back-translated again into English to check for consistency. After face validity (face-to-face query) was determined among 20 secondary school adolescents, only 10 items were included in the survey. Construct validity was established from 407 school adolescents through random selection in the same locality. More than 60% of the respondents were female, a majority (67.3%) were schooling in rural areas. Then, the reliability of the questionnaire was determined with Cronbach's alpha. Results: EFA has grouped PTSQ into two components, they are associated with either knowledge or attitude towards smoking. The variance and Cronbach's alpha for the first and second component were 38.24% and 0.861 (7 items) and 21.62% and 0.661 (3 items) respectively. Conclusion The PTSQ showed good validity and reliability for measurement of perception in smoking among school adolescents in Malaysia, thus this is a viable measurement tool. More importantly this study shows an urgent need to improve the smoking education among adolescents in Malaysia.

The study aims to determine the relationship of attitude and social-norm with intention to smokein the future among non-smoking youth. Data were derived from astudy on smoking among form four students in selected secondary school in Peninsular Malaysia, which utilised apre-validated questionnaire to obtain data from the selected respondents. Descriptive statistics and structural equation modelling (SEM) were used in data analysis. The study revealed independentvariables accounted for 22.6% of the variance inintention to initiate smoking and the model had good fit. Asignificant relationship was observed between subjective norm and intention to initiate smoking (R=0.46). The study revealed that attitude and social norm substantially explained intention to smoke among non-smoking adolescents. Future measures should concentrate oncorrectingthe subjective norms to reduce intentionto initiate smokingamong non-smoking youth.

Studies have shown that parents and peers are among the dominant factors that contribute to smoking initiation among non-smoking adolescents. The paucity of this information in Malaysia warrants a longitudinal study to determine the actual factors associated smoking initiation. The study aims to address the gaps in our knowledge on the factors that associated with smoking initiation among non-smoking school-going adolescents. We carried out a longitudinal study among non-smoking secondary school-going adolescents in Kota Tinggi district, Johor. A representative sample of 1682 was selected via multi-stage sampling and respondents were followed-up for a period of one year. A pre-validated questionnaire was used to collect data from the selected respondents and multivariable logistic regression was employed to determine the factors associated with smoking initiation among non-smoking school-going adolescents. Approximately 1 in 10 non-smoking school-going adolescents-initiated smoking at the end of follow-up. Having peers and a father who smokes were significantly associated with smoking in univariate analysis, similarly relationship was also observed in multivariable analysis between parents who smoked with smoking initiation after the effect of other independent variables were controlled (Adjusted relative risk: 1.81, 95% CI 1.06-2.95). The study revealed that parental influence was more dominant than peer influence with regards to smoking initiation. Therefore, intervention programmes should involve parents/guardians to enhance their chances of success and reduce the incidence of smoking among non-smoking school-going adolescents.