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.

Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.

PURPOSE: To develop a profiling tool which accurately assigns a patient to the appropriate attitudinal cluster for the management of asthma. METHODS: Attitudinal data from an online survey of 2,467 patients with asthma from 8 Asian countries/region, aged 18-50 years, having had ≥2 prescriptions in the previous 2 years and access to social media was used in a discriminant function analysis to identify a minimal set of questions for the Profiling Tool. A split-sample procedure based on 100 sets of randomly selected estimation and validation sub-samples from the original sample was used to cross-validate the Tool and assess the robustness of its predictive accuracy. RESULTS: Our Profiling Tool contained 10 attitudinal questions for the patient and 1 GINA-based level of asthma control question for the physician. It achieved a predictive accuracy of 76.2%. The estimation and validation sub-sample accuracies of 76.7% and 75.3%, respectively, were consistent with the tool's predictive accuracy at 95% confidence level; and their 1.4 percentage-points difference set upper-bound estimate for the degree of over-fitting. CONCLUSIONS: The Profiling Tool is highly predictive (>75%) of the attitudinal clusters that best describe patients with asthma in the Asian population. By identifying the attitudinal profile of the patient, the physician can make the appropriate asthma management decisions in practice. The challenge is to integrate its use into the consultation workflow and apply to areas where Internet resources are not available or patients who are not comfortable with the use of such technology.
Asia ; Asian Continental Ancestry Group ; Asthma* ; Discriminant Analysis ; Disease Management ; Humans ; Internet ; Prescriptions ; Social Media