BackgroundThree National Health and Morbidity Surveys (NHMSs) had been conducted in Malaysia in 10-year intervals from 1986–2006. Based on the latest NHMS survey in 2006, we describe the prevalence of smoking and identify the social and demographic factors associated with smoking among adult males in Malaysia.MethodsA cross-sectional study among 15,639 Malaysian adult males aged 18 years and above was conducted using proportional to size stratified sampling method. The socio-demographic variables examined were level of education, occupation, marital status, residential area, age group and monthly household income.ResultsThe prevalence of smoking among adult males in Malaysia was 46.5% (95% CI: 45.5–47.4%), which was 3% lower than a decade ago. Mean age of smoking initiation was 18.3 years, and mean number of cigarettes smoked daily was 11.3. Prevalence of smoking was highest among the Malays (55.9%) and those aged 21–30 years (59.3%). Smoking was significantly associated with level of education (no education OR 2.09 95% CI (1.67–2.60), primary school OR 1.95, 95% CI (1.65–2.30), secondary school OR 1.88, 95% CI (1.63–2.11), with tertiary education as the reference group). Marital status (divorce OR 1.67, 95% CI (1.22–2.28), with married as the reference group), ethnicity (Malay, OR 2.29, 95% CI ( 1.98–2.66; Chinese OR 1.23 95% CI (1.05–1.91), Other Bumis OR 1.75, 95% CI (1.46–2.10, others OR 1.48 95% CI (1.15–1.91), with Indian as the reference group), age group (18–20 years OR 2.36, 95% CI (1.90–2.94); 20–29 years OR 3.31 , 95% CI 2.82–3.89; 31–40 years OR 2.85 , 95% CI ( 2.47–3.28); 41–50 years OR 1.93, 95% CI (1.69–2.20) ; 51–60 years OR 1.32, 95% CI (1.15–1.51), with 60 year-old and above as the reference group) and residential area (rural OR 1.12 , 95% CI ( 1.03–1.22)) urban as reference.ConclusionThe prevalence of smoking among Malaysian males remained high in spite of several population interventions over the past decade. Tobacco will likely remain a primary cause of premature mortality and morbidity in Malaysia. Continuous and more comprehensive anti-smoking policy measures are needed in order to further prevent the increasing prevalence of smoking among Malaysian men, particularly those who are younger, of Malay ethnicity, less educated, reside in rural residential area and with lower socio-economic status.

BackgroundTo determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults.MethodsWe analysed data on 1044 men and 1528 women, aged 24–64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors.ResultsThe response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors.ConclusionThe prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.

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The present study provides new insights into the factors affecting physical activity participation among adolescents. Specifically, self-rated excellent academic performance, household size and physical education can increase the likelihood of being physically active. Evidence of the present study implies that policy makers should pay special attention to females, Chinese, adolescents with self-rated poor academic performance and adolescents who have low maternal education.

INTRODUCTIONExposure to secondhand smoke (SHS) has been proven to be detrimental to health. However, there is little information on SHS exposure among Malaysian adolescents. This study aims to assess the magnitude of and factors associated with SHS exposure among school-going adolescents in Malaysia.METHODSWe performed secondary analysis on data from 25461 respondents of the Global School Health Survey in Malaysia. Descriptive analyses and multivariable logistic regression were performed to determine factors associated with SHS exposure.RESULTSRespondents were adolescents of mean age 14.84 (SD=1.45) years, 50.2% of which were male and 49.8% female. Approximately four in ten respondents were exposed to SHS in the past week (41.5%). SHS exposure was significantly higher among respondents who smoked than among non-smokers (85.8% vs 35.7%, p<0.001). The likelihood of exposure to SHS was higher among smoking adolescents (Adjusted OR=1.66, 95% CI: 1.07–2.56) and non-smoking adolescents (AOR=3.15, 95% CI: 1.48–4.71) who had at least one smoking parent/guardian regardless of their own smoking status. Male adolescents had higher risk of SHS exposure compared to their female counterparts (current smoker AOR=1.66, 95% CI: 1.07–2.56; non-smoker AOR=1.50, 95% CI: 1.12–2.00) and increased with age, regardless of their smoking status.CONCLUSIONSOur findings suggest that prevalence of exposure to SHS among school-going adolescents in Malaysia is high. Parents should be advised to stop smoking or abstain from smoking in the presence of their children. Education programmes are recommended to increase awareness on avoidance of SHS as well as smoking cessation interventions for both adolescents and their parents.

Background: Smoking among adolescents has been linked to a variety of adverse and long term health consequences. "Susceptibility to smoking" or the lack of cognitive commitment to abstain from smoking is an important predictor of adolescent smoking. In 2008, we conducted a study to determine the psycho-sociological factors associated with susceptibility to smoking among secondary school students in the district of Kota Tinggi, Johor. Materials and Methods: Two thousand seven hundred students were randomly selected by proportional stratified sampling. Analyses on 1,736 non-smoking students revealed that prevalence of adolescents susceptible to smoking was 16.3%. Results: Male gender (aOR=2.05, 95%CI= 1.23-3.39), poor academic achievement (aOR 1.60, 95%CI 1.05-2.44), ever-smoker (aOR 2.17, 95%CI 1.37-3.44) and having a smoking friend (aOR 1.76, 95%CI 1.10-2.83) were associated with susceptibility to smoking, while having the perception that smoking prohibition in school was strictly enforced (aOR 0.55, 95%CI 0.32-0.94), and had never seen friends smoking in a school compound (aOR 0.59, 95%CI 0.37-0.96) were considered protective factors Conclusions: These results indicate that follow-up programmes need to capitalise on the modifiable factors related to susceptibility to smoking by getting all stakeholders to be actively involved to stamp out smoking initiation among adolescents.

A growing number of fast-food outlets in close proximity to residential areas raises a question as to its impact on childhood overweight and obesity. This study aimed at determining the relationship between the availability of fast-food outlets that were in close proximity to residential areas and overweight among Malaysian children aged 5 to 18 years. Measurement data on the weight and height of 5544 children (2797 boys, 2747 girls) were obtained from the National Health and Morbidity Survey 2011. Overweight (including obesity) is defined as BMI-for-age z-score > +1 SD based on the WHO growth reference. Geographic information system geospatial analysis was performed to determine the number of fast-food outlets within 1000 m radius from the children’s residential address. Multiple logistic regression was conducted to examine the association between the availability of fast-food outlets (none or more than one outlet) and overweight with adjustment for age, sex, ethnicity, monthly household income, parental educational level, residential area and supermarket density. Our results showed that the prevalence of overweight was 25.0% and there was a statistically significant association between the density of fast-food outlets and overweight (odds ratio: 1.23, 95% confidence interval: 1.03, 1.47). Our study suggested that the availability of fast-food outlets with close proximity in residential areas was significantly associated with being overweight among children. Limiting the number of fast-food outlets in residential areas could have a significant effect in reducing the prevalence of overweight among Malaysian children.