Pattern of Shisha and Cigarette Smoking in the General Population in Malaysia

Abstract

Background: Smoking is a primary risk factor for cancer development. While most research has focused on smoking cigarettes, the increasing popularity of shisha or water pipe smoking has received less attention. This study measured the prevalence and risk factors for shisha and cigarette smoking and related knowledge. Materials and Methods: This cross-sectional analytical study was conducted in Shah Alam, Malaysia. Participants aged ≥ 18 years were selected from restaurants. Data regarding demographic variables, smoking patterns, and knowledge about shisha smoking were collected in local languages. Logistic regression was performed to assess risk factors. Results: Of 239 participants, 61.9 % were male and 99.2% revealed their smoking status. Some 57.4% were smokers: 50.7% only cigarettes, 5.9% only shisha and 42% both. Mean age of starting cigarette smoking was 17.5 ± 2.4 years and for shisha smoking 18.7 ± 2.0 years. In a univariate model, male gender, age 33-52 years and monthly income > MYR 4,000 increased the risk and unemployment and being a student decreased the risk. In a multivariate model, male gender increased the risk of smoking, while being a student decreased the risk, adjusting for age and income. The perception of shisha being less harmful than cigarettes was present in 14.6% and 7.5% had the opinion that shisha is not harmful at all, while 21.7% said that it is less addictive than cigarettes, 39.7% said that shisha did not contain tar and nicotine, 34.3% said that it did not contain carbon monoxide and 24.3% thought that shisha did not cause health problems. Conclusions: Prevalence of shisha and cigarette smoking is high in the general population in Malaysia and knowledge about shisha smoking is relatively low. The findings of our study might have implications for understanding similarities and differences in incidence of shisha and cigarette smoking in other cultural/geographic regions.

Shisha smoking centers in a satellite township near Kuala Lumpur, Malaysia: an observational study.

“…Al-Naggar et al, studied the pattern, related knowledge and risk factors for shisha smoking among Malaysians 7 . They concluded that Malaysians had relatively low knowledge about shisha smoking and the prevalence of shisha smoking was high among Malaysians 7 .…”

“…They concluded that Malaysians had relatively low knowledge about shisha smoking and the prevalence of shisha smoking was high among Malaysians 7 . Al-Naggar et al, also studied the associated risk factors for shisha smoking among University students.…”

Investigação de critérios diagnósticos utilizados no transtorno do uso de nicotina do DSM-5 em indivíduos da Área Metropolitana de São Paulo

“…The following socio-demographic correlates were considered: gender, age (categorized as [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] and 55 years or more); education (0-4, 5-8, 9-11, 12 years or more, respectively defined as low, low-average, high-average, and high); marital status (married/cohabiting, previously married [separated/divorced/widowed], never married); employment (working/student, homemaker, retired, unemployed/other);…”

“…There is the need to explore the applicability of DSM and ICD diagnostic approaches in different populations, such as Brazil, because studies have found different trends and correlates of tobacco smoking in Low-and Middle-Income countries (LMIC) [25,26,27]. For instance, the relationship between smoking and socio-economic correlates in LMIC countries seems to be different from that seen in Upper-Income countries [25,26,27].…”

“…For instance, the relationship between smoking and socio-economic correlates in LMIC countries seems to be different from that seen in Upper-Income countries [25,26,27]. A study from Malaysia, a middle-income country such as Brazil, found high levels of household income to be associated with smoking [25].…”