Source of cigarettes among youth smokers in Malaysia: Findings from the tobacco and e-cigarette survey among Malaysian school adolescents (TECMA)

Abstract

INTRODUCTION Understanding how and where youth obtain tobacco products are major factors in the development of suitable intervention programs to reduce youth smoking. This study aimed to determine the source of cigarettes and the associated factors among Malaysian school adolescent smokers. METHODS Our sample consisted of 1348 youth aged 10–17 years who were current smokers (having smoked at least once in the last 30 days). The source of cigarettes (commercial, over-the-counter purchases; or social, borrowing or obtaining from someone else) was the dependent variable, and multivariable logistic regression was employed to determine its association with independent variables (i.e. sociodemographics, smoking behavior, and knowledge of laws prohibiting sales of cigarettes to youth). RESULTS Over half (54.3%) of current smokers obtained cigarettes from commercial sources, with a proportion nearly two times higher (84.2% vs 43.7%) among frequent smokers (i.e. those smoking more than 20 days per month) compared to less-frequent smokers, and among young males (56.5% vs 32.0%) compared young females. Multivariable logistic regression indicated that in urban areas, young females (AOR=12.5, 95% CI: 1.38–99.8) frequent smokers (AOR=4.41, 95% CI: 2.05–9.46), and those studying in lower (AOR=3.76, 95% CI: 1.41–10.02) and upper secondary (AOR=4.74, 95% CI: 1.72–13.06) school students were more likely to obtain cigarettes from a commercial source. On the other hand, in rural areas, only frequent smokers were more likely to get their cigarettes from commercial sources, whilst other variables were not significant. CONCLUSIONS The proportion of youth smokers who obtained cigarettes from commercial sources appeared to be high, suggesting that law enforcement and health promotion activities should be enhanced to reduce the rate of smoking among Malaysian youth.

Nicotine Dependence among Adolescents Single and Dual Cigarette Users

“…A study conducted among Negeri Sembilan’s adolescents revealed that the prevalence of tobacco use in the rural area was higher than in the urban areas [ 23 ]. Coupled with lack of implementation, enforcement, and surveillance of tobacco law in Malaysia, access to tobacco product for adolescents in both urban and rural areas is not monitored [ 24 ]. Data from the National Tobacco and E-cigarette survey among Malaysian Adolescents (TECMA) revealed that rural adolescents who frequently smoked were more likely to purchase their cigarette from commercial sources such as supermarkets, grocery stores, and road stalls [ 24 ].…”

Tobacco use and other aspects related to smoking among school-going adolescents aged 13–15 years in Malaysia: Analysis of three cross-sectional nationally representative surveys in 2003, 2009 and 2016

“…The questionnaire for GYTS 2003 was adopted from the GYTS Core Questionnaire with Optional Questions 15 . A panel of experts selected the country-specific optional items to be included in the final questionnaire.…”

Smoking in Malaysia: Main issues and ways to overcome

“…There are a few factors that contribute to younger age of smoking initiation, which includes tobacco factors, school factors, family factors and social factors. [23][24][25][26][27][28][29][30][31][32][33] For tobacco factors, easy availability of contraband cigarettes (cheap cigarettes) links to younger age of smoking initiation. According to the Nielsen Company (US) L. Illicit Cigarettes Study (ICS) in Malaysia (2019), 62.3% of the cigarettes in 2019 were cheap contraband cigarettes which were smuggled into the country.…”