Support for smoke-free policy among Malaysian adults: findings from a population-based study

Abstract

ObjectivePublic opinion and support can be powerful mandates for smoke-free policy. However, the scarcity of evidence on public opinion among Malaysians necessitates further investigation. Therefore, this study aimed to determine the level of support for smoke-free policy at various public domains and its associated factors among Malaysian adults.DesignData were derived from the Global Adult Tobacco Survey, Malaysia (GATS-M). GATS-M is a nationwide study that employed a multistage, proportionate-to-size sampling strategy to select a representative sample of 5112 Malaysian adults aged 15 years and above. Multiple logistic regression was used to identify factors associated with support for smoke-free policy in selected public domains that is, workplaces, restaurants, bars, hotels, casinos, karaoke centres, public transport terminals and shopping centres.ResultsThe level of support for enactment of a smoke-free policy at selected public domains varied from 37.8% to 94.4%, with the highest support was for gazetted smoke-free domains, namely, shopping centres (94.4%, 95% CI: 93.2% to 95.3%) and public transport terminals (85.2%, 95% CI: 83.3% to 86.9%). Multiple logistic regression revealed that non-smokers were more likely to support smoke-free policy at all domains. In addition, respondents who worked in workplaces with total or partial smoking restrictions were more likely to support a smoke-free policy ((total restriction adjusted OR (AOR): 14.94 (6.44 to 34.64); partial restriction AOR: 2.96 (1.138 to 6.35); non-restriction was applied as a reference).ConclusionA majority of the Malaysian adult population supported the smoke-free policy, especially at gazetted smoke-free domains. Therefore, expansion of a total smoking ban to workplaces, restaurants, bars, hotels, casinos and karaoke centres is strongly recommended to reduce exposure to secondhand smoke and to denormalise smoking behaviour.

Exposure to Second-Hand Smoke (Shs) and Attitude, Perception, and Acceptance Towards Smoke-Free Policy in Open-Air Eateries in Peninsular Malaysia - A Protocol

“…The Ministry of Health, Malaysia have taken several initiatives such as health promotion activities and introduction of smoke-free areas in various public areas to reduce the SHS exposure, in which, the reduction of SHS had been stipulated as one of the target goals in the National anti-smoking strategic plan ( MOH 2015). Various measures had been initiated and implemented to achieve the goal namely, the healthy lifestyle campaign since 1990 and gazettement of smoke-free areas which had been expanded through the provision and amendment of Control of Tobacco Product Regulation 2004 (Government of Malaysia 2005; the government of Malaysia 2017; Lim et al, 2019). Smoke-free city concept have also been introduced to prohibit smoking at particular public areas, in which Malacca smoke-free areas had been gazetted on 15 June 2011 was the first initiative by Malacca state government,…”

“…Open Access: e-Journal (MBAR ) and Ministry of Health. Currently, 38 public areas had been gazetted as smoke-free areas (Lim et al, 2019).However, The Global Adult Tobacco Survey (GATS) 2011 (IPH 2012) revealed that the exposure to SHS was significantly high among Malaysian adult in open air restaurant (71%) and 84.9% in cafes/coffee shops/bistros, Smoke free Melaka city evaluation report reveal the MBAR has resulted in positive impact on perception, attitude and behavior of smoking on people who live or visiting the Melaka city, reduction of smoking in front of children and other non-smokers in public places and low level concentration of PM 2.5 in gazette indoor areas for smoking compared to concentration of PM 2.5 in public areas without such restriction (USM 2014 ) Therefore, the MOH intended to established more smoke free areas especially in non-air conditioned eateries restaurants which had been shown to have higher SHS exposure among Malaysian adults.…”

“…In addition, public acceptance and attitude are important pre-requisite elements in securing and enforcing effective smoke-free laws [IARC, 2009]. It was especially true in democratic nations like Malaysian, where by public opinion, acceptance and support are necessary for the legislation of comprehensive smoke-free policies for successful enforcement and good compliance, even in controversial areas such as mamak stalls and open-air eateries (Chapman, 2007;Lim et al, 2019 ). Therefore, the present study is greatly warranted in order to provide an evidence-based findings to policy-makers and/or stakeholders for planning, formulation and implementation of smoke-free policy via the following objectives:…”

“…The studies on attitude toward SFI's support level revealed that average support level was high ( more than two-thirds of respondents usually support the SFI initiative, In which the support was high among non-smokers, higher education attainment, woman and living in the smoke-free environment ( Lim et al, 2019). Wang et al in their study on attitude towards smoke-free public housing among US adult revealed that Favorability was 44.3% among current cigarette smokers, 73.2% among former smokers, and 80.4% among never smokers.…”

“…Smoke-free policies are related to direct improvements in air quality (Connolly et al 2009, Shamo et al, 2015) , and reduction in smoking-related behaviour (Hawkins 2016) . There is also evidence that indoor smoking bans are supported by employees (Chang et al,2009), and elicit satisfaction among customers ( Lim et al, 2019;Rashid et al, 2014). In addition, some studies suggested that more restrictive smoke-free policies, including outdoor bans, would support employees in attempts to reduce or quit smoking.…”