Perception about e-cigarettes in Malaysia : sociodemographic correlates

The prevalence of e-cigarette smoking is increasing. Many people still have a poor understanding of the risks of e-cigarettes. The purpose of this study is to examine sociodemographic factors associated with the perception that e-cigarettes are less dangerous than regular cigarettes. Multivariable logistic regressions are utilised to estimate the effects of sociodemographic factors on the likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. A Malaysian nationwide survey that consists of a large sample size (n = 4176) is used for secondary analysis. The survey was conducted in 2011. Younger age, male gender and high educational level are associated with good perception about e-cigarettes. Older individuals are less likely to think that e-cigarettes are less dangerous than regular cigarettes compared with younger individuals (aOR: 0.971; 95% CI: 0.957, 0.985). Males are more likely to have the perception that e-cigarettes are less dangerous than regular cigarettes relative to females (aOR: 2.302; 95% CI: 1.631, 3.249). Having primary (aOR: 0.171; 95% CI: 0.096, 0.304) or secondary (aOR: 0.447; 95% CI: 0.318, 0.629) educational level rather than tertiary educational level is associated with a reduced likelihood of having the perception that e-cigarettes are less dangerous than regular cigarettes. Targeted intervention to the high-risk population plays an important role in determining the perception about e-cigarettes. Nationwide health promotion programmes directed toward changing the perception about e-cigarettes among individuals who think that e-cigarettes are less dangerous than regular cigarettes may be effective in lowering the risk of suffering from the currently unknown long-term negative effect of e-cigarettes

Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population

AbstractBackgroundCardiovascular risk-prediction models are used in clinical practice to identify and treat high-risk populations, and to communicate risk effectively. We assessed the validity and utility of four cardiovascular risk-prediction models in an Asian population of a middle-income country.MethodsData from a national population-based survey of 14,863 participants aged 40 to 65years, with a follow-up duration of 73,277 person-years was used. The Framingham Risk Score (FRS), SCORE (Systematic COronary Risk Evaluation)-high and -low cardiovascular-risk regions and the World Health Organization/International Society of Hypertension (WHO/ISH) models were assessed. The outcome of interest was 5-year cardiovascular mortality. Discrimination was assessed for all models and calibration for the SCORE models.ResultsCardiovascular risk factors were highly prevalent; smoking 20%, obesity 32%, hypertension 55%, diabetes mellitus 18% and hypercholesterolemia 34%. The FRS and SCORE models showed good agreement in risk stratification. The FRS, SCORE-high and -low models showed good discrimination for cardiovascular mortality, areas under the ROC curve (AUC) were 0.768, 0.774 and 0.775 respectively. The WHO/ISH model showed poor discrimination, AUC=0.613. Calibration of the SCORE-high model was graphically and statistically acceptable for men (χ2 goodness-of-fit, p=0.097). The SCORE-low model was statistically acceptable for men (χ2 goodness-of-fit, p=0.067). Both SCORE-models underestimated risk in women (p<0.001).ConclusionsThe FRS and SCORE-high models, but not the WHO/ISH model can be used to identify high cardiovascular risk in the Malaysian population. The SCORE-high model predicts risk accurately in men but underestimated it in women

Knowledge on modes of HIV transmission and attitude related to working with people living with HIV among health care trainees in Malaysia

Background: Poor HIV knowledge and attitude among health care personnel were reported to compromise the care of people living with HIV (PLWH). This has been shown to arrest the success of HIV preventive, care and support measures in general. The objective of the study was to determine knowledge on modes of HIV transmission and attitude related to HIV among health care trainees. Materials and Methods: A total of 1404 trainees in an allied health sciences college in Malaysia consented in this cross sectional study. The data was collected using a self-administered questionnaire which consisted of knowledge on different modes of HIV transmission and attitudes related to HIV. Result: The overall response rate was 96.6% and majority of the respondents were able to identify different modes of HIV transmission namely sexual transmission (>75%), needle sharing (99.5%), blood transfusion (94.3%) and mother to child (85.8%). However, there were common misconceptions about HIV particularly with regards to HIV transmission via social contacts and other modes of transmission among. Up to 50% still have fears and discriminatory attitudes in relation to HIV. Conclusion: Health care training requires more comprehensive HIV education subject in the curricula in order to improve HIV knowledge and attitude amongst health care trainees

Iodine Deficiency Disorder and Goitre among School Children in Sarawak -A Nationwide Study.

Iodine deficiency disorders (IDD), is one of the most important micronutrient deficiencies which has multiple adverse effects on growth and development. The aim of this study was to determine the prevalence of IDD among school children and to elucidate the distribution of iodized salt at household level in Sarawak, East Malaysia. This cross-sectional study was conducted among school children aged 8 to 10 years in 2008. A multi-stage probability proportionate to population size(PPS) cluster sampling method was used to obtain a representative state sample of 1200 school children. Spot urine samples were collected for the determination of urinary iodine concentration while the iodine content in salt was determined using field rapid test kits. The thyroid status was determined by palpation. Response rate was 92.0% (n=1104/1200). The prevalence of goitre among school children in Sarawak was 2.9% (5.2% in urban, 0.7% in rural). The median urinary iodine concentration (UIC) among the school children was 102.1 μg/L (IQR, 62.3-146.5 μg/L). Urban children had significantly higher median UIC of 109.3 μg/L (IQR, 72.4-159.0 μg/L) than their rural counterparts [91.9 μg/L (IQR, 55.7-140.2 μg/L)]. The salt samples tested by rapid test kit (RTK) showed only 46.0% of household salt contained iodine. The present study revealed that the population in Sarawak were of borderline iodine sufficient with mild IDD seen in rural areas. Hence, the state IDD control programmes need to encourage and advocate the consumption of iodized salt in order to eliminate IDD-related health problems in Sarawak

Do adolescents under-report their smoking status? – Findings from secondary school students in Kota Tinggi, Johor

Background: The denormalisation of smoking behavior and anti-smoking measures taken to curb smoking prevalence have created an environment which might contribute to the under-reporting of smoking status among adolescents. The detection of under-reporting is crucial in ascertaining the accuracy of smoking data, therefore this study was undertaken to determine the prevalence of under-reporting of smoking status among school-going adolescents. Materials and Methods: A total of 405 of 2700 adolescents who participated in a longitudinal study in Kota Tinggi were randomly selected and their exhaled carbon monoxide concentration was measured using a pre-calibrated carbon monoxide (CO) analyzer. The cut-off point of exhaled CO of 5 parts per million (ppm) was used to determine smoking status. A total of 343 adolescents responded (84.69%) in the study, of which 85 smokers and 8 non-smokers with recent respiratory illness were excluded from the analysis. Results: Of these 250 non-smoking adolescents, 44.6% (115) were male, and 76.4% (197) were in lower secondary school. Analysis showed that the concentration of exhaled CO among 257 adolescents (99.6%) were between 0 - 5.00ppm. In addition, the CO level of all non-smoking females and lower secondary school students were in the range of 0 - 5.00ppm. This study revealed that the under-reporting of smoking status was negligible. Conclusion: Self-reported smoking status among adolescents can be accepted as valid answers for their smoking status. However, more studies in different localities on a larger scale are warranted to determine that self-reported smoking status is a valid measurement of actual smoking status among adolescents in the country

Support of smoking restriction in public areas among adolescents in Malaysia-the findings from tobacco and e-cigarette survey among adolescents in Malaysia (TECMA)

Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years. The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis. Majority of respondents supported smoking restriction in public areas (86.3%, 95 CI 85.4-87.1). The proportion and likelihood of support of smoke-free initiative were higher among respondents with better knowledge of the harmful effects of second-hand smoke (SHS), been taught in school about the health effects of smoking, older age group (16-19 years), female, those students schooling in urban areas, Malay and other Bumiputras from Sabah and Sarawak. However, current smokers and ECV users were less likely to support smoke-free initiatives in public areas. The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future

Prevalence and factors associated with smoking cessation among elderly in Malaysia- A findings from the population-based study

Introduction: The information of prevalence and associated factor(s) with smoking cessation among the elderly will assist in formulating the suitable policies and reducing the mortality among Malaysian elderly due to smoking-related diseases. This paper aims to describe the prevalence and factor(s) associated with smoking cessation among Malaysian elderly. Methods: We carried out the population-based study using the cross-sectional study design and a sample size of 2,674 respondents obtained via a multistage sampling method. Validated questionnaire and face-to-face interviews approach were the methodologies employed to collect data from the selected respondents. The interview was conducted by trained enumerator using a standardized and validated questionnaire. Descriptive and multiple logistic regression were used in data analysis. Results: The present findings demonstrated that almost 1 out of 10 of Malaysian elderly are current smokers. The prevalence of smoking was significantly higher among men (28.1%) compared to women (2.9%). Multivariable analysis showed that males and other ethnicities were less likely to cease smoking, while those with advancing age were more likely to stop smoking compared to the younger-aged elderly. Based on multivariate analysis, diabetes, hypertension and hypercholesterolemia were not significant factors associated with smoking cessation. Conclusions: The study has shown a low proportion of Malaysian elderly is ex- smoker. Suitable measures and programmes should be formulated and implemented to increase the quit smoking rate among them and subsequently to increase the quality of life by reducing the burden of smoking-related disease among the Malaysian elderly

Age, educational level and consumption of medical care: evidence from Malaysia

The present study examines age and educational level determinants of the consumption of medical care using data from Malaysia. A nationally representative data with a large sample size (n = 14838) was used for analyses.Several important findings are noteworthy. First, age and educational level are positively associated with the consumption of medical care. Second, the impact of educational level on the consumption of medical care varies across age.Third, there is no diminishing marginal effect of educational level on the consumption of medical care.Findings of the present study suggest that age and educational level play an important role in determining the consumption of medical care.When designing policies to improve population well-being, consideration should be given to the effects of age and educational level on the consumption of medical care.It is important for policymakers to understand which age group and educational level of people are more or less likely to use medical care.The present study offers a better understanding of the effects of age and educational level on the consumption of medical care and assists policymakers in developing more effective intervention measures to improve population well-being

Awareness, knowledge and acceptance of community on a non-communicable disease intervention – findings from the “Healthy Community, Developed Nation” (KOSPEN) in the Southern Zone of Peninsular Malaysia

Introduction Community-based health promotion programme has been recognised to reduce modifiable lifestyle risk behaviours for non-communicable diseases. The aim of this study was to evaluate the proportion of the awareness, knowledge and acceptance of a community-based intervention programme, “Komuniti Sihat, Pembina Negara“ (KOSPEN) (Healthy Community, Developed Nation). Methods This cross-sectional study employed a two-stage proportionate sampling method to select a representative sample of communities in the Southern states of Peninsular Malaysia, Negeri Sembilan, Malacca, and Johor. Face-to-face interviews by trained research assistants using pre-validated questionnaires was the study tool applied. Results The study revealed that approximately two thirds of respondents were aware of the KOSPEN programme (65.5%) and almost half (45.4%) of them were involved in the health promotion activities, namely health screenings (84.8%), health talks (66.4%), and providing plain water in formal occasion (52.9%). About two thirds and one-quarter of them have a very good (73.4%) and good (24.1%) general view on this programme. Four out of ten respondents faced difficulties joining the activities. Lack of time (83.0%) was reported as the main barrier. Conclusions The KOSPEN programme in overall was moderately accepted by the community. However, the need for future improvement has to be highlighted in order to enhance the involvement and participation of the communities

The Third National Health and Morbidity Survey: Prevalence of obesity, and abdominal obesity among the Malaysian elderly population

Obesity is an emerging public health threat in the elderly population in developing countries. Hence, the Third National Health and Morbidity Survey has assessed 4746 individuals aged 60 years and older recruited through a household survey to determine the prevalence of adiposity using body mass index and waist circumference. The national's prevalence of overweight and obesity in men was 29.2% (95% confidence interval [CI] = 27.2-31.3) and 7.4% (95% CI = 6.4-8.6), respectively. However, the prevalence decreased with age. The figures in women were 30.3% (95% CI = 28.5-32.1) and 13.8% (95% CI = 12.5-15.2), respectively. The prevalence of abdominal obesity was 21.4% (95%CI = 20.2-22.6), with 7.7% (95% CI = 6.7-9.0) in men and 33.4% (95% CI = 31.4-35.3) in women. Predictors of adiposity include the following: Malay and Indian ethnicity, higher education level, higher household income, from urban area, and being married. In conclusion, adiposity affects about one third of the Malaysian elderly population, especially those of the younger age group, women, and those with higher socioeconomic status